Thursday, May 28, 2015

thoughts on VBAC vs. repeat cesarean

During one of my first doctor's appointments I talked to my doctor about my options for having this baby: VBAC [vaginal birth after cesarean] or repeat c-section. With Emerson I was planning on having a regular birth, but that all changed very quickly when the doctor decided they needed to do a c-section right away. I was fine with that decision, whatever was best for the baby was what we were going to do. But now that I have had a c-section, I now have to choose between having another one with this baby or having a VBAC. A choice I really wish I didn't have to make. 

My doctor talked about both options with me, told me pros and cons for both, and what risk factors would be involved for both, the biggest risk for having a VBAC being uterine rupture. Although, according to The American Pregnancy Association, "the risk of uterine rupture in a vaginal delivery is .2 to 1.5%, which is approximately 1 change in 500." Not very high, but there is still a risk, and that's what gets me.  And if you choose to have a VBAC you are monitored closely and whisked quickly into the operating room for an emergency c-section should anything go wrong. But there is no way to tell in advance if a uterine rupture will happen.

For the past few months I have been thinking that I would for sure have a repeat c-section, I only talked to my doctor about it once and did little additional research on my own. However, as we get closer to meeting baby, I have been considering having a VBAC instead. My biggest hang up being the possibility for a uterine rupture, which can cause compilations for both baby and mama. I know what a c-section entails and what the recovery would look like, I know what it would be like to go in to the hospital and have a c-section. I have no idea what it would be like to go in and have a natural delivery, that along with the possible risk factors has me uncertain, now more than ever.

It would be so nice to be able to leave the hospital and be able to walk up and down the stairs at will, pick up Emerson whenever I want or need to, and be able to crawl in and out of bed by myself for that matter. It would be nice not to have to rely on other people for so much help. It was different when I had Emerson, because he was all I had to care for, but now, I'll have Emerson and a new baby and I know I will need help, as much as I hate to admit it or ask for it. I'm a pretty stubborn and independent person and hate having to rely on others to help me. It would also be nice to let the baby decide when he wants to come and not have to choose his birth date, though that has already been done.

However, it would also be nice to leave the hospital knowing that my baby and my body are healthy and that I made the right choice for us. I know that ultimately the decision is up to me and that I will have to do whatever I feel most comfortable with, but it's just something I'm trying to sort out and decide right now. So, have you been in this situation before? Have a close friend or sister who opted for one verses the other? What did you/they choose and why? Even if you didn't have to make this choice I'd still be curious to hear your thoughts.

Additional reading found here, here, and here.

  

6 comments:

Jessica said...

This is a tough one. And definitely a very personal decision. I know mamas who have made both choices - some for repeat c-sections and some for VBACs. I see the pros and cons foe both. Fortunately I have not had to make this decision, so I can't offer much in the way of experience with this. But I will say that I think vaginal delivery is a much easier recovery - which, as you mentioned, is definitely nice with a toddler running around! Praying that God lays the right decision for your family on your heart soon!

Courtney said...

My sil had an emergency c with her first and a super successful intervention free vbac with her second.

Something to consider is family size- you can only have so many c sections and my sil knew she wanted more than she'd be allowed.

Obviously babies sometimes dictate what you need. So maybe you won't have to make the decision ;) vaginal birth is always "ideal" because c section is major, major surgery. But if the situation arises and it is necessary, then obviously it's a wonderful wonderful option to have.

Amy said...

So many choices & decisions to make. Whichever route you have to go down, will be what's best at the time. Praying for you as you make this decision.

Laura said...

It's not an easy choice. I was grateful I didn't need a c-section, but I have many friends who have. One of my dearest had an emergency c-section with #1, and just last month had a perfect VBAC. She was monitored, and the doctors here did a great job helping her feel comfortable with her decision to at least try. She was so happy with her choice. Another friend in AZ had the same great experience. My friends who have had 2+ c-sections were always forced to by the doctor because the doctor was old-fashioned and refused to give them the option. They all regret not finding another doctor in hind sight. Praying for you as I know it's a tough decision. The great news is, either way, you'll soon have TWO sweet boys to cuddle!!!

Laura said...

It's not an easy choice. I was grateful I didn't need a c-section, but I have many friends who have. One of my dearest had an emergency c-section with #1, and just last month had a perfect VBAC. She was monitored, and the doctors here did a great job helping her feel comfortable with her decision to at least try. She was so happy with her choice. Another friend in AZ had the same great experience. My friends who have had 2+ c-sections were always forced to by the doctor because the doctor was old-fashioned and refused to give them the option. They all regret not finding another doctor in hind sight. Praying for you as I know it's a tough decision. The great news is, either way, you'll soon have TWO sweet boys to cuddle!!!

kelseylynae said...

Obviously I've never been in your shoes, so I think you have to go with your heart and then lay your reasons on top of that, if that makes sense?

My sister in law had three c-sections and loved them. They were planned, she knew exactly what to expect [after her first crazy one], and felt like the recovery was a little smoother each time. She does not regret them at all. [Actually, hearing her talk made me want to have an elective c-section!].

Personally, my first vaginal birth was a horrific recovery, but my second was much better. So I wouldn't choose a vbac JUST because of an "easier" recovery. Because I've heard horror stories [and "easy" stories] EITHER way!

I know one of your big things is that the baby comes when the baby/God chooses. If you chose to have a VBAC would they let you go in to labor naturally? That could be a factor to consider.

Like I said I've never been in your position, and whatever choice you make will be the right one...because there is no right choice :)