I always thought it was crazy to think you could actually plan a child's birth. But I believe in knowing as much as you can about the birth, trying to figure out what you think will work best for you, listening to the doctors/midwifes/duolas/relatives/friends whose opinions you respect, and then going with the flow once the labor process starts. Most importantly, I believe it's so important to be flexible and not be set on how it has to be because babies, your body and nature are going to do what they do regardless of what you expect them to do.
I really believe that my feelings about flexibility and not mentally insisting that labor and delivery had to meet my ideal expectations helped me adjust well to the Pumpkin's labor and delivery. The labor which started with what I had thought were Braxton Hicks until my water broke at the movie theater, continued with 16 hours of labor in the hospital and ended with an unplanned C-section for her delivery. I never mourned "what should have been" or felt robbed of any particular experience. I was truly fine with the whole thing and was simply happy that I was a healthy mother of a healthy baby.
Now that I get closer and closer to my due date (June 19, 2009), I find myself constantly thinking about the boy's upcoming labor and delivery. With this child, I'm at a completely different starting point, as a woman who is pregnant after having a C-section. Right from the get-go, I (with my husband) have a choice to make towards planning my labor and delivery that actually will influence the start of labor: Do I try for a VBAC or just go with a planned C-section?
I've known (mostly online) many women who have had successful VBACs. I thought it would be no big deal, really. It would be something to try, and if I could do it great! If it ended in another C-section, fine. Been there, done that, could do it again. I also thought it was important for the baby to start the process of labor to help prepare him for the world, although I'm not sure where I got that from. So I thought we'd plan a C-section for just after the due date to give us time to go into labor and attempt the VBAC.
So since my first OB appointment with the boy, I've been telling the doctors I'd like to at least attempt a VBAC. Most of the doctors mentioned that there were risks, but it was up to me/us if we wanted to try it. My primary OB, Dr. A, said the same and didn't disparage the VBAC, but something in his demeaner gave Londo and I the impression that he was not a big fan of the VBAC. The only real words of caution he gave was that if this baby looked to be a big one, he would be highly recommending a planned C-section.
Apparently, the risks during VBACs with a larger baby are greater than VBACs when the babies aren't so large. The Pumpkin was 9 pounds, 5 ounces, and both Londo's family and my family tend to have big babies. As Londo pointed out to me, we have to assume this baby is also going to be large based on our history and family history. Londo has voiced to me that he is concerned about attempting a VBAC because of the risks in general and the heightened risk of a larger baby. I said I would look into the risks of the VBAC more and we'd discuss it with the doctors more. I will not make this decision alone because we are a team, and if he is uncomfortable with a VBAC I respect that and will not brush it off. Yes, it's my body. But I'm his wife, and this is his son. What happens to me and this baby is of great concern to him, as it should be.
So yesterday, we happened to see a different doctor at our practice, Dr. W. After the ultrasound (the boy's kidneys still look good so the doctors aren't concerned, and that was my last ultrasound!), we had our appointment with the Dr. W, who delivered the Pumpkin. (We love this guy! We love all the doctors at this practice, but this guy safely got out the Pumpkin!) I told Dr. W, "My husband would like to talk about the risks involved with a VBAC." Dr. W confirmed what Dr. A said about large babies, and he went into the risks specifically.
Apparently, there is a 1 in 100 (1%) chance that the internal scar will rupture. I knew this, but still didn't think there was much to be concerned about. But then Dr. W went on to say that the biggest problem is that they would have very little idea that there was a rupture, because the signs of a rupture? Pain and blood. What happens during labor and delivery? Pain and blood. So how can they tell?
A rupture can lead to many different issues that could affect mother and/or baby. Most of which I can't recall at the moment (I currently have the memory of a goldfish), but the two that caught my attention were possibilities of a ruptured bladder (bladder apparently lies on next to the incision scar or something like that) or need for a hysterectomy. I kind of like my bladder the way it (normally) is, and a rupture of it that they wouldn't even realize happened sounds like it would suck. And I am still hoping to keep my options open for a third child. (I totally forgot to ask what repeated C-sections mean for another pregnancy, but I will next appointment.)
Still, I did not have an easy time of it during the C-section and recovery from it. I start to tear up when I think about having to go through the recovery again: the pain of the surgery, being laid up in bed, the months it took to for the incision to heal, the year or more until the itchiness of the scar started to get better... Well, it just sucked. And that doesn't even include the worst part of my entire labor and deliver, which was being the surgery recovery area for 1.5 hours without my child or anyone except the very nice nurse who was checking on me. That was probably the worst 1.5 hours of my life, and I'm not exaggerating. Some of it was purely my circumstances, such as the nausea during the surgery leading to them not giving me anything to drink for SO LONG even though my mouth was as dry as a desert!
So we talked to Dr. W about planning the C-section and the recovery from it. A main difference from a planned one to an unplanned one is that I wouldn't be exhausted from hours and hours of labor. That is actually a HUGE difference and I think would make the recovery (short term and long term) go so much smoother. Also, they would give me something for the possibility of nausea before I started feeling nauseous. In addition, my mother can be in the surgery recovery area with me, AND Dr. W said that they now do some of the newborn checkup stuff right there where I'd be recovering! I'm pretty sure he meant where I'm recovering from surgery, but we are going on a hospital tour soon where I will find out for sure.
We are giving birth at the same hospital, but now they have Mother/Baby suites where Londo could stay the night while MIL stays with the Pumpkin at our house. No sharing rooms! No waiting on the verge of tears for Londo to walk through the door in the morning! No worrying about how others feel when I have the baby room-in with me! No strangers glancing into my curtain while I try to breastfeed my infant!
Finally, a planned C-section means that we will (most likely) know the date of the boy's birth and make sure everything is in place (this is huge for my hubby who is a total planner). We can set up our support system, make sure that my mom is available to be in that recovery room with me, and ensure that my MIL is at our house (5+ hours from hers) to stay with the Pumpkin. We will (probably) not have to sit around wondering when labor will begin and worry about gushing water somewhere inconvient.
The idea of going through labor again doesn't scare me. I like the thought of possibly delivering vaginally. But the more I look into the risks, the more I look into the benefits, the more I think about our history and the likelihood that my labor will most likely end in a C-section anyway... Well, let's just say that we are heavily leaning towards a planned C-section. My biggest concerns with going through another C-section really seem to be mitigated by the circumstances of planning and the changes at the hospital.
I'm open to any stories, thoughts, ideas, facts, statistics or whatever you guys have on VBACs versus planned C-sections. I will listen to it all. Londo and I need to figure out what is right for us, but as I said in the first paragraph I believe in learning all I can before figuring what is going to work for us. And even then, nature might have something else in store for us!