VBAC vs elective CS - were you as confused as I am?

[Miss E]

Ok, I'm not too sure of what the point of this post is... guess I just need to get it off my chest. It would also be nice to know that I'm not alone in these thoughts or hear others experiences with this dilemma...

With DS I was induced because my waters broke and labor had failed to progress after 4 days. I ended up having an emergency CS after what was a pretty hideous labour, with DS being posterior and then getting stuck with an anterior lip.

At the time I was a bit disappointed because I had hoped to have a natural birth. But didn't focus on it too much and instead enjoyed my precious little boy. As time went on I pretty much came to the conclusion that next time round I would try for a VBAC...

But now that I'm UTD I'm not so sure that I want to...

In some ways it's like the first time around where labour is this 'big unknown' but then I have this hideous induction experience too (and I 'know' that an induced labour is typically a lot more painful etc than one that progresses naturally). Part of me is afraid of a natural birth... There's always the chance that I could end up with another emergency CS (which would be a huge disappointment) and on the other side of it there's the fear of a forceps and a severe episitotimy (a friend just had a really nasty one which is probably a big factor in this fear).

Then on the other hand there is the option of an elective CS. I'd know exactly what I'm in for and I know what to expect in terms of recovery. On the logistical side of things (which really shouldn't come into it) it would be easier to manage with DS in terms of the delivery, but then the recovery would be difficult, but DH will be home for 4 weeks too.

So here I am weighing up the pro's on con's over and over. Yes I've got plenty of time to make up my mind... And I'm very lucky that my OB is pro-VBAC, but will support whatever choice I make....

Argg.. not sure what to do????

Thanks for reading/listening x

[Beach Mama]

You sound exactly like me and your reasons for C/S were the same as mine! I think the whole thing is, is that we were induced and forced into medical labour before our bodies were ready. I ummed and ahhhed for a while wondering what to do and if it would just be easier than trying for a VBAC - then when I decided to go for a VBAC if I found myself panicking and wondering if I was doing the right thing, I would refocus on the fact that nothing is set in stone. Just because you plan for a VBAC doesn't mean you have to have one ITMS. Also doesn't mean you will go into labour even after 14 days as I found out

I think the best thing you can do is start reading VBAC birth stories, get some books like Silent Knife, and VBAC Companion and although it isn't a VBAC book per se I loved Labour of Love. read read and read some more and then make a decision keeping in mind our bodies are made to birth. Yes your first birth didn't go to plan but it doenst mean your second one will be the same. You also know that you carried posterior, like I did so I did everything I could to get the baby into a more favourable posse by not leaning back etc.

As for recovering, every person I know who has had a vaginal birth, even with tears and forceps etc has had a better recovery than me with 2 c/s. It is major surgery at the end of the day and I was very hesitant to put myself through potentially life threatening surgery for no good reason. Yes an epi/tearing is a risk but so is surgery. ( Hope I don't sound preachy - am just passionate!)

Good luck hun and keep asking questions and at the end of the day you need to do what is right for you and your baby xoxox

[wysiwyg]

Hi,

I recently had my second, went for a VBAC but was unsuccessful here is link DS Birth Story - but although was not an elective c-section - it was far more "planned" than the first and was a good experience. If I was making decision again I would try for a VBAC again, because it was worth a shot and I don't see that an elective c-section could really have been any better experience than I ended up with. Also although recovery this time is going fine, I hate not being able to lift my toddler, and it makes life very awkward (I have been told no lifting her for 6 weeks - she is about 15kg) - my mum is here so is ok, but is just awkward so I think a VBAC would have been far better from that point of view.

At the beginning I had similar thoughts to you, but in the end decided VBAC worth a shot and would just make sure I had thought about at what point I would go for the section this time so that I wasn't too exhausted - I am really happy with my decision - I got to have another go but also had a positive c-section.

[*Belle*]

Hugs, its a real hard decision. Firstly every birth is different, you can approach this a few ways.

1) you can try for VBAC and get prepared but if you need to be induced at the end of the pregnancy and decide you dont want to, ask for the c/s (Elective) at the last minute (ie 40 weeks) when they are talking to you about induction.

2) Elective c/s - my first birth experience is the same as yours in the fact I had induction and emergency c/s after 36hrs, I had elective c/s for my 2nd birth and the recovery was soo soo much faster and better than the first, the reasoning was I wasnt in labour or as tired. Also it is more calming in the fact you know whats happening, ie, you have the spinal block, it takes affect, you go into theatre they operate, the birth the baby via the c/section and then you hold the baby. Ask if you can have baby in recovery with you, I did this for my 3rd c/section and it was awesome and really helped breastfeeding.

I recovered faster again from my 3rd elective c/section than the first, walking normally after 3 days no more painkillers, driving after 3 weeks etc no pain.

PM me if you want to chat about anything.

Try not to worry about the decision making, do you need to make a decision is your Dr asking you to or will they wait until 38 weeks or so?

[LMS]

Just popping in here to say that I have been in the same position. My first was natural, no drugs just lots of hard work plus a problem with the anterior lip, but they pushed it back several times and she came out fine. 2nd labor was just as long, got to 10cm and the anterior lip stopped her from coming but was told to keep pushing, she flipped into brow presentation and I needed an emerg c-sec.
I am so torn as to what I should do. This week I am all for a vbac but last week I just thought I wanted it to be all smooth sailing and not be hypa and stressing about what may happen, especially in the full throngs of labor, so a C-sec was on the cards. I just want to keep control, all this said I would love to have a natural birth again if I could be promised that it would go smoothly.

Good Luck with your choice. Go with your heart.

[LMS]

can i do this?

[Miss E]

Kanda

I'm still umming and arring about what to do. I've just been doing some reading on anterior lips. From what I can tell they are very common, but usually only problematic in first labours. In my case they tried everything to rectify it and got nowhere, so after 2 hours I had to have a CS.

From some of what I've read, they suggest that if you had an anterior lip with your first and birthed your baby you are unlikely to have it with your second But that contradicts your experience....

For the last week or so I've been thinking I will try for a VBAC, but then after doing all this reading on anterior lips I can't help but think I'm likely to have one again and the odds of if not being resolved are much the same as last time.

It's such a hard choice to make isn't it. I hope you're able to make a decision you're comfortably with

[Arimeh]

I don't know anything about anterior lips, but just wanted to show my support to both of you whichever way you decide to go.

You could always pick the path of not making any decision and just going with the flow, and see what the baby decides to do I planned so much for my VBAC, and after 14 days of waiting, had to have another c-section, and I was horribly disappointed. Crushed beyond belief, 3 years later I have finally got to a place where I don't cry when i think of her birth.

However with #3 and #4 - I had the opinion that I was going to strive for a vbac (strive, NOT plan) and if it happened that way good - but if it ended in another c-section, so be it, at least I had tried and couldn't beat myself up down the track for NOT trying - ya know?

As it turned out I got my VBA2C and my VBA2C2. But I had made peace with both delivery options in my head, so whatever way it panned out, I was happy to let the baby decide which way they wanted to be born.

[Miss E]

Great advice MNB! Also very inspirational.

That's pretty much where my head is at right now. I don't have to make a decision now, in my mind it's waaaaayyy too early to commit to a CS. At this point I think my plan is to work towards a VBAC, but be prepared for events that may mean it's not possible (even if that means me chickening out at 39 weeks).

At this stage I'm trying to do as much research into the things that went wrong with my labour, so that I can try to avoid them this time round. Induction is clearly the biggest thing, and there is no way I will be induced this time around. It is possible that that played a part in my anterior lip, perhaps with more time DS wouldn't have been posterior either? Who knows...

[Arimeh]

Nobody knows what is going to happen, which is the hardest thing I reckon. Could be baby's positioning, could be labouring position, could be induction, could be that you needed to stand on your head and sing a funny song or something ... lol

Every pregnancy is different, every labour is different - every baby is different. Mine weren't posterior, but DD3 went into the birth canal posterior and made it very hard to push her out. Totally different than DD2, she went in perfectly. If DD3 had been the one I birthed first, I probably wouldn't have gotten my VBA2C - because of the position. perhaps I only got her out because the path had already been paved by DD2? Who knows. Its pretty much all speculation and assumptions in the end.

I figure - what do you have to lose by trying a VBAC? Is the disappointment of not getting a vbac going to be harder to deal with than the feeling of disappointment within yourself for not trying in the first place?

[Heaven]

I had all the same thoughts Miss E!

I felt like having a VBAC was going to be so difficult and I had to do a lot to prepare and sometimes wondered whether it would be easier to just have a c/s. I was also scared I'd end up having a long labour and then a c/s anyway like last time which was awful.

In the end I thought about it like this- which would I regret more: going through a long labour and ending up with a c/s, or not trying for a VBAC at all and pretty much guaranteeing for myself I'd never have a vaginal birth. I decided that although it was tough the first time, if worst case scenario it happened the same, I could survive it. But I would really regret it if I never tried for a VBAC. So that made my mind up for me. And then I had to do a lot to prepare and try to overcome the fear of labour after last time!

I can tell you now I am SO glad I did try.

[Miss E]

I had to do a lot to prepare and try to overcome the fear of labour after last time!

Thanks for sharing your story Heaven. You are so right. But I think your point about your fear of labour is probably what makes approaching a VBAC so hard. First time round we're all frightened of the unknown, but it is purely the unknown, we've heard both good and bad stories but have no experience. With a VBAC you still have that fear of the unknown, but worse, you have experience which in my case isn't pleasant. What did you do to overcome your fear of labour?

MNB, you're so right, we have no idea how it will go. I can do all the reading I like about anterior lips, but it may not be an issue this time around

[Heaven]

I read lots!!

I loved 'Ina May's Guide to Childbirth'!!!! I decided to trust my body. I figured people have been doing this for thousands of years so there's no reason I can't too! I realised that last time wasn't because there was something wrong with me, it was because of the interference of the hospital. I decided this time no one was going to interfere with my labour!! I was going to let my body do it's thing!!

I read lots about VBAC (like 'Silent Knife') so that I was confident and not scared about a VBAC and I stayed home as long as I could. I also got into a midwifery program and got a good midwife. I wrote a birth plan saying that I would not be consenting to any of the usual VBAC procedures (i.e. constant monitoring, cannula, time limits, etc) and got an OB to sign it.

I also felt that last time I didn't deal with the pain very well and needed more ideas so I read Juju Sundin's 'Birth Skills' and it made me feel more in control and like I had options. So in control in fact that I never even got to using many of my ideas because I was doing fine with breathing and pacing and didn't feel I needed to!! The pain never got unbearable. With DD1 it was unbearable!! I thought it would be the same. Maybe it was, but I was more in control. There is no guarantee it will be the same as last time, you can have a labour that is less painful and that you actually enjoy!! I never thought I'd say that.

You can do it! Believe in yourself.

[Miss E]

Thanks hun... about to go book shopping!

[Heaven]

I got Silent knife from the book depository

[Arimeh]

I read all the same books as heaven, and Birthing from Within and Childbirth without fear were my favourites.

I was too scared of childbirth the first time round, hence my elective c-section - so I had a lot of fear based barriers to break down before labouring. I think fear of childbirth is totally normal but we need to embrace it, not run from it. Childbirth without Fear definitely helped me trigger some things and sort them out - I was still scared, but not scared enough to let it stop me like it did in my first pregnancy.