vbac v c-section question (long) : Cesarean Sections

Fri Oct 16, 2009 5:04 pm

Hi ladies. I'm not currently prego, but I posted on here back in February because I ended up needing a c-sec because DD was breach....I'm not prego yet and not even TTC yet, but I have been thinking a lot about the decision I will have to make at some later date when DH and I decide we are ready for number 2 and I figured you ladies would be a good sounding board. Hope you don't mind!

(I love BZ for this reason!!!!)

Anyway, as I mentioned DD was born via c-section in February because she was breach. I had a section scheduled for the beginning of March, but despite the fact that everyone was sure she would wait until the date, DD came early, so I had to have an emergency section. I didn't go through tons of labor (just minor labor for about 10 hours--until I realized I was actually in labor). My recovery went well, but a little slow because DD was born with a large ventricular septal defect (a whole between the left and right ventricals in the heart) and had to have open heart surgery at 2 weeks of age, so I got no time to rest and recooperate. None of DD's doctors have ever said that it was good that DD didn't go through a vaginal delivery, but she did go in to heart failure a lot faster and harder than anyone expected, so I am guessing that it probably was beneficial to her heart to not have to get "beat up" coming down the birth canal and do all that work to get out. We didn't know that she had this condition until after she was born despite having a fetal echo cardiogram done where they found nothing. I don't know yet if I will be considered high risk next pregnancy because of DD's condition, but I am sure they will watch the next baby's heart very closely, so they should find something if there is anything wrong and then decide on what to do based on that.

Here's my thing though, what if they don't find anything and I decide to try for a vbac (which DH has mentioned that he would prefer that I do a vbac instead of a c-section) and then they actually missed something and then find out that I should have had a c-section because a vaginal birth was too hard on the baby? The chance of the next baby having a similar condition is very low, from what I know about it, but it still scares me......

On the other hand, I also feel like that since there was no risk to me and no known risk to DD at the time of the birth that caused my section the first time, that I really should go for a vbac......but then in some ways I think that since I know what to expect with a c-section and there is less of a risk that I don't want to go the vbac route, but then I feel guilty for that.....

I know that I am being totally ahead of the game and that many of the factors of my next pregnancy will weigh in on my decision, but this has been on my mind so much lately that I just had to get it all down and see what other people who have been through c-sections thought......

Thanks for getting all the way through that!

Fri Oct 16, 2009 9:38 pm

I would never get to experience natural bith. All my babies are c/s. I can't push a kid out the old-fashion way.

I would attemp natural birth if I could. It's all with what you feel comfortable doing. C/S for me isn't easy, but that's the only way I can have kids. So I'm happy I can experience mother hood one way or another.

Sun Oct 18, 2009 1:38 am

If it were ME I would go for the VBAC. Honestly if the chances are very LOW of a second child having the same issues, and knowing you'll probably get a gazillion tests to try and see if your second child DOES have the defect chances of them Missing it is alsp very very LOW. Really there are SOOO many things that can go wrong suring child birth No matter how you deliver you are taking a risk anyway. If you can have a Natural delivery I say Go for it.

this coming from someone who can not, has not and will never even go into labor! I have had 3 scheduled c-sections and will have my 4th and final in dec.

Tue Oct 20, 2009 8:34 pm

You'll have to make the decision on your own, but I'll explain how I decided to do an elective c-section. Until about my 7th month I was still unsure as to if I would try VBAC or just do another c-section. My DD got an infection while still in the uterus. I had to have an 'urgent' c-section and didn't even experiance labor. She was taken to another hospital with a NICU that was 50 miles from me. All of this happened when we were living in Italy. It was just a miserable experiance.
When I had my first appointment with my new OB (it was at 7 months because I moved), he listened to my story. I told him all I want is to have a happy normal birth experiance. I want to reduce any risk of anything like that happening again. He recomended that I have a c-section because it was likely that I would have the same infection that made Vivian sick during this pregancy. He also made me feel like this birth would be positive experiance even though it's a c-section.
So after a lot of soul searching It came down to what would be the best and most worry free experiance for our little family. C-section was what was right for us. I'm sure that a VBAC would have gone just fine, but the c-section is what is right for me.
Best of luck in your decision.

Sun Nov 08, 2009 3:31 am

Hello. Before I put in my 2 cents, I must tell you where I am coming from.
I am preggo with #2, and my first was via emergency c-section.
I am finishing training to be a birth doula, and I finish RN school in May. I have also done lots of studying regarding pregnancy, L&D, and postpartum care because I would like to be a Certified Nursing Midwife and open a clinic here in my town.

So with that, I have to say there are 2 things you should base your decision on: how you personally feel about the c-section experience and its effect on you, baby, and family... the health risk vs benefits for both you and baby.

Planned c-sections have poorer outcomes for babies than c-sections that occur after labor has started, or a natural birth. This is because labor causes the release of endorphines in baby that stimulate breathing and the production of surfactant in baby's lungs. This helps baby's lungs open fully after birth and stay open. With planned c-sections, baby doesn't get the same amount of endorphines and they tend to have breathing problems requiring oxygen, or collapsed lungs. This is more common than popularly known.
There is a higher risk of infection and post partum complications for c-sections all around, including wound problems and increased risk for bleeding and blood clots. This goes for all major surgeries.

VBACs are very safe and healthy for baby and mommy. Even with congenital heart defects, the "stress" of labor can be beneficial and can sometimes minimize the negative effects of the disorders. Most heart failure problems do not occur until a couple weeks after birth because of the change from fetal circulation to normal circulation. A VBAC should not have effect on that particuar outcome, and should not be the cause of that kind of complication, which appears to be your worry.

My best advice to you would be to research VBAC's, planned c-sections, and take a good look at actual problems, benefits, and complications of each. Your best weapon in life is knowlege. (I suggest using peer reviewed medical sites, if using the internet, like WEBMD, instead of wikipedia or forums, which can have false information.) Once you have a base of knowlege, talk with your doctor and husband. Make sure you let your doc know that you are informed, and that you want the WHOLE facts as well as their professional opinion. I warn you that some "opinions" are based on convenience rather than true benefit. Make your decision based on a combination of your thoughts and feelings then, but not until you truly know your options and what those options mean to you and baby.

I wish you the best of luck.

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vbac v c-section question (long)