Anxious about VBAC

Hi there everyone!
My son was born 15 months ago via emergency caesarean due to fetal distress throughout the labour.
I was induced 11 days before my due date because of high blood pressure. I could have delivered naturally but had a caesarean because his heart rate started to drop after my obstetrician pressured me into an epidural cos she thought I wasn't going to handle the birth.

I'm due for our 2nd baby next month, so they'll be 16 months apart. This time I'm going to the public hospital, I feel like I'm treated better there than I was at the private. So far the doctors & midwives are fully encouraging a VBAC attempt because I have no existing reason for a caesarean so am therefore a good candidate for a successful VBAC.
However, I'd feel alot less anxious & more confident if I heard more stories of successful VBACs. Has anyone had a successful VBAC within 16 or so months after their c-section? I've heard that uterine rupture is possible but rare.
Seeing as I'm coming close to my due date I really need some encouragement or good feedback to make me stress less about this birth.

[peekawho]

There are ladies here who have had sucessful VBACs.  If your midwives and your doctors are encouraging you, VBACing is a wonderful idea.  good luck!

[tomel]

I just had a VBAC birth 2 weeks ago.
My c-section was 5 yrs. ago. My son was breech at 38 weeks.
My VBAC went very well. I was 6 days past my due date, went into the hospital with contractions...broke my water the next morning.. went into labor which lasted 12 hours...pushed for 45 minutes..my baby was 8 lbs, 20 inches.

THe number one questions I would be asking if I were you are
Did the doc who did your c-section do a double stitch on your uterus?
Do they think you have had enough time to heal in between pregnancies?
Are you dealing with a doctor or hospital who has experience with high risk? VBAC is considered high risk. Make sure the doc you have is conservative.
Are they going to perform NST (non stress tests) prior to see how babies heart rate is with contractions?
There is only a 1% chance for rupture..they will have you sign something saying your aware of all the risks involved..this will state that on there.
If your wondering about an epidural...yes you should have one..in case of emergency csection..you dont want to be knocked out.
I guess last all dont go in there with the mindset that you are gona have a VBAC no matter what. Go in there with the mindset that your gona try it..but if another csection is needed your ok with that as long as you and baby are safe.
I was ok with the fact I may have needed another csection, although I was scared when I had the contractions and it came time to push...my blood pressure sky rocketed cause I was so worried,,but once the nurses reassured me the baby was low enough and rupture wouldnt occur at that point..I felt much better. The nurses and doc were awesome.
It was an awesome experiecne for me, I would do it all over again and SOOOOO much better than a cesection.I feel great.
Good luck and let me know if there are any other ? I can answer or help you with.

[tomel]

Something else to think about.
Is this going to be your last baby?
If not there are also risks with having multiple c-sections.
C-sections are not free and clear of dangers.
Here is a recnt article regarding rise in death during childbirth, some of it being attributed to rise in csections .
http://news.yahoo.com/s/ap/20070824/ap_on_he_me/dying_from_childbirth

I know what you are going thru. I went back and forth my whole pregnancy regariding doing this.
I knew this would be my last baby, so I really wanted to experience the whole excitment with childbirth...I also wanted my husband to expereince it as well.I also knew I DID NOT want to have to go thru the horrible recovery of another csection. I did have a bad experience with mine..included getting an infection.  

Good luck on whatever decision you make. I hope a VBAC works for you.

[tomel]

Sorry one more thing.
Since you have a midwife are you planning on doing some home laboring?
I had talked to a midwife and she had helped me out during the end of my pregnancy.  
She had suggested to me doing some home laboring..and I was considering it. However once I talked it over with my doc he said that was NOT a good idea. Since the rupture can occur during contractions...it may not take long for a problem to occur.
I did not labor with my first..so my second was actually considered my first (make sense?)

Since it sounds like you labored with your first this will be considered your second and may happen VERY quickly. If it happens to quick and there is a problem you may not get to hospital on time.

Also is your midwife opposed to epidural?
I thought I wouldnt have one at first but then realized during labor that everytime I had the contraction that fear of rupture was even stronger.. also knew I wanted to be awake if a csection was needed. An epidural can very quickly be converted to a spinal.

[pertykitty]

at 25 weeks i am still debating the idea of a vbac.  my dr doesnt do them.  the thought of changing drs now is scary.  the thought of rupturing would be very scary during pushing same as tomel said, i dont know if i would be able to relax.  good luck i hope it all goes smoothly for you.

[tomel]

I actually switched docs at 34 weeks. Even though the doc I had said he was willing to do it..I wasnt trusting him (was with him for 11 yrs.) He was pretty shocked..even called me on the phone. It was the BEST decision I made.
It was scary...the epidural did help take some of that fear away... and they are constantly monitoring you.
Also my husband had to keep telling me to relax cause the blood pressure monitor kept beeping.
But like I said once the babies head is decnded enough that chance goes down alot. They told me they waited for him to decend as naturally as he could go.
I was shocked when they told me he was 8 lbs. I was pretty tiny during my pregnancy..If I would have known his weight sooner I probably would have really been freaking.    

[pertykitty]

i guess i will talk about this with my dr, and just be honest about my want for vaginal.  thanks.  however the thought of tearing from one hole to the next doesnt sound pretty either!  do they do an ultrasound while your in labor or just prior to make sure the baby is in the correct position?

[tomel]

I had an ultrasound at 36 weeks, cause prior to that he was breech and I was actually scheduled for version. He turned back to head down (thank God).
That was the last ultrasound I had done prior to delivery. They can tell if the baby is head down when they check the heartbeat...heartbeat will be detected below your belly button.
They can also tell by palpitation and internal exams.
However if you would feel comfortable with having one you could request it and see what they say.

Believe me I was worried about that to the whole stretching of vagina...well its only been 2 weeks and I feel like I could have sex already...of course I have to wait at least 6 weeks.
My body and mood ares SOOO much better than it was with my c-section. If it is your first vaginal birth your vagina will go back to shape...I have asked that ? many times and everyone has told me it goes back.  Ripping thru the stomach muscles and uterus several times I didnt feel would be pretty either. I wanted to be able to excercise within a reasonalbe amount of time.
Good luck. Let me know if you have any other ?.

[tomel]

Also I had my baby at 41 weeks.

[Stobie]

Well I'm not actually with the same doctor who delivered my first baby through c-section. But would you suggest getting in contact with her just to find out if she did do a double stitch on my uterus? The hospital I'm with now is very experienced with VBACs & has good success rates too. But you are right about going in there with an open mind, and not expecting to successfully VBAC it. I've been getting used to the idea of a repeat c-section, as much as I hate the thought. However, I'm really just putting all my energy into delivering vaginally this time.
I'm not familiar with what NST is, but I will definitely look into it. What do they actually do?
The doctors & midwives haven't told me (yet anyway) that it's too soon between pregnancies for me to safely attempt a VBAC. I'm hoping to atleast have a trial of labour, and thanks for the tip about not doing home labour, I really was going to stay at home as long as possible this time, but after hearing that the risk of rupture is high during contractions, I'd feel alot better if I were at hospital ancase that were to happen.
I've heard a story of a woman who has had a successful VBAC within 16 months of her c-section. I didn't hear all the details except that she did it, but obviously it is possible right? Do you think I atleast have A chance of a successful VBAC?

[Stobie]

Also, I do want to have more babies, eventually. My partner and I decided we might try for one more in maybe 6 or 7 years, seeing as this baby is another boy, it would be nice to have a girl one day (not that that is a big deal though, I'd be happy with all boys)

PS. Congratulations on your successful VBAC! I envy you. You must feel so victorious, I know I would, especially if I beat the odds with this birth. Did you have any complications at all? I love hearing success stories, it really helps.

[tomel]

A NST or non stress test simply checks the babies heart rate during movement and when he/she is still...also checks what happens to babies heart rate during a contraction (braxton hick)... they also monitor your blood pressure during.
Did you have pre exlampsia with your last? Is that why there was fetal distress?
If you did have fetal distress with your last I would think they would want to do some NST's if your gona have a trial of labor.
I would check with your last doc to see if she did a double stitch.
Yes especially cause of possibiltiy of fetal distress you DONT want to stay home to long. I know there are some success stories of VBAC's with midwifes at home...but I wouldnt chance it.
The midwife could go with you to the hospital and be a support. I wish I would have had the midwife with me at the hospital..although I will say my DH did pretty good.
If your doc is willing to do it and thinks you have had enough time to heal then I say go for it.
Let them know all your concerns and questions and dont be afraid to ask for or request something..like ultrasounds or NST's. I think you have a good shot.  

[tomel]

I learned about the double stitch thing when I was in labor..the old doc I had delivers at the hospital I was at...the new doc I had asked one of the nurses if they knew whether or not my old doc did double stitching...the nurses said yes..so the new doc told me that was really good and made chances of rupture even smaller.
I hadnt even known about that prior...but now that I know that I pass that info. on.
The nurses epxplained to me that some docs arent very good (obviously) and they dont take there time with the sewing up process after c-section. I was glad to know that my old doc (even though I was very leary of him) at least did that for me.

[Stobie]

I thought that's what NST was, I had that with my last pregnancy because of high blood pressure from 31 weeks. (I was under alot of personal stress then which was a big contributing factor)
I've recently heard of alternative fetal monitors, ones that aren't attatched to your belly and don't prevent you from being mobile. Did you have anything like that? I want to have an active labour this time, my doctor wouldn't allow me to walk around with my last labour for whatever reason (she was so controlling) Is active labour recommended if your attempting VBAC?
11 days before my EDD I had protein in my urine, so yes I did have pre-eclampsia.
The obstetrician who performed the op said the baby was under distress because of the umbilical cord being tight around his neck. She never mentioned anything to do with my condition, but it may have had something to do with it too. I believe the epidural contributed, but that's just my opinion.
This baby's head is already facing down and always has been as long as they could tell. I keep telling myself how low the risk of rupture is because if it is only 1% then that does make me feel a little more confident about attempting VBAC. Do you think I'd notice anything at this stage (pain, bleeding, etc) if there were a chance of rupture? Or is it something that is only evident during labour?
Also, this may sound stupid, but do you have any helpful tips for the remaining of the pregnancy that may increase my chances of a successful VBAC? I've been maintaining my exercise and drinking *tonnes* of water, I've also started drinking Raspberry Leaf Tea. What's your opinion on that?

[tomel]

[tomel]

With the NST you have to sit in a chair hooked up to the monitor...but it only takes an hour.
I had several done (2 times weeks for 3 weeks) before I had my baby.
WHen you have a VBAC you have to be constantly hooked up and monitored during labor...you can get out of bed and sit on therapy ball...however with that being said...my baby always passed the NST with flying colors and his heart rate was perfect during labor...so they would let me walk around for 30 minutes at a time....I would come back and they would hook me up to the monitor some more...get the reading they needed and then let me walk again.

I'm pretty sure Pre eclampsia can affect fetus and put fetus in distress...although I am not an expert on this.

If your not having any hard contractions no I dont thinkyou will rupture...it is only when you have constant contractions that you need to get to the hospital..talk to your doc about when she wants you to go to the hospital

As far as prepping..how far along are you?
What I did yes..excercise, tons and tons of water...nurse told me a hydrated uterus works the best in labor......took evening primrose oil 1 a day and rubbed evening primrose oil on my perintatal area
Ask midwife about this.
Eat lots of iron rich protein food and veggies.

Are you planning on an epidural?

I didnt have any complications. But I did test positive for group B strep so I had  5 bags of penicillin  during labor. I was able to walk around with this though. Its an IV hooked up to a bag. My husband just pushed it while I walked.

I have been on cloud 9 since my VBAC. It was awesome for me to be able to do it. I was feeling pretty low and even kinda like a looser about having had a c-section and was feeling low about the possibility of another one(I know that sounds silly). But I was stubborn and did everything I could, even switched docs at 34 weeks.

Igot really tired of always having to explain why I had to have my csection. alot of people can be very jusdemental about this...now I am an expert at both
My DH and I also had alot of people praying for us..which I feel really helped. But I know some people arent religous.

I will pray for you that it works out.

[tomel]

Oh and squat all the time..sit on a therapy (yoga) ball as much as you can..if you have one..sit up striaght..dont slouch back or recline....rock back and forth on all fours

get that babies head as low as possible...the rocking bask and forth will help get baby head down and face down (dont want him sunny side up)

I would even get up  in the middle of the night and do like 5 standing squats..anytime I could I would squat, squat, squat

[Stobie]

Oh ok, *derrr* I must sound like I know nothing when it comes to this. So the fetal monitor that I'm talking about isn't exactly the same as an NST but I know what you mean now. Thanks. I just really want to be as active as I can during the labour, even if I do have to be constantly monitored.
I didn't know about the evening primrose oil, when should that usually be started and can I just purchase that from a Naturopath? And that just helps to avoid tearing does it?
I'll definitely keep up the h20 and exercise!
I'd rather avoid an epidural as much as possible but if it is recommended as the safest option for my circumstance then I'll consent to it. I probably sound desperate to have a vaginal delivery and that's true, I am. But if my baby or myself are at risk then ofcourse I'll go for another bloody c-section, as much as I dread it!
I'm currently 33 weeks. Due on the 21st of October. So they'll probably do the NST at my next antenatal visit at 36 weeks. I haven't had any braxton hicks, or sharp pains, but I have had lower back & upper leg/pelvic pain, which I guess is to be expected. But yeah, walking regularly has been helping. My blood pressure was up high at the very beginning of the pregnancy, but that I suppose was cos I stressed so much about it that it went through the roof. Sometimes I get a bit of "doctors fright" when having my blood pressure checked. But my last check up at doctor it was as perfect as they could ask for.
I know what you mean about getting sick of explaining why you had to have a c-section. Everytime I have to talk about it and remember, I feel like a failure and like I should've done something else and maybe it wouldn't have turned out that way.
I've learned that stressing plays a huge part in things going wrong, so I've become a bit more relaxed now and am enjoying the pregnancy as much as possible, even though I am anxious about the birth.
I am religous, so I really appreciate the prayers- thanku!

[tomel]

I started taking the evening primrose at 36 weeks, it supposed to help "ripen" the uterus or cervix or something like that. And doint the pereantal massage will help stretch out the vaginal muscles a bit. You can buy ep at any health food store or pharmacy.

Yes try to relax and mabye try and avoid salt or salty foods.  

When you are being monitored at the hospital during labor you will need to stay in bed or close to bed. Again though you can get out and sit on therapy ball next to bed and even rock back and forth on all fours in bed as well as squat next to bed. One of the nurses there told me she thinks the only thing walking does is tire the person out. Its true what they say labor and delivery is like running a marathon...even with an epidural...man pushing is hard work...I was so dang tired from that

[Stobie]

Thanks for that! Yeah you're probably right, that walking during labour just tires you out. I didn't mean that I wanted to go on a hike or anything, just that I don't want to be on complete bed rest & wait for whatever's going to happen. I want to be atleast a bit mobile and to have atleast some involvement in my babys' birth. Having a c-section (especially an elective one) deprives you of that experience and involvement.
Does the therapy ball help with dilation? How did it benefit you? I wasn't fully dilated when I was taken in for emergency c-section. Would you say that dilating quickly is good for someone attempting VBAC? If so, what tips do you have for quick dilation? I'm sure you're probably thinking I should ask all these things to my doc/midwives, but hearing others' personal experiences are very helpful too.

[Stobie]

Ok this is to anyone who's ever had a c-section.
I had an emergency c-section for my last baby & am due next month for my 2nd. I'm puting all my energy into having a vaginal delivery, but I'm also trying to keep a level state of mind, knowing that a repeat c-section is a possibility.
I dread the thought of another caesarean, and never getting to experience a natural vaginal birth, but obviously if it has to happen then there's nothing I can do about it. So I want to learn how to just accept & be content with whatever happens.
I don't want to feel like a failure again, disappointed and excluded from my child's birth.I felt like I had no say or involvement. How do I find a different state of mind/better outlook on something so scarring? I can't seem to think positively about a caesarean birth because to me, it's not a good experience.

[tomel]

I did not dialate quickly....12 hrs of labor.
I would say if you dialate quickly and are gona have a VBAC that yes that is a very good thing. If I were to guess I would say your gona have a fast labor with this one.  
Therapy ball helps get baby more head down in the pelvis. I dont think theres really anything you can do on your own that will make you dialate faster....I'm not sure. Oh another thing that helps get everything ready is sex (orgasm and sperm).
They broke my water to speed up labor, the only other option is a little pitocin.
Hope that helps.

[Stobie]

Yes that helps- thanku! I've heard that sex helps as a natural induction, but I heard that pitocin increases the chances of repeat caesarean. Obviously didn't for you. But as I said, hearing about yours and others' experiences is far more beneficiary to me than hearing what doctors have to say. Knowing that there actually are people out there who have succeeded makes me feel like the chances of succeeding myself are better.
Were you this anxious during your pregnancy before you had VBAC? I spose I should just calm the heck down and relax lol.

[tomel]

I didnt have any pitocin...it was gona be an option (a little bit of it) if I didnt progress on my own after my water was broke.,, But I progressed after that.

I was a little anxious during my pregnancy...mabye try getting a pregnancy yoga video (I had gotten one from the library) and doing that...it may help you relax....have someone give you a massage...that may help also.

[peekawho]

Most doctors do a double layer closure on the uterus.  It is not absolutely necessary for a VBAC.  The information will be in your operative report from the hospital where you delivered.  You can request it in writing my contacting the medical records dept. of the hospital, NOT via your old OB.  It won't be in your old prenatal records.

All that is usually required is knowing that the uterine incision was transverse (sideways, not up and down).  And 99% of the time, it is or the doctor would have been very careful to tell you that it wasn't.  
Not the skin incision, but the uterine one.  Again, it will be in your operative report from the C/S, but if it wasn't a transverse incision, the doctor should have told you that you would ALWAYS have to have a c/s.

You will have to constantly be monitored in labor if you are VBACing.  You can get up on the ball or sit in a chair, only if they can monitor the baby.  You won't be induced with any medications if you have a history of a C/S.

[tomel]

My doc was actually gona let me have some pitocin (I was suprised by this..and didnt really want any), but he was gona let me..fortunatley I didnt need it.

[tomel]

Question, How do they make the skin incision sideways..but the uterine one up and down...do they pull the skin back?

[peekawho]

They can let you have Pitocin for augmentation, just not for induction.  A lot won't use it at all, though.  

[tomel]

Yeah, he did break my water first...so that makes sense.

[peekawho]

Yep, they retract the skin out of the way.

But really, classical uterine incisions, the up and down ones, are rarely done.

[Stobie]

Thanks for that info, is it true that being induced could lower the chance of a successful VBAC? If so, why is that?
And usually if they do a classical uterine incision isn't that for reasons such as placenta praevea or if baby is lying sideways? Like they wouldn't have done a classical unless it was for a good reason right? In my case, the baby was in the right position, head down, anterior, the only reason for c-section was fetal distress (apparently due to the umbilical cord being too tight around his neck)

[Stobie]

My partner spoils me with massages every day which is great!! And you're right it does help to relax, I feel so relieved after a good back rub. I never got into proper yoga, but I did try some sort of meditation a few months ago with a friend who was visiting from Canada (I'm from Australia) & I found it alright, but not my thing. I do however love listening to relaxation music. I have a cd called "Hypnobirthing" which I'm definitely all for. Have you ever tried that?
Also, were you induced because you were beyond your due date? Is it common to be induced if attempting VBAC cos I did hear that it can decrease chances of success (obviously not for you) but don't they usually try to avoid inductions in those cases?

[tomel]

Well I dont know if breaking water is considered being induced..not sure.
I actually went in on a Sunday with contractions...the nurse told me "Oh since there not extremely painful..we might be sending you home" I was like well I am doing what they told me to do and that was come in if they are close together for an hour...plus having a VBAC you dont wanna stick around and wait for the really bad ones..that can be very dangerous. So she checked with the doc..and he said no were keeping her she is a VBAC and 6 days past her due date.
They waited to see what was gona happen on my own...plus I had to have 2 doses of antibiotics before labor began because of Group B Strep....so he came in and told me after I had the antibiotics he would break my water in the morning...and then if need be if I wanted could have some pitocin...he broke my water and then labor started (slowly) on its own. When I went in I was already 2 cm and 75 effaced...I think if I hadnt been effaced or dialted they may have sent me home..not sure...it makes no sense to me though why you have to be in awful pain before they will admit you..I know of 3 people who LITERALLY almost didnt make it on time to the hospital...one girl she could feel the babies head at home...another one got to the hosptial and boom 17 min later baby was out....another one same thing...baby was out like that....ALL because the stupid hospital sent them home the first time.

This was actually a first time labor for me...even though it was my second child..I didnt have ANY labor with my first..it was a schedules c-section at 38 weeks.

Remember 2nd babies always or at least usually come alot faster...all the examples of friends I gave above were alltheir 2nd birth.

As far as dangers of Pitocin...it makes contractions MUCH stronger...very bad... and from what I understnad the stronger the contraction...the greater the rick for rupture...so thats where the danger of another (repeat) c-section.

I have heard of the hypnobirthing.... but havent tried it

[tomel]

If I had gone another week (they were willing to let me go 2 weeks past my due date) with no sign of labor..it was gona be another c-section....Im SOOO glad it worked out the way it did..and Im so glad that wonderful doc did what he did....He rocks in my book!  

[Stobie]

I always thought that having your waters broken was considered being induced, but maybe I'm wrong. There are so many different methods of inductions.
If you don't mind me asking, why did they break your waters? Was it just cause you were 6 days past your due date? Is it dangerous or risky going past your due date if your attempting a VBAC?

[Stobie]

Why didn't they let your waters break naturally if you were already getting contractions?

[tomel]

I'm not sure why he decided to break my water...they hadnt mentioned it to me any earlier...I think when I go for my 6 week post pardum appt. I'm gona ask....at the time obviously I didnt care why...I just wanted to have the baby...my guess is its because I was past my due date and I was a little dialated and effaced. Most docs wont let you go past yor due date w VBAC..my other doc (the one I left at 34 weeks) wasnt gona let me. The new doc knew VBAC was very important to me....the only way they were letting me do it was if I went for NST's 2 times a week...They knew baby was doing well...actually its really not that great for ANY pregnant woman to go way past the due date...you start to loose fluid.  

I think alot of my experience was all a good call by the doctor...I feel lucky it went the way it did

Its not uncommon for woman to need their water broken...water bag doesnt always break on its own naturally...in fact I talk to more women that had theirs broken by the doc...just because someone is getting contractions...doesnt mean their water is gona break

[tomel]

When are you due?

[Stobie]

That's so good your new doc was supportive of your wishes. It doesn't help having a doctor who over-powers you.
I'm due on the 21st of October, so I have about 6 weeks to go now. This morning I had a meeting with a local doula, which I found very beneficial. Doulas charge quite a bit but if my partner agrees to it I think it would make a huge difference. What do you think about doulas? She gave me such a positive but realistic perspective on VBACs n' it all made complete sense.
Did you have your VBAC privately with an obstetrician or did you go through the public system?

[Stobie]

Also, what would you say is the very earliest that Evening Primrose Oil could be used? Could it be dangerous if used too early? Could you give me a bit more feedback on that stuff.