To VBAC or Not to VBAC, That is the Question

I had a c-section with Mia.  She was breech, turning her was not possible, and a c-section was the only safe way to proceed.  I would like to state from the get-go here that I was very happy with Mia's delivery.  Sure, I was a little upset when I learned that she was breech and it took me a few days to readjust my expectations, but I have no regrets whatsoever and I would do it again in a heartbeat.

Now, however, I'm facing the decision of how to deliver Mia's sibling.  My OBs are not pushing me one way or the other, thank goodness, but they are pushing me to decide since the voluntary c-section schedule at our hospital of choice fills up 4-5 months in advance.  No kidding.  I'm having an almost impossibly hard time making this decision.  I can see pros and cons to both a repeat c-section and to a vaginal delivery.  I'm concerned about the added risks involved in a vaginal birth after cesarean, but I'm also concerned about the added recovery time of a second c-section, as well as some of the less mama-friendly policies the hospital has after cesarean deliveries.

A lot of people have very strong opinions on this topic, and a lot of people have agendas they want to push.  So while I really want to talk to you guys about this, I would like to avoid those agendas as much as possible.  I'm hoping you'll help me out by telling me your stories.  If you had a c-section and had or are expecting or considering another child, how did you deliver?  Or how do you intend to deliver?  Why did you make that choice, and in retrospect, do you feel it was the right one?

Comments

[farfromca]

I had a c-section with Little Man, he was stuck and wouldn't descend. So, really, we had no choice. Then we were faced with the same decision and had the same concerns and hopes. I did want to try for a VBAC, but knowing that there were risks that I wasn't sure I really wanted to face. So, decided to try for a VBAC until we got to the point that my OB would decide that he was too big and/or too late in the pregnancy to go ahead with it. We scheduled our c-section for a few days after his due date (since the schedule fills up quickly, we too did this 4 months out). Then, we crossed our fingers. As it turns out, Squeaker had an agenda of his own, so being a month early made the VBAC an even stronger possibility. When I went into labor (just before my 36 week checkup), they told me they couldn't induce me or stop the contractions, so I had to wait it out. Since we were opting for the VBAC, the doc was monitoring us pretty frequently and was ready to tell us that it wasn't going to be a good idea at any time. We didn't want to take any unnecessary risks -- He popped out pretty easy (you know, as far as I can tell and still with the pain and all that stuff). So, it was a success. The recovery was much harder initially (like the first few days) but in the end, I would soooo prefer it to a C-section, if given the choice again.

[ballerinamommy]

BOTH of my kiddos were breech, so I had no choice. Before I knew #2 was breech, I planned on having a c-section. They are only 16 mos. apart in age, and I felt that my uterus couldn't handle the added stress of a VBAC. My recovery the 2nd time around wasn't so bad, since I knew what to expect. My ob/gyn told me that he would not do more than three c-sections on a woman, because of the scar tissue, so that's something to think about or ask your dr. if he/she has the same policy.

[RossRuns]

My mother-in-law is a mother/baby nurse at the better hospital in town. She sees a lot of women who come in hoping to do a VBAC and end up having to do a second c-section. Many of them are upset at this, I guess because they were hoping to avoid a second surgery. I think if you do decide to go for a VBAC, be aware that there is a reasonably good chance you'll end up in an emergency c-section, with all the stress and excitement that comes with it, possibly after you're exhausted from 12+ hours of labor before the Dr. decides it's time to give up on the vaginal birth.

On the other hand, if you're okay with this chance, you'll get a much faster recovery (and not have to worry about a major surgery) if you go for the VBAC and make it.

FYI, my wife too is on the fence - I think she's leaning more towards a 2nd, planned c-section, as she really didn't like being in labor for 26 hours before finding out that she was going to get carted off to the operating room for an emergency c-section. Then again, it's looking like I'd be home for a couple weeks after a c-section to be able to let her recover somewhat, whereas the timing means that with a VBAC that might not occur until after the Christmas holidays, I'd be forced back to work much sooner.

[Sharlene]

My first was an emergency c-section. When pregnant with my second I was given the option, I jumped at the VBAC. I was able to have number two with the VBAC and said to my husband, now I see why people have many children. The initial c-section was emergency after 20 hours of labor and many hours of pushing. The recovery was nightmarish. After number two I felt great! Of course I didn't see or hear any vbac horror stories until after! My ob was upfront that we would attempt a vbac but there were no promises. Good luck with your decision!

[Lisa M]

Funny, I was going to email you as an Ask Beth about this topic.

My first was a c-section because I was 8 days late and had a big baby...too big. So I'm middle of the road as far as successful VBAC's go (according to my doctor).

I'm still sitting on the fence undecided about this. Because of my situation, I've decided a course of action, but I'm 90% sure it will lead to another c-section; and I'm OK with that. We (husband, self and doctors) have decided that if birth process starts on it's own before 39 weeks, then we'll let things happen and see where it leads. If birth hasn't happened before 39 weeks, I say take him out. That's mostly because I found out it's another boy, and likely to be as big as my first. But since I never went into labor on my own last time, and second babiies are usually bigger than first, I'm reasonably certain I'll end up with another cesaerean.

Honestly, before I found out that this baby is a boy, I was holding out hope of a little girl (emphasis on little) and the natural childbirth I didn't get last time. Now, I think I've relaxed and just want a healthy boy, and to be healthy myself. I'm not willing to risk uterine rupture by going past 39 weeks (because of big baby, not any inherent danger of going 40+ weeks, that I know of).

But even so, a part of me is thinking about how easy scheduling a c-section sounds. Drop my toddler off at daycare for the day, head to the hospital and have grandparents get to meet the new little guy, before my mom heads out to pick up the first son from daycare and keep him for the night. Doesn't that sound easy? It takes out so many of the issues I didn't have to worry about with the first. And my mom still gets to meet the new baby, everyones happy. Plus my recovery was so easy the first time, and I like that idea too (especially with a toddler to chase after). So many things to think about and consider.

[LyndaL]

Yuck. Horrible decision to have to think about and since I live in Scotland and therefore our medical system is completely different here (you get to CHOOSE a c-section? In ADVANCE???) I will be of limited use. However, for what it is worth I had a planned c-section with FirstBorn because I had pre-eclampsia and he was breech. We held on until my test results got sufficiently icky that they delivered him. But I only got 1 day's warning! When pregnant with SecondBorn, my consultant (for whom I had a huge amount of respect - he delivered my sister-in-law!) told me that I would aim to have a normal delivery if the baby presented ok, but if it was breech then I was having another section because the stress of a potentially difficult labour on top of previous scarring etc was inadvisable. I was ok with that but I was able to leave the decision until much nearer the time. As it happened, my own doctor messed up and thought the baby was head down when it turned out, after 36 hours of labour, to be breech so I had an emergency section. Meh. Good luck with your decision (personally I never found recovering from c-sections to be too problematic but maybe I have been lucky.)

[Sharri]

Because I hate to be rushed into decisions...can you schedule your c-section to get in before the 4-5 month thingy and then cancel if you change your mind?? I'd think so. They can't MAKE you have a c-section, right?

[Maggie]

As someone who worked for several years as an OB RN, I would never personally opt for a VBAC. The (very small) risk of uterine rupture is still to large for me.

Best of luck with your decision making!

[Swistle]

Oooh, tough decision! I was glad not to have to make it. I can tell about my cousin, though, who had a c-section with her first baby (failure to progress, I think), and then had a VBAC. She said she really liked having done it both ways, because she likes having the experience. Also, she said the recovery was a little easier--but she said, "There were stitches both times, but in the second case they were in a more painful location."

You've had a c-section, so you already know what they're like. I suppose the question, then, is would you LIKE to try for a VBAC? Does it appeal to you? Do you want the experience? One thing my cousin did is she went into it with a "Hey, doesn't hurt to try!" attitude, and I think that helped: if it HAD gone to c-section, she wouldn't have been disappointed, it was just that she thought she might as well give the VBAC a whirl.

[averil]

despite the higher cost and longer recovery period, i'd so go with the c-sec cuz the long labour and stretched.. umm.... woohoo, is so much less appealing.

good luck making your decision! =)

[Christina]

I have no experience with this - I gave birth vaginally BUT it was a tough delivery and they were prepping me for an emergency c-section. The OB and midwife gave me one last chance to deliver vaginally and I did because I SO was not going to have that C-section!

In our small town, we have a great non profit org that does a whole class(es) on VBAC - perhaps you can look into attending something like that to learn even more. It is a pretty hippy dippy organization but it seems like a lot of helpful information is provided and some times it is good to find a support system if you do opt for the VBAC.

My 2 cents. GL!

[B]

You really put this out there for others to comment on? Girl, you are BRAVE!

I have no opinion one way or the other, but my sister who is a labor and delivery nurse would NEVER have a VBAC. Her second pregnancy had placenta previa, so she had to have a c-section, then had two more for #3 and #4.

[Kristine]

I had my first by emergency C-section. I was induced, he was quite large (9lbs, 9 ozs), failure to progress, fetal distress, turns out he had a cord wrap, he backed up and turned sideways. I was devastated, it took me 9 months to get past it. I had a rough recovery coupled with PPD.

I'm not planning to have another baby any time soon, but I will opt for a VBAC. If I need another emergency C-section, so be it - hopefully I'll be able to accept it better than I did the first time around, but the recovery from a vaginal delivery is supposed to be so much easier than a c-section.

I see the risks as being about equal from what I read, so the decision is basically whether you feel like you want the experience of a vaginal birth if possible.

[chatty cricket]

Well, both my kids were born vaginally, so personally I can't speak to this. But my SIL had an emergency c-section with her first, and also had to decide well in advance what the plan of action for #2 would be. She weighed all the pros and cons, and in the end decided to just do a repeat c-section. She felt as though the risks involved in a VBAC just did not outweigh the positives, and frankly speaking, she didn't want to end up going through hours of labor, to need a c-section in the end. I should add that the reason she needed a c-section with the first is that he was unable to descend through th birth canal, and her doctors thought there was a possibility (but not a guarantee) that she would end up needing a c-section anyway. So, long story short, she decided to schedule a c-section. And I'll also add that she felt it was easier to recover from the second c-section than it was to recover from the first. I wonder if that's a general trend, because I felt the same way about recovery after Mister.

It's a tough call. I kind of prefer when then nice people with the epidurals tell me how this is going. I certainly can't imagine having to work up a birth plan 5 months early!

[Tina]

I had a c-section with #1 due to failure to progress, then 14 yrs later when given the option of VBAC or sceduled repeat c-section, I chose the c-section. Like one of the other posters, I, too thought the 1% risk of rupture was still too high.....because it usually means a very bad outcome. Whereas the risk to the mom for a c-section was one I was willing to take. I wasn't looking at it as a convenient thing (because who in the world thinks major surgery and not being able to walk, lift,get out of bed or poop is convenient?)But #2 decided to be breech and not descend ANYWAY. So her plans just happened to gel with mine anyway. Then my water broke on the scheduled day. I was relaxed and calm, ready for the surgery, much more aware of what was in store for me, and wouldn't have changed my decision at all. Both scars are in the SAME place. And I recovered very quickly, even at 37. Too bad they are "rushing" you on this decision. Good luck weighing your options!

[Missie]

Had c-sec with son because he was breech (and was 8lb 7oz). Opted for c-sec with daughter because she was supposed to be waaay bigger (ended up 8lb 13oz) and I was waay older (9.5yrs). I didn't find recovering from either section bad. In fact, my recovery was so great that I wouldn't hesitate to do it again (but thank the Lord, the baby factory is shut down permanently).

I am not trying to influence you one way or the other, but if you do end up having a second section, it's not this terrible horrible end of the world scenario, either. You still end up with a healthy baby who never lets you sleep, so there ya go.

[ckirby50]

Raegan was stuck and couldn't move, so she was an emergency c-section after 20 hours of labor. My second pregnancy, I debated the VBAC until I found out I was having twins. As he was still showing us the twins for the first time on the ultrasound machine, I told him, "You are tying my tubes when you take these babies." I had real easy recoveries with both of my c-sections, but I know women who have had long recoveries with both. I hope our stories help you, but ultimately, it is your own personal preference and what works for you and your family. This is not an easy decision, but either way, you will have a baby in the end.

[JuJuBee]

It's so weird, Beth, but just this morning you popped into my head and I was wondering if you had a plan considering this, but I couldn't think of what it was called, I was calling it VGAB or DVAC or some such nonsense. No advice for you as my three were all born vaginally but wanted to share the crazy timing of your post. Well, crazy to ME anyway.

[the speckledpup]

schedule the c-section. you can always change your mind, but you cannot always go back and reserve the space.

[SK]

I had an emergency c-section under general anesthesia with my son. After 16 hours of labor with pitocin (and an epidural).

We're not planning on a second child, but I've thought about it and if I were to have another, I'd go for a planned c-section.

While natural childbirth sounded good to me, I was always open to pain meds and was glad to have them when the time came (impatient to get them, actually).

I think this is a personal decision. I know a lot of women are very concerned with how their childbirth goes. I wasn't disappointed with the c-section, but I would have preferred to avoid getting knocked out.

I had 26 hours of labor, pushed for 3 hours, and then had a c-section with my first. My son was not a large baby and because of the way my body tried to deliver in the past (progressing very slowly), my Dr. felt like my risks were higher than most for very serious complications if I tried a VBAC with my second. Therefor I had a scheduled c-section scheduled for two weeks before my daughter's due date.

However, she decided to come even earlier so I did have to experience a couple of hours of labor with her. But the hospital, knowing I had a scheduled c-section, got me in very quickly and she was delivered 2 hours after I went into delivery.

Recovery from a c-section after 2 hours of labor compared to 26 hours of labor was miraculously different. I was up walking around the same day, took no pain relievers other than motrin, and unlike the first time I went home and had no trouble sleeping and getting in and out of a bed. Oh... & my scar was smaller and nicer after the second one than it was after the first. (Generally the Dr. cuts in the same place, gets rid of the old scar tissue, an creates a new one. If you had an ugly scar like I did after my first...bonus!)

I don't know if that helps you are not, but there's my story. Good luck with your decision.

[Kellyology]

I don't know how the above posted with out my info...but it did!lol Anyway, the one with 26 hours of labor was me.

[Colleen]

With Zoe we went into the hospital with full blown labor... and when we were at 7cm they felt a tushy. So... off we went for a c-section. I have a few friends who had c-sections and were miserable with recover and would never do it again if they had the choice. But me... I had no problem with the recover. Right now, I completely plan on having a c-section the next time. The thought of that (the known) is far less scary to me than a VBAC.

[nicole]

I have had one c-section, a VBAC, and then two more c-sections and will likely have another c-section with this baby. The VBAC was a scheduled c-section, but the baby came early and quickly. She was actually foot-first breach and there were other complications, so I don't consider it a very normal VBAC experience. However, my recovery was okay. Our baby did spend some time in the NICU and dealing with all of the "accessories" needed to clean up after going to the bathroom was less than pleasant in a public restroom. But, I know that is not normal.
I have had easy recoveries with my c-sections, but I'm fortunate. Not all women are able to say that. I have fears about the risks of VBACs and repeat c-sections. In the end, I trusted my doctor to tell me what he thought was the safest option. You should consider how many children you may want to have, as risks increase with each delivery with repeat c-sections. I like the option one woman shared, that they scheduled a c-section as a backup a few days after her due date, but let things go at the baby's pace until then. If that is an option for you that sounds ideal to me.

[NotAMeanGirl]

I had an emergancy C-section with Shecky... AFTER having my labor induced. I was in HARD labor for HOURS and never got past 3 cm. My blood pressure went bonkers and I hit stroke level numbers after 10 hours of maxing out the thingie that measures the strength of contractions, taking pain meds (Which I vowed not to do at first) and my blood pressure going sky high they decided to do the C. Had I to do it over again I've have opted for the C from the start. They could have given me an epidural rather than knocking me completely out and I'd have been the first to see my lil man... instead of last. (People I WORKED with were there when he was born and saw him before me! I was PISSED lol)

I guess I've said all THAT to say I'd go with the C-section if they're giving you the option. Going through all that labor just to have it anyway was just... well... annoying and disappointing.