Saturday, May 10, 2014

VBAC-2 or Repeat-Cesarean

To recap: 

With Claire, I had a small tear in my amniotic sac which was causing me to leak a small amount. It was my due date and I had a doctor's appointment. She checked me out and as she did, there was more of a gush. Not broken, but she had moved the sac enough that more water came out so she sent us right to the hospital to get started. We were so excited, thinking that we'd have a baby in a few hours.   40 hours of labor, pitocin, no food or water, no epidural until hour 36, and never dilating more than 2cm later we finally had to pull the plug and do a c-section. Worst experience and worst recovery because of all the labor beforehand.

With Alex, I was set on a VBAC (vaginal birth after c-section) and found a great doctor who was supportive and on-board.  That was the plan until we found out I had placenta previa (placenta attached to my scar tissue and staying too low over the cervix, blocking any exit for baby and making it a bed-rest kind of pregnancy).  Recovery was much better but the anxiety before and during surgery was intense. They almost had to put me out because I couldn't stop sobbing. I was so scared. The added risks involved with previa didn't help, but I was just losing it. 

With baby #3, I have been thinking from the very beginning that I have to have a c-section again... because that's just what you do after you've had two.  When I went to my first doctor's appointment and we were talking about the past two, he said to me, "Are we thinking c-section then again?" I was taken back a little and said, "I've been thinking c-section because I thought I had to?" And he said "Well if you were in tears right now telling me you wanted to do it vaginally, we'd talk about it." I didn't think much more of it and continued with my "have to have another c-section" thinking until about a week ago. 

A couple of months ago I made the mistake of watching my first c-section on YouTube. Don't do it. Don't do it!!!!  I was bawling and it majorly freaked me out.  I think in my mind I just pictured a clean little surgery with easy cuts, minimal bleeding and.... who knows. I just didn't picture it like it truly is.  

Also, in St. George with all the walking and activities we were doing, I was experiencing a LOT of contractions. Most taking my breath away and getting one every 10 minutes or so for a couple hours (still nothing serious, just braxton hicks) but more than I'd had before.  This got me thinking... do I really have to do another c-section??  So I started researching it. And here were a couple of interesting things I found: 

"If you had a previous cesarean, the risk of uterine rupture in a vaginal delivery is .2 to 1.5%, which is approximately 1 chance in 500."
Source here

"If you do not have a clear and compelling need for a cesarean in the present pregnancy, having a VBAC rather than a repeat c-section is likely to be: safer for you in this pregnancy and far safer for you and your babies in any future pregnancies."
Source here.


Basically, in my mind: 

C-section
Pros: I know what to expect, no uterine-rupture risk, it's scheduled 
 Cons: anxiety, painful longer recovery, always worried about the look of the scar w/new doc, not birth experience

 VBAC 
Pros: Even if tear - faster recovery, get to experience "birth" not surgery 
Cons: low, but still risk of uterine-rupture, could tear

I have an appointment on Tuesday and will be getting my doctor's opinion. But what it comes down to to me is that if the only risk with a VBAC is uterine rupture, that's probably the same chance as something going wrong with surgery during a c-section. So if the risk levels are the same, why not choose VBAC? And if we could at least see if my body will go into labor on its own before the due date and set a time that if I haven't, then we will do c-section then I will at least know I tried.  And if I do go into labor and everything goes smoothly--HOORAY, I did it! And if things don't go smoothly and we have to do an emergency c-section, well that would be fine because I've been there, done that.  

This is a big deal to me right now and a wrestle in my mind. Lots of prayer and hopefully I'll get some inspiration and answers this week with the doctor.  

I know that bottom line is that it doesn't matter how I get the baby here, as long as it's healthy.  I want to do what's best for the baby. But I would just like to think about the possibility of experiencing a vaginal birth, as it was meant to be.  I feel like I could do it! I feel like there is a trend with c-sections (and research to prove the increase) and being induced is part of the problem.  Obviously, there are reasons to be induced, and c-sections are a blessing (as Alex and I would have died in pioneer days with placenta previa). But due dates are not a SET date and we get too impatient. I think it's also easier for doctors to do scheduled c-sections (they probably make more too?)  And for some people, c-sections are great and they love them - I have a hard time with them.  I would like the option. I think it would be a more sweet and tender delivery to have the experience of vaginal rather than in a sterile operating room, strapped to a table and I get to hold the baby an hour later. 

In the end, I don't think I will be making the decision: vbac or c-section. I think it will be a decision of 'Should we TRY for a VBAC and see how it goes? And if it doesn't go well, then we do a c-section…. '
We shall see! All will work out :) 

7 comments:

Lindsey said...

Girl, I am with you! I wanted a vaginal birth SO BAD with Luc but I was 8 days overdue and my dr insisted on inducing me {still upset about that one, in the beginning of my pregnancy she told me i could go up to 14 days over. and then at the end she pulls this whole 'hospital policy' thing on me and set the induction date 6 days sooner than i wanted} and after 30 hours of pitocin, no food, no epidural, and three hours of pushing {i got to a ten! he just wouldn't move those last few inches down and out. so frustrating!} i had a c-section. My recovery was rough too because i was EXHAUSTED and sore EVERYWHERE {as i'm sure you know}. Ever since then i've been hoping for a VBAC on the next one. i totally think it's better to try because if it succeeds, it IS better for you and baby. and if it doesn't succeed, you'll be at the hospital where that can do a c-section immediately and it will probably end up just fine. The risks seem the same to me, so i'm choosing to try, whenever my next turn comes. But it's a personal choice and whatever you choose will be best for YOU.
Good luck deciding, and i'll send lots of good birthing vides your way :) Lets hope this baby cooperates!

Karen said...

That sounds really tough. I've never been pregnant, but I've read a bunch about it, and would also hope for a vaginal birth if at all possible. If you do have to have a c-section, you could find out more about having a gentle c-section (which I think is a new-ish thing) where they create a more calm environment (dim lights, music of your choice) and let you do skin-to-skin contact right away. More info here: http://www.womenandinfants.org/havingababy/All-You-Want.cfm You also might like the podcast "The Longest Shortest Time". It's really great stories about surprising struggles in early parenthood, and I think they've started a fb community that might help you. Good luck! I can't wait to see pictures of your new babe!

Racher said...

Camille, I am excited for you about this research you are doing! If you are interested, I can put you in touch with several moms who have vbac-ed after repeat cesareans (one after 3). Whatever you decide, I'm happy you are doing the work to make an informed decision--I respect that every mom gets to choose what's right for every baby, but I do feel bad when women aren't given all the options, and it's great to know that even if you decide on another Cesarean birth it's not because you thought there was no other choice. Good for you! Maybe check out the ican network (http://www.ican-online.org/) if you haven't already! And if you'd like to talk to the women I mentioned, my email is mrsjstrange@gmail.com or you can pm me on facebook! Lots of luck to you and wishes for a comfortable last few weeks!

Todd and Mallory said...

I am a total supporter that you need to do what feels best to you. I honestly don't think I need 40 weeks to make a baby. Both of my babies came early and good size (one big...almost too big). So with #2 I begged to be induced early to avoid a tear. Thankfully she decided on her own to come three weeks early. My point is that you should follow your gut. If it tells you that you should try and your doctor is willing then I don't see a problem.

Tracee said...

You should totally try for vaginal if your Dr gives you the all clear. It's what you want and you already know the risks and what would happen if labor doesn't progress and youre prepared for that. And your lady parts will find their way back to mostly normal ha ha. I don't have any experience with c sections but I loved the experience of vaginal birth, and if you want that, I'd say go for it! You're strong! And I'd wager your uterus is too!

Tracee said...
This comment has been removed by the author.
Claire Hawkes said...

I totally understand! I'm so thankful for my c-section because Liv wouldn't be here without it, but it was such a terrible experience and so different from what I prepared for. For a long time, I would get emotional when I read anyone's birth stories where they got to hold their newborn on their chest. I feel better about it now but I still hope to experience a normal birth someday!
If you want support, the ICAN community in your area is great. The coordinator is named Marcie Hunter. I don't plan on being pregnant anytime soon but they have a bunch of info about hospitals, doctors, midwives, and doulas. If it turns out to be better to have a c-section, some hospitals in Utah do gentile c-sections.
Good luck, I hope everything goes better this time around even if you don't have a regular birth!