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10 Bright Stars
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| Posted: March 20 2007 at 7:22pm | IP Logged
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I was wondering if anyone had any advice or experience concerning vbacs or repeat c-sections? In the past, I have had all of my children normally. I am usually induced two weeks early because I have gigantic babies.  Anyway, last year I delivered twin girls via c-section because they were both breech. They are 15 months old, and I am currently about 20 weeks along with baby #8. I am 37 years old. (Don't know if this matters. :>)
The first doc I went to said that he absolutely refused to do VBACS, and I would HAVE to have a repeat c-section. He told me the risk was too high etc. for him to take, so it was his policy to not do VBACS at all. For other reasons, I decided to go back to my old docs office. When I brought the subject up with him, he said we would play it by ear, but that it shouldn't be a problem to try a VBAC.
So, now I am completely confused. Is it safe, or isn't it? Do the number of previous births matter? Does age matter? Since I just had twins last year, does that matter? (Not very long since my c-section, and they were huge too; 7.5 lbs and 6 lbs at 39 weeks!!!!)
I would rather have a VBAC, but if it is at all dangerous for the baby, then I will opt for the c-section. The doc did tell me that I would HAVE to go into labor naturally; something I don't usually do anymore due to the big baby problem. (Largest was almost 11 pounds!) He did say natural labor was neccesary because any unnatural intervention, like induction, just tends to increase the risk of uterine hemmorage during a VBAC rather than help.
Anyone have any similiar experiences? I tried looking into information online, but everything is very vague. Thanks for any help you all can offer 
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Kim married to Bob (22y)
Mom of 11 blessings:
Bobby 19, David 17, Noah 14,
Mary 12, Gracie 10,
Isabelle and Sophia 8,
Gabrielle 6,
William Anthony 4, Joseph 3 and Luisa Marie - born in M
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Mary G
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| Posted: March 20 2007 at 8:02pm | IP Logged
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Kim,
My first was a C (I think the doc induced too soon and Joe went into fetal distress, but hey, who was listening to me ) I've had 4 successful natural births since. I think it's mostly why the c-section was necessary and if there is the potential again.
Knowing now what I wished I'd known then, I would have fought against the induction ... I definitely would try to find an OB that would at least wait until you're almost due before dictating a c or VBAC .... does that make sense?
I'll keep you in my prayers, Kim.
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MaryG
3 boys (22, 12, 8)2 girls (20, 11)
my website that combines my schooling, hand-knits work, writing and everything else in one spot!
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JodieLyn
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| Posted: March 20 2007 at 9:28pm | IP Logged
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It's being driven by insurance.. when they realized VBACs worked they pushed all women to have them without considering individual history.. lots of problems doing that.. so now they've flipped the other way and are discouraging VBAC unless there's an anesthesiologist (sp?) on duty 24/7.
The Silent Knife is an older book but supposed to a great resource.
Henci Goer has collected data on safety issues in birth. I think she has some articles online.. also she has a book "Obstetric Myths vs. Research Realities"
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Jodie, wife to Dave
G-18, B-17, G-15, G-14, B-13, B-11, G-9, B-7, B-5, B-4
All men who have turned out worth anything have had the chief hand in their own education.
-Sir Walter Scott
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Angel
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| Posted: March 21 2007 at 7:06am | IP Logged
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I'm pregnant with #6 after twins. My last two births (the twins and a single) were both C-sections. The doctor I am going to now is leery of doing a VBAC after 2 C-sections, but is willing to let me try. If I want to try VBAC, I have to sign a waiver, though, saying I know all the risks. That's completely an insurance thing.
Here's what the doctors have actually told me regarding risks and when VBAC is okay vs. not:
1. In order to have VBAC, I will have to go into labor normally. Induction increases the risk of rupture.
2. The risk of rupture increases if VBAC comes within 18 months of a previous birth.
3. The risk of rupture increases based on how many C-sections you've had. (As far as I know, most doctors are ok with VBAC if you've only had 1 C-section. It's when you've had 2 or more that it becomes more dicey. I know a woman who had a VBAC after 4 C-sections, but now that she is pregnant again, her new doctors -- my doctors -- say they will absolutely not allow her to do VBAC even though her last child was delivered naturally.)
4. My new doctor's office wants my old operative records so they can see exactly what kind of incision was made on my uterus in each of my previous C-sections. If the incision in either of them turns out to be large, then they won't allow me to have a VBAC.
To be honest, I'm still undecided. My husband, who tends to fret about these sorts of things, wants me to just go with the planned C-section. I don't have a great track record of going into labor naturally, so I think everyone is a bit skeptical of my chances with a VBAC anyway. But I'm still thinking about it.
I think there is an old thread here on the subject (which I keep meaning to look up)?
--Angela
Three Plus Two
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Elizabeth
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| Posted: March 21 2007 at 7:48am | IP Logged
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I had a very successful VBAC last fall.  . There is some concern with induction, particularly if you need to use pitocin or prostaglandin gels to get you going. Some docs will use a little pit (my midwife was prayerfully wrestling with this up until my delivery). P-gel is completely contraindicated because it is correlated with a significant risk of rupture. I was 10 days overdue when I was induced. All it took was artificial rupture of my membranes and labor kicked in quickly. My uterus and scars feel better than they did before I conceived this last baby.
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Elizabeth Foss is no longer a member of this forum. Discussions now reflect the current management & are not necessarily expressions of her book, *Real Learning*, her current work, or her philosophy. (posted by E. Foss, Jan 2011)
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JennGM
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| Posted: March 21 2007 at 10:11am | IP Logged
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Angel wrote:
| 4. My new doctor's office wants my old operative records so they can see exactly what kind of incision was made on my uterus in each of my previous C-sections. If the incision in either of them turns out to be large, then they won't allow me to have a VBAC. |
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I know for a fact my incision is too high and high risk for rupture, so VBAC isn't an option for me. I'm not going to push it--too many horrible things too close to home for me to risk that.
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Jennifer G. Miller
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hopalenik
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| Posted: March 21 2007 at 10:33am | IP Logged
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Hi,
After my twins were born at 31 weeks via csection, I had a horizontal cut. The doctors, I tried about 6 offices, refused a VBAC. So I have had 2 more sections. Honestly, I kind of like them. It isn't normal, but I really don't see what the big deal is. I am up and out of bed without help about 6 hours later. But I know for a fact that in CT, and RI you would not be able to find a doctor who would do a VBAC. The rules up here are really strict.
Holly
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Philothea
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| Posted: March 21 2007 at 12:14pm | IP Logged
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I thought the vertical cut was bad, and the horizontal was what was needed if someone wanted to try VBAC?
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JennGM
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| Posted: March 21 2007 at 12:20pm | IP Logged
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Philothea wrote:
| I thought the vertical cut was bad, and the horizontal was what was needed if someone wanted to try VBAC? |
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There are two cuts, one of the uterus, the other of the skin and muscles. I had to find this out for my own personal info.
Low, horizontal cut of the uterus is what you want for VBAC. It doesn't matter where the cut is on the outside. For the uterus, vertical isn't good, and cuts either horizontal or vertical in the higher parts of the uterus where it is thinner and less muscles is more risky for VBAC.
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Jennifer G. Miller
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monica
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| Posted: March 21 2007 at 12:20pm | IP Logged
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oh! a topic so close to my heart! i only have 2 kids, but my first was breech, so i had to have a C, but it was the "best" scenario for it. planned, uneventful, bikini incision. i was truly blessed with a wonderful, christian doctor and midwife who both were big cheerleaders for me to have a VBAC. i was definitely set on it, but if they werent then it would have been much harder. son #2 was a textbook pregnancy and delivery. he came in the wee hours of the morning, so i didnt get the VBAC doc that i wanted, but it still worked out. i had a doula that was experienced with VBACs and that really helped me be confident in my bodys ability to give birth. i would definitely recommend a doula to anyone considering VBAC
i too was 10 days overdue, was having irregular contractions for the 5 days before he came. fun fun. i was getting really worn out, and the day he was born i was due to have a checkup and i was ready to say- do what ever it takes, just help me have this baby. but i knew that inducing would make a VBAC unlikely.
for me, there was just no comparison between csecton and VBAC. i had a good recovery with both, but after the VBAC i was so full of energy and joy. the csection was fine, but i feel like i was so out of it for the first few days of his life.
if you are interested, i can send you my birth story, which gives my specific experience. can you tell i love to talk about this??
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10 Bright Stars
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| Posted: March 21 2007 at 5:30pm | IP Logged
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Thanks for all the neat responses. They were all very interesting! It really is a tricky situation, and I guess we won't know for sure until "D" day. (or will it be "C" day?)  The other problem I am having is that I cannot be certain of an exact or even approximate due date, other than sonogram, because I have not had a cycle since my October 2005 c-section!! Yes, you heard that right, so I have NO idea how far along I am really. The sonogram says I am around 20 weeks, and gives a due date of the first week of August. This will make it even more tricky to base decisions around going into labor naturally, I think, since we are sort of basing all of the calculations on what the sonogram says. I don't know how accurate they are. ( I think fairly.) But, it is still a little unnerving. I will let you all know what "they" decide in the end, but please pray that the right decision is made.
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Kim married to Bob (22y)
Mom of 11 blessings:
Bobby 19, David 17, Noah 14,
Mary 12, Gracie 10,
Isabelle and Sophia 8,
Gabrielle 6,
William Anthony 4, Joseph 3 and Luisa Marie - born in M
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Ruth
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| Posted: March 21 2007 at 6:11pm | IP Logged
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Kim, I'm praying for you, dear friend My first was a C-section and the last 5 were VBACs. I haven't had any trouble, praise God!!! I'm here for you, babe
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hopalenik
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| Posted: March 22 2007 at 11:25am | IP Logged
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Sorry, I totally screwed up my post. The first was vertical and the second two were horizontal. Duh! on my part. We thought after the twins that we could have a VBAC because the doctor said everything was OK. But they cut me vertically and I think they didn't want to tell me that because they did not expect my son to live. I was vocal about wanting to have a VBAC in the future, that I feel they did not want to upset me even more by saying that was not an option. So we didn't learn until 25 weeks into the 3rd pregnancy that VBAC was not an option. I was devastated because my first birth-vaginally-was awful and I had to have every intervention under the sun. But now I don't mind so much....the birth date is planned and I get 4 days by myself in the hospital before coming back to the craziness at home. It is my chance to sit on the phone and talk to old friends and pray and relax because once I come home-I have to do everything again. I don't have so much help, and my mother in law comes here and expects me to do it all again. So I have come to the conclusion that God knows best and put in place a plan for me that will work better with the type of husband and mother in law that I have.
Holly
Good luck! Just believe that God has the right plan for you, even if it isn't what you want.
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anniemm
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| Posted: March 26 2007 at 9:14pm | IP Logged
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I also had a C-section with my first child, and I blame that on a combination of inexperience/lack of knowledge on my part and a scalpel happy OB. When I switched to a VBAC friendly OB after my original OB said "no way," she reviewed my records and said that in no way did I need a c/s with the first. Quite frusturating for a 22 year old with a whole future of childbearing in front of her. I had a successful VBAC with my second daughter. I had no idea the birth experience could be full of so much joy. My first certainly wasn't. I am expecting again in about 3 1/2 months and I am much more confident in the VBAC.
I understand the big baby thing, my VBAC baby was over 9 lbs. which was not a problem at all.
I would suggest to you that you go to the ICAN (International Cesearean Awareness Network) website. I found a wealth of information and a sense of empowerment through the organization and the yahoo group associated with it.
The worst part, in my opinion, is having to fight for the birth that God created women to have (not that I don't appreciate an *appropriate* c/s)...The medical community is just so worried about legal issues that I think they do an incredible disservice to patients. After a lot of reading and research last pregnancy, I really think that a VBAC is consiterably safer than a planned c/s. And in MY situation, I felt that attempting the VBAC was the very best way for me to be open to life. Repeated c-sections really scare me!
I wish you the best of luck and assure you of my prayers! I just wanted to encourage you!
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Andrea
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Topic: VBACS vs repeat c-section
