Now contemplating VBAC after agreeing to a 2nd c-section. Confused.

posted 3 years ago in Pregnancy
Post # 3
Member
42469 posts
Honey Beekeeper
  • Wedding: November 1999

Talk to your doctor again about your options. Even if you choose to give VBAC a try, the doctor and nurses will intervene if your baby needs help. They are not going to allow things to progress to the point were there is risk of harm to the baby without talking to you  about what’s going on and what they recommend.

You need to have confidence in your doctor to help you make the best possible decision for you. Every labor and delivery is different. There are many things that can cause a baby to be in distress. The same thing may or may not happen again.

Post # 4
Member
1996 posts
Buzzing bee
  • Wedding: September 2013

The doctors will definitely intervene just like they did with your 1st pregnancy when your baby was in distress (I assume heart rate dropped). I had a csection with my daughter. I’m pregnant again & at my 1st appointment my doc just said we’d discuss options. Following appointment we talked a little about it, he isn’t against a VBAC but does suggest the csection.  He gave me some info & told me there’s a few risks but we’d thoroughly discuss at my next appointment I’ll be almost at the halfway point there. Ultimately the decision is mine I’m going to way the risks & do some research then make a decision.  

Post # 5
Member
1613 posts
Bumble bee
  • Wedding: September 2012

@mysticgrace:  First off, it’s great that you love your doctor!  It sounds like she has her reasons to suggest that a planned c-section is her recommendation for you, but it does no harm to ask her to discuss it further with you and explain her rationale.  You have every right to gather as much information as you need to make the right decision for YOU.  No health care provider should be making that decision for you and to be honest your doctor isn’t doing her job if she doesn’t take the time to discuss your options fully before recommending a course of action.  If the whole discussion consists of, “I’ll book your section for 39 weeks, OK?” that’s not at all sufficient or appropriate.

 

The decision to try for a VBAC or plan a repeat section is a big one, and one that lots of women need to wade through.  The best thing you can do is gather lots of information, good solid information about the pros (lots) and cons (lots) of each (VBAC vs. elective section).  You “own” your medical record and can ask for copies of the information about your last birth from the hospital if your doctor doesn’t already have it.  Tell your doctor you’d like to review it with her and have her go over the specifics.  Your doctor will/should help you sort through that information based on your personal situation.  Certainly, the amount that you were dilated last time plays a role, as does the type of incision that was made and the closure technique (double vs. single layer; although double layer is the usually the standard and it is safer for future attempts at VBAC)…..but another bigindicator for successful VBAC is that the initial reason for the first section *isn’t* a recurring issue.  In your case, the baby’s heart rate was dropping (without seeing the specifics I can’t comment in depth about that as a reason for the section) and this ISN’T usually a recurring issue that will put you at lower chance to have a successful vaginal birth.  Just as a different example, a baby that was too big to fit through during pushing would be something that could occur in the second pregnancy.

 

This is a brocheure that we give out to clients to help give them information:

 

http://www.powertopush.ca/wp-content/uploads/2010/05/Best-Birth-Clinic-VBAC-Patient-Info-Booklet-with-BC-Data_web.pdf

 

This is an article about ACOG updates about VBAC:

 

http://www.aafp.org/afp/2011/0115/p214.html

 

Lastly, this is a website that provides evidence to help evaluate your options:

 

http://www.vbac.com/making-informed-decisions-about-vbac-or-repeat-cesareans/

 

Hope this helps! Best wishes for a healthy pregnancy and birth!

 

 

 

Post # 6
Member
5745 posts
Bee Keeper
  • Wedding: April 2011

I would do your research. vbacfacts.com, vbac.com, and childbirthconnection.org are all great places to get accurate up to date information & legal rights regarding vbac. the NIH 2010 consensus & acog are also good places.

The recommended requirements for vbac candidacy are:

  • atleast 18 months between deliveries (not bewteen delivery & pregnancy)
  • a low transverse incision (although there are women with “special scars” that vbac all the time.

I find it incredibly concerning that your doctor would recommend an erc b/c it’s “safer” when, if you meet cadidacy, vbac comes with significantly less risks. 🙁 acog’s recommendation is even to counsel moms for vbac over suggestioning erc b/c of this & because each cesarean poses more immediate & long term risks than the last… they’ve even gone so far & to ammend their prior recommendation of requiring a 24hr on-site obgyn & anesthesiologist & OR team ready in 30 minutes or less to informing moms of all the risks involved (for both) and letting a mother decide what she would like to do regardless of them being able to fulfill the on-site staff recommendations.

I would discuss your concerns with your doctor asap AND be sure that what she is suggesting lines up with the recommendations & the evidence.

I myself had a vbac 15 months ago & acutally planned a homebirth b/c the hospitals where I live have defacto vbac bans. After looking at all the risks & benefits associated with all birthing options having an hbac still showed less risks than an erc so that’s what we chose. Whatever route you go, you should be completely informed, not pressured, and be empowered by your experience! I’d be happy to answer any other questions you have, just pm me! GL

Post # 7
Member
1613 posts
Bumble bee
  • Wedding: September 2012

Also, please note that an elective section is not necessarily safer than attempting a VBAC; it depends on the specific circumstances.  It’s really inappropriate for a physician to give that mis-information to women…not saying any physician’s pertaining to this thread did, just saying to clarify.

As the above poster says, ACOG actually *encourages* trial of labour over elective section in most women, saying that VBAC is safe and appropriate for most women.  Now THAT is a strong arguement for VBAC since ACOG tends to be very (very) conservative!

http://www.acog.org/~/media/ACOG%20Today/acogToday0810.pdf?dmc=1&ts=20130630T1540025907

 

Post # 9
Member
5745 posts
Bee Keeper
  • Wedding: April 2011

@mysticgrace:  A de facto ban is where there is no actual policy in place but no physician will do one. We have 1 doctor in our entire medical community that is open to vbacs (she’s done them in her past before moving her) but is bound by the policy of her practice (which is a multi physician practice). Even if you come in pushing they will prep you for a cesarean…. which is exactly what happened with me, I just pushed my DD out before they could quite get me there.

Definitely definitely do your research & know your rights. Even if your current provider won’t do one (maybe they’re bound by the same things our one vbac friendly doctor is) you can get connected with your local ICAN chapter and find a provider that would be supportive. My MW has had mommas transfer to her care AFTER their edd b/c their obgyns were trying to push unneccesary induction, don’t feel stuck if you don’t have to be… it’s only too late to switch providers if you’ve already had the baby. 😉

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