Thursday, January 8, 2009

VBAC or not to VBAC...that is the question.


So I was feeling pretty confident about our decision to try a vaginal birth after ceserean, "The VBAC", until this morning after my latest doctor's appointment. Upon further confirming my decision for a VBAC with the doctor I was given a sheet of paper from the insurance company to discuss with Chad, sign, and bring back. It looked something like this...

1. I understand that I have had one or more prior cesarean sections..........check! (What kind of question is that? How could I have forgotten!)

2. I understand that I have the option of undergoing an elective repeat cesarean section or attempting a vaginal birth........check

3. I understand that approximately 70% of women who undergo a VBAC will successfully deliver vaginally........check (not perfect odds, but most likely I will fall within the greater %....although Chad was not comforted by this)

4. I understand that the risk of a uterine rupture in someone such as me who has had a prior incision in the non-contracting part of the uterus is approximately 1%.......check (1% is very low, barely recognizable.....however, upon reading the next two statements, it somehow seemed a lot more of an issue)

5. I understand that VBAC is associated with a higher risk of harm to my baby than to me.
&
6. I understand that if my uterus ruptures during my VBAC, there may not be sufficient time to operate and prevent permanent brain damage or death to my infant.
(The doctor informed me it takes only 3-4 minutes for this damage and even death to occur and 15 minutes to actually preform a very quick c-section upon discovering a rupture. Rupture also most likely = hysterectomy. Tears usually happen right at the beginning of labor and most often are not even felt. He ended by saying that the scars usually always begin to separate a little with VBAC's but don't often cause a problem)

The check list goes on, but after reading through it, what seemed like a pretty sure decision feels more unsure. Chad straight up said, "Let's just do another C-section" after reading through it all.

So here's my dilemma...The risk of a uterine rupture (due to the scar tissue being weak from my last c-section) is pretty low and pretty rare, but if something were to happen the consequences and complications would be huge. So why not just go for a second c-section? For one thing, recovery time is quicker with vaginal births and I'm thinking that having a two year old and a new born will definitely require some quick recovery whether I like it or not. Then after two c-sections the policy is always c-sections; so I feel like this one carries with it more weight. Also, the more c-sections you have, the more the risk for rupture or the placenta attaching to the scar tissue increases. We really do want to have 5 or 6 kids, but could my poor little uterus handle 6 incisions? Who knows.

But really, doesn't any girl wonder how much pregnancy, labor, contractions, incisions, etc. their body can handle. I just vote that men have the babies! J/K No, really I do love being able to have this experience. It just worries my little mind sometimes when I consider all that has to be done to get these little human bodies out of our big, achy, exhausted, pregnant human bodies.

So, I have done some reading and researching on my own, but I guess what I'm really asking for is what PMB asked for before her last delivery.....stories. Have any of you had experiences with VBACs or known someone who has? How did it go? Have you ever been faced with the decision yourself? What did you choose and why? Really anything would be useful. Thanks fellow bloggers.

18 comments:

Henderson Family said...

Okay Vandi, there is a lady in my ward who had her first child vaginally, and then had two sets of twins only 11 months apart. Both sets she delivered by c-section. She then had another child about 2 or 3 years later which she delivered vaginally. I think that you would be at greater risk if you were having your children 1 yr. apart, but I think you have given yourself enough time to heal so the chances are the greatest for you right now. I would probably get an epidural for sure though, so that you can be completely relaxed and won't experience a lot of stress when you are having your contractions. Follow the spirit and you'll know what to do. But don't let fear take over. You'll be okay!!!

emily said...

I agree with the Henderson family. Don't let satans tool (fear) take over. My sister I think had a C-Section the first time & she was told if she wanted to have more than 3-4 kids she had to have the rest VBAC. I think you will have more risks involved if you had another C-section for future births. I would try to VBAC but give your doctor the heads up that if things aren't going soomthly you might change your mind. Nothing wrong with being prepared.

Ashley's Cakes by Design said...

Wow, I can't say that I know anything you are going through, except wanting your baby to be taken care of. If for ANY reason you need to bring Em over here PLEASE DON"T HESITATE! That even means in the middle of the night if you go into labor....anything! Good luck with your decision!

Stephanie C. said...

I know I'm not your visiting teacher anymore, but I feel like leaving you some advice, no matter how cheesy. I would pray about it. If you feel like a vaginal birth or c-section is the way to go, the Lord will help you out. He understands our bodies way more than any doctor. Good luck with the decision. Everything will work out!

Englebright said...

Oh, MAN Beus. What a hard choice! If Aaron and I were in this situation I'm sure Aaron would be opting for the C-section as well. But come to think of it, even normal vaginal births have %1 chances of complications. Geez. I'm no help at all.
Just know I'm thinking about you guys and I love you!

Laura said...

I am of no real help here either. But I did have a neighbor who had 2 C-sections then opted to go to Boise and have a VBAC. Everything went perfect.

With how they do the low/horizontal cuts now in the uterus for c-sections, I have heard that there is a lot less chance of it rupturing.

Good luck with it all!!! I know that whatever you decide it will be the right choice for you and your family!

koster family said...

I'm in the same boat as you (well, except I'm not currently pregnant) but I had a C-Section with Gray. Anyways, I have a friend who is a labor and delivery nurse and she recommended the repeat C-Section, however, I told her that the next one I have will be the last. I think she was a little partial though because she had recently assisted in a VBAC where the 1% occurred and the baby died. So...I'm not sure if I would have asked her at another time she may have given me a different answer. It's a hard decision. Best of luck.

Shalee said...

Hi Vandi! I just came across your blog and was really excited to see your smiling face! What a cute family you have!!

I actually just had my first baby on October 1st and had to have a C-Section because she was breech. I talked to my Dr. at my 6 week appointment to see what my future looked like (not that I am in any hurry) and he said he would definitely recommend sticking with the c-sections. He was involved in VBAC case that went bad and they lost the baby because they could not get it out fast enough. He also said that because you most likely have an epidural, you often times do not know that you have torn because you don't feel it which gives them even less time to do an emergency c-section. He also told us that when your uterus is contracting so strong that it would look for the weakest point to rupture or tear....which would be your incision. I also have a friend who had a c-section, tried a VBAC and tore and had to have an emergency c-section. Her baby was fine but it did permanent damage to her and she was not able to have any more babies. On the other hand, I also know several people who have done a VBAC and had no problems at all!

I am totally with you...it is a hard decision and I don't now what I will do with my future babies. I am NOT trying in any way to tell you which way to go...just putting out the info that I have been given.

Hope you are doing great!!
Shalee

Carrie Fowler said...

Vandi,
I don't know really what advice to give you but I just want to say thanks for bringing the topic up because that is a decision that we will also have to make (sometime in the future) since I had a c-section also. It was really good for me to read all of that info so I can start thinking about that now. Good luck with everything, if you need me to watch emryi at anytime, let me know!

SmustysGirl said...

Well, I think 1% is really low and that more than likely you probably would have a fine VBAC. However, if your uteris tore and the baby is fine you might have irreversible damage and couldn't have anymore babies. Then you'd have only 2 out of your 5 or 6 that you wanted. I think that your chances of having all the kids you want would be greater by doing them all c-section. It seems like it's not "holding" the baby that c-section uteruses can't handle, it's the contractions. So having a greater number of kids should be ok, as long as you don't try to deliver them vaginally and risk the tearing. IDK, I'm sorry you guys have to make such a difficult decision. In the end, pray, do what your head tells you. The heart makes decisions too personally. Just pretend you're Al and use only logic and no emotion :) haha I love you guys!

Unknown said...

Vandi and Chad,
We were faced with this decision as well. Payton, now three, was breech and only 28 weeks, so we had to do a c-section. Carson, now 15 months, was also born c-section because Tod, like Chad, was very scared for me and the baby and wanted me to just do another c-section. We decided, that for us, even though the risk for rupture was small it was too great a loss if something bad did happen. Anyway, Hope this helped! Good luck and I think it's probably a good idea to pray about it! You'll make the right decision for you and your growing family!
Good luck, Emily

Blake said...

I figured that I would put my two cents in. The statistics, and information are very good to know, but ultimately, this is a decision that is made between you, Chad, and the Lord. I know Chad, and he is an inspired person, and does what he can to follow the spirit. If he feels strongly one way or another, it is probably an inspired thought.

Having said that, the best thing to do is to pray about each decision, and why that decision is a good or bad choice, and let the spirit guide you.

Many people have multiple c-sections, and there is nothing wrong with that. BTW - I believe that Anna Mae had all of her kids through c-section. You might want to check with mom about that.

Also, blessings can be powerful things, and can give you a lot of insight when trying to make a difficult decision.

proudmamablogga said...

Well, i already told you my two stories. One friend had 5 cesareans. she's fine, and all babies are fine. Another woman had a cesarean and then 4 vaginal births. She's fine, and all babies are fine. These stories may not help since they are second hand. But I can totally, 100% empathize with you and many other women who experience fear or misgivings about labor and delivery. It is perhaps the most dangerous, physical, spiritual, selfless, and enabling act we experience as a human being. I am very grateful to be a mom to two wonderful people, and sometimes I still think i cannot comprehend the enormity of the experience.

Everyone you know wants the best for you. And I'm sure you will find the support you need whichever way you decide to go.

Mrs. Mandy said...

I can't speak from experience, but it sounds like you do have a tough decision to make. I just know that modern technology is amazing, never perfect of course, but my sis-in-law had her first c-section but then had her next two vaginally and both have been wonderful for her. You're right about the faster recovery, but there's alot of pain involved either way. Just know that you have lots of helping hands close by with which ever method you guys decided on.

Snidbits said...

Vandi
Good luck with the decisions... those waivers always make it sound worse than it is though. They just want you to know there is still a risk...well there's a risk in everything right?
I totally missed you when you texted me about sledding and games during the holidays! It made me want to see everyone so incredibly bad. I think we've already decided that we'll be home for Christmas next year for sure soooo...we'll have to plan on something!
Blue pride

proudmamablogga said...

F.Y.I.
Don't even now if I should be telling you this.
I talked to Pisces about this last night. He said 1% is quite medically significant ("They take preventative measures for risks at even 1 in a 1000, let alone 1 in 100," he said.)
I may be a terrible friend for telling you that, but I guess I would feel worse if I told you after.

Gardiner said...

Hey Vandi. So I could be categorized as a blog stalker, but anyway, here is my opinion. I work Labor and Deliver in Brigham City, and we deal with this all the time. The staff will be informed if you chose to go VBAC and will be prepared for anything. They have to tell you all the odds to cover themselves legally. I have seen the results of c-sections and vaginal deliveries. Recovery time is much quicker and painless with a vaginal birth. I think you would be okay to go natural, but again, the choice is yours. Good Luck!

mckell said...

Hey Vandi! I love your blog. And I just thought I'd throw this in: my mother had 2 c-sections and then her last 4 vaginally (which isn't even allowed anymore). Her uterus (and bladder) ruptured with my youngest brother. It was scary for her- she lost a lot of blood and had a long recovery. But that was child number 6 . . . I agree with Stephanie. Pray about it! And we'll pray for you. :)