Planned c-section vs. vbac - what would you do?

[Anonymous]

Anonymous wrote:You think it's odd that a doc would want your complete records before providing his medical opinion??? I don't think you want to hear the truth, OP. I think you just want someone to assure you that a VBAC is the best option for you....but I don't think you are going to hear that. Sorry.

Why are you so opposed to the c-section....or put differently, why are you so eager to try the VBAC?

I don't get this reaction at all.

I totally understand not wanting to request a transfer of medical records if you haven't decided to leave a practice. In fact, I had a similiar situation myself. During my 3rd trimester, I had an issue with one of the OB's at GUH and thought about transferring to GW's OB group. When I called, I got the same response. And I also thought it was a bit odd. I understand why they want the information but I felt like I was in a tough position with my current OB group. I ultimately decided to stay with GUH and had a successful vbac.

Also, having delivered at GUH where there are a lot of doctors, I got wildly different responses from different OB's within the same practice on the vbac issue. Some would use pitocin, others wouldn't. One was comfortable letting me proceed with a vbac with a big baby. Others pushed hard on a repeat c/s. Different doctors have different opinions. It makes perfect sense to get a 2nd opinion. 10% seems like an awfully specific number to give someone for a vbac success rate. In my case my numbers were initially high because my c/s was due to my baby being breech. But then those numbers dropped when my 2nd son was measuring large. My OB never gave a formal percentage at the end but she was putting it at less than 50%. I guess I'm just a little skeptical someone can say 10% with such certainty. I would want a 2nd opinion.

OP - GL! I hope you can find a provider that you like. Even if you stay with your current OB, that doesn't mean you can't have a successful vbac. I stuck with GUH despite some concerns about their commitment to letting me vbac. And I had an amazing experience. I felt fully supported by the OB's there even though prior to my vbac they were encouraging me to consider a repeat c/s. If you want to stay with your current OB I would just hire a doula and convey that you want a trial of labor. It sounds like he will be respectful of that.

[Anonymous]

Just a heads up, you may want to start emailing doulas now (if you haven't already). I found that the best doulas (at least the ones that looked the best from their websites and had good reviews on DCUM) were booked up way before I got to them.

[Anonymous]

If the doc is saying 10% with such certainty it's likely he knows something....like the shape and size of her pelvic bone having been the one who delivered her first (and ultimately needed an emergency c). Let's face it: he can't say she has a zero chance of having a successful VBAC since it might be possible....but my take on 10% is that he really means zero. And we can continue to pontificate about the what ifs all day long, but only her OB is equipped to provide a medical opinion based on facts and not our anecdotal stories.

[Anonymous]

Anonymous wrote:If the doc is saying 10% with such certainty it's likely he knows something....like the shape and size of her pelvic bone having been the one who delivered her first (and ultimately needed an emergency c). Let's face it: he can't say she has a zero chance of having a successful VBAC since it might be possible....but my take on 10% is that he really means zero. And we can continue to pontificate about the what ifs all day long, but only her OB is equipped to provide a medical opinion based on facts and not our anecdotal stories.

Well, I'm glad you live in a world where doctors are never wrong and where two doctors looking at the same set of facts never reach a different conclusion. If the situation is as you say, then a 2nd doctor looking at her medical records will give her the same opinion. And then OP can make an informed opinion on whether attempting a vbac is worth it to her.

[Anonymous]

I agree she should get a second opinion from a reputable OB if she wants to. I just bet that there's a reason why her OB came up with such slim odds for her. That's all. I hope she reports back on what another OB says.

[Anonymous]

Anonymous wrote:Just a heads up, you may want to start emailing doulas now (if you haven't already). I found that the best doulas (at least the ones that looked the best from their websites and had good reviews on DCUM) were booked up way before I got to them.

I have been contacting them for a couple of days now but haven't heard back from a lot. I am hoping to pick one soon!

[Anonymous]

Anonymous wrote:I'd choose csection recovery over the pelvic floor issues I currently have any day....

I have terrible pelvic floor issues and I had a c-section...just an FYI. But I didn't like the c-section one bit so I'm definitely not advocating for one!

[Anonymous]

Anonymous wrote:Since you like your OB and your chances of a c-section do seem pretty high, why not just stay with him and hire a doula? Get a piece of writing that says your doctor doesn't require an IV to be placed when you go to the hospital (since he said he'd go with that). Do whatever prep in terms of classes and reading for a vaginal birth, but have your backup there. See how it goes.

FWIW, I used Fern Compton as a doula for my VBAC and I thought she was fantastic! She's very calm and has a good amount of experience with VBACs. She also does not have an agenda. I ended up opting for an epi when I was about 8 cm and she never made me feel bad about that decision.

I would go to a provider who is pro VBAC and get that person's opinion on your chances of success. I think it's reasonable to ask for your medical records to give an informed opinion. Just ask your current OB to make a copy rather than sending the records in case you end up not switching. Good luck!

[Anonymous]

OP here!

I have set up an appointment set up with an OB at GW practice for a second opinion. I plan to ask for the copies of the records at my current OB office and just bring hard copies to the appointment and also the operative report from Fairfax hospital. I haven't made up mind yet as for switching, but I guess that will come after this consultation!

I have decided that the second opinion from a credible OB in a different (more pro VBAC practice) will give me information to make the best decision possible. If second opinion is that I have 10% chance as well, well, then I know that my OB was right and stay with him with peace of mind. If second opinion is that I have much greater chance, then I have a decision to make as to whether to transfer or not, and also I would go into VBAC with much more confidence.

My appointment is not for 10+ days, but once I have the talk I will definitely report back!

Thanks everyone for your invaluable advice and support!!

[Anonymous]

Don't know if this has been pointed out already: there's an app for that.

Pregnancy: Repeat C-section or VBAC?
https://itunes.apple.com/us/app/pregnancy-repeat-c-section/id578140099?mt=8

Cheesy graphic but based on the medical evidence.

[Anonymous]

Hi everyone - OP here!

I did meet with Dr. Larsen from GW OBGYN. He basically told me the same thing as what my OB told me, just in different language. It does seem like that I am not a good candidate for VBAC based on my specific situation and what my operative report says. He said that a chance of success for a normal candidate would be 70% + but would estimate mine at much less than 50%. He actually recommended I go with a repeat c section although he would let me try VBAC if I really want to try. That doesn't sound too optimistic to me. Similar opinion coming from two credible doctors, I have reconsidered my wishes for VBAC. My plan for now is to have a repeat cs scheduled, and play it by ear if baby decides to come much earlier than due date by any chance (hence smaller size, etc.).

Thank you everyone for your advises on this post!!

[Anonymous]

Anonymous wrote:Hi everyone - OP here!

I did meet with Dr. Larsen from GW OBGYN. He basically told me the same thing as what my OB told me, just in different language. It does seem like that I am not a good candidate for VBAC based on my specific situation and what my operative report says. He said that a chance of success for a normal candidate would be 70% + but would estimate mine at much less than 50%. He actually recommended I go with a repeat c section although he would let me try VBAC if I really want to try. That doesn't sound too optimistic to me. Similar opinion coming from two credible doctors, I have reconsidered my wishes for VBAC. My plan for now is to have a repeat cs scheduled, and play it by ear if baby decides to come much earlier than due date by any chance (hence smaller size, etc.).

Thank you everyone for your advises on this post!!

I'm sorry, OP. It sounds like you have made up your mind. At least you have done some research. In your shoes I'd feel better knowing that I explored all of the options.