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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Jan 13
    2011

    VBAC vs planned c-section?

    Archived User

    Your book was recommended to me through a friend of a friend.  I haven’t had a chance to read it but I looked at the chapter contents and I still have a rather big question/dilemma. My first pregnancy was awesome. I loved every minute of it and I cannot remember any sort of complications… that is until I was about 38 weeks.  I woke up in the middle of the night to go to the bathroom and as I got up, I felt fluid b/w my legs.  I thought my water had broke but when I got to the bathroom I was bleeding profusely.  We called the ambulance and I was taken to our nearby hospital (but not the hospital I wanted to give birth in)    I had partially abrupted, the bleeding had stopped on its  own but I was admitted  to the delivery floor.  I was induced first with Cervadil (? Spelling) which did not work. Then it was encouraged to me that I induce labor. I was induced with Pitocin, my water was broken and labor came fast and furious so I received an Epidural.  When I was ready to push we pushed for about 2 hrs… my dtr would not come … forceps were used multiple times and the vacuum was used even more.  The pain was unbearable.   I also received an episiotomy. My dtr’s heart rate dropped dangerously low and all of  sudden we were going for an emergency c-section.  I passed out b/w the DR and the OR, I was tubed for the section and my dtr was born.  Her apgar was 3-4, she had swallowed meconium and an ultrasound of her head showed a small bld in her head as a result of the vacuum.

    My dtr was in hospital for just over a week and was released home with no ill effects and is now thriving normally  at the age of two (thank god!!)  I required 2 units of bld and a week in hospital.

    I am now pregnant again and terrified of a repeat performance.

    What are the chances of another abruption (partial or complete)?  Am I at higher risk?

    My mother was unable to delivery her babies vaginally… is there a correlation?

    Is a VBAC possible? I almost don’t even want to try and my husband is understandably very afraid for us.

    I am hoping for any and all information I can get!

     

    Thank you for reading this and any reply.

    We appreciate it!

    Henci Goer

    I am happy that you and your daughter are OK but so sorry that you have been through this terrifying experience. I want to start by recommending Solace for Mothers, a website with information and a peer support community for women who have had traumatic birth experiences.  

     As for the likelihood of a repeat placental abruption (the placenta detaches partially or completely before the birth), I do not know the statistics on how likely it is likely to repeat, especially in a healthy woman with no predisposing factors such as extremely high blood pressure. That would be a good question for your care provider.

    As for VBAC, let me start by saying that the fact that your mother had her babies by cesarean means nothing. The cesarean rate in this country and most others has been so high for so long that it is impossible to say whether your mother's surgeries were avoidable. Even if they were not, it would still say nothing about you, and while there was a medical indication to induce in your case, nonetheless,  inducing labor in a first-time mother whose body is not ready to labor doubles her odds of cesarean. Administering cervical ripening agents do not reduce those odds. Considering the distress you must have been in, there may well also have been emotional factors interfering with your ability to birth your child.

    If you are trying to decide between planning a VBAC or a repeat cesarean, I see three components to making  the decision. The first two have to do with you. One component is to acquire complete, unbiased information on the benefits versus harms of planned VBAC versus elective repeat surgery. Lamaze has a guide to VBAC on its website that can help. The second component is dealing with the emotional aftermath of your first birth. Neither you nor your husband will be able to make the best decision for you and your family if the decision is driven by fear. The third component only applies if you decide to plan a VBAC and it is finding a care provider who attends them. Few do these days, and shame on those who do not because while they may try to tell you differently, it isn't about health and safety. As you will see in the guide, both options carry risks. Moreover, once a woman has a VBAC, she will almost always go on having uneventful VBACs with subsequent children, but every cesarean increases the risk of life-threatening complications in future pregnancies. If you decide to plan a VBAC, write again if you want ideas about how to find a VBAC-friendly care provider.  If you decide on a planned cesarean the International Cesarean Awareness Network has a page on planning for a family-centered cesarean experience. 

    ~ Henci  


    All Times America/New_York

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