Friday, August 5, 2011

Decisions, Decisions - Childbirth Edition

At my appointment a week ago, my OB asked if I'd given any thought as to how I'd like to birth this baby and the fact is that I'm just not sure at this point in time.  Thanks to the way Kaiser staffs OBs in their hospitals, he doesn't have any vested interest in pushing either method of delivery (surgical or vaginal) and I truly get the impression that it doesn't make a difference to him one way or another.  The only thing that he had a definite opinion on is that he asked that I decide how I'd like to birth this baby by the 7th month or so and I'm hoping that I'll have an answer by then.

I hate feeling this way, but I fear that my body won't do what it's supposed to do if I choose to have a VBAC.  I feel like my body has already failed me in terms of pushing out a fetus so I have zero confidence in my ability to vaginally birth a baby being born at term.  I know myself well enough to realize that I will feel like a personal failure if I go for the VBAC and still end up with a c/s and the last thing a hormonal new mother needs to feel like is a failure.

On the other hand, I felt like I was hit by a freaking bus after my c/s.  I really don't relish the thought of such a painful recovery while caring for a newborn and my son.  I also would like to spend as little time in the hospital as possible and I'm pretty much committing to three-days if I go the c/s route. 

Adding another wrinkle to my decision making process is that I'd prefer to have my doctor do the honors if I have to have someone slice open my abdomen.  I know it sounds kooky and I'm sure the other OBs on staff are perfectly competent, but I have absolute confidence in my doctor's competence and I don't want some stranger to cut me.  Going back to the way Kaiser staffs their OBs at the hospital, the only way I can be sure that my own doctor will be the one rifling around in my insides will be if I schedule the c/s.  Well, that and it would be important to know if he'll be scheduled to work in the hospital at some point when I'm at term.

At the moment I'm leaning toward having an elective repeat c-section and it's only the weeks of pain that I know I'll experience if I go that route that is keeping me from outright saying that my baby will be cut from me rather than naturally released.  I feel so emotionally scarred from my failed natural miscarriage that I don't think a VBAC is right for me under any circumstances.  I can't even visualize a VBAC without thinking about that painfully heartbreaking day and I'd hate to cloud this baby's birth-day with memories of such sadness.  Of course, my thoughts may be totally different on another day so my decision is far from being made.

Did you have a c/s and end up having another child afterward?  What did you choose?  Why?  What was your outcome?  Thoughts, advice, and opinions are welcome and I only ask that all comments are kind and respectful.


  1. Hi Heather, this is Elisha...I have many patients who come in to my office who are born VBAC, though it is uncommon. Mommies that victorious this feat-if that's what you would call it-are so incredibly BEAMING AND PROUD of their VBAC accomplishment. But, MOST moms I encounter would rather to repeat c/s because it was "so easy the first time"...though I beg to differ. I delivered both of those Soto boys naturally, and I'm curiuos what complications (aside from your warranted fears) may arise with VBAC?? In what ways is it dangerous?

  2. Hi Elisha! Yes, VBAC moms are deservedly proud of their accomplishment!

    The primary concern that most people have with VBAC is uterine rupture and that concern is generally based more on fear than facts. This is where the uterus rips apart at the former c/s incision site during labor/childbirth. However, it's important to put the risk in perspective and it's a little less than 1% of all VBAC attempts that result in that outcome. Of course, that can be a devastating outcome because it can result in the worst case scenario - fetal and maternal death. But, again, it's a statistically insignificant percentage that result in it in the first place.

    My cervical dilation problems (it's like a steel door - ha!) and my concerns of having a trial of labor (TOLAC) still result in a c/s are the main reasons why I'm not too keen to even bother trying. I know that I'll feel horrible if I tried and failed. Otherwise, VBAC is a perfectly safe option based on my former c/s reasons (assuming breech & sunny side up presentation doesn't occur this time around too)& the incision my doctor gave me at that time.

    Speaking for myself, I can say that a c/s is not a surgery that I would ever take a cavalier attitude toward. You have all the risks of childbirth AND all the risks of a major abdominal surger all rolled into one. I have also noted that c/s mothers generally suffer significantly higher levels of pain weeks after birth than their counterparts who delivered vaginally and that pain is no joke! It really was the worst pain I'd ever felt in my life - until I felt the pain of trying to push a fetus out of a totally closed cervix, THAT pain actually made me faint.

    Ultimately, I think it doesn't matter if a woman chooses to VBAC or have an elective repeat c/s as long as she isn't tricked into either option. Ideally, a woman would know the risks and benefits and make a truly informed choice. Had I not had the miscarriage in January, I would most definitely have gone for a VBAC.