Questions About VBAC

I am an RN that also had to have a c-section with my first baby. I researched the subject of VBACs when i was pregnant with my second child and decided it was not worth the risk. I work in a neonatal unit and have to be present in deliveries often so i have also seen firsthand some of the complications including abruptions. It is my opinion that repeat c-sections are more controlled and safer for the baby than VBACs.

With my second child I also wanted to have a vaginal birth. I was informed by my ob that my pelvis was too narrow for the babies head to make a normal delivery. So ended up with 3 c sections and 3 BEAUTIFUL children. If there are no issues preventing you from having the vbac then go for it but remember no matter how the baby is delivered, you are going to be the mother of a BEAUTIFUL baby!!!!

I had a C-section with my first and vaginal deliveries with my 2nd and 3rd, however there was 10 years between my first and 2nd children, so I had a long time for my body to recover.

As a labor and delivery nurse, I can tell you that it totally depends on why you had to have a c-section to start with. If it was because of not having enough room for the baby to come thru, it totally makes sense to have a repeat c-section. If it was because of fetal interance to labor/fetal distress or an odd presentation, it might be worth trying to vbac. Many docs will not give pitocin to someone that has had a previous c-section because of the risk of uterine rupture with labor. You are at an increased risk of uterine rupture with a previous c-section anyway. I've seen it happen, and it's ugly when it does. They ended up having to have a hysterectomy and almost bled to death. I would ask her why she's so set on having you have a c-section before I jumped into finding another doctor. She may have very good reasons. The other possibility is that if they did a classical incision versus a transverse incision on your uterus you would have to have a repeat c-section. Just talk to your doctor about it. Most docs are totally willing to work with you as long as you all understand where you're coming from. Obviously it's not worth risking harm to you or your baby. I don't know if you labored or not before your first section, but I can tell you it's way easier recovering from a repeat section without laboring than it is if you labored as well. I've also seen beautiful vbacs! Good luck, and congrats!!!

Hi M.,
I had an emergency C with my first child in 1988. In 1991 and in 1996 I delivered without complication via VBAC. The '91 delivery took almost 28 hours start to finish...the '96 delivery took less than 3 hours. I did not have an epidural with either delivery...just because I made the decision to go with out meds. if possible.

All three of my children are Honor Roll students and athletes! And, most importantly they are really, really nice human beings!

Good luck with whatever you decide...and remember, it's the end result that is most important. The baby outweighs the importance of the delivery method EVERYtime. :0)

Best wishes!!
V.

My daughter was four when I had my son. She was born through C-Section due to fetal distress, he was born vaginally with no problem. I also now have another baby and she was born via C-section. So, right in the middle of my c-sections I had a vaginal delevery. I only had to sign a paper saying that if they saw it was medically necessary (sp) to stop trying vaginally and go ahead with a c-section that i agreed. I also had to sign a paper stating that I understood the risks of a VBAC. All in all, everything in my delivery and birth of my son went smooth and NO c-section. Hope this helps

J.

My first birth was a c-section then I went on to a successful VBAC with my 2nd child and another c-section with my third cild (after attempting another VBAC). I would definitely recommend that you try for a VBAC. That birth was by far the easiest of the 3 (and since he was a 9lb 1oz baby and I pushed for 3 hours thats saying something!). But to do this you are going to need an ob/gyn who is supportive. Too many ob/gyns are still using the old logiv of "once a c-section, always a c-section" and it doesn't have to be that way. If you really want a VBAC discuss it with your current ob/gyn and if she is not supportive or cann't offer you a sound medical reason why you can't try for a VBAc then I would recommend researching other ob/gyns.

I have heard they no longer do vbac's.... if you have a c-section it is automatic c-section everytime.... you may want to talk with your obgyn to make sure...V.:)

Hi, M.. My name is C., and I'm in Chattanooga, TN. I have two girls 12 & 15. My first child was delivered via C-section because I couldn't dilate enough, and my ob told me that my second would probably have to be the same. Both times I had to have induced labor - not fun. During the birth of my second child, my ob had me prepped and ready to go for another C-section. After the epidural was administered I had to wait for about 45 minutes before the nurse came in to take me to the operating room. During that time I was able to relax and laugh at a sitcom on television. When the nurse arrived, I asked her to just check and make sure I hadn't dilated enough, since I really didn't want another C-section. When she checked, the baby's head was crowning, and I was immediately taken into delivery. The vaginal birth was much easier to recover from.

I don't know why you needed a C-section, or why your ob says you will need another, but my best advice is to RELAX during labor, and move as much as you can. If you need pain meds to help you relax, do it. Good luck, and I hope this helps.

I am lucky enough to have had both of my boys at home with a midwife, but I do have a friend who had a very traumatic c-section with her first baby. Unfortunately they waited too long to perform the procedure and her baby was still born. 22 months later she did a VBAC successfully and now has a beautiful boy who is almost 6. They told her no way would they allow a VBAC because of the history with her first child. She, like you was not confident that they were judging the merits of her current pregnancy, not her last one. She just decided to take it as it came and things went great for her. Just believe that you know what is best for your body and your baby.

Some doctors and/or hospitals do not allow VBACs any more; they used to encourage them. But a study came out that showed that *managed* labors (in other words, induced or augmented with Pitocin or prostaglandins like Cervidil and Prepidil) had a higher rate of scar separation and rupture than planned C-sections; however, the rate of spontaneous labors had the same rate.

There are a few times when a VBAC attempt has a higher rate of uterine rupture, so you'll want to make sure you are a good candidate for a VBAC. These include a vertical uterine incision, inducing or augmenting labor, if the uterine scar is too thin, or pregnancies too close together (getting pregnant before a year after your C-section has a slightly higher rate of uterine rupture, but I've known women that fit this category that haven't had any problems).

The risk of uterine rupture is very low; but occasionally if the uterus ruptures the baby is put at risk, and the mother may require a hysterectomy. Having a repeat C-section is not a guarantee of a problem-free birth, though! I just read a story (there's a link on my blog) in which a woman had a repeat C-section at the request/demand of her doctor, and ended up with a hysterectomy.

A few resources to check out: hencigoer.com (look at the studies on VBAC, as well as check out her book from the library); ican-online.org (this is the premier C-section and VBAC website); and more resources on my blog (http://womantowomancbe.wordpress.com)--you can check out the links I've got on my blogroll as well as posts in the "c-section" category.

I would strongly suggest that you start having these conversations with your ob NOW. First, if you are a poor candidate (let's say you had an emergency C-section under general anesthesia with a vertical incision), then you'll know and you can start getting mentally prepared for a necessary repeat C-section. But if your doctor just doesn't allow VBACs, even if you're low-risk, then you'll need to know your options. If you stick with that doctor, then you'll have to fight her tooth and nail to give birth vaginally, or just submit to a C-section that you believe to be unnecessary. You have other options, though. You can switch to a VBAC-friendly doctor, or possibly find a midwife and have a home-birth. (I forget Kentucky's rules, but I think midwifery is illegal there, so you'll have to get connected to find a midwife who will attend you, if you take this option.) There are even women who have had unattended VBACs, because they felt so strongly that having a C-section or fighting for a vaginal birth in a hospital were unacceptable. If you wait until you are near the end of your pregnancy, though, you will not really have any options, because some care-providers will not want to accept you so late in your pregnancy, or you simply will not have time to find a VBAC-friendly doctor, hospital, or midwife.

VBAC success rates range from 66-80%, I think--definitely a majority. The more vaginal births you've had (whether before or after a C-section), the better your chances of having a VBAC.

The reasons for your first C-section may or may not be a factor in whether it would be wise for you to have a repeat C-section. If your first C-section was due to a failed induction or slow dilation or long labor, then that's not a big indicator of anything other than the doctor's failure to wait. I understand you had complications, and an induction and/or C-section may have been necessary; but inductions are notorious for failing in first-time moms--this does not mean that *you* were a failure, but that *the process* failed you.

You're doing the right thing--gathering information and resources. Once you feel prepared, you should initiate the discussion with your doctor and try to change her mind. Don't be afraid to seek a second opinion. Call around to your local doctors and hospitals (or perhaps even some that aren't so local, but within driving distance), and ask if they allow VBACs, or who is a VBAC-friendly doctor; talk to local moms and find out their recommendations, too. If you get a nice, easy-going, laid-back doctor who is very pro-VBAC, but looks at your chart and says "no" then you'll be satisfied that you really are not a good candidate. Otherwise, you might be heading for a completely unnecessary C-section.

hth,
K.
womantowomancbe.wordpress.com

Hi M.,
I agree that you should push for the birth you want. Finding a new provider that is VBAC friendly is probably not a bad idea. I wouldn't wait, I start searching now and asking your questions. You are "in charge" and it is possible to have a VBAC. Your doctor does sound like she made up her mind and will possibly try all the scare tactics she knows just to keep you "in fear". I am an ALACE trained birth assistant & I respect that you are researching your options. You may find more information and support here. http://www.ican-online.org/ I also encourage you to find yourself an area doula. I'm not sure exactly where you are located but you should be able to find one, if not more, in your area. You can email me offline if you need help locating one.

Here is a great article about one mother's triumph and her successful VBAC. Surround yourself with positive stories like these and avoid the negative.

http://www.mothering.com/articles/pregnancy_birth/cesarea...

Peace,
J.

Your desire to have a natural birth is not uncommon with women who have experienced Cesarean Section. And there is nothing selfish about desiring a more positive birth experience. If you do the research you will find that VBAC is actually the safer option.
I am a Chapter Leader for a support group that provides evidence based information about cesareans and VBAC.
In fact there are tons of resources supporting the safety of VBAC and validating your feelings about your cesarean.
The more cesareans a woman has the more chance for complications. In fact there are 33 risks to cesarean section compared to 4 in vaginal birth.
Studies prove time and again that VBAC is less risky than cesarean section.

Here are some resources.
1) www.vbac.com
2)www.childbirth.org
3)www.ican-online.org
There is a booklet available called"What Every Woman Needs to Know About Cesarean Section." It endorsed by very credible organizations and is evidence based.
All the information on these sites and I have tons more is evidence based and will quote all the latest studies.
There is a book called "Our Bodies, Ourselves" by Judith Norsingion.
It is full of the latest information. I met her last week at a Tea put on by a Family Practice office in our area.
She has been on Oprah, Donahue and many other shows and works with a large organization that helps promote information for womens health issues.
Also reinforces that most of what is practiced is not evidence based and goes into the reasons.
I have worked with women who have had cesareans and VBAC's for many years.
You would not believe the risks that increase for mom and baby with cesareans. If you want to think about the safety of your child do the research. You will find that VBAC is very safe and much safer than repeat cesarean.
It is all out there. Those are just a few resources you can check.
Also there is CIMS (Coalition for Improved Maternity Services.) Type in CIMS and go to their website.
Hope this helps.
K

Hi M.,
I had my 1st daughter Katelyn at 37weeks via c section 1/10/06 in florida after 23hrs of labor dialated only 3cm i was induced by the doctor because she was "too big" they estimated her to be 10lbs and was 8lbs 12oz the doctor obviously just wanted my daughters birth to be very predictable probably didn't want to mess up dinner with his family... i moved to n.c. in august of 07 pregnant with my 2nd daughter. I had Kylie via VBAC at 41weeks on 11/22/07 after 3hrs of labor... she was 7lbs 14oz... see where I'm getting at ... IT IS POSSIBLE... not to say there aren't risks because there are... there are risks to a 2nd csection too... don't let your doctor push you into anything you don't want its YOUR body... I waited til my c ontractions were 5minutes apart before hauling butt to the hospital just incase they'd try the whole csection bit... practically had her head out... it is your right to have the birthing experience you want...

this is from a local online group I am on and this is a group for VBAC info. Hope this helps!!
L.

http://health. groups.yahoo. com/group/ Louisville_ VBAC
Next ICAN Support Meeting: 3/10
Next ICAN Educational meeting: 4/7: Cesarean Awareness in our Community

ICAN of Louisville
www.icanoflouisville.com
____@____.com
Chapter secretary: ###-###-####, ____@____.com

I wanted to try for a Vbac after my csection. but my ob explained that there were so manyt hings that could go wrong that it was better not to risk it. Like your uterus rupturing and things like that. Which would put the baby at risk. So i had a csection. I still prefer a vaginal delivery but my second section was alot easier and the healing time was quicker than with my first.

I had a VBAC when my daughter was born 22 months after my son. So, yes, it is possible. Every birth is different. Your doctor should at least try for a VBAC. Mine did. I would definitely discuss with her the reasons why she is saying you need another c-section.

My son was delivered naturally after his birth-mother had her 1st son by C-section. She was adamant about the fact that she wanted him to be born naturally, if at all possible. I was in the delivery room with her and she had no problems and bounced back very quickly from the birth. She looked like she hadn't had a baby after just a couple of weeks. I would go with what you feel and if your OB is trying to push a Csection I would find another OB. Hope this helps and congratulations!

I have three boys and they are 17 months and 19months apart. The first was a c-section after being in hard labor for two hours and fully dialated they decided on a c-section. He was to high up and never progressed down to the birth canal. My second was a v-bac and my doctor told me that we would try naturally as long as the same thing didn't present itself (baby not coming down). I delivered him naturally without any complications. My third was also delivered naturally and could have very easily been a c-section as he was upside down (feet first) when I went into labor but with a wonderful doctor and nurse they stopped my labor and externally rotated him so that I could deliver naturally. So talk to your doctor and tell ask him what was the reason for your first c-section and why he/she thinks you can not do it naturally the second time around. Good Luck.

I had a VBAC in Nov. and my other child is 2. I would strongly encourage ou to do a variety of things. First, go to the ICAN (ican.org) website and see if there is a local chapter near you. It is a non-profit organization to help with c-section education and support. If there is a chapter, then get linked in with them to learn about any docs in your area that are VBAC supportive. If there is not one close, then I would atleast call your closest leader and speak with them. Secondly, I would go to DONA.org which is a national website for doulas. If you can afford one, then I would hire one that has VBAC experience or atleast one you feel comfortable with. Your chances of a successful VBAC increase when you have a doula or other birth support person to assist you through all the hoops/scenarios. Even if you cannot afford one, if there is one that has VBAC experience ask them what docs in the area are supportive/they have had success with. There are a variety of different books you can read. The best one I read was Natural Childbirth after C-section. If you cannot get your hands on that one, then try to get Active Birth or Ina May's Birthing Book (I cannot remember the actual title, but it is by her). Regardless if you want to have a natural birth all these books address birthing after a c-section and have some important info. Lastly, I would call around to different offices in your area and try to find another doc. Question your current doc as to why you need a repeat c-section. Ask other doc their feelings. Consider a family practice that will deliver you. They are often times more open to let birth develop on its own. If you want a list of questions to ask your own doc, and potentially a new one, then feel free to contact me. I changed docs at 28 wks and I am so glad I did. I ended up delivering at a different hospital and driving an extra 20min. for all my appointments, but the care I got was well worth the extra time in the car. My original doc told me I was in the lowest percentile to have a VBAC because of the circumstances of my c-section. The office I switched to never really addressed it, they were supportive about my deciaion, and we worked through some different things that I could do to change the scenarios of what caused my first c-section. I live in NC, but can email you more about things we did. Good Luck and feel free to contact me if you want more info. I have gone through your struggles and understand.
PS - Given the scenario of your first c-section you may want to consider taking evening primrose oil starting around 37 weeks.

M.,

Hi! It's great you have done your own research - It does sound like you may be a good candidate for a VBAC, however, many ob/gyn's simply will not do them, regardless of whether or not it is appropriate or even better for the mom. Based on your comments it sounds like your doc has already made up her mind - even if you continue your pregancy beautifully without any complications it is likely she will refuse the VBAC. You may want to consider finding a medical provider now who is open to VBAC's - it is possible to switch providers even at the end of your pregancy if you can find someone to take you on - however, the longer you wait - the more difficult that might be. You may want to interview local midwives, other ob/gyn's, and consider hiring a doula to provide you with prenatal, birth, and postpartum support. Ofter times, doulas will have suggestion on how you might reach your birth goals.

I hope this helps.

C. Bombardier, LCSW, CHt, HCHI
MindMatters Hypnosis & Counseling, Inc
Hypnobabies Natural Childbirth Instructor
www.mindmattersincorporated.com

Yes, a VBAC can be dangerous, as the previous poster mentioned, but you WILL know if something's wrong and c-sections are MUCH MORE DANGEROUS. I went to Dr. B. Campbell and he does VBACs, but I had to drive to Lexington. I didn't get one, but at least I was allowed to labor until I felt a burning pain. I almost ruptured, but by listening to my body, I knew something wasn't right and the Dr. was very knowledgable and kind, he really wanted me to VBAC! Check the website: www.baby-moon.org, that's where I found my Dr.

Good luck!!!!

My first birth was also a c-section. My OB said he wouldn't allow me to do a VBAC...as much as we loved him, he was fired. It was MY birth and MY experience, so I found an OB who would. I delivered naturally the second time with very little complication. Good luck to you and don't let ANY doctor tell you how your birth experience will be!

Hi M.,
With my now 3 year old, I labored for almost 13 hours (3 of which were hard pushing) and my pelvic floor would not open up therefore I had to have a C-section. With my 9 month old son, I was also advised by my OB that I would need to have another C-section. I did and everything went great.

My husband and I are friends with our OB and his wife (a physician as well - who has had 2 c-sections, 1 due to complications and a repeat one) as well as our Pediatrician and his wife (an internist). Our OB and Pediatrician have experienced a large number of births in their careers. In speaking at length with the 4 of them, the dangers that a uterine rupture present were just not worth it. If your uterus ruptures, it puts the baby and you in serious danger. I fully trust the opinions of our physicians, as physicians AND as our friends, so I would talk at length with your OB before deciding completely against a repeat C-section.

Also, we live in a fairly rural area where about 50% of mothers deliver at our small (4 floors - probably 100ish bed) hospital and the rest travel about 45 minutes away to a larger women's center. Our hospital is very good and we wouldn't even consider going anywhere else. However, due to insurance, hospital policy, etc, VBACs are only allowed at our hospital when the physician is present for the entire labor process. Due to the fact that only 4 OBs deliver at our hospital, this is usually not feasible. So, there may be a number of reasons that your OB is suggesting a repeat C-section.

If you are concerned about the c-section, I will just say that I have absolutely zero regrets about having both of my children via c-section. My doc would have let me stop pushing at an hour and a half with my 3 year old, but I was stubborn and determined. He let me try as long as I would and knowing what I know now, I would have listened to him earlier.

Good luck with what you find out! I am sure that your doc will be glad to discuss why exactly she suggests the repeat C-section. I know that a number of women have had good experiences with VBACs, but I just wanted to provide another perspective to let you know that repeat sections are not so bad.

Good luck!
A.

My name is D. and I also contemplated having a VBAC. After having twins in 1996 we thought we were done. In 2002 we found out we were having baby number 4. I had a csection with my twins because they were both breach. My best advice is do your research!!! After I did mine I was convinced to repeat the csection simply because the risk was to high of something goinmg wrong. When I told my doctor I wanted a VBAC she put me as high risk. The possibility of your uterus tearing is higher and you run a greater risk of a tragic outcome. I chose not to take that risk. I have had many friends have a very succesful VBAC. When my baby was born my doctor told me I made the right decision. Our baby had her cord wrapped around her neck twice and where my previous csection incision was, my uterine wall was very thin with a small hole.
Again, for me I didn't take the risk. My encouragement would be to do all the research possible.
Good Luck
D.

Hi M.,

I had my first child 5 years ago and I was hoping for a natural birth. Unfortunately, she was tangled in her cord and couldn't descend into the birth canal. My body was responding well to labor, but it couldn't have been helped - we had to have a c-section. I was really devastated even though we did everything we could to have her naturally. I hated the recovery with the c-section and all the interventions for her were not ideal for how I wanted her to enter the world.

Fortunately, I was with the birth center in Chapel Hill and even though I didn't have natural birth, they were there with me through everything as midwives. I was able to continue my care with my 2nd baby at the birth center and my plan was a v-bac. They were very supportive of my decision.

To prepare for it, I hired a doula and had my midwife, both were very confident that I could do it. I wish I had gone for a refresher course with my husband on child birth education - we took the Bradley method with our first and we could have gone in for a refresher but didn't.

Despite that, we had the most amazing delivery at UNC in 2006 - our baby boy was delivered v-bac by our midwife with the help of my husband and doula by my side. He was a whopping 10.4 lbs!! They were all amazed. My labor was intense but brief - I pushed for 35 minutes.

You have every right to have the kind of birth you want. I recommend that you start calling other practices in your area to find an OB or midwife who will deliver you v-bac. You deserve it and your baby deserves it. Our culture is so discouraging for us as women to have the kind of deliveries we want. I had my baby without any interventions and it hurt and it was unbelievable pain - but it didn't last forever! He came out alert - with his eyes open - and I got to pull him up out of me and up on my chest myself. I'll never forget it.

I wish you all the best! I hope you find the right practice who will listen to your wishes. I hope you will prepare yourself for natural birth and take a childbirth education class, hire a doula, and read about dealing with childbirth pains and how you can do it!

Blessings, R.

You deserve support from your caregiver for wanting to give birth naturally, vaginally. There are risks to a VBAC, yes. But there are other risks, and some of them just as serious if not more so, associated with scheduled repeat cesareans; and also for other interventions that are being done very easily without discussing at length the possible side effects and complications associated with them: artificial rupture of membranes, pitocin, epidural, IV hydration, continuous monitoring, limited movement, limiting positions for labor and pushing, etc.

Educate yourself, research it yourself, so that you have a good grasp of the issue and can make an informed decision. Remember to consider the baby in the equation (e.g. letting baby decide when he or she is ready to be born, versus scheduling a cesarean or an induction based on dates only). Educate yourself not only about cesareans and VBACs but on all possible interventions. Know the pros and cons of each, and what each would bring with it (e.g. pitocin automatically will involve IVs and continuous monitoring).

The ICAN web site has been mentioned already along with a few other web sites. I would like to add to this list www.childbirthconnection.org. They have a whole section specifically devoted to VBAC or Repeat C-Section.
I also recommend you look at The Rights of Childbearing Women.

I myself had a cesarean for my first birth and had a successful VBAC for my second, despite a whole slew of interventions.

I was the doula for a woman who had a cesarean for her first birth, and she wanted a VBAC for her second. She did great, she had a wonderful vaginal birth. She was a petite lady and her VBAC baby turned out to be 9 lbs 12 oz. The doctor had expected an 8 lbs baby at the most. While the doctor enjoyed witnessing this unmedicated natural and successful VBAC, her comment after learning the weight of the baby was: "if I'd known the baby would be this big I would not have let you labor, I would have done another cesarean" - Huh?? why not? She just saw that this lady birthed this baby sucessfully without any problems whatsoever.
This same client has had a 2nd successful VBAC since then, vaginal and unmedicated, no problems whatsoever.

There is never a guarantee, but you deserve the opportunity to give it your best shot and have the full support for doing it.

Somebody made the comment that VBACs are only allowed at their hospital if there is an OB in the building, and that it can not always be the case, since there are only four OBs.
I would have to say that this hospital then shouldn't be allowed to perform ANY births. A small percentage of ALL births can become a true medical emergency very quickly and an OB needs to be available on very short notice. Any hospital needs to be able to perform an emergency cesarean within 30 minutes. If that cannot be guaranteed for VBACs it cannot be guaranteed for any birth, which in my book says they are not really prepared to handle labor emergencies at all.
Uterine rupture can happen in a first labor and birth, does this women not deserve to have a chance to be treated very quickly?

Best wishes to you for your successful VBAC!

My first child was c-section. The way my dr. cut into my uterus (vertical cut which was against the grain of my mucsle) I knew my second had to be a c-section too. It turned out to be a huge blessing!! I had what they call a window in my uterus. There was a portion of my uterus that was so thin, you could see the baby without cutting into the uterus. My doctor said that if I had gone into labor and labored for a few hours, my uterus would have burst and the baby would have died. I don't want to scare you, just want to let you know that this is a possibility.

M.,

The issue may not be how well your pregnancy is going but rather how your last c-section went and where it was. I had a c-section with my 1st and was told that I was not a candidate for a VBAC b/c my uterus had not thinned enough when the c-section was performed, therefore they had to cut me at the thickest portion of my uterus - normally this would have been very thin due to the labor process. I would definitely ask your OB since it may have to do with your 1st birthing process. Personally I would be cautious if your OB is recommending you not have a VBAC, I'm sure there's a reason for that and ask him/her to explain it to you in detail to answer all of your questions.

Hi M.,

My first delivery sounds like yours....we had a "failure to progress" and my son went into fetal distress, resulting in a C-section where the anesthesia did not "take" on my right side. Yup, felt the whole thing. So with my second son 2 1/2 years later, I requested to have a VBAC with the understanding that if anything went wrong, a C-section would then be performed. The results were wonderful! During labor, I did have a terrible sensation of "being ripped apart" at the insiscion (sp?) location which was really scary, but my doctor kept a close eye on it and all went fine. In fact, during the pushing stage I wasn't ready for him to come out...I was having a great time! My results, of course, are individual to me, but I was 37 when my second son was born, so age was definately not a factor in a successful VBAC. Weigh your options and doctor's suggestions. Good luck to you!!

A.

Hi Megan. I had my first child when I was 33 yrs old (almost 34). Like you I had a lot of complications and had to have an emergency c-section. I only dilated to 3 after being induced and having an epidural then after 36 hours of labor, I swelled shut.

With the second pregnacy (at the age of 36, almost 37), I tried a normal delivery. I dilated all the way this time,because I was told to sit up the whole time in labor and I would dilate. It worked! But after 2 1/2 hours of pushing, I still ended up in the operating room. But I do know that it is possible to have a normal delivery even if you have had a c-section. I was just to small to deliver. Hang in there. I can't advise you if you should try it or not. But I would check with another doctor to see. I would not advise pushing as long as I did though. I don't think it is good for you or the baby. My second son was on oxygen for 8 hours afterward. He is very healthy though. He is 12 years old now and in the 6th grade and is a straight A student.

I wish you the best of luck!

C.

Of course your OB wants a C-section... she can plan that and don't have to wait around for you to labor...she can do it in less than five minutes...and she will get a lot more money (about 3 times as much) for a surgical birth. my advice is to watch ( The business of being born) ...If you want to avoid them you have to get out of the hospital setting But with your prior birth experiance you probly arn't going to be comfortable with home birth...If you stay with your OB; prepare yourself for a lot of scare tactics there are many pros for the doctor to want a surgical birth but, there are many cons for you...much longer healing time , scares and adhesions, problems getting breast feeding started and extreme cost not to metion the emotonal disapointment you will feel for not getting the birth you wanted...let your OB know how inportant to you this is...if your OB's not willing to help you achieve the kind of birth you want find a doctor or midwife that will...I know from my own prior experance that one birth can be a nightmare with many complications...and the next can be wonderful, meaningful, and healing. trust yourself, and your body to do what bodies do, remember that pregnacy and birth are natural states of the body that (rarely) need treatment or medical intervention....
Trust Birth

Wow, I'm impressed with how many vbac-minded moms and how few fear-mongers there are on this list! I was pretty afraid to read the responses to such a question. What an enlightened and supportive community!

I'm with those that vote for the vbac, provided you're a good candidate (and there are very few who aren't) and an otherwise healthy woman and baby. My first was a surgery and my second (born almost exactly two years later) was a natural, normal birth. Having done both a sincerely prefer the latter!

Was it smooth sailing? Yeah, pretty much. The labor and delivery went like clock-work, just like we'd read it would. The pregnancy was a little stickier. I had to convice first my husband and then my family that I wasn't crazy. And I had to switch providers. I discovered about halfway through the pregnancy that the OB I was with (because he was in-network and geographically convienent) was stringing me along. When I brought up vbac, he'd say, "We'll see." But, lo and behold, he works at a hospital with a vbac ban! Talk about a bait and switch! So right around the 20 wk mark I changed to a hospital midwife group (also in-network, but 40 minutes away).

You know how real estate is about location, location, location? Well, I think vbac is about provider, provider, provider. Get with someone who believes you can do it.

I also feel like I owe a lot to my Bradley childbirth classes. They helped my husband to really get on board. I read a lot to prepare, particulary vbac stories and also natural birth stories, so that I'd *know* it was possible and what it looked and felt like in all its variables. (For example: "Ina May's Guide to Natural Childbirth". It's just one of many good books out there.) And I researched the heck out of it. I had all the stats handy to reassure me when people started telling horror stories about uterine rupture or whatever. (Rupture risk is about .5%. No more than any other emergency complication that might arise.)

The women at ICAN's support list were an awesome source of info. I'd also suggest the vbacfacts.com website.

C-sections aren't evil or anything. Of course, if it's a life and death situation, you'd choose it. But who would willing sign up for elective major abdominal surgery on the same day you're handed a newborn, if it wasn't necessary?

Feel free to email me privately! Good Luck!
L.

i have not had a vbac, but i did work for years in the labor and delivery unit at the university hospital. i think that you should definitely try for the delivery that you want. you may have to speak at length with your ob-gyn, and maybe even ask to speak with one of the others in the office if their are others. what i have seen of vbacs, if your doctor and you decide that it is something you are going to try, my advice would be this: make sure you have a good iv, just in case they need to do a c-section later, try not to use pitocin, it can make the contractions so strong that they can stress the scar from your previous section, if you must have an epidural, have the lowest dose that you can so that you can feel if their is any pulling to the previous incision, and remember, labor can take many, many, many hours, keep your bag of fluid in take as long as possible so that you can safely labor for as long as is needed. as long as the baby is healthy, and you are tolerating labor, you can keep going. dont let the staff at the hospital guilt you into a c-section because they are tired of dealing with you. oh, i forgot to ask if your c-section the first time was a horizontal or vertical cut. if it is vertical(belly button to pelvis) you can not have a vbac no matter what. it is almost sure to rupture your old scar, not to scare you, just an after thought.

I had a VBAC with my second child and it was smooth sailing. My Dr. let me have the choice as to whether I wanted it or another C-section. When I went into labor with my second, everything progressed as it should have and I didn't have any problems recovering. I feel that you should discuss this with your Dr. if you want to try for the VBAC. There is no reason why you couldn't try for it first and if things were to get bad, then they do the section (hopefully not though). I am so glad that I decided to have the VBAC.

Express your disire with your doctor, she may not fully understand your "want" for a VBAC. There ARE serious risks involved, so only do it if you're fully confident in the doctor and the hospitial you'll be delivering at. I had an emergency c-section with my oldest, and when pregnant with my 2nd expressed my desire for a VBAC to my doctor. I was just like you, I wanted the "chance" to experience natual childbirth. She explained to me all the potential complications and risks, but backed my decision 100%. Still, I at least wanted the chance. I had none of the complications that I had with my first pregnancy and was scheduled for an induction 2 weeks before my due date. (I was already experiencing early labor contractions and probably would not have made it to my due date anyways.) Lo and behold #2 ended up another c-section after 14 hours of non-progression (due to other complications) but the pain and recover time was MUCH shorter than with my 1st.

M.,

Of course you are a candidate for VBAC!!!

You might want to contact ICAN, if you haven't already, and find out if there is a group in your area- if not maybe you can at least find online support.

http://www.ican-online.org/

Hopefully there will be someone in your area who can refer you to a good OB or midwife. If that is your OB's attitude, you will definitely need to switch! The most important things for VBAC are a supportive provider and a supportive environment for birth.

If ICAN can't help you in your area, La Leche League might be able to help. LLL Leaders cannot give referrals to health care providers, but natural childbirth is a common theme for many (not all!) LLL members and moms who attend meetings. Pregnant women are always welcome at meetings and you do not have to be a member to attend. Hopefully one of the moms there will be able to give you a referral to local docs or midwives who are natural birth friendly- those who support natural birth generally support VBAC, even if you choose not to go natural. In addition, LLL groups also have lending libraries with books on childbirth, many groups will have some c/sec and VBAC specific books available for loan. Many libraries are member only, but some group libraries are available to the public as well, it varies from group to group.

http://www.lllusa.org/

Another idea for you to get referrals for a VBAC friendly provider (and VBAC friendly hospital if need be) would be to contact doulas in your area, assuming there are any.

HTH

Hi M.,
My first child was a C/S and then I went on to have 3 children after him...all of which were VBAC. I purposely found an OB that was comfortable and believed in VBACs. Do your research on the subject. I am not sure what the details were that led to your C/S...also, what type of incision do you have...which direction does it go...across or from top to bottom? Did your doctor give specifics on why he/she thinks you have to automatically have another C/S? I wish you the best...please let me know how it goes!
B.

Wish I could tell you I had a successful VBAC, but I was a two c-section girl. That said, I don't regret at all giving it the college try--because every birth is different.

With my first, I labored 22 hours but got stalled out at about 7 centimeters for around 8 hours. My doctor made the final call on my c-section, saying I was failing to progress. My first child weighed 10 lb, 11 oz and I'm fairly small, so the doctor said to some extent that may have been the reason. He was also sunny side up and they attempted to turn him externally and were unsuccessful.

With my second, I insisted I wanted to try to VBAC. My doctor said I was making a mistake and disagreed with me throughout the pregnancy about the VBAC issue. I said that it was my body and that lots of people are successful at it. In the end, I labored 21 hours then I made the call for the c-section because she was in a weird position and the epidural wasn't helping my pain--really bad back labor. She was c-sectioned by another doctor in my practice who was wonderful about not pressuring me into the c-section and letting me decide since the baby wasn't in distress. Turns out to have been a good decision (the c-section) because my daughter's head was caught in a weird pocket of my pelvis and took two doctors on top of the table and me to get her out--dramatic ending but all was fine.

With both children, I progressed through the early stages of labor "normally" but couldn't get the last 3 centimeters of dilation. Could be coincidence or just the way my body works. Anyway, don't regret the second labor because I had wanted to try for a vaginal birth to experience it, but in my case, it wasn't meant to be. Two healthy children is the best outcome, regardless of the method of delivery :).

Best of luck to you!!
L.

Hi there! Congrats to you on your new a baby to be in August. I too had a terrible and long labor with my first child. (water broke first, stalled labor, drugs didn't work to speed things up, was in labor 40 hours, wound up with a c-section in the end and an infection of the uterus afterwards!) Anyway, not to scare you...but with our second I too wanted to have a typical delivery, VBAC. I changed doctors, I went with the midwife, and was into all kinds of alternative methods of practicing to get ready for baby #2 (yoga, exercises, doula etc). I am a petite person, and my pelvis was not big enough to handle our first which is why my labor stalled and the end result was a c-section. I consulted with everyone and did my research and the end results were another c-section with our 2nd, but I didn't give up trying. All my drs were in agreement to allow me to progress as far as I could if not all the way with my labor, and at the earliest sign of any problems I was under the agreement that I would need to have a c-section. My two kids are 15 months apart and their biggest concern was tearing. Don't give up with trying to have a VBAC. Talk to your dr and explain why and how strong you feel about this. If you feel like your dr won't even let you try, then maybe consider switching drs or practices. All drs and midwives are looking out for you, despite the typical thoughts that they want to "schedule your c-section before they go out for their afternoon golf". Don't give up either, look into taking yoga for pregnant women, it helps with breathing and allowing for you to focus on your body and sensing things and hopefully giving you the extra edge to progress naturally. With our second, I didn't even know I was as far along as I was. I was having somewhat regular contractions over several days, but in short time periods. Over the course of an hour, they would be 10-12 minutes apart, and then stop. I thought I was just have Braxton Hicks Contractions and I was under the "false labor" alarm. They got to the point where they were getting kinda painful, but not consistent enough to think I was in labor. So I went in and I was 5 centimeters and 2 weeks early! So we went to the hospital that morning and had our son (via c-section) that night. I tried, I really tried to have a VBAC, all my nurses and my midwife were there and we did everything we could to have this kid naturally. God just didn't want it to happen. He was not quite sunny side up, but more looking to the side and my small pelvis was not allowing him to get through. I think I made it to 8-9 cm on my own. I was devastated and upset that I was so close, but his heartbeat was starting to drop during contractions and they didn't want to take a chance. The best advice is to go in with your heart set on what you believe in, BUT do not be discourage if it doesn't happen the way you want. You will still get to have your little boy and hold him in your arms and become a mom all over again! Best wishes, good luck and enjoy the next few months with only 1, b/c with two it gets kinda crazy sometimes!!

A.

Hi, Yes I had a VBAC. My first was sunny side up and not moving down. After 12 hours they said c-section. I wanted to try a vbac with my next child. I did a lot of reading and gathering info. I felt I was a good candidate. The one thing that helped was having a doula(midwife) help me out. Get a good one that has a nursing back ground. She helped me move through labor and put my body in positions to help the baby. With this I delivered in three hours with less pain. Just remember there is still a chance of having another c-section. It depends on your situation. Get lots of info and talk with a doula.

I was in labor for 41 hours with my first, 26 of those on pitocin, and never progressed past 4cm and had a C-section to deliver my son.

Three years, three months and 10 days later I was induced at 37 weeks because they could already tell my son was big (10 lbs, three weeks early) and he was a VERY successful VBAC. They gave me a walking epidural which took the edge off, and I was in labor from 7a on Monday until he was born at 1:13p. Tuesday, all of it on pitocin except for 7 hours overnight where they turned off the drip so I could get some decent sleep even though I was still in labor (to a degree).

Two pushes and that giant baby came flying out and I am THRILLED that I had a VBAC with #2. I'd find another OB ASAP if you feel yours will not support you in having a VBAC. If you wait too long, some doctors won't allow you to transfer to their care.

Some doctors prefer to do repeat C-sections because they can schedule it and not have it interfere with their sleep or planned activities.

Good luck!