16 Weeks and Thinking about the Birth | Repeat C or VBAC??

I went to see my Obstetrician on Thursday for my sixteen week prenatal visit and we ended up talking for about an hour about the upcoming birth! We discussed my low platelets and what my options will be if they are at or below 100,000 by the time I’m 30-something weeks, and what my numbers will mean for my delivery. More on platelets in another post. We also talked about several possible birth scenarios.

I’ve been thinking for a number of weeks now that I’m going to have an elective cesarean no matter what, but much of what she was saying about VBAC made me feel like it might be a better choice. She absolutely wasn’t trying to sway me, and she said the decision is 100% in my hands, but I wanted to know about both, and that’s what she gave me. The four reasons I was thinking c-section are as follows, in order of their importance (in my mind):

  1. My other cesarean will have only occurred 19 months before this birth so…increased uterine rupture risk. O_O
  2. I thought I wanted a tubal ligation so why not have it while they’re already doing surgery?
  3. I was pretty much traumatized by my last birth and I really, really didn’t want to experience labor again.
  4. It is so nice to think about the convenience of just walking in there on a set date and having them deliver the baby because my husband can plan it with work, etc.

BUT, most of the reasons seem a little less valid after our discussion.

  1. For one thing, I found out that “uterine rupture” is a really scary way of describing a condition that can range in severity. It sounds like your dang uterus explodes, right?! But it’s actually about tearing, which can be minor or major. And the risk for a woman who’s had a previous cesarean is about 1 in 10,000. Because my babies will be less than two years apart, that risk doubles for me, but that still only means 1 in 5,000. Not terrible.
  2. The tubal ligation thing might not happen now. Or ever. The effectiveness is not what I was hoping it would be. It’s something like 1 in 300/400 women can still get pregnant after having it. Considering my husband and I 100% don’t want to have any more children after our fifth one, those odds don’t seem so great. And if I were to have a successful VBAC, it would mean an outpatient surgery at six weeks postpartum, not a procedure done at the hospital following the birth like I’ve read some doctors do. I know myself and I’m not going to want to go through another procedure with a six week old.
  3. I’m still traumatized by my birth experience with Elizabeth, but we discussed a few scenarios that made me feel a little better. One is that I could go into labor earlier than 39 weeks, and show up at the hospital already quite dilated, with not much more to go. If I’m 8cm when I get there, am I really going to want to pass on the VBAC option? I don’t think I would. My chances of having a repeat of what happened with her (essentially getting stuck) after having had three babies just fine are probably pretty low. Another scenario would be that I get there at 5 or 6cm and they start prepping me for surgery but by the time they’re ready to take me back, I’m at 8cm. Again, would I still go in the operating room at that point? Probably not.
  4. While there’s no denying the convenience of having a set date and time, I’m still not totally free of the spontaneity factor because it will mean I have to make it to 39 weeks. I could certainly go into labor before that point.

So, as it is now, I’m looking at two possibilities. My view could certainly change but here’s what I’m comfortable with currently:

C-Section

If I go all the way to 39 weeks (Jan 31, 2017), I will have a scheduled c-section. I absolutely do not want an induction, which would significantly increase the risk of uterine rupture and/or could end with me in the O.R. anyway, and I don’t want to go beyond 39 weeks because of my age and the incidences of still birth, as well as the size of baby (for me) after that point.

VBAC

If I go into labor before that, I am feeling like I want to play it by ear and see how labor progresses. With my last two pregnancies, I got to 4cm before labor even started so I arrived at the hospital at 8cm and 6cm respectively, without a whole lotta laboring going on to get me there in the second case and only some in the first. It sure would be nice to recover from a vaginal birth instead of surgery.


Honestly, I’m just still really (really) scared of the pain. It’s still fresh in my mind. The pushing stage with Elizabeth, in particular, was frightening because of her position. I can’t even describe how bad it hurt my ribs and diaphragm. I’m trying to think positively about it and not focus on that because I really do think a VBAC sounds better.

Thoughts?

15 thoughts on “16 Weeks and Thinking about the Birth | Repeat C or VBAC??

  1. I understand! My first ended up being an emergency c-section because she got stuck also. Her head was coming out flat on top instead of having one of the soft spots coming out. I’d tried to have a home birth, and the midwife was horrible. I ended up pushing for 12 hours before losing strength and needing a c-sec. So I understand the delima! My second was born 20 months after, so close to you. My husband is very natural, so knowing he was cheering me on to do a vbac gave me enough umph to try. I only pushed for 3.5 hours with her, and she ended up coming out vbac. She essentially was my first baby, since the first didn’t come out that way. The recovery was nice and shorter than c-sec. Two months ago I was in the same place you are, looking at having our third. The dates were confused by 3 weeks, so I ended up going to the hospital and having my waters broken. But hard labor was only 2 hours(it was intense, since he was 10lb 3oz). My hubby again was cheering for a vbac. I honestly grew up with stories of my brother being c-sec, and me being vbac(back when they didn’t usually do that). So scheduling a c-sec seemed very nice! I have friends and relatives who have done both. Know that whatever you choose, you have done an amazing job carrying this baby, especially after the last traumatic birth. Many wouldn’t even try again. It sounds like you’ve done your research and weighed the options and landed at a good place. Own it and go forward with confidence!

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    1. Wow, our situations are really similar!! Goodness, you went through such a long labor before your surgery. :( It’s awesome that your VBACs were successful! And woo – what a big baby!! My fourth child was my biggest, at 8lbs10oz. I’m really not sure how this birth will go but I’m open to either scenario! Thank you for your encouragement to be confident. XO

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  2. Well, my vbac was only 17 months after my csec and it went well (the labor and pushing) especially considering I was induced. I do plan to vbac again this time and my drs are very supportive of that choice , although my hubs is 100% for scheduling things to make it less stressful. I have no idea how things will play out… will I go into labor naturally? Be induced? Will baby be head down? Not in distress? So many variables. I’m trying to keep an open mind. But after having 1 successful vbac, I do want to try again if me and baby are doing well at that point. I hope you have an easy birth whichever way you decide to go. There are no wrong choices here. Just do what feels the most comfortable and healthy at the time.

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    1. There really are so many variables and choices! Glad you were able to have a VBAC – that’s great. Best of luck this time, too. I’ve no idea how things will go – guess I’ll just have to wait and see! Thank you for the support. I’m anxious but open to both scenarios. :)

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  3. I have no experience in this, but I do know from what you said, and other moms every single child is different. I’ll be praying for the position of this little one to be much easier on you!!! :) Peace of mind and assurance be with you, Valerie! Thinking of you!

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  4. I think you are in good hands with a doc who’ll talk that long with you about it!!! I don’t have c-section experience, but it does sound like you’re leaning toward that. i mean, you don’t have to prove to yourself or anyone else anything by having a VBAC…
    Best to you whatever you choose!

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    1. Right?! She talked about so many different things with me. It was great (well, until she started about genetic testing and detailed ultrasounds because of my age, which I declined. *sigh*)
      I’m definitely not about proving myself with this birth. I don’t even care if I have a VBAC so I can say I had one (if you know what I mean) but I want to have a peaceful experience and healthy one. That could certainly be achieved by c-section, but is also a possibility with VBAC so who knows… Thank you for your support! ^_^

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  5. I only have one, so I can’t help with that… but I have a friend who had a VBAC at 17 months and it all went well. In talking to friends, it seems to me that the topic of a VBAC is just about as controversial (and competitive?) as breastfeeding vs. formula. I say go with what your gut tells you and what YOU are comfortable with doing.

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    1. Haha, it sure is a controversial and competitive subject! No idea why as it doesn’t affect anyone but the woman/baby/family. Kwim? I couldn’t care less if a mama has more than one cesarean so long as it was the right decision for them. My problem is that I just don’t know which is right for us, lol. Oh well, time will tell. I know I won’t feel guilt or pride or anything like that, no matter how it goes, because it isn’t a hot topic to me. ;) Thank you for your support! XO

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  6. I think it’s so hard to know what to do because labour and birth are so unpredictable. I absolutely did not want to be induced at 39 weeks as I was convinced it being my first baby that it was going to take days. I agreed to it because of medical advice and in the end I had a very quick, uncomplicated labour which was a surprise to everyone. I know people who have had great and terrible natural birth experiences and the same with C-Sections and the same with VBACS. I just don’t think there is any way of getting these babies out without some drama/pain. I am sure you will make the right decision for you though.

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