VBAC question...PLEASE HELP!!

  1. Hi All!

    My sister is due May 24 w/ her 2nd baby. The doc asked her if she wanted a c-section since she had had one w/ her 1st baby. She said that the doc told her that VBACs are frowned upon now and suggested that the c-section might be best, but that it is her decision.

    He also said that since she is due the 24th, if she decided on the c-section that he would take the baby during the week of the 12th so she "wouldn't have to go thru labor and end up having a c-section anyway"???

    Somebody, anybody, please help me with this. She is asking me for advice (more b/c I have given birth to 5 children than b/c I'm a nursing student) and I don't know what to tell her.

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    About chiefswife, BSN, RN

    Joined: Mar '03; Posts: 554; Likes: 331


  3. by   Browneyedgirl
    Even if a woman opts for a cesarean, the effects of labor on the uterus help prepare the baby for life outside the womb.

    have her read 'The Thinking Woman's Guide to a Better Birth" by Henci Goer.
  4. by   Jolie
    You might want to try looking up a thread in the OB section titled "Why the anti-VBAC stance in hospitals" started by l e mae. I think it's on page 3. It includes lengthy discussions pro and con regarding VBACs vs repeat C-sections.

    If she chooses to have a scheduled C-section, it is common for them to be done in the 38th week of pregnancy. This virtually eliminates the risk of prematurity due to inexact dates, and usually spares the mother the discomforts of labor.

    Good luck to all and best wishes for a happy, healthy baby!
  5. by   boggle
    Sara610, glad your sister is asking. VBAC is a valid option. Check the ACOG (American College of Obstetrics and Gynecology www.acog.org )guidelines. They have specific recommendations about VBAC and Cesarean prevention.

    There is an organization , International Cesarean Awareness Network http//www.main.org/ican/ that has resources/websites for women looking for more info on VBAC and cesarean prevention. This is a grassroots, consumer based organization. They present many opinions as well as facts. Read with a critical eye. Some info is emotionally charged, but there also is much factual, extremely helpful info. This organization was very helpful to me in my search for a VBAC several years ago.

    Your sister needs as much education on the subject as possible to make an informed decision. Seek information from a variety of sources. Once she knows her options, based on facts, then she can make a decision that she can live with. At least then she has had a say so in the matter.
    I strongly suggest a midwife's care and the services of a doula or trained labor support person to be with the laboring mom.

    Had a VBAC myself many years ago. No problem, but took lots of planning, educating myself and asserting myself. Ended up switching docs and hospital. Final plans weren't in place till 6 weeks before due date. Had a wonderful VBAC experience.

    Also had a friend whose planned VBAC resulted in cesarean after a long, long labor. Third and fourth babies were VBAC (after 2 c-sections)

    A lot of the decision to have a VBAC or repeat cesarean depends on the reason for the first C-section. Each labor is different.

    "Failure to progress" in the first labor does not predict the events of a second labor. (I think "failure to progress" should be renamed "failure to wait".)

    Feel free to PM me. I hope you and your sister find the info she needs to make the decision that is best for her.

    If you don't know your options, then you don't have any.
  6. by   boggle
    WOW, I just did a web search on VBAC. http//www.vbac.com has a huge list of resources.

    I almost forgot, The International Childbirth Education Association (ICEA) also is a great source of info.
  7. by   Rissi-Roo
    Boggle wrote:""""A lot of the decision to have a VBAC or repeat cesarean depends on the reason for the first C-section. Each labor is different.

    "Failure to progress" in the first labor does not predict the events of a second labor. (I think "failure to progress" should be renamed "failure to wait".) """

    This is exactly what I was going to say so ... GOOD POINT:-) I would add that if the reason was failure to descend or CPD then I would myself probably opt for a repeat. But if it was non reasuring fetal heart pattern or malpresentation or FTP like you said .. I would definately go for the VBAC.

    Labor may be somewhat difficult at times BUT a C/S I would think would SUCK to recover from...
  8. by   chiefswife
    Thank you all so much for your input. I'm going to call my sister tonight to let her know about the books and web sites. I hope she decides to try a VBAC, but...I'll keep you posted!
  9. by   Texagain
    Had an interesting VBAC to C-S case last week. 35yo, G2, P1, hx C-S 6 years ago, desires BTL. SROM at 39 weeks, desired VBAC. She labored for 5 1/2 hrs on the unit (she waited at home for a while) with failure to progress, no descent. Went for C-S and was found to have a 3 cm rupture with amniotic fluid in the abd. 6 lb 11 with Apgars 5-8-9.
  10. by   SmilingBluEyes
    It is a good idea to discuss EARLY ON with one's doctor about having a VBAC delivery. Unfortunately for your sister, it is very late (she is due in 3 weeks?)----and it may be hard to change this doctor's mind about how he/she feels. Were it me, I would have sought a doctor/midwife (hospital-based) who was supportive of my desires to have a vaginal delivery very early-on in pregnancy. I am not trying to be discouraging but preparing you for what you may be up against if a physician is firm on his/her stance regarding VBAC.

    The arguments everyone presented above are VERY valid to support her desire to persue a VBAC delivery but sadly, it will really be up to the doctor/hospital staff to support her. And she may not get much if their minds are set against it.

    I wish her luck, but like I said, if the doctor's mind is set, she will need lots of luck to change it. I hope she can. Successful VBAC deliveries are beauty to behold and very rewarding for the families experiencing them! I hope she has a safe, happy delivery and healthy baby. Let us know what happens!
    Last edit by SmilingBluEyes on May 2, '03
  11. by   ShandyLynnRN
    If she does decide on VBAC, she needs to check with the hospital she will be delivering at to see if they have an OR crew round the clock, or if one will have to be called in if there is an emergency.
  12. by   chiefswife
    My sister called this morning and apparently I failed to even get thru to her on any level! She is having her baby at around noon on the 19th.

    I'm so mad I could scream!!

    Maybe I don't know what I'm talking about, and if that is the case, please let me know, but the doc told her this morning - 3 weeks from "due" date - that she should be dialating and she is not so the c-s would be best! I thought the body did what it was supposed when it was supposed to and not before!
  13. by   fergus51
    Her doc sounds a little....welll, not what I would want for my ob. I hate the docs who schedule the sections so early because I have had a few who were supposed to be 37 weekers but were definitely not. But, that's what she has and she's chosen to do what he recommends for whatever reason. All you can do now is be supportive of her decision, even though you think it's wrong.
  14. by   SmilingBluEyes
    You were in an uphill battle, from the start, it would appear. THE DOCTOR has had his/her mind made up...and has seemingly cowed your sister to do what is in HIS/HER best interests. Just what I feared. I agree, just be supportive and hope for the best. It sounds as if the situation is set now, for better or worse. I wish your family well.