C-Section or VBAC?
Question: I just watched the movie last night. I’ve been on the fence on whether to do a VBAC. My daughter was born at St. Lukes Roosevelt (Hospital in the film) and I was processed just like the movie said. I got there in full labor and they proceeded to put on a fetal monitor because the doctor couldn’t stay in the room with me. The nurses wouldn’t let me move my position and after 10 hours I couldn’t take it anymore. At one point they figured out the baby was posterior, which I think happened because I couldn’t move and I got an epidural while we tried to turn the baby (2 hours). Then I had pitocin, then after two hours of pushing, they said ‘c-section’. So now I’m 32 weeks pregnant again and I have to decide this week if I will get another c-section or try vbac. One think that’s helped with my decision since last night is that I figured out it will be impossible to have a vbac in the regular hospital. (oh, very important as a side note, I had something called Bandels Ring, which I heard can be heriditery and happen again which can prevent the baby from moving down my pelvis). Should I try and do the birthing center at SLR at this late date or just realize I really have no chance. I feel like emotionally I can’t go through what I went through last time, but at the same time I really want to be able to push my baby out. Any advice. Sorry so long winded.
From Stacy
A: Dear Stacy,
Since VBAC is being presented to you as an option, you have already crossed
one of the biggest hurdles to VBAC which is that VBAC is not even offered as
an option by many obstetrical providers. The fact that you have been offered
a VBAC would indicate that your provider feels that you are good VBAC
candidate with a reasonable chance of success. Beyond the medical issues,
there are the emotional issues since one reason I think many women elect
repeat cesarean sections is to avoid the physically and emotionally draining
scenario that happened at the first birth - the prolonged immobility you
were subjected to sounds awful. That being said, remember that with a VBAC,
you can throw in the towel and elect a cesarean section anytime if things
are really not going well. However, to avoid some of the pitfalls of your
first birth, you will want to make sure you are in a situation where you can
move around, and if progress is slow to ask your provider to determine if a
posterior presentation is an issue much earlier in the process. A doula or
midwife who knows positioning and prenatal yoga can help you with exploring
positions that help baby navigate through the birth canal and even turn
posterior presentations. If the Bandel’s ring turns out to be a problem when
you are in labor, then you can always decide to have a cesarean section
then. Perhaps if you go into labor planning for a VBAC yet knowing you are
not obliged to go the whole distance if things become prolonged or difficult
would feel like a flexible enough situation to keep your options open.
Ultimately, it is and should be up to you. I wish you the best in making
this important decision about how you want to give birth to your baby , and
I wish you a healthy and safe birth whatever decision you make.
Eden G. Fromberg, DO, FACOOG, DABHM
SOHO OB/GYN
430 West Broadway #2A
New York, NY 10012
(212)941-0011
fax (212)941-5977
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