vbac advice pls

[lou0504]

hi all well from day one of my pregnancy my ob said as i had emergency c sec last time it was very advisable to have it this time. I had vaginal delivery with my 1st then i was overdue and induced with my 2nd and ended up having a em c sec ue to faliure to progress and bubba having a high head, i also lot quite a bit of blood during section. So i got my head round having a c sec although this will cause life distruption as i cant drive for 6 weeks and having 3 kids and hubby can only get 3 weeks off work itss going to be hard. So went for my 34 week ob appointment today and my normal ob was off sick, i see his colleuge who didnt have my full notes so didnt even know why i had a c sec last time, i said am i booking my c sec today, and he said why are u having a section and i said becuase i was advised. He said theres no need, u had vaginal delivery with your 1st and theres no reason u cant with this one. I am very confused at this point. Obviously id love a natural delivery but i didnt know any of the risks of vbac and reading on here there obviously is some. He done an internal exam and said my cervix was open and soft, and being only 34 weeks he didnt think it make it to 38 weeks, so let nature take its course and try natural, i would love your thoughts on this, im now worried about risks, do you think i should book appointment for a 2nd opinion and ask for my 38 week c sec to be booked incase i dont go into labour before that and if i do what would you recommend? thanks 4 reading x

[Tobily]

Hi Lou

It is true that VBAC carries a risk - the main one that concerns caregivers is the risk of uterine rupture. However, this risk is very small - about 0.07% if you go into labour under your own steam.

Repeat caesarean section also entails a number of risks - prematurity, breathing issues, higher risk of infection than a vaginal birth to name a few - as well as a significant recovery period which you're already aware of.

The overwhelming majority of evidence lies in favour of the safety of VBAC over repeat caesarean, all things being equal. The fact you have a previous vaginal birth under your belt is also very much in your favour.

The reasons why obstetricians sometimes encourage repeat c/sections despite evidence that is not the safest option for a healthy mother and baby are a bit complicated. Basically it comes down to their feeling more in control and comfortable with the risks entailed with caesareans (as an op that they perform routinely) over the more unpredictable (but very small) risk of something happening to your scar during labour. This tends to see them encourage women to elect a caesarean rather than a have a vaginal birth.

It's very likely that your last c/s was fundamentally due to your being induced - baby wasn't engaged, your body wasn't ready...a term pregnancy lasts up to 42 weeks, and if you were induced before your body and baby are ready, you are more likely to end up with a caesarean. Since induction isn't usually on the table for a vbac, if you're able to go into labour when your baby and body are actually ready you probably won't have the same issues again. And as I said, you've already had one vaginal birth so that's proof your body knows what it's doing

Good luck

[Aphrael]

I know its a hard decision to make for some people but in the end it is actually safer to have a VB, there are risks with caesar as well as VBAC!

You've had a baby naturally already which means you will have more success than if you had never gone into labour (my situation!), so long as you keep fit and healthy and am aware the risk for rupture increases with induction and an epidural is out of the question (one of the first signs of rupture is pain in the scar area so epidural is not allowed generally) then I'd try for natural!

It really is your choice, do your research and google VBAC (there are some great american websites out there) and make an informed decision.

Cheers,

Beck