Friday, July 22, 2011

C-sections up, VBACs down


 If you read my birth-story, you'd know that I tried to have J "naturally" for at least 7 hours of medicine-free labor. Well, I did have that one dose…but it only lasted an hour…and I don't even remember it helping that much.

My doc came in at 5:30 or 6:00 a.m. and said that I'd been pushing for 3 hours and suggested I have a C-section. My response: Just get him out!

I saw this article on Babble.com today titled "C-section Birth Trends: Why the rise in C-sections and the decrease in VBACs?" Some interesting facts:

  • At Yale-New Haven Hospital, 36% of births in 2009 were by C-section. In 2003, it was 26%.
  • Contrary to popular belief, very few moms actually choose a cesarean without a medical reason. In the Yale study, only 8% of the increase in C-sections could be attributed to moms' choice.
  • In the mid-90s, 30% of moms were having VBACs (vaginal birth after cesarean). Today, that number is 5-10%.
  • VBACs are uncommon because of the worry of uterine rupture, even though last year the American College of Obstetricians and Gynecologists said that, "a VBAC is a safe and appropriate choice for most women who have had a prior cesarean delivery". (I remember hearing this on the news during my recovery at the hospital.)
  • An abnormal fetal heart rate is one of the most frequent triggers for the operating room. (I HATED being hooked up to the fetal monitor. It HURT to be on my back for 15-20 min as the nurses tried to get a "good" reading.) The other popular reason is mom’s slow or stalled labor. (That was me)

The article says that "C-sections are going up for what could be called subjective reasons." In my case, I don't think I could have pushed any longer and was happy to have the C-section. Though afterwards, I certainly experienced my share of baby blues because of it (feelings of failure, etc.).

I have considered whether I'd try a VBAC for my second, but that risk of uterine rupture concerns me. Mostly, I think I'd be scared since I already know what childbirth feels like. Maybe with an epidural I'd be ok though. But what if there's no time for one? The second one does come faster. Also, it can be challenging to find a hospital that performs VBAC because of legal reasons. I'd have to find a midwife and childbirth center probably.

I know a few moms who've had C-sections for their first child. I wonder if any of them had (or wants) a VBAC...

5 comments:

  1. Also, despite what the ACOG says in its books, a lot of docs are afraid of malpractice, especially since OBGYN has a high malpractice %---so I think there are some docs who prefer their patients not to try for a VBAC.

    I know of a couple women who were "urged" not to try by their docs. I think there was a NYT article 3 years ago about how insurance companies also prefer women not try for VBAC.

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  2. I had an unexpected section with my first baby 6 months ago, and suffered from serious c-section remorse which I recently wrote about on my blog. I am very interested in a VBAC for my next pregnancy (which I'm hoping is about 3 years from now!), but the possibility of uterine rupture scares the bejesus outta me. I have some research to do clearly. Would love to hear from people who have had VBACs or attempted VBACs.

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  3. @Talking Thirty, I'd google The Feminist Breeder for her experiences! I think she did VBAC and then homebirth. Yea, the uterine rupture scares me too, also the pain. I didn't handle the pain very well the 1st time. Dunno if an epidural woulda helped either...

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  4. E1 and E2 were born vaginally and I had an emergency C with E3 because of a prolapsed cord. With E4 my OB actually encouraged me to go with VBAC. I was also very concerned with uterine rupture but had always wanted to have a natural birth so finally decided to not over think things and just go for it. Though dealing with the pain with no epidural was no fun (epidural does help with the pain if you are wondering, I got it with my first two births), I must say that when it comes to pushing, I think it is "easier" without an epidural because you can feel your body telling you exactly when to push whereas with an epidural you are numb to the pain and the urge to push is dulled, in my opinion. Personally I thought giving birth to E4 naturally and being a VBAC was actually my easiest. I recovered faster, no grogginess from the epidural to deal with after and actually was back to my normal self much sooner than all my previous births.

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    Replies
    1. That's really cool that your OB encouraged you to do the VBAC. I don't think many OBs would do that. At my 6-week postpartum appointment, I asked about VBAC and my OB said, "Well, since your first vaginal attempt didn't go well, chances are your next one won't go so well either." Encouraging, right?

      So you're saying I shouldn't get an epi for the 2nd one, if I go VBAC? Well, now I'm doubly scared ;). But I totally see your point and see the advantages!

      Thanks for sharing and encouraging!

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