Both my dilemma over potentially having to deliver five hours away from home, and my VBAC anxiety have been resolved, in a way that part of me kind of expected.

To recap quickly, I had an unplanned C-section after a very long labour with my firstborn, owing to her posterior positioning stalling labour despite interventions and augmentation. I was loosely aiming for a VBAC this time around, but our baby is male and there’s a risk that he could be a hemophiliac. We don’t have a NICU in this hospital, and my doctor was concerned about meeting the requirements for a safe delivery with the risk involved — if anything went wrong they would have to quickly medevac me and baby via airplane. She decided to talk it over with one of the most experienced obstetric doctors on staff, and get back to me.

I went into the appointment with zero expectations, really — more just hope that I would get a definitive answer. I trusted the doctors to make the right decision, though I really wanted to be able to stay close to home. My doctor came in and we had a conversation that went something like this:

Doctor: “This is how things are going to go: if you have an easy, quick delivery, no problems, that’s fine — I’m not worried about you, I’m worried about the baby. But if anything starts to go awry, I will be moving you to the OR much faster than I would move most other patients. We can’t have any trauma to the baby that could cause bleeding.”

Me: “Honestly — after my last experience with labour and delivery, I’m kind of inclined to want to head to the OR earlier rather than labouring forever and ending up with surgery anyway.”

She hadn’t factored in my previous labour, so she basically stopped short, turned to my chart, and said, “Okay, let’s start over.”

We talked about why I ended up with the c-section before. We talked about whether or not Mac Daddy and I are planning to have more kids (probably not) because if we wanted to have several more children, cesareans pose a problem. We talked about whether or not I wanted my tubes tied (no) because if I did, that would push things toward a c-section. She took a break to call the lab and find out if we could have factor on hand in case baby needs it (yes). At the end of working out the pros and cons she looked at me and said, “I can’t tell you what I would do, because I don’t know.” I laughed and said, “That was literally my next question!”

Ultimately, after weighing it all out, she told me she thinks a scheduled C-section would be the least risky for baby — while the VBAC success rate is fairly high at 75%, and she thinks I would stand a good chance at it given that the only problem last time was positioning, she is not willing to do any augmentation or intervention to get there.

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When you look at the hierarchy of what types of delivery are best for a potential hemophiliac baby, it starts with an intervention-free, trauma-free vaginal birth, then a C-section, then a potentially traumatic birth. We can’t guarantee that I would be able to deliver without interventions, and it would be much worse to come to that conclusion after waiting around for baby to come, waiting through the earlier stages of labour, and working with whichever staff happened to be on call at the time. With a scheduled C, we will have my doctor, the head of obstetrics, and the factor on hand, with everyone in on the plan, with a consultation from hematology in the meantime. It will be as controlled as possible, heavily reducing the risk to baby.

When she said that it would be the safest for baby I knew it had to go that way. It was up to me to decide, really, but as much as part of me is wondering if I would have been able to do a VBAC without intervention or issue, I know that if something bad did happen I would seriously regret the attempt. I would rather choose the safest route and be left wondering about my own body’s capabilities than choose the riskier route and be left wondering if I’m endangering my kid. We went through a lot to get this far with him, and all I want is for him to be safely delivered.

I’m finding it kind of mind-boggling to have his birthday picked out! My mom will be able to make arrangements to be here, because we’ll know exactly when he’s coming. We’ll all be able to schedule our time off work without any surprises, and I know M will have child care on that day, plus someone to pick her up and drop her off. I can plan for pain management and have everything in order as much as possible beforehand unless he comes early — the surgery is scheduled for 39 weeks.

So much of my last pregnancy centered around that long, long wait for baby to arrive — the tension and the excitement and the wonder and the worry of the last few weeks, wondering if that would be the day I went into labour, worrying about how it would all work. I never expected the C-section, so this feels very different to me. There will be no wondering, there will be no worry about things like positioning or size or dilation. There won’t be contractions, there won’t be laps around the hospital, there won’t be that what the heck happened last night feeling when I wake up after an unplanned C-section. I will never know what it feels like to push a baby out. It’s a lot to take in!

Paint

We’ll be painting in double-time now.

On the practical side of things, time has suddenly sped up. We’ve got a month to finish renovations and get the nursery together, a month to cross off all the remaining to-dos for baby prep (I can’t find the infant car seat!), a month to spend as a family of three. I have to wrap up some things at work, sort out my application for maternity leave, and make sure that we’re ready for Christmas before baby arrives. I am definitely feeling like we’re going warp speed.

This isn’t exactly how I pictured the last month of my second pregnancy, but as I said earlier, part of me expected it, a bit. A repeat Cesarean makes sense in a lot of ways, and I’m mostly at peace with it.

If you had a repeat Cesarean, or a scheduled C-section the first time around, what was your experience like? I only know about it from the unplanned, exhausted side, so I’m very curious about what the difference is going to be!