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Monday, April 25, 2011

VBAC or Casearean Section???

As we move closer to the date of expected delivery of our second child, I am naturally becoming more and more indecisive with any decision that I am faced with.  My first son was delivered via cesarean section, and it has been proposed that I undergo another c section for the delivery of my second son. 

At this time, I am carefully considering the positives and negatives to both a vaginal delivery (VBAC) and a c section.  Since I did attempt a vaginal delivery before, I can remember the feelings afterwards of pain and discomfort caused by both a vaginal delivery and a c section.  The pain afterwards from a vaginal delivery is minimal compared to that of a c section. 

What I am unfamiliar with, though, is how the recovery period from a c section will feel while caring for a 30 pound toddler and a newborn!  It is understandable that I want to try to avoid a c section for this reason.  I am also fearful of being on an operating room table, awake, while 8-9 people gather around my naked body, tie me down, and cut me open! 

On Wednesday, I asked my OB if I could attempt a VBAC if I should go into labor naturally.  She responded by giving me some paperwork, telling me to review it with my husband before deciding, and showing me a form that I would have to sign prior.  She did not say much else about it.  My question is, is she just recommending a c section because that is the thing to do after one delivers one's first child that way, or is there a medical reason that a VBAC should not be first attempted?

Here are some of the items I would have to sign off on:
  I understand that approximately 70% of women who undergo a VBAC will successfully deliver vaginally.
  I understand the risk of uterine rupture during VBAC in someone such as myself, who has had a prior
  incision in the noncontracting part of my uterus, is around 1%.
  I understand that VBAC is associated with a higher risk of harm to my baby than me.
  I understand that if my uterus ruptures during my VBAC, there may not be sufficient time to operate and to
  prevent the death of or permanent brain injury to my baby.
  I understand that the decision to have a VBAC is entirely my own, and the option of an elective repeat
  cesarean has been discussed with me.
  I understand that VBAC carries a lower risk to me than does a cesarean delivery.
  I understand that if I deliver vaginally, I most likely will have fewer problems after delivery and a shorter  
  hospital stay.

From this paper, it's hard to tell what the doctor's opinion is.  The informational pamphlet that she gave me to review contains some contradictory information that I intend to bring to the OB's attention in May.  It states that vaginal deliveries have fewer risks for me and the baby than a c section. 

I am leaning towards the planned cesarean birth now because that is what the doctors have said to do for my next baby in the past, but I feel the need to discuss VBAC further with my OB.  I need to know what she is recommending based on my previous medical record of my first delivery. 

Ultimately, Chris and I want to do what is best for our son and then what is best for me.  We want an unremarkable delivery which results in the three of us resting together happily in a regular hospital room and going home in 2 to 3 days time.

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