Vaginal Birth after a Cesarean (VBAC)
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Vaginal Birth after a Cesarean (VBAC)
Dec 2007
I'm going to try to stick to the basics & hope to get some
feedback that fits our situation. 1st birth - emergency c-
section due to OP presentation (face up), stuck in birth canal,
fetal & maternal distress (general not an epidural). Labor
progressed fine, dialated quickly, considering presentation
realtively short. No medication until general administered. Now
on pregnancy #2. Child #1 will be a few months past 3yrs at due
date. He is needy, has some sensory issues (mild), sleeps great
*only* at home, has never spent a night without Mom putting him
to bed -- he is all about his routine. I can't stress this
enough.
So if I do a planned c-section, husband can be with child
mostly, we can have help scheduled, BUT I have to deal with c-
section recovery + toddler. (recovery last time was ok, not
horrible.)
Or, we try for a VBAC (my OB thinks my chances are good to have
a vaginal delivery) but my concern is I'll end up with another c-
section and *not* have all the help in place and my son will be
a wreck etc etc. But the quick overnight at the hosptial and
easier recovery are very appealing.
I have lots of good friends who have offered to help, but unless
you have a kid who really really needs his routine/consistency,
its a little hard to imagine - ie, they've offered but I am not
sure they realize what they are getting into.
Also, there are no grandparents/relatives that our son is
connected to who can come stay for a while.
Anyone gone one way and wished they did the other? Any other
thoughts on how to make this decision the best one for all
parties? Because of all the drama last time, my husband is in
favor of the c-section.
Thank you for sharing your experiences.
tough choice
Hi -- I had an emergency C section with baby #1 and VBAC for 2
and 3. While a C section was not nearly as bad as I anticipated,
it was a much longer recovery than the VBAC. I actually wanted to
have another C with #2 because that is what I knew, and I did not
want to end up going through 20+ hours of looong labor with #2 as
I did for #1. Can I tell you, if your doctor thinks it is
possible, GO FOR THE VBAC!! While there are risks, in my opinion
and that of our OB, the risk of infection with a C section is
much more real and likely than all of the other issues
surrounding VBAC if your C section incision is well healed. My OB
actually pretty much insisted that I should try a VBAC and it was
SO much easier than a C. Could you not have your help in place as
though you were going to have a C section? Then if you have the
VBAC, you can use less help *or* actually have that extra help to
allow you to get on your feet more gradually. That adjustment to
2 after either delivery is a lot, so why not have the extra help
either way? That is what we did, and it was a HUGE help. Good luck!
Dear Tough Choice,
I had a C-section due to breech presentation with baby #1, a
wonderful VBAC at a free-standing birth center 12 years later
(three years ago), and #3 is due in a couple of months (planned
home birth.)
My VBAC recovery was at least 50 times faster than my C-section
experience, breastfeeding was a breeze, and #2 has been
incredibly healthy and strong since birth. Moreover,
a VBAC for me was a very empowering experience, more so than
getting a PhD and qualifying for Boston marathon.
Have you read Ina May Gaskin's Guide to Natural Childbirth?
Best wishes for a happy delivery and healthy baby, whichever
path you decide to take.
Happy VBAC mom
I was in almost your exact position last year. My first was an
emergency
c-section
due to fetal distress/cord wrapped around him. He was 3 years 2 months
when
baby brother was born, mildly autistic with communication delay, very
attached to
mom and routine. Fortunately we did have a grandparent that could come
stay with
him during the birth and that helped. I went through all of the back
and
forth in my
head about what would be best for my son (VBAC or C-section), and
ultimately
decided that I had to go with what I felt was best for me and the baby.
As hard as it
is to disrupt your son's routine knowing what it will do to him, it is
just a couple of
days, and he will get over it. And, he is going to have to learn to
deal
with changes
eventually. The baby itself is about to send his world into a tailspin.
It is not good
for any of you to have your life dictated by his need for routine.
If you have time before the baby comes, I would recommend getting him
used to
other people caring for him now. Maybe start with an afternoon out and
work up to
a date night. Or have your husband take over the bed time routine. Let
him see that
his routine can change and it is OK. If you haven't already, you might
want to
consider seeing a developmental pediatrician for an assessment. They
might be able
to offer help and advice about the sensory issues.
By the way, I had a successful VBAC and was able to come home the next
day, but
was disappointed in how hard the recovery was. I am still glad that I
was able to do
it, but I am not sure it was that much easier than the c-section.
Been There
I will try to stick to the question. I had two c-sections, both
after trying for vaginal delivery. People told me that the
second csection would be easier to recover from but I didn't
believe then -- how could that be? However, it really turned
out to be the case. Given what you said, a planned csection
might be a great solution.
been there
My first child (7 1/2 now) was breach -- upside down. I
had ''massages'' by a professional to try to get her turned
around. It hurt a lot to try to this this but it didn't work.
I had a C-Section with her and it went fine more or less. I
stayed at the hospital (CPMC) for three days and went home
after that. I was able to walk around pretty well
afterwards... slowly, however.
I had an option with my second child. C-Section OR vaginal
birth, it was up to me. I got lots of grief from other people
who told me I should do the normal way. So I did. I REGRETTED
IT. First, it was luck I got an epidural. These doctors don't
really pay attention to your needs regarding the pain and most
women I know don't get it -- supposedly because the time is too
close to birthing. You have to tell them at just the right
time you want the pain medicine.
This child was bigger than the first. The doctor did not like
how the baby's heart was sounding so it had to come out right
away. FORCEPTS would used. It was painful, uncomfortable and
recovery time, believe it or not, was much longer for the
regular birth than the C-Section.
Ultimately, you have to make the decision. Just don't let
silly things like -guilt- lead you to make a decision you might
regret.
s
I really wanted to go VBAC for my second, but I ended up being
hospitalized for 2 weeks because of preeclampsia and then because
I had to deliver the baby before term due to the complications,
we couldn't induce because it was too soon and the chances of
rupture greater. My advice is you need to be prepared for any
emergency whether you try and schedule the c-section or not so
you might as well work with your friends jsut in case. I also
didn't have problems recovering from the c-section and don't feel
guilty or disappointed at not having a vaginal birth. HOWEVER, I
do believe you're better off trying for a VBAC over surgery if
you can as long as you don't get too emotionally attached to
having a vaginal birth that could prevent you from not making a
sound decision for the safety of your baby. Sounds like you
won't. Our friends and day care really rallied when I went to the
hospital. We had no time to plan and it was 8 weeks prior to my
due date. We survived. You will too. Let your friends help. Give
them some practice time with your kid. Hell, let them help you
when you come home by taking care of the kid. Good luck.
survived and proud of my scar
Hi,
Your situation was very much like mine. My first pregnancy
resulted in an emergency c-section, though I had a difficult
recovery. My second was a VBAC (had to sign 2 consent forms to
have the VBAC btw) and it worked out well. Our firstborn also
thrives on routine, so we kept him in daycare when I went into
labor and my sister drove in from out of town(she was 3 hrs away)
to pick him up and take care of him while my husband was with me
during the delivery. He got to enjoy a special snack and a movie
with his auntie and didn't even miss us. I was anxious about the
vaginal delivery, because I'd never gone through it. It took me
20 hours to fully dilate with medication and every other measure,
so I thought I was heading toward another emergency c-section but
it worked out, surprisingly, the actual pushing time was only 20
minutes...You are correct that the recovery can be very smooth
for a ''normal'' vaginal delivery, that was my experience.
My advice is to get help in place regardless of whether you have
a VBAC or planned C-section. My quick recovery was directly
related to the fact that I had help and only needed to focus on
one thing at a time. I learned that I'm not a pioneer woman, and
that I didn't need to be a ''martyr'' so for the first week, I let
others help me while I worked on resting and nursing.
Because we made my sister a regular part of our older son's
routine the weeks prior to my due date and kept him in daycare
(it really minimized the change for him) his transition to the
new baby was very smooth. My husband also began reading ''I'm a
Big Brother'' with our older son every night for a few
weeks...that seemed to help with his adjustment to a new baby
too. Since we had help with the cleaning and cooking (thanks to
my mom), my husband was able to spend lots of one-on-one time
with our first son while I tended to the new baby. While our
first son was at daycare my husband and I bonded with our newborn
w/o interruption.
Good luck to you with whatever choice you make.
Been in your shoes and thankful for help!
Nov 2007
I am hoping to have a VBAC with my second child (first babe was
footling breech). My due date is tomorrow, but the baby hasn't
dropped, I'm not dilated, and my cervix isn't effaced. My doctor
told me today that she is reluctant to induce labor with pitocin
(at 42 weeks) but would maybe consider a small amount. She
really would prefer me having a C-section if I don't go into
labor naturally. We're going to try all the natural induction
methods first, but I am feeling worried. . . I really do not want
to have another C-section. Has anyone been induced for their
second birth after having a C-section? How was the experience?
Also, any thoughts on the risks of uterine rupture with pitocin?
Hoping for a VBAC
Let me offer my two cents -- consider taking the section. I
really wanted a VBAC for my third child, was very determined,
would not listen to my dr. re: risks of induction, etc. She
would not induce because malpractice insurance will not allow
it. The percentage of people who rupture may be reasonably
small but the consequences of rupture are enormous -- inc. very
possible death of baby, death of mother (yes, even today) and
emergency hysterectomy. In the end, I went into labor
naturally at 41.5 weeks. The baby was large, I pushed for
hours, ended up with a c section anyway, and the drs. noticed
that my uterine wall was very thin by the end and I might have
been near rupture. More than that, I ended up, once again,
with hours of labor PLUS a section, and now have damage from
the pushing that I would not have if I had just had the
section. If there was a next time, I would definitely just do
the section....
anonymous
From the stats I have read, induction increases the risk of
rupture pretty dramatically. And, I have also read that if you
know the signs of rupture, they can manage it after the fact and
while you probably will lose your uterus, lots of blood, the
baby *should* be ok.
That said, I had c-section (emergency) for baby #1 and trying to
decide what route to go. A c-section + toddler is not an ideal
situation, but I am clear, after both my first birth experience
as well as previous pregnancy losses, that bringing home a
healthy baby is my first priority. I don't think I would do an
induction - again, from what I have read - but I may plan a c-
section. I have a few months to decide. I hope you don't have to
make this decision & your baby comes out on its own!
Good luck
I was in exactly the same situation as you were, except I was
told that they would not induce. The primary reason I was given
was that, in my circumstances anyway, there was over a 90%
chance that I would end up with a C-section anyway. That figure
may depend on the reason for the original C-section (mine was
due to the lack of any progress after many hours of pushing and
absolute exhaustion on my part).
I completely understand your desire for a VBAC. However, in
case that doesn't work out for you, I would like to add that the
recovery from my second C-section (since I didn't go into labor
naturally) was MUCH easier than the first. I wish you all the
best for a healthy delivery.
Anonymous
I had a C-section the first time, and a VBAC the second time.
My doctor did a ''let it happen on its own'' approach with no
Pitocin, as it is safest to simply let the baby descend
naturally. The uterus can burst, so you don't want to take
Pitocin to move things along faster. Go with a natural descent!
Glad I had a VBAC
If you are worried about this and have 2 weeks to go, it might
help to start acupuncture. I had it with both my pregnancies,
and then just a tiny bit of pitocin in the hospital, things
really took off. Good luck!
anon
Well, I hope this finds you on time!
I would not induce, unless you were at 42 weeks or your baby was
showing problematic signs. Any time you are asking your body and
baby to start labor before it happens spontaneously comes with
more risks. I would try to avoid Pitocin and especially Cytotec.
Since you're only 40 weeks (or maybe now 40 weeks and a few days)
why not wait until you're actually overdue, which is 42 weeks,
and that's only if your dates are accurate. OBs are pushy and it
is sad that VBAC is so frowned upon. I hope you get your VBAC!
Your body, your baby, your choice!
I was in your boat two and a half years ago. Try accupuncture
with Marti Lee Kennedy. She's got lots of recommendations on
the BPN site. She worked wonders for me and is just a
beautiful person. I can't recommend her highly enough.
I was two weeks past my due date with my first child 4.5 years
ago. I was REALLY sick of being pregnant and scheduled a
session with Marti. One treatment got my labor going
naturally. Unfortunately, two midwives and an OB had missed
that my son was breech, and after I pushed out a foot I ended
up in the hospital with an emergency C-section (that was a bad
day, but all's well that ends well). When baby #2 came along,
my docs were not thrilled with the VBAC option I wanted to
pursue, but said as long as I didn't go past my due date they'd
play along. Three days before my due date I went back to
Marti, had one session in the late afternoon, and went into
labor the next morning. Forty-five mintues later my second son
was born. I got to the hospital just in time for my doctor to
catch him. That part was unintentional, but I did get the
natural childbirth with #2 that I wanted.
Good luck!
VBAC Mom
While pitocin isn't the end all of methods for inductions, it dripped in my arm for 12
hours before I had ONE contraction, It is often used with varying degrees of success
with few complications. That said, my husband is an anesthesiologist. VBACS have
fallen out of favor BIG TIME because there have been a rash of ''bad outcomes.'' You
don't want the details but suffice it to say its devasting for EVERYONE involved in the
births. John Muir is one of the few places still doing VBACs with any regularity so if
you are not having your child there I would guess your doctor is reluctant to
continue the pregnancy and risk a complication whether its due to labor or
induction etc. I would probably side with your doctor and have your child by the
safest means possible given your docs concerns. The birth experience while touted
as a definative part of the motherhood experience is such a small part of being a
mom that I would forgoe the ideal for you simply to insure the safety of your baby.
This is written after watching my husband peel out of the driveway because there is
a STAT section, never a good thing.
anon
It is my understanding that induction, pitocin & prostaglandins
(used for softening the cervix for induction) all carry
increased risk of uterine rupture. So definitely use any
natural method you can - I would recommend seeing an
acupuncturist and/or homeopath, as well as doing home measures
like evening primrose oil on the cervix, nipple stimulation,
having sex, and castor oil (as a last resort!)
One thing to remember though - you are not overdue yet. ''Term''
is considered 37-42 weeks, though you wouldn't know it from the
way we fixate on due dates. So you've still got two weeks
before you're overdue. A lot can happen in two weeks - perhaps
you can trust that your baby & body know what to do and you
will go in to labor easily and soon. It doesn't hurt to talk
to your baby about that too - let him/her know what you want
and ask baby what s/he needs to be born.
I feel for you - and I wish you a peaceful & powerful VBAC.
Annemarie
I would not even want to induce labor w/ pit after a c-section.
I had pit w/ my daughter and went through all of that before an
emergency c-section. Her head got stuck and we had to sew me up
and head off for surgery. That was in '05.
The only reason I had a VBAC w/ my twins (late '06) was because
I went into labor naturally at 36 weeks. My MD would not induce
w/ pit-
Yes, c- sections are rough -but- what if you rupture ? Yes, the
percent is low - but - still. The thing is - you never know
what is going to happen. I tore so badly w/ my twins that they
had to sew and pack me. That was rough, too. Just please go w/
the recommendation of your MD.
K.
I had a very successful VBAC almost three years ago which
included an induction. I was surprised but happy that my doctor
was willing to do this. I was induced due to high blood
pressure, but I was already starting to dilate before the
induction. It was about 2 weeks before my due date. I had both
pitocin and an epidural. I ended up with a fairly short labor
of 6 hours. So it can be done. My second baby was about 2
pounds lighter and in a much better position but that couldn't
really be told ahead of time. I haven't really heard any other
successful experiences but mine couldn't have gone more
smoothly.
I wanted to suggest that you question your assumptions about
whether a VBAC is better than a c-section. With my first child,
I was adamant about having natural birth, with no drugs or
anything. After 35 hours of labor (and induction), I had an
emergency c-section and cried my eyes out with disappointment.
With my second child, I went for a planned c-section and was SO
happy that I did. Because it was planned, we could arrange
childcare for our toddler, so my husband could be with me during
the surgery. And my recovery was A LOT faster than the first
time around, because my body wasn't exhausted from a long labor.
Plus my milk came in faster and I produced more - also because
my body wasn't so exhausted. The thing that put me off a VBAC
was the risk of uterine rupture. That risk far outweighed the
benefits. And, as it turned out, the c-section ended up having
more benefits than I expected. Oddly enough, my second child is
healthier than the first. I thought those hours of labor would
have some benefit for my first child, but I guess not. So
please, question your assumptions and do what is best for your
body and child, not what you think you ''should'' do.
C.L.
I didn't see the original post, but all these responses sound
very ominous. I delivered my second baby VBAC. My water broke a
few days after my due date, but I did not progress, just very
mild contractions, for 30 hours. I then decided to start
pitocin. It worked like magic and I delivered my baby 12 hours
later. Your question seems to have been about induction, and as
I recall my doctor (Amy Huibonhoa) did not recommend induction,
but she felt that pitocin once labor had started was perfectly
safe. I'm just sharing this because it seemed like many
responders said pitocin was dangerous and for me at least, it was
not.
anon
No one mentioned this but there are herbs that are safe for
''natural'' induction if the need arises. Black and Blue Cohosh
work very well. I used them a few months ago myself. Also, they
don’t cause the painful contractions that pitocin generally
causes. Check the ICAN list for more answers but be forewarned
they are very into homebirth and all natural. I know it can turn
people off how adamant they get, but if you can ignore that I
think you can find great, accurate information. Also, find a
local midwife for other alternatives. Good luck with your VBAC. T
cindy
I wanted to recommend attempting a VBAC since I have just had an
extremely positive experience. I cannot remember all the details
of the original post and I did not have pitocin but all the
response experiences were quite negative and mine was positive. I
had an emergency C-section after a long (but not difficult
labour, with epidural) 2 years ago. My ob said that he was not
keen to induce or use pitocin after that, but was quite happy for
me to do a trial of labor for more than 2 weeks after my due
date. In the event I had a vaginal delivery (with epidural) 1
week late. It all went very smoothly. I have a feeling that they
might even have agreed to give me pitocin, had I needed it. The
difference in my overall experience and particularly recovery
period was immense. I had my baby 1 week ago. I had not thought
my C-section experience was bad at the time but I had to move
very slowly and carefully and everything ached and I took pain
killers for weeks. After the C-section, day 5 was the day we came
home from hospital. After the VBAC, day 2 was the day we came
home from hospital and day 5 was the day we went to a party (with
both kids). I hope things go well with you and am sure that
whatever decision you come to with your medical advisers will be
the right one.
Nicola
I had to second the comment from the poster who asked you
to ''question your assumptions about whether a VBAC is better.'' I
totally agree, and had the same experience. Long labor with the
first, induction, emergency c-section, terrible disappointment.
I hang out with a crowd that does homebirth, and they were
terribly disapproving of my ''interventions,'' not that I had a
choice. The community can be very disempowering of women who
don't have the ''ideal, natural'' birth, but please keep safety
and other family issues primary over ''achieving the perfect
birth.'' I wanted a VBAC, but ended up needing to schedule a c-
section. Like the other poster, it was SOOO much better than the
first birth. Arranged childcare, husband with me, milk came in
faster and more so no nursing issues this time, fast procedure,
fast recovery (which is critical when you already have a child),
much less exhaustion. Despite the concerns that led to the c-
section, it was a very peaceful birth. My 2nd child is also
healthier than my first. It might sound like I'm advocating for
c-sections, but I'm really just advocating for safety and for us
to let go of standards that aren't realistic or safe in some
cases. Best of luck.
glad I did
Just wanted to respond with my POSITIVE VBAC experience. I
couldn't find any when I was doing my own research so this is
for all those mamma's who are considering it.
I had a C with the first due to the fact she was breech. I
never even felt a contraction - it was all scheduled. With my
second,the minute I got pg I knew I was going to deliver vag.
My due date came and went and still no labor. I did 4 sessions
of accupucture, took Blue and black cohash, ate every spicy
food in the East Bay and FINALLY 10 days after my due date I
went into labor for the first time. I labored at home ( WITH A
DOULA) for 20 hours. I headed into the hospital and at 22 hours
of labor and only 4 cm, I got an epidural. My contractions
didn't budge remaining at every 4 minutes ( Great! as this was
my biggest concern that my labor would slow) 2 hours later I
was complete and I needed to push.
I pushed for half an hour and out came my sweet baby boy. He
was 9lbs 12 oz!
It took me at least 6 weeks to come down from my VBAC high. It
was truely amazing.
-Jen
Nov 2006
I read through the archives and have seen some recent postings
on the topic of VBACs. I'm also hoping to have one - I'm 17
weeks pregnant and my current OB in Castro Valley is unable to
offer me one. My first baby was born 2 years ago by C-section
at Eden Hospital and unfortunately they don't do VBACs. My
first was delivered by c-section because he was in fetal
distress, and I never even really started labor. I had to be
induced 10 days after my due date, and after they started the
pytocin, I started having very mild contractions and his
heartrate continued to drop.
I'm hoping that this time I'll have a much different
experience! I'm looking for a new OB who supports VBACs, and
am looking at either Alta Bates or Valley Care in Pleasanton
(which is much closer to me). Friends have recommended Dr.
Helen Matthews (for Alta Bates) and Dr. Bleecker (for Valley
Care) - does anyone out there have experience with either one?
I realize there are some risks involved with having a VBAC, but
I trust that with the right OB and the right hospital, I will
receive the right care that will ensure my baby and I are not
in danger. What have others' experiences been?
One other question - I didn't have a doula with my last birth
and I've never been too fond of the idea, but do you think it's
necessary - or extremely beneficial - to have a doula when
trying for a VBAC? Anyone you'd recommend?
Thanks in advance!
Nancy
I had both my children when we were living on the East Coast, so I can't comment
on specific practitioners or hospitals out here. What I can comment on is my own
VBAC. My first child was an induction that went badly, leading to a crazy long
very difficult labor and finally a C-section. I had wanted natural childbirth to
begin with and the whole thing was quite stressful. With my second child, I was
very assertive about wanting to try for a VBAC while recognizing that anything
might happen. In fact, I decided explicitly I would not be induced again, that if
I didn't go into labor I would opt for a planned C-section.
I delivered with a midwife who practiced with OB's and did hospital deliveries, an
arrangement that I was very comfortable with. She was very supportive of the VBAC
and worked with the OB's to make some space for me to pursue that.
Some consequences, though, of the VBAC under doctor/hospital guidance were that I
had to go in to the hospital earlier than I really wanted to, and had to have more
monitoring. They were simply a lot more conservative. Thus, when I got to the
hospital after about 8 hours of labor at home, it was too soon, my contractions
stopped, and had to be restarted with pitocin. An undersired intervention, but
this time it really worked, and at the lowest dose. It was just enough to restart
labor.
I had been pretty scared about whether my body could even go into labor, and
whether I could push a baby out, not having done it before. Well it did and I
could.
(Frankly, I wasn't scared at all about a negative outcome from trying the VBAC.
I'd
looked at the data and felt very comfortable with it). It was a really amazing
and
empowering experience, to be able to hold my daughter right away, instead of lying
there on the operating table wacthing other people hold my child, and not have all
the pain from the surgery afterwards. I was out of bed in a couple of hours,
unlike the last time when it was a couple of days. I wasn't tethered to IV drips,
catheter and all that other baggage. Very liberating, and very worth the effort.
So I would encourage you to try, but also to have a good backup plan, or two.
Good luck!
Happy VBAC Mom
Hi there,
Just wanted to let you know that as far as I know, Valley Care does not do VBAC's.
Sorry!
Pleasanton res.
The incidence of malpractice suits filed against obstetricians who used VBAC has
become very high. Many hospitals no longer permit them. There are significant
risks to both mother and baby with VBAC, and the legal atmosphere is such that
VBAC has become a procedure to be generally avoided. I would advise checking with
doctors as well as hospitals; since the hospital has to be involved in the event
of a complication of labor in a patient who has had a prior C-section. Robert
Nancy,
I would encourage you to do what you need to do to increase your chances of a
successful VBAC. Those would include getting a supportive doctor, getting a
doula, reading up (I believe I used a book called the VBAC companion), etc. Most
importantly, I would prepare yourself emotionally for the effort as well as the
potential for another C-Section.
I did everything I could to prepare and although I never went into labor, baby
never descended, I realized the likelihood of a successful VBAC were low, and
ended up electing way after my due date to have another C-section (my first baby
was 10 pounds early!), having done everything I could to try for the VBAC
empowered me and helped me come to terms not only with having a repeat C-section,
but actually helped me deal with the first one as well.
Best of luck to you!
2xC mom
I'd suggest Dr. Hank Streightfeld for Alta Bates I was (still am although not
expecting at the moment)his patient when expecting my son in 2004/2005 and am
typically condsidered a ''high-risk''
mom due to my epileptic condition.
I found him to be straight forward, down to earth, tell-it-like- it is type of
doc. Extremely supportive. His office is right accross the street from Alta Bates.
You may also want to see some additional postings regarding him on BPN
wishing you the best
Go for the VBAC! My aunt and a good friend of mine both had very successful VBACs.
Barring any life-threatening complications, there's no reason not to do it.
Both of them received little support from doctors, but persisted and were rewarded
with wonderful births.
As for the doula question--I'm puzzled: the idea has never appealed to you to have
some one there who is supporting you in having the birth experience that you want?
I had a doula at my birth, and I was so glad to have some one who was experienced
with the process, experienced dealing with hospital staff and would support me AND
my husband to have a terrific birth. I can't recommend it highly enough.
Studies have shown that people who have doulas have fewer interventions, and,
therefore, FEWER C-SECTIONS.
Yes, I think you are more likely to have your VBAC if you have a doula by your
side, reminding you that you can do it, and supporting you every step of the way.
After all, even if YOUR OB is supportive, you might not get your OB when the time
comes, and you'll have to contend with whomever is on call. Your doula is there to
do the contending for you, since that's the last thing one wants to do while in
labor.
Good luck to you!
Loved My Doula
Hi Nancy,
I had a wonderful VBAC two years ago at a birth center in MA, assisted by my
husband and two midwives, with no drugs or medical interventions of any sort
except for periodic monitoring of baby's heart rate with a hand-held device. Our
stay at the birth center lasted for around 8 hours, and then we drove home with
the baby to rest.
In early pregnancy, my OB said that in a VBAC baby's heart rate would have to be
continuosly monitored and that I would need a heparin lock. That's when I
switched to midwifery care.
I did not feel the need to have a doula. The midwives were very helpful. Also,
my husband and I read a lot of books on natural childbirth. I would highly
recommend the books by Ina May Gaskin.
Best of luck to you!
Rasa
Nancy,
I am also very much interested in having a VBAC next time around. I delivered at
ValleyCare in Pleasanton the first time and had a c/s for failure to progress,
i.e: not having the baby in the timeframe the doctor would have wanted, it was
late, he wanted to go to bed..uugghh... Anyway, I can tell you ValleyCare does not
allow VBACs, so you would need to go somewhere else. I know Alta Bates does and so
does John Muir in San Ramon. I have read a lot on the subject and gotten great
help and support through ICAN. I would strongly recommend you visit their website
and join their email list because you will find awesome resources to assist you.
www.ican-online.org I can tell you I am definitely planning on having a doula for
my VBAC when the time comes, because from friends' experiences and what I have
read everything seems to indicate this is a GREAT resource for VBAC moms. I would
love to chat more on this subject if you would like. Feel free to email me
directly maria
Hi Nancy;
I had a very successful VBAC experience. With my first, I had a c-section after a
failure to proceed and very painful 24 hours
+ of labor. With my second, I too really wanted a VBAC and
hired a doula to help make sure it would happen the way I wanted. I had a doctor
with the Alta Bates Group - she has since retired - but it is the hospital and its
capabilities that determines if a VBAC is possible or not - and Alta BAtes has
great facilities and programs about VBACs.
It turned out that my doula had three other women in labor the same night - a
freak occurance - the labor and delivery room was a complete madhouse for some
unknown reason. It turned out I really did not need her as I had my baby within 3
hours of my water breaking. However, she was good at getting my husband and I on
the same page and making us comfortable with our decision.
It was absolutely fabulous in comparison to the c-section! I was so much happier
and comfortable with the baby/recovery etc then the first time around.
Because you did not go into regular labor the first time, it may be more similar
to a first time labor than a second time (i.e. longer than my 3 hours) but it is
really is worth it!
My current OB GYN is named Dr. Arzou Ahsan - she is great. Her number is 845-8047.
They recently changed the practice name otherwise I'd tell you that too.
Best of luck!
Mindy
I had a very similar experience when I gave birth to my daughter
4 1/2 years ago: pitocin, fetal distress, and C-section. When I was pregnant with
my son I really wanted a natural birth and I had a VBAC 1 1/2 years ago at Alta
Bates with Dr. Hank Streitfelt. I felt that both my OB and the nurses at Alta
Bates were very supportive. But I also want to say that I do not think I would
have managed without my doula. I would say it is extremely benefical to have a
doula. The nurses were great, my husband was great, but the doula really made me
believe I could do it. I highly recommend my doula. Her name is Casey Bastiaans,
her numbers are 510-532-5137 or 510-388-8632 (cell), email is
casey[at]berkeleysoundartists.com.
Cesarean Support Group - ICAN of Mt. Diablo The best way to avoid a
surgical birth is to educate
yourself. This is a local chapter of The International
Cesarean Awareness Network, Inc. (ICAN). ICAN's mission is to
improve maternal-child health by preventing unnecessary cesareans
through education, providing support for cesarean recovery, and
promoting Vaginal Birth After Cesarean (VBAC).
For more information visit www.ican-online.org.
Join our Yahoo Group! Online at
http://health.groups.yahoo.com/group/ICANMtDiablo/
Facilitator: Holly Wiersma, CD, CLE and Deanna Jesus, CD, CLE.
Dates/Times: Meets the second Wednesday of each month from 11:30am to
1:30pm - December 13, January 10, February 14, and March 14.
Cost: This event is free of charge.
Deanna
June 2005
I am trying to decide whether or not to try a VBAC. I am 29
weeks. With my first labor 2 years ago, my daughter was face up
and I had preeclampsia which began during labor. So, I was on
Mag-Sulfate (which the doctor says stalls your labor) and I
stopped dialating at 5 cm. After almost 24 hours, they sectioned
me. But the baby wasn't too big for my anatomy or anything as far
as we know. She was 7#4. But I am so traumatized by it. I forgot
all my breathing and the epidural only worked on half of my body
and lasted like an hour. I kind of want to just plan another
c-section. I am not dedicated to a natural labor or anything. I
just want my baby to come out healthy (and hopefully with minimal
damage to me). But there are risks involved with a 2nd c-section,
like bladder and bowel damage to me. The 1% risk of rupture with
a VBAC would harm the baby and me. Although a very small risk, I
feel I would rather risk myself than the baby. I recovered in
like 2 weeks from my first section and I feel like if I didn't
have 24 hours of labor first, I could recover even quicker this
time. But the idea of standing up and walking out of the hospital
the next day sounds so great if I did a VBAC. And the fact that
it's healthier for myself and the baby. And then there is the
fact that I could only have 1 or 2 more kids. (But I don't want
more than that). I was just so bad at labor the first time! I saw
the archives, but I thought I might be able to get some more
recent advice. By the way, I will be delivering at the new Kaiser
Oakland facility (I did Alta Bates last time). Thanks!
--confused
Yours is a very difficult decision. When I was in your same
position I asked around and got very conflicting advice. The
fact is that whether a VBAC or planned C-Section is right
depends so much on one's very personal preferences and ''how
things go'' the second time around and it is just impossible to
in advance which will be best. Two things: 1) is your doctor
able to give you a sense of whether or your next labor/delivery
will be like your last one? An individualized estimate from
hin/her of how likely you are to suceed at a VBAC, given your
past experience, would be useful information. The last thing I
wanted was a drawn-out failed VBAC (I got a very quick, but
unsuccesful, VBAC trial). Personally I would choose a C-section
over that scenario. 2) if you are really more comfortable with
the idea of a C-section, it is fine plan for that. In
retrospect I wish I had planned a c-section but I felt so guilty
about admitting that I thought the C-section would be easier.
Turns out, for me, that it definitely would have been easier.
Just remember that you will need LOTS, LOTS, LOTS of extra help
with your older child if you have a C-section. But on the other
hand, if you plan a C-section it will be easier to plan care for
your older child while you are in the hospital.
2 C-sections and fine with it
Although I am not pregnant right now, we are starting to work on
that this month. Other than that, your post sounds so similar to
what I have been debating since my first child was born 19
months ago. I was 2 weeks past my due date, also had a small
baby, but went into labor and could not dilate and then the c-
section happened due to infant distress. The staff at Alta Bates
was amazing, and it was very reassuring to have such a top-notch
NICU right upstairs. But also, like you, I will be delivering at
Oakland Kaiser this time. What I have decided at this point, is
that I will try for a VBAC knowing that the 1% risk is something
I am willing to gamble on. However, this time, I will let them
start an epidural so that if things get dicey, the C-Section can
be a bit smoother than the last time. The other part of the
decision is that I am not going a day past my due date, and will
actually schedule a c-section on the due date in case labor does
not start naturally before then. For me, going past the due date
meant that my placenta was not able to supply enough oxygen to
the fetus and we almost lost our baby. I do have some concerns
about the new Kaiser facility, but not about my OB-GYN surgeon
(Dr. Laura Minikel)- she was amazing and perfect in a very scary
emergency situation and if she did that well under fire I have
no doubt about her abilities to perform a routine scheduled c-
section. Glad to talk to you more about this...
lou
Your story sounds just like mine! I'm 33 weeks and also thinking
a lot about this. I was induced with #1, because of Pre E, I got
to 6 cm and stalled after 26 hours. I would do anything to avoid
the Pitocin and the mag sulfate this time, so I'm probably going
to plan for the section, but if I happen to go into labor, I
would like to give it a try, assuming my blood pressure is
cooperating, which it is so far. The idea of a quick recovery
does sound wonderful, I'm so jealous of women who have no health
concerns and can just wait for labor to start ;) Sorry I can't
be more helpful than that...
Jill
You should choose the delivery that feels best to you. I
wouldn't worry too much about your baby, after all, the doctors
and nurses can do that. I had an excruciatingly painful and very
long back labor with my first child (as well as multiple,
life-threatening complications), and ended up with a c-section.
For my second, I decided to bypass the whole labor thing (on the
advice of my OB, actually) was very happy about it and have no
regrets. My OB is a good surgeon, and I have had neither of the
bladder/bowel side-effects that you mentioned. By the way, you
are right in your speculation that a straight c-section is much
easier to recover from than long labor PLUS c-section. The second
c-section was a piece of cake compared to the first. (This
actually matters, as you have your older child to consider.) As
for the health of my children: My first child showed extreme
distress signs after 35 hours of labor - her heartbeat stopped.
My second child was probably quite surprised at her sudden birth,
but her condition was absolutely perfect and she didn't have to
endure what her older sister did. Anyway, you do what feels
right for you - it's your body, after all, and your decision.
good luck.
anon.
I know you will get a lot of advice about this because I was asking the same
questions last year and got a lot of pressure from both sides. Here's my two cents. I
highly recommend having a c-section again. The risks of VBAC are NOT small.
About 1 in 100 women rupture their uterus. When the uterus ruptures, it usually
ruptures at home before you even get to the hospital because most ruptures happen
with the first couple of strong contractions. If the doctor can't get to the baby fast
enough, the baby can be brain-damaged or die from lack of oxygen. If you're at
home during the rupture, there is no way the doctor will get to ou in time. Even if
the doctor is standing over you with a scalpel she might not get to the baby in time.
My doctor told me one story of how he had a women rupture her uterus and he kept
looking for the baby and finally found her way up along side the mother's lungs!
That baby was thankfully ok, but that doesn't sound fun! Why should you take that
chance (1 out of 100 is not a long shot at all) when you've already come through a
c-section just fine? I don't mean to scare you but I believe these are very real risks
and you deserve to know what they are. I couldn't stand taking that risk with my
baby's life so I had another c-section and it is a good thing I did. Turns out my
muscles were already split open and there were holes and adhesions in my uterus
from the last c-section and all the stretching from this pregnancy. SO I would have
ruptured for sure. Not only did they deliver a healthy baby but they repaired all the
problems withmy uterus and lasered off my old scar and gave me a beautiful
practically invisible new one!
C-Section Fan
Well, I've never had a c-section, but everything I've been reading suggests that
trying for VBAC is overall better for mom's and babies. There are LOTS of risks
with c-sections that are just not really mentioned in the medical world. For
example, there is a new, common suturing technique that is very popular these
days (1 layer suturing as opposed to the old, 2 layer suturing) that appears to
be causing problems for many moms: increased chance of rupture (less of a
problem if this will be your last child), the suture not healing, internal bleeding,
and more.
Also, c-section has risks for the baby: baby's get cut, and they are more likely
to have respitory problems (because going throught the birth canal in a vaginal
birth helps squeeze fluid out of the baby's lungs, which doesn't happen with a
c-sectin).
These are just a few examples of risks associated with c-sections. You can find
out more in the books that I read about these issues: ''Ina May's Guide to
Childbirth'' and Henci Goer's ''The Thinking Woman's Guide to a Better Birth.''
Both of them are definitely biased toward natural childbirth, but they are both
very well researched, so they are good sources of information. Henci Goer, in
particular, tries to give you a good idea of both pros and cons of various
interventions, but Ina May has information that Henci Goer doesn't, which is
why I found both to be valuable. I'd really recommend reading them both
before you make up your mind, because they can give you facts and statistics
and information that you can't get from just the individuals who tell you about
their personal experiences here. You can find them on Amazon.com.
Finally, I know you're afraid, but please remember that EVERY PREGNANCY IS
DIFFERENT. Not just between individuals, but every individual will have a
different experience with each pregnancy. Your 2nd is not doomed to be like
your first!
Best of luck!
anon
I'm going to be attempting a VBAC sometime in the next couple
weeks at Kaiser Oakland as well. I can't tell you whether its
worth it or not since I have not yet tried, but I can tell you
my reasons for deciding to and the resources that I took
advantage of. I do know that Kaiser has over a 70% success
rate and from talking to every mom I know, every labor is
different. Just because you didn't have a vaginal delivery the
first time, doesn't mean you can't this time. Is a vaginal
delivery something you want? Does it mean more to you than
just not having to be in bed for 2 weeks after? For me it did,
which was a huge influence in my decision. If not, then I
would certainly look at some of the benefits of a repeat c-
section, which I can't personally attest to.
As for my story... my c-section delivery followed about 20
hours of intense labor and failure to progress past 5
centimeters. My son turned out to be 10 pounds (I'm 5'2'' and
was about 100 pounds) so some people think, ''well of course you
had a c-section'' but I don't necessarily believe that. Post-
surgery I was wheeled into a recovery room alone for about 4
hours and wasn't able to see my husband or my baby during that
entire time. I looked forward my whole life to having a baby
and then there I was (after waking up from the morphine and
demerol), alone, afraid, unable to move, and not knowing what
was going on with my baby. Months and months later I saw a
picture of my husband in the nursery feeding my son a bottle of
water with all my friends and family right outside the room.
Then I saw another picture of about 15 family and friends all
standing around my baby. I broke down in tears (almost a year
later!) and realized how much it had affected me. Yes, my son
was healthy, and I was grateful for that, but I think he could
have been just as healthy delivered vaginally.
At that point I began looking into VBACs and was referred to
the book ''the VBAC Companion'' by another VBAC mom. The
information in the book was incredibly helpful in cementing my
decision and commiting me to trying. It made me realize that
other mom's had the same disappointed feelings about their
delivery and that the ''well at least your baby is healthy''
doesn't always make everything better. In fact, it helped me
realize that I didn't need to feel guilty about my
disappointment when people would say that to me.
The book also put the risks of a VBAC into perspective. Some
of the risks they put into perspective were that uteran rupture
rate is actually less than 1 and there is some risk of rupture
whether or not you've ever even had a c-section so as far as
how ''increased'' the risk is, its really low. also, the
complications if you have a rupture can likely be handled with
little impact if you're in a properly equiped facility (i.e.
one that can perform a c-section within 17 minutes). They also
point out the risks of a c-section which is not problem free.
Another major point the author makes is the very positive
aspects of attempting a VBAC regardless of whether or not you
are successful. Labor itself is beneficial to you and your
baby not only in the release of chemicals but having the baby
be in the womb until it is ready to come out.
I realized then, my second biggest VBAC fear (aside from the
rupture issue) was that I'd invest all this effort, go through
all this pain, and get my hopes up, only to be disappointed in
the end. Upon reading how beneficial it can be to the baby and
mom to experience labor, I let go of that fear and am now just
content to give it a try.
Then during my Kaiser Oakland hospital tour, I was shown the c-
section recovery room. To my surprise, there was a ''partner's''
chair, a baby crib (hospital kind of course), and a bed, just
like every other recovery room. I was so pleased to find out
that after a c-section at Kaiser Oakland, your baby and partner
stay with you and that they will put the baby to your breast as
soon as possible (if you do breastfeed). I suddenly felt so
much relief that if I were not successful, at least the post-op
recovery would not be so traumatic. Thank you Kaiser! This
really helped my anxiety over attempting a VBAC.
With all that said, I know that many many moms chose a repeat c-
section. The comfort in knowing when it will come is huge (I
am in my last two weeks and wish so badly I could just
KNOW!!!). I also have heard that the recovery from the second
c-section (if you labored the first time) is SO much better,
its almost like night and day. A best friend of mine however
had a worse recovery with the second because of a leak in her
spine from the epideral and a few other issues (one of which
was the lack of bonding she felt with the second. one of the
chemicals released during labor is ''oxytocin'' which is often
considered the ''bonding chemical.'' It increases trust and
scientists have actually found it can be administered to
patients to increase their trust levels. Anyway, perhaps not
having that chemical released because her body never initiated
labor had something to do with the difference in bonding
between the first and second. either way, she is unbelievably
bonded to her second now so that is just a little thing I
suppose and could totally be an exception). This friend of
mine said if her recovery from the first c-section had been as
bad as the second c-section, she probably would have considered
a VBAC. Just goes to show that every delivery, and not just
labor, is different.
I wish you the best of luck with making your decision. Its
different for everyone and I'm sure once you're informed
(definitely read the VBAC companion!) you'll make the right one
for you.
Hoping to be a VBACer
VBAC, for sure. You'll be amazed at the power of your body when
it does what it is built to do. I had a VBAC this winter and
went in prepared to have a c-birth if neccesary and that baby
practically slipped out of my body - four hours total labor, 20-
25 minutes of pushing. We did Bradley Birth Method the first
time around and only the Kaiser refresher course the second
time. Believe me, all the breathing classes in the world can't
really prepare you - your body knows what to do and it leads the
way. I say go for it! You'll be so happy you did! (Not to
mention, recovering from a c with a toddler has got to be a
drag!)
Best of luck to you and yours.
It sounds like your first child's birth was a challenging one - something none of us
expect, I think. My own labor was surprisingly long - 38 hours not including early
labor. I never expected it since my mother had me and my sister each in about 6
hours.
I wonder if it might be helpful for you to take a little time before your next baby
arrives to do some healing work around the difficulties of your first child's birth - so
that you are as clear and prepared as you can be for your second baby's arrival. I
would recommend a session or two with Nancy Friedrich, a hypnotherapist who
specializes in work around pregancy and birth. She's in Sausalito at 415-868-9744.
Birth is traumatic for mother and child, no matter how easy or complicated it ends
up being - it's also an incredible opportunity for healing and Nancy can help with
this.
There is incredible potential for transformation in vaginal birth - if you are not at
high risk for a VBAC, and it sounds like you aren't, I would recommend you consider
it. A VBAC is much lower a risk than doctors and hospitals will have you think. Here
are some helpful resources so that you can further weigh your options:
www.maternitywise.org/mw/topics/vbac-cesarean/index.html
www.gentlebirth.org/archives/icanvbac.html
www.midwiferytoday.com/articles/vbacprimer.asp
There are also many books on the subject, but these can be overwhelming in how
much information they provide. You can do a Google search on ''VBAC vs. C-Section''
for more information. All the best to you in your pregnancy and birth.
Gal
Feb 2005
Looking for advice and/or experiences regarding VBACs at Alta
Bates in Berkeley. I will be attending the hospital's VBAC
class on April 8th, but am looking for info before then to help
in my decision. Thanks!
Dawn
I wish I had had a second c-section rather than a VBAC. I feel
like there's a lot of push in the Bay Area to do the VBAC which
focuses on the risks of the C-section, but doesn't mention the
risks of the VBAC. Of course there's the risks of major surgery
and risks of uterine rupture talked about. People say the
recovery is so much better w/ the VBAC, but that's misleading.
It's different.
First of all, from many stories I've heard, recovery from a
second kid is much better than the first, regardless of whether
you went c-section, then vaginal or vice versa, of course unless
you had a problem. Certainly the stress of having a kid is easier
the second time.
After my c-section, my body took a while to recover. I was weak
and tired and caring for a little baby. But by 2 months, I was
fine except for a tiny line across my abdomen.
After my VBAC, I had skin torn that was never properly
reattached, my nerves and muscles were in bad shape. I found
myself urinating, it running down my legs urinating, if I bent
over to tie my shoes or other seeemingly irrelevant things.
Psychologically, I was turned off sexually, due to worrying over
my damaged skin & tissue. Physically, sex has never been as
pleasurable since the birth 1 and 1/2 yrs ago.
I didn't have an infection, I didn't have a tear to the anus,
things could have been much worse. There are some disturbing
stories at:
http://parents.berkeley.edu/advice/parents/postpartumsex.html#painful
Just make a decision weighing all factors.
Also, even if you go with a VBAC, I would schedule a C-section. I
think normally scheduled C-sections are 1 week before your due
date. Decide how long you're willing to go - a few days past your
due date? a week? more? Talk to you dr. and schedule this one in
case you're late (they won't want to induce you). I ended up late
and couldn't schedule a c-section until a few days after I was
willing to have it, and ended up with the VBAC just before my
c-section.
Good luck and remember, both choices are fine and most end up
just fine! :)
VBAC isn't all great
I am a certified nurse midwife and I work at Alta Bates and
Highland. I am not responding as a spokesperson for any
hospital, nor do I want to be quoted.
You should have an in depth discussion with your doc or midwife.
So they routinely offer VBACs? what's their success rate? would
they be willing to induce or augment your labor if need be? do
they prefer that you have an epidural in place? will you be
expected to have internal fetal and contraction monitoring?
The worst case complication with a VBAC is uterine rupture which
can result in fetal brain damage or death. As such you will
probablly have continuous monitoring of your contractions and
the baby. This is a good thing because, altough it is rare, it
can happen and a good outcome depends on a swift diagnosis and
emergency c-section delivery.
The nursing staff is excellent and very comfortable with VBACs.I
really can't say enough about the skill of the nurses in labor
and delivery. They are fantastic!!
I hope you have a wonderful birth no matter how your baby
decides to be born. It's a tough decisions and I hope you have
lots of support.
Good Luck
I had a VBAC at AB and had a good experience. I took the VBAC
class, which both my husband and I thought was great! My OB was
very supportive and we had a doula, who was helpful as well. I
encourage you to try if you feel like it is what you want.
sally
Sept 2003
I am due early next year and am agonizing over whether I should
opt for a VBAC or not. The doctor has laid out all the pro's and
con's of each and frankly, my husband and I can't decide which is
best. I'm sure lots of you moms have been through this and I
would love to hear any advice on the subject, from those who
chose VBAC's and from those who opted for cesareans; and what the
experience was like.
Thank you
Apolgies for this long post! I know there are strong opinions
about VBAC and C-sections, but I wanted to offer my experience.
First off, please note that the decision should be based on
YOUR comfort level.
When we were due with our first baby, my husband and I had
taken a birthing class in which the instructor had us watch a
video on C-sections. I'd never thought about C-sections before,
other than assuming I wouldn't have to deal with it. After the
video, I was a bit shaken. It was incredibly negative. The
women all talked about how they had regretted having C-sections
and felt inadequate for not being able to deliver vaginally.
When it came time for my son's delivery, I ended up being in
labor for more than 21 hours. About 10 hours into labor, one of
the doctors in my doctor's group stopped in to check and said I
should have a C-section. Well, you can imagine my reaction. I
started crying, saying that I felt inadequate. Here's the funny
thing: I even told my husband that I wasn't able to deliver
vaginally because I was anal retentive (we like to joke about
this now!). The nurse on our team sympathized with us and we
went ahead and tried again to deliver vaginally.
After 21-plus hours, my son's head was stuck, he and I were
both at high risk for infection, and my doctor broke it to me
gently that I really needed to have a C-section for our health,
moreso for my son's. So we had the C-section. I ended up with
an infection and had to stay in the hospital a day longer than
the normal 3 days. I didn't get out of the hospital bed at all
the first day and not out of the hospital room the entire stay.
I was in intense pain, even with meds, and the recovery was
incredibly painful. When my son cried, I couldn't even get out
of bed quickly or without help. It was about a month before I
was without pain.
18 months later, I became pregnant again. My doctor, without
any bias whatsoever, explained that because of my failure to
progress situation, I had a 50/50 chance of the same happening
again. She gave me a lot of information about both sides to
help me decide. The entire pregnancy I was vacillating between
having another C-section or a VBAC (could I be on the other
side of the 50 percent that had successful VBACs?), even though
I had told my doctor that I was prepared to have a VBAC. As the
pregnancy wore on, I grew increasingly anxious. I finally
admitted that I was deathly afraid of labor, of having to
endure what I gone through before. When I changed my mind and
decided to have an elective C-section, I was incredibly
relieved.
We set the date, and then, Murphy's Law, the baby decided to
come three days early. I had painful contractions the day I had
a doctor's appointment. Turned out I was already 3 centimeters
dilated. As my husband drove me directly to the hospital, I
started wondering if I shouldn't have a VBAC since I was at 3
centimeters. We still went ahead with the C-section, and after
all was said and done, there were 3 good reasons why it was the
good choice for me: 1. I had not dilated at all in three hours,
from the time the doctor saw me to the time I was having the
surgery, 2. my daughter's back was to my back (which is why my
contractions the last several weeks had been extremely
painful), so it was going to be a painful back delivery, and 3.
strangely, my daughter had moved back up (which explains why we
heard her cry for a long time before the doctor announced
whether she was a boy or a girl). I recovered really easily
because my body wasn't exhausted from hours and hours of labor,
and I was walking the morning after. I was in minimal pain but
able to do a lot of things right away.
This is obviously a story from a mom who had a failure-to-
progress history. I know some moms who had C-sections with
breach babies and delivered VBAC successfully. That's the first
thing you have to separate--why you had a C-section in the
first place--but the most important thing to consider in your
decision-making process is what feels most comfortable for you.
Patty
I opted for a second c-section. I read the previous reccos on the website
and no one who posted there had two in a row, so I thought I would put
in my two cents.
I had 24 hrs of terribly painful induced labor with my first, and ended up
with a c-section because my uterus got infected. The controllable pain
associated with recovering from the c-section, to me, was preferable to
the uncontrollable pain of labor. Even though I had an epidural during
labor (which only worked on half my body) and a great emergency
doula, I was seriously tempted to run out onto Ashby and let a car run
over me after about 12 hours. Labor was just too much for me.
So, I had a scheduled c-section the second time, and I just took it easy
and took my pain meds and everything was great. I knew what to expect
and it was not traumatic like the first one. I did have a dangerous
reaction to the spinal during the operation the second time, but they took
care of it quickly and there were no more complications. If I have a third,
I will have another c-section, although I will have to address the spinal
reaction problem.
Some Kaiser practitioners tried to talk me into a VBAC, but I just kept
saying ''no thank you''. I was asked over and over why I was choosing a
repeat (for forms, etc.) and I did feel like I was getting some flak for my
decision, but I just stuck to my guns.
no regrets
Hi,
I had a c-section with my first after days of labor and a midwife. There
was a difficult presentation, (posterior, brow presentation) and the c-
section was the only way to go. However, my second labor and delivery
were very different, even though the presentation was also difficult
(posterior, asynclitic, meaning head turned to the side and face up).
Anyway, the two labors were night and day. Also, my second child was
significantly smaller than my first, and that was helpful. I was very
committed to a VBAC and found a midwife (Hsiu-li, who works out of
Summit and has hundreds of loyal moms) committed to it as well. I
needed no pain killers the second time around, it was fast, and beautiful,
the type of labor you'd request. So, I'm saying this so you don't make
assumptions about how the second labor will be like the first b/c you just
don't know. I strongly encourage you to try a VBAC unless there's a
reason not to. It's so wonderful, and the recovery is much, much easier.
However, your doctor saying you could go either way seems like a
premature piece of advice. Why have significant surgery if there's no
medical necessity? Good luck and congratulations.
anon
I had a successful VBAC at a birth center three years
ago. My previous C-section was eight years earlier. Also my
midwife looked over my files and determined that my initial C-
section was unnecessary. The OB-GYN community has become less
and
less favorably disposed to VBACs over the past five years or
so. This is because of a study that claimed to have found an
increased risk of uterine rupture with VBACs. However, I believe
that study tarred all VBACs with the same brush, when it really
was increased risk when inducing labor, especially with the use
of cytotec.
My advise to you is that yes, it is possible and under certain
conditions, completely safe. You have to find out why you had a
c-section to start with, was it due to some condition that could
reoccur or a one time incident - placenta previa, breech etc.
Secondly, you really need to explore your desire to have a VBAC.
Ask yourself why, come up with your reasons. You have to be sure
of them and have the support of those around you, doctor
included. It is almost as if the cards are against the VBAC
mother from the start, especially since the self-doubt doubles.
All throughout my pregnancy, I had times when I was convinced I
couldn't do it. This is probably true for all women, but I had
this haunting feeling of how I couldn't do it the first time, so
I wouldn't be able to do it. Also scheduling a C-section is such
and easy out.
With my first birth, I was 18 years old and though the father
was in the room he was so useless, he might as well have not
been there. And he was it. So, scared and alone, I felt I
couldn't do it and lo and behold, I didn't. Demerol, turned to
an epidural, to a c-section.
My second birth was quite a different experience. The man with
me this time, my husband, was an amazing source of strength and
encouragement. It is because of my own experience that I stress
the need for labor support. All laboring women need that
physical and emotional support. Consider asking close friend or
a doula experienced with VBAC deliveries.
Feel free to email me if you have any other questions.
VBAC mom
I am due in the early spring and definitly want a VBAC instead of
another cesarean. The primary reason is that with my
toddler I just don't want to spend three months recovering, if I
can help it. I vividly remember being so frustrated by the slow
recovery time and I hopefully will not have to do that again. Of
course I am a bit nervous about vaginal birth but at least when
it's over it's basically over. Another strong reason for my
decision is that I would like my daughter to be there when her
sibling is born.
gael
Hi- I personally would think that if I were you, I would try to
have a VBAC if your doctor is saying that the option is open.
Most women are told that they can't have a VBAC and so
automatically assume they have to have that repeat Csec. If you
try for the VBAC, the worst that could happen would be that you
have a normal vaginal delivery and don't have to go through the
recovery of major abdominal surgery again, and if something
comes up in labor (an emergency situation) and you have to have
a Csec again, at least you TRIED. Here are a couple of good
sites to check out so that you can make the best decision for
YOU. I hope this helps.
www.ican-online.org
www.vbac.com
http://www.childbirth.org/section/VBACindex.html
I feel so strongly about you making choices for yourself
because I am a doula and although I haven't had a Csec (my son
was vaginal delivery) I know how hard the recovery is for mom
AND baby after that surgery and that if you have the chance to
try for a VBAC and doc is giving go ahead to at least TRY then I
say GO FOR IT! Dont have major surgery unless there is an
emergency that requires it!
Shaana Keller
Celebrations Doula Services
www.celebrationsdoula.freewebsitehosting.com/Main.htm
I had a c-section and then opted to have a VBAC for my second
child, and it was fine. Your doctor should have explained to
you that two critical factors weigh in on your decision: 1) if
you have a horizontal scar/surgical c-section, and if yes, then
that's good for having a VBAC; 2)what the reasons were for your
c-section: if you had complications with the birth and issues
that meant having a c-section, then a VBAC may be a bad idea.
Or, if your baby was a breech, then that's no real reason to
have another c-section. My first child was in a full breech
position, with both legs extended down, and we knew it well
before the due date. Also, check the New York Times archives
for an article that came out in mid 2001, about VBACS being
more riskier than doctors realize or care to admit. Overall,
though, if you're healthy and had no complications, I'd say go
for it!
Good luck.
Been there
I had a very successful VBAC 2 years after the 32 hour labor,
3.5 hours of pushing and c-section of my 1st son. Here's what
made my VBAC a success:
1) I told my OBGYNies that I was having a VBAC.
2) My OBGYNies were very supportive (I would have found another
practice if they were not).
3) I hired a fantastic doula, Treesa Maclean, to increase my
chances of success.
All went very well, so well in fact, that I barely made the 4
block drive to the hospital before I was completely dilated and
ready to push. I was also postive, and harbored little anxiety
about the whole thing (what was the point, the baby had to come
out!). I also remained flexible with my nurses, doctors and
doula that based upon their opinion, if through labor I needed
another C-section I would do it.
My advice...go for the VBAC, if it doesn't work out at the
hospital be prepared (mentally) for the C-section. Recovery from
a VBAC is SO MUCH better than a c-section.
Sastisfied VBACer
I had a VBAC. (I was extremely curious to know what it would feel
like. But when the baby came out, I couldn't feel a thing b/c of
the epidural. And I couldn't see anything in the mirror b/c the
doctor was in the way.) I had no regrets about the C-section,
didn't feel any less joyous about the birth experience.
Surprisingly, the VBAC recovery for me was just as slow as my C
recovery (2-3 months). I couldn't walk or stand for more than 10
minutes at a time, although less so as time wore on. I was
sitting on ice packs and rubber donuts for a long time!
Everything down there felt weak and sore. I had no strength
between my legs, couldn't get up off the floor, crouch down to
pick something up, etc. It hurt just to sit for more than a
month. For me, it's a toss up, the VBAC or the scheduled C. But
some factors that may affect this are (a) my memory of the
C-section is over 2 years old and (b) my child born VBAC had a
very large head (in the 97% percentile.)
Bruised twice
I didn't have a C-section myself, but a good friend is planning
a VBAC (due next month), and I think that she had a number of
reasons for doing so. No sure how much research you have done
(didn't see the original post), but there are compelling reasons
for attempting a VBAC. Have you been to the VBAC website,
http://www.vbac.com/ yet? Here is a quote from their website:
''A cesarean can be a life-saving procedure for a mother and/or
her baby, but overall, birth by cesarean puts healthy pregnant
women at risk for medical complications.'' There's also the
Cesarean awareness website, at http://www.ican-online.org/
Mothering magazine has some articles online you might want to
check out: http://mothering.com/11-0-0/html/11-4-0/11-4-0.shtml
(defintely pro-VBAC)
Jennifer R
Nov 2003
I am currently planning a VBAC and looking for VBAC stories
and information from women who have attempted VBACs
within the last few years or so (successfully or not). Your
input will help me shape my own plan. Here are some
specific questions:
1. What was the reason for your prior C-section? Did it
recur?
(My baby never dropped and I was induced, got to 9 cm and
stopped --''failure to progress.'' Any others in the long
gestation boat? Did labor start for you naturally the next time
around? Did you help it out?)
2. Did you have a doula at the C-section birth? The VBAC
birth? Comments?
3. For the VBAC, did you plan a home or hospital birth (and
how worried did your provider suggest you should be about
uterine rupture)?
4. What sorts of rules did your medical provider give you
about when to get to the hospital? When did you actually
go? Did you negotiate this with your provider, or make your
own informed decision about it?
5. If you did go to the hospital for the VBAC, how was fetal
monitoring handled? (I'm especially concerned about going
in and getting strapped down flat on my back, a big labor
killer.)
6. How supportive was your provider of your VBAC decision,
and did s/he make any practical suggestions to increase
your chances of success?
7. What happened? Did it work out?
Any additional insights or resources you could recommend
would be greatly appreciated.
Thanks!
Second time Mama
This is just my experience here and each birth, each person is
unique BUT my advice here is: trust your instinct and do what
you think feels right ! I had a C-section with my first baby,
just like you, failure to progress, stuck at 8cms, 12 hours
labor ending in a c-section. I had this specific problem that
while laying down in bed, contractions would stop but since I
had a bad case of ''back labor'' (contractions seemed like a stab
on my lower back) I couldn't have gone through a 12h labor
without an epidural. So when I got pregnant a second time, less
than a year after the birth, I was VERY reluctant to go through
the same experience and I really wanted to have a scheduled c-
section. I guess my OB was very persuasive because I let him
convince me that trying for a natural birth again would be
better. Sure enough, second time was worse than the first one,
and after 24h of labor, going nowhere and an epidural that was
not working, the doctor finally performed a c-section. Results ?
I was exhausted from the labor (sleep that I've recovered only 2
years after the birth) and I had the c-section anyway.
I would have to do it again I would choose c-section in an heart
beat, also because both recoveries were so easy for me. However,
I'm still griefing at some level, the fact that I didn't
experience a normal delivery.
Good luck with your choice !
anon
Hi there- I just want to tell you first off that the decision
is completely up to you on whether or not to have a VBAC.
Secondly, there are so many risks involved in having a c-
section that doctors don't tell you about and having a 2nd c-
section can even raise that risk. Yes there is that risk of
uterine rupture that all the medical community says is sooo
high etc. but in reality here is the info: for a first time mom
laboring (for a vaginal birth) the risk of uterine rupture is
about 1%. For a second time mom who had a c-section w/ the
first baby, the risk of uterine rupture is about 2%...so as you
can see the risk is not that much higher. I would recommend
that you do a lot of research- read books about VBAC's and try
finding forums online w/ moms who have had VBAC's or are
aspiring to have one. Right now I am working with two moms who
are both going for a homebirth VBAC and are very eager to
experience birth 'naturally'.
One thing I should say- what were the reasons you had the c-
section the first time around? Failure to progress? Inadequate
pelvis? Well, there can be a lot of reasons and I'm not saying
that all of them are wrong because there are real emergencies
that require c-sections, but a lot of times if the diagnosis
for c-section is 'failure to progress' or CPD (inadequate
pelvis)...usually the mom was stuck in bed flat on her back
unable to move around and utilize gravity to help her dilate
and progress... OK I'm not trying to preach or anything, but I
feel passionately about the birth process and that with good
physical support, suggestions, and an emotional and mental
belief that YOU CAN DO IT, you can acheive that natural birth
that you want.
Please feel free to email me off list privately for some
suggestions on specific websites or books to look at. If you
really are striving to have a diff. experience than your last
birth, it is possible but you have to do your homework and know
whats involved. Also having a supportive doctor who is
supportive of your VBAC is more important than you might think.
Anyway, to keep this short please do email me or call me and I
can talk to you more about it.
Shaana Keller, Labor Doula
I did not see the original posting on VBAC, but saw the
response by a doula. I have to throw in my 2 cents.
Listen very carefully to your doctor whether or not you can do
a VBAC. In this instance she/he does know best.
As far as the c-section vs. vaginal being natural - as the
doula suggested - gimme a break! Right now you have to do what
is best for you and your baby. If anyone feels like they are
less of a woman because of the birth experience, they have
other problems.
I had a successful VBAC in July. I wouldn't trade that
experience for anything! Everyone's circumstances are different
and this is a very personal decision. But, I have to agree with
the previous poster that you should do your own research and
make your decision based on facts. From my personal experience
and what I have read, I believe that some physicians manipulate
the statistics to scare women in to having a c section. I also
have to concur with the previous posting that a VBAC supportive
provider is incredibly important. My doctor claimed to be VBAC
friendly when in reality he wasn't. I was under enormous
pressure from my provider to schedule a c-section when I was
approaching and ultimately passed my due date. I stood my
ground and ended up switch providers 5 days before I gave
birth. It took alot of resolve and ended up being the most
incredible experience of my life.
I would recommend you look at the VBAC support bulletin board on
Babycenter.com. In my opinion, that was the best on line forum
for support. Also, if you do a google search for VBAC you will
find a wealth of information on both sides of the issue. Be
very clear on the statistics between being allowed to go in to
labor naturally vs being induced. The risk of uterine rupture
goes up significantly with induction.
Best of luck to you in whatever decision you make.
Jennifer
Jan 2003
I'm pregnant for the second time. My son was born via c-section
when he showed some signs of distress after a prolonged labor.
This time I'd really like to have a vaginal birth and my OB has
said it shouldn't be a problem. I'm wondering if anyone out
there has had a successful VBAC and can offer advice on
anything I can do now to increase my chances of success. Or, if
you hoped to have a VBAC but ended up with another c-section,
is there anything you think you could have done differently
during your pregnancy that would have changed the outcome? I've
already looked at the postings on the web site. Thanks for the
advice!
AM
I had a succesful VBAC at age 44, and am proud of it! Yes,
go for it! One thing that I did which I think helped was to see
someone who I did 2 sessions of hypnotherapy with. It
helped to visualize the process of actually giving birth.
Otherwise I had some blocks, thinking I couldn't do it (age,
size, previous c-section, etc.). So, believe in your ability, and
try it, is my advice. Good luck!
Yvonne
My first child was c-section (long labor and nearly 11 pounder)
and my second child was a 4-hour start to finish labor with a
great vaginal delivery (9 pounder). I, too, wondered how I
could do things differently. First, I found a Nurse Midwife
(Hsieu-Li Chang) who was well known for her high VBAC success
rate (she delivers at Summit). She clearly told me (after I
gave her the details of the first birth) I could have a vaginal
delivery. Knowing that, I exercised regularly, ate better,
hired a very competent labor coach (Carol Rice Shattuck), took
evening primrose oil(?) about 6 weeks before the due date, and
after that trusted and surrendered to the labor process. I told
myself it was a gift to deliver vaginally and if I had a c-
section again it was meant to be. The first time around I was
way too attached to a homebirth delivery. Then I realized I can
do my part but the rest was out of my hands and control. Good
Luck!
Anon
I had a c-section for my first child because of the full breach
position of my baby girl. I then had a successful VBAC when my
son was born 15 months later, at 42 years old. My doctor made it
clear that it was my decision to have a VBAC, and in no way
would she be responsible for it! We talked and she agreed with
me that it comes down to a ''crap shoot'' whether it works
successfully or not. She did say that because my c-section of my
first birth was due to a breach, not to complications, that that
would help my chances of having a successful VBAC. Also, check
the New York Times in the spring of 2001, when there was an
article about VBACS being more risky than was thought before. I
had my two babies at CPMC in San Francisco (superb place!) and
would highly recommend it. It was my doctors' policy to not give
a VBAC mother anything to induce the labor, like Pitocin, which
might cause a rupture of the uterus. I had what is called
PASSIVE DESCENT, letting the baby drop down on his own. I also
had back labor and got an epidural right from the start. I had
17 hours of labor. I would advise you to choose your doctor
wisely if you do go the VBAC route. You want someone who is
absolutely competent, technically, to handle things should they
go wrong. I might add that a vaginal birth is SO MUCH easier
post-birth. You deserve a chance to enjoy the homecoming without
another c-section!
Been there
I had a VBAC, and although I don't know why I was successful, I think it
might have had to do with hypnotherapy. I went to Carolyn Shaffer (652-
1498) a few times, and we worked through some issues I think might
have otherwise interfered with my having a VBAC. My first child was
born via C-section after failure to progress despite 24 hours of hard,
unmedicated labor followed by 12 more hours with epidural, pitocin, etc.
My second child was born vaginally, 45 minutes after we arrived at the
hospital. So, I'd recommend Carolyn!
Susan
June 2002
My first two children were delivered via c-section because
both were breech. I am due to deliver #3 in a month, and
due to a serious post-partum hemorrhage last time (in
which I almost lost my uterus) and the fact that the current
baby was also breech, my doctor and I had planned a
c-section. Today at 35 weeks, however, I found out the baby
has turned down into the correct position and suddenly I'm
very tempted to go for for a VBAC, (risk of hemorrhage
notwithstanding). I would like advice from anyone who has
tried for or had a successful a VBAC after 2 c-sections
and/or with another ''high risk'' factor. What issues should I
consider before I make my decision? What prep can I do for
my body in the next couple of weeks? Also, can anyone
recommend a doula who specializes in VBACS and could
help with my delivery at UCSF, but who is otherwise based
in the east bay? And who also might be able to take on a
very last minute customer??!! Thanks so much!
Mary
I recently had a vbac after 1 c-section, so I can't speak to
having 1 after 2 c-sections, but I can recommend a terrific
doula -- Michlene Cotter-Norwood. Michlene herself had a vbac
& is very sensitive to the issues it raises. She works very well
w/ medical staff -- all the nurses we dealt w/ at Alta Bates
said how much they appreciated working w/ her. She is also a
wonderful person who was incredibly supportive to both me & my
hubamd during a very long & difficult labor. She is based in the
E. Bay. Reach her at birthspirit AT prodigy DOT net. Good luck.
Colleen
Good for you on wanting to find a Doula for your VBAC. That choice
will make the process so much easier emotionally and physically.
BirthWays in Oakland, across from the Grand Lake theater (510/869-
2797), is a great resource for finding a Doula who will provide
excellent support on short notice, and who will be experienced in
VBACs. Please give them a try, and good luck to you and your baby!
Nora
Trying to decide about having a VBAC
Nov 2000
I'm four months pregnant with my second child and had a c-section
for my first one. I'm trying to decide whether or not to have a
VBAC (vaginal birth after cesarean). It's a crap shoot as far as
I can tell, whether or not I have a uterine rupture. Any advice out
there? Thanks.
My first baby was breech so I had a C-section. My second was a very
sucessful VBAC. So much easier a recovery even though I had a 2nd
degree tear. Not knowing the reason for your c-section, I would say
go for VBAC. Besides, if your older child is still quite young
you'll have an easier time tending to them if you have VBAC. If your
C-section was because of "failure to progress" then I can understand
the hesitation. Yes there's a risk of rupture and that can be a
scary thought but the stats aren't THAT much higher. Chances are
you'll come through with flying colors. There are a lot of articles
on VBAC out there (check the web) and Alta Bates did have a free
lecture on VBAC. Good luck.
caroline
The risk of uterine rupture with VBAC is small (less than 1%) and
the likelihood of having an uncomplicated vaginal delivery is high
(around 60-80%, depending on why you had your first cesarean section).
If you had your first c-section for breech or fetal distress, the probability of successful VBAC is on
the higher side, if you had
your first c-section for "failure to progress" in labor the
probability of success is on the lower end of this range. The
probability of successful VBAC is lowest if in your first delivery
you got all the way to being fully dilated, pushed for a while and
then wound up with a c-section. Also, rates of uterine rupture
are exceedingly low if your labor begins spontaneously (not induced).
All in all, I would say in most circumstances it is worth trying VBAC.
I would recommend doing it in a hospital where an obstetrician and
anesthesiologist are immediately available (in case you need an
emergency cesarean), I wouldn't do it if you or your obstetrician
thinks the baby is huge and I would wait for labor to happen spontaneously. Also remember, you
can always change your mind (even
after your labor has started)
Hope this helps.
Alisa
I had my daughter by (emergency) c-section almost seven years ago (she
was 18 days post due-date and then had some distress) and my son two
years later, by VBAC. Having been through both, here are my
observations: I am glad that the C-section came first, because the recovery was much, much
slower, much more painful, ultimately, no
driving for two weeks, longer hospital stay, less ease of movement
with a newborn to care for. VBAC: much, much faster recovery,
driving right away, fully functional within a few days time. And
the second time around, I needed to bounce back from the birth of my
son, because I had a two-year old to care for, which the VBAC allowed
me to do. The c-section, while sparing things like episiotomy, is
major surgery, and with the VBAC, once my son arrived, that was that,
on with life again. If I had to opt for one or the other, knowing
what I know now, I would definitely elect VBAC. And that is compounded
by all of the benefits to the infant during the process of labor and
VBAC delivery. Lastly, I really loved the experience of having my
son arrive in the world in the way he did, it was very fulfiiling
and something I had (mildly) missed with the birth of my daughter.
But the baby's health is of course the determining factor, always.
Best of luck with your decision and your baby's arrival.
I had a c-section because I had a very big baby (10 pounds) and my
second child was very big too. My doctor wanted to try natural birth
but after four hours in labor, he told me it is better to have a second
c-section. I am glad he said that because with my first one I had been
in labor for 40 hours and I was very tired when they performed the
c-section. I believe it depends from each individual case.
12-1/2 years ago, I had a successful VBAC delivery. The C-section
I had four years previously was for "failure to progress"; I think
part of the problem was some less-than-adequate prenatal and hospital
care I received. There's not much likelihood of rupture in a VBAC,
and if you get yourself good support from a coach or knowledgeable
friend (I personally think husbands shouldn't have to be responsible
for this), you should do just fine.
Louise
For the reader who had a c-section with her first child and
is now considering whether to try a VBAC ... I don't know why you had a
c-section, and I don't have any medical advice or statistics for you, but I
can share my own story and give you some encouragement. I had a c-section
for failure to progress with my first baby and decided to try a VBAC the
second time. My second child (who was about the same size as #1) was born
VBAC less than an hour after we arrived at the hospital. My doctor was very
supportive of trying for VBAC, and that was important for my confidence
level (according to him, uterine rupture is not a huge risk given the
current c-section technique). The other thing that helped me a lot was
going to a hypnotist to work on clearing away any mental roadblocks, and to
get focused and not have self-doubts. (Her name is Caroline Shaffer) Good
Luck!!
Susan
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