Vbac - Goodyear,AZ

Coming from someone that had two c-sections and was devastated by the first, I would say to go ahead and do a c-section. While I know that a c-section is not what you want, I think that it would be the safest route for you and the baby.

I have often thought about having a vbac, however, the thought of that scares me more than the c-section itself. I know that this might be the most selfish reason to want a c-section, but I LOVE the fact that I knew when I was going to have my daughter and I could make concrete plans for the care of my son while I was in the hospital. I also enjoyed the extra few days in the hospital;) Personally I would not take the risk of additional complications, I would go with the c-section.

I would really recommend joining the ICAN (International Cesarean Awareness Network) Yahoo group and posting your question there, also possibly the Phoenix Birth Circle Yahoo group. There are a ton of birth professionals on those two groups who could probably give you some really good input. Blessings!

I doubt there's much research about the mesh and vbac. The answer to that would just be a guess, no matter who is answering (doctor included). I did a presentation on VBAC in September to La Leche, and I do have some statistics I've gathered. The risk of uterine rupture for someone who has had 2 or more c-sections is 1.4%. The overall risk of a baby dying during a vbac is 0.046%. That is so much smaller than the rupture percentage because the rupture percentage includes scar thinning too - not just full breaks. The risk of repeat c-sections are problems with the placenta in later pregnancies(placenta previa and abruption), infertility, and the standard surgical risks. How VBAC is viewed is so biased because the rupture risk is over-emphasized and the risks of c-section under-emphasized. However, even if VBAC is safer in your case (which would be hard to know for sure), it would take a lot of conviction to stand up for yourself - finding a doctor to do VBAC mainly. (Some doctors seem to be supportive at first but then start pressuring for the c-section or an induction near the due date, even though induction makes a VBAC so much more risky.) It looks like it wouldn't be worth it to you since you are leaning towards c-section right now.

However, if you are interested in finding out more about vbac, beyond all the scare tactics, there is a conference in March on VBAC. If you register for the webcast, you can access the archives for free for a week after the conference. The website for the conference is: http://consensus.nih.gov/2010/vbac.htm.

I think after 3 c-sections, especiallly with the mesh, you shouldn't take the risk of rupturing. If you do decide to vbac, make sure you are in a qualified hospital that is equipped in case of rupture during labor. You only have so many minutes to get the baby out! I tried vbac with my second, but he didn't want to come out so I ended up with a c-section anyway. The doc said I would've ruptured if I had gone into labor because my incision was paper thin. So, with my 3rd c-section was the safest way to go. Good luck!

I had a different experience. I did vacuum with my son with an episiotomy and still tore. It took forever to heal. That being said, looking back I should have gone C-section because ithe vaginal traumatized him some. I was 3 hours hard labor getting nowhere and then the decision came. You need to do what is right for your baby. If the baby is having any sort of problems then do a C-section. Follow the doctor's advice.

Hello!
I would also be very concerned about the risk of a rupture of the uterus after all the previous procedures. Depending on where a rupture occurs, it could affect the blood supply to the baby. That means also the oxygyn supply and there are only minutes until brain damage. Given also that you already have 4 other "responsibilites", plus husband, I would give up the idea of a VBAC.
I considered one for our second child, ended up choosing a c-section for the reasons above and it turned out to be a good thing as my Dr even commented on the thiness of my uterus wall which could have ruptured easily.....
Plus I knew exactly when I needed to have back-up organized so our oldest was in good hands, which was a great relief, but you know about that already.

Good luck to you on whatever you decide :)

D.

I understand your desire to have a baby naturally. I ended up having a C-section with my first since she was breach and tried to have a vbac with my second. Long story short, I decided that it was best for my baby to have a second c-section. This was a decision that I made after evaluating all of my options. The risks for me were to great. I still feel a bit cheated, like I took the easy way, I didn't actually go through the work to get my kids. But in the end, my kids are healthy and so am I.

T.

Prior uterine surgeries aren't the only risks for uterine rupture. Four or more pregnancies can thin the uterus to a rupture point, which is why women with multiple pregnancies or after twins are considered high risk.

The greatest risk of rupture after cesarean occurs when medications are used to induce labor. 1 out of 41 women ruptured when prostaglandin medications were used for induction. When the uterus did rupture, 1 in 18 babies died, and 1 in 23 of the women required a hysterectomy. The odds go down considerably if you go into labor naturally without induction medications but even then, the risk to the baby is too great, in my opinion.

Sounds like you are receiving wise counsel from your doctors. Your history makes you an especially risky candidate for VBAC because of the threat of uterine rupture and fetal distress. I'm thankful you had the opportunity to experience vaginal delivery the first time, but really it's just too risky after 3 c-sections (and a hernia mesh which could interfere with healing) to attempt it again. Keep in mind the goal is always to deliver a healthy baby to a healthy Mama whatever the method. Blessings to you! R., Certified Nurse Midwife for 10+ years and married SAHM for 5 yrs. Expecting my third bundle of joy any day.