There are women who feel they've been wronged because they've had cesareans. They sense they've been permanently damaged and feel the medical establishment has failed them in some way. I am not one of those women.
Robey was born by cesarean because he was no longer safe inside my body. My labor with him progressed quickly - from 5 cm to 9 within a few hours of being admitted to the hospital. But he was under stress the whole time, his heart rate was skyrocketing, he was face up in the birth canal - and then my cervix stopped dilating - just stopped dead at 9 cm for hours on end. So he came out through a small slit cut into my abdomen by a smart, capable doctor. I healed quickly and felt fully recovered within a few weeks. In reality my body probably took a bit longer than that to heal, but I was so overwhelmed by the baby blues and the burdens of early motherhood that worries over the surgery were the last thing on my mind.
There are women who are adamant about attempting a VBAC (vaginal birth after cesarean) for spiritual, physical and therapeutic reasons. I am not one of those women. So when I learned that VBAC is not an option in this small town (due to medical malpractice insurance premiums primarily), I was not alarmed. I felt a bit dismayed that I didn't have a choice but also a bit relieved that I didn't have to make the choice.
My doctor would schedule the C a week or so before my due date, I'd check in, adorn the gown, get drugged up and wait for them to cut into the fading scar just below my hair line and remove the baby from my womb. I'd never have to suffer through a single labor pain, my husband wouldn't have to pace the hall, wipe sweat from my brow or hear me curse the world for the pain of childbirth. I wouldn't have to weigh the pros and cons of epidurals, episiotomies, assisted births or the many other birth plan options. Plus, I'd get two extra days in the hospital and two extra weeks paid maternity leave.
At my last appointment, however, I started asking a series of what-if questions about the delivery that led my doctor to inform me about their practice's partnership with a larger, university-affiliated hospital in a city 60 miles away. There, I could attempt a VBAC. I would continue under his care until my 37th week when I would drive weekly to visit the doctors in this larger city. Then, when I went into labor, my husband and I would drive 60 miles to the hospital where I would attempt a vaginal delivery .
So now we've been doing the research, talking to friends and asking advice. Did you know the odds of delivering vaginally are higher for a VBAC than the odds of delivering vaginally with your first child? VBAC patients deliver vaginally 80 percent of the time and the vaginal delivery rate for first-time moms in the U.S. is somewhere around 75 percent. Plus, the risks of VBAC are low - so low that I'm still unclear why malpractice insurance companies won't cover them in most small hospitals.
I'm leaning toward the VBAC option primarily because of the recovery times. While I can't imagine a recovery much quicker than the one I had last time, I hear vaginal recovery times are even quicker. And, they say the recovery from a cesarean is much harder the second time around, especially if you have another young child at home. And - mind you - my child is a clingy, 30-pound toddler who still wants to be picked up, carried around and held by his mommy everyday. That's not likely to change when a new baby comes. Yet, I'll be under orders not to lift anything over 10 pounds for up to 6 weeks.
Jeromy was leaning toward the scheduled cesarean until he learned about the dangers of repeat cesareans. Though slight, your odds of complications in future pregnancies - including miscarriage - increase with each cesarean. Since our family plans may include more children, and since I have a history of miscarrying, why increase the risks of future pregnancies unnecessarily?
But then there's the 60-mile drive to the hospital. Did I mention my labor progressed quickly the last time? Seriously. I only labored at home for 90 minutes before the pain and the spacing of the contractions was enough to send us to the hospital - where I was admitted at 5 cm. I know every pregnancy is different, and I might not progress as quickly this time, but I could progress even faster. And I'm definitely not likely to stall out at 9 cm again.
Realistically, the odds of a highway delivery are slim, but the odds of a painful, hour-long drive in a highway-bound vehicle are a sure thing. That's 60 minutes of active labor with no drugs in sight. While we're likely to get there in time to deliver, we're also less likely to get there in time for me to be numbed from the waist down. Yes, I'm talking about an epidural. I don't know if I'll be screaming for it or not, but after laboring for 60 minutes in a highway-bound vehicle, I'd like to have the choice (see it's all about choices with me).
I don't have to decide today. Right now, I'm 26 weeks, so I have about 10 weeks to mull it over. In that time I'll be listening to my body, watching the baby's position, praying about the decision, reading about VBACs and asking advice from friends, doctors and co-workers.
So - if you have any advice or experience with VBACs, let me know sometime in the next 10 weeks.
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