Just chiming in here to say that I had a baby a year ago, my first, and it was a vaginal delivery. There are good reasons to choose either option, but I was with a doctor and hospital that aim to avoid unnecessary c-sections, and we agreed that my best chance at reducing complications was to try for a vaginal delivery. It was luckily not affected by and did not affect my pouch, and I hope to have more vaginal deliveries in the future.
Good luck as you consider your options!