Elective C-sec or spontaneous labour onset to perform c-sec?

Hello!

My sister-in-law is 33 weeks pregnant with a baby girl. She has an almost 3-year old son that was born by c-sec after an induction at 38 weeks and "failure to progress" after 12 hours...

At first, her ob-gyn told her she could have a VBAC but now she's claiming she doesn't want to "risk it" because it is only safer to try VBACs with a larger interval than 4 years between births... Anyway, my siste-in-law thinks she can't handle labour and is keen on having a c-sec.

My question is related to another detail her ob-gyn told her: she says its "dangerous" to have her go into spontaneuos labour and wants to perform an elective c-sec at 39 weeks...

Can someone find me some studies or official data on this last question? Is it really safer to schedule a c-sec or can it be as safe and best for baby if the c-sec is performed after she enters in labour spontaneously? 

Thanks!

Tags: VBAC, c-sec, elective, labor, spontaneous

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I am reading "Born in the USA" by Marsden Wagner and he recommends waiting for labor to start before performing a cesearan section because it reduces the risks of prematuratity and respiratory distress. Hope that helps :)
I don't think it's "dangerous" to wait for labor. However, in the OB's eyes, your SIL may run the risk of delivering before they get the OR setup (IF she had a very, very fast labor), and we know this OB considers VBAC's risky. From the mom's perspective, it can be a lot more uncomfortable to wait for labor. Depending on the quickness of the labor, she may be panicked to get the c-section over with. My mom had a scheduled repeat c-section with my youngest brother but went into labor before that date. Everything turned out fine (in fact that brother was healthier than the other c-section baby), but it was extremely difficult for the anesthesia to be administered because her labor was so intense. She was also extremely nervous the entire time that her baby would be born vaginally (this was in the days when the c-section incision was vertical and more prone to rupture---she also had my brothers close together).

So in your SIL's case, I can understand that she might want to schedule early. But I don't think there is necessarily a "danger" to going into labor on her own.
P.S. I have no idea where her OB got the 4-year rule. I'd be interested to read that study. There are plenty of women who have VBAC's with babies that are closer together. 3 of my friends did---one girl's kids were only 18 months apart.

Thank you for your answers.

We live in Portugal and some doctors here are very close-minded... Her ob-gyn is the militar type: "do this, do that 'cause I'm the doctor and of course, I know best". My SIL doens't have the courage to inquire about the studies because she doesn't want to upset the doctor... The hospital where she will have the bb has 24 hour ob-gyn emergencies service, and she lives like 10 minutes by car from it, so I think there wouldn't be any problem with waiting for spontaneuos labour... except for her doctor, that would have to be available to come at the day and hour my SIL required, if she wanted her to perform the c-sec and not some other doctor (and she does).

Thank you again and all the best for MyBestBirth!

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