VBAC or Elective C?

I had my first midwife appointment today and she asked how I felt about this question, and I can’t say I haven’t thought about it a lot, but I am nowhere near reaching a decision!

VBAC (Vaginal Birth After Caesarean) or an Elective C-Section?

During my previous pregnancy I had high hopes of a natural delivery, hopefully including a water birth. Because of my SPD I felt this would be the best route as the water should help support my pelvis and limit at least some of the pain! I was quite open regarding pain relief and figured that as I had no idea how labour felt, or how I would react to that pain that the best approach was to see how it went and make decisions at the time.

Then, Monkey was Breech. After lots of attempts to turn him, ranging from being advised to ‘visualise the baby turning’ which hubby helped with by turning himself around in bed (lol, which was hilarious, and ridiculous, but sadly DIDN’T help!) to having a consultant attempt to forcibly turn him in the womb via an ECV. That was seriously painful and not an experience I’d care to repeat! It obviously comes with some risks too.

So as he refused point blank to turn around it was recommended that we have a C Section. I hate the word elective as it feels like somehow you are choosing that option, for no other reason than you want one. What they mean is ‘planned’ rather than ‘emergency’ so I wish they’d just use the word planned! Anyway, digressing, I know it is possible to deliver a breech baby naturally however I did do a lot of research and found evidence to suggest that since C-Sections have become the more popular option in breech cases, that the skill level required to deliver a breech baby naturally isn’t found as commonly in hospitals anymore. While you may be lucky and have a midwife who has delivered breech babies, and knows exactly how best to do it, you may also have a midwife who has never delivered a breech baby before, as they are more commonly born via C-section. This means that the risks of a natural breech birth are now actually higher than the risks of having a C Section. (That is how I interpreted the research and advice I received at the time – I am not a midwife, doctor or scientist and it may not be correct, all I can do is say how we made our decision.)

So we opted for a C-section. Now, it turns out that I have a Bicornuate Uterus (sort of heart shaped rather than round) and Monkey had no chance in turning round, because he was stuck in one side and could not turn. The consultant advised that there is basically a 50/50 chance that any future pregnancy would also be breech, which would mean there isn’t much of a decision to make and we would go for a C-Section again without question.

But the question is, what would I do if the baby is not breech. Would I go down the road I know and have a C-Section regardless? Plan it in and eliminate all doubt? Or do I think back to my original hopes for my previous pregnancy and aim for a natural water birth?

Now, don’t get me wrong, I don’t relish the thought of going under the knife again. I would much rather not have the post surgery recovery time, the agony of life that is post C-Section, when you realise more than ever before how important your stomach muscles are and how debilitating it is when moving them causes you agony! I don’t want to be in hospital for days post birth again, being kept awake by all of the other babies on the ward, in addition to my own, struggling to care for baby in those hours overnight when hubby has to go home and I can barely move. That I am NOT looking forward to should I choose that route.

BUT, and it is a big but, the birth itself was calm and relatively stress free.We knew the day, I went to a wedding the day before, knowing the next day I would have my baby. We checked in and were second on the list so Monkey was born by 10am. there was no pain pre-birth, it all ran very smoothly and was just lovely and calm.

I am a planner so for me the unknown elements of giving birth have always terrified me somewhat. When will it happen? Will I go to hospital too early and be sent home? Will I leave it too late and not get there in time? How bad will the pain be? How will I cope? (I’ve watched one born and I know some women cope better with the pain than others – not criticising, we are all built differently and can’t compare, it’s just hard not knowing how it will be for me.) Will I need an epidural? What if something goes wrong? What if I need an assisted delivery? What if I need an emergency C-Section anyway and still have all the negatives of a C-Section, without the benefits of the calm build up?

Add to this the SPD, I know women with SPD give birth naturally all the time but there are added complications and there are fewer recommended positions, for example being on your knees is recommended far and away above lying on a bed with your legs in stirrups.

Am I just nervous? Is that why I am hesitating? Am I a coward for wanting to go down the ‘known’ route of a planned C-Section? Am I less of a woman if I never go through the experience of a natural birth? Am I missing out? But then should I take the option of a natural birth (which comes with it’s own risks as well after a C-Section, including tearing the uterus scar) purely to avoid these opinions? Should I be swayed by such negative thoughts?

I am not going to rush the decision as I am well and truly divided over which I would prefer. I may end up having very little choice anyway if this baby is breech too, so in some ways I don’t want to get my hopes up for a natural birth. I am being referred to the VBaC Clinic, where they will hopefully be able to give me some further advice and help me to make an informed decision.

have you had any experience of this decision? Which way did you go?

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53 thoughts on “VBAC or Elective C?

  1. A great post & i’m sure many women out there can completely understand where you’re coming from. I had to have an ‘emergency’ section with bear, after 50 odd hours of labour on just gas & air (after wanting as natural as possible, & practicing natal hypnotherapy!), & I often wonder what ‘route’ i would take for the next bubba. One of my good friends who shared the same birth story as me, in fact just had her 2nd & we went through all the scenarios you’ve discussed: She opted for the planned (elective) section & was so pleased she did. I think you’ll know within yourself what is the right choice & there is no rush, let your body tell you & don’t dwell on it. Having medical intervention for the birth of a child (in which ever shape or form) certainly makes you no less of a woman.
    Ooh, I’m so broody now!! :) x

    • Thank you, oh god bless, it must have been so hard and one of the reasons I am very tempted to go for a planned c next time. I don’t blame your friend for wanting to do that either, I can’t blame her for not wanting to go through it all again. Maybe I will too, sometimes it’s better to stick with what you know. We shall see I think! Thank you for the lovely comment, sorry to make you broody ;) xx

  2. I also have to face this decision I had to have an emergency c section and I was very ill afterwards. I was told I had to try VBAC and this scares the life out of me because of the labour I had before hand. I’m really hoping I can have a planned c section this time. To be honest both options scare me and I’m really hoping a planned section is so much better than an emergency one. I have to wait and see what route they let me take!

    • Aww bless you, I can completely relate to your fears and I hope you can have the planned C section. Sometimes you have to really push for what you want, and I have to say having the planned C section was such a calm experience so if that is what you want, I say push for it, it’s your choice as the one going through it. They will always want you to have a VBAC as has got to be cheaper for them, but they have to listen to your wishes too. I’m sorry to hear you were ill after the c-section too, like you say, both options are a bit scary. Whatever happens I really hope that things work out well for you!! xx

  3. Oh my! I have a Bicornuate Uterus too! You’re the only person I know who has one apart from me!!

    My first was breech and I had a planned c-section….I was told all the way through with my 2nd that she was breech too until the last appointment at 36 weeks that she wasn’t and I could have a normal birth….The doctors were not very happy but I wanted the c-section….In my head I’d prepared myself for it throughout the whole pregnancy…..I wasn’t mentally prepared for a natural birth….

    If they had said at the beginning of my pregnancy I could have a normal birth I probably would of been fine and gone with it though….I would of liked to know what it was like to go into labour but I don’t feel bad for having a two c-sections!

    Good luck x

    • Oh wow, and ditto! Gosh I don’t blame you, being mentally prepared the whole time for a C-section then having the game change at the last minute – well done for pushing through to have the c-section. It is funny not knowing what natural labour is like isn’t it? But like you say, there is no reason to feel bad for having a c-section, thank goodness for modern medicine in my opinion! xx

  4. Oh my goodness, decisions like this are impossible.

    I’m the opposite way around. My first birth was very traumatic. I was induced, son came out arm first and got stuck, I needed ventouse then forceps and I lost a lot of blood. I needed to have a blood transfusion to keep me alive.

    My second birth was an elective section, although my waters broke early so I ended up starting labour and having the section two weeks earlier than planned.

    My advice would be to follow instinct. There’s no right or wrong. Don’t let other people try to sway you. It’s your body and you’ll be the only person who can know what is best for you.

    Good luck!

    • Sorry for the late response to this, I somehow missed it this morning! My goodness though, it does sound like your first was very traumatic, and then with your waters breaking early with your second? Certainly nothing calm about either birth! Thank you for your lovely comments, I think I just have to wait a while and see what happens, and then trust my instincts when it comes to making a decision! Xx

  5. I had a horrible, very much emergency c-section with my first. Baby basically took 5 days in the birth canal when the staff finally saw her crown it was her neck, so she had to be dragged back up and taken out the ‘sunroof’. Worse still the retrieval of her meant that the surgeons ripped my womb in several places and I sustained (temporary) damage to my bladder. And yet still worse, due to inappropriate after care I ended up in Intensive Care (without my baby who had to stay with Daddy) 3 weeks later. I cannot tell you how sad that still makes me. It utterly ruined my birth experience. When I was pregnant for a second time (yes, I think people were a bit shocked I ever wanted to be again!) – I too had no choice about delivery – the tears in my womb could apparently open back up during labour, so a c-section was my only option. If I had a choice though I would have gone for a ‘natural’ birth – and hoped baby number 2 wasn’t in some silly position. However I would have demanded a c-section much earlier if the birth was proceeding slowly (which in my opinion probably would have prevented all the drama the first time). C-sections really do ruin your tummy – my first one was barely noticeable, and the scar hardly visible, the second however did leave a little ‘shelf’ (I think because they basically go in the same place and have to cut the old scarred skin off completely?). To me it is the painful and permanent reminder of how the health service let me down. Sorry to be so miserable but I think what I’m trying to say is this time round you will go in with so much more knowledge and confidence – you could try for a vbac, and then if things aren’t working out go to a c-section that isn’t quite as ‘emergency’ as some! As long as baby gets out safely and you are happy with the choices made, then you can look back knowing you were in charge…

    • Oh my goodness, first of all don’t apologise, you clearly had a traumatic experience first time round so well done for doing it again, and still hoping to try for a natural birth! Very interesting what you say about the scar because mine isn’t too bad, but I can imagine how the second would be worse. Overall I think you’re right. I think my aim may be for a natural birth but only IF certain things go to plan. IF baby isn’t breech, IF my pelvis isn’t too terrible and IF labour progresses naturally. Apparently being induced increases the risk of the scar tearing so if I were to get to that stage I would opt for a C section instead of being induced. Thanks for the very thoughtful comment and I think you hit the nail on the head there about feeling in charge – which is so important! xx

  6. This is such a difficult choice to make Caroline! I never had to think about this as I had two vaginal births – but let me tell you, don’t think you’re missing out by not experiencing labour pains!! Having said that I did have a lovely water birth with EJ but I was in agony for about 48 hours leading up to finally going into hospital and being told I was 9 cm dilated. I have a friend who had a breech baby first time round and had to make the same decision with her second. She also spent many months umming & erring over what to do. In the end she went for a planned C section but did actually just start going into labour the day of the surgery so she said at least she knows what it feels like (although early labour is somewhat different from what comes later!). I think if I was you with the SPD and everything I would probably err on the side of C rather than V but I take your point about the negatives of going down that route too. Either way it has absolutely nothing to do with your womanly status – you will have grown two amazing little people inside you – can’t get much more womanly than that :-) X

    • Thanks, it is a bit tricky though am trying not to worry too much, and just wait and see what happens really! Lol, thank you, i guess it’s just weird never to even experience it. Not sure that’s enough of a reason to do it though! Thank you, that is very true :) I think I will see what happens – If everything falls into place I may try for a V but chances of that are probably slim! Will see how I go though! thanks for the lovely comment as always :) xx

  7. I had an emergency with my first after failure to progress and 40 hours. For my second it was a really hard decision, but we decided to give him a chance and opted for vbac. However the doctor would only let me go three days past my due date so in the end I had an elective section. During it they told me my uterus had torn as it hadn’t healed properly during my first section and if i had tried for a VABC and torn it would have been a huge risk. In the end only you can decide and you will know when the time comes. It’s definitely not an easy decision to make though x

    • Gosh well I guess thank goodness that things worked out the way they did in the end! I’m going to have to wait and see, I think I would like to try a vbac, but only if circumstances permit really. Thanks for the thoughtful comment! Xx

  8. It’s a very individual decision and no Ceasaerean is ever ‘easy’. But I too had the same choice and opted for a planned c-section. Honestly, I found it a lovely way to experience the birth of my son. It was calm, I got to hold him for 45 minutes whilst they tidied up and the pain and discomfort was minimal for me afterwards. Compared to the stress of my first birth, it was wonderful to be honest. And I too am a planner so it helped me to prepare mentally as well as practically. But as I said, that’s just my experience and everyone has their own choice to make ultimately. I wish you well xx

    • Thank you Iona, and you’re absolutely right, C sections aren’t easy, because of the recovery, but they are a lot less stressful. Thank you for sharing your story, every little helps with the decision making! xx

  9. Yikes Caroline! Big decisions for you. I think, ultimately, the right decision is the one which gets the baby out safely, and causes the mummy least trauma, isn’t it? I’ve always taken a sensible approach to having babies (I’m not sure I’d have had three if I hadn’t!) – we live in a world with medicine to make it less painful, and procedures which will help. Why not use them? I think us women are far too hard on ourselves at times, and the guilt is never ending – we really shouldn’t be! This too shall pass lovely lady. Enjoy pregnancy and the amazing wonder of birth as much, and in whatever way you can! Xxx

    • Ah you are so right, that motherhood guilt definitely starts before the baby is born doesn’t it, worrying what you “should” do. I love your attitude and we really are so lucky to live in an age with modern medicine to help us. Thank so much for your comment! xx

  10. What a really hard decision! I wonder if it may be best at times to keep an open mind. I prefer too to know and plan and be prepared and I don’t envy your decision at all but good luck I hope every thing goes smoothly for you #sharewithme

    • Thank you, I am trying to just keep my mind open at the moment and worry about it when the time comes, and hope that I will know what to do then. Fingers crossed all goes smoothly, whichever way I go! Thank you xx

  11. Wow that’s a hard decision but I’m sure you’ll give it lots of thought and whatever you decide will be right for you and your baby, good luck with everything :) #sharewithme

  12. Ahh great post hunny always great to talk it around and see how you feel after the flood of advice I am sure you will getting. I had SPD severely with my two and had two easy natural births. I think it is an amazing feeling to have a natural birth and until I did it I didn’t know how much I would love it. Yes I said that don’t hit me everyone. But it is powering and when you get to cut the umbilical cord yourself and watch as the rest of your baby comes out into this world. And grab them skin to skin first contact it’s pure heaven. That’s just my experience. The SPD didn’t effect either of my births at all. Buba I was on my back and MM I was on my knees didn’t seem different either position. I think you might surprise yourself if you go for a natural birth and it’s not breach. But follow your gut and your body. You want it a great experience. Just wanted to say I had SPD badly and had two great experiences so don’t let the ones that have had it horrible scare you off. Just be aware of your options. Thank you so much for linking up to Share With Me. #sharewithme

    • Thanks Jenny, it is so lovely to read your positive stories as it really helps to read about cases where it has not gone badly, as well as when there have been problems. I think IF everything falls into place and baby isn’t breech and I don’t go overdue then I would like to at least try for a natural labour, as I wuld love to have the experience that you had. But, we shall have to wait and see what happens I think! xx

  13. It sounds so difficult to be weighing up all the pros and cons, I’ve never had to make that decision, I’ve had six natural births and hopefully this next one will be too. All any of us want is the best for our babies and I’m sure you will make the best decision for the both of you. x #sharewithme

    • It is tricky so I will just have to see what happens I think, I love that you’re coming up for your 7th natural birth, I think it’s really wonderful. Thank you, I’m sure I will keep everyone posted! xx

  14. My water broke a month early. Then my OB Gyne has to induced me. I slept I think. Then when I woke up the baby is gone. The first person who saw him is my sister rather than me. When I saw him my blood up to my head and I cried. I think that whatever you choose is okay as long as you are going to be safe. Thats the most important. Be safe cuz you are needed my your lil monkey and the new lil one in your tummy. I hope I make sense as I am not good with his at all. #sharewithme

    • Aww thank you Merlinda! Bless you that must have been difficult and you’re right in that as long as we are safe, that is the most important thing, out of every other consideration. xx

  15. That cannot be an easy decision to make. I have to say giggled when I read the reference to your husband turning around in bed hoping Monkey would turn as well. How sweet! I remember reading a while back that your husband was very much involved in raising Monkey. That is such a fab example of his involvement. A great story for Monkey’s 18th birthday! Mel #ShareWithMe

    • Lol, thank you, I’m glad someone spotted it, he is so hilarious and wanted to ‘help’ in any way he could, not a story I will forget! xx

  16. A tough decision, but I think ultimately you have to go with what you feel is right for you. After having an emergency c-section with O, which turned out to be more complicated than we’d thought, the decision has been taken out of my hands if we are lucky enough to have another. It would have to be a section because of the damage to my uterus caused by the first one. Maybe that makes it easier as I know I have no choice, so nothing to think about.
    Good luck with whatever you decide xxx

    • I can totally understand that, and I think that part of me almost hopes the baby is breech, and then the decision will be out of my hands. But we will have to wait and see what happens I think! Thank you xx

    • Thank you, I have loved reading all the responses and different opinions and experiences. Thank you, I am sure we will make the right decision, whatever that may be! xx

  17. Oh my goodness, birth is such a pain in the ass! I’m not even sure I want a VBAVB (vaginal birth after vaginal birth!) and after publishing some really lovely planned c-sections (this one is amazing: http://www.mumsdays.com/mama-h-elective/) I can honestly see the benefit in going down that route (and would be tempted). But I can also say that after all the trauma of Reuben’s birth it was the most incredible experience of my life. But then maybe that was just because there was a baby?

    I wish it could be straightforward for you (and me) and as a planner I can see why this is so hard for you. It’s hard to prepare for labour now if there is doubt as to whether you will go through with it, I think you just have to trust your gut. As with everything to do with kids! Go with your instinct. Apparently a good trick is to ask your head a question before you go to sleep and in the morning your unconscious mind will have worked out the answer! Genius :) xx #allaboutyou

    • Lol, it really is and I totally understand why! I will have to read that post! I guess it’s the feeling that I may be missing out on the ‘experience’ some women have of natural birth – good or bad, to just know what it is like. But then I’m not sure that’s enough of a good reason to do it! Thank you, I will wait and see how things go and then trust my instinct. I lov that about asking your unconscious mind a question, will have to give it a try :) thanks for the lovely thoughtful comment! xx

  18. Great post! It’s such a personal decision. I recently had what I considered to be the ‘perfect’ birth, at home, in water, gas & air, no interventions, but still ended up in hospital for 2 nights afterwards with all the rubbish that goes along with it! You never know how either way will go, but whatever you choose you’ll have a gorgeous little baby to cuddle afterwards and however peaceful/calm/traumatic/difficult it is, once it’s over, it’s over!

    • Thank you and that is really interesting, I guess you really can never tell how it is all going to work out! xx

  19. Hi there, great post! I had to make the same decision just over 2 years ago. I had an emergency C-Section first time around, a very traumatic experience but a life saving one. I was very open to a VBAC second time around much to the delight of my Consultant who was very pro VBAC. Unfortunately for me this was not to be, I even did special anti natal classes focusing on VBAC, but i went into labour at 26 weeks and we spent the next 2 months trying to prevent that labour progressing – successfully – and we made it to 38 weeks but we made the choice for an elective section at about 35 weeks to take the unpredictability out of it as we were having so many other complications. I must admit my second C-Section was such a positive experience, it was so controlled, planned, pleasant and stress free and I recovered really quickly from it, so I have no regrets. As an aside, if I had delivered before 35 weeks I would have tried a VBAC at the recommendation of my consultant and midwives as it would have been more beneficial for baby’s lungs apparently. Huge decision to make, take your time, only you know what will be right for you. Best wishes for the rest of your pregnancy! #PoCoLo

    • Oh gosh, yo really just can’t predict what’s going to happen can you? And even the best laid plans can change at the last minute. I’m glad all worked out well for you and that you have no regrets. Thank you! xx

  20. My first was an emergency C-section, the next five were all successful VBAC’s. You raise good points for both choices, and in the end the choice you make will be the one that’s best for you. #PoCoLo

  21. You certainly are NOT less of a woman at all!! It is sometimes easier to go with what you know as you know it worked for you. I was lucky to have been able to follow my birth plan to the tee with Grace. I went into labour midday on New Years Day, I was in the birthing pool at the hospital at a similar time the following day and Grace was born at 6.39pm in the pool. At about 4pm I did want to give up and get extra pain relief but the midwife told me it was too late in the day! I carried on and I still am so pleased that I was the first one to pick Grace up out of the water :) I hope you are able to follow the plan that YOU want. Thank you for linking to PoCoLo x

    • Thank you, that was pretty much my original birth plan and I am so pleased it worked out so well for you! We will see how it goes I think, but I will definitely go with what’s best for me and baba, rather than what anyone else wants me to do! xx

  22. A very difficult decision for you, whatever the outcome I really hope you have a smooth and trouble free birth and that you feel happy with whatever decision is made. I was lucky enough to have 2 ‘natural’ births after being induced so have not had to face the decisions bothering you #sharewithme

    • Thank you, I just hope all goes well, whichever decision I make! I am really pleased you had fairly smooth births for both of your 2 though I know being induced can be extra painful sometimes! xx

  23. Really interesting post, and a hard decision for anyone to make even with spd thrown in.

    After I’d had N, by unplanned (officially emergency, but it was the calmest thing ever as I didn’t progress past 3cm, in 13 hours on a drip, after arriving at 1cm) cs, I always thought that if I had another that another cs would be preferable. Like you, a planner, because I’d had a great experience with the first one, and afterwards didn’t really suffer with much pain. The worst experience was being stuck in the middle of nowhere unable to drive for 6 weeks. But then, I had my mum to help me with housework and all that kind of stuff, as my OH went straight back to work being a farmer.

    Now, I’d probably opt for the vbac if we were going to have another, purely because I just don’t have that support again afterwards and with a second child, there’s a lot more having to get on with things rather than taking it easy.

    Thankfully I’m not in the position of having to choose. I do have a friend who’s first was breech, born 5 weeks early by emcs, but the second she had with no problems by vbac. No complications with spd, and right up til near due date, she still wasn’t sure which she wanted.

    Good luck with your decision #pocolo

    • I can completely understand why you would opt for a vbac now, and the recovery from a c-section with no driving etc is one of the main things making me think along the same lines. I still have to wait and see though, IF all goes ok then I will try for a vbac, but I am prepared for that not to happen one way or another, and I survived the c-section recovery last time and I’m sure I’ll manage again too Thanks for the comment! xx

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