Supafly wrote:

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Thank you ladies! Jennifer, I have been doing that very thing! When I left on Tuesday, I was a mess. IHNI how to ever make this decision. I spent the whole day in knots over it, and then I thought, why am I doing this??? And at that moment, I started praying for the answer to reveal itself. In the last day and a half, I am feeling more and more that I am going to want to try the VBAC. I don't have all of the facts and info I feel like i need yet, but everything in me is screaming at me to avoid surgery if possible, and that my OB bucking the norm to talk with me about this means something.

Time will tell.

Juni-I also asked on my UC board about delivery modes, and overall, what I have heard is that the delivery itself didn't cause flaring in either case-though some women said they had bad hemmies from the pushing. But anyone can have that problem, plus I already have internal hemmies. What's a few more, right??? Plus I know I have options to treat those, and they don't bother me like a flare would. To me that is a very minor concern. Some women seem to have some flaring later on, but didn't think it had anything to do with delivery itself. So that is comforting to me as well. I have done the labor part-and I actually enjoyed the process, truth be told, so I feel confident I could do it again without help. IDK how the pushing will go, but by that time, you have no choice!!!

Alaina-I have read and heard the same things-although they say now that because meds are better controlled, they don't hold the same impact. Still, I would insist on no interventions. It just isn't worth the risk. I would rather schedule a c/s again if I didn't go into labor than risk rupture. But it seems the risk are fairly low, and the benefits (especially for me personally since my c/s recoveries have been so so bad, and my disease complicates treatment of any potential infections and such) of being able to deliver vaginally are high. I would only feel comfortable doing it in the hospital setting, because if something were to go wrong, I want to be sure that immediate action is taken. But I feel sure I could do it!!

More research needed, but I am definitely leaning towards VBAC!!! (that said, we still won't be finding out gender, even if we go that route.)

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 if it makes any difference delivery for me was fine. i got a steroid dose since i was on steroids they said my body wouldnt produce them on my own and since delivery i am back to being completely med free

Juanita wrote:

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Laura, I'm a FIRM believer in prayer and if you've been praying for the answer and you've been having peace about it, I believe that's God giving you your answer

I'll pray for him to make it crystal clear for you too

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Thank you so much. I actually did think of you, lol. As soon as I realized I needed to let this go-I thought, "Jenn would tell me to pray and put it in God's hands." So I did!! I have had so much more calm as a result.

Things aren't crystal clear at this moment, but things also keep lining up in the direction of a VBAC. I called the CNP at my GI's office today because I never see her anymore, but I really value her opinion. She said she feels that in my case, if I can do the vaginal birth, it would definitely be the prederred option for me, and that as far as the UC-my risks are lower with the VBAC because of the potential for infection afterwards.

Of course, all of this hinges on my having a good pregnancy-no GD, no high blood pressure, head down baby, etc.

beckhamgirls wrote:

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I can't tell you what you should do, but if I were in your shoes, I'd go for it.

That being said, I'm kind of jealous!  I brought this up to my OB at my first appointment, I've also had 2 prior c/s.  He basically said hell-to-the-no (in a much more polite way.)  I even brought articles that I'd read about VBAC2's being recommended for certain patients.  He said he doesn't do them.  So, I contacted a local doula, and she said she only knew of 3 OBs in our tri state area that will do a VBAC1, but gave me some docs to call.  I called 3.  Two of them said they would do a VBAC1, but not a VBAC2, and 1 said I could come in to meet in person, but it was unlikely.  UGH.  I was frustrated and just gave up.

It's not something that was of life or death importance to me, but knowing this is my last one, I was hoping to at least be able to try it....

Good luck on making your decision!!!!

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CoffeeQueen wrote:

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question. i am so not knowledgeable on this, but it has intrigued me. so, when did drs. stop doing vbac? did they start to see high # of complications? when you say the risk is a uterine tear? what happens or how complicated is that? are we talking life or death complications? i never had a c-section and so I never had to really research this. does it tear as you are pushing and then the baby is still in there? what are the risks to the baby? you do not have to answers these questions if you do not want. i can google and start to read, but I wondered if you already knew.

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I will answer as much as I know, but I am still researching too, so I don't know everything at this point!!

I think in the past, if you had had a c/s, you would always have them. I am not sure when they started researching and decided it was safe for a woman who had had one c/s to try VBAC. Since they now do the low tranverse cuts as opposed to the classical vertical, they seem to feel it is safer-they do the incisions now low where there is less likelyhood of rupture. And it has only be very recently that the guidelines are changing to include women who have had 2 c/s as potential candidates for VBAC. (of course, people can do it, but the traditional medical community thus far has been against it. And as you can see from Barbie's post, and Jayna having to call so many people, most OBs probably are still against it-some hospitals won't even allow it)

There are certain conditions that have to be met for someone to be a candidate-such as no blood pressure issues, baby must be head down, and the reason for c/s should be something not likely to repeat. Women who have had true failure to progress or had babies too large to push out are generally not as successful with VBAC as women who had breech babies or a baby who was in distress, etc. So not everyone is a candidate. Because I had labored and fully dilated with Anna, that helped my OB to feel more comfortable in making the suggestion to me-also because mine were breech-not like I tried and tried, but couldn't get them through my hips or something, kwim?

Uterine rupture can be complete or incomplete. An incomplete rupture would be when the uterus begins to seperate (where the previous incision(s) took place), but does not do so fully. From what I understand, when this happens, it usually does not require treatment. However, a complete uterine rupture, when the uterus complete separates, is life threatening. Emergency surgery would be required-both baby and mother are at risk-death or permanent disability to the child can occur (though it doesn't always) and death to the mother can occue (though again, it doesn't always). A full hysterectomy would be a likely outcome if a full rupture were to occur. The risk is low-less than 1%, but still there. Which is why I would insist on only doing this at the hospital and without intervention, because induction and cervix ripening meds increase the risks.

Rupture does occur during labor, but not always. From the info Jayna has given me, it seems that when a rupture happens, it happens during labor about 1/3 of the time. That means that the other 2/3 happen at other times during pregnancy (typically the 3rd trimester). She also said it was important for them to do u/s at 37-38 weeks to determine the thickness of your scar-the thinner it is, the higher your risk.

So yes, there is a definite risk involved. However, a friend of mine had her 3rd last year, a 3rd c/s. She ended up hemmoraging so badly after the birth they weren't sure she would make it-she had a hysterectomy and was really down and out for a long time. She lost a lot of blood. And she hadn't had so much as a contraction. So repeat c/s is not without risk as well. Doctors like it because they can better control things, as a general rule, and ensure a good outcome for baby. But there are risks involved without question.

I read a story online of a women who did have a rupture with her 3rd baby-VBA2C. The baby had to be recucitated upon birth and she had a hysterectomy. It was devastating for them. But she was induced with both pitocin and prepidil at 10 days past her due date, and interestingly enough, her uterus ruptured down the left side-not at her incision site.

I feel fully confident that I can do it, and at this point, I truly feel that it is a safer option for me. But that is assuming certain things. If the pregnancy progresses and things are not lining up for a VBAC, I won't do it. And I would not want to go past my due date or be induced. If it doesn't happen naturally before I am due, I would be willing to schedule a c/s rather than risk induction. Like I said, I would insist on it being in the hospital so I am where I need to be in case of an emergency, and would want to have a plan in place with my OB so everyone knows what to do. All of the elements that are within my control, I would want to be sure are lined up just right. A HS friend of mine messaged me yesterday to tell me she thinks I am crazy and why not have just one more c/s,  but after I explained my circumstances to her, she understood. I feel like I can plan for a VBAC and fall back on a c/s if I need to, but I can't do the reverse. Another thing in my favor is the length of time since my previous c/s.

Does this help? Again, I do not have all of the info yet myself. I am doing a lot of research on the subject, obviously. It *is* scary, and I do understand why many women do not consider VBAC. I messaged Jools about this yesterday-I am so excited about the prospect, but I have those fears-what if I am in that less than 1% and I put myself and my baby at serious risk? But then I think about the risks and unknowns of another c/s, and it isn't all that clear cut...more info and definitely more prayer are needed before I decide for sure. And honestly, I probably will plan for the VBAC, but reserve final judgment until I am closer to the end of my pregnancy and we can more reasonably assess where things are.

Supafly wrote:

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beckhamgirls wrote:

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I can't tell you what you should do, but if I were in your shoes, I'd go for it.

That being said, I'm kind of jealous!  I brought this up to my OB at my first appointment, I've also had 2 prior c/s.  He basically said hell-to-the-no (in a much more polite way.)  I even brought articles that I'd read about VBAC2's being recommended for certain patients.  He said he doesn't do them.  So, I contacted a local doula, and she said she only knew of 3 OBs in our tri state area that will do a VBAC1, but gave me some docs to call.  I called 3.  Two of them said they would do a VBAC1, but not a VBAC2, and 1 said I could come in to meet in person, but it was unlikely.  UGH.  I was frustrated and just gave up.

It's not something that was of life or death importance to me, but knowing this is my last one, I was hoping to at least be able to try it....

Good luck on making your decision!!!!

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Ugh!!!! That is really frustrating, Barbie. I am sorry. And wow-realizing more and more how fortunate I am in all of this. Even though he was hesitant about it, he still brought it up. My fear though is that he will be the ONLY one in the practice who is willing to even consider it, and how do I guarantee that he will be there when I go into labor??? I guess those are things we will have to discuss. I probably never would have even brought it up-I just assumed it was not an option. I doubt it would have been if it weren't for my specific set of circumstances. But I am really sorry you have gotten the door slammed in your face. Jayna said she saw 3 doctors and contacted more than that before finding one who was willing to take her on with the VBA2C.

I don't remember-why did you have c/s with the girls?

 

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Supafly wrote:

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Melissa-I wish there were guarantees!!!! Really, the more I read, the better I feel about it. Truth be told, the statistics indicate that the rate of rupture, even in women with more than one incision (given that labor was not augmented), is no greater than the risk of placenta abruption in the general pregnancy population-both have about a 1% risk. The rough estimates for women who will experience a prolapsed cord is 0.6%, whereas the overall risk of rupture is 0.8%. About 1% of babies will have a knot in the cord. I think we all sometimes forget that birth is never without risk. Ever. And there are definitely times when c/s is the safest choice, as well as times it is life saving! There are many good reasons to perform them, without question. But there are also many good reasons for many women to choose VBAC, and to be allowed to try it. There is definitely a perception amongst people in the medical (and I am sure insurance) communities that a doctor who decides to go with a repeat c/s is reducing risk, and in some way they are-but it really should be on an individual basis. Not a blanketed thing, which I am finding is not as uncommon as I had thought.

When I was pregnant with Kate, I wanted a VBAC and my OB didn't even pause before telling me they would let me try it-but he was also quick to tell me that if anything went outside the realm of "normal" they would do the c/s. And now my new OB brings this up after I have already had 2 c/s-I was surprised, but figured *most* people's doctor's would be ok with a VBAC after one. It seems that isn't the case at all. I think that is a shame.

Interestingly enough, I also saw a statistic today that said when VBAC is

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 I just wanted to tell you about a lady in my church.

She had a uterine rupture with here fourth. ON her way to her csection for her 5th she had the baby in the car. Shes now had successful Vaginal births with number 6, 7, and 8 as well.

This shows that both can happen but I really think the body will do what its meant to do most of the time. I think your a great candidate.