VBACs

velvet pawsvelvet paws Posts: 1,250Registered Users
I'm not pregnant, but I'm already thinking about my next baby - my husband and I really want to try for number two as soon as I start ovulating again.

I want to do everything in my power to avoid a c-section, but because of my clotting disorder, I have to give birth in a hospital (I'm scared of bleeding out because of the thinners I need to take while pregnant). However, I'm a bit wiser this time around and I'm going to do things differently. I really want to try for a VBAC.

For those of you that have had a VBAC, was it difficult for you to find a doctor that supported you? From what I gather, OBs seem to pay a lot of lip service to supporting VBACs, but aren't that supportive when it comes time to actually birth the baby.
3A / 2B / 2C wavicelli

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Comments

  • iris427iris427 Posts: 6,002Registered Users
    No insight into VBACs, but I'm curious about your statement that you're wiser this time? Could you elaborate? What would you do differently?
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  • RedCatWavesRedCatWaves Posts: 31,259Registered Users Curl Connoisseur
    The very best source of information on VBAC is through the International Cesarean Awareness Network (http://www.ican-online.org/). They've got all the latest information, recommendations on how to find a supportive OB, and they also have an excellent support group online. They were tremendously helpful to me when I was planning my VBAC.
  • velvet pawsvelvet paws Posts: 1,250Registered Users
    Iris, I let myself be talked into an induction on my due date because of my condition - but I believe that I was pressured into it because it was more convenient for my doctor. She was going on vacation and wanted to be there for the delivery (I ended up with a different doctor, but that's beside the point). After the miscarriages and being labeled "high risk" (even though my pregnancy went so smoothly - everything was absolutely perfect from day one), I wasn't confident in my own ability to carry a baby to term.

    Even though I didn't get the birth experience that I wanted, I now KNOW that I can carry a beautiful, healthy baby to term and that I don't need to worry so much. I trust my body a lot more, so I feel confident that I can get what I want next time around.

    I also know that I can labor for a loooooooong time without pain meds, even on pitocin (I caved after about 10 hrs on pit), so I know I can give birth vaginally, med free, provided there are no problems with baby. I also know that I can deal with having an other C, if that's the last resort - I know what the surgery is like and what to expect during recovery.

    After the birth, I also know that I can breastfeed and that I know what's right for my baby, despite what ****ty nurses have to say to me about it. I won't let them treat me the way they did after Lucas was born (can you tell I'm still pissed about them? lol)


    RCW, thanks. I should've thought of ICAN. :)
    3A / 2B / 2C wavicelli

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  • SigiSigi Posts: 2,379Registered Users
    The hospital where I delivered is very VBAC friendly. I had an unexpected csection because they discovered while I was laboring that the baby was breach. With my second pregnancy, I wanted to VBAC and on the day I was admitted into the hospital the doctor on staff discussed with me the VBAC success rate. He set me up with pitocin to see how the baby handled the contractions and if there were no signs of distress we'd procede with the VBAC. I had requested an epidural, but for some reason the anesthesiologist wasn't available and showed up when I was 9, almost 10 so he couldn't do it. Sometime after that my baby went into distress, the doctor got the vacuum and told me to try to push the baby down, but I couldn't do it. They prepped the OR and wheeled me in, and I woke up 2 hours later. The next day he came in and said that when he made the incision the baby was visible (window?) and that any other babies I had should be delivered by csection. So coming from the doctor who encouraged my VBAC to begin with, I trust his opinion even though I wish I could have a vaginal birth.

    I say give it a shot, and like you said, you know what you're dealing with if you have another csection. I hope my story didn't discourage you. Just thought I'd give a perspective.
  • PixieCurlPixieCurl Posts: 5,656Registered Users
    My best advice is to find local moms who have been through it (through LLL, an AP group, etc.) and ask for recommendations.
    Faith, 3Aish redhead
    Mama to two wild superheroes and a curly-headed baby boy :love5:
  • sarah42sarah42 Posts: 4,034Registered Users
    No experience with VBAC, I just wanted to comment on blood clotting disorders. I don't know what type of disorder you have, but I have low platelets, and I couldn't get an epidural for that reason. Also, my sister tried for a VBAC for her second baby. They wouldn't induce with pitocin because of the risk of uterine rupture. She got to 2 weeks past her due date with no dilation or signs or labor, so she had to have another c-section.
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  • RedCatWavesRedCatWaves Posts: 31,259Registered Users Curl Connoisseur
    Sigi wrote: »
    The hospital where I delivered is very VBAC friendly. I had an unexpected csection because they discovered while I was laboring that the baby was breach. With my second pregnancy, I wanted to VBAC and on the day I was admitted into the hospital the doctor on staff discussed with me the VBAC success rate. He set me up with pitocin to see how the baby handled the contractions and if there were no signs of distress we'd procede with the VBAC. I had requested an epidural, but for some reason the anesthesiologist wasn't available and showed up when I was 9, almost 10 so he couldn't do it. Sometime after that my baby went into distress, the doctor got the vacuum and told me to try to push the baby down, but I couldn't do it. They prepped the OR and wheeled me in, and I woke up 2 hours later. The next day he came in and said that when he made the incision the baby was visible (window?) and that any other babies I had should be delivered by csection. So coming from the doctor who encouraged my VBAC to begin with, I trust his opinion even though I wish I could have a vaginal birth.

    I say give it a shot, and like you said, you know what you're dealing with if you have another csection. I hope my story didn't discourage you. Just thought I'd give a perspective.


    Well...I question his encouragement. OB's who truly support VBAC don't induce VBAC's with pitocin without a valid medical reason to induce. They don't use pitocin just "to see" how baby or your uterus tolerates labor. Pitocin greatly increases the risk of uterine rupture much moreso than a natural labor. With pitocin, uterine rupture rates increase to about 5%, versus less than 1% with natural spontaneous labor. Those uterine "windows" are thought to actually be quite common in late-term pregnancy, when the uterus develops its lower uterine segment. It's very probable that windows occur with some frequency in vaginally birthing women also, but we just can't see them, as no surgery has occurred.
  • SigiSigi Posts: 2,379Registered Users
    I had to be induced because I had basically no measurable amount of amniotic fluid and the baby's heart rate was lower than it usually was during previous visits. I was 3 days from my due date and they wanted to induce me. I think the reason why they did the pitocin was sort of like a contraction stress test for the baby or something. I don't remember exactly. So anyway, I had planned to go into labor on my own, and it didn't happen. I felt comfortable with the options presented to me, even if it was misinformation or misguided.
  • DelmaDelma Posts: 1,121Registered Users
    Sigi wrote: »
    I had to be induced because I had basically no measurable amount of amniotic fluid and the baby's heart rate was lower than it usually was during previous visits. I was 3 days from my due date and they wanted to induce me. I think the reason why they did the pitocin was sort of like a contraction stress test for the baby or something. I don't remember exactly. So anyway, I had planned to go into labor on my own, and it didn't happen. I felt comfortable with the options presented to me, even if it was misinformation or misguided.


    Okay this is totally me just being nosey but does that mean this baby will be your last? Your only supposed to have 3 c-sections ,right?
  • RedCatWavesRedCatWaves Posts: 31,259Registered Users Curl Connoisseur
    Your only supposed to have 3 c-sections ,right?


    There is no set number. It's individual, and frankly, it's always up to the woman. Doctors can only advise based on individual medical circumstances, but it's up to the woman to take the advice or not. There are women who have had MANY c-secs...6, 7, 8, even 12.
  • DelmaDelma Posts: 1,121Registered Users
    Your only supposed to have 3 c-sections ,right?


    There is no set number. It's individual, and frankly, it's always up to the woman. Doctors can only advise based on individual medical circumstances, but it's up to the woman to take the advice or not. There are women who have had MANY c-secs...6, 7, 8, even 12.


    12! Wow, some how that just doesn't seem safe.
  • RedCatWavesRedCatWaves Posts: 31,259Registered Users Curl Connoisseur
    Delma wrote: »
    Your only supposed to have 3 c-sections ,right?


    There is no set number. It's individual, and frankly, it's always up to the woman. Doctors can only advise based on individual medical circumstances, but it's up to the woman to take the advice or not. There are women who have had MANY c-secs...6, 7, 8, even 12.


    12! Wow, some how that just doesn't seem safe.


    Ethel Kennedy (Bobby Kennedy's wife) is supposed to have had 11 c-secs.
  • KitaraKitara Posts: 1,224Registered Users
    My doctor gave me the choice between a csection or a VBAC. He gave me the pros and cons of both and never pushed me one way or the other. I chose VBAC, but ended up having a c-section anyway. Either way, it was always my choice. I don't know if that is the norm.
  • shellibeanshellibean Posts: 4,500Registered Users
    I don't know anythign about VBACs and I'm not trying to get all up in your business, but is it safe for your body to become pregnant just a few months after a c-section? My doctors told me that my insides would bot be fully recovered for 6 months. Is it okay to be puting your body through pregnancy so soon? My friend's sister had major health problems and her doctor said it was b/c she didn't let her body heal after her c-section before getting pregnant again... What does your doctor say?
    A closed mind is a wonderful thing to lose.

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  • RedCatWavesRedCatWaves Posts: 31,259Registered Users Curl Connoisseur
    shelli wrote: »
    I don't know anythign about VBACs and I'm not trying to get all up in your business, but is it safe for your body to become pregnant just a few months after a c-section? My doctors told me that my insides would bot be fully recovered for 6 months. Is it okay to be puting your body through pregnancy so soon? My friend's sister had major health problems and her doctor said it was b/c she didn't let her body heal after her c-section before getting pregnant again... What does your doctor say?


    That's a good point.

    Velvet, There was a study a few years ago, that looked at VBAC and interdelivery interval (time between birth of one baby and birth of next baby), and found that women with an interdelivery interval of less than 24 months had a 3 times increased risk of uterine rupture. It's really not a good idea to have babies so close together after a c-sec, especially if you're seeking a VBAC.
    Bujold et al.[41] examined the medical records of 1527 women who underwent VBAC-TOL. Uterine rupture occurred in 2.8% of the women with an interdelivery interval of 24 months or less compared to 0.9% in women with an interdelivery interval greater than 24 months (P < .01). After controlling for potential confounding variables, women with an interdelivery interval 24 months or less were almost 3 times more likely to experience uterine rupture (OR: 2.65; 95% CI: 1.08-5.46). Furthermore, the combination of an interdelivery interval 24 months or less and single-layer uterine closure of the previous uterine incision increased the incidence of uterine rupture to 5.6%.
  • velvet pawsvelvet paws Posts: 1,250Registered Users
    I was envisioning getting pregnant when my son would be around 10 months - so 19 months or so between deliveries, potentially. I'm BFing and aren't planning to start my son on solids early or anything, so I was guessing that my first ovulation would take place well after the six month mark. However, it seems like there is there could be a good reason to wait a little bit longer, so I'll talk to my doctor about it and see what she thinks.
    3A / 2B / 2C wavicelli

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  • PhDCowPhDCow Posts: 1,621Registered Users Curl Connoisseur
    shelli wrote: »
    I don't know anythign about VBACs and I'm not trying to get all up in your business, but is it safe for your body to become pregnant just a few months after a c-section? My doctors told me that my insides would bot be fully recovered for 6 months. Is it okay to be puting your body through pregnancy so soon? My friend's sister had major health problems and her doctor said it was b/c she didn't let her body heal after her c-section before getting pregnant again... What does your doctor say?

    I got pregnant with Colin 9 months after Emma was born. When my OB did my c-section, he said that my uterus was "weak" along the previous incision and I probably would have ruptured had I attempted a VBAC. After Colin was born, I was advised to wait at least 2 years before attempting another pregnancy -- not an issue since we're done, but that information would have been useful after Emma was born.
    God doesn't give special kids to special parents. He takes ordinary, imperfect people, and gifts them with his greatest treasures. And therein, he creates special parents.

  • DelmaDelma Posts: 1,121Registered Users
    PhDCow wrote: »
    shelli wrote: »
    I don't know anythign about VBACs and I'm not trying to get all up in your business, but is it safe for your body to become pregnant just a few months after a c-section? My doctors told me that my insides would bot be fully recovered for 6 months. Is it okay to be puting your body through pregnancy so soon? My friend's sister had major health problems and her doctor said it was b/c she didn't let her body heal after her c-section before getting pregnant again... What does your doctor say?

    I got pregnant with Colin 9 months after Emma was born. When my OB did my c-section, he said that my uterus was "weak" along the previous incision and I probably would have ruptured had I attempted a VBAC. After Colin was born, I was advised to wait at least 2 years before attempting another pregnancy -- not an issue since we're done, but that information would have been useful after Emma was born.

    This has nothing to do with the thread but I like your new pic, yellow is a really nice color on you!
  • SweetPicklesSweetPickles Posts: 850Registered Users
    Velvet, There was a study a few years ago, that looked at VBAC and interdelivery interval (time between birth of one baby and birth of next baby), and found that women with an interdelivery interval of less than 24 months had a 3 times increased risk of uterine rupture. It's really not a good idea to have babies so close together after a c-sec, especially if you're seeking a VBAC.
    Thanks for sharing this info RCW (and for bringing it up Shelli). I am really conflicted at the moment about whether to try for a VBAC or just schedule a c-section for this next baby. No amount of analysis or discussion is bringing me closer to a decision. This information is something I honestly hadn't even thought about, but I guess I should have since it will just be over 24 months between births. It definitely gives me pause and is something I will bring up with my doctor at my next appointment.
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  • RedCatWavesRedCatWaves Posts: 31,259Registered Users Curl Connoisseur
    Velvet, There was a study a few years ago, that looked at VBAC and interdelivery interval (time between birth of one baby and birth of next baby), and found that women with an interdelivery interval of less than 24 months had a 3 times increased risk of uterine rupture. It's really not a good idea to have babies so close together after a c-sec, especially if you're seeking a VBAC.
    Thanks for sharing this info RCW (and for bringing it up Shelli). I am really conflicted at the moment about whether to try for a VBAC or just schedule a c-section for this next baby. No amount of analysis or discussion is bringing me closer to a decision. This information is something I honestly hadn't even thought about, but I guess I should have since it will just be over 24 months between births. It definitely gives me pause and is something I will bring up with my doctor at my next appointment.


    If 24 months have elapsed at the time the next baby is due, your uterine rupture risk has gone back down to the 0.9% risk. That is a very low risk.

    You have to put the risks into perspective also. For instance...all pregnant women have a 1% risk of placental abruption, a rare but deadly labor complication. We don't run around scaring women about that risk, yet the OB industry tries to scare VBACing women with the less-than 1% risk of uterine rupture.

    With a 24 month interdelivery interval, and if you avoid labor induction/augmentation drugs like pitocin and cytotec, your uterine rupture risks are very low and shouldn't be a determining factor in your decision to VBAC or not.
  • SweetPicklesSweetPickles Posts: 850Registered Users
    With a 24 month interdelivery interval, and if you avoid labor induction/augmentation drugs like pitocin and cytotec, your uterine rupture risks are very low and shouldn't be a determining factor in your decision to VBAC or not.
    Because I've already had a c-section, it's the policy of my OB here to not do any sort of induction at all. So that is definitely off the table and won't be a factor - and frankly, I'm glad for that. The other reasons I'm conflicted over the decision are, unfortunately, complicated by a lot of other factors :(
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  • marielle448marielle448 Posts: 1,823Registered Users
    SP - good luck in making your decision. It must be very hard.

    I have a friend (a family doctor mind you) that just had an HBAC after having her 3 year old son via cesarean. She delivered with the same midwife I'm using and was so proud of herself for doing it. Another friend is delivering this month sometime with said midwife and will also be doing an HBAC with my very best friend as her doula.

    I understand weighing the risks and making sure to get info. Just don't hold back on getting all the support you need if you do decide to VBAC. Getting in contact with the local ICAN chapter would be a great place if you haven't done that already.
  • DelmaDelma Posts: 1,121Registered Users
    Speaking of ICAN if you do not feel comfortable having a homebirth you can find VBAC friendly ob's through ICAN as well.
  • marielle448marielle448 Posts: 1,823Registered Users
    sorry didn't want to make it seem like I was only advocating for homebirth. It's a local thing - my MD friend was actually pseudo-patted on the head and given a "we'll see and we might let you try" with her first OB visit thus her choice for an HBAC.
  • SweetPicklesSweetPickles Posts: 850Registered Users
    SP - good luck in making your decision. It must be very hard.

    I have a friend (a family doctor mind you) that just had an HBAC after having her 3 year old son via cesarean. She delivered with the same midwife I'm using and was so proud of herself for doing it. Another friend is delivering this month sometime with said midwife and will also be doing an HBAC with my very best friend as her doula.

    I understand weighing the risks and making sure to get info. Just don't hold back on getting all the support you need if you do decide to VBAC. Getting in contact with the local ICAN chapter would be a great place if you haven't done that already.
    Thanks Marielle. There are a lot of factors to consider, some of which have little to do with the birth I'd have in my *ideal* world. This decision would perhaps be easier if I didn't now live in a really rural, middle-of-nowhere place, with incredibly limited options (well ones that aren't hundreds of miles away). I got spoiled living in Pittsburgh, where cutting-edge (and progressive!) medical services were just the norm. I really do need to come up with a plan soon though - I've got 7 weeks left. Though, if my last birth was any indication, it's more like 9+ weeks :wink:
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