April 7, 2011

To "C" or Not to "C"

That is the question that I've been volleying back and forth in my head for the last few months.  "C" as in C-Section, which was the outcome of my last attempt at labor.
Soren's birth, at 10 days later than expected, resulted in a c-section.  Having my son removed via scalpel with my guts on display really wasn't the issue at hand--it was more of the process that led to the c-section that to this day still bothers me.

I had gone into labor just hours before my scheduled induction, and rather than let my body do its thing, the hospital staff told me they would start me on the scheduled induction (ie. the evil Pitocin), otherwise I'd have to go home.  Mind you, my contractions were intense, and I was only getting about 60 seconds of relief in between.  Add that to the fact that this was my first time in labor, and have been scared S***-less about the pain and process of delivering a baby since I was little (my mom had 5 kids, so I kind of knew about the process of birth long before other kids my age).

After hours of laboring, an epidural, pokings and proddings from doctors, students, nurses, etc. without much progression, Soren's heart rate was dropping and the staff was concerned about his health.  His big head was also wedged in the birth canal, and he was also a big baby (9lb 5ox).  Exhausted, confused and emotionally drained, I relented and said that I thought the c-section would be best for the well-being of my son.
Of course it all ended well, but this time around I'm wondering how I should approach labor and delivery.  My OB practice is supportive, surprisingly, of a VBAC.  I assumed that the way hospitals are nowadays, with lawsuits and all, that I'd have to fight for a VBAC, even up to the hour of birth.  Considering the new guidelines from the American College of Obstetricians and Gynecologists, it seems like VBACs are becoming more encouraged.

The VBAC in theory is the way I'd like to go, but I can't help but worry about complications or ending up with a c-section in the end again, after all the hard work and fatigue of labor.  My recovery from the surgery was surprisingly great, but who knows what might happen this time.

I wish I was the strong, confident kind of woman who could enjoy a home birth (since I often consider myself a crunchy hippie and all that) but when it comes to labor, I'm about as independent as a hog on ice (to quote Tom Waits' Cemetery Polka).  Especially after the awful pain of contractions, definitely not as bad as I expected, and I thought I had a pretty high tolerance for pain.
Not my finest moment
I'd really love to hear your stories, especially if you've gone through a VBAC or c-section.  I'm not allowing myself to get sucked into too many online searches on the topic, since you tend to find horror stories of all sorts on the interwebs.

20 comments:

  1. There are two things I would suggest if you want to avoid a c-section and go for the VBAC, try your hardest not to do the epidural or pitocin. Yeah, Sometimes they are just unavoidable. but those are both things that increase your chances of a c-section.

    Epidural/pitocin or not I have one big suggestion that is the greatest decision you can make for yourself... Get a doula! Best decision I had with my first son (hospital birth). I don't think I would have gone through it as well if I hadn't.

    Take mine and everyone elses advice lightly and remember, in the end, a happy healthy baby and mommy is the goal! The process of getting their is neither here nor there in the end! :) Good luck this time around!

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  2. I attempted a VBAC with my second, and even though I ended up with a C-section, I am glad I gave it a try. Good luck!

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  3. I had an almost identical first labor and delivery as you. I was induced without a great reason, my son was also large and got stuck in the birth canal, resulting in a c-section. I had a successful VBAC with my second child. Here are some tips if you try VBAC: Stay in as good of shape as possible- I used a pregnancy yoga video several times a week that involved using an exercise ball. Silly? yes. Helpful? Extremely! I also waited as long as possible before going to the hospital when I was in labor. I knew if I got hooked up to all those wires and IVs, it would go downhill fast. Because labor was SO MUCH EASIER when it came naturally vs. induced, I almost waited too long! When I got to the hospital, I wasn't even sure I was in active labor, I just didn't feel that bad. Turns out I was 9.5cm. dilated and ready to push! I realized afterward, that I mostly just needed to prove to myself that my body could do what it was designed to do. Both deliveries resulted in healthy babies, and that's the main point! I'm not one of those women that is pro-VBAC at any cost. Just weigh the pros and cons for yourself and know that either way, the ultimate goal is a healthy baby and mom!

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  4. BTW, this is Rebecca, not Adam. I just signed in with my hubbie's Google account, lol.

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  5. I am sorry to hear you had a bad time of things with Soren's birth.
    My friend just had a baby boy a few weeks ago and she had a VBAC, it went really well. They induced her, I think they er on the side of induction with vbac's because they don't want you to go longer than the due date.
    I struggled with the same thoughts as you...I hate pain, and I want to do it naturally :OP
    Praying for you to make the best decision for you and baby!!! HUGS!

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  6. I have gone through several worry sessions this time around, for me weighing the pros and cons associated with epidurals. I think you've already gotten some good advice. My two cents is that my doula was immeasurably helpful in getting through labor without interventions. This time I'm not getting a doula, mostly because I'm considering an epidural, and if I decide during labor to do it with no medication, I already know what that's like.

    LOL. That's so true about the online birth story sites! They can freak you out about any option.

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  7. Your experience sounds similar to mine - my first child was 15 days late. I turned down the pitocin and took the alternative morphine shot and went home, only to turn around 45 minutes later (instead of 8 hours)... suddenly dilated to 8 cm (from 1)... 9 more hours of labor, followed by a C-section for 5 different reasons (baby in bad position, epidural either not working at all or working so well i couldn't feel or move anything, baby heart rate falling and not recovering, placenta torn, cord around baby's shoulders - didn't find out about the last two til during the C-section). Anyway, it sucked. So, I said for the SECOND child, I am scheduling a C-section one week AFTER my due date. I fI go into labor before then, we will try to do a VBAC. If I don't go into labor, we are going straight to a C-section. There will be no inductions, in any case. So... I had another slow bun, and she was born by C-section without labor. It was way easier, and the recovery way faster the second time. SO, I can't tell you anything about having a VBAC, but I can tell you a C-section NOT preceded by labor is 20 times easier than a C-section AFTER labor.
    Xa Lynn

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  8. Child #1: long labor followed by emergency "C" (he was late, pitocin...all that, too). They actually cut into my belly button that's how much of a hurry they were in.

    Child #2: Male doctor substituting for my vacationing female doctor pushes for VBAC. His wife had no problems. I tell him, "I'm not your wife." I in now way shape or form wanted to even remotely go through the first experience, so I opted for a "C." (Female doctor didn't argue at all when I got to see her. Just told me to pick a day.) Even though I had to get a new scar, I wasn't sorry one bit.

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  9. I'd love to offer some form of advice here, but unfortunately I got nothing for you. Lol

    All I can say is I wish you nothing but the best of luck on your decision, and I continue to send you, your family, and the new bundle of joy loving energies :)

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  10. I have no experience or advice on this topic either, but I will pray that all goes well, and you deliver a beautiful, healthy baby!

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  11. I really wish I had had a c-section. My kids had huge heads too and both were induced (I don't know if anyone has told you this, but synthetic oxytocin causes much worse contractions, so should your baby come naturally, the contractions aren't likely to be as bad). My doctor (also a family friend, who was a mentor to me as a kid, needless to say I trust him implicitly) tried vacuum extraction, then ultimately used forceps but both times there was threat of cesarean at the last minute.

    Now that being said, my second was much easier than the first--you know what to expect and so does your partner. I totally connected with my husband and he knew just how to help me push or encourage me. Then ultimately when the deed is done, you are a little less freaked about SIDS and actually let yourself rest.

    Bottomline, if your trust your doctor and those there to help you in the delivery room, then it should be much easier.

    Oh, and your crazy for soliciting delivery horror stories right before you're due. Good luck!

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  12. Whatever you decide, I hope this labor is much better than your last one, it sounds like it was awful!

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  13. Sixteen years ago I had to have an emergency C-section with my son. It surprised everyone, including my OB. A year and a half later, my daughter was born via VBAC, and it was so easy, especially compared to the non-scheduled C-section. I'm so glad my OB then, who was young and female, wasn't even considering anything but VBAC unless absolutely necessary. Best wishes for all going well!

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  14. Good luck! You're so brave & I hope things turn out the way you want them to. I had my kids ~15 years ago, hope sharing some of this helps.

    I always wanted to deliver my kids with no drugs or interference. With #1, no water breaking, just terrible back pain. I ended up on Pitocin, having my water broken, wearing a heart-beat thing around my middle (no medical reason, just 'procedure'). People that trusted doctors more than my instincts came to be with me and kept insisting that pain killers would be best. Was dehydrated, needed an IV. I took an epidural, it did nothing for me. I ended up tearing, needing stitches and having doctors tell me what to do, and generally having a horrible experience in labor for a whole day, delivered naturally but was so disgusted and unhappy.

    A year later, I decided to hire a doula to help me out with #2. Got a new OB. Doula insisted I write a letter to the hospital & cc: my doctor that said "don't offer me drugs" "no unneccesary monitoring" & "leave me alone until the last possible moment". I read a book - learned there are stages to labor (wish I remembered the title). My Dr. told me to stay home until I couldn't take the contractions anymore. I stayed hydrated. It worked. I felt like I had a plan and that I had support! Anyone that wasn't supportive wasn't welcome. I knew that I could do it, it's what we're made for! And after only 2 hours in the hospital I gave birth and was euphoric. It was so amazing to not have my senses dulled at all. I have read, that even if you need a c-section that it helps to go through a bit of labor first, since there are so many chemicals running through your body that are good for you and make you feel good.

    Again, best wishes and thanks for being a great blogger!
    Tammy

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  15. Thanks everyone! Your stories and advice has been so helpful. I'm looking into a doula, which will hopefully ease some of my fears and prove to be a necessary ally and advocate in the hospital. Wish me luck!

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  16. Kathleen--

    Good luck with everything! I had a c-section with Raileigh as well, but I had no other option. Still, as crazy as it is, I really wish it could have been the other way.

    Miss you guys!! Raileigh especially misses Soren :)

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  17. 1st pregnancy (1996) - my water broke at home but was not contracting at all. Went to the hospital, checked in, they started pitocin right away as my water had been broken for about 2 hours and still no contractions. After 9 hours of thinking I was going to split open and die (without an epidural because I wasn't dilating at all...we later found out it was because the cord was wrapped and she wasn't pushing down so that I could dilate.) I gave in to a c-section. My recovery was easy. I was out shopping the day after I was released from the hospital. I never took pain medication after I left the hospital.

    2nd pregnancy (2001) - had full on support from my OB to try for a VBAC. I had a birth plan and a coach and was thinking I was gonna do it. In my 8th month I was contracting a lot but not dilating. I chickened out at the end and scheduled a c-section because I didn't want to go through all of that horrible labor and still end up with surgery. Second time around with surgery, recovery was a little harder. I was attempting to nurse (I succeeded) and take care of another child as well. I needed the pain medication and I wasn't comfortable walking or anything for about a week after I went home.

    3rd pregnancy (2006) - VBAC was not an option. My OB didn't advise it and I didn't argue. We scheduled surgery and that was it. Third time around the recovery was horrid. But my doctor also told me it might be worse because I'd also had a tubal ligation (two birds, one stone). I needed the pain meds. NEEDED..and actually ended up having to get more. Plus two kids at home...it was just harder to feel normal after surgery.

    Good luck with whatever you decide to do. I fully support VBAC and c-sections. However, I hate pitocin and don't wish it on anyone. LOL

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  18. I had a C with my son after he stopped moving. The doc, CNM, and nursing staff were all fabulous, but the knowledge that my son could have been born still fills me with terror. Add in the fact it took me two years to conceive each child, and, letting nature take its course is just something I cannot trust.

    My OB runs the in-hospital home-like birth center, but did not bat an eye when I asked for a repeat C right at 39 weeks. Turns out this pregnancy ended up being high-risk anyway, and I had a previa that moved off the cervical opening but was still less than a cm away from it. My OB was still OK with trying for a VBAC, and when I went into spontaneous labor at 39 weeks exactly, I thought I'd see how things go. I labored 13 hours this time (36 last time), and eventually started bleeding. That did it for me! My daughter was out by the surgical route within a couple hours. No regrets! Nothing was worse than the car ride to the OB office with my son, wondering if I carried a dead child with me.

    I totally support VBAC though if it's wanted. Pitocin is not really used in VBACs, so it means waiting to go into labor. I say talk with your doc. They may be happy to schedule surgery so you have an end-point, but can change your mind. You may find a VBAC isn't so bad.

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  19. I had a planned C-Section, as my baby was breach and not moving. As I am also diabetic and had been on seven weeks of bedrest for high blood pressure, my vascular system was too compromised for them to try moving her manually. That would probably have resulted in an emergency C-Section.

    I don't regret my decision as the whole time I was just praying for a healthy live baby to be the end result and with so many complications at times that result looked like it could be in doubt. Plus my recovery went very smoothly, I think because my body never went into labor or distress. However, breast feeding was impacted but that's a whole different story.

    I was told by my doctors in Santa Fe that I would have to have C-Sections for all subsequent pregnancies. So I was very surprised to find out that my new doctors in MI are also encouraging and reccommending a VBAC. I am planning on trying it and seeing how it goes the doctors seem very supportive and really feel that's the way to go.

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  20. Hi Kathleen!
    We have 3 healthy boys each born after being induced with Pitosen. Everything turned out fine BUT if I were to do it again, I REALLY would try to avoid that. It just slams your body into out of control contractions that are much more painful than if you had time to ease into it more naturally. Just my 2 cents...whatever happens, you will do great!

    Donna
    Chris's Aunt in Wisconsin!

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