VBAC?
Moms View Message Board: General Discussion Archive: Archive January 2005:
VBAC?
Has anyone had one? I'm just curious about your experience, vbac vs. a repeat c-section. At first I was all for it. I still am, partially. I've been doing research, so I know the risks involved. I'm also aware the risk for complication from a repeated c-section is slightly higher than a VBAC. Anyway, I'm just looking for personal experiences if there is any. My next appointment is at the end of Feb. and I'm planning on asking my doctor a lot of questions.
I had a VBAC. I was a good candidate because the only reason I had my 1st c-section was due to ds being breech. I had a hard recovering from my c-section, so I was happy to have a VBAC. I thought it was a piece of cake. I was in labor only 4 hours and pushed maybe 2 or 3 times. That was it!! I was out of the hospital in 24 hours and feeling great.
Now, everyone is different. There are factors your doctor will need to look at to make sure you are a good candidate. For me personally, it was a good experience.
To echo Debbie, it really depends on the circumstances of your first c-section to determine if you're a VBAC candidate or not. Every case should be looked at individually. Also keep in mind that different doctors have different opinions. I say this because of my experiences. DS was born via c-section after 45 hrs. labor, pitocin and all. They finally took an x-ray and learned he was wedged against my heart-shaped pelvis. My OB/GYN at the time, who I had been seeing for several years, told me NO baby would ever fit through. That I could *try* if I wanted but she highly doubted I could deliver vaginally. When pregnant with DD we lived in a different area, therefore I went to a different OB/GYN practice. All of the doctors in that practice agreed with my decision for a repeat c-section but ONE. He made me feel terribly guilty about not wanting to attempt a VBAC. Grrrrr! Why oh why would I want to repeat many hours of labor only to have to deliver via c-section again?! Sorry, little vent there. LOL! Anyway, DD was a scheduled c-section. Well, actually she was *supposed* to be scheduled but my water broke 5 days prior to the scheduled date. They wheeled me into the OR for a c-section. Delivery and recovery went MUCH better than the first time around.
Thanks for the information. I really believe that I would be a good candidate for a VBAC. I had a low-transverse incision. The reason for the c-section was pre-eclampsia and fetal distress. I was dialated to a 4 or 5(can't remember) with Pitocin. I think my Epideral slowed things down. I was sort of "dumb" and accepted the Epideral even before I felt any contractions. My doctor is all for the VBAC. I guess I will continue my research. I'm writing down questions to ask at my next appointment. Thanks for the stories/advice!
BTW, I'm really suprised at how well my recovery was from the c-section. I was feeling fine, not in any pain, as soon as the Epideral wore off. I wasn't allowed out of bed for a couple of days due to the elevated BP. Other than that, I was fine!
I had a VBAC 7 months ago...e-mail me if you want to ask me any questions 
I did a VBAC too for children 2 and 3 after a c-section with 1st dd. She was breech and absolutely refused to turn. Recovering from a c-section is hard...I much preferred the recovery time from a vaginal delivery. Of course, as others have said, it depends on what your situation is. Good luck!
I never wanted a vbac after my csections. I'll take 1-2 weeks recovery with pain Rxs and an extra long stay (rest) in the hospital to labor any day. That aside though, you may need to check and see if the hospital you are planning to use allows them. Apparently, quite a few - including the one I had my first two children at - are no longer allowing them due to the liability factor.
this is the article about the hospitals not allowing vbacs.
Mother fights for choice of birthing method
By Rachel Forrest
news@seacoastonline.com
STRATHAM - Despite a study published Dec. 16 in The New England Journal of Medicine that concludes women face a low risk of complications from vaginal births after cesarean, or VBAC, most area hospitals do not offer the option of a natural birth if a woman has previously had a child via C-section, a surgery commonly used to deliver a baby when there are complications in labor.
The study concluded that "the information is relevant for counseling women about their choices after a cesarean section." The information may be used by doctors and parents to make decisions about options in childbirth, including a C-section.
Lisa Kuester, of Stratham, had her fourth child on Dec. 23, but the weeks leading up to the birth were filled with uncertainty about whether her new daughter, Jade, would be delivered via VBAC or C-section. Kuester said she didn’t feel as if she had a choice.
She wanted to give birth naturally rather than undergo a C-section as she did 15 years ago with her first child, but she wasn’t going to be allowed, despite the fact that Kuester has had two successful VBACs.
"The birth of my second child was in 1990 in Dover, and the midwife was so excited that we were changing the tide with the VBAC. I felt like I was a part of that change and it was a positive thing for women."
Kuester’s third child was born in 1996 at Portsmouth Regional Hospital, also via VBAC.
"In 2004, I was most excited about doing a water birth. At my second appointment, the midwife told me the rules have changed and I’d have to have a C-section if I wanted it in Portsmouth Hospital," the Stratham resident said. "How is it that I could have my second and third children VBAC and not this one? Was there less risk then? I don’t think so."
Kuester asked her physicians and the hospital why she would have to go all the way to Manchester to have a VBAC.
"I haven’t gotten any good reasons and no good scientific reasons," she said.
Women are having a harder time finding hospitals that allow VBAC. In New Hampshire and Vermont, half the hospitals have ceased doing VBACs, according to Dr. Peter Cherouny, associate professor of obstetrics and gynecology at the University of Vermont.
In 1999, the American College of Obstetricians and Gynecologists set guidelines for VBACs, which can raise the risk of uterine rupture and other complications. A rupture can be caused when a scar from prior surgery gives way during labor or in women who have had five or more children, or have a distended uterus. Due to the risks and guidelines, local hospitals made the decision to stop doing VBACs.
"The bottom line is that ACOG put out the standard that you must be prepared to do an immediate C-section if attempting a VBAC," said Katherine Hazelton, head of the maternity department at Portsmouth Hospital.
Hazelton said that having an operating room, a physician and an anesthesiologist available are some VBAC requirements.
"With this one particular emergency, when there’s that kind of a standard, we have to look at what we can reasonably do," Hazelton said. "When you have to respond immediately, you have no leeway and you want it to happen right. If we’re going to do it, we want to do it as well as we can."
Mary Peskovitz, director of the Family Center at Exeter Hospital, agreed. While a decade ago the trend was toward natural births and alternative births like water birth, she said the tide has turned.
"We know the risks. We did VBACs for four years straight and nothing happened, but when ACOG came out with the statement that any hospitals that do VBACs need to meet certain requirements, we decided to stop them because we couldn’t keep up to the standards," said Peskovitz. "It can be a major disaster when there is a uterine rupture. We just don’t have a large enough volume of VBACs to be able to fulfill all the requirements.
"If it’s too late, we can’t refuse them, and they sign a waiver," said Peskovitz. "But a lot of families say they don’t want to deal with the hassle and they want to be at home, so they go ahead with the C-section rather than travel to another hospital. No one’s pushed the issue. They just go somewhere else."
Organized by the National Institute of Child Health and Human Development, the study compared 17,898 women who attempted VBAC and 15,801 who had a C-section in 19 medical centers. Less than 1 percent of the women who attempted VBAC suffered a ruptured uterus.
Seven infants suffered brain damage from oxygen deprivation and two died. The report states that women who had C-sections had no ruptures or infant brain damage from oxygen deprivations.
Professor Mark B. Landon, of Ohio State University, led the study and has stated that the results show a low level of risk, that VBAC is generally safe and that women will still opt for VBAC.
But some say that risk is still risk and, while the report has medical professionals debating, effects on hospital policies, if any, will be a long time coming.
"It’s not that C-sections are bad," Kuester said before the birth of her daughter. "They’re saving lives. It’s just that my choice has been taken away.
"I’m sure there will be a time when I’m in the pain of giving birth; I’ll be thinking, ‘I wish I had a C-section,’ but if I did that, I’d be taking away the magic of the birth."
Ten days before her due date, Kuester remained in limbo, wondering whether she’d be able to have her child the way she wanted to - naturally and in her local hospital - or if she’d have to leave the Seacoast to have those options. Another option was to labor until the last minute at home in the hope that a VBAC in the hospital was the only choice left for hospital staff.
In the end, Kuester’s choice was made for her. On Monday, Dec. 20, her blood pressure was up and she began to swell. Tests revealed Kuester had pre-eclampsia, a pregnancy-induced hypertension that occurs in 5 to 8 percent of pregnancies.
Doctors and midwives worried that Kuester’s liver was not functioning properly, and the only cure was to get the baby out. Kuester delivered Jade via C-section on Dec. 23.
Kuester’s C-section was unrelated to the risk of rupture during VBAC, and she pointed out that the issues of choice for parents remains.
"I want women to know they have options, and they should be looking at all the possibilities," she said.
Tried for a VBAC. Didn't work. My amniotic sac ruptured at home (what a mess! LOL!) Doc insisted on putting in internal monitors. (no fun, let me tell you) By noon, my temp was 102.7. Up to that point, I was making progress. When my temp spiked, I was 5 cm and didn't go any further. I already had an epidural, so they started me on pitocin. It didn't help. Late in the afternoon, monitor shows Emily doing weird heart things, so we decide she isn't coping well anymore and go ahead and do the section. I was exhausted by this point anyway, from the fever, so I didn't much care at that point.
During surgery, they discover that she was posterior (face up instead of face down) AND had the cord around her neck 3 times! She also weighed 8 lbs, 1 oz. The doc said I would have never gotten her out.
So, I have 2 healthy kids, but I will never know what it feels like to push a baby out! Sometimes, I think I'm lucky anyway and sometimes I feel deprived!
LOL, Colette! DD was born in Dover in 1998. That's the practice where the ONE doctor gave me a hard time about not wanting to attempt a VBAC.
This statement irked me.
"I’m sure there will be a time when I’m in the pain of giving birth; I’ll be thinking, ‘I wish I had a C-section,’ but if I did that, I’d be taking away the magic of the birth."
As if the births of my children weren't magic because they were delivered via c-section. NOT. Also, a c-section is no walk in the park either!
No c-sections are NOT a walk in the park. Gas pains and coughing after surgery come to mind! Also, with my first one, I lost more blood and felt so tired and weak afterwards. I remember eating because I knew I should, more than because I was actually hungry.
With Emily's (2nd child) c-section, I didn't lose as much blood and perked up much faster. The recovery time wasn't as bad that second time.
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