Panicking about VBAC, but petrified about a 2nd c section...

(29 Posts)
loveroflife Tue 29-Jan-13 14:38:22

I had a bad first birth with ds. Hind waters broke and I was kept in hospital for 3 days and then had an induction, with pessary and drip etc. Very slow progress for 2 days and eventually had an emergency c section after getting stuck at 6cm. SLow recovery from that etc - all in all, a negative experience,

However, I can choose now to go through with a VBAC or request a c section. My biggest fear is going through everything I did with my first birth and then having to have an emergency c section again. I have been advised that I can book an elcs which is a kinder, gentler, experience?

I have some questions that I would be very grateful if any wise mn'etters could answer as my midwife is very pro VBAC and not interested in answering c section questions...

What's the latest you can book the ELCS for? Can you wait until 40 weeks or do they prefer you to have it earlier?

Do they cut through the existing scar or make a new incision?

Is it harder to breastfeed with an elcs because the milk is delayed because the body hasn't gone through labour?

Because of complications afterwards I had about a week in hospital with ds. What's the 'estimated' recovery time for an elcs as I now have a toddler to think about.

Sorry, for all the questions. I'm having sleepless nights over what decision to make and need to come to a conclusion soon.

Thank you

shelley72 Tue 29-Jan-13 14:46:52

i too am having VBAC/CS dilemmas. i had an ELCS last time for breech presentation so i can only answer a couple of your questions.

it wasnt any more difficult to BF than with my VB. easier in fact (though of course, i had done it before). DD was delivered on to me and as soon as she was weighed/measured she was placed back on my chest and was feeding before we even got to the ward. she is now 2.7 and has just stopped feeding. so it CAN be done.

recovery (for me) was a lot easier post CS. its true, i didnt drive for 6 weeks but i really wanted to make sure that i had healed properly and that i did no damage to my scar. i was out of hopsital 24 hours or so after the section, i did take it easy for the first few days at home but i know i was up and about three days after as i remember taking DD to get her tongue tie snipped, and i also took my then toddler to nursery. i healed and recovered much quicker than with the VB.

saying all that i know its not easy to decide whats for the best as i have to do it too! major surgery / risk of rupture and incontinence through tearing. hmm lovely choiceshock.

good luck with whatever you decide.

DoodleAlley Tue 29-Jan-13 14:57:15

Watching with interest. Currently 29 weeks and debating vbac v elcs since I found out it was an option due to previous trauma.

DoodleAlley Tue 29-Jan-13 14:57:54

Btw I got told needed to decide at 36 weeks

PooFlower Tue 29-Jan-13 15:08:27

I had a similar first time to you, induction ending in emcs.
P
I chose an elcs for DD2

I was booked in for 39+2 as they don't do planned cs at the weekend.

In my case they made a new incision but this was because I had infections the first time and they said the new incision would heal better ,which it did. My friend had her 2nd Cs a few months ago and they went through her old scar.
I didn't breast feed but above friend managed to breastfeed after both her c sections.

I found my planned cs a lovely calm experience, I had DD2 at 10am, mithered the poor midwives to help me get up and was up pottering about by 4pm.
I went home at lunchtime the next day and had a fast recovery with no problems. My Dd1 is 8 though it might be a little harder with a toddler.

I think you can choose to see if you go into labour naturally and they book you in for elcs at an agreed date, so they book you in for 40 wks or 41 wks.

I asked for a cs from when I found out I was pg as I wanted to be sterilised at the same time.

Lexiesinclair Tue 29-Jan-13 15:13:54

I had a horrendous VBAC with DC2 that resulted in him spending 2 weeks on a neonatal unit after being asphyxiated, and me in intensive care, in separate hospitals. The problems stemmed from me being allowed to labour too long (72 hours!) which resulted in my uterus rupturing and an emergency caesarean when DC's heart beat dropped dangerously low. I had wanted a ELCS but allowed myself to be persuaded that a VBAC was the better option.

In contrast, my elective caesarean with DC1 was very positive and straightforward.

I realise that what happened to me was rare and that the vast majority of VBACs end well - if you decide to go with this option then I would suggest having a conversation with your consultant re having a caesarean if your labour is not progressing as quickly as you would like, for reassurance.

I had no problems with breastfeeding after either CS - even though I didn't actually see DC2 until he was 4 days old. sad

Good Luck with whatever you decide!

Lexiesinclair Tue 29-Jan-13 15:14:43

With mine they used the same incision - they just had to widen it as DC2 was bigger.

bonzo77 Tue 29-Jan-13 15:25:34

Posting on phone so can't check back. Please excuse multiple posts.

If you definitely want an elective they usually book at 39 weeks as its easier if you are not in labour.

Sometimes they remove the old scar and sometimes they go straight through it. I had a very neat scar so they went back through it. It's even neater now!

Recovery: DS2 was in NiCU. I went to see him in a wheel chair after about 3 hours, and walked to see him after about 10 hrs. I felt ok to go home the next day, but chose to stay as would be closer to NiCU and I didn't want to give myself the blood thinning injections at home. I felt so much better than I did after the emcs. Was off pain killers after less than a week, driving in 2 weeks, lifting my toddler after 3.

The actual op was more unpleasant than the first: they had problems placing the cannula and the epidural, both of which were painful during and after. I had a lot of adhesions and it took about half an hour to open me up. DS2 also had breathing difficulties which is quite common after all CSs and you should be prepared for.

BF: I didn't actually BF either DS, but my colostrum was in the following day, and milk seemed to come in day 4ish like with my first one.

I saw the consultant yesterday, and have booked for elcs on fri

I could Wait until 40 weeks and then go for an elcs

They said they would go through my existing scar

Bm starts being produced when the placenta detaches from the uterus so not going through labour shouldn't make a difference

They said most people go home on the 2 nd day after the cs

Should say I'm 38 weeks tomorrow and only a candidate for vbac due to having an incompetant cervix.

Even though they said I could wait until 40 weeks if I wanted to I was a bit nervous due to very big first baby and not being an ideal vbac candidate so they have decided as I don't have strong feelings about having vbac it's safer for me to have the cs now at 38+2

ILikeToMoveItMoveIt Tue 29-Jan-13 15:41:35

Your milk doesnt take longer to come in after a csection. It's not labour that instigates milk production,it's the removal of the placenta. However it is harder to be mobile after a section and can be uncomfortable to feed in certain positions, which has the possibility to affect your milk supply (less skin to skin time and time at the breast etc etc). So if you make sure you have lots of skin to skin and time at the breat, that should help.

Each surgeon has a different way of opening and closing.

Recovery times can vary a lot. Some people a week, some people six weeks. Being mobile as soon as the epidural wears off will help a lot - and I mean just little walks around the ward, not a sprint down the corridor!

Everyone has a wobble with their birth choice I think. The fear of the unknown is tough, and everyone is different.

I had two amazing VBAC's, they were very healing after my EMCS and probably my two proudest achievements. But I also understand that not everyone feels like I do about VBAC.

One thing I would say is remember that your body did not fail you with your ds's birth. The induction drugs failed.

noblegiraffe Tue 29-Jan-13 15:51:52

I had an ELCS a few days ago, after an EMCS first time around.

While the operation itself wasn't pleasant, it was better than the scary build-up and being whisked off for surgery of the first time (v painful labour, baby in distress).

The recovery has been a completely different kettle of fish. With my EMCS I felt dreadful, had to be forced out of bed when they removed the catheter and wanted to stay in bed all the time. This time I was itching to get up and was demanding the catheter be removed, then I was able to get up and change nappies no problem. I was in hospital 2 nights after a mid afternoon section. First time I was on painkillers for 2 weeks and was very aware of when the next dose was due; this time I've skipped doses and been late taking them even only a few days later. It's unbelievable how different it's been, I have to keep reminding myself to take it easy.
I've been bfing, hasn't been easy, and a mucousy baby due to the c-section means that the start was tough, but my milk came in bang on time (as it did first time around).

noble how long was it before you were able to get up?

DoodleAlley Tue 29-Jan-13 16:00:16

How did people make their decision if it wasn't based on medical necessity? I feel I have no idea how to choose one option over the other?

noblegiraffe Tue 29-Jan-13 16:13:20

I had the op mid afternoon one day, catheter was removed around 10am the next day - for some reason I was missed off the morning list and it should have been done earlier, and I would have been fine to get up around 12 hours post-op. I surprised my DH by meeting him in the corridor when he came to visit at lunchtime having pottered around all morning.

loveroflife Tue 29-Jan-13 19:14:49

Thanks so much for all the advice and answers.

I am in two minds over this and will need to have a think and research a bit more. I honestly can't remember chunks of the birth last time as I was so drugged up and exhausted. My most vivid memory is vomiting all over the operating table after being rushed down to theatre.

However, I remember afterwards I was so scared to stand up - I almost felt like my stomach was going to split into two. It was so painful but I think that was coupled with the exhaustion, the labour and the previous week spent in hospital.

This time though I will have some idea of what to expect, but still feel pressure to have the VBAC rather than as my midwife says 'the easy option'. <So unhelpful and irritating!>

Doodle - I think you would have to present a sound argument that you want an elcs for psychological reasons if there were no 'medical' reasons for you not to have a vaginal birth. You say in your post that it's an option for you because of previous trauma - so this would surely would be a good enough reason for your choice, if you wish to press ahead?

My due date is a sunday, so I would hope to hold out for the following day and technically then be 'overdue' as they don't do elcs at weekends.

RedToothBrush Tue 29-Jan-13 20:06:55

but still feel pressure to have the VBAC rather than as my midwife says 'the easy option' <So unhelpful and irritating!>

Not to mention unprofessional and judgemental.

Happysurprise Tue 29-Jan-13 20:35:32

I think lots of people are judgemental about elective c-sections, they assume just because its "natural" is going to be safer but from what I read its not necessarily the case.

Some very interesting posts and good luck in makeing your decision loveroflife. I am definitely being swayed in favour of elective c-section at the moment but will properly investigate all avenues first.

Happysurprise Tue 29-Jan-13 20:37:53

I meant to write "they assume because VCB is natural its going to be safer".

Whereisthesnow Tue 29-Jan-13 20:50:38

Just to say op I'm similar to you - started thread myself the other day on ssimilar topic, except I am more pro vbac but wobbling about this at the moment. what puts me off the elcs is that it's still a major op and incision to the body. good luck to you though, your mw doesn't sound v helpful!

DoodleAlley Tue 29-Jan-13 21:26:02

Sorry I didn't make it clear. I've been offered the choice between c section and vbac because of trauma with my first birth.

I'm just dithering over what to choose. I like the planned nature of a c section than risking everything I went through last time, but I'm
Scared of what I perceive as increased risks from the "non - natural" option of possibly unnecessary surgery.

I've got an appt at 36 weeks to communicate my decision but I feel no closer to even knowing how to make this decision let alone making the decision itself

noblegiraffe Tue 29-Jan-13 21:52:21

Tbh, when I read all the stories on here about forceps/ventouse deliveries, 3rd degree tears or worse, days long labours, crowning and all that, I've heaved a sigh of relief that I've not had to go through that, and was allowed to choose a c-section the second time around. I might have a massive cut in my stomach, but at least it wasn't in my bits.

duchesse Tue 29-Jan-13 22:01:56

My sister's had 5 CS, a range of emergency, emergency after attempted VBAC and planned CS. She says planned is a gazxillion times better than emergency and doesn't mind them at all.

salvadory Tue 29-Jan-13 22:03:31

I had emcs then elcs 2 years later. Had elcs at 41 weeks to give my body a chance to go into natural labour (I refused to be induced after first birth). Both cs were v straight forward but the elcs was a really pleasant calm experience. I even asked to watch (am not squeamish) but they refused. I bf both babies with no problems. Recovery the same for both (I appreciate I was lucky) although my belly is not v pretty I put it down to diastasis recti not the 2 sections.

It was only last week that I decided that if the baby didn't come before I'd go for elcs at 39 weeks , they won't induce me though so I didnt want to go to term + and still end up going down the elcs route. I was surprised though to find out they wanted to do it at 38 weeks!

I had an awful vb with ds1, days of failed induction, forcepts, pph 11lb 2 baby. Ds2 was totally different though. One hour of active labour, no tearing. I really good experiance.

How many weeks are you?

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