Tuesday, November 17, 2015

VBAC vs. Repeat C-Section - Choosing a delivery option


The pros and cons to help choose between delivery options
My first pinterest image! PIN IT or else. Jk. 

*Warning - this post is devoid of baby pictures and just my rambling thoughts. Sorry! Edited to add - ok I had to do ONE.

With Dalton, I scoffed at birth plans, or, more accurately, the idea of planning a birth. And rightly so, because if I could have planned his birth, I sure as hell wouldn't have requested 30 hours of labor, getting sent home from the hospital, and an emergency c-section. But the birth is a means to an end and it isn't called labor because it's a good time. While Dalton's birth was scary in the moment, it resulted in a healthy baby boy so it isn't something that's concerned me now that it's over. Plus, it makes a good story to scare expectant moms.

When he was BRAND NEW omg.

Now, having had a c-section, I'm in the position to have a choice, to some extent, about how to deliver baby #2. Back in the day, once a woman had a c-section, that was the only way they were allowed to deliver subsequent babies. In this modern medical era, (some) women can now attempt to go through labor and deliver a baby naturally even if they've had a c-section previously.

At my 6 week postpartum appointment, I asked my doctor if I was a candidate for  VBAC (vaginal birth after cesarean), mainly out of curiosity, since clearly I wasn't interested in conceiving again at that point. The reason for my c-section was Dalton's heart rate dropping suddenly, as opposed to him getting stuck due to the way my body is positioned, a health issue, or something that would be likely to happen again. That means that if I want to, I can try to get this baby out the old fashioned way.

I'm overwhelmed with the choice and have agonized over it for far too long, considering I essentially have very little control over it to begin with. Here's the breakdown.

C-Section - Pros 


  • NO LABOR, enough said. Right off the bat, I was all about the repeat c-section. Labor was nice and fresh in my mind and I was like F%$& THAT. 
  • Being able to plan ahead. Even if my mom jumped in the car the second my first contraction hit, it would be a good 6-7 hours before she could be at our house to watch Dalton. Getting him settled and not having to have 58 contingency plans for various times/days/scenarios of going in to labor is huge. 
  • Knowing what to expect. Eric is very pro c-section for this reason. Obviously he will support me whatever I decide but apparently the whole situation with Dalton was really terrifying for him. I never knew because in that situation, only one person is allowed to lose their shit, and that's the person on the operating table (me), so in the moment he was all calm and collected like it was no big deal. When I got pregnant again, it came out just how scared he was and he really doesn't want to risk that again. 
  • My sister, my running friend, my coworker, etc, etc have all had planned c-sections after emergency ones and had fantastic experiences. I love the idea of being positive that I can "enjoy" this kiddo's birth and focus on meeting him or her. 
C-section - Cons

  • It's major surgery. Obviously. 
  • The recovery time. I have a lot of friends with babies, and from my "research" of chatting with them, here's how I see it. With a vaginal birth, your recovery might suck. With a c-section, your recovery is pretty likely to suck. But, by all accounts, including my OB, recovery from a planned one is much easier than emergency. Still, that would leave Eric in charge of a newborn, toddler, and hormonal, incapacitated woman until I healed, and it breaks my heart to think of not being able to lift or do anything with Dalton for a few weeks. It's not like he would be old enough to understand. 
  • The hospital time. It's generally more with a c-section and I'm already having heart palpitations at the idea of spending our first night away from Dalton and barely (if at all) seeing him for a few days. I literally cry even time I think of it (including now) #hormones.
VBAC - Pros

  • Possibly an easier recovery, fewer restrictions (I could climb stairs, lift Dalton, drive, etc). 
  • Less time in the hospital.
  • The "experience". Ugh, it pains me to say this, but I want the experience of pushing a baby out and having him or her placed on my chest to snuggle right away. I never regretted not having that with Dalton, he was born how he was born and he was fine (and I wouldn't have had skin to skin time anyway since he needed a minor intervention right away). But a part of me is having trouble accepting that I would never get that experience (a second c-section means I can't try for a VBAC even if we did have a third child). 
VBAC - Cons

  • Labor. Obviously. The fact that I'm even considering it means that I've forgotten what contractions are truly like but I do remember they weren't pleasant. 
  • The risk of uterine rupture. This one scares me. My doctor said that once you are 18 months out from a c-section, there is a 1% chance for this. My due date is 19.5 months after Dalton was born, which is clearly more than 18 months, but not by a huge margin. 1% is a low risk, but it's still frightening. 
  • Scrambling for care for Dalton. I have wonderful friends and a ton have already offered to help, which is awesome. But they all have jobs and their own children and while I know they would make it work, it stresses me out that it can't be planned. It would all be complicated and I don't like the idea of leaving Dalton without him settled with someone he's comfortable with. 
See, in our original plan, Dalton would be like, 4 when all this happened. He would no longer need to be lifted out of a crib, he would have a solid grasp of the English language (receptive and expressive), and we would have already spent a night away doing something fun and romantic, not giving birth and then likely cluster feeding an infant. But then we just couldn't wait and our little impulse baby is on the way, and he's still just a little guy. I know it will work out whatever happens, but, like every second time mom, I'm naturally going to be worried about my first baby. 

I searched "VBAC" on pinterest and there were all sorts of hits. Most were blog posts written by people who wanted a VBAC so they could have a unmedicated labor and go on to have 5-7 children in all (repeat c-sections limit how many deliveries you can have). There were suggestions about eliminating gluten from your diet and doing planks to ensure a successful VBAC?! And the general overall feeling that OBs are evil monsters just plotting away to put pregnant women under the knife, not to be trusted. In short...not my people. (Don't get me wrong, I have friends that I love and respect that are devoted to unmedicated labor - but I've made it pretty clear it's nothing I'm personally interested in.) I actually don't know anyone in real life that has had a VBAC. So, I kind of feel like all this is pointing to a repeat c-section. I keep trying to get myself resolved to that outcome, but something about it just feels off. 

Let's take a poll - which delivery option should I go with? The joke will probably be on me and the baby will be breech and then it won't even be an option.



14 comments:

  1. Why not be a trendsetter and see if you can give birth via vomiting?

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  2. I think you should have a water birth at Small World at Disney World. That way, you have many concerned employees calling you princess and wishing you a magical day throughout the delivery, you get a vacation in, take some character pics with Dalton before the new kid moves in on his scene, AND come home with a baby among your mouse ear and t-shirt souvenirs. Of course getting through TSA with one more human without an ID than you had on the first leg of your travel might be challenging. Good luck on that one.

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  3. My hairdresser (I know this makes me an expert) had a horrible first induced labor that resulted in an emergency c section. For her second child (7 years later) she was planned c-section all the way. That is until she felt achy for 2 days and then had some really bad pains. By the time she got to the hospital she was already 10 cm dilated! So they were like you are having this baby before we could even get you prepped for surgery! Much easier to recover from she said.

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  4. So for me, the VBAC was funsies for all the reasons you listed (actually healing ended up being not so great but I think my case was out of the ordinary...still better than the section though, I think) but another csection would have been fine too, for all the reasons you listed.
    Whatever you decide, I hope it goes safely and snoothly and that everyone is supportive of your decision!

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  5. I'm sure I already told you but my SIL had a VBAC. I'd put you in touch with her but she's crazy. But, she had two kids vaginally after her first was a scheduled C-section (the doctor told her the baby was too big).
    I'm also sure I told you that I had some restrictions after my vaginal birth. I was told not to drive and to limit stairs to once per day for a week. Probably if I didn't have stitches I wouldn't have had any restrictions?
    I'm sure when the time comes you'll make the best decision for you and your family.

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  6. My labor was long, but not really traumatic other than wanting sleep and I was back on my feet literally immediately after giving birth, so that's definitely a pro for VBAC. Then again, who knows what I would say if I had had your experience. What does your doctor recommend?

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  7. Since birthing is generally outside my realm of expertise, I think you should just get hypnotized and then the baby can be born while you are asleep.

    My brother was born when I was 2.5 yrs old and I remember none of it. I stayed with my aunt and apparently I was very sad and really wanted my dad to come get me. But like I said i don't remember anything so even if it is traumatic for Dalton to be away from you, he likely won't remember!

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  8. How about a VBAC for this one and then you can go back and read these pros and cons for Baby 3.

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  9. Wait. You mean you're not dying to do planks when your pregnant? I know I am (just kidding, I don't believe in doing planks whether I'm pregnant or not. Like all working out, it's bad for the soul. Obviously.).

    Why not just do a freebirth at your local park and hug a tree while you push this little one out? Then Dalton can play on the swings with Daddy while his sister or brother is born. It's a win/win. It seems almost as legit as planking guaranteeing a VBAC...

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  10. My first was vaginal. My 2nd was csec. I'm in the same boat as you wondering if my 3rd will be vbac or not, I'll be 19 mos after the csec. Research for best outcomes is now trending towards vbacs so that's what I'm going to shoot for but I'm keeping an open mind. For me, csec recovery was no big deal except I hated having to be all doped up for my daughters first day alive. After that though, I was fine; not everyone is so lucky, I might not be that lucky if I do it again. Vaginal recovery sucks too. My 'undercarriage' was on fire for what seemed like forever.
    So, I'm going to leave it up to my doctor. I make big babies. My daughter was 9lbs9ozs and 4 days early. If they estimate large baby again, which I kinda expect, we'll probably csec and I'm okay with that.

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  11. Will your OB do a VBAC? Many won't.
    My 1st was vaginal, 2nd c-section (danged kid was sideways) and I had a nightmare of a recovery from it. (blood clot, MRSA...went on for about SIX months) Not the norm, but enough for me to shoot for a VBAC with the 3rd.
    My OB was behind it 100% and the (natural, vaginal) birth of my 3rd was textbook and magical.
    If you ever want a sounding board, please don't hesitate to contact me, an imaginary, internet buddy. :)

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  12. I had a "normal" birth with my first with an epidural and relatively short labor and an emergency c-section with my second. However, if I were going to have a 3rd child, I would choose the C-section all the way. Even though it was rough with a 2 year old at home not being able to lift things, I still felt way better after my c-section than after my normal birth. Probably it was because I was in much better shape in my second pregnancy than my first. I missed my son when I was in the hospital having my daughter but I thought it was also important to have some time with her alone before I went home and tried to balance the needs of 2 children (FYI they are now 4 and 6 and it is not any easier, they are just louder). But whatever the birth situation, as long as the healthy baby is the end result it is a good day in my opinion.

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  13. I just had a baby boy on the 24th. Our older son is 4, so we are living your original plan. It is still really rough, mainly bc I now have mastitis, yay! The birth was vaginal, but we had to spend 5 days in the hospital away from my older son due to my 48 hour labor with a uterine infection.

    My mom was thankfully able to stay with him and he did great, but it still sucked. We had left him overnight before, but never anything like this. I also was given post-birth restrictions- no lifting anything heavier than the baby, no stairs, etc. I had a second degree tear and stitches (he came out facing sideways with his hand up over his face) so maybe that is why? Anyhow, probably this doesn't help at all, but I don't think you are missing anything not actually pushing the baby out. But I have so never felt a runner's high. Do you get those? I feel like my friends who love exercise also love natural birth. Maybe I am just a lazy wimp.

    Anyhow, I doubt we'll have more kids, but if I did get pregnant again and someone offered me an elective c-section, I would probably take it. I know the recovery is supposed to be worse, but I have also heard it is a lot easier with a planned one vs your 30 hours of labor and then c-section. To me, just the ability to plan ahead would be worth it bc Lord only knows how we would manage childcare for both of them.

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  14. I was hoping for a VBAC (planned c section with the first because he was breach and 9+ lbs), but baby no. 2 showed no signs of coming. They wouldn't induce or let me go past due date with 40 weeks - or at least I didn't feel strongly enough to push them on it - so I had the scheduled c section. I know it depends on the person but I can definitely say that recovery was not bad at all and we actually enjoyed having some time with just baby number 2 in the hospital before going home. It also helped with scheduling - my mom came in from out of town to watch our older son for the four days. It is strange having two kids and no labor or contractions, ever, but I've resigned myself to that :)

    Just found your blog and really enjoying it!

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Thanks for commenting! Comments make me probably more happy than they should.