Wednesday, March 27, 2013

The big VBAC (or not) decision

With Truitt I was induced at 39 weeks and 2 days.  He was suspected to be big, I was already 3cm, and I was in a lot of pain from SPD.  The induction went well and I had no problems dilating but he would never drop past -2 station.  We went on with the csection and my 9lb 12oz baby boy was soon in my arms safely.  Do I feel like I need a csection? Absolutely.  Had I not gotten an epidural and was able to labor squatting or on hands and knees, and had he been smaller, and had he been in a better position, and had my pelvis been better aligned then maybe he would have come out vaginally but there were too many things going against us.

I never felt like I was cheated.  I didn't feel like his birth was something to be ashamed of or traumatic.  I didn't hate the experience.  I gave labor a try and it didn't work for us so we did what was the safest.

Before we were TTC #2 I began looking into VBACs, vaginal birth after cesearan.  I felt like this was something I really wanted to pursue.  If I was proactive from the start then we could eliminate some of the issues that contributed to us needing a section.  If I followed a low carb diet, baby would maybe be smaller.  If I went to a chiropractor, my pelvis could be as open and best alligned as possible.  If I hired a doula, I could labor more freely and it better positions to assist baby in descending through my pelvis.

I knew I'd be faced with a major decision- our hospital and my OB do not allow VBACs.  The main reason being that while a VBAC mother is laboring, the OB must remain at the hospital in case of rupture.  When we were about 12wks pregnant we had a consult with one of the main VBAC doctors in the DFW area.  He told us point blank that out of all of the reasons why people have c-sections, that my situation (baby wouldn't descend through birth canal) is the least likely to successfully get a VBAC.  This was discouraging but hadn't taken away my hopes for a VBAC.  We didn't care much for his personality and didn't feel like it was worth switching out OB care to him with little chances of success and the next closest provider that is recommended for VBACs is over an hour and a half away.  Our plan was, with the help of my doula, I was going to labor at home until transition.  We would then show up at my original hospital, with my original OB, and hopefully be near delivery so since the Dr was already there then we would be able to finish with a vaginal delivery.

This all changed when they mentioned my anterior placenta at my elective scan at 17 weeks.  The chances of rupturing with a spontaneous labor are very low.  In a typical pregnancy with a posterior or fundal placenta, IF rupture were to happen, the placenta stays intact on the back or top of the uterus and you have enough time to get baby out even if you're at home when rupture happens since the uterus burst from the front bottom at the previous scar site.  With an anterior placenta, rupture is most likely catastrophic.  THE VBAC doctor (he's over an hour and a half away) in the DFW area- the one that will do VBACs after multiple c-sections, or breech babies, or multiples, etc, even discourages mothers with anterior placentas on VBACing and if they want to pursue them then he wants ALL of labor to be done in the hospital which is the opposite of normal VBAC recommendations of laboring out of hospital as long as possible.  This meant that there was too much risk to continue our plan. The final kink was thrown in the plan when we found out that not only was my placenta anterior but it was also previa which in itself requires a c-section.  Thankfully the previa has moved up but it is still very low lying and completely covering my scar.  If the scar goes, the placenta instantly loses bloodflow.

So, our new plan is to go forward with a c-section.  I am slightly disappointed but I know that once again in this situation that a repeat section is the best and safest for us.  I am still hoping to go into labor on my own so that I know Bennett is ready but that will only be able to happen if he decides he's ready before 40 weeks.  We will see how things go but hopefully this results in the best possible outcome of a healthy baby and momma!

1 comment:

  1. i think it is so neat that you even looked into it! & awesome for you for reazling it isnt the safest option for you & bennett! :)