to VBAC or CBAC, that is the question

I have really been going over and over the risks/benefits of both a VBAC and CBAC and can't seem to come to a decision.
I know I am a good candidate for a VBAC since the I naturally went in to labor with Will and only had a c-section bc he was breech, it has been (alot!) more than 2 years since said c-section and the incision was a low-transverse cut.
I also know that it would be easier to plan a c-section as far as having Will taken care of and DH's work schedule. And I had a great experience with my first c-section - it all went smoothly and the recovery was a breeze.
I don't know that I really want to have to go through surgery (at least not elective), but going for the VBAC, I've heard that using pain meds can cause problems, and I'm not sure if I could do a natural birth. I also am scared of a uterine rupture, of course.
I just don't want to make the wrong decision and have something go horribly wrong, for me or the baby.
DH is pretty much up for what ever I want to do, so he's not much help.

Any advice ladies???
Thanks in advance!

Personally, I am of the opinion that going as natural as possible is always best. I believe that your body and the baby will know when the time is right, and nature will take its course. natural labor is way easier than a forced (induced) one. Not to mention in a case like yours where $ is a real concern, all those drugs are expensive. and a c-section requires a longer stay, all those Dollars add up fast. If i were in that position, I would be hoping for a natural labor, vag delivery, and then getting the heck out of the hospital in 24 hours.
Although, if there was concern for the baby's safety, or my own, it wouldn't matter how much it cost, I would find away to pay it. I don't really know anything about the dangers of VBAC.

I would try for th vbac even though my repeat was wonderful I wish now that i would have at least tried for it.

I agree 100%.

I've thought about this some too. I had an emergency c-section with Thomas and while I would NEVER want to have to go through that again, the recovery for me was great, easy peasy. I'm thinking a planned c-section would be even better. I think I'll do the repeat C for our next child, it's just easier with DH's work and planning child care for Thomas. Now if I would have had a bad experience (other than it being VERY rushed) the first time I might be singing a different tune. I know some women feel cheated if they had to have a C, I don't feel that way fortunately so that's not really an issue for me.
Good luck with your decision, it's not an easy one.

I totally agree with tara...but that said, if there was even a chance no matter how small, and it sounds like there is, that something could go wrong, well then, a c section it would be.
I mean I only had the section with our last because they thought he was to large, they were wrong, but still it was done, and I dont know that I would go for a vbac if I had that option. Just because there is a risk there.
Having had both experiences, I wouldnt feel that the birth would be any less special..I would say in my own opinion if I were in your shoes, it would be a section.

Its just easier in the long run, with getting dh there due to work, and also time to find a place for wil, and you wont have the thoughts of a rupture on your mind the entire time you are trying to give birth. It sounds like a win, win...
I do wish you the best of luck either way you decide.

That's kind of what we've been thinking... the slight risk of something going wrong during the VBAC just scares me. Then again, if something did go wrong we could do an emergency c-section, I guess. Of course, that way would cost us even more.
Having had a c-section never made me feel that I am a mom any less, or that I missed anything. Esp since I did go into labor and got to feel a little of it. So that part doesn't bother me at all. I do wonder how soon I could have the baby afterward, though. After a brief moment to touch his little foot right after birth I didn't see Will again until about 1 1/2 hours after the surgery. I was in recovery for an hour and then it took a little while to get him to the room. I'd feel better I think if I knew they'd let me have him in recovery, esp since I had such a hard time nursing last time. I will have to check in to that.
Sigh..... I have a lot to think about I think. Thanks for the opinions/advice. This is such a tough decision.

it is a hard decision, dh and I discussed and discusses it and decided for the repeat. BUT I have had two doctors tell me that I have a flat pelvis which makes it harder for baby to come through, Autumn was smaller though so there was a chance I could have delievered her. My recovery was in my room so Autumn I was able to have her with me in recovery I just had to wait for her to warm up which it was like 30minutes and then they brought her to me. I was also able to have everyone come hang out in my room with me, it was great until i got the "crack itch" haha apparently something that was in with the morphine (they put through the spinal) they gave me for pain made my face itch HORRIBLY it was SO uncomfortable but funny at the same time

I had a planned section with Laila after an emergency section with Jack. Honestly I wouldn't recomment a repeat section. I did not like it and wished in many ways I didn't do it - BUT I also didn't want a repeat of the emergency situation with Jack.......I did not like the surgery, the recovery or any of it.

Just my experience

I know what my decision would be. With Owen I had an unnecessary 'emergency' c/s. My doc didn't want to let me labor, which I was doing fine with. She pushed me into saying yes to a c/s. As a result I am one of those women who felt cheated and robbed of my birthing experience. I experienced severe PPD from it and I don't recommend that doc to anyone. My choice would be for a VBAC. Yes there are risks. But from what you said you are a good canidate for it. The biggest worry most women have is of uterine rupture. Although I think the name adds most of the worry to it. I know when I think of 'rupture' I imagine my uterus exploding and the baby flying out (into DH's arms of course). The reality of it is that most ruptures are only a centimeter big at the most. Which is an easy stitch-up, from what I've read. When I have my next baby I will plan on a delivery assisted by a professional birth coach who can help me relax and focus on the goal.

Sorry that got so long. I have very strong feelings on this subject and was actually holding myself back from spilling my guts on it.

I would recommed that you talk it over with your hubby, doctor, best friend, mom, who ever can help you come to a decision that you will be happy with in the long run.

Can't wait to see the baby pics.

What does your dr say? I think I'd start by asking what his opinion on the risks is and think about it a little more.

There are risks with both, but I would personally try for a natural birth. It is what your body is designed for.

I am not sure of your history in regards to child birth besides what you mentioned. Is there some sort of risk of bleeding or something? I know that if you are at risk of bleeding, they keep a very close eye on it. If you have bled badly after a previous birth you would usually have an IV in and ready so they can administer medication to make your uterus clamp down following birth.

Vaginal births seem scary, but it isn't. We are designed to give birth this way. Yes, it is painful, but the chances of something going wrong are low. And, as far as I know, recovering after a vaginal delivery is much quicker and easier than following a c-section. Your uterus and stomach has to deal with being cut open; a c-section is quite a big surgery. Following a vaginal delivery, your uterus doesn't have to deal with being cut open and you have no wound to care for. With a vaginal birth you have the risk of possibly tearing, but it's low, and maybe the placenta might not fully come out.

The biggest pro for me though is the fact that once your baby is out, thats it. You can hold them for as long as you like, you don't have to worry about the fact you have to be sewn up. It's done and dusted. Plus, once the hormones and adreneline get surging, you forget about the pain.

Are you working with a midwife during your pregnancy? I recommend speaking to your midwife about the options you have. She can give you better advice about what a natural birth will be like for you. Ultimately, you just have to decide which option you feel more comfortable with. It is your birthing experience and you should get to experience what you feel is right.

I do not have a midwife - have never thought of having one, actually. I guess it's bc I truly do trust my doctor and his staff fully, and I feel safe in their care.
My dr says he recommends a CBAC due to the fact that I have never had a vaginal delivery before. He says it can be harder for the body during the first vag delivery and so he thinks it would put undue stress on my body and the baby.
As for any other problems there have been none mentioned (no high-risk of bleeding, odd/small pelvis, that sort of thing) but I will be sure to ask him about all of this.
My sister is an RN and she thinks I should try the VBAC, as does my friend. But they aren't doctors nor do they know all the details about me (heck, I don't even know them!). I think it's going to take me a lot of discussion, particularly with my doctor, to come to a decision.
I appreciate all of the insight and advice... these feels like such a huge decision and I feel like I'm on the verge of making the wrong one.

I can see how this would be a tough decision. I've never had a C-section so I don't think I can offer any advice. I usually do my own research and then if I am still on the fence, I tend to go with the doc's advice if I really trust the doc. But, that doesn't mean that you have to do as your doc recommeded -- it's ultimately your decision. Good luck with your decision. Sorry I am no help.

i'm gonna sound a bit like Mollie here. I would stress to you to do your own research, and a lot of it, in addition to listening to what your Dr says. Not that your Dr isn't good or what ever, but in my experience I have met a LOT of really bad Drs. and their patients LOVE them, and think that they are "all knowing". They do what ever the Dr says because "they are the Dr, they must know" and really, I just want to warn them, but I can't. So I will warn you. Just because they went to Medical school doesn't mean that they know everything, and no one knows you and your body like you do. Read up on it as much as you can, and do what you believe in your heart is best for you. Take what they say into consideration, but at the end of the day, this is YOUR pregnancy, labor, body and baby, so do what is best for you.

You can ask the advice of a midwife too. They know a lot about vaginal delivery's, etc, so you could get some good advice. Also, you can work in conjunction with your Doctor and midwife, having one doesnt mean you can't have the other.

Even if you just set up a chat with a local midwife, it could make your decision easy. As Tara said, you should do some research. And if you decide to go with a vaginal delivery, it;s good to have a midwife through your pregnancy for the continuity of care giver thing.

I though vaginal births were fine after c-sections. I would be more inclined to think it would be mor stress getting a second c-section, as you have scar tissue. I don't know though, lol, Im not a doctor.

Vaginal birth seems scary if you've never done it, but it's the same the other way around. I would be terrifid to have a c-section because I have never experienced it before.

They can, but so can the things they give you to numb you for a c-section. So it kind of equals out in terms of risks of medication.

Keep us posted on what you decided

Oh you're right - I never take any one person to be the end-all to anything, which is why I'm making all of you help me. I do respect and trust my doctor, but I also know he is human and prone to errors, too. I also talked to a couple of ladies in my homeschool group today, and they both gave differing opinions. One said that I should try for a VBAC since I'm a good candidate (that I know of anyway) and that our bodies naturally know how to give birth. The other said she would probably go with a c-section just bc of the rupture risk, though it is low, and the convenience factor.
I've looked up so much stuff about this on the internet I think that's all my computer knows how to pull up now!
Every site I find has a different viewpoint and leans to one side or the other -- makes it difficult to tell opinion from fact. And while I have found statistics, such as 2% of VBACS end in a rupture of some type (mostly small, insignificant ones, not the life-threatening variety) and that 60-80% of VBACS are successful (which makes me wonder how they both can be right), I still am just unsure. I just would hate to try it and end up with an emergency section.... but I also love the idea of actually birthing my son all the way this time, not just having a small taste of labor.
Why, why, why does this have to be so difficult??!!??

because you are a good mommy that wants the best for her baby.

I guess - if I didn't care then it wouldn't matter to me, huh?

I ended up having a csection with Sammy. When I found out I was pregnant with Abby -- I instantly knew I was going to schedule a csection with her. I know uterine rupturing is a small chance, but it does happen. I could not see risking losing my baby because I wanted a vaginal delivery. Not worth the risk to me. The decision was a no-brainer for me.

Good luck with your decision !!!

ps - I've had more losses than I do children,,,so I might just be a little paranoid with stuff like this.

This post has been edited by Sam & Abby's Mom on Sep 11 2008, 09:01 AM

I really wouldn't care either way as far as delivery goes... I feel like a mom is a mom whether she gave birth to her child vaginally, through c-section, or not at all (in the case of adoptive moms). That part really has never been an issue for me, luckily, though I know many women who feel less, who feel like they failed due to a c-section.
I am just trying to weigh all the risks/benefits of each to come up with the best decision for us.
I absolutely understand your choice completely -- it may even end up being mine.

For me to have a repeat Csection was a very easy decision - there was no way I was ever going to subject myself or another baby to an emergency c-section - it came down to get her out of something was going to happen to her - I didn't want ANY chance of a repeat for that situation and in my case it was likely to happen that way - I guess it depends on why you had the c-section in the first place? Olivia was sunny side up and wasn't flipping - Dylan was too in the end when they did the c-section......

Good luck - whatever you decide but if you really don't care then I would go with the c-section to avoid the other issues that come with a natural birth not working - I know there are risks with a c-section too but....I guess its what are the worst of the evils....

I had the first c-section bc Will wanted to moon the world upon entrance - an attitude he has yet to grow out of! He was breech, with his head and feet up top.

Ok, I've really been thinking about this hard over the last couple of days, and I think I've decided to do an induced labor. I've based this decision on the facts that my DH works slightly out of town a lot (he drives his truck on average about a 5 hour one-way drive from here) and my closest family that could take Will on a moment's notice if I were to go into labor is still 20 min away. I just keep thinking, what if I start labor and DH is still down in Florida, up to 4-5 hours away. I'd have to get Will, me and our stuff together, take Will to the family and hope DH got to the hospital on time.
I just don't think I could take the stress of that. If DH worked close by it wouldn't be a big deal, but he doesn't and that's the biggest problem I see with just letting labor happen naturally.
Now, in inducing labor, I'm not sure how much that would effect the success of a VBAC, or if I should just plan a c-section. Either way is fine with me physically/mentally, though of course a successful VBAC would be a lot less cost. Of course, if I tried a VBAC and ended up with a c-section, the cost would be greater that just a straight forward c-section (I still haven't found out if my ins will cover the emergency c-section or not).
Anyway, do you think that makes me a bad mother/person, not wanting to just leave it to nature?