Thursday, January 22, 2009

Of Birth Choices and VBACs

This is a really rather "biological" post, so don't read if you are squeamish.. eww..

Sophie was born by emergency C-section on 6th March last year, as I had been in labor for about 24 hours with progress only to 3 cm dilated. She has also passed stools in the womb and her heart rate was not keeping up well with the contractions.

After I had Sophie, I did wonder whether had the conditions been different, I would have been able to have her naturally.. in Singapore, gynaes tend to be very cautions eg. inducing if baby if not born by EDD, only allowing mums to labour for 24 hours max, sending for a C-section once there is any sign of baby distress or passing of stools. Whereas in other countries like US etc, the mum is much more "in control" and labour can go on for days, and Baby is not continually monitored and much less intervention is attempted.

Of course, I am not saying that I WANT to have labour for many days, that I am anti-anesthetic, anti-C-section etc. And of course, I am willing to have anything done as long as most importantly Baby is safe and sound. I am just wondering whether it was really medically necessary for my emergency section and whether I could have had Sophie naturally if I had the liberty to labour for longer by myself.

Because now, with Baby Zoe due in 1st June 2009, I am deliberating between attempting for a natural birth and going for a scheduled repeat C-section.

Natural birth:
There is a risk of uterine rupture which could happen at the site of the previous C-section wound. This would be very very dangerous and highly likely fatal for either mother or baby. Which is why there is the phrase "once a C-section, always a C-section". The risk is low but appreciable (between 1-2% depending on studies in a all-natural ie. no induction setting).
There is also the possibility I may end up having to do another emergency C-section again if I also have failure to progress within 24 hours. Which will be another expennnnnnnsssssssive experience!
But I do wish I can have natural birth because the recovery time is so much faster! Recently I visited my friend who just gave birth.. within 24 hours of the birth she is up and walking around like machiam never birth like that! C-section it took me 1 day just to get off the bed and that was with lots and lots of pain.. that I rather stay "bed-ridden" and not do anything at all for the 1st week!

C-section:
If I do go in for a scheduled C-section it will be cheaper than having an emergency C-section. Much cheaper! And apparently 2nd C-section is nowhere near as painful as the 1st. But of course there will be more down time than having a natural delivery.

Sigh.. how to be able to decide?

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