Choosing an Exit Strategy: VBAC Versus Planned C-Section
Though I've already had a C-section, I am not required to have another. Repeat C-sections are a popular choice among women who have had them before, and more than 9 out of 10 births following a C-section are now surgical deliveries. The reason is two-fold. After encouraging more women to try VBAC in the 1990s, the obstetricians and gynecologists group in 1999 advised that VBACs only be allowed in hospitals with an "immediately available" surgical team, which is why some hospitals don't allow VBACs. Also, some women don't want to risk even a small chance (0.5 percent) of uterine rupture during childbirth, which can lead to the death of the mother and child.
My age—35—is a consideration, as my risk of uterine rupture is slightly higher (about 1.4 percent, according to one study). And if my history is any indication, I will also have a large fetus, and I'll be over 40 weeks if I wait to go into labor. Both of these factors may also heighten my risks of rupture.
For me, the slight risk of a uterine rupture is enough to merit the risks of surgery. But with two daughters already, I'm also put off by the four week recovery that would follow a planned C-section.
After the baby is born, I plan to bring her home to her two sisters, who will also need a lot of attention as they adjust to the new arrival. How can I manage this situation while high on Vicodin, with my gut barely glued together? After a C-section, everything is more challenging: nursing, sleeping, lifting children—all of the essential skills of mothering three small children.
I know this from experience now. When doctors quote a four week recovery time, they mean it. You aren't even allowed to drive a car for the first two weeks. There is also a great deal more pain following the procedure, so avoiding painkillers is simply not an option.
Next Page: C-sections to avoid vaginal births [ pagebreak ]This is why I'm baffled that so many women are now opting for elective C-sections simply to avoid vaginal births. Instead of two days of post-labor pain, you have a month. Why would this be favorable?
Both Christina Aguilera and Britney Spears elected to have C-sections in order to spare themselves the agonies of a vaginal birth, and now that I've experienced both options, I recognize the appeal of skipping labor altogether. When my second daughter's birth devolved into an emergency C-section, I confess that I was relieved to be giving birth without pushing at all. And I secretly celebrated that my nether-regions would avoid the wear and tear of another large baby passing through.
Nevertheless, I'm toying with the idea of a VBAC instead. In addition to the much longer recovery time associated with a C-section, there's also a small risk of infection, heavy blood loss, blood clots in my legs, injury to me or the baby, or complications from the anesthesia.
Luckily, Health.com has a Decision Point guide to help in these situations, which includes some questions I hadn't considered. For example: Do I plan on having more children? If so, I should apparently try for the VBAC. After this anxiety-riddled pregnancy, another pregnancy doesn't hold much appeal, but am I willing to commit to that decision?
In the next few weeks, I will think this through, seek help from my doctor and various experts in the field, and research the art of the planned C-section. If we do go that route, how do we best prepare? And if we opt for the VBAC, my experience will vary greatly from the natural childbirth I experienced with my daughter, and I will need to learn how to mitigate the danger of uterine rupture.
I hope that this is the last big decision associated with this pregnancy, but one thing is for certain: Every day we become more excited about meeting this little girl.