Relax Im not there yet.
I am at 8 weeks so there is a little time to decide but the thought is preying on me and I think it might take a while to get the answers I need.
I posted this on another board too because I know that what I am going through is unusual and I am trying to spread a broad net in hopes of finding someone with real world experience on the subject. I am hoping someone here might know someone or even have heard about a similar situation and can give me advice as I am at a loss.
My first son had his cord around his neck so we had to do an emergency c-section. I was 19. I panicked. My first husband panicked. It was a nightmare all the way around because the room filled up with students (it was a teaching hospital) and I felt like I was going to lose my mind. Being little more than a kid at the time I didnt stand up for myself and to be honest the experience haunts me whenever I consider doing another c-section. Added to that, I have some special issues with pain meds because of damage to my digestive system. You see, pain meds slow down your digestive system and if I take them I can literally end up in the ER because of blockages. I know that sounds minor but for me it is actually life threatening so I have to avoid them. Ive gotten through a number of surgeries without anything but the anesthesia at the time they are operating but those were all laparoscopic surgeries. (Think tiny multiple incisions instead of one big one.) A c-section is one huge incision big enough to pull a baby out of so I think it is a fair bet that it will hurt far worse plus I will have a baby to take care of so I am dreading that thought too.
On the other hand a vaginal birth is not exactly optimal either. I did give birth twice after the c-section and to be honest I am (or was that was 20 years ago) one of the lucky women who has very easy childbirth. I remember the nurse asking me if I wanted something for the pain and listening to the woman in the next room screaming and saying I would wait until it started to hurt and then about 5 minutes later my son was born. I guess I am some kind of freak or something but it just never was that bad for me compared to what other women describe.
But (and it is a big but) that was 20 years ago. Ive got a lot of internal damage due to a physical attack a number of years ago. Random bad luck I guess you could call it or not thinking to keep my eyes open, if I am in the mood to blame myself. Either way I am a mess on the inside. Unfortunately, because I was pregnant at the time a lot of the damage is in that area. Plus there is the damage done by the actual assault which has made a real mess of my digestive system and left me with a lot of scar tissue. Right now I am on bed rest and will be so until I deliver because from my doctors best guess a piece of scar tissue between my bladder and uterus has grown back again. I last had it removed a year ago so I remember the feeling and I am pretty sure he is right. At the moment it causes contractions when I stand up because it pulls on my uterus & irritates it so I am on bed rest for the next 32 weeks. (Im due in late July)
That creates two problems. First there is the chance that the scar tissue could cause my uterus to rupture. It was a very thick band when last removed and likely is thick again so I can see that as a real possibility even if I do not think it is likely. That could be very dangerous if it happens and even fatal to both the baby and I BUT I could also fall off the table break my neck and die. 
The odds are worse than for most women but its not like we are talking 50/50 odds or something. The problem is that the only way to gauge the risk is to do another surgery while I am pregnant which could in itself cause more scar tissue to grow. So there is a real catch 22 there. I think I am safe but who knows. Then there is the thing that is likely to happen and thus more of a concern. The walls of my vagina and lower large intestine are weak due to the damage so odds are giving birth vaginally might do some damage and could possibly end up causing me to have more surgery later. This is something I know I will have to do again and again anyway, so I am not totally freaked out about it.
I have a great gastro doc who handles all my issues of this nature but we are not on very good terms at the moment because he wants me to let this pregnancy go (stop the progesterone and miscarry) and try again later because of all the problems I am having with other issues due to the damage. Im ok but things are just not going as we were told to expect and he feels this is too much of a strain on my body and that was before we found out about the scar tissue. (which only became obvious as my uterus began to grow and weigh more) With all the miscarriages and other stuff I have gone through there is no way in hell I will throw away a viable pregnancy with a healthy fetus. You know what IVF costs emotionally, physically and financially so I am sure you understand my logic but he doesn't. So talking to him about how to give birth isnt going to be productive at the moment because between the long drive and the stress of him pushing me to make myself miscarry I would be going against the whole point of bed rest and might miscarry due to that.
The OB thinks I can do a vaginal birth but is leaving the last choice up to me. I almost wish he would say that I have to do a c-section because I am at a loss as I really want to do the vaginal birth but worry that I am letting fear of the pain of an unmedicated c-section recovery mess up my judgment. As I said earlier I know this is kind of a weird situation so I am hoping that someone might have know someone in a similar situation and could advise me as to how it went.