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I have had one vaginal birth and 2 C-sections. I have having another C-section on Dec 15th with my first TR baby. I am also hoping to have more after this baby, altough I am 40! We will just see what God has planned for us. That being said, there are risks involved with vbac that for me out weight C-section.
Despite limitations of the best available research, the following conclusions seem clear:
Scar giving way: The scar is more likely to give way during a VBAC labor than in a repeat c-section; for most women (exceptions noted below), the added risk of the scar giving way is about 27 in every 10,000 VBAC labors. In other words, nearly 400 women would need to experience the risks involved with repeat c-section to prevent one uterine rupture during a VBAC labor. Death of baby: While the scar giving way poses a threat to the baby, the added risk that the baby will die from a problem with the scar during a VBAC labor, compared with women planning repeat c-sections, is about 1.4 in every 10,000 VBAC labors. In other words, over 7100 women would need to experience the risks involved with repeat c-sections to prevent the death of 1 baby due to uterine rupture. Hysterectomy in mother: If the scar gives way, some women have a hysterectomy (removal of the uterus). The added risk of needing a hysterectomy from this cause is about 3.4 in every 10,000 VBAC labors, when compared with women planning repeat c-sections. However, considering risk for hysterectomy from all causes, women who plan a VBAC are not more likely to experience an unplanned hysterectomy than women planning repeat c-section.
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As far as the rule being "ridiculous" I think quite simply the rule is err'ing on the side of caution. If it saves one life or reduces one risk of a uterine rupture - which is life-threatening for many reasons - then while it's a complete PITA for most healthy ladies then it's worthwhile.
For all the negativity most people have about health insurance companies and hospitals - it's speaks volumes that most are willing to pay the additional expenses for sections. In the day of malpractice and high-tech medical advances, I think the fact this "rule" is in place says they still believe the risk is significant enough to take what they believe is the safer (albet more difficult) route.
Andrea - Best of luck to you again. I hope everything goes beautifully for you, and whatever way you deliver allows you to continue to have more children!
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Andrea - I live near a pretty large research hospital (University of Rochester Medical Center) which is staffed by multiple doctors and surgeons and residents all hours and they will not allow VBAC unless you came in like 10 CM dilated with the babies head hanging out!! Not kidding!
I had 4 c-sections and am hoping to have another (baby). When I had my first ones even up to #4 the encouraged VBAC and really pushed it but now 10 years later it is just easier I think to do the c-section. I think the c-section was a big reason I always got my body back in a couple days so its not so bad. I am hoping to just be awake this time - I had general before.
Good Luck! Meridith PS congrats on the pregnancy!!
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Andrea - I was an attempted VBAC gal with my second child. My first child was a c-section after 24 hours of labor and no progress as far as dilation/effacement. I was/am healthy, uncomplicated pregnancies and good prenatal care.
Like you - my insurance wouldn't even allow an attempt at VBAC with Carly, so I had little to no choice in the matter.
Personally - for your own health - I wouldn't even attempt the delivery in a birthing center. Way too risky, although I'm sure everything would be fine. There is always a small chance of rupture due to the thinning of your uterine wall being cut. As times you can "pull apart" in small places as you near the end of your pregnancy.
I know from your posts your a healthy and young woman, with uncomplicated pregnanies and with other children at home the recovery from a section is much more difficult. I too have had minor complications (infected incision with the first, healed around a staple on #2) and dreaded the recovery.
I understand your strong desire for more children, and I hope that everything looks beautiful in there for future pregnancies. I know many ladies have multiple sections with no issues. I was one of the "don't have more" ladies and it didn't bother me simply because I felt we were complete. I would have felt terrible if we were still growing our family.
Best of luck to you. As much as I hate to be the downer - I would probably tell you that section is the eventuality of your journey, but I hope it doesn't have to be!
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As a Midwife in training, I will be allowing VBAC homebirths. The danger for placental abruption comes more from labor augmentations than from the actual birth. This means ALL labor augmentation! Go to the library read a few books by Ina May GAskin. Repeat C-sections can be more dangerious than a VBAC.
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I am planning a vbac. My Dr said that they will allow it. She said that in order for the hospitals to allow it they need a Dr there 24/7 to do the emergency c-section if it is needed. Most civillian hospitals dont have a Dr there all the time. They come and check in and go. I guess this is the lucky thing about delivering at a military hospital because they do have a couple of Drs there 24/7. They just run things a little different than other hospitals.
I told myself that I was going to have this baby vbac. I have had 3 vaginal deliveries and 1 c-section for twins. If they told me that I couldnt do it then I would wait as long as possable before I went in hoping that once I got there I was too far and would refuse a c-section.
I will say that I wouldnt feel ok with going to a birthing center for my vbac. I would hate myself if I lost the baby because we couldnt get the c-section fast enough but that is also why if you do it at a hospital then you want a Dr there all the time. If there is a problem you dont want to wait for the Dr to get there. Good luck I would check with the hospital and find out exactly why they dont allow it. Is it the Drs being there or how many c-sections you have had? Some things you can try to work with and some you cant.
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first baby c-sec. attempted vbac, but cord around neck and the baby's heart rate was lost for too long in between the contract which caused a second c-sec. here in florida, if you have 2 c-sec, the hospitals will not allow vbac no matter what. they don't want the liability and the chances of rupturing uterus.
posted
I know I haven't had a baby in 13 years, but that policy is rediculous. It seems to me that a VBAC should absolutely be at the hospital with a doc in attendance, not at a center 7 min away.....are these policies made by 80 year old men? Isn't that what hospitals are for....medical emergencies? If we knew everything was going to go smoothly, we would just do it at home, or in the fields or rice patties and go right back to work. If you went early with your two vaginal births, then maybe set your c-section for 39 weeks, and then hopefully God will see that you will go naturally before then. They aren't going to stop it if you are 6-8 cm and force you to have a c-section are they? Of course, it wouldn't suprise me if they did - thinking that was "less of an insurance risk"...Good luck, and I hope it works out the way you want.
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Andrea....my first baby was a c-section(she was breech)....my second baby(7lbs 3.5 oz) was a v-bac. I had no complications. Unfortunatly they have changed the laws around here as well so my third child was born via c-section. The baby I'm carrying now will also be a c-section. I would much rather deliver vaginally again...no recovery time! Good luck on your decision...I guess there is a small risk with everything....I did have my v-bac in the hospital so if anything went wrong I was right there. Michelle
Okie dokie..so now the fun part. How to deliver. I fully realize this is all individual, but that's exactly what I'm looking for.
I'd like to hear from ladies who either had a VBAC, attempted a VBAC, or seriously weighed the options. I'll list my "specs" (LOL!) to see what similarities our stories have.
I had 2 vaginal births first. First was 6lbs 10 oz, and second was 8lbs 10 oz. Both were fairly quick labors and uncomplicated deliveries.
My third baby was transverse with the cord around her neck, so I had a planned c-section once that was discovered. We then moved to an area where VBAC's are not allowed no matter what the circumstance, and I had another baby so I had another planned section..what a waste!
Now I'm pregnant again and have zero reason to "need" a section, other than I've had them before. It's clear I can birth babies, and nice sized babies at that, with my 2nd being pretty big.
The only problem is, I have to have a VBAC at a birth center with no doctor in attendance. The center is about 7 min from the hospital. I don't anticipate any problems, (my OB said it's a shame because I'm and excellent candidate and he'd do it if it weren't for hospital ins policy) but the minute chance of risk is catastrophic..thus leaving my children likely without their mother and sibling.
So, for now, I'm planning c-section against my will, LOL! I'm not looking forward to the unnecessary (for me) recovery and the potential bad infection I had post partum last time.
Oh, and the extra bit of info is that I am praying for as many children as God blesses us with..being that I'm 31, that could mean this one, or many more...
My doc said I had zero scar tissue issues with my 2nd section, but that he can only tell when he's in there how it looks for next time. I know many women who have had more than 5 c-sections, but I would have a hard time with "don't have anymore".
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