VBA2C Advice, Info?

New recommendations recently came out from ACOG recommend that even those who have had 2 c-sections can be candidates for a "trial of labor"

http://www.acog.org/from_home/publications/press_releases...

I would discuss with you OB and with a midwife to see if you are a candidate.

I believe the American College of Gynecology's guidelines on VBA2C is that only mothers who have had at least 1 previous successful vaginal delivery are considered as viable candidates for VBA2C. Even then, it'll be very difficult to find a doc willing to allow you to labor.

I have also had 2 previous c-sections and was really bummed about not being able to have a vaginal delivery, and I think I will always be a bit bummed, but I know deep down that it is best. (My 1st was an emergency section due to my son being wrapped in the cord about 3.5 weeks before his due date. The 2nd was an attempted VBAC for which I was induced (not a great idea, I know.)).

Check out the website: www.ican-online.org

I don't think VBAC is a viable option after a SECOND cesarean, but I am not absolutely sure.

Im also having a 3rd CSection in January after 2 csections. I didnt even entertain the thought of a vaginal birth. Ive heard stories of women becoming depressed because they ended up with a csection but I dont understand it. Being pregnant is an amazing experience in itself. No matter how your child arrives you are apart of a miracle. Many women would give anything just to be able to carry a child.

I know you are looking for success stories but dont set yourself up for disappointment if this doesnt work out the way you hope.

a VBAC after two c-sections would put you in the high risk category and I don't think it's a good idea to do that at home with a midwife- mainly because if something happened and the stress of labor caused your uterus to rip- you would not have time to make it to the hospital. - Your baby might survive, but you would not and I think that any midwife willing to take that risk is not a midwife you would want to have.
Even a VBAC after one c-section is risky. I did have a VBAC after 1 c-section and I am very thankful that I was able to experience it- we had moved by the time we were pregnant with our third and the new hospital had a "no VBAC" policy so I had to have another c-section.
I would talk more to your doctor about it to see if it is an option he is willing to do with you and also what the hospital policies are. If it is something both you and your doc feel comfortable with- I would say go for it! But since you are a high risk pregnancy(after a c-section you are considered high risk because of the scar) be prepared for the likelihood of an emergency c-section if things aren't going the way they were planned.
Good Luck!
~C.

I applaud you for doing your research and becoming educated. I know SO MANY women who have had VBACs, but not after 2. I would schedule a consult with a homebirth midwife. She will be frank and honest about your possibilities and also how to maneuver "the system" should you go the hospital route. Good luck!

To me it didn't matter how my kids got here as long as the delivery was safe and my kids were healthy. My 1st was an emergency C-section, my 2nd was a VBAC and I had failure to progress so I had another C-Section. My 3rd was a scheduled C-Section after having 2 I felt it was better to have another C-Section.

I didn't feel like I missed anything, my concern wasn't the type of birth.

My two births were completely different. 1st was 7 weeks early c-section due to amniotic sak leak. 2nd was successful induced vbac at 42 weeks, cord around his neck twice, meconium, and level 3 episiotomy.

I would't feel bad about things thinking that you've missed out on anything. Labor is hard, often long, and comes with it's own set of possible dangers to yourself and the baby, just as a cesarean does.

I opted for the vbac because my recovery from my C was long and I had residual pain the entire 2nd pregnancy. My doctor was very frank with me about the potential dangers of the vbac and made me understand that she at any time during my labor could decide to operate if she saw a need.

I think the only reason that my vbac was successful was because I was actually in light labor that morning. But I was only dilated to a 3, and the baby had not dropped because of the double nucal. Fortunately, most of it went well and he was out and healthy, within 4 hours of starting the pitocin.

Every delivery is different. Having had 2 C's you know what your risks are. Follow your own intuition - but make sure it is your own. Everyone will have strong opinions on both sides which may seem to sway you. Be sure your do what you feel is best for you and your baby.

My strong opinion, take it our leave it: a home birth is not an option for you. If anything goes wrong you will need to be next to an operating room. Death of yourself or your child is not an option, so don't put yourself in that possible position.

There is a chance that you won't even go into labor on your own. After two c-sections, your body may not be able to figure out what to do. Inducement is not recommended for vbacs because the strength of the contractions is harder on the uterus than natural labor.

Possible options at the hospital: a room with a hot tub that you can relax and warm up in prior to your water breaking, delivering on all fours or squatting instead of on your back, no IV so you can get up and walk around to speed things up and get the baby down lower, music birth therapy or hypnobabies - I know a few who swear by these methods.

Best of luck either way. I would love to hear how it goes!

I would have a midwife with experience with VBACs evaluate your situation before assuming you can't do a home birth. It's too bad thee are not more free standing birth centers around. Midwives would know about those as well...there real reputation. (I've had some friends let down by birth center experiences ...it's not just hospitals.) Best of luck to you. If you have insurance you may have to talk to more than one person to get any treatment that is not the "standard of care"!

I'm glad to see moms like yourself thinking about C-sections and VBACs. C-sections are life-saving surgeries and I'm happy we have them as an option, but in my opinion shouldn't be viewed as just an alternative to going through vaginal delivery. There is risk to both vaginal and C-section delivery. I highly encourage you NOT to look for a midwife who will entertain the option of homebirth for you should you become pregnant again. Any midwife who is willing to assume the risk of a home delivery after 2 prior C-sections is not a wise one. The risks are just too high. However, depending on why and how your C-section was done, you might be a candidate for a VBAC in the hospital with much surveillance. An experienced, competent physician/midwife who has done many VBACs. The goal of every pregnancy should be a healthy baby and healthy mom--in the end that is ALL that matters. Vaginal delivery is definitely an experience (painful, but wonderful in it's own way), but not to be seen as the ultimate or best way to have a baby. Thank God for C-sections because I believe today they have saved the lives of many. It's just too bad that they are so convenient and common place for sometimes they are done when they are not necessary or best. R., nurse midwife and married mother of 3 little ones

I was the third child and born vaginally after my mother had two c-sections...and that was well over 20 years ago. I personally say go for it. I watched the Business of Being Born too...made me choose a midwife for #2- BEST decision I ever made. And honestly, natural vaginal birth is not that bad. I think the epidural/hospital birth was much worse even though it was relatively pain-free. I'd do a natural home birth any day. Good luck & go with your gut!!!

This link has lots of stories: http://www.plus-size-pregnancy.org/CSANDVBAC/VBA2Cstories.... As a doula, I have been to a VBA2C (and 3rd vaginal birth). Another friend had a VBA2C this year that went well. The overall rate of successful VBAC is around 70% - so the odds statistically are for you.

I'm currently (slowly) listening to the archives of the NIH VBAC conference from March. If you're interested, that's another resource. I haven't gotten to them talking about VBA2C versus 1C, but from what I've heard before, it's not as big of a deal as the general impression. It's after 3 or more that the risks start going up dramatically of even being pregnant.

But after listening to the NIH Conference, I've been thinking how VBAC is such a complex issue, and the decision should be made by the mom after the process of being informed, like you are now. I would seek out a midwife/OB/doula who is well-informed and generally supportive of VBAC for some counseling. I know Paula Matthew White in Prescott does VBAC counseling. Another place to explore this decision is at an ICAN meeting. The next ICAN meeting Weds NOV 3rd, 7-9pm at Blossom Birth Center.

As for where to give birth, homebirth midwives in AZ are not allowed by licensing guidelines to attend any VBACs. I'm pretty sure VBAC is not an option at either birth center in Phoenix, either. I've heard names of good hospital providers for VBAC. I forget the OB's name, but the midwives at Bethany Women's Center (?) do VBACs. Send me a message if you'd like me to look that up again. Or I'm sure you'd find out at ICAN.

VBAC is one of my areas I'm especially interested in as a doula/childbirth teacher. If I can help anymore, feel free to send me a message.

My first was a scheduled c-section because of a breech baby and then I had a VBAC. But, my Dr. said that if things didn't go well, she may have to do a c-section. But luckily, it went just fine. There's no way I'd have done it at home. If the uterus were to rupture, a definite risk, you would need to have another c-section. This is definately something you would have to discuss with your docor.

Of course it is possible. I've had 2 c-sections, neither of them scheduled, but now the ob/gyn had a lot to do with the outcome. I am pregnant with my third and this time I found me a doctor who believes a vaginal birth is best even after several c-sections. I am due in a month and am planning a natural birth. Have a doula too. Dr Steve Nelson in Phoenix is who I am going to.

I think anything is possible. But I would talk to your doctor a lot about the risks. Were the previous c-sections scheduled because of complications or were they elective?

I had two emergency c-sections. My third pregnancy I finally had an non emergency c-section. They had to work carefully because my bladder is attached to my uterus but they did not have to rush as before. The nurse placed my baby on my chest as they finished sowing me up. I really appreciated that because that was the part that I felt that I missed from not having a vaginal birth.

So, learn all you can, be prepared for anything, and put the health of your baby and yourself in the forefront.

Good luck!

I sat go for it. I am trying hard to find a doc who will do it for me. I had 14 years between. Absurd that the gap even counts. MIne were breech and placenta previa.

I had a VBA2C at home with midwives!! Best birth ever!