Friday, July 30, 2010

VBAC vs. Repeat Csection

(FYI: This is my 600th post!)

VBAC- Vaginal Birth After Cesarean

There is SO much information on this topic that I can't hardly discuss it all here in enough detail that it would do each side justice. However, I did want to put out a good resource that I used on making myself more informed and educated on the pros and cons of each decision in case someone else out there is searching for answers. Childbirth Connection answered all the questions I had and even gave me more to think about. If you're debating this decision, I'd highly recommend you read up this evidence based material and then take your own circumstances into account. The site may be a little biased towards a VBAC if circumstances allow, but I think that's just because that's where the evidence shows is the safer position.

After reading up on all my information from the above website, I went in and talked to my OBGYN. Thankfully, she is very pro-VBAC if the cirumstances are right. Her partners, unfortunately, are not so supportive. However, since I'm delivering at a different hospital than last time, this new hospital seems to be "more okay" with them. With that said, there is at least one doctor in particular there who refuses to perform VBACs. So on the off chance that all the cards line up, I go into labor, head to the new hospital and he's on call, he'll section me and won't even let me try. Doesn't that just STINK? I really thought so, too, but it's out of my hands.

For the cards to line up for my VBAC, we'll need to:
1. Get registered at "new hospital."
2. Transfer to see the new docs at 34-36 weeks.
3. Have all heart problems resolved, like they did with Drew
4. Go into spontaneous labor (no cerivcal softening agents or Pitocin) by 41 weeks
5. NOT get aforementioned MD who refuses to do VBACs on that particular day/night

When I look at this list, really only one thing concerns me and that is I hardly dilated at all with Drew by almost 38 weeks, 5 days and he was an 8lb. 7oz. baby. I just wonder how big this girl could be if I went into labor at 41 weeks! Ah! But they say each pregnancy is different....

Reasons I Want a VBAC:
1. Easier recovery with a good VBAC
2. More possible to VBAC future kids with only 1 Csection (yes, we want more than 2)
3. Less risk for infection, blood clots post partum
4. Csection scarring can affect fertility issues for future children (see site listed above)
5. Statistically safer for mom and future babies

Did that last one surprise you? It did me, too!

Of course the main concern for a VBAC is uterine rupture, where you get a weak spot and then tear in the uterus, exposing baby, uterus, placenta, and blood to mom's abdomen. In the words of my doctor, that event is usually catastrophic. Life threatening. Scary.

But what are the odds? 27/10,000 women or less than 1% chance for rupture. Even women who have had a previous Csection and elect for another section can have a uterine rupture, so I carry the small risk anyway. Different sites will give you different numbers, but the same conclusion stands: the chance for a rupture is small and the benefits can still outweigh the risks for a VBAC.

Whew! Are you thoroughly confused?

With all that said, we are moving ahead prayerfully. Very, very prayerfully. In my mind, I'm leaning towards the VBAC and hoping for a great delivery that way. However, my mind is still very much aware of the idea that it's very possible to have to have another Csection. We have several cards that will have to line up before we can go through with the VBAC, but my doctor is confident that I'm a great candidate so we're pressing forward in that direction. I have confidence that God will give us a clear-cut answer as to which method to try. If this baby turns out breach, we'll have no choice but to section again!

Now, go study because there will be a test over all this material next week!


Az girl said...

Hello, i was blog hopping and i happened to come across yours! Which was soo weird because I too have been praying and praying for the chance to try a VBAC. I had a horrible delivery the first time around which ended up in a horrible section! Ever since i gave birth almost 2 years ago the thoughts of a vbac consume me!!! haha. So it must have been a sign to come across your blog! I am also a nurse!!! I have done all my research and continue to read more and more about it! Good luck to you! I will be waiting to see how it goes!

Jackie said...

Praying everything will turn out for you as you hope. Hang in there!

Amy said...

Since I am not a nurse and have never had a c-section, I am rather uneducated about this. I am curious it not possible/safe to induce with a VBAC?

Audra Laney said...

AZ Girl--Definitely research it to see if you're a candidate! It could be a possibility for you! Your little boy is so cute! Love your pictures!

Jackie--Thanks, girl!

Amy--Evidence has shown that the medications used soften the cervix may also soften the previous Csection scar on the uterus, leaving it more likely to rupture. Pitocin starts your contractions harder earlier on (as opposed to natural labor where they supposedly start easier and progress to harder contractions) and puts more force on the scar early in the labor process, leaving it more likely to rupture. Because of that, my doctor and I have agreed to not induce at all. I hate that it isn't an option, but I don't want to up my risk substantially for a rupture. Does that short explanation make sense? The website I listed has more information on this topic.

Amy said...

Makes sense! Was curious in the event that we have another that requires a C-section. Thanks!

Brittany said...

just an encouragement, my friend just had a vbac 2 months ago after delivering twins via csection about 2.5 years ago. she was induced about 2 weeks early & had the baby with no problems early in the afternoon after being induced that morning. she delivered at baptist womens.

Audra Laney said...

Brittany--thanks for that story! I seem to way too many of the negative stories. I don't know why people want to share those with you when you're considering a VBAC, but they do! ;) Thanks again!

The Lively's said...

Wow! Hard decision. I don't know what to tell you. I think you have the answer- pray about it! God is good.

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