Tag Archives: vbac

To Push or Not to Push: That is the question

pregnancyThe third trimester has officially started at our house. Woohoo! As Raise a Mother regulars will know, this pregnancy hasn’t been the easiest, so I am excited to be heading into the homestretch.

At the same time, we’ve still got so much to do. When I was pregnant with our first, I carefully researched and planned, making sure we got things ready throughout the nine months so we wouldn’t have too much to do at the end. This time…not so much. One of the things we have yet to sort out? Whether or not to try for a vaginal birth after c-section (VBAC) or to opt for a repeat c-section.

We are fortunate to have health care providers who are committed to giving us all the information we need and then supporting whatever decision we make, (Shout out to Ontario’s midwives!)

Still, it’s a big decision. After all, it’s literally deciding how we want our child to come into this world. If you had asked me right after my son was born, I would have said, without a doubt, that I wanted a VBAC. I even asked my midwife at my discharge appointment what I could do to help to increase the odds of a successful VBAC the second time around.

I had a hard time with my c-section, both before and afterwards. I was disappointed when my son refused to move from his breech position – our little Buddha making surgery a necessity. I was scared shitless when my belly stopped growing properly around week 34 and then my amniotic fluid got low, ultimately resulting in our surgery being scheduled earlier than initially planned because little buddy was no longer getting the nutrients or space he needed. After the surgery, my body temperature remained too low for me to hold my sweet baby, so I watched from under an inflatable hot-air blanket as my husband had the first skin-to-skin contact with our son. I had to wait at least an hour to hold him, let alone try to feed him.

I felt like a failure whose body hadn’t done what it was “supposed” to do. It didn’t help that I, like many women who have had c-sections, had difficulty breast feeding. My son didn’t regain his birth weight for a full three weeks, and we ultimately moved fully to formula feeding after three months of struggling with a never-ending cycle of bottles, boobs and pumping. I promised myself that if I had the chance to do it again, it would be a vaginal birth all the way.

But now, more than two years later, I can honestly say I’m torn about what to choose.

Because I’m not the same Mom I was when my son was born. I have enough distance, perspective and confidence to know that I didn’t fail my kid when we had a c-section (or for that matter, when we switched exclusively to formula). In fact, that was me Mom-ing Up. We did away with my expectations of how things were supposed to go and instead went with what was going to work best for my kid and for our family.

Now, there is a big part of me that finds it appealing to go with what I’ve already done – the “devil I know”, so to speak. After all, there are so many things about parenting that throw you into the deep end, leaving you to either sink or swim. Why not choose the thing that’s more familiar – where you know what to expect – if given the option to do so?

On the other hand, assuming that all is going well and there are no complications, VBACs are statistically safer than having another major surgery – which is, of course, what a c-section is. Not to mention that the idea of trying to deal with a six-week recovery period with a two-and-half-year-old at home sounds far from appealing, if not impossible. Seriously, how am I not going to pick up my firstborn for six weeks?

And, just because my c-section no longer makes me feel like a failure doesn’t mean that I’ve given up my desire for that moment of having my child placed on my chest immediately after he’s emerged from my body. Do I really want to give up that opportunity voluntarily?

On the other hand (yes, I have three hands in this scenario), the idea of trying to have a VBAC and ending up with an emergency c-section scares me the most. The idea that I could shoot for the moon and end up with a birth where I feel even more separate from my baby – and both of us are put at greater risk – is my personal nightmare. So, does that mean we shouldn’t even try?

At the recommendation of our midwife, my husband and I attended a VBAC information session run by ob-gyns from a local hospital. The facilitator emphasized that we shouldn’t think of this as a single decision, c-section or VBAC. Instead, we need to answer a series of questions: Are we comfortable with any medically-approved induction methods or do we want to rely on my body going into labour naturally in order to go for a VBAC? At how many weeks do we give up on that and schedule a c-section? If we opt for an elective c-section, what does our birth plan look like if I go into labour before the scheduled surgery date?  etc, etc, etc.

I found this framing very helpful because it recognizes the many variables that come into play in any birth experience. My husband and I want to ensure that we are on the same page, so our plan now is for each of us to answer the questions and come up with what would be our own ideal birth plan. Then we’ll compare and find the plan that will work best for both of us.

Of course, the decision may not end up being ours in the end. I know all too well that kiddos have a way of rendering your well-thought-out plans irrelevant. The circumstances of this pregnancy may shift and a VBAC may no longer be an option. The best we can do is plan for the best-case scenario, be prepared for things to change, and keep our focus on getting our little nugget here safe and healthy.

I’d love to hear about your experiences with a repeat c-section or VBAC. Any advice you can offer to this mama-of-two-to-be?