help me decide vbac vs elcs post loooong first labour and em cs

(31 Posts)
mmmmsleep Tue 04-Dec-12 23:00:36

I'm in 3rd trimester and struggling with decision about vbac vs section. I've read all evidence talked to professionals and yes i know that a mumsnet poll isn"t scientific but i guess i probably need hand holding more than anything..

Ds will be few months under 2 when this baby is due. His birth was horrid. waters broke contractions stopped when i got to hospital. Induced next morning nothing happened with prostin other than ds's heart rate plummeting. Syntocin started next morning after that. Epidural took ages to come then didn't work when it did. Back to back labour. uterus over reacted. Took while to dilate but went from 4 to 8 quickly then took 8 hrs to get to 9cm spent 4 hrs at 9cm then em section.

Thought of recovery from section with toddler to care for doesn't fill me with excitement and if i could have normal uncomplicated vaginal delivery would be best. My quoted chances of success of vbac are around 60% but success includes forceps or ventouse. I would never consent to induction again so if did vbac would include a cs date if go over. I guess i'm just not convinced my chances of success are high enough and thought of labouring and ending up with emcs or complications fills me with dread as does risk of being left like i was last time when clearly it wasn't happening. I just keep clinging to that thought of an uncomplicated vb and being up and about faster .

Just can't decide...not that i expect you to tell me what to do. Just interested in thoughts!

mmmmsleep Tue 04-Dec-12 23:01:24

Sorry title should have a please in it...how rude!

ICompletelyKnowAboutGuineaPigs Tue 04-Dec-12 23:13:21

Ive had an induced birth with assisted delivery and a 3rd degree tear. Then an ELCS, which was very dignified and straightforward. It was a pain trying to look after a small child after a section though and this is primarily why I am opting for vbac this time.

I will also refuse induction and opt for expectant mgt, then elcs after that if still no baby.

I'm doing natal hypnotherapy CDs to try and help release memory blocks from last time and to learn some techniques so I feel more in control - which I did not feel even close to with DS. They do a vbac cd so it might be worth looking into? Haven't tried it yet as I'm still on the pregnancy relaxation cd until 32 weeks when I'll start the 'preparing for birth' bit of the programme.

Not sure I was helpful but I can absolutely appreciate your dilemma. I was there 3 years ago with DD and even though I had my elcs booked I still tried to bring on labour so I could have a go - should have just waited in hindsight. That being said I can't fault the actual cs itself so if you opt for this I think you'd find it very different to your emcs.

WhatSheSaid Tue 04-Dec-12 23:13:52

Tbh it's very hard to know what would be best for you and impossible to predict - you may have a very quick easy second labour and delivery - you may end up with another emcs - there's no way of knowing!

I had an elcs after emcs the first time, I was not in the slightest bit bothered about having a vb and I was given about a 60-70% chance of having another emcs if I tried a vbac.

Recovery from elcs was good (you haven't been in labour for hours or days and will have slept well beforehand, which helps). Dh only had 10 days at home (including the 3 I was in hospital) and after that I was on my own with baby and 2yo, it was fine. I started driving again after 2 weeks, mainly to be able to get the 2 yo out of the house. We live abroad so no family around but it was fine.

mmmmsleep Tue 04-Dec-12 23:35:18

Thanks for replies so far. I guess the fact i'm in tears remembering last labour and can't sleep speaks volumes. I have the birth prep natal hypno cd. Did feel calmer after listening to it so need to give it more of a go.

For my vbac I did the hypno cd every day from about 35 weeks. It was very very important to me that I managed to have a vbac though so I did as much prep as I could for it, like private midwives, cycling till around six months pregnant, acupuncture and reflexology, if there was a chance that it could help, I tried it.
If you did want to attempt a vbac, is there any chance (I know that it's quite late in the day) you could look at having a doula? Having someone who can support you and your birth partner could be very helpful.
On the other hand, planned c-sections are a lot less stressful than emergency ones, you know what's going to happen and it removes some of that uncertainty.
I was four days off having one when I had my vbac as I had already decided that I did not want induction under any circumstances and I did not want to go more than forty two weeks. I actually think that having that arranged allowed me to relax enough to go into labour!

jaggythistle Wed 05-Dec-12 00:05:17

hi. i had long, augmented labour with DS1 ending in cs as well.

i also really wanted a VBAC with a 2 1/2 year old around. i used the natal hypnotherapy pg relaxation and VBAC prep cds. i also read the natal hypnotherapy book and Ina May Gaskin's which are both full of positive stuff.

i also hated not being in control the first time. i wasn't panicked, but not happy Iyswim. the reading and cds really helped with relaxation.

DS2 was born in about 14 hours from first contractions. i only spent a couple of hours at the hospital! forceps were used when his heart rate was causing worry, i still felt recovery was 100% easier and i was home that day to see DS1. i ended up just using the hypnotherapy techniques to cope which i was a bit shock about, partly due to late arrival at hospital though so no time for drugs.

it was the right decision for me, but it's so hard as you just can't predict anything!

good luck. smile

mumnosbest Wed 05-Dec-12 00:11:29

your 1st sounds very much like mine. it was a real ordeal ending in emcs. i recovered well although my milk took some time to 'come in'. Might be a consideration if you plan to bf.

my 2d and 3rd were a planned cs, which turned into emcs and a planned cs (no option of vbac). it's much less stressful. you go in fully prepared and organised. no surprises or waiting. However the cs itself and recovery after have been progressively more difficult and longer. it is difficult to care for your older dcs and newborn whilst recovering. i certainly didn't get a good nights sleep before and the surgery really took it out of me. Also you might want to consider whether you will want more dcs as cs become more risky the more you have. i was advised to make my 3rd my last.

sorry if i've rambled. i think given the choice i'd have chosen a vbac but that's me. good luck whatever you choose.

marimama Wed 05-Dec-12 01:15:45

I am in similar situation. 44-hr labor with DS1. I was a week overdue, waters broke at home, went to hospital where i was induced and then pumped full of drugs, non-stop contractions from drugs so needed epidural. Never dilated more than a couple of cm. my doctor had warned me a week earlier that i would likely need cs. I ignored her & in the end she was right. Maybe. Still think the drugs messed me up no end.

DS will be 3.5 if my current pregnancy goes well... I am scared of vbac, horrified by prospect of another marathon medical session, but just don't want to be stuck in bed recovering with another DC at home. Yuck all around.

Consider ing switching hospitals/doctors because last time was so rough. Very least will talk with a doula, i think...

Would love to know name of you vbac hypno cd.... grin

mmmmsleep Wed 05-Dec-12 04:12:49

Just wish i could stop my brain from thinking about it and get some sleep. Thank you for replies so far. Cds i've used are natal hypnotherapy. Need to see if i can rip them to mp3 so can listen with earphones as dh would not be impressed if i woke him now to play them on stereo in bedroom to help me sleep!

mmmmsleep Wed 05-Dec-12 07:07:58

Well that was a fun night's sleepsad

LaTrucha Wed 05-Dec-12 07:23:34

It's a very personal decision, and I don't think there is a right answer. I thought you might like a positive VBAC story, though.

DD was born by EMCS. She was transverse and I was very bruised as she was difficult to get out. It took me a long time to recover in every way. Even so, I was very difficult to persuade to a vbac until I was quite late on with DS.

I wouldn't do it any other way now. I would almost have another baby just to have another vaginal delivery! In the end I suddenly decided to go for it. DS was born with all the monitoring etc, which I didn't actually mind at all, with no intervention and not even a tear. I was very fortunate there was no one else labouring that night and I had great support. The next day I came home practially dancing, did seven loads of washing and posted pictures of the new baby to everyone I knew. So different from the terrible state I was in after DD.

Maybe if you went for it but came to terms that you could OPT for a c-section at any time in the labour you would feel more in control? I am no expert but there are a lot of good threads on vbac on here if you want to have a search.

Haggisfish Wed 05-Dec-12 09:45:41

i am in exactly the same position - looong first labour, but I dilated no more than 4cm, ending in EMCS after three days of labour. I have opted for an ELCS at 39+4. In my plan, I have said if I go into labour spontaneously, I am happy to have a go at a VBAC, without continual monitoring and with the possibility of labouring in water if all is going well. I don't want to go overdue and spend the first week of jan fretting about labour, plusmy OH doesn't get any paternity leave (complicated!), so it's much easier for us all round if I have baby on 27th, as planned. mentally, I feel more prepared and relaxed having arranged an ELCS, while knowing that I have the option of cancelling/trying for a VBAC if I want to. I'm in Worcestershire and we have a specialist VBAC midwife who I saw and was immensely helpful. Anyone like that where you are?

mmmmsleep Wed 05-Dec-12 20:19:34

Hi thanks for comments. Yes i have seen the vbac midwife. She was very good. Still my choice though. Toying with the idea of cs date booked for 41 weeks and vbac if i labour before that.

mmmmsleep Wed 05-Dec-12 20:40:19

And thank you for your positive story la trucha

BlueSkySoftSand Wed 05-Dec-12 20:54:47

Hello OP, I have a positive VBAC story.

After DS1 being a long, painful, drawn out labour and EMCS and alltogether a pretty awful experience . . . I had the option of booking in for an elective CS with DS2 and had a review date with the consultant in the diary a couple of days overdue.

But my gorgeous boy arrived early and with a very quick and relatively ok delivery. So, so different from my first experience and was so made up holding my newborn in my arms (didn't get to do this with DS1).

My birth notes stated that if I wasn't progressing after x amount of hours I was to be taken to theatre for CS.

I will go for a VBAC again with DC3 (15 weeks pregnant), but will be sure that MW knows about past experiences and have back up plan just in case.

(sorry if that's a bit waffly - I'm exhausted!)

Best of luck OP, I guess at the end of the day it is what you feel comfortable and confident doing.

mmmmsleep Wed 05-Dec-12 22:30:21

Thanks bluesky and congratulations on your pregnancy!

BlueSkySoftSand Thu 06-Dec-12 11:50:04

You're welcome. Hope you get the labour and birth that is right for you x

chroniclackofimagination Thu 06-Dec-12 23:46:19

I had an ELCS two weeks ago after a traumatic first birth that ended in EMCS. It was a completely different experience, much less stressful and physically much less of an ordeal than a failed labour and EMCS. I am recovering quite fast but we are paying my younger sister to stay with us for a few weeks to help with my two year old. I can't pick him up and would struggle to care for both right now as newborn is breastfeeding every two hours or so. No matter which option you choose you can't foresee how you'll be afterwards so if you can organise help in advance do! Good luck.

oscarwilde Fri 07-Dec-12 00:25:33

Agonised over this choice recently and eventually went for ELCS as the devil I knew. Have a number of friends who have needed post birth surgical repair which I didn't fancy. Got good feedback from a trusted and non-involved consultant that multiple CS's were v low risk these days too if I wanted a 3rd child. I did feel like I was copping out so it was a v difficult decision and there was always the question of what if it was quick and easy the second time around...
In short, my DC2 had other ideas and came early so I had a vbac in the end as things moved too quickly and the theatre was in use for EMCS's. it all went well and I was v chuffed at the time, esp to be discharged the next day but I am finding the recovery difficult and posted about it here today under 'postnatal recovery'. For me at the moment, I might as well have had a CS.

mmmmsleep Fri 07-Dec-12 21:04:29

Thanks chronicle and oscar. Wish i had a crystal ball!! Oscar sorry to hear your recovery hasn't been good...hope things improve for you quickly. Congrats to you both on your new arrivals and well done!

JKSLtd Fri 07-Dec-12 21:08:18

It's late for me & i was up too early so not going to attempt proper reply just now.

I had a very successful vbac (HBAC actually) with DD after an emcs with DS2.

However there are pros and cons to everything.

Try and sleep well tonight smile

StrawberriesTasteLikeLipsDo Fri 07-Dec-12 21:14:17

Im having an ELCS (2 weeks today!) after a long labour failed induction and eventual EMCS with substantial blood loss. Im hoping this time the illusion feeling of control, the lack of labour and the general civilisation (my perception thereof) of the event should make for a better experience, only you can decide though

mmmmsleep Sat 08-Dec-12 13:38:09

Starting to err on side of vbac but so scared of ending up with forceps and bad tears which would be just my luck. Last time was told at section that due to type of cord insertion into placenta they were glad they did section as cord would have snapped for vb...cue baby and mum haemorrhage. Detailed scans this time say no repeat but those what ifs are terrifying aren't they. Althouhh i know that is the same for any birth. Decisions decisons...

TotesFeckingAmaze Sat 08-Dec-12 13:49:55

I bottled out of a VBAC late in the day. I realised that I just couldnt risk another long, traumatic labour ending in emergency section. It was the right decision for me. My elective section was serene and lovely, I recovered well and I am glad I did it.

I guess you have to really ask yourself how you feel about a potentially 'not perfect' labour and birth if you go for VBAC. If you only really want a great birth experience, how will you feel if you dont get it, iyswim?

Good luck .

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