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Normal Birth Forum Featuring Henci Goer
Subject: Dilemma about vbac vs. repeat section

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05/03/2006 3:35 PM Quote Reply
Hi Henci,

Its great to find you here! I wrote to you a few years back on parentsplace and now I `d like to pose a new question to you.

I had a fatal shoulder dystocia with my 2nd birth, a planned homebirth that turned into an emergency transfer. There was no warning, just normal labor and then his head came easily with no tearing, but both shoulders were stuck. It took almost 24 minutes to deliver his body & yet he still had a heartbeat. He passed away after 7 weeks in a coma. What finally got him out was cutting a 4th degree so attendants could break his clavicle. Everything else had been tried,(short of Zavanelli) including the Gaskin maneuver & I had no epidural so I could easily move. I am also not overweight, normal weight is 140 lbs at 5'8. I had gained 40 lbs in that pregnancy.

My first delivery was also a hb transfer, but he was a vaginal birth (posterior) big baby, and I sustained a 4th degree tear that time also.

With my next baby, I felt emotionally unable to attempt another vaginal delivery and no care provider would agree to one anyway, so I had a scheduled C/s. I actually had a great recovery and felt very respected in the c/s birth. It was much easier than recovering from a 4th degree.

Now, I am pregnant with # 4 and I am less afraid of vaginal birth. For many reasons, I wouldn`t mind avoiding another section. My current doctor feels like if I showed up in labor before 38 weeks she would be fine with VBAC, but is not comfortable with ME & macrosomia. (2nd baby was almost 12 lbs.) My predicament is that my husband is still terrified at the thought of vbac b/c of shoulder dystocia. I know all the ways to avoid it & they didn`t work for me & honestly, statistics are meaningless to me, b/c of what happened. I can`t get too caught up in dreaming of a smooth v. delivery b/c I don`t want to be a mess if I end up with another section. How could this be reconciled? Should I just wait & see if i go into labor early, yet plan a section for a later point? Is there a way somebody like me can have multiple sections & heal well or are risks like accreta in the future just inevitable? I wish there were a 3rd way to have a baby. I believed in my body & it didn`t work out too well for me, yet I would love to avoid future risks to my fertility. Still, this baby is the only thing that matters to me right now, the future is not guaranteed. Thanks in advance for reading this,

P.s. I also have rh sensitization, although a low titer, so the baby may have to come out before I actually go into labor & I know I can`t be safely induced for vbac. By: Anonymous
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05/13/2006 9:32 AM Quote Reply
Let me begin by saying I am so sorry for your loss. But as to whether you should plan repeat cesarean or a VBAC, that is a decision only you can make after weighing the pros and cons, and with the complexities of your history, it is not an easy or straightforward one. I think this will be a 2-step process. The first step is the intellectual and logical part of gathering information and parsing through your various options. To help you with this, I recommend a couple of sections on the Childbirth Connection website: Informed Decision Making and VBAC or Repeat C-section, which includes material on how to have a safer cesarean and a positive cesarean birth experience. After the intellectual work, though, in the end you will have to rely on what your heart tells you. Give yourself time, talk it through with your husband, meditate or pray over it, if that is what feels right to you. Whatever you decide, I wish you the safe delivery of a beautiful, healthy baby.

-- Henci By: Henci Goer
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05/16/2006 9:37 PM Quote Reply
Thank you Henci for getting back to me, I will really explore my options. I do feel that I could plan a positive section if I have to. Thanks for all you do here!
-Claire By: Anonymous
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05/17/2006 10:05 PM Quote Reply
If you feel like sharing this information, I would like to know how everything goes for you in this next birth.

-- Henci By: Henci Goer
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05/27/2006 8:18 AM Quote Reply
Thank you Henci. I would be happy to let you know how everything goes. Have a great memorial Day weekend, Claire. By: Anonymous
TropicAngela (guest)

02/07/2007 2:49 PM Quote Reply
Hello, I'd like to hear about your birth too
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