Which Birth - What would you do in my situation?!

[julezboo]

Hey

Jsut after a bit of advice, few history points first though

~ my ds was born by emergency c/s 4 yrs ago
~ I have a blood clotting diorder so I am on heparin and aspirin.
~ 5 mc's
~ I have lots of scarring on my belly, previous c/s scar, 12 inch scar going from belly button to c/s scar, few other small ones from laparoscopys.
~ my chances of rupturing is higher than most
~ my chances of bleeding heavy after birth/ if i ruputure is higher than most.
~ I need to come off injections at least 48 hours before c/s or birth!

Now I need to decide which birth I want within the next 7 weeks ready for my next appt. DS was born early at 31 weeks so ddnt have much choice with him, but have been told I can "trial labour" if i really feel strongly about it. I dont really, having another c/s doesnt phase me, at least this time it will be planned. But I wanted to ask what would you do in my position. I have a higher risk than most of rupturing because of all my scarring on my belly, if i did rupture I would end up with a c/s anyway, plus the hieghtened risk of bleeding heavier because of the heparin injections.

Now if i was to go for a VBAC i would be able to have a epidural unless they gave me a date and induced me because I need to be off the heparin 48 hours before. With a c/s we would know the date, therefore know when to stop them. Im probably not making much sense, I had already resided to the fact I was having another c/s but now the doc tells me I can try labour, should I at least try and experience it??

What do you think? Would i regret not trying? This is most probably our last child so I wouldnt get the chance again. Part of me does want to try it, but then another part i terrified of going through a vaginal birth, or getting so far and ending up with an emergency c/s anyway!

Thanks x x

[lemonaid]

Hmm. If you did a trial of labour, couldn't have an epidural because of the heparin, and then needed an emergency c/s would you be able to have a spinal block for the c/s, or would you need to be put under a general anesthetic? If the general anesthetic then I think that by itself would push me in the direction of the planned c/s where you could come off the heparin, have an epidural/spinal block and be conscious for the birth.

[julezboo]

hmm good point, thanks I didnt even think about that!

[hoppybird]

Hello julezboo,

I recently gave birth to a little girl by c-section - my first birth to my ds was an emergency section due to foetal distress in a premature labour (35 weeks). All through this pregnancy, I was really wanting to have a VBAC - I felt totally confident about it, knowing that labour was beneficial for the baby and I wanted the experience for myself, as I felt it would help with bonding for me, which I found hard first time around.

In the very last week before my due date, it was found that I had oligohydramnios (very little fluid) and was advised to go for a section, as the contractions without that cushion of fluid would send the baby into distress and = another em c-section. So I reluctantly went for an "elective". However, just after the birth, the surgeon told me that my womb was very thin and had torn at a right angle to my first section scar as my dd was born. I was obviously extremely relieved that I had gone along with the consultant's advice and chosen the section. However, any subsequent pregancies for me would be high risk, and I would certainly not be allowed to labour.

Induction is not advised in women with previous sections, as the resulting contractions may be too strong and put too much pressure on a scar.

So julezboo, in your position, I would go for another section, as you wouldn't be able to plan when to come off your meds, and if you've already been told you have more chance of rupture than most, then I'd take their word for it. If you don't feel strongly about wanting to labour, it won't be a great loss that you haven't experienced it. Part of me still wishes I could have given birth the usual way, but, hey, that's life.

Good luck with your baby and whatever mode of delivery you decide upon.

[hoppybird]

oops. Just re-read that - what I meant is that you couldn't necessarily plan when to come off your meds if going for a trial of labour, as inductions are not advised for VBACs.

[mummydoc]

labour is way overrated IMO, i have laboured twice , second ended in emergecny c/s after a placental abruption during early induction , followed by uncontrollable bleeding and a hysterectomy, if i had had the planned c/section that was suggested that may not have happened and i would be able to have a much longed for third child. a planned c/s though no walk in the park would definightly be the safer option for you by hte sounds of it - you have to think about the child you already have before you put yourself at risk by having a go at a naturel delivery. you are no less of a mothe rif you don't have a natural delivery despite all the pressure to do so . good luck with whatever you decide

[jasnDISMemBERED]

In your situation I don't think I would consider a VBAC.
I had one last year and it all went well for me, but I do not have the history you do.

Unless you are really desperate to try labour, which it doesn't sound that you are, why take the risk?

Your children will not care how they were born. A safe birth is much more important than a "natural" birth.

Good luck, whatever you decide.

[magnolia1]

I agree that I wouldn't go for a vbac in your sitation. I had a c section for dd4 3 years ago and was going to try a vbac this time but have stage 4 placenta previa so its another section but to be honestt The main thing is getting baby out safely for me and him and thats the safest way for us Sounds the safest for you and your baby too xxxx

[julezboo]

Thankyou for all your opinions, DP thinks i should give it a go, but he says its up to me in the end, I am kind of looking forward to the planned c/s (i know must be mad) I think I will go for that option, thanks girls x x

[EliBoo]

Sounds like you got to your decision, well done!

You're not alone, eihter - am in a similar position (32 weeks, last child, dodgy history, loads m/c, don't feel wildly strongly about it but bit wistful, previous section, wasn't expecting to be given the option of trial of labour even) and also have to decide soon.

I think I am 95% going for the planned section as things stand, and yes, I do feel a bit torn...but dh pointed out to me that (long story) we're lucky to be having kids at all, and perhaps giving up the opportunity of experiencing a vaginal delivery is just...par for the course, for want of a better expression.

It helped reading your thread - if you want to see mine, its lower down titled 'decision re mode of delivery' or something like that!

[julezboo]

Thanks eliboo, I just read your thread, Im pretty much 98% decided now after reading yours. Like one of the other posters on there Im a wimp when it comes to pain.

With my DS i was put to sleep, after the doc spending 2 hours trying to persuade me to have the spinal block LOL I was determined i wouldnt get a needle in my back at all, that all went out of the window of course when a day later i ended up in ICU and had 3 lumburepunctures, so I think after coping with DS's birth i can have the epidural this time!!

thanks again!

[3andnomore]

Normally I would say, oh go for trial of labour...but I think in your specific situation even I would go for VBAC...and seeing that you would feel happier with that anyway...