planes and playdates

I was 14 weeks along at my first antenatal appointment when the midwife first asked the question “Have you given any thought as to how you want to birth this baby?” Well, no. I was still in the midst of morning sickness and all day nausea. I was just trying to make it through each week.

And then, when I did start to think about it, I realised that the thought of giving birth, either by c-section or VBAC, kind of terrified me slightly. The possible complications that could arise either way. The unknowns. The lack of control. What if something goes terribly wrong and I will forever wish I chose the other option?

My last birth resulted in an emergency caesarean because of “failure to progress due to malpositioning”. Something that simply cannot be predicted if it will happen again. It has been a few years since then, with plenty of time to heal and therefore I was told at that early appointment that the decision was up to me.

I have been asked at almost every appointment since and it was decided to hold off on making the decision until after another ultrasound in my third trimester. Well that time is fast approaching.

So here are some of my thoughts for each option:

PROS AND CONS FOR A C-SECTION

• Booking in a date would mean I could arrange care for my child, it would be during the day and he would be prepared with a proper goodbye (as opposed to me potentially disappearing in the middle of the night with natural labour). This does have some value to it, particularly giving my four old the time to prepare as we haven’t actually spent a full night apart before. Employers would probably be happy with the notice of leave (eg. husband and my Mum’s workplaces).
• “Do you really want to go through all of that again to just end up with a c-section?” I have been asked. I have heard from several women that their c-section recovery was a lot quicker when it had been scheduled in, compared to their emergency caesareans. I can see the point made there, particularly when considering how much energy is used in labour which could have been put towards recovery.
• The doctors can see inside your body, so in theory they will see that all the placenta has been removed properly, see any other problems and fix them and of course, most importantly, the baby will be born and would in theory not have any injuries (I know most babies don’t have injuries but I’m thinking about shoulder dislocation, etc, that could happen with a ‘natural’ birth). The use of forceps would be avoided and potential (severe) tearing of my body “down there” would also be avoided. Of course, on the other side of the coin, I would be undergoing major abdominal surgery and have a higher risk of infection plus a longer recovery (most likely) than if I had a vaginal birth. My previous emergency caesarean took me a long time to recover from and I would like to avoid that happening again.
• Another negative for me is that I would be unable to drive for six weeks. I have a four year old already that I would be running around after, groceries to buy, upcoming school visits, housework to do and it would be the lead up to Christmas. Last time it was a bit inconvenient and that was just having my baby to look after. Not being able to get out and about with my other child may make things harder from a behaviour perspective and it would take a bit of coordinating for people to come and help me on short notice.

PROS AND CONS FOR A VBAC

• I hear so often that a ‘natural’ birth (in theory) has a quicker recovery time. Obviously, this is only if it is a straightforward birth with no complications. This would be very helpful when also looking after a very active four year old. The stay in hospital is also meant to be shorter which helps put my mind at ease as I don’t want to be away from home for too long. Of course that would mean that the baby will arrive when it wants (although I’ve been told they won’t let me go too far over my due date) so there may be some rushing around and no goodbye with my child.
• I could drive myself places without having to wait 6 weeks. I would be able to take my other child to kindy, to school visits, activities and not have to have someone on call to help. I could drive around and let the baby fall asleep if I really had to. I would feel more in control and less helpless.
• I didn’t have a birth plan last time (well, except “keep us both alive”) and I don’t really this time either. I think I feel a bit more prepared (well except for covid changing certain rules – another reason why I want to go home sooner, as current covid procedures won’t allow children into the hospital). While I know that either option is still a real birth, I think that there are still negative associations made towards those who have a caesarean. I felt really defensive about it last time. This time I don’t mind what society thinks quite as much but my own personal experience from last time plays on my mind and mentally, I think having another go at a ‘natural’ birth might be good for me. Possibly. I still can’t decide. But the mental elements should be considered too.
• I have also been told that I will be monitored the whole time I’m in labour and that at any sign of distress or if it takes too long, they will move me to a c-section. That helps take away some concerns I have about natural birth and at the same time makes me think they just lean towards a c-section anyway. I have been told the risk of uterine rupture is 1 in 200. Even though that is considered low it is still a scary thought but since it has been close to five years since my c-section my healing time gives me a better chance of success. That risk of rupture is why the labour will be monitored so closely.

THEIR ADVICE / MY DECISION

I have basically been told that while they will monitor a few things and check closer to the due date with extra scans if needed that the decision is up to me. However at several appointments I have certainly felt that they may be trying to push me towards a c-section. There feels like there are a lot of extra conditions with going ahead with a VBAC and they sound like the chance of ending up with an emergency c-section will be higher.

I have seriously been debating this, on and off, in my head for a good 10 weeks or more and I am still regularly changing my mind on what the ‘best’ option for me and my family is going to be. I have however come up with a few ‘deal breakers’ – if any of those things happen, I will be choosing a c-section. They mostly consist of changes to medical advice previously given, the baby measuring too large, any health complications and if my scar starts experiencing intense pain. However if everything continues well I may just give a VBAC my best shot.

YOUR THOUGHTS?

Have you been in this position before? What did you choose? I am always curious about how people come to their decisions and I won’t judge. It is a hugely personal decision with varying factors that each family has to consider.

***The information in this post relates to my own personal experiences, it should not be considered as medical advice. ALWAYS FOLLOW THE ADVICE PROVIDED TO YOU BY YOUR DOCTOR***