Friday, February 18, 2011

To VBAC, Or Not To VBAC? That Is The Question.

Anyone up for the debate?

(If you're a guy, you might want to back out now - words like vaginal and uterus are ahead.)

I have the choice at this point, to choose a vbac after having 2 twin c-sections. If I start to swell beyond normal human standards like I did with the twins, I might drop the idea completely. Now, here's a little background info. I had a vaginal delivery with Ella that was nothing short of fabulous, it really couldn't have gone any better. I didn't push long, my labor wasn't awful, and she was beautiful :).

Oh, and there were drugs. I'm an epi kind of girl.

Then, because the twins weren't head down, I had 2 consecutive c-sections. Our doctor thought it was to risky to try a vbac with the 2nd set of twins - I had preeclampsia, my uterus was so stretched, and so fragile...after all, I was carrying almost 16 pounds of baby, and I was measuring 50+ weeks, you know.

But now, he says he's open to giving it a go. And in all reality, it would be ideal to not have the longer recovery that comes along with major surgery. Not to mention that my little guy and I will be coming home to 5 little ladies who are just rearing to go.

I kind of feel nervous when I think of those first few days back in the saddle. I guess we can talk about that later.

I have talked to a good bloggy friend (turned IRL friend this summer) who has been super encouraging and really made me feel good about a vbac. But then you also run into people who say, "why on earth would you do that....it would be so much easier to just plan the surgery....it's so risky!"

I do selfishly want to have a vbac, but at the same time I have already been blessed with great memories of Ella's. It would just be so much easier in the end without all the stitches...pain killers...and that burning feeling in your incision.

Anyway...

So what do you guys think? What's your experience? And do you think my uterus has been through enough, maybe I should just give it a break from all the labor and go with the c-section??

Have I crossed a line here on the blog? Is this TMI? Sorry.

I trust your opinions, so give 'em to me :)!

36 comments:

Sarah Halstead said...

do it do it! ha ha! i had a vbac. it was fabulous!! anyways i will support you either way. :)

Meredith said...

You may want to check, but I believe ACOG recently released their new stance that VBAC even after two C-sections is considered, if you are a good candidate, is safer than another C. Also, if you have 4 C-sections and are pregnant again (I don't know if you plan for this to be your last or not) then the risks to that baby are significantly increased. If your doctor feels it is the safer way to go, the recovery is much nicer!

Jenn said...

No lines crossed, after all it is your blog!

My opinion (for what it's worth, I've had 2 vaginal births, one complicated, one not, zero c-sections)...

I've heard the same research as the previous commenter, that vbac2 may still be safer than c-section. Also as the commentor said, I'd be worried that they don't recommend more than 4 c-sections (and I never like the idea of limiting options when it comes to having babies!)

I'd go with what makes you feel most mentially/emotionally comfortable. After all, feeling safe & calm is also an important element to birthing.

A friend of mine recently had a vbac (after just 1 c section) and her doc had her push in an OR "just in case".

Jenn said...

No lines crossed, after all it is your blog!

My opinion (for what it's worth, I've had 2 vaginal births, one complicated, one not, zero c-sections)...

I've heard the same research as the previous commenter, that vbac2 may still be safer than c-section. Also as the commentor said, I'd be worried that they don't recommend more than 4 c-sections (and I never like the idea of limiting options when it comes to having babies!)

I'd go with what makes you feel most mentially/emotionally comfortable. After all, feeling safe & calm is also an important element to birthing.

A friend of mine recently had a vbac (after just 1 c section) and her doc had her push in an OR "just in case".

Jenn said...

No lines crossed, after all it is your blog!

My opinion (for what it's worth, I've had 2 vaginal births, one complicated, one not, zero c-sections)...

I've heard the same research as the previous commenter, that vbac2 may still be safer than c-section. Also as the commentor said, I'd be worried that they don't recommend more than 4 c-sections (and I never like the idea of limiting options when it comes to having babies!)

I'd go with what makes you feel most mentially/emotionally comfortable. After all, feeling safe & calm is also an important element to birthing.

A friend of mine recently had a vbac (after just 1 c section) and her doc had her push in an OR "just in case".

Catherine said...

I just had a c-section with my second after a fabulous vaginal delivery with my first. If we ever have a third, I'll go vbac for sure. Recovery, surgery, it's not worth it to be 'scheduled' to me. If you are a good candidate like your dr thinks, then I say go for it. Good luck!

Steph said...

I think if you've had a successful vaginal delivery previously, and your only reason for a C/S was twins before, then I say go for a vaginal delivery!

I used to work in a hospital that allowed VBACs and I saw more complications wtih C/s than I did with VBACs.....

Kim said...

Hi! I'm just finding your blog from multiples & more! We have 2 sets of twins and a singleton too and I'm really hoping for one more, so I've loved reading through this blog! Congratulations on your next little one!

I had a VBAC with the boys. The girls were a c/s due to positioning (DS1 was a vaginal birth). But the boys were both head down and it was the most amazing experience. It's not selfish at all to want a VBAC and it is usually safer than a c/s (which is major surgery no matter how you slice it!) My VBAC recovery was incredible - I was up and feeling great that day! I would definitely recommend giving it a try. Then if you end up with a c/s at least you can say you tried it and don't have any "what ifs".

I don't know if you do any hypnobabies, but they have a great VBAC script (and hypnobabies is great for birthing in general). I loved listening to them during my pregnancy.

The Beaver Bunch said...

I can't say yay or nay to the vbac b/c I was blessed enough to deliver my twins vaginally.

BUT, all 4 of my vaginal deliveries (including the twins) was an amazing experience. In fact, I often dream of being pregnant JUST so I can deliver (and have a baby too, I mean).

Having never had a csection, I can't say what I'd do. BUT, I know that there is nothing sweeter than them laying a fresh, slimy, greasy newborn on your chest.

Nothing in the whole wide world. But you already know that.

hdearth said...

Ultimately your decision. Just giving opinion since you asked. I have not had any c-sections but loved my 3 vaginal births. So I totally get where you are coming from. Just remember they are all different so it might not be as perfect as Ella's. Go into it with the mindset that it could turn c-section so you are not disappointed. If it was me I would do the v-bac and be closely monitored.

April said...

I think you should do whatever God desires, whether VBAC or not. Personally, I would not but only because of the risks involved. But it's a decision that needs to be decided by God, you and your husband and as much as I would caution you to consider the risks carefully, I can't make that decision for you, nor can anyone else. I think you are brave to even ask the question online, opening yourself up to a lot of negative comments. Praying you will choose what is best for you and that precious little boy! :)

mandbrid said...

I was able to VBAC my second set of twins (thanks to an AMAZING doctor). I can tell that my new OB is slightly hesitant to deliver this last one vaginally even after my VBAC with #2 twins....she's willing to give it a go though. I try to keep my mind open to both options.
Go with what feels best Kate. Best of luck!

Thoughts for the day said...

As a 55+ grandma my advise would be to LISTEN to your doctor, talk to your husband and see what he thinks honestly. Safe delivery for mom and baby is the main priority, it is wonderful to deliver naturally but, if there is a risk as there is in any birth, and the risk is higher because of scar tissue. I vote for C section. I am sure you have a)family and b)friends who can come help with the little girls.
I had a normal birth 36 years ago although the doctor still gave me a block which in hindsight I didn't need. Then I had a c section with my breech daughter 33 years ago. In many ways the C section was easier because I could at least 'sit'...comfortably. :o)
Ultimately the choice is between you, your husband and your doctor. What ever you decide be safe.

*Ross and Katy* said...

I say do whatever your doctor recommends :) I know a lady who went against her doctor and had an emergency c-section. However, if your doctor says you can do either at this point, either go with what you want, or ask him which would be safer for you and baby boy.

This Heavenly Life said...

I had a C-section for breech with my first, then a VBAC with my second, and...

I kind of think that to have another C would be more HARD on your uterus than to have a VBAC. Stitches in a uterus rather than natural evacuation? Definitely more invasive and more risky than a vaginal birth would be. I don't feel like the ease of scheduling is worth the recovery and dangers of C's.

So I guess I say VBAC ALL THE WAY!! It's by far the safest, healthiest option, especially if you'll have your Dr. standing by monitoring you as closely as he needs to feel safe. Have faith in that stretched uterus! It's an amazing organ, and even when stretched out time and again will still know how to do the job.

Especially with a concerned, thoughtful mama such as yourself :)

wonderchris said...

I vote VBAC, but I have zero experience in the arena. I can't imagine your doctor would give you a green light if he were the slightest bit worried. Give it some time, see how you feel, and know that you don't have to stick to any "plans". Your baby boy will arrive just as he is supposed to. :)

Kristi said...

I am a Labor and Delivery nurse. I have had 2 c-sections and no vaginal. BOTH my boys were breech!! I would have definitely tried a VBAC if I could have. I say go for it. There is a chance for uterine rupture, but it is very small. Get the epidural early so if you have to get an emergency section it is already in, and stay on the fetal monitor so they will be able to detect any problems.

Kimmy J said...

I had a c section with my first (she was breech). Then I had two successful vbacs. When I compare the two labors/recovery, I would choose a vbac hands down. But, as I did with both of them, I had an open mind and was willing to have a c-section if I had to.

But with the labor you had with your first it just sounds like a good idea.

With my first vbac, I was induced and with my second vbac I took castor oil to induce instead of the pitocin...I hated the pitocin.....but in the end pray about it, I am sure God will give you the peace for the right decision.

Oh and yes, I had A LOT of people tell me I was crazy for trying a vbac, but it's your body--you and your doctor decide.

Julia said...

I have had two vbacs, and I agree that its a much easier recovery! I'd do it again if given the choice. I hate the recovery from a c-section and the fact that I couldn't get out of bed for so long and having somebody else clean me up. I HATED that.

If you've already had one easy birth, I do try to do a vbac. I'm glad your dr is open to the idea! Yay for him!

julia said...

I don't have any first hand experience, yet, so what I have to say comes from someone who has decided to try a vbac in a couple of weeks. I have only had one c-section and I am not sure my dr. would go for it after 2, but since you have delivered vaginally before that might change things. I think it is definitely worth a try, though, if your dr is willing! At my last prenatal visit I asked lots of what-if questions concerning a vbac and came to the conclusion that they have just gotten a bad rap. Yes, there are serious complications that are possible. Complications that you wouldn't have to worry about with a c-section, but let's face it, there are different serious complications possible with c-sections. Based on what I have learned, those complications with a vbac are few and far between and can be managed with attentive medical care. I am a little apprehensive only because I have never delivered vaginally before (I have no idea what to expect) but not because of the potential complications. I trust my doctor to do everything necessary to keep me and baby boy safe, even if that means changing plans and doing a c-section. If I didn't, I would be using a different doctor. I am sure you feel the same way, so I would trust your doctor. If he is totally on board then give it a try.

Sandra said...

Is there such a thing as crossing a line on a blog? I wasn't aware of that :)
I don't know what to tell you. I had vaginal births and loved it. But honestly, at the end of the labours, after that kid was pushed out,and I was still on the delivery table, I would say, "A Csection would have been so much better...pant pant...groan groan..."

susan said...

I have had four vbacs

{had to have a c/s with my first after she was a breech presentation..... and my doc would NOT be talked into giving it a go!!}

...... GO for it. I'd hate to have another c/section... but of course if it's medically warranted you should absolutely follow your doctor's advice.

The recovery is just so much faster with a normal vaginal delivery. Good Luck.....

Healthy Mummy, Healthy Child

XXXXXXX

jenny said...

Of course, you know I only had c-sections, so don't have much info for ya. But, I would say you've gotten some good helpful comments promoting both avenues....so I would take those into consideration, continue to get doc's opinion, and see what the Lord gives you peace about. I'm sure He'll show you the best choice for your little babe.

Mari said...

Kristi- I can't beleive that as an L&D nurse you would recommend that a VBAC mom get an epidural right away jus tin case she needs a cesarean! That's ridiculous. On the contrary, I would say that if you want to VBAC, avoid the epidural until your active labour is well established. If there really was a truely emergent need for cesarean, they could always use general anethesia.

Jaded said...

The main reason I wanted a VBAC was because of the recovery. I hated the feeling the my insides would fall out at any given moment. I only have 2 kids, and I was worried about how I would be able to go up and down the steps with the toddler and baby. I was terrified of not having any help.

When I started researching VBAC's I realized that it meant a lot more to me to deliver vaginally than I originally thought. I am so glad I did.

Mari said...

I also can't believe all the women saying "listen to your doctor" as their onl advice! Of course a doctor's opinion should be taken into consideration, but they are also only human and have their own biases. They can never be completely objective and you need to haev a say in your own care as well.
If there is no medical need for a cesarean, then I would at least consider the option of VBAC. With the July 2010 ACOG practice bulletin, it seems you are an ideal VBAC candidate and your chances of success are high. Yes there are some small risks of rupture, but what most people don't realize is that the rate of rupture in a woman who has NEVER had a cesarean are statistically comparable.
I encourage you to do your research and trust your gut (and God, if you are religious) and know that you will be lead in the right direction. Not all doctors and midwives are supportive of VBAC despite the evidence that it is a relatively safe procedure, so please don't just listen to the doctor.

MeesterMama said...

VBAC!! I have had a VBA2C and a VBA2C after that. Bother were great!
www.vba2c.webs.com

MeesterMama said...

That was supposed to say and a HBA2C after that! Homebirth was awesome!

Loralee said...

I just had a vbac last May--at home. It was wonderful. Our birth care provider believed in my body. We had a backup plan in case.

I also grew to knew that I could trust my body. Reading through the literature and other women's stories helped me realize that I could trust my body to let me know if the vbac was safe or not.

As long as I didn't have pain meds, I could tell what was going on with my body and baby and if I needed to get to the hospital and something was wrong with the baby.

Have you read 'Birthing From Within'? Excellent book to read through.

Trust your body. Trust God. If something is going wrong, God and your body will let you know. That's how He designed us:)

Ami said...

I vote vba2c, but then that could be in part because that's what I'm presently fighting for. :) If your doc is supportive and saying you're a good candidate, and you are educated about your options and comfortable with the idea, then definitely go for it. There is a lot of information out there indicating that the risks of vbac in general are significantly less than the risks of another major surgery, so it seems almost like a "no-brainer" to me. (Now to convince my doctor.)

heather@it'stwinsanity said...

Don't let people make you feel selfish! After all, vaginal birth is SAFER for the baby than a c-section. A c-section carries more risks for you AND the little guy, so it's not selfish at all to want to have a VBAC. Whatever you choose, you just need to be comfortable in your decision. ((hugs))

amycath said...

Well I have to say, that after having to C/S I would love the chance to deliver VBAC. I am hoping to find a Doctor that will at least let me try. I agree that it is a very hard recovery with a C/S. And to have all those kids depending on you afterwards...recovery was hard for me with just two little men. :) Not to mention what being cut open does to your body. But I also say go with the flow. Try for it, and be open to if its not working.

Laura said...

Hey! Love your blog! All my kids have their own website and they are soo out of date...I need to catch up. I personally wouldn't do a VBAC. My Dr. won't do them anyhow. Having said that, all my deliveries were vaginal so I don't know what C/Ss are like. I surely wouldn't do it if Pitocin is in the plan since it makes the contractions a lot harder. With my first I had a placental abruption bc the pitocin made the ctx so hard...I can't imagine the stress it would put on a CS scar would be good. Just some things to think about! I think VBACs are probably judged on a case to case basis, so if your Dr. is for it, no one else's opinion matters :-)

Katie@The Baby Factory said...

I'd say DEFINITELY do it, but make sure you know the condition of your uterus as MUCH as possible.
I have a friend who wanted to have a VBAC, and discussed it with her doctor, she and the doctor decided to pray about it {a Christian doctor--yay!} for a month and then decide. When she came back, she told him that she didn't have peace about it, and the doctor said, "Oh, I'm glad you said that--I don't either"...and after delivery, the doctor said I am SO Glad the Lord was in that decision, you uterus was so thin, it never would've survived a VBAC.

wow! Good luck, lady!!

Beana said...

I have to say, go with your gut....every second of the way. My #1 was breech and the dr. offered to try to turn her but my gut (and my husband's) after prayer, said "no." I had a c/s and turns out she was wedged way up in me and the cord was around her neck so the version wouldn't have been successful, or good.

With my #2 I was determined to have a VBAC and I almost got it...but after 2+ hrs of pushing and the vacuum, my dr said it was time for a c/s and my gut said he was right. It broke my heart...but I knew it was right. Sure enough, complications arose quickly and it was a good thing i said yes to the c/s when I did.

This decision is SO personal. And you have to have 100% peace about it. Even though I had complications (read btwn the lines: rupture) I am still so glad I tried the VBAC and was able to experience labor and even pushing. I needed that, and I think God knew it. I am SO thankful he was protecting me and my daughter.

I did have a 3rd baby too...automatic c/s due to the rupture, labor started before my scheduled date, so my dr. did my c/s early--and it was actually my best c/s of all 3.

Sorry to be so long--but it's a topic I enjoy sharing my story on :)

Sarah said...

I read this post a while back and wasn't able to comment at the time (aka. my hands were full of kiddos), so I wanted to come back to it because this is something very close to my heart.

Just wanted to encourage you to go VBAC if you have any desire to, since your doctor has approved. I just had a VBAC birth with my little boy 5 weeks ago, and I am soooo glad. It was amazing, and so healing (after a bad birth experience) and just empowering too.

Also, it seems that the more c-sections you have, the more possible health problems that can come as a result, not to mention the recovery from major abdominal surgery. I would choose a natural birth and healing from that over a c-section any day!

That said, it does have to be your decision. Praying for wisdom for you and your husband as you make this decision! Can't wait to "meet" your precious boy! :-)