Confused about what to do for birth

Honestly I seem to be in the minority on these forums, but I have no desire for the VBAC whatsoever, my first section (planned after failed induction) was such a lovely experience, really calm and fast, and though recovery was a bit rubbish I was happily on my feet and basically back to normal a week later. So I am really looking forward to going for the section this second time around.

But you'll know best what it is that you want and how you want your delivery to be. I had to really push for my first section, I was very firm with them and eventually they let me sign the forms and go for it. If you want the VBAC, they will obviously help you - but make sure they don't push you into something that you know isnt for you. If you want the op, tell them that.

Good luck either way!!

Hello!

I had an emergency csection the first time round, 2nd time I REALLY wanted a natural birth but again it didn't happen so had a csection. 2nd csection was such a nice experience, I'm not even going to stress myself out thinking about it. I'm booking another cesarean but if anything happens before hand I'll give it a whirl I spent so long stressing last time because I wanted to do it naturally. This time I really don't care as long as it's out one way or another

Not much advise or help i know but thats what I'm doing xxx

I’ve only ever done natural births but my friend said her 2nd planned c section (first was emergency), both the surgery and recovery were amazing and peaceful. So a planned section would likely be a positive experience.
I’m not sure another vbac would be better than the 2nd Tbh, my 3rd delivery was quite a bit harder than my 2nd... hoping my 4th is easier than the 3rd!!

You should study the research and get back with your providers. I've heard something like every 1 in 3 deliveries is c-section and these aren't needed. They do carry risks, and not simply to that one pregnancy.

For example, you may feel you are done having kids, and maybe you will stick with that conviction. But let's say the US goes to war with China and you can't get reliable birth control (I have no idea where birth control is manufactured...), well, then let's say you get pregnant again and the placenta attaches to your c-section scar and then ends up with you and the baby dying in a placental abruption. This is a risk of c-section and it increases with each one because (I don't think) the doctor opens you up at the same scar site each time. And how he cuts you is very important.

VBAC is an option many women have been fighting for. They believe that it can be a safe option, and some women even want to do it outside of a hospital setting! So it must be *generally* safe, and I am encouraged that medical professionals are actually encouraging you to do this! I think it's awesome.

I have given birth five times vaginally and with no pain meds. I am horrified at the routinization of c-section. There are lots of healthy mamas who don't want them and get bullied into them even when their intuition tells them "no" and statistics prove that all these women who think they *had* to have a c-section really didn't. Mostly this happens because women don't put their foot down. But the women themselves never realize that they were not really saved by c-section. They always think there was no alternative based on their experience. There are always rare cases that it is the only option for or could have saved if it were used but it was impossible to know.

(I just want to say with an intervention like ultrasound, studies show that with ultrasound there is no improvement in birth outcomes at a population level. Obviously, there are birth situations that can be helped by detecting them through ultrasound, like placenta previa. So what does the data mean? It means that for every "save" of a mother or baby there is a death of a mother or baby that is the result of ultrasound, whether miscarriage due to the technology, or death or injury from the interventions that result from true or false detection of issues. Most people don't realize rhat the data showing that routine ultrasounds don't improve outcomes doesn't mean that ultrasounds are harmless, but that for each woman and baby helped, another is harmed. And this is kind of how *I* think every woman should think of c-section and why it should never be used unless actually needed, and I think your experience is showing that medical professionals are changing their perspective on that.)

Anyway, I understand that your idea of the best way to give birth probably will and does impact your health and birth outcomes in some way. So if you believe from research, not common practice, that the c-section will be *as safe* as VBAC (or nearly so), then you could try to insist on your way.

But if you find that not to be the case, watch a documentary like "The Business of Being Born" and do research on the dangers of c-section to see of you might be won over to the more natural method of childbirth. It will be important to you to believe that the way you are giving birth is not the most convenient or familiar, but the safest and healthiest.

I am not saying this as anyone who knows anything about the actual statistics on VBAC and how they compare to another c-section. I just know that c-section has dangers, particularly in cases where women will have more kids. You may not think you will now, but there are women who might have two kids with a husband and then divorce and remarry (which you never expect or plan to do!) and then want to have one or more kids with the new hubby. Or your attitude about having kids changes. So it's advisable that particularly young women in their 20s and 30s really consider that your decision has implications beyond this one time birth. But it certainly also could be more or less important toward this birth outcome too.

sky2012 said:

thanks for taking the time to reply, I really appreciate it! I do feel they want me to try for a natural and sometimes when people talk they make out as if your less of a woman if you haven’t given birth naturally! My experience with the c section was same as yours. Only thing stopping me from c-section would be that I have 2 other kids to look after aswell the newborn so may be tricky but then again if I have an episiotomy again I’m in the same boat! Lots of thinking and weighing my pros and cons I know . Hope your pregnancy is going well and your section goes smoothly for you x

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Hm. I had an episiotomy with the first. This was because my female OB who says that womens' bodies usually tear in the best way for them compared with episiotomy, which often causes a bigger tear, was out of the country and I had a young male doctor instead. So when he did cut me, the cut split deeper, but I didn't have as bad as some women get as a result of episiotomy.

I told him beforehand that I did not want an episiotomy, but when the baby's shoulder was stuck (not for very long, but this scares doctors because the baby needs to come out soon at the shoulders otherwise the cord is compressed and the baby can die...), he cut me anyway without asking as he probably deemed this a medical emergency. On the otherhand, I had already told him no about screwing an electrode into my baby's head to more closely monitor the heartbeat. I told him if the heartbeat got below his comfort level on the normal monitor, I woukd go in for a c-section, but I was not going to screw something into the top of the baby's head!

What should have been done when the shoukders were stuck is (1) a new mom should never deliver on her back, so change position to something more desirable like hands and knees. A fiest time mom's vaginal muscles have not yet stretched before and she will not have enough space in per pelvis in a back position to help a first time delivery. Then, if the baby gets stuck at shoulders, there is a window of time (maybe a couple minutes) and something like two pushes the woman can try before it is an emergency. I doubt the doctor had me try two pushes - he certainly didn't get me in a better position (the hospital staff asked if I wanted a birth bar at the beginning of labor, I said yes, and they never brought it). The doctor should also manually turn the baby by putting his finger just inside the woman, catching the baby under the under arm. He can pull each should out and/or spin the baby (I don't recall the correct order). I think when doctors panic, they snip because they don't want to perform the other manuever for whatever reason.

Babies rotate as they come out of the birth canal. The shoulders should be delivered so that one shoulder is pointing toward the mother's stomach, and the other toward her back. So the head comes out usually with the face toward the mom's back, and this means the shoulders are also in the birth canal horizontally (if the woman is lying on her back), the body then gets rotated in the canal in order for the shoulders to be delivered. This haooens naturally, but if not, the doctor can assist with rotation and can even get the baby pulled out by delivering the arms, etc.

I supoose one reason thry may not want to do this is because parents might be upset if a newborn baby gets a dislocated arm or something. Maybe they get sued? And so maybe legally it is better to cut the woman before performing any other manual techniques on the baby. But it woukd be nice for them to discuss this fully with the woman and for the woman to be in the best birthing positions from the get go. Also, they numbed me in my private part for labor, which they did not ask me about and I did not want. So it's possible that interfered in some way. For example, right before the head comes out, the woman naturally stops pushing. This gives more time for blood flow around her perineum which helps her stretch without tearing, and plthat probably contributes also to whether or not she can quickly deliver the shoulders.

But after that first delivery, I did *NOT* ever need another episiotomy because my lady part had already stretched before. I don't even think I ever tore again or if I did, I never needed stitches, and I've had five babies naturally.

Also, when I had the episiotomy, it was something like a 2nd degree cut. But I didn't seem to notice any difference in recovery times after the vaginal births where I did not need stitches. I've heard c-section takes six weeks to recover from, but I rebounded very quickly after natural childbirth. With my first, of course, that was different because everything was new to me, but itnwas nowhere near a six week recovery by any means.

I am thinking episiotomy should have nothing to do with recovery unless it is significant, like 3rd or 4th degree tears (I have no idea how that affects someone).

Otherwise, if it wasn't a significant degree tear/cut, do you think that you may have had a drug interaction from any drugs you received during the vaginal birth that would have been different from drugs given for the c-section?

LoneWanderer said:

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This is a bit off topic, but an edit to what I said above:

I just realized I did not have an episiotomy because of shoulder distocia. The doctor gave me one apparently for no good reason after I already had discussed with him that I did not want an episiotomy (as I discussed with my normal OBGYN, who said she lets women tear on their own if it's going to happen). I probably could have sued the doctor, but I forgive him. My husband and I both discussed this with him not even an hour before the birth...

All these years I assumed the cut happened when the baby's shoulder was stuck (I am not sure it was a true distocia even...but time is of the essence). But since I wasn't watching, I hqd to double check with my husband. My husband confirmed that the cut happened before the head was out.

I also know they numbed me *down there* without consent with some kind of cream, though I had no official local or other anasthesia. I thought they did that for the crowning of the baby. I now realize they did that all without consent so that the doctor could cut me. I think even though it has been 12 years, I am forgiving, but I will be emailing him to let him know that I know he performed a medically unnecessary procedure on me not only without consent, but with exactly the opposite.

I was only 20 at the time and my husband 21, so we did not kniw that what the doctor was doing was completely illegal. From my other births I now know that there wasn't anything happening during the birth for him to think, "I need to cut her." It was just his way of medically managing the birth without permission. He might have justified it to his self thinking that I have no right to dictate that I shoukd not have an episiotomy since I'm not an expert and am perhaps confused about what is in my best interest as a patient. However, I did feel informed, and 12 years later I continue to believe that I did not need an episiotomy.

Let me restate and clarify: My husband and I told the doctor NO episiotomy. Should distocia only happens when the head is out, but the shoulders don't come in the next one or two pushes. The baby's head was NOT out at all, and the doctor discussed an episiotomy with me to which I consented (I have no recollection of this, which I assume was due to being in labor and pushing) because he said the shoulder was stuck. As far as I know now, the shoulders can't be stuck if the head wasn't out!!! So he flat out lied to get me to consent to an episiotomy.

My husband says there never was a distocia because the baby did come out without additional interventions, but the distocia is the reason they told us the baby had to be cut off the umbilical cord immediately to be inspected, which we had said ahead of time we did not want so the baby could get all of his cord blood which has healthful stem cells and such.

So it was all one big lie. No distocia. No need for episiotomy, no need to cut the baby off the cord suddenly. And I am just figuring this out...as I think through episiotomy and natural childbirth and recovery.

I've had five live all natural births, two at home unassisted. So when I say that recovery without medical interventions is easy, I really mean it. I would love for childbirth to be painless, but for me it wasn't, but recovery was very easy.

Sky2012 - if you ask 100 people what they think you'll get 100 different answers and its likely that none of them will apply directly to you. There is any amount of information available and you could read it and still feel unsure. I'd say go with your gut, put a loose plan in place and see how it goes, let's face it you could schedule a csection and deliver in the car heading to the hospital! The most important thing is you and your fabulous baby's health and safety (mental as well as physical). Very good luck when the time comes.

I have to second Rags.

And everyone has an opinion about everything. I get judgey looks all the time because I got an epidural. As long as you’re feeling comfortable and safe and happy, ignore everyone else. Wishing you a lovely labor and delivery when the day comes