Week 50: How to have a baby

A note about Sandy Hook

Before diving into the post I’d planned, I just need to mention a few words about Sandy Hook Elementary School.

I have no connection to Newtown, Conn., but I cried along with the rest of the world imaging how an end so horrific could come upon such innocent babies, about the grief of parents who had to walk away from that school without their children and the long road ahead as the community and survivors recover.

My heart and thoughts are with them all.

Week 50

When it comes to growing a person, risk seems to dangle above your head like an anvil waiting for the wrong move to send it crashing down.

My surgeons delivering Sophie into the world.

My surgeons delivering Sophie into the world.

This week marked the entry into the third trimester of my second pregnancy and I find myself pondering a risk I had not expected in the question of how I’d like to have my baby.

Each of the possibilities carries a greater risk, either for myself or the baby, because of how my first child came into this world, an emergency Caesarean section.

So after my doctor asked if I wanted to elect another surgery (RCS or repeat c-section) or attempt a natural delivery  (VBAC or vaginal birth after c-section), I have been searching for my answer in clinical as well as anecdotal outcomes.

What I’m finding is making the decision no clearer.

I’ll start by saying that my surgery, while unplanned and terrifying at the initial realization that I was headed to the operation room, was not bad.

My doctor was reassuring. I had none of the problems some complain of with C-sections. I was able to hold my daughter while being stitched up. I was able to nurse as soon as we were in my room recovering, about 30 minutes after surgery. I had some pain but it was controlled by medicine and that medicine did not make me feel out of it or unable to care for my daughter. I was comfortable earlier than several of my friends with vaginal deliveries — some who tore, some who broke tail bones, some with hemorrhoids. The devil I know scares me less than the devil I don’t know.

That being said, there are loads of vocal advocates for natural delivery. Their birth stories are inspiring and at times their advocacy in the VBAC v. RCS fight (and in the world of babies, it is a fight) seems radical. I’ve also found those who are happy with their choice for repeat surgery. Both sides offer a lot of “X is safer than Y” statements.

Then there’s research based on data collected from the National Institute of Health, and statements from the Mayo Clinic, Web MD and an interesting blog from a midwife.

Here’s what I’ve found, though at times I feel like I need a power point flow chart:

  • RCS carries greater risk of the mom dying, needing a hysterectomy or blood transfusion. But it’s an extremely small risk at 13 deaths per 100,000 women compared with 4 for every 100,000 who have a VBAC.
  • VBAC carries more risk of baby deaths at 130 per 100,000 compared with 50 for RCS. Risk of brain damage in the baby following oxygen shortage is also greater though still rare. Again, traumatic outcomes are highly unlikely. The most talked-about risk is uterine rupture, also very rare, but when it happens can be fatal for 6 percent of babies.
  • About 25 percent of moms who attempt VBAC will have to have surgery anyway for one reason or another. That’s about the same rate quoted for the first-time moms as well, so no big jump there. The so-called “failed trial of labor” steadily climbs to about 35 percent as birth extends two weeks beyond the due date, according to this study.
  • Risk of uterine infection is greater if the mother goes into labor but then requires an emergency C-section.

The problem I am finding for myself in looking at all of this is my typical initial catastrophic thinking. The risk is not zero. That means some poor mother died giving birth or had to say goodbye to the baby who died entering the world. How am I supposed to choose?

For a while, the question kept me up at night. The rational, statistical argument gets buried far beneath the words “could die.”

I was once offered a test to determine whether there were genetic problems with my baby before she was born. I refused based on the 1 percent chance the baby could die after the test was administered. That’s a 99 percent success rate. A 99 percent chance that nothing at all would go wrong and I could not accept that risk.

But there’s no way out of the risks this time. The baby will come. One way or another.

I posed the question to a group of women due around the same time I am and the response was split down the middle. About 30 women had planned an RCS and the same number had chosen to pursue VBAC. All of them had determined what risk they were willing to take and what option fit their beliefs.

Meanwhile, I sit squarely on the fence. Unable to let go of the fear that risk lies along each path. Knowing the most likely outcome will be a happy, healthy mamma and baby doesn’t seem to make this decision any easier.

I have time. A couple of months still. Heck, who’s to say the decision will be mine, anyway. I could face the same issues with No. 2 as I did with Sophie and land in the OR. Or I could pop and drop the baby in an instant at home.

Knowing me, however, I’ll continue to stare at these numbers and read all of the stories and waiver back and forth for, well, two months. So if any of you out there have any stories you’d like to share, I’d love to hear how you had your post-C-section babies.

About Tara McLaughlin

I'm a stay-at-home mom to two girls in my boyfriend's hometown of Bern, Switzerland. Life as a new mom in a foreign country has been, in so many ways, rewarding and challenging. I will document that journey here, on Another 52 Weeks.
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8 Responses to Week 50: How to have a baby

  1. Sarah Morgan says:

    This was me 6 months ago! I opted for a RCS. If you want the reasons why, I’ll PM you because I’ve been harassed for this decision by some VBAC zealots and don’t like to talk publicly about the reasons now! BUT, I will say, I had a great first c-section and an even easier 2nd. I think knowing what to expect the second time around helped. I was up walking the next day (would have been sooner but I had nurse issues!) and was walking around The Shedd and downtown Chicago 2.5 weeks later! Would I love to have experienced a natural birth? yeah. Would I make the same decision again? Absolutely!! Good luck with your decision! It sure isn’t an easy one!

  2. Heather Palumbo says:

    I had a repeat c-section with Ezra. I hemmed and hawed about the whole thing. More so that American doctors don’t seem to leave the choice to you rather it seems an assumed norm that if you had one c-section you just keep on going exponentially. Not cool. That being said I went with it in the long run and had the second c-section. I loved it. No really, I actually loved it. My friend said, its not a day at the spa, Heather. Whatever. Given my history with my first. The second was so nice. I actually enjoyed almost every minute. I agree with Sarah, I knew what to expect the second time and overall it was a great experience. I know its a personal decision. I just wish and hope and pray that like me you let go of all the what if’s and crazy irrational pregnancy thoughts ( I was waaaaaaaay prone to them too, sister….) and just enjoy the experience fully. Any way you do it, that is ultimately the key!!!!!!

  3. Jamie Lott says:

    As a mother there are few “easy” choices, but I think you should base your decision on what your doctor says and your instinct. If you believe in prayer, pray about it too.
    My best friend just had a vbac with her 4th baby and it went smoothly. I had an induction after all vaginal deliveries that nearly ended in a section. You just never know. Why did Sophie’s birth become an emergency section? Were there factors with her birth that suggest you should have a RCS?

    You will make the best decision, I’m sure! I cannot wait to meet your new little one!

  4. Emily H. says:

    You’ll probably hear success (and horror) stories from both sides. Me, I have had two uncomplicated unmedicated vaginal births (with no tearing), so I would choose that any day IF given the choice. Now, by uncomplicated I don’t mean “easy” so you have to go in prepared (for almost anything). I was literally walking around an hour after birth both times, eating, nursing, resting comfortably. If you go the NCB route, I highly recommend bouncy balls and tubs for labor (though no water birth for me). I didn’t have a doula but I know lots of people who loved having one. I do know a planned CS tends to be a much smoother recovery than unplanned, but I just don’t see a surgical procedure as a better option unless necessary. RCS is going to provide a known birth plan and I think that is a big reason why people choose it. In the end, they are both safe and reasonable options. It is clearly a personal choice so good luck with that!

  5. Adelita says:

    My DD is an April 2011 baby who came c/s because she was breech. This baby is due March 2013 and I made my decision to try for a VBAC. Am I terrified? Hell yes. But I want to try! If it doesn’t work, I am at peace with that and a c/s it is. Now if only I can get my husband 100% on board!

  6. carla mack says:

    As mom, I wish I could allay all your worries. Kudos for all the research you do, but, sometimes I worry that too much knowledge can take away from your simply enjoying the experience. There are risks in just breathing


  7. Leslie Cook says:

    I had an emergency c-section at 31 weeks with my first child. I had a very bad experience due to dr neglect. I had so many things go wrong. When I found out I was pregnant with my son just one year later I was terrified. I was determined to have a VBAC. I wanted to experience natural child birth as I felt that the emergency c-section and time seperated from my daughter had taken something away from our bonding.(she was in the nicu for 26 days while I had to have a resection due to infection of the incision) I was horrified when I had to be hospitalized at 35 weeks with my son, as signs of the pre-eclapmsia had started to present with him as well. The Dr kept me on magnesium sulfate for 7 days to enable me to carry him to 36 weeks. Then the big day arrived and the decision was taken away from me as the mag counteracted the pitocin used to induce labor. I had a smooth RCS with no complications and was taking care of my son within 6 hours. I was truly satified with the whole experience the second time as my husband was even able to be in the delivery room and was able to cut the cord.

  8. Pingback: 2013 Week 3: Hypnotize me | Another 52 Weeks

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