VBAC vs repeat C... again... sorry

Hello all...

I know this has really been discussed on here several times recently
-- VBAC vs. repeat C-section. Thanks to all who have helped me up
until this point. I have to make a decision in about 8 weeks as to
what I am going to do.

I joined the ICAN list, but quite frankly, I didn't feel like I
connected with those people. My c-section was necessary. I am not
angry that I had one. I don't feel violated because I had a
c-section. I can understand if someone had a c-section that turned
out to be unnecessary that they might feel angry or violated.

My hospital had at first seemed very willing to help me in any way,
but they are throwing out more and more restrictions as it gets closer
to the time of the birth. They don't seem as helpful anymore.

I was wondering if there are some resources online that I should be
reading. Please no medical studies. I have read those until my head
hurts. I know the risks. I am more looking for personal experiences
or people talking about VBAC or c-section. Maybe a how to on
c-section and VBAC. That sort of the thing.

Any help would be appreciated! TIA!

--
Daye
Momma to Jayan
"Boy" EDD 11 Jan 2004
See Jayan: http://jayan.topcities.com/

On Tue, 21 Oct 2003 20:54:00 -0500, Nan wrote:

But I'm wondering, what type of restrictions is your hospital wanting
to impose?

Basically, I have to go into birth naturally before my due date. My
baby has to progress *to their standards* -- not sure what that is,
but it probably ain't the same as mine. I will be monitored pretty
heavily. If these are not met, c-section.

So the deck is pretty stacked against me anyway.

--
Daye
Momma to Jayan
"Boy" EDD 11 Jan 2004
See Jayan: http://jayan.topcities.com/

Daye wrote:


I was wondering if there are some resources online that I should be
reading. Please no medical studies. I have read those until my head
hurts. I know the risks. I am more looking for personal experiences
or people talking about VBAC or c-section. Maybe a how to on
c-section and VBAC. That sort of the thing.


Aside from the medical risks and the emotional
hurdles (not meaning to downplay either), I would imagine
that a successful VBAC is no different from any other vaginal
birth. How much of this is that your head says you ought
to be considering a VBAC, but your gut is more comfortable
with the devil you already know? It seems to me that for
you to have a VBAC, there has to be a part of you that
*wants* a vaginal birth, not just a part that thinks you
*ought* to want a vaginal birth. You've been struggling
with this issue for a long time now, and I certainly
understand that it's a difficult issue to wrestle with,
but really, what are you looking for that would incline
you towards a VBAC?

Ultimately, for you to choose a
VBAC, you have to perceive that there is some benefit
to it that outweighs the disadvantages you perceive.
I guess I've never heard you say anything that made
me believe that you wanted a vaginal birth other than
a sense that *maybe* it's the lower risk thing to do
and *maybe* you'd be missing out on something good if
you didn't. Set against that, you have a lot of worries
about labor getting out of control or something bad
happening. I keep getting the vibe that if you chose
to try a VBAC, you'd go into it white-knuckled. Whether
that's rational or not is a bit meaningless at this
point. If you still feel that way after all the research
you've done, there might not be a way to make you
comfortable with choosing a VBAC. If you can't be
relatively comfortable with the decision, it's hard to
see how it would turn out to be a good experience. It
seems like you'd almost have to be ambushed by a fabulous
vaginal birth experience against your will and all
expectations ;-) Sometimes these decisions just aren't
as rational and clinical as we'd like them to be. If
your emotional reality is simply that you're not where
you'd need to be for a VBAC, then maybe the thing to do
is recognize that and plan accordingly. Or, if that
thought is abhorrent to you, then maybe you need to
commit to the idea of a VBAC.
At some point, you need to stop torturing yourself!
And, of course, you can always change your mind up until the
very point that you head into the OR or are about to push
out a baby if you decide you don't like your decision. I
know the hospital folk will try to get you to make a
decision and will cover their butts by explaining all
the ways that they might not be able to accommodate
what you want when you want it, but truth be told,
if you're willing to put your foot down you will very
likely get whatever you want reasonably close to when
you want it. They're just not going to say you will
because then you'll hold them to it.

Best wishes,
Ericka

On Wed, 22 Oct 2003 11:35:38 +1000, Daye wrote:

Hello all...

I know this has really been discussed on here several times recently
-- VBAC vs. repeat C-section. Thanks to all who have helped me up
until this point. I have to make a decision in about 8 weeks as to
what I am going to do.

I joined the ICAN list, but quite frankly, I didn't feel like I
connected with those people. My c-section was necessary. I am not
angry that I had one. I don't feel violated because I had a
c-section. I can understand if someone had a c-section that turned
out to be unnecessary that they might feel angry or violated.

My hospital had at first seemed very willing to help me in any way,
but they are throwing out more and more restrictions as it gets closer
to the time of the birth. They don't seem as helpful anymore.

I was wondering if there are some resources online that I should be
reading. Please no medical studies. I have read those until my head
hurts. I know the risks. I am more looking for personal experiences
or people talking about VBAC or c-section. Maybe a how to on
c-section and VBAC. That sort of the thing.

Any help would be appreciated! TIA!

there are tonnes of stuff out there that you could read... but you
probably already read most of it if you've been listening to what came
thru your mailbox on the ICAN list.

this is a lovely site (has graphic c/s pics- warning)
http://www.pattiramos.com/birthmemories.html

going thru my bookkmarks;
http://www.vbac.org.uk/ is great

http://www.victoriousbirth.com/ has some stuff


I have more, but I guess that it's not really a matter of persuading
you. I have abstracts at hand about risks of c/s that to me far
outweigh any risks of VBAC, but you said no studies.

The only other thing I'll say is that recovery from a repeat c/s was
SO HARD on a close friend of mine that she now *wants* a VBAC for the
baby she is currently carrying. Scar + overhang issues; surgical
recovery issues while trying to parent a toddler. I wouldn't wish
that on you.

My own VBAC was the happiest, most astonishing experience of my life-
I would wish that on you :-).
http://users.bigpond.com/hope.nesmit...tarabirth.html

You gotta do what you're comfortable with though.

I also realise that you can decline any intervention or test (you
mention restrictions and don't sound happy about them).

sorry this is terse I am nak. Hope all goes well for you.

Hope

--
Riley 1993 c/s
Tara 2002 HBAC
proudly distributing Mayawrap Baby Slings Down Under
http://www.babyslings-australia.com

..

The only other thing I'll say is that recovery from a repeat c/s was
SO HARD on a close friend of mine that she now *wants* a VBAC for the
baby she is currently carrying. Scar + overhang issues; surgical
recovery issues while trying to parent a toddler. I wouldn't wish
that on you.
Hope


Well that's a total YMMV thing. Even with Lewis' horrendous birth, the
physical recovery was the same as the other 2 c-sections - easy. I don't
get the big deal about already having a toddler either. Plenty of people do
tough things while they have kids. Do you think no mothers have any other
kind of surgery - even elective surgery? Of course they do and everyone
gets through it just fine.

"Ericka Kammerer" wrote in message
...
Aside from the medical risks and the emotional
hurdles (not meaning to downplay either), I would imagine
that a successful VBAC is no different from any other vaginal
birth.

To be fair, I'm not sure this is entirely true. Mechanically, of course,
they're probably no different from one another. But certainly for those
patients who really *wanted* a vaginal birth, having their first successful
one is probably a more significant event from an emotional POV than the
vaginal births of most other women. So while there may not be many
functional difference, I'll bet for most successful VBACers, there's an even
higher degree of satisfaction and empowerment in their birth experiences
than for the vast majority of either primiparas or multiparas who've had
normal vaginal deliveries.
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [19mo] mom)

This week's special at the English Language Butcher Shop:
"Use repeatedly for severe damage." -- Directions on shampoo bottle

Daddy: You're up with the chickens this morning.
Aurora: No, I'm up with my dolls!

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman

"Daye" wrote in message
...
On Tue, 21 Oct 2003 20:54:00 -0500, Nan wrote:
But I'm wondering, what type of restrictions is your hospital wanting
to impose?

Basically, I have to go into birth naturally before my due date. My
baby has to progress *to their standards* -- not sure what that is,
but it probably ain't the same as mine. I will be monitored pretty
heavily. If these are not met, c-section.

So the deck is pretty stacked against me anyway.

In all honesty, I don't get the impression that your caregivers are terribly
supportive of any attempt on your part to VBAC. Constant monitoring *is*
important in a VBAC given the higher risk of rupture, but that's the only
part of the equation as you've stated it that makes sense to me. Given their
expectations vis-a-vis labor onset and progress (which are neither rational
nor medically justifiable, BTW), I think it's reasonable to fear that even
if you choose a VBAC, you'll wind up having a c-section anyway. Have you
asked your caregivers how many of their patients have had successful VBACs?

Supposing, just for a moment, that the restrictions regarding labor onset
and progress were removed, how would you then feel about choosing a VBAC?
Just as importantly, how did you feel about and approach vaginal birth in
your first pregnancy? How did you prepare for labor and birth and what sort
of birth did you plan for (i.e., did you think you'd want an epidural or
other pain relief medications or that you'd prefer an unmedicated birth?)

Obviously, all of those plans were derailed, but I wonder if a factor in how
you're approaching this decision isn't related to how you felt about labor
before your first baby was born. And I think that could be true regardless
of what type of birth you were hoping for then. You might suppose that I
mean if you were lukewarm about the idea of giving birth and wanting pain
meds as soon as possible once in labor, you'd be more likely to want an
ERCS, but I don't think that's necessarily the case. I can see equally that
having prepared for and really wanted an unmedicated labor and birth and
then seeing your plans go up in smoke might well make you even more wary of
having your hopes crushed a second time.

I get the impression that what is holding you back from choosing a VBAC is
primarily the fear that you'll just have another c-section anyway, perhaps
after a long and difficult labor (although, with the progress requirements
your caregivers are placing on you, I can't imagine it would be all *that*
long!). I can understand and appreciate that fear. At the same time,
however, it seems counter-intuitive to me to choose a c-section because you
fear winding up with one! The only way that makes sense is if you view the
c-section after attempting a VBAC as meaning you've failed in some way
and/or as evidence that the decision to try the VBAC was flawed in the first
place. I don't think either is true for a VBACer than for a woman attempting
*any* vaginal birth, though.

Think of Andrea, who wound up with her first c-section after ten vaginal
births. Did she fail in some way? Was her choice to try a vaginal birth for
the 10th time a mistake? Of course not! Nearly a quarter of women (in the
US, at least) wind up with a c-section after trying to give birth vaginally,
whether before or after a previous c-section. Plenty of them are "managed"
straight into those c-sections by their caregivers, but the fact that they
wound up having them doesn't mean either that they "failed" at giving birth
or that they shouldn't have bothered trying a vaginal birth in the first
place.

Obviously, if you find the idea of c-section after a trial of labor to be
worse than the idea of an elective c-section, then choosing an elective
c-section certainly makes a great deal of sense. There's certainly a fairly
high likelihood of that happening; I have no idea what the c-section stats
in Australia are, but I'll be they're closer to 1 in 5 women than 1 in 10.
VBAC or not, that's a pretty high risk of that outcome occurring. At the
same time, however, I can't *imagine* choosing an elective c-section to
avoid that outcome if I'd never had a c-section before, and the risk of that
outcome really isn't significantly greater (from what I've read) for VBAC
patients than for women who've never had a baby before. IOW, the risk of
c-section after trial of labor in a VBAC patient is roughly equivalent to
what you would have faced had you gone into labor with your first. Is that
amount of risk really high enough to drive you to choose ERCS? (That's not a
rhetorical question, but a real one. I have no idea what constitutes
sufficient risk to you.)

Anyway, like Ericka, I think if you're going to go into a VBAC with white
knuckles and anxiety, it doesn't matter very much whether that's rational or
whether most women who have successful VBACs are thrilled with their birth
experiences or whether most women who wind up with c-sections after TOL wish
they'd just chosen the ERCS in the first place or whether 99% of your
caregivers' VBAC patients manage to have vaginal births. If you really
*want* a vaginal birth, choose a VBAC. But if you're really not sure it's
worth it, then by all means, choose the ERCS and don't overanalyze that
decision because no amount of analysis is going to make objective sense of
what's ultimately an utterly subjective and emotional choice.

Subjective, emotional choices are okay! After all, we make many of the most
life-altering decisions, such as whom to marry, on almost entirely
subjective, emotional grounds.
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [19mo] mom)

This week's special at the English Language Butcher Shop:
"Use repeatedly for severe damage." -- Directions on shampoo bottle

Daddy: You're up with the chickens this morning.
Aurora: No, I'm up with my dolls!

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman

"Elfanie" wrote in message
...
On Wed, 22 Oct 2003 09:19:14 -0700, "Circe" wrote:
Constant monitoring *is*
important in a VBAC given the higher risk of rupture,

This is only really true if you're anesthetised....
because in an unmedicated mom, anything that shows up on a monitor is
one of the LAST signs you'd have.

(I had a wonderful VBAC homebirth just 13.5 months
ago...restrictions/monitoring/etc was no different for me as a VBAC.
But I also was not anesthetised...which does make a difference.)

Thanks for the clarification, Stephanie. Makes sense to me that, without
anesthesia, you'd *feel* the rupture well before it appeared on the monitor.

hat said, I wonder if it would be immediately recognizable to most mothers
as something *wrong* as opposed to just unusually painful contractions.
Maybe it would be incredibly obvious, but having never had a rupture, I
wouldn't know! I'd think it would be relatively easy for an experienced
midwife to pick up on the difference, but in a hospital setting, I'd be
concerned that the laboring mother wouldn't be sufficiently attended by
experienced personnel to ensure that a rupture was identified before the
last minute. IOW, hospitals tend to rely so much on constant monitoring that
women tend to be left alone with relatively inexperienced labor partners
(husbands, friends, etc.), so a laboring mother might well get into trouble
and without the monitor, the hospital staff would have no way of knowing
there was trouble until *after* the last minute.
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [19mo] mom)

This week's special at the English Language Butcher Shop:
"Use repeatedly for severe damage." -- Directions on shampoo bottle

Daddy: You're up with the chickens this morning.
Aurora: No, I'm up with my dolls!

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman

Daye wrote in message . ..

I joined the ICAN list, but quite frankly, I didn't feel like I
connected with those people. My c-section was necessary. I am not
angry that I had one. I don't feel violated because I had a
c-section. I can understand if someone had a c-section that turned
out to be unnecessary that they might feel angry or violated.

IKWYM. I'm okay with my history of medically necessary c-section.

My hospital had at first seemed very willing to help me in any way,
but they are throwing out more and more restrictions as it gets closer
to the time of the birth. They don't seem as helpful anymore.

That really sucks. I was hoping for better for you.

I was wondering if there are some resources online that I should be
reading. Please no medical studies. I have read those until my head
hurts. I know the risks. I am more looking for personal experiences
or people talking about VBAC or c-section. Maybe a how to on
c-section and VBAC. That sort of the thing.

Any help would be appreciated! TIA!

The only thing that popped into my head was that you might like to
hear what I'm thinking about the same situation.

I'm not angry and I don't feel violated because my section was
medically necessary. If I do the whole pregnancy thing again, though,
I am going to be hell on wheels trying to avoid an unnecessary
c-section. I *would* be angry if I was managed into a c-section by
hospital protocols on rate of labor progress even though I was making
progress on my own and had no signs of pre-eclampsia and the baby was
fine. (I suspect I would be check myself out against medical advice
angry.) I would be angry if my OB wanted to do a ERCS even if the
scar tissue was thick on ultrasound. I would be angry if anyone said
"prostaglandin". Essentially, I will be angry if I am cut for no
particular reason when VBACs are the standard of care. I do not want
substandard care; I wanted a homebirth last time and if a second
pregnancy ends in a successful VBAC I may go for a third HBAC. I
wanted that homebirth because in the vast majority of cases a
homebirth results in superior care.

Mind you, in a case of repeat severe pre-eclampsia, I have no argument
with ERCS whatsoever. I healed very quickly last time. The nurses
said I wasn't acting "magged out", that I was up and about much more
quickly than the other c-section moms on the floor, none of whom were
on IV mag sulfate, and that it was probably because I'd been taking
such good care of myself during pregnancy. (I told them that my
nutrition plan for my next pregnancy was marijuana and Pixie Stix
since all my careful attention to diet and exercise had ended the way
it had.)

I would ask: Are you okay with getting a c-section even if the only
reason for the c-section is that you've had one before? If you are,
then there's no reason not to schedule an ERCS if that's how you're
most comfortable. If you're not, then go for the VBAC.

--
C, mama to one year old nursling

In article ,
says...
I am more looking for personal experiences
or people talking about VBAC or c-section. Maybe a how to on
c-section and VBAC. That sort of the thing.

I've had a vacuum extraction vaginal delivery with episiotomy, an
emergency c-section, an unscheduled c-section after a failed VBAC
attempt, and a successful VBA2C. You know, because I like variety.


I think the biggest thing that caused the success of my last delivery
was no epidurals and no induction, other than them rupturing my
membranes. This did have a drawback of no effective painkillers,
which I could have lived without, but my doctor was on vacation so I
was delivered by the other doctor in the practice, and it happened so
fast that they didn't have time to get Fetanyl from the pharmacy
anyway, which my doctor would have tried to use. I was also adamant
beforehand about people doing their best to leave me alone, and my
doctor was very supportive of my VBAC attempt, and was actually
fighting the hospital board for his two VBAC patients to finish that
way, since the hospital was adamant about changing it's policy to "no
VBACs, ever."

I can give you more specifics if you like them, but those are the
things I really felt made the experience work.

Michelle
Flutist

--
In my heart. By my side.
Never apart. AP with Pride!
Katrina Marie (10/19/96)
Xander Ryan (09/22/98 - 02/23/99)
Gareth Xander (07/17/00) Zachary Mitchell
Theona Alexis (06/03/03) (01/12/94, fostered 09/05/01 - 07/23/03)