Advice about VBAC (Vaginal Birth after a Cesarean)
Parent Q&A
Archived Q&A and Reviews
- What's the right support for a VBAC?
- Have you had both vaginal and C-section deliveries?
- C-section vs attempt VBAC
- VBAC Induction?
- Want to have a VBAC; current OB can't offer it
- C-Section or VBAC?
- VBAC at Alta Bates
- VBAC versus a C-section
- Seeking VBAC stories
- Trying to decide about having a VBAC
What's the right support for a VBAC?
March 2010
Dear fellow parents, I'm looking for advice about what the right support might be in trying to have a VBAC. A doula? A midwife? No support person but other preparation (are there books, web sites etc. that you'd recommend)? I'll be delivering at Kaiser Walnut Creek. We had a doula the first time around and she was wonderful during our at-home labor. When I arrived at the hospital I was 9 cm. But I ended up with an emergency c-section. It's very difficult to know whether or not it was truly necessary, but the doula did not do the questioning, or stopping the process that we'd discussed and in our post-partum follow-up she didn't know whether the right thing had happened. She wasn't very experienced, though wonderful in every other way. I'd like to find some one with a lot of specifically VBAC experience. Thanks so much Anon
I highly recommend checking out the ICAN forum. You can post your birth story and see what other people thinks regarding your experience. The organization is for people who've had c-sections. The website also has books you can read specific to VBACs. I find that there are a variety of opinions on what the ''right'' thing is. So the best thing is to educate yourself and form your own opinion. Everyone has their own comfort level when it comes to what they're willing to risk. A lot of things in birth, in my opinion, are only guesses and only in hindsight is it 20/20. anon
Have you had both vaginal and C-section deliveries?
Aug 2008
I am 8 weeks pregnant with my second child. My first child was delivered via C-section after over 3 hours of pushing and trying to vacuum the baby out. I really want to try to deliver this baby vaginally but I have concerns. I am worried about the risks of having a VBAC (ruptures, etc.) but I know there is a lot of evidence out there showing that the risks are very slight and that it's more of accepted medical practice than an actual health issue. My biggest concern is that I have to repeat my first birth - being in labor for over 30 hours, then having to push over 3 hours only to have a C-section. Recovering from both a vaginal and C-section delivery was very difficult. I wanted to get advice from women out there who have had both and what their experience was - was it easy to have a vaginal after C-section, did they have a successful vaginal delivery, was it difficult to convince doctors, etc?. I understand the research out there on VBACS so please no lectures about that risks or no- risks related to that. I'm looking more for practical advice to the actual birth and not people's philosophical reasons for or against it. Thanks. Anon
My first child was in a breech position and after a long difficult labor I ended up having a c section. When I was pregnant with my second child I read alot in trying to decide if I wanted to attempt a VBAC. What I remember most is that the baby should not be very large and that labor should be progressing. My baby was over 9 pounds and my labor was not progressing. In spite of this, the doctor wanted me to continue labor. I finally insisted on a C section, and he complied but was annoyed. Later a nurse who was ther told me it was really good that I insisted on the C section as it would have been a difficult birth with such a large baby. I think some doctors want to be able to say they have a low c section rate, but this is not always in our best interest.Had I read more before my first baby, I would have insisted on a C section then too. My daughter was head up with one leg up, and when they finally did a C section many hours later, she only had an apgar score of 3 and had to be suctioned to start breathing. Fortunately both of my children were fine, but I am not convinced that would have been the case had I continued labor. Ellen
I had an amazing VBAC experience. My first child was breech, so I had a planned C-Section. I very much wanted to have a vaginal birth for my second, and it worked out wonderfully. My doctor was supportive and made me feel like it was no big deal. I delivered at Alta Bates and the nurses were super. They too made me feel confident about delivering vaginally. Having professionals around me who were supportive helped me forget about the risks of rupture. I also tried to remember that C-section is major surgery with lots of risk, too. . . If you really want a VBAC, I would say that if you have the support of people around you, then go for it. robyn
I can hear the anxiety coming through your post and would like to share my positive experience with a VBAC. My cesarean was also a little ''traumatic'' and the recovery period for me was closer to 7 months...it took a long time to get over the sporadic and spasmic sharp pangs in my abdomen, and literally took 9 months before I could resume running and working out comfortably. I went through a similar struggle when I was expecting my second child and like you read up on the subject, tried to talk to others who've experienced it and really weighed my options. In my (positive) experience, the VBAC was easier than anticipated. I pushed for 40 minutes and since I had an epidural (which only took on one side), I couldn't really tell how forceful my pushes were, so I ended up tearing quite a bit. Even with all the stitches I received, I was up and walking after 24 hours, able to shower and nurse without a problem. The recovery period was definitely different from my cesarean recovery period. If you'd like some of the more ''gory'' and super happy details (about the VBAC, tips that helped me, grooming and hygiene needs afterwards, etc) I'd be happy to correspond with you. Feel free to shoot me an email. maiski
I, too, labored for over 30 hours (med free) and ended up with an emergency c-section for my first child. I did, however, have a successful VBAC with my second child, albeit after another 30 hours of intense labor. I think that birthing at UCSF under the guidance of very skilled and knowledgable staff (both midwife, nurses and a doctor)paved the way for a vbac. However, I was open to a c-section knowing there were risks with a vbac. In fact I really wanted one after the first 20 hours of labor and unsuccessful attempts at modifying the pain!! The staff and my husband helped me through to the bitter end-- and in fact the actual pushing was the least of the pain and only 20 minutes long. The recovery was, by far, much easier and faster than that for the c-section. I wish you and your child a healthy birth. Please feel free to email me if you would like any other info/advice, etc. Meera
I had a vbac after a c section. The first birth was 24 hours hard labor, baby had alot of distress and they finally did a c- section. The second birth I was pretty focused on having a vbac. I had so much information about how much better a vaginal birth is for the child etc. Well, they offered a c-seciton if I wanted it. We ended up with 12 hours of labor and then a vacuum assited birth. My daughter stayed in the NIC for one week due to difficulty with switching over to outside the womb breathing. If I were to do it again I would vote C-section for the second. For her and for me! ( Recovery was pretty much the same for me. One complication was that my v stiches popped and they could not find the tear to restich. That was very painful.) My personal opinion is that while a vaginal birth just seems more natural, I think that you have to think what the best for you and the child. PS. My kids both had very big heads! Wear a big hat
My first child was delivered by c-section and my second was VBAC, both at Alta Bates. I had a great doula who helped me ENORMOUSLY. My OB was very supportive and I think this made a big difference. My husband was also great, but even he would say that our doula was the lynch pin. Although we had thought out a birth plan (great exercise, but pretty much irrelevant when I was in back labor and crawling into the hospital), the thing I was most intent on was to avoid medication that would slow labor. I recall that the data seemed to indicate this increases chances of a c-section outcome. I did have some narcotics. Also, I had an IV line in once at the hospital. I believe this is a precaution with VBAC labors to allow fast action if an emergency situation did occur. It was great to be home with my new baby and my toddler the day after the VBAC, without the added demands of recovering from abdominal surgery. I had done just fine after the previous delivery by c-section (I did not labor before, so I was not worn out to begin with), but was very happy that the VBAC was a success. Although both births were wonderful, I am really happy that I was able to do the VBAC. Best of luck to you! happy VBAC mom
I had a VBAC this past December and am so pleased that I did. I weighed the pro's and con's to both a c-section and VBAC and felt the VBAC was worth a try. My doctor was very supportative as was the hospital (Alta Bates). I could not have been more pleased with both the doctors and hospital during my VBAC. The experience was very different from my c-section and I'm so thankful I had the opportunity. Recovery from the VBAC was quicker, aside from horrible hemroids, no major set backs. Amity
Talk to your doctor about it. Some doctors are supportive, and some aren't. If yours won't do it, find one that will. Your doctor can also tell you whether or not you are a good candidate to attempt VBAC. Alta Bates will do VBACs, many other hospitals won't. Alta Bates has about an 80% success rate, I think.
When my first was born I had envisioned a totally natural, drug-free labor in the bathtub. Instead, labor never progressed and I had an emergency c-section due to fetal distress. I had a lot of depression from feeling like my body was defective. When I had my second and chose to do a VBAC, I hoped to have the natural birth that I had wanted with my first. This time, labor progressed so quickly and so intensely that I was pretty much begging for an epidural as soon as I hit the door. Then, I think because I had the epidural, my doctor put an internal monitor on the baby. I had all kinds of tubes and wires on me and there was no way I was going to be able to leave the bed, but I didn't really care. The monitor helped allay my fears about a rupture so I could relax, the epidural totally knocked out the pain so I could sleep, and labor and childbirth ended up actually being pleasurable. My husband, mother and I sat around chatting and joking with the nurse most of the time. I did strain my back pushing because I couldn't feel and I had a headache from the epidural for a week or so, and sure, it wasn't the birth I had thought I was going to have, but I have a healthy baby and a great memory of the experience. No regrets
Midwife Lindy Johnson would be worth interviewing, if you can get an appointment. I am a doula and have been fortunate enough to attend many births with her. She is warm, extremely experienced and a wealth of information. You can look her up on BPN. I hope you find what you are looking for. Nancy
I have read all the other posts about the VBAC thing, and I wanted to add my FANTASTIC VBAC experience. My first little boy was breach, so I had no choice other than c-section. I was open to a c-section the second time but really wanted to try a vaginal birth. I had an early epidural (due to some previous health issues-I needed to rest at night as I labored through the night), but my body kicked in and my labor progressed beautiful. As someone else said, my doctor made me feel very comfortable about the VBAC. The nurses were pulling for me the whole time. I felt very supported by Alta Bates, and I can truthfully say I did not feet worried about rupture during labor at all. I let the epidural wear off at the end, so I could feel when I pushed, but I am sure the pushing would have been much more painful minus the epidural. It wasn't ''natural'' (no pain meds), but nothing ever felt more natural. My second son popped into the world after about 15 hours of labor. I totally get if you want to have another c-section (I did all the research too), but if you want, go for the VBAC. I did, and it was so so special. Laura
C-section vs attempt VBAC
Dec 2007
I'm going to try to stick to the basics & hope to get some feedback that fits our situation. 1st birth - emergency c- section due to OP presentation (face up), stuck in birth canal, fetal & maternal distress (general not an epidural). Labor progressed fine, dialated quickly, considering presentation realtively short. No medication until general administered. Now on pregnancy #2. Child #1 will be a few months past 3yrs at due date. He is needy, has some sensory issues (mild), sleeps great *only* at home, has never spent a night without Mom putting him to bed -- he is all about his routine. I can't stress this enough.
So if I do a planned c-section, husband can be with child mostly, we can have help scheduled, BUT I have to deal with c- section recovery + toddler. (recovery last time was ok, not horrible.)
Or, we try for a VBAC (my OB thinks my chances are good to have a vaginal delivery) but my concern is I'll end up with another c- section and *not* have all the help in place and my son will be a wreck etc etc. But the quick overnight at the hosptial and easier recovery are very appealing. I have lots of good friends who have offered to help, but unless you have a kid who really really needs his routine/consistency, its a little hard to imagine - ie, they've offered but I am not sure they realize what they are getting into.
Also, there are no grandparents/relatives that our son is connected to who can come stay for a while. Anyone gone one way and wished they did the other? Any other thoughts on how to make this decision the best one for all parties? Because of all the drama last time, my husband is in favor of the c-section. Thank you for sharing your experiences. tough choice
Hi -- I had an emergency C section with baby #1 and VBAC for 2 and 3. While a C section was not nearly as bad as I anticipated, it was a much longer recovery than the VBAC. I actually wanted to have another C with #2 because that is what I knew, and I did not want to end up going through 20+ hours of looong labor with #2 as I did for #1. Can I tell you, if your doctor thinks it is possible, GO FOR THE VBAC!! While there are risks, in my opinion and that of our OB, the risk of infection with a C section is much more real and likely than all of the other issues surrounding VBAC if your C section incision is well healed. My OB actually pretty much insisted that I should try a VBAC and it was SO much easier than a C. Could you not have your help in place as though you were going to have a C section? Then if you have the VBAC, you can use less help *or* actually have that extra help to allow you to get on your feet more gradually. That adjustment to 2 after either delivery is a lot, so why not have the extra help either way? That is what we did, and it was a HUGE help. Good luck!
Dear Tough Choice, I had a C-section due to breech presentation with baby #1, a wonderful VBAC at a free-standing birth center 12 years later (three years ago), and #3 is due in a couple of months (planned home birth.)
My VBAC recovery was at least 50 times faster than my C-section experience, breastfeeding was a breeze, and #2 has been incredibly healthy and strong since birth. Moreover, a VBAC for me was a very empowering experience, more so than getting a PhD and qualifying for Boston marathon.
Have you read Ina May Gaskin's Guide to Natural Childbirth? Best wishes for a happy delivery and healthy baby, whichever path you decide to take. Happy VBAC mom
I was in almost your exact position last year. My first was an emergency c-section due to fetal distress/cord wrapped around him. He was 3 years 2 months when baby brother was born, mildly autistic with communication delay, very attached to mom and routine. Fortunately we did have a grandparent that could come stay with him during the birth and that helped. I went through all of the back and forth in my head about what would be best for my son (VBAC or C-section), and ultimately decided that I had to go with what I felt was best for me and the baby. As hard as it is to disrupt your son's routine knowing what it will do to him, it is just a couple of days, and he will get over it. And, he is going to have to learn to deal with changes eventually. The baby itself is about to send his world into a tailspin. It is not good for any of you to have your life dictated by his need for routine.
If you have time before the baby comes, I would recommend getting him used to other people caring for him now. Maybe start with an afternoon out and work up to a date night. Or have your husband take over the bed time routine. Let him see that his routine can change and it is OK. If you haven't already, you might want to consider seeing a developmental pediatrician for an assessment. They might be able to offer help and advice about the sensory issues.
By the way, I had a successful VBAC and was able to come home the next day, but was disappointed in how hard the recovery was. I am still glad that I was able to do it, but I am not sure it was that much easier than the c-section. Been There
I will try to stick to the question. I had two c-sections, both after trying for vaginal delivery. People told me that the second csection would be easier to recover from but I didn't believe then -- how could that be? However, it really turned out to be the case. Given what you said, a planned csection might be a great solution. been there
My first child (7 1/2 now) was breach -- upside down. I had ''massages'' by a professional to try to get her turned around. It hurt a lot to try to this this but it didn't work. I had a C-Section with her and it went fine more or less. I stayed at the hospital (CPMC) for three days and went home after that. I was able to walk around pretty well afterwards... slowly, however.
I had an option with my second child. C-Section OR vaginal birth, it was up to me. I got lots of grief from other people who told me I should do the normal way. So I did. I REGRETTED IT. First, it was luck I got an epidural. These doctors don't really pay attention to your needs regarding the pain and most women I know don't get it -- supposedly because the time is too close to birthing. You have to tell them at just the right time you want the pain medicine.
This child was bigger than the first. The doctor did not like how the baby's heart was sounding so it had to come out right away. FORCEPTS would used. It was painful, uncomfortable and recovery time, believe it or not, was much longer for the regular birth than the C-Section.
Ultimately, you have to make the decision. Just don't let silly things like -guilt- lead you to make a decision you might regret. s
I really wanted to go VBAC for my second, but I ended up being hospitalized for 2 weeks because of preeclampsia and then because I had to deliver the baby before term due to the complications, we couldn't induce because it was too soon and the chances of rupture greater. My advice is you need to be prepared for any emergency whether you try and schedule the c-section or not so you might as well work with your friends jsut in case. I also didn't have problems recovering from the c-section and don't feel guilty or disappointed at not having a vaginal birth. HOWEVER, I do believe you're better off trying for a VBAC over surgery if you can as long as you don't get too emotionally attached to having a vaginal birth that could prevent you from not making a sound decision for the safety of your baby. Sounds like you won't. Our friends and day care really rallied when I went to the hospital. We had no time to plan and it was 8 weeks prior to my due date. We survived. You will too. Let your friends help. Give them some practice time with your kid. Hell, let them help you when you come home by taking care of the kid. Good luck. survived and proud of my scar
Hi, Your situation was very much like mine. My first pregnancy resulted in an emergency c-section, though I had a difficult recovery. My second was a VBAC (had to sign 2 consent forms to have the VBAC btw) and it worked out well. Our firstborn also thrives on routine, so we kept him in daycare when I went into labor and my sister drove in from out of town(she was 3 hrs away) to pick him up and take care of him while my husband was with me during the delivery. He got to enjoy a special snack and a movie with his auntie and didn't even miss us. I was anxious about the vaginal delivery, because I'd never gone through it. It took me 20 hours to fully dilate with medication and every other measure, so I thought I was heading toward another emergency c-section but it worked out, surprisingly, the actual pushing time was only 20 minutes...You are correct that the recovery can be very smooth for a ''normal'' vaginal delivery, that was my experience. My advice is to get help in place regardless of whether you have a VBAC or planned C-section. My quick recovery was directly related to the fact that I had help and only needed to focus on one thing at a time. I learned that I'm not a pioneer woman, and that I didn't need to be a ''martyr'' so for the first week, I let others help me while I worked on resting and nursing.
Because we made my sister a regular part of our older son's routine the weeks prior to my due date and kept him in daycare (it really minimized the change for him) his transition to the new baby was very smooth. My husband also began reading ''I'm a Big Brother'' with our older son every night for a few weeks...that seemed to help with his adjustment to a new baby too. Since we had help with the cleaning and cooking (thanks to my mom), my husband was able to spend lots of one-on-one time with our first son while I tended to the new baby. While our first son was at daycare my husband and I bonded with our newborn w/o interruption.
Good luck to you with whatever choice you make. Been in your shoes and thankful for help!
VBAC Induction?
Nov 2007
I am hoping to have a VBAC with my second child (first babe was footling breech). My due date is tomorrow, but the baby hasn't dropped, I'm not dilated, and my cervix isn't effaced. My doctor told me today that she is reluctant to induce labor with pitocin (at 42 weeks) but would maybe consider a small amount. She really would prefer me having a C-section if I don't go into labor naturally. We're going to try all the natural induction methods first, but I am feeling worried. . . I really do not want to have another C-section. Has anyone been induced for their second birth after having a C-section? How was the experience? Also, any thoughts on the risks of uterine rupture with pitocin? Hoping for a VBAC
Let me offer my two cents -- consider taking the section. I really wanted a VBAC for my third child, was very determined, would not listen to my dr. re: risks of induction, etc. She would not induce because malpractice insurance will not allow it. The percentage of people who rupture may be reasonably small but the consequences of rupture are enormous -- inc. very possible death of baby, death of mother (yes, even today) and emergency hysterectomy. In the end, I went into labor naturally at 41.5 weeks. The baby was large, I pushed for hours, ended up with a c section anyway, and the drs. noticed that my uterine wall was very thin by the end and I might have been near rupture. More than that, I ended up, once again, with hours of labor PLUS a section, and now have damage from the pushing that I would not have if I had just had the section. If there was a next time, I would definitely just do the section.... anonymous
From the stats I have read, induction increases the risk of rupture pretty dramatically. And, I have also read that if you know the signs of rupture, they can manage it after the fact and while you probably will lose your uterus, lots of blood, the baby *should* be ok.
That said, I had c-section (emergency) for baby #1 and trying to decide what route to go. A c-section + toddler is not an ideal situation, but I am clear, after both my first birth experience as well as previous pregnancy losses, that bringing home a healthy baby is my first priority. I don't think I would do an induction - again, from what I have read - but I may plan a c- section. I have a few months to decide. I hope you don't have to make this decision & your baby comes out on its own! Good luck
I was in exactly the same situation as you were, except I was told that they would not induce. The primary reason I was given was that, in my circumstances anyway, there was over a 90% chance that I would end up with a C-section anyway. That figure may depend on the reason for the original C-section (mine was due to the lack of any progress after many hours of pushing and absolute exhaustion on my part).
I completely understand your desire for a VBAC. However, in case that doesn't work out for you, I would like to add that the recovery from my second C-section (since I didn't go into labor naturally) was MUCH easier than the first. I wish you all the best for a healthy delivery. Anonymous
I had a C-section the first time, and a VBAC the second time. My doctor did a ''let it happen on its own'' approach with no Pitocin, as it is safest to simply let the baby descend naturally. The uterus can burst, so you don't want to take Pitocin to move things along faster. Go with a natural descent! Glad I had a VBAC
If you are worried about this and have 2 weeks to go, it might help to start acupuncture. I had it with both my pregnancies, and then just a tiny bit of pitocin in the hospital, things really took off. Good luck! anon
Well, I hope this finds you on time! I would not induce, unless you were at 42 weeks or your baby was showing problematic signs. Any time you are asking your body and baby to start labor before it happens spontaneously comes with more risks. I would try to avoid Pitocin and especially Cytotec. Since you're only 40 weeks (or maybe now 40 weeks and a few days) why not wait until you're actually overdue, which is 42 weeks, and that's only if your dates are accurate. OBs are pushy and it is sad that VBAC is so frowned upon. I hope you get your VBAC! Your body, your baby, your choice!
I was in your boat two and a half years ago. Try accupuncture with Marti Lee Kennedy. She's got lots of recommendations on the BPN site. She worked wonders for me and is just a beautiful person. I can't recommend her highly enough. I was two weeks past my due date with my first child 4.5 years ago. I was REALLY sick of being pregnant and scheduled a session with Marti. One treatment got my labor going naturally. Unfortunately, two midwives and an OB had missed that my son was breech, and after I pushed out a foot I ended up in the hospital with an emergency C-section (that was a bad day, but all's well that ends well). When baby #2 came along, my docs were not thrilled with the VBAC option I wanted to pursue, but said as long as I didn't go past my due date they'd play along. Three days before my due date I went back to Marti, had one session in the late afternoon, and went into labor the next morning. Forty-five mintues later my second son was born. I got to the hospital just in time for my doctor to catch him. That part was unintentional, but I did get the natural childbirth with #2 that I wanted. Good luck! VBAC Mom
While pitocin isn't the end all of methods for inductions, it dripped in my arm for 12 hours before I had ONE contraction, It is often used with varying degrees of success with few complications. That said, my husband is an anesthesiologist. VBACS have fallen out of favor BIG TIME because there have been a rash of ''bad outcomes.'' You don't want the details but suffice it to say its devasting for EVERYONE involved in the births. John Muir is one of the few places still doing VBACs with any regularity so if you are not having your child there I would guess your doctor is reluctant to continue the pregnancy and risk a complication whether its due to labor or induction etc. I would probably side with your doctor and have your child by the safest means possible given your docs concerns. The birth experience while touted as a definative part of the motherhood experience is such a small part of being a mom that I would forgoe the ideal for you simply to insure the safety of your baby. This is written after watching my husband peel out of the driveway because there is a STAT section, never a good thing. anon
It is my understanding that induction, pitocin & prostaglandins (used for softening the cervix for induction) all carry increased risk of uterine rupture. So definitely use any natural method you can - I would recommend seeing an acupuncturist and/or homeopath, as well as doing home measures like evening primrose oil on the cervix, nipple stimulation, having sex, and castor oil (as a last resort!)
One thing to remember though - you are not overdue yet. ''Term'' is considered 37-42 weeks, though you wouldn't know it from the way we fixate on due dates. So you've still got two weeks before you're overdue. A lot can happen in two weeks - perhaps you can trust that your baby & body know what to do and you will go in to labor easily and soon. It doesn't hurt to talk to your baby about that too - let him/her know what you want and ask baby what s/he needs to be born. I feel for you - and I wish you a peaceful & powerful VBAC. Annemarie
I would not even want to induce labor w/ pit after a c-section. I had pit w/ my daughter and went through all of that before an emergency c-section. Her head got stuck and we had to sew me up and head off for surgery. That was in '05. The only reason I had a VBAC w/ my twins (late '06) was because I went into labor naturally at 36 weeks. My MD would not induce w/ pit- Yes, c- sections are rough -but- what if you rupture ? Yes, the percent is low - but - still. The thing is - you never know what is going to happen. I tore so badly w/ my twins that they had to sew and pack me. That was rough, too. Just please go w/ the recommendation of your MD. K.
I had a very successful VBAC almost three years ago which included an induction. I was surprised but happy that my doctor was willing to do this. I was induced due to high blood pressure, but I was already starting to dilate before the induction. It was about 2 weeks before my due date. I had both pitocin and an epidural. I ended up with a fairly short labor of 6 hours. So it can be done. My second baby was about 2 pounds lighter and in a much better position but that couldn't really be told ahead of time. I haven't really heard any other successful experiences but mine couldn't have gone more smoothly.
I wanted to suggest that you question your assumptions about whether a VBAC is better than a c-section. With my first child, I was adamant about having natural birth, with no drugs or anything. After 35 hours of labor (and induction), I had an emergency c-section and cried my eyes out with disappointment. With my second child, I went for a planned c-section and was SO happy that I did. Because it was planned, we could arrange childcare for our toddler, so my husband could be with me during the surgery. And my recovery was A LOT faster than the first time around, because my body wasn't exhausted from a long labor. Plus my milk came in faster and I produced more - also because my body wasn't so exhausted. The thing that put me off a VBAC was the risk of uterine rupture. That risk far outweighed the benefits. And, as it turned out, the c-section ended up having more benefits than I expected. Oddly enough, my second child is healthier than the first. I thought those hours of labor would have some benefit for my first child, but I guess not. So please, question your assumptions and do what is best for your body and child, not what you think you ''should'' do. C.L.
I didn't see the original post, but all these responses sound very ominous. I delivered my second baby VBAC. My water broke a few days after my due date, but I did not progress, just very mild contractions, for 30 hours. I then decided to start pitocin. It worked like magic and I delivered my baby 12 hours later. Your question seems to have been about induction, and as I recall my doctor (Amy Huibonhoa) did not recommend induction, but she felt that pitocin once labor had started was perfectly safe. I'm just sharing this because it seemed like many responders said pitocin was dangerous and for me at least, it was not. anon
No one mentioned this but there are herbs that are safe for ''natural'' induction if the need arises. Black and Blue Cohosh work very well. I used them a few months ago myself. Also, they don\x92t cause the painful contractions that pitocin generally causes. Check the ICAN list for more answers but be forewarned they are very into homebirth and all natural. I know it can turn people off how adamant they get, but if you can ignore that I think you can find great, accurate information. Also, find a local midwife for other alternatives. Good luck with your VBAC. T cindy
I wanted to recommend attempting a VBAC since I have just had an extremely positive experience. I cannot remember all the details of the original post and I did not have pitocin but all the response experiences were quite negative and mine was positive. I had an emergency C-section after a long (but not difficult labour, with epidural) 2 years ago. My ob said that he was not keen to induce or use pitocin after that, but was quite happy for me to do a trial of labor for more than 2 weeks after my due date. In the event I had a vaginal delivery (with epidural) 1 week late. It all went very smoothly. I have a feeling that they might even have agreed to give me pitocin, had I needed it. The difference in my overall experience and particularly recovery period was immense. I had my baby 1 week ago. I had not thought my C-section experience was bad at the time but I had to move very slowly and carefully and everything ached and I took pain killers for weeks. After the C-section, day 5 was the day we came home from hospital. After the VBAC, day 2 was the day we came home from hospital and day 5 was the day we went to a party (with both kids). I hope things go well with you and am sure that whatever decision you come to with your medical advisers will be the right one. Nicola
I had to second the comment from the poster who asked you to ''question your assumptions about whether a VBAC is better.'' I totally agree, and had the same experience. Long labor with the first, induction, emergency c-section, terrible disappointment. I hang out with a crowd that does homebirth, and they were terribly disapproving of my ''interventions,'' not that I had a choice. The community can be very disempowering of women who don't have the ''ideal, natural'' birth, but please keep safety and other family issues primary over ''achieving the perfect birth.'' I wanted a VBAC, but ended up needing to schedule a c- section. Like the other poster, it was SOOO much better than the first birth. Arranged childcare, husband with me, milk came in faster and more so no nursing issues this time, fast procedure, fast recovery (which is critical when you already have a child), much less exhaustion. Despite the concerns that led to the c- section, it was a very peaceful birth. My 2nd child is also healthier than my first. It might sound like I'm advocating for c-sections, but I'm really just advocating for safety and for us to let go of standards that aren't realistic or safe in some cases. Best of luck. glad I did
Just wanted to respond with my POSITIVE VBAC experience. I couldn't find any when I was doing my own research so this is for all those mamma's who are considering it. I had a C with the first due to the fact she was breech. I never even felt a contraction - it was all scheduled. With my second,the minute I got pg I knew I was going to deliver vag. My due date came and went and still no labor. I did 4 sessions of accupucture, took Blue and black cohash, ate every spicy food in the East Bay and FINALLY 10 days after my due date I went into labor for the first time. I labored at home ( WITH A DOULA) for 20 hours. I headed into the hospital and at 22 hours of labor and only 4 cm, I got an epidural. My contractions didn't budge remaining at every 4 minutes ( Great! as this was my biggest concern that my labor would slow) 2 hours later I was complete and I needed to push. I pushed for half an hour and out came my sweet baby boy. He was 9lbs 12 oz! It took me at least 6 weeks to come down from my VBAC high. It was truely amazing. -Jen
Want to have a VBAC; current OB can't offer it
Nov 2006
I read through the archives and have seen some recent postings on the topic of VBACs. I'm also hoping to have one - I'm 17 weeks pregnant and my current OB in Castro Valley is unable to offer me one. My first baby was born 2 years ago by C-section at Eden Hospital and unfortunately they don't do VBACs. My first was delivered by c-section because he was in fetal distress, and I never even really started labor. I had to be induced 10 days after my due date, and after they started the pytocin, I started having very mild contractions and his heartrate continued to drop.
I'm hoping that this time I'll have a much different experience! I'm looking for a new OB who supports VBACs, and am looking at either Alta Bates or Valley Care in Pleasanton (which is much closer to me). Friends have recommended Dr. Helen Matthews (for Alta Bates) and Dr. Bleecker (for Valley Care) - does anyone out there have experience with either one?
I realize there are some risks involved with having a VBAC, but I trust that with the right OB and the right hospital, I will receive the right care that will ensure my baby and I are not in danger. What have others' experiences been?
One other question - I didn't have a doula with my last birth and I've never been too fond of the idea, but do you think it's necessary - or extremely beneficial - to have a doula when trying for a VBAC? Anyone you'd recommend? Thanks in advance! Nancy
I had both my children when we were living on the East Coast, so I can't comment on specific practitioners or hospitals out here. What I can comment on is my own VBAC. My first child was an induction that went badly, leading to a crazy long very difficult labor and finally a C-section. I had wanted natural childbirth to begin with and the whole thing was quite stressful. With my second child, I was very assertive about wanting to try for a VBAC while recognizing that anything might happen. In fact, I decided explicitly I would not be induced again, that if I didn't go into labor I would opt for a planned C-section.
I delivered with a midwife who practiced with OB's and did hospital deliveries, an arrangement that I was very comfortable with. She was very supportive of the VBAC and worked with the OB's to make some space for me to pursue that.
Some consequences, though, of the VBAC under doctor/hospital guidance were that I had to go in to the hospital earlier than I really wanted to, and had to have more monitoring. They were simply a lot more conservative. Thus, when I got to the hospital after about 8 hours of labor at home, it was too soon, my contractions stopped, and had to be restarted with pitocin. An undersired intervention, but this time it really worked, and at the lowest dose. It was just enough to restart labor.
I had been pretty scared about whether my body could even go into labor, and whether I could push a baby out, not having done it before. Well it did and I could. (Frankly, I wasn't scared at all about a negative outcome from trying the VBAC. I'd looked at the data and felt very comfortable with it). It was a really amazing and empowering experience, to be able to hold my daughter right away, instead of lying there on the operating table wacthing other people hold my child, and not have all the pain from the surgery afterwards. I was out of bed in a couple of hours, unlike the last time when it was a couple of days. I wasn't tethered to IV drips, catheter and all that other baggage. Very liberating, and very worth the effort. So I would encourage you to try, but also to have a good backup plan, or two. Good luck! Happy VBAC Mom
Hi there, Just wanted to let you know that as far as I know, Valley Care does not do VBAC's. Sorry! Pleasanton res.
The incidence of malpractice suits filed against obstetricians who used VBAC has become very high. Many hospitals no longer permit them. There are significant risks to both mother and baby with VBAC, and the legal atmosphere is such that VBAC has become a procedure to be generally avoided. I would advise checking with doctors as well as hospitals; since the hospital has to be involved in the event of a complication of labor in a patient who has had a prior C-section. Robert
Nancy, I would encourage you to do what you need to do to increase your chances of a successful VBAC. Those would include getting a supportive doctor, getting a doula, reading up (I believe I used a book called the VBAC companion), etc. Most importantly, I would prepare yourself emotionally for the effort as well as the potential for another C-Section.
I did everything I could to prepare and although I never went into labor, baby never descended, I realized the likelihood of a successful VBAC were low, and ended up electing way after my due date to have another C-section (my first baby was 10 pounds early!), having done everything I could to try for the VBAC empowered me and helped me come to terms not only with having a repeat C-section, but actually helped me deal with the first one as well. Best of luck to you! 2xC mom
I'd suggest Dr. Hank Streightfeld for Alta Bates I was (still am although not expecting at the moment)his patient when expecting my son in 2004/2005 and am typically condsidered a ''high-risk'' mom due to my epileptic condition. I found him to be straight forward, down to earth, tell-it-like- it is type of doc. Extremely supportive. His office is right accross the street from Alta Bates. You may also want to see some additional postings regarding him on BPN wishing you the best
Go for the VBAC! My aunt and a good friend of mine both had very successful VBACs. Barring any life-threatening complications, there's no reason not to do it. Both of them received little support from doctors, but persisted and were rewarded with wonderful births.
As for the doula question--I'm puzzled: the idea has never appealed to you to have some one there who is supporting you in having the birth experience that you want? I had a doula at my birth, and I was so glad to have some one who was experienced with the process, experienced dealing with hospital staff and would support me AND my husband to have a terrific birth. I can't recommend it highly enough. Studies have shown that people who have doulas have fewer interventions, and, therefore, FEWER C-SECTIONS.
Yes, I think you are more likely to have your VBAC if you have a doula by your side, reminding you that you can do it, and supporting you every step of the way. After all, even if YOUR OB is supportive, you might not get your OB when the time comes, and you'll have to contend with whomever is on call. Your doula is there to do the contending for you, since that's the last thing one wants to do while in labor. Good luck to you! Loved My Doula
Hi Nancy, I had a wonderful VBAC two years ago at a birth center in MA, assisted by my husband and two midwives, with no drugs or medical interventions of any sort except for periodic monitoring of baby's heart rate with a hand-held device. Our stay at the birth center lasted for around 8 hours, and then we drove home with the baby to rest. In early pregnancy, my OB said that in a VBAC baby's heart rate would have to be continuosly monitored and that I would need a heparin lock. That's when I switched to midwifery care. I did not feel the need to have a doula. The midwives were very helpful. Also, my husband and I read a lot of books on natural childbirth. I would highly recommend the books by Ina May Gaskin. Best of luck to you! Rasa
Nancy, I am also very much interested in having a VBAC next time around. I delivered at ValleyCare in Pleasanton the first time and had a c/s for failure to progress, i.e: not having the baby in the timeframe the doctor would have wanted, it was late, he wanted to go to bed..uugghh... Anyway, I can tell you ValleyCare does not allow VBACs, so you would need to go somewhere else. I know Alta Bates does and so does John Muir in San Ramon. I have read a lot on the subject and gotten great help and support through ICAN. I would strongly recommend you visit their website and join their email list because you will find awesome resources to assist you. www.ican-online.org I can tell you I am definitely planning on having a doula for my VBAC when the time comes, because from friends' experiences and what I have read everything seems to indicate this is a GREAT resource for VBAC moms. I would love to chat more on this subject if you would like. Feel free to email me directly maria
Hi Nancy; I had a very successful VBAC experience. With my first, I had a c-section after a failure to proceed and very painful 24 hours + of labor. With my second, I too really wanted a VBAC and hired a doula to help make sure it would happen the way I wanted. I had a doctor with the Alta Bates Group - she has since retired - but it is the hospital and its capabilities that determines if a VBAC is possible or not - and Alta BAtes has great facilities and programs about VBACs.
It turned out that my doula had three other women in labor the same night - a freak occurance - the labor and delivery room was a complete madhouse for some unknown reason. It turned out I really did not need her as I had my baby within 3 hours of my water breaking. However, she was good at getting my husband and I on the same page and making us comfortable with our decision. It was absolutely fabulous in comparison to the c-section! I was so much happier and comfortable with the baby/recovery etc then the first time around.
Because you did not go into regular labor the first time, it may be more similar to a first time labor than a second time (i.e. longer than my 3 hours) but it is really is worth it! My current OB GYN is named Dr. Arzou Ahsan - she is great. Her number is 845-8047. They recently changed the practice name otherwise I'd tell you that too. Best of luck! Mindy
I had a very similar experience when I gave birth to my daughter 4 1/2 years ago: pitocin, fetal distress, and C-section. When I was pregnant with my son I really wanted a natural birth and I had a VBAC 1 1/2 years ago at Alta Bates with Dr. Hank Streitfelt. I felt that both my OB and the nurses at Alta Bates were very supportive. But I also want to say that I do not think I would have managed without my doula. I would say it is extremely benefical to have a doula. The nurses were great, my husband was great, but the doula really made me believe I could do it. I highly recommend my doula. Her name is Casey Bastiaans, her numbers are 510-532-5137 or 510-388-8632 (cell), email is casey[at]berkeleysoundartists.com.
Cesarean Support Group - ICAN of Mt. Diablo The best way to avoid a surgical birth is to educate yourself. This is a local chapter of The International Cesarean Awareness Network, Inc. (ICAN). ICAN's mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC). For more information visit www.ican-online.org. Join our Yahoo Group! Online at http://health.groups.yahoo.com/group/ICANMtDiablo/ Facilitator: Holly Wiersma, CD, CLE and Deanna Jesus, CD, CLE. Dates/Times: Meets the second Wednesday of each month from 11:30am to 1:30pm - December 13, January 10, February 14, and March 14. Cost: This event is free of charge. Deanna
C-Section or VBAC?
June 2005
I am trying to decide whether or not to try a VBAC. I am 29 weeks. With my first labor 2 years ago, my daughter was face up and I had preeclampsia which began during labor. So, I was on Mag-Sulfate (which the doctor says stalls your labor) and I stopped dialating at 5 cm. After almost 24 hours, they sectioned me. But the baby wasn't too big for my anatomy or anything as far as we know. She was 7#4. But I am so traumatized by it. I forgot all my breathing and the epidural only worked on half of my body and lasted like an hour. I kind of want to just plan another c-section. I am not dedicated to a natural labor or anything. I just want my baby to come out healthy (and hopefully with minimal damage to me). But there are risks involved with a 2nd c-section, like bladder and bowel damage to me. The 1% risk of rupture with a VBAC would harm the baby and me. Although a very small risk, I feel I would rather risk myself than the baby. I recovered in like 2 weeks from my first section and I feel like if I didn't have 24 hours of labor first, I could recover even quicker this time. But the idea of standing up and walking out of the hospital the next day sounds so great if I did a VBAC. And the fact that it's healthier for myself and the baby. And then there is the fact that I could only have 1 or 2 more kids. (But I don't want more than that). I was just so bad at labor the first time! I saw the archives, but I thought I might be able to get some more recent advice. By the way, I will be delivering at the new Kaiser Oakland facility (I did Alta Bates last time). Thanks! --confused
Yours is a very difficult decision. When I was in your same position I asked around and got very conflicting advice. The fact is that whether a VBAC or planned C-Section is right depends so much on one's very personal preferences and ''how things go'' the second time around and it is just impossible to in advance which will be best. Two things: 1) is your doctor able to give you a sense of whether or your next labor/delivery will be like your last one? An individualized estimate from hin/her of how likely you are to suceed at a VBAC, given your past experience, would be useful information. The last thing I wanted was a drawn-out failed VBAC (I got a very quick, but unsuccesful, VBAC trial). Personally I would choose a C-section over that scenario. 2) if you are really more comfortable with the idea of a C-section, it is fine plan for that. In retrospect I wish I had planned a c-section but I felt so guilty about admitting that I thought the C-section would be easier. Turns out, for me, that it definitely would have been easier. Just remember that you will need LOTS, LOTS, LOTS of extra help with your older child if you have a C-section. But on the other hand, if you plan a C-section it will be easier to plan care for your older child while you are in the hospital. 2 C-sections and fine with it
Although I am not pregnant right now, we are starting to work on that this month. Other than that, your post sounds so similar to what I have been debating since my first child was born 19 months ago. I was 2 weeks past my due date, also had a small baby, but went into labor and could not dilate and then the c- section happened due to infant distress. The staff at Alta Bates was amazing, and it was very reassuring to have such a top-notch NICU right upstairs. But also, like you, I will be delivering at Oakland Kaiser this time. What I have decided at this point, is that I will try for a VBAC knowing that the 1% risk is something I am willing to gamble on. However, this time, I will let them start an epidural so that if things get dicey, the C-Section can be a bit smoother than the last time. The other part of the decision is that I am not going a day past my due date, and will actually schedule a c-section on the due date in case labor does not start naturally before then. For me, going past the due date meant that my placenta was not able to supply enough oxygen to the fetus and we almost lost our baby. I do have some concerns about the new Kaiser facility, but not about my OB-GYN surgeon (Dr. Laura Minikel)- she was amazing and perfect in a very scary emergency situation and if she did that well under fire I have no doubt about her abilities to perform a routine scheduled c- section. Glad to talk to you more about this... lou
Your story sounds just like mine! I'm 33 weeks and also thinking a lot about this. I was induced with #1, because of Pre E, I got to 6 cm and stalled after 26 hours. I would do anything to avoid the Pitocin and the mag sulfate this time, so I'm probably going to plan for the section, but if I happen to go into labor, I would like to give it a try, assuming my blood pressure is cooperating, which it is so far. The idea of a quick recovery does sound wonderful, I'm so jealous of women who have no health concerns and can just wait for labor to start ;) Sorry I can't be more helpful than that... Jill
You should choose the delivery that feels best to you. I wouldn't worry too much about your baby, after all, the doctors and nurses can do that. I had an excruciatingly painful and very long back labor with my first child (as well as multiple, life-threatening complications), and ended up with a c-section. For my second, I decided to bypass the whole labor thing (on the advice of my OB, actually) was very happy about it and have no regrets. My OB is a good surgeon, and I have had neither of the bladder/bowel side-effects that you mentioned. By the way, you are right in your speculation that a straight c-section is much easier to recover from than long labor PLUS c-section. The second c-section was a piece of cake compared to the first. (This actually matters, as you have your older child to consider.) As for the health of my children: My first child showed extreme distress signs after 35 hours of labor - her heartbeat stopped. My second child was probably quite surprised at her sudden birth, but her condition was absolutely perfect and she didn't have to endure what her older sister did. Anyway, you do what feels right for you - it's your body, after all, and your decision. good luck. anon.
I know you will get a lot of advice about this because I was asking the same questions last year and got a lot of pressure from both sides. Here's my two cents. I highly recommend having a c-section again. The risks of VBAC are NOT small. About 1 in 100 women rupture their uterus. When the uterus ruptures, it usually ruptures at home before you even get to the hospital because most ruptures happen with the first couple of strong contractions. If the doctor can't get to the baby fast enough, the baby can be brain-damaged or die from lack of oxygen. If you're at home during the rupture, there is no way the doctor will get to ou in time. Even if the doctor is standing over you with a scalpel she might not get to the baby in time. My doctor told me one story of how he had a women rupture her uterus and he kept looking for the baby and finally found her way up along side the mother's lungs! That baby was thankfully ok, but that doesn't sound fun! Why should you take that chance (1 out of 100 is not a long shot at all) when you've already come through a c-section just fine? I don't mean to scare you but I believe these are very real risks and you deserve to know what they are. I couldn't stand taking that risk with my baby's life so I had another c-section and it is a good thing I did. Turns out my muscles were already split open and there were holes and adhesions in my uterus from the last c-section and all the stretching from this pregnancy. SO I would have ruptured for sure. Not only did they deliver a healthy baby but they repaired all the problems withmy uterus and lasered off my old scar and gave me a beautiful practically invisible new one! C-Section Fan
Well, I've never had a c-section, but everything I've been reading suggests that trying for VBAC is overall better for mom's and babies. There are LOTS of risks with c-sections that are just not really mentioned in the medical world. For example, there is a new, common suturing technique that is very popular these days (1 layer suturing as opposed to the old, 2 layer suturing) that appears to be causing problems for many moms: increased chance of rupture (less of a problem if this will be your last child), the suture not healing, internal bleeding, and more.
Also, c-section has risks for the baby: baby's get cut, and they are more likely to have respitory problems (because going throught the birth canal in a vaginal birth helps squeeze fluid out of the baby's lungs, which doesn't happen with a c-sectin).
These are just a few examples of risks associated with c-sections. You can find out more in the books that I read about these issues: ''Ina May's Guide to Childbirth'' and Henci Goer's ''The Thinking Woman's Guide to a Better Birth.'' Both of them are definitely biased toward natural childbirth, but they are both very well researched, so they are good sources of information. Henci Goer, in particular, tries to give you a good idea of both pros and cons of various interventions, but Ina May has information that Henci Goer doesn't, which is why I found both to be valuable. I'd really recommend reading them both before you make up your mind, because they can give you facts and statistics and information that you can't get from just the individuals who tell you about their personal experiences here. You can find them on Amazon.com.
Finally, I know you're afraid, but please remember that EVERY PREGNANCY IS DIFFERENT. Not just between individuals, but every individual will have a different experience with each pregnancy. Your 2nd is not doomed to be like your first! Best of luck! anon
I'm going to be attempting a VBAC sometime in the next couple weeks at Kaiser Oakland as well. I can't tell you whether its worth it or not since I have not yet tried, but I can tell you my reasons for deciding to and the resources that I took advantage of. I do know that Kaiser has over a 70% success rate and from talking to every mom I know, every labor is different. Just because you didn't have a vaginal delivery the first time, doesn't mean you can't this time. Is a vaginal delivery something you want? Does it mean more to you than just not having to be in bed for 2 weeks after? For me it did, which was a huge influence in my decision. If not, then I would certainly look at some of the benefits of a repeat c- section, which I can't personally attest to.
As for my story... my c-section delivery followed about 20 hours of intense labor and failure to progress past 5 centimeters. My son turned out to be 10 pounds (I'm 5'2'' and was about 100 pounds) so some people think, ''well of course you had a c-section'' but I don't necessarily believe that. Post- surgery I was wheeled into a recovery room alone for about 4 hours and wasn't able to see my husband or my baby during that entire time. I looked forward my whole life to having a baby and then there I was (after waking up from the morphine and demerol), alone, afraid, unable to move, and not knowing what was going on with my baby. Months and months later I saw a picture of my husband in the nursery feeding my son a bottle of water with all my friends and family right outside the room. Then I saw another picture of about 15 family and friends all standing around my baby. I broke down in tears (almost a year later!) and realized how much it had affected me. Yes, my son was healthy, and I was grateful for that, but I think he could have been just as healthy delivered vaginally.
At that point I began looking into VBACs and was referred to the book ''the VBAC Companion'' by another VBAC mom. The information in the book was incredibly helpful in cementing my decision and commiting me to trying. It made me realize that other mom's had the same disappointed feelings about their delivery and that the ''well at least your baby is healthy'' doesn't always make everything better. In fact, it helped me realize that I didn't need to feel guilty about my disappointment when people would say that to me.
The book also put the risks of a VBAC into perspective. Some of the risks they put into perspective were that uteran rupture rate is actually less than 1 and there is some risk of rupture whether or not you've ever even had a c-section so as far as how ''increased'' the risk is, its really low. also, the complications if you have a rupture can likely be handled with little impact if you're in a properly equiped facility (i.e. one that can perform a c-section within 17 minutes). They also point out the risks of a c-section which is not problem free. Another major point the author makes is the very positive aspects of attempting a VBAC regardless of whether or not you are successful. Labor itself is beneficial to you and your baby not only in the release of chemicals but having the baby be in the womb until it is ready to come out.
I realized then, my second biggest VBAC fear (aside from the rupture issue) was that I'd invest all this effort, go through all this pain, and get my hopes up, only to be disappointed in the end. Upon reading how beneficial it can be to the baby and mom to experience labor, I let go of that fear and am now just content to give it a try.
Then during my Kaiser Oakland hospital tour, I was shown the c- section recovery room. To my surprise, there was a ''partner's'' chair, a baby crib (hospital kind of course), and a bed, just like every other recovery room. I was so pleased to find out that after a c-section at Kaiser Oakland, your baby and partner stay with you and that they will put the baby to your breast as soon as possible (if you do breastfeed). I suddenly felt so much relief that if I were not successful, at least the post-op recovery would not be so traumatic. Thank you Kaiser! This really helped my anxiety over attempting a VBAC.
With all that said, I know that many many moms chose a repeat c- section. The comfort in knowing when it will come is huge (I am in my last two weeks and wish so badly I could just KNOW!!!). I also have heard that the recovery from the second c-section (if you labored the first time) is SO much better, its almost like night and day. A best friend of mine however had a worse recovery with the second because of a leak in her spine from the epideral and a few other issues (one of which was the lack of bonding she felt with the second. one of the chemicals released during labor is ''oxytocin'' which is often considered the ''bonding chemical.'' It increases trust and scientists have actually found it can be administered to patients to increase their trust levels. Anyway, perhaps not having that chemical released because her body never initiated labor had something to do with the difference in bonding between the first and second. either way, she is unbelievably bonded to her second now so that is just a little thing I suppose and could totally be an exception). This friend of mine said if her recovery from the first c-section had been as bad as the second c-section, she probably would have considered a VBAC. Just goes to show that every delivery, and not just labor, is different.
I wish you the best of luck with making your decision. Its different for everyone and I'm sure once you're informed (definitely read the VBAC companion!) you'll make the right one for you. Hoping to be a VBACer
VBAC, for sure. You'll be amazed at the power of your body when it does what it is built to do. I had a VBAC this winter and went in prepared to have a c-birth if neccesary and that baby practically slipped out of my body - four hours total labor, 20- 25 minutes of pushing. We did Bradley Birth Method the first time around and only the Kaiser refresher course the second time. Believe me, all the breathing classes in the world can't really prepare you - your body knows what to do and it leads the way. I say go for it! You'll be so happy you did! (Not to mention, recovering from a c with a toddler has got to be a drag!) Best of luck to you and yours.
It sounds like your first child's birth was a challenging one - something none of us expect, I think. My own labor was surprisingly long - 38 hours not including early labor. I never expected it since my mother had me and my sister each in about 6 hours. I wonder if it might be helpful for you to take a little time before your next baby arrives to do some healing work around the difficulties of your first child's birth - so that you are as clear and prepared as you can be for your second baby's arrival. I would recommend a session or two with Nancy Friedrich, a hypnotherapist who specializes in work around pregancy and birth. She's in Sausalito at 415-868-9744. Birth is traumatic for mother and child, no matter how easy or complicated it ends up being - it's also an incredible opportunity for healing and Nancy can help with this.
There is incredible potential for transformation in vaginal birth - if you are not at high risk for a VBAC, and it sounds like you aren't, I would recommend you consider it. A VBAC is much lower a risk than doctors and hospitals will have you think. Here are some helpful resources so that you can further weigh your options:
www.maternitywise.org/mw/topics/vbac-cesarean/index.html www.gentlebirth.org/archives/icanvbac.html www.midwiferytoday.com/articles/vbacprimer.asp
There are also many books on the subject, but these can be overwhelming in how much information they provide. You can do a Google search on ''VBAC vs. C-Section'' for more information. All the best to you in your pregnancy and birth. Gal
VBAC at Alta Bates
Feb 2005
Looking for advice and/or experiences regarding VBACs at Alta Bates in Berkeley. I will be attending the hospital's VBAC class on April 8th, but am looking for info before then to help in my decision. Thanks! Dawn I wish I had had a second c-section rather than a VBAC. I feel like there's a lot of push in the Bay Area to do the VBAC which focuses on the risks of the C-section, but doesn't mention the risks of the VBAC. Of course there's the risks of major surgery and risks of uterine rupture talked about. People say the recovery is so much better w/ the VBAC, but that's misleading. It's different.
First of all, from many stories I've heard, recovery from a second kid is much better than the first, regardless of whether you went c-section, then vaginal or vice versa, of course unless you had a problem. Certainly the stress of having a kid is easier the second time. After my c-section, my body took a while to recover. I was weak and tired and caring for a little baby. But by 2 months, I was fine except for a tiny line across my abdomen. After my VBAC, I had skin torn that was never properly reattached, my nerves and muscles were in bad shape. I found myself urinating, it running down my legs urinating, if I bent over to tie my shoes or other seeemingly irrelevant things. Psychologically, I was turned off sexually, due to worrying over my damaged skin & tissue. Physically, sex has never been as pleasurable since the birth 1 and 1/2 yrs ago.
I didn't have an infection, I didn't have a tear to the anus, things could have been much worse. There are some disturbing stories at: http://parents.berkeley.edu/advice/parents/postpartumsex.html#painful Just make a decision weighing all factors. Also, even if you go with a VBAC, I would schedule a C-section. I think normally scheduled C-sections are 1 week before your due date. Decide how long you're willing to go - a few days past your due date? a week? more? Talk to you dr. and schedule this one in case you're late (they won't want to induce you). I ended up late and couldn't schedule a c-section until a few days after I was willing to have it, and ended up with the VBAC just before my c-section.
Good luck and remember, both choices are fine and most end up just fine! :) VBAC isn't all great
I am a certified nurse midwife and I work at Alta Bates and Highland. I am not responding as a spokesperson for any hospital, nor do I want to be quoted.
You should have an in depth discussion with your doc or midwife. So they routinely offer VBACs? what's their success rate? would they be willing to induce or augment your labor if need be? do they prefer that you have an epidural in place? will you be expected to have internal fetal and contraction monitoring? The worst case complication with a VBAC is uterine rupture which can result in fetal brain damage or death. As such you will probablly have continuous monitoring of your contractions and the baby. This is a good thing because, altough it is rare, it can happen and a good outcome depends on a swift diagnosis and emergency c-section delivery.
The nursing staff is excellent and very comfortable with VBACs.I really can't say enough about the skill of the nurses in labor and delivery. They are fantastic!! I hope you have a wonderful birth no matter how your baby decides to be born. It's a tough decisions and I hope you have lots of support. Good Luck
I had a VBAC at AB and had a good experience. I took the VBAC class, which both my husband and I thought was great! My OB was very supportive and we had a doula, who was helpful as well. I encourage you to try if you feel like it is what you want. sally
VBAC versus a C-section
Sept 2003
I am due early next year and am agonizing over whether I should opt for a VBAC or not. The doctor has laid out all the pro's and con's of each and frankly, my husband and I can't decide which is best. I'm sure lots of you moms have been through this and I would love to hear any advice on the subject, from those who chose VBAC's and from those who opted for cesareans; and what the experience was like. Thank you
Apolgies for this long post! I know there are strong opinions about VBAC and C-sections, but I wanted to offer my experience. First off, please note that the decision should be based on YOUR comfort level.
When we were due with our first baby, my husband and I had taken a birthing class in which the instructor had us watch a video on C-sections. I'd never thought about C-sections before, other than assuming I wouldn't have to deal with it. After the video, I was a bit shaken. It was incredibly negative. The women all talked about how they had regretted having C-sections and felt inadequate for not being able to deliver vaginally.
When it came time for my son's delivery, I ended up being in labor for more than 21 hours. About 10 hours into labor, one of the doctors in my doctor's group stopped in to check and said I should have a C-section. Well, you can imagine my reaction. I started crying, saying that I felt inadequate. Here's the funny thing: I even told my husband that I wasn't able to deliver vaginally because I was anal retentive (we like to joke about this now!). The nurse on our team sympathized with us and we went ahead and tried again to deliver vaginally.
After 21-plus hours, my son's head was stuck, he and I were both at high risk for infection, and my doctor broke it to me gently that I really needed to have a C-section for our health, moreso for my son's. So we had the C-section. I ended up with an infection and had to stay in the hospital a day longer than the normal 3 days. I didn't get out of the hospital bed at all the first day and not out of the hospital room the entire stay. I was in intense pain, even with meds, and the recovery was incredibly painful. When my son cried, I couldn't even get out of bed quickly or without help. It was about a month before I was without pain.
18 months later, I became pregnant again. My doctor, without any bias whatsoever, explained that because of my failure to progress situation, I had a 50/50 chance of the same happening again. She gave me a lot of information about both sides to help me decide. The entire pregnancy I was vacillating between having another C-section or a VBAC (could I be on the other side of the 50 percent that had successful VBACs?), even though I had told my doctor that I was prepared to have a VBAC. As the pregnancy wore on, I grew increasingly anxious. I finally admitted that I was deathly afraid of labor, of having to endure what I gone through before. When I changed my mind and decided to have an elective C-section, I was incredibly relieved.
We set the date, and then, Murphy's Law, the baby decided to come three days early. I had painful contractions the day I had a doctor's appointment. Turned out I was already 3 centimeters dilated. As my husband drove me directly to the hospital, I started wondering if I shouldn't have a VBAC since I was at 3 centimeters. We still went ahead with the C-section, and after all was said and done, there were 3 good reasons why it was the good choice for me: 1. I had not dilated at all in three hours, from the time the doctor saw me to the time I was having the surgery, 2. my daughter's back was to my back (which is why my contractions the last several weeks had been extremely painful), so it was going to be a painful back delivery, and 3. strangely, my daughter had moved back up (which explains why we heard her cry for a long time before the doctor announced whether she was a boy or a girl). I recovered really easily because my body wasn't exhausted from hours and hours of labor, and I was walking the morning after. I was in minimal pain but able to do a lot of things right away.
This is obviously a story from a mom who had a failure-to- progress history. I know some moms who had C-sections with breach babies and delivered VBAC successfully. That's the first thing you have to separate--why you had a C-section in the first place--but the most important thing to consider in your decision-making process is what feels most comfortable for you. Patty
I opted for a second c-section. I read the previous reccos on the website and no one who posted there had two in a row, so I thought I would put in my two cents.
I had 24 hrs of terribly painful induced labor with my first, and ended up with a c-section because my uterus got infected. The controllable pain associated with recovering from the c-section, to me, was preferable to the uncontrollable pain of labor. Even though I had an epidural during labor (which only worked on half my body) and a great emergency doula, I was seriously tempted to run out onto Ashby and let a car run over me after about 12 hours. Labor was just too much for me.
So, I had a scheduled c-section the second time, and I just took it easy and took my pain meds and everything was great. I knew what to expect and it was not traumatic like the first one. I did have a dangerous reaction to the spinal during the operation the second time, but they took care of it quickly and there were no more complications. If I have a third, I will have another c-section, although I will have to address the spinal reaction problem.
Some Kaiser practitioners tried to talk me into a VBAC, but I just kept saying ''no thank you''. I was asked over and over why I was choosing a repeat (for forms, etc.) and I did feel like I was getting some flak for my decision, but I just stuck to my guns. no regrets
Hi, I had a c-section with my first after days of labor and a midwife. There was a difficult presentation, (posterior, brow presentation) and the c- section was the only way to go. However, my second labor and delivery were very different, even though the presentation was also difficult (posterior, asynclitic, meaning head turned to the side and face up). Anyway, the two labors were night and day. Also, my second child was significantly smaller than my first, and that was helpful. I was very committed to a VBAC and found a midwife (Hsiu-li, who works out of Summit and has hundreds of loyal moms) committed to it as well. I needed no pain killers the second time around, it was fast, and beautiful, the type of labor you'd request. So, I'm saying this so you don't make assumptions about how the second labor will be like the first b/c you just don't know. I strongly encourage you to try a VBAC unless there's a reason not to. It's so wonderful, and the recovery is much, much easier. However, your doctor saying you could go either way seems like a premature piece of advice. Why have significant surgery if there's no medical necessity? Good luck and congratulations. anon
I had a successful VBAC at a birth center three years ago. My previous C-section was eight years earlier. Also my midwife looked over my files and determined that my initial C- section was unnecessary. The OB-GYN community has become less and less favorably disposed to VBACs over the past five years or so. This is because of a study that claimed to have found an increased risk of uterine rupture with VBACs. However, I believe that study tarred all VBACs with the same brush, when it really was increased risk when inducing labor, especially with the use of cytotec.
My advise to you is that yes, it is possible and under certain conditions, completely safe. You have to find out why you had a c-section to start with, was it due to some condition that could reoccur or a one time incident - placenta previa, breech etc.
Secondly, you really need to explore your desire to have a VBAC. Ask yourself why, come up with your reasons. You have to be sure of them and have the support of those around you, doctor included. It is almost as if the cards are against the VBAC mother from the start, especially since the self-doubt doubles. All throughout my pregnancy, I had times when I was convinced I couldn't do it. This is probably true for all women, but I had this haunting feeling of how I couldn't do it the first time, so I wouldn't be able to do it. Also scheduling a C-section is such and easy out.
With my first birth, I was 18 years old and though the father was in the room he was so useless, he might as well have not been there. And he was it. So, scared and alone, I felt I couldn't do it and lo and behold, I didn't. Demerol, turned to an epidural, to a c-section.
My second birth was quite a different experience. The man with me this time, my husband, was an amazing source of strength and encouragement. It is because of my own experience that I stress the need for labor support. All laboring women need that physical and emotional support. Consider asking close friend or a doula experienced with VBAC deliveries.
Feel free to email me if you have any other questions. VBAC mom
I am due in the early spring and definitly want a VBAC instead of another cesarean. The primary reason is that with my toddler I just don't want to spend three months recovering, if I can help it. I vividly remember being so frustrated by the slow recovery time and I hopefully will not have to do that again. Of course I am a bit nervous about vaginal birth but at least when it's over it's basically over. Another strong reason for my decision is that I would like my daughter to be there when her sibling is born. gael
Hi- I personally would think that if I were you, I would try to have a VBAC if your doctor is saying that the option is open. Most women are told that they can't have a VBAC and so automatically assume they have to have that repeat Csec. If you try for the VBAC, the worst that could happen would be that you have a normal vaginal delivery and don't have to go through the recovery of major abdominal surgery again, and if something comes up in labor (an emergency situation) and you have to have a Csec again, at least you TRIED. Here are a couple of good sites to check out so that you can make the best decision for YOU. I hope this helps. www.ican-online.org www.vbac.com http://www.childbirth.org/section/VBACindex.html
I feel so strongly about you making choices for yourself because I am a doula and although I haven't had a Csec (my son was vaginal delivery) I know how hard the recovery is for mom AND baby after that surgery and that if you have the chance to try for a VBAC and doc is giving go ahead to at least TRY then I say GO FOR IT! Dont have major surgery unless there is an emergency that requires it!
Shaana Keller Celebrations Doula Services www.celebrationsdoula.freewebsitehosting.com/Main.htm
I had a c-section and then opted to have a VBAC for my second child, and it was fine. Your doctor should have explained to you that two critical factors weigh in on your decision: 1) if you have a horizontal scar/surgical c-section, and if yes, then that's good for having a VBAC; 2)what the reasons were for your c-section: if you had complications with the birth and issues that meant having a c-section, then a VBAC may be a bad idea. Or, if your baby was a breech, then that's no real reason to have another c-section. My first child was in a full breech position, with both legs extended down, and we knew it well before the due date. Also, check the New York Times archives for an article that came out in mid 2001, about VBACS being more riskier than doctors realize or care to admit. Overall, though, if you're healthy and had no complications, I'd say go for it! Good luck. Been there
I had a very successful VBAC 2 years after the 32 hour labor, 3.5 hours of pushing and c-section of my 1st son. Here's what made my VBAC a success:
1) I told my OBGYNies that I was having a VBAC.
2) My OBGYNies were very supportive (I would have found another practice if they were not).
3) I hired a fantastic doula, Treesa Maclean, to increase my chances of success.
All went very well, so well in fact, that I barely made the 4 block drive to the hospital before I was completely dilated and ready to push. I was also postive, and harbored little anxiety about the whole thing (what was the point, the baby had to come out!). I also remained flexible with my nurses, doctors and doula that based upon their opinion, if through labor I needed another C-section I would do it.
My advice...go for the VBAC, if it doesn't work out at the hospital be prepared (mentally) for the C-section. Recovery from a VBAC is SO MUCH better than a c-section. Sastisfied VBACer
I had a VBAC. (I was extremely curious to know what it would feel like. But when the baby came out, I couldn't feel a thing b/c of the epidural. And I couldn't see anything in the mirror b/c the doctor was in the way.) I had no regrets about the C-section, didn't feel any less joyous about the birth experience. Surprisingly, the VBAC recovery for me was just as slow as my C recovery (2-3 months). I couldn't walk or stand for more than 10 minutes at a time, although less so as time wore on. I was sitting on ice packs and rubber donuts for a long time! Everything down there felt weak and sore. I had no strength between my legs, couldn't get up off the floor, crouch down to pick something up, etc. It hurt just to sit for more than a month. For me, it's a toss up, the VBAC or the scheduled C. But some factors that may affect this are (a) my memory of the C-section is over 2 years old and (b) my child born VBAC had a very large head (in the 97% percentile.) Bruised twice
I didn't have a C-section myself, but a good friend is planning a VBAC (due next month), and I think that she had a number of reasons for doing so. No sure how much research you have done (didn't see the original post), but there are compelling reasons for attempting a VBAC. Have you been to the VBAC website, http://www.vbac.com/ yet? Here is a quote from their website: ''A cesarean can be a life-saving procedure for a mother and/or her baby, but overall, birth by cesarean puts healthy pregnant women at risk for medical complications.'' There's also the Cesarean awareness website, at http://www.ican-online.org/
Mothering magazine has some articles online you might want to check out: http://mothering.com/11-0-0/html/11-4-0/11-4-0.shtml (defintely pro-VBAC) Jennifer R
Seeking VBAC stories
Nov 2003
I am currently planning a VBAC and looking for VBAC stories and information from women who have attempted VBACs within the last few years or so (successfully or not). Your input will help me shape my own plan. Here are some specific questions:
1. What was the reason for your prior C-section? Did it recur? (My baby never dropped and I was induced, got to 9 cm and stopped --''failure to progress.'' Any others in the long gestation boat? Did labor start for you naturally the next time around? Did you help it out?)
2. Did you have a doula at the C-section birth? The VBAC birth? Comments?
3. For the VBAC, did you plan a home or hospital birth (and how worried did your provider suggest you should be about uterine rupture)?
4. What sorts of rules did your medical provider give you about when to get to the hospital? When did you actually go? Did you negotiate this with your provider, or make your own informed decision about it?
5. If you did go to the hospital for the VBAC, how was fetal monitoring handled? (I'm especially concerned about going in and getting strapped down flat on my back, a big labor killer.)
6. How supportive was your provider of your VBAC decision, and did s/he make any practical suggestions to increase your chances of success?
7. What happened? Did it work out?
Any additional insights or resources you could recommend would be greatly appreciated.
Thanks! Second time Mama
This is just my experience here and each birth, each person is unique BUT my advice here is: trust your instinct and do what you think feels right ! I had a C-section with my first baby, just like you, failure to progress, stuck at 8cms, 12 hours labor ending in a c-section. I had this specific problem that while laying down in bed, contractions would stop but since I had a bad case of ''back labor'' (contractions seemed like a stab on my lower back) I couldn't have gone through a 12h labor without an epidural. So when I got pregnant a second time, less than a year after the birth, I was VERY reluctant to go through the same experience and I really wanted to have a scheduled c- section. I guess my OB was very persuasive because I let him convince me that trying for a natural birth again would be better. Sure enough, second time was worse than the first one, and after 24h of labor, going nowhere and an epidural that was not working, the doctor finally performed a c-section. Results ? I was exhausted from the labor (sleep that I've recovered only 2 years after the birth) and I had the c-section anyway. I would have to do it again I would choose c-section in an heart beat, also because both recoveries were so easy for me. However, I'm still griefing at some level, the fact that I didn't experience a normal delivery. Good luck with your choice ! anon
Hi there- I just want to tell you first off that the decision is completely up to you on whether or not to have a VBAC. Secondly, there are so many risks involved in having a c- section that doctors don't tell you about and having a 2nd c- section can even raise that risk. Yes there is that risk of uterine rupture that all the medical community says is sooo high etc. but in reality here is the info: for a first time mom laboring (for a vaginal birth) the risk of uterine rupture is about 1%. For a second time mom who had a c-section w/ the first baby, the risk of uterine rupture is about 2%...so as you can see the risk is not that much higher. I would recommend that you do a lot of research- read books about VBAC's and try finding forums online w/ moms who have had VBAC's or are aspiring to have one. Right now I am working with two moms who are both going for a homebirth VBAC and are very eager to experience birth 'naturally'.
One thing I should say- what were the reasons you had the c- section the first time around? Failure to progress? Inadequate pelvis? Well, there can be a lot of reasons and I'm not saying that all of them are wrong because there are real emergencies that require c-sections, but a lot of times if the diagnosis for c-section is 'failure to progress' or CPD (inadequate pelvis)...usually the mom was stuck in bed flat on her back unable to move around and utilize gravity to help her dilate and progress... OK I'm not trying to preach or anything, but I feel passionately about the birth process and that with good physical support, suggestions, and an emotional and mental belief that YOU CAN DO IT, you can acheive that natural birth that you want.
Please feel free to email me off list privately for some suggestions on specific websites or books to look at. If you really are striving to have a diff. experience than your last birth, it is possible but you have to do your homework and know whats involved. Also having a supportive doctor who is supportive of your VBAC is more important than you might think. Anyway, to keep this short please do email me or call me and I can talk to you more about it.
Shaana Keller, Labor Doula
I did not see the original posting on VBAC, but saw the response by a doula. I have to throw in my 2 cents. Listen very carefully to your doctor whether or not you can do a VBAC. In this instance she/he does know best. As far as the c-section vs. vaginal being natural - as the doula suggested - gimme a break! Right now you have to do what is best for you and your baby. If anyone feels like they are less of a woman because of the birth experience, they have other problems.
I had a successful VBAC in July. I wouldn't trade that experience for anything! Everyone's circumstances are different and this is a very personal decision. But, I have to agree with the previous poster that you should do your own research and make your decision based on facts. From my personal experience and what I have read, I believe that some physicians manipulate the statistics to scare women in to having a c section. I also have to concur with the previous posting that a VBAC supportive provider is incredibly important. My doctor claimed to be VBAC friendly when in reality he wasn't. I was under enormous pressure from my provider to schedule a c-section when I was approaching and ultimately passed my due date. I stood my ground and ended up switch providers 5 days before I gave birth. It took alot of resolve and ended up being the most incredible experience of my life.
I would recommend you look at the VBAC support bulletin board on Babycenter.com. In my opinion, that was the best on line forum for support. Also, if you do a google search for VBAC you will find a wealth of information on both sides of the issue. Be very clear on the statistics between being allowed to go in to labor naturally vs being induced. The risk of uterine rupture goes up significantly with induction. Best of luck to you in whatever decision you make. Jennifer
Jan 2003
I'm pregnant for the second time. My son was born via c-section when he showed some signs of distress after a prolonged labor. This time I'd really like to have a vaginal birth and my OB has said it shouldn't be a problem. I'm wondering if anyone out there has had a successful VBAC and can offer advice on anything I can do now to increase my chances of success. Or, if you hoped to have a VBAC but ended up with another c-section, is there anything you think you could have done differently during your pregnancy that would have changed the outcome? I've already looked at the postings on the web site. Thanks for the advice! AM
I had a succesful VBAC at age 44, and am proud of it! Yes, go for it! One thing that I did which I think helped was to see someone who I did 2 sessions of hypnotherapy with. It helped to visualize the process of actually giving birth. Otherwise I had some blocks, thinking I couldn't do it (age, size, previous c-section, etc.). So, believe in your ability, and try it, is my advice. Good luck! Yvonne
My first child was c-section (long labor and nearly 11 pounder) and my second child was a 4-hour start to finish labor with a great vaginal delivery (9 pounder). I, too, wondered how I could do things differently. First, I found a Nurse Midwife (Hsieu-Li Chang) who was well known for her high VBAC success rate (she delivers at Summit). She clearly told me (after I gave her the details of the first birth) I could have a vaginal delivery. Knowing that, I exercised regularly, ate better, hired a very competent labor coach (Carol Rice Shattuck), took evening primrose oil(?) about 6 weeks before the due date, and after that trusted and surrendered to the labor process. I told myself it was a gift to deliver vaginally and if I had a c- section again it was meant to be. The first time around I was way too attached to a homebirth delivery. Then I realized I can do my part but the rest was out of my hands and control. Good Luck! Anon
I had a c-section for my first child because of the full breach position of my baby girl. I then had a successful VBAC when my son was born 15 months later, at 42 years old. My doctor made it clear that it was my decision to have a VBAC, and in no way would she be responsible for it! We talked and she agreed with me that it comes down to a ''crap shoot'' whether it works successfully or not. She did say that because my c-section of my first birth was due to a breach, not to complications, that that would help my chances of having a successful VBAC. Also, check the New York Times in the spring of 2001, when there was an article about VBACS being more risky than was thought before. I had my two babies at CPMC in San Francisco (superb place!) and would highly recommend it. It was my doctors' policy to not give a VBAC mother anything to induce the labor, like Pitocin, which might cause a rupture of the uterus. I had what is called PASSIVE DESCENT, letting the baby drop down on his own. I also had back labor and got an epidural right from the start. I had 17 hours of labor. I would advise you to choose your doctor wisely if you do go the VBAC route. You want someone who is absolutely competent, technically, to handle things should they go wrong. I might add that a vaginal birth is SO MUCH easier post-birth. You deserve a chance to enjoy the homecoming without another c-section! Been there
I had a VBAC, and although I don't know why I was successful, I think it might have had to do with hypnotherapy. I went to Carolyn Shaffer (652- 1498) a few times, and we worked through some issues I think might have otherwise interfered with my having a VBAC. My first child was born via C-section after failure to progress despite 24 hours of hard, unmedicated labor followed by 12 more hours with epidural, pitocin, etc. My second child was born vaginally, 45 minutes after we arrived at the hospital. So, I'd recommend Carolyn! Susan
VBAC after 2 c-sections
June 2002
My first two children were delivered via c-section because both were breech. I am due to deliver #3 in a month, and due to a serious post-partum hemorrhage last time (in which I almost lost my uterus) and the fact that the current baby was also breech, my doctor and I had planned a c-section. Today at 35 weeks, however, I found out the baby has turned down into the correct position and suddenly I'm very tempted to go for for a VBAC, (risk of hemorrhage notwithstanding). I would like advice from anyone who has tried for or had a successful a VBAC after 2 c-sections and/or with another ''high risk'' factor. What issues should I consider before I make my decision? What prep can I do for my body in the next couple of weeks? Also, can anyone recommend a doula who specializes in VBACS and could help with my delivery at UCSF, but who is otherwise based in the east bay? And who also might be able to take on a very last minute customer??!! Thanks so much! Mary
I recently had a vbac after 1 c-section, so I can't speak to having 1 after 2 c-sections, but I can recommend a terrific doula -- Michlene Cotter-Norwood. Michlene herself had a vbac & is very sensitive to the issues it raises. She works very well w/ medical staff -- all the nurses we dealt w/ at Alta Bates said how much they appreciated working w/ her. She is also a wonderful person who was incredibly supportive to both me & my hubamd during a very long & difficult labor. She is based in the E. Bay. Reach her at birthspirit AT prodigy DOT net. Good luck. Colleen
Good for you on wanting to find a Doula for your VBAC. That choice will make the process so much easier emotionally and physically. BirthWays in Oakland, across from the Grand Lake theater (510/869- 2797), is a great resource for finding a Doula who will provide excellent support on short notice, and who will be experienced in VBACs. Please give them a try, and good luck to you and your baby! Nora
Trying to decide about having a VBAC
Nov 2000
I'm four months pregnant with my second child and had a c-section for my first one. I'm trying to decide whether or not to have a VBAC (vaginal birth after cesarean). It's a crap shoot as far as I can tell, whether or not I have a uterine rupture. Any advice out there? Thanks.
My first baby was breech so I had a C-section. My second was a very sucessful VBAC. So much easier a recovery even though I had a 2nd degree tear. Not knowing the reason for your c-section, I would say go for VBAC. Besides, if your older child is still quite young you'll have an easier time tending to them if you have VBAC. If your C-section was because of failure to progress then I can understand the hesitation. Yes there's a risk of rupture and that can be a scary thought but the stats aren't THAT much higher. Chances are you'll come through with flying colors. There are a lot of articles on VBAC out there (check the web) and Alta Bates did have a free lecture on VBAC. Good luck. caroline
The risk of uterine rupture with VBAC is small (less than 1%) and the likelihood of having an uncomplicated vaginal delivery is high (around 60-80%, depending on why you had your first cesarean section). If you had your first c-section for breech or fetal distress, the probability of successful VBAC is on the higher side, if you had your first c-section for failure to progress in labor the probability of success is on the lower end of this range. The probability of successful VBAC is lowest if in your first delivery you got all the way to being fully dilated, pushed for a while and then wound up with a c-section. Also, rates of uterine rupture are exceedingly low if your labor begins spontaneously (not induced).
All in all, I would say in most circumstances it is worth trying VBAC. I would recommend doing it in a hospital where an obstetrician and anesthesiologist are immediately available (in case you need an emergency cesarean), I wouldn't do it if you or your obstetrician thinks the baby is huge and I would wait for labor to happen spontaneously. Also remember, you can always change your mind (even after your labor has started) Hope this helps. Alisa
I had my daughter by (emergency) c-section almost seven years ago (she was 18 days post due-date and then had some distress) and my son two years later, by VBAC. Having been through both, here are my observations: I am glad that the C-section came first, because the recovery was much, much slower, much more painful, ultimately, no driving for two weeks, longer hospital stay, less ease of movement with a newborn to care for. VBAC: much, much faster recovery, driving right away, fully functional within a few days time. And the second time around, I needed to bounce back from the birth of my son, because I had a two-year old to care for, which the VBAC allowed me to do. The c-section, while sparing things like episiotomy, is major surgery, and with the VBAC, once my son arrived, that was that, on with life again. If I had to opt for one or the other, knowing what I know now, I would definitely elect VBAC. And that is compounded by all of the benefits to the infant during the process of labor and VBAC delivery. Lastly, I really loved the experience of having my son arrive in the world in the way he did, it was very fulfiiling and something I had (mildly) missed with the birth of my daughter. But the baby's health is of course the determining factor, always. Best of luck with your decision and your baby's arrival.
I had a c-section because I had a very big baby (10 pounds) and my second child was very big too. My doctor wanted to try natural birth but after four hours in labor, he told me it is better to have a second c-section. I am glad he said that because with my first one I had been in labor for 40 hours and I was very tired when they performed the c-section. I believe it depends from each individual case.
12-1/2 years ago, I had a successful VBAC delivery. The C-section I had four years previously was for failure to progress; I think part of the problem was some less-than-adequate prenatal and hospital care I received. There's not much likelihood of rupture in a VBAC, and if you get yourself good support from a coach or knowledgeable friend (I personally think husbands shouldn't have to be responsible for this), you should do just fine. Louise
For the reader who had a c-section with her first child and is now considering whether to try a VBAC ... I don't know why you had a c-section, and I don't have any medical advice or statistics for you, but I can share my own story and give you some encouragement. I had a c-section for failure to progress with my first baby and decided to try a VBAC the second time. My second child (who was about the same size as #1) was born VBAC less than an hour after we arrived at the hospital. My doctor was very supportive of trying for VBAC, and that was important for my confidence level (according to him, uterine rupture is not a huge risk given the current c-section technique). The other thing that helped me a lot was going to a hypnotist to work on clearing away any mental roadblocks, and to get focused and not have self-doubts. (Her name is Caroline Shaffer) Good Luck!! Susan
I didn't have the kind of complications that you did, but I tried for a VBAC after a c-section and ended up with another c-section. If I had it to do over again I would just go directly to the c-section. People will try to shame you and make you feel ashamed of not "being able" to do it "naturally" but don't let them. Labor and childbirth - even though I never made it to the pushing stage has got to be the most horrendous experiences I've ever been through. When I decided to let them do the c-section I thought to myself, well if its been this horrendous so far, how much worse could the pushing be? I didn't want to find out. And yes I had an epidural - still was vomiting from the pain both times. It is a horrendous experience. Somehow I thought the second time would "go better" since I "knew what to expect." After each C section I was up doing everything within a day, very easy recovery. Don't let anyone make you feel bad. Also, no one ever talks about this, but you don't get all stretched out from a C section, if your sex life means anything to you or your husband.
I delivered both my kids at Kaiser Oakland, and broke my tailbone with the first kid. While I didn't end up with a c-section, I had complicated, painful birth and had to be rushed to the operating room after it, since I was bleeding and it wouldn't stop. They saved my life. I passed out and don't remember much of the whole traumatic birth, but my husband has told me what happened. I had a large tear and swelling and it hurt so much, I didn't even know my tailbone was broken for the first week. The tailbone took 11 weeks to heal.
With my second, I was impressed how prepared they were given my history. They had a whole team ready for another traumatic birth, and induced me so I'd give birth in the middle of the day with their whole team (and extra equipment) ready. I also had a lot of pain medication and epidural with the second, as the first was unmedicated. I didn't have any trouble with the second kid, and I didn't even feel my tailbone (or any other pain) until much later when the epidural was out. I may not have felt the 2nd kid arrive, but I was alert, held him right away and remember the whole thing. My tailbone didn't break the second time. I'd recommend Kaiser Oakland to anyone with a complicated history- they know what they are doing.