Second CS or VBAC?

(82 Posts)
2margarinesonthego Tue 21-May-13 10:53:19

Hi All,
My DD1 was planned CS due to being breech, and I initially decided to go for a VBAC for this baby (DD2). But now I'm having cold feet for lots of reasons I won't bore you with.

I wondered if anyone had any pros / cons of going for either option. I feel I don't get the full story from medical professionals, IYKWIM.

Many thanks smile

Dozer Wed 22-May-13 23:02:54

Fantastic birth story amazingmumof6! Staring contest with the midwife grin Midwives must see it all!

Good for you pinkbeans for holding out.

amazingmumof6 Wed 22-May-13 23:34:34

I kept on saying " I'm not doing it" in a tone of "and what you gonna do about it?"

she and DH were going " oh but you've been doing so well, let's get this baby out! "

me: ok, call the surgeon then, I'm having a C-section

dh: come on darling
me: you fuck offangry

mw: well you need to push blah blah blah
me: I want a C-section. I'm not pushing, I don't know how to.

DH: but you've done it before. FOUR TIMES!
me: I know. not today....

seriously, it was surreal. grin grin grin grin

MummytoKatie Thu 23-May-13 09:32:53

Hi 2marge I had an EMCS with dd - got to 9cm but she was back to back and had turned her head the wrong way and by then it was 14 hours since I'd turned up to the hospital at 7cm so we had to stop. Had a PPH during the surgery due to clots forming which wasn't great.

Also dd started crying before he was born and inhaled a load of mucus that she spent the first 3 days of her life coughing up.

I have decided to go down the VBAC route. I'm due in 8 days (and dd was 4 days early) so it really is any second now. I'll try and come back on this thread after and let you know what happened.

I won't list my reasons as they are already up there given by others. I did have a complete choice although my instinct (VBAC) matched the doctor and midwife's advice.

A few things I will say about how it is right before:-

I do feel (and I hate this word but please bear with it) very empowered that this labour is my choice. I do not have to do it. I can change my mind. But I have made the decision that it is right for my baby and my body and that does take some of the fear out.

Childcare for labour is stressing me out slightly. We have lovely friends who are keeping their phones on. We have in laws who are chomping at the bit to race down the motorway and take over. But I don't know when it will happen and that is a bit scary. If I had a ELCS I would have a date nd we could plan.

Finding it hard to go to sleep and not know if I will wake up in labour. Didn't really happen with dd as she was a few days early and first babies are usually late so not really expecting it.

But it would be even more scary (I think) to just turn up at hospital for the operation. The best (and worst) thing about labour is that once you start you can't stop so you just cope!

If I had had an ELCS I would probably have the baby now which is really really weird. There is a little bit of me that is thinking "if I turned up at the hospital today and said "changed my mind - want my baby" would I get it"????

Squitten Thu 23-May-13 09:41:06

LOL @ amazingmumof6 grin

I can't give you statistics OP but I will tell you what happened to me.

DS1 was a breech baby, which was not discovered until 41wks. The consultant recommended a section because it was a first baby, etc, so that's what happened. Recovery was fine, no complications with me. BF was a total and utter nightmare though and it made the first weeks really rotten. I don't know if that was connected to the section, the quite rubbish care on the ward or the fact I was a total noob at babies!!

With DS2 I was in a different hospital and they were hugely encouraging of VBAC. I went to hospital when things kicked off at 3am and delivered DS2 6.5hrs later. I had a canula put in my hand and a monitor on my belly so i was quite confined to the bed but I think that was mostly because it never occured to me to move around. I tried a bit of G&A but everything made me sick so I had no pain relief whatsoever. Baby was born fine and, since I had been intervention-free throughout, I had a physiological last stage and got the placenta out with the help of baby BF. The only damage done was a 2nd degree tear, due to shoving DS2's fat head out in one big pop! Few stitches and that was that! Showered, had breakfast and spent a few hours in delivery room waiting for them to process my stuff and discharge me and was home at lunchtime.

My second experience was so much better than my first. Despite not exactly appreciating it at the time, having a VBAC was brilliant. Obviously my nethers were worse off afterwards than with DS1 but it passed, BF was excellent and everything was just really easy and straightforward.

I'm now expecting DC3 and will be having a homebirth this time.

No one can tell you what to do - it is your body and your decision.

I had an EMCS for failure to progress with DD and was really keen to avoid another CS with DS as I found the recovery hard and the thought of recovering, not being able to drive etc, with a 3 yr old and a newborn was awful.
After doing a lot of research, i decided to try a home VBAC in a birthing pool. I weighed up the risks and made my own informed decision. This is in accordance with NICE guidelines, which state the doctors and midwives must respect the pregnant woman's decision, no matter what they believe she should do.

Once the hcps found out I was planning a home birth, they seemed to go a bit doolally and not once did anyone point out the risks of having a c-section. They go on and on about risks of vbac, scar splitting but don't tell you the risk of a uterine rupture are only slightly higher for a vbac than with a first timer (first timer can and do have a rupture with no previous scar). There is a higher risk of PPH with a c-section and it can affect bf.

My first cs definitely affected my ability to bf DD.

In the end, i ended up with a second cs but I feel OK as I let DS choose his own birthday (41+6!) as I declined induction. I laboured for a good couple of days at home, the last 9 hrs in the birthing pool which was calm and wonderful.
I transferred in after the hb midwives suspected DS might have turned transverse and carried on labouring in hospital for another 12 hrs as he was head down after all. It ended up with a crash c-section, and it turned out my bladder had become attached to my uterus and if DS had come out vaginally, he would have burst my bladder. My body must have known this as DS did not descend properly during the labour.

But mentally, I am so glad i stood up for my choices and attempted a home birth.

Whatever you decide, it's up to you. CS recovery is harder, as you know but if you do decide surgery, I'd go for an elcs rather than an em or crash. VBAC is very very empowering.

izzywotnot Thu 23-May-13 10:55:31

As with Pinkbeans I had to "fight" for my second CS - first with the midwife at the ANC and then the Consultant at my 36 week booking.

I think what swung it for me was that I asked for my request for a CS to be written in my notes so that if anything happened during my delivery I could refer back to my original request. He then agreed to a section straight away.

Don't be bullied - it's your body and your right to choose!

jellybeans Thu 23-May-13 12:48:55

I've had 3 C/S and 2 VBACs. One of my C/S had life threatening complications but it was twins which is higher risk...The elective C/S was pretty good though compared with the crash/emergency sections I had prior. But my first VBAC was amazing. I was euphoric to have actually 'done' it. Given a choice I would go for VBAC if you are low risk. Because the recovery etc is so much better even if you are unlucky and get a bad tear (I did). Plus less time in hospital. Also if you want a big family c/s will limit the number you can have although I know a few people that have had 4.

Heather1977 Thu 23-May-13 13:24:07

I had wavered about whether to go for a VBAC with my 2nd ds. In the end, my feelings were that however small the risk of rupture, the results can be catastrophic and I was just not willing to expose myself to that risk, however small. Yes, I understand there are many other risks associated with a cs, it was just what made me feel more comfortable in the end. Plus, you will generally not be able to labour as long when you have already had a cs, so I preferred to go with odds and just book in an elective cs, which is so much less stressful on your body than an emcs. You can also book in childcare, prepare your dc, and feel calm and control about everything. Just how I felt!

Heather1977 Thu 23-May-13 13:27:20

Sorry one more thing, and probably quite controversial: I think feeling empowered or sticking to a birth plan for your own reasons, should always come second to the health and safety of the baby.

PoppyField Thu 23-May-13 15:03:57

Hi,

I had an EmCS with DC1 as the cord was wrapped round her and she did not engage during labour. Was going to attempt VBAC for DC2, until I discovered with a late scan that he would be at least 9lbs, which would have made complications i.e scar ripping or non-textbook 8-10hr labour much more likely. The main thing I wanted to avoid was another EmCS, so the least worst option for me was to go for an elective ceasarian.

DC2 came out at 39 weeks weighing 9lbs5oz, so I think it would have been a tough call to push him out textbook stylee for first VB. Especially if it had gone to 40 or 41 weeks.

I had lots of good (as it turned out) advice from my obstetrician. He was in favour of an elective. Who knows if he was one of these that likes to 'medicalise' birth, or maybe he liked to be able to put it in his diary beforehand rather than let nature take its course. Or maybe he just believed, on the evidence and with the weight of his experience that this was the best option. He said he would be completely happy if I wanted to try for a VBAC also, but gave me the contingencies. I trusted him, went with his advice and I was happy with my decision.

I am also glad I have my pelvic floor intact. This is a side issue I know, but I like to run to keep myself sane and there are any number of women I know who cannot run because of pelvic floor issues. I felt that I already had a CS scar, I didn't particularly want a ruined pelvic floor as well. Again, who knows whether I would have suffered that if I had gone through with a VBAC. I will never know. But I am grateful that I've only got one lot of scars.

Good luck with it.

amazingmumof6 Thu 23-May-13 15:37:58

Heather baby's and mum's safety is always paramount. that's common knowledge. smile

I had an EMCS with DS1 as he was an undiagnosed breech. As that was the only complicating factor I decided to go for a VBAC with DS2 after having a scan at 36 weeks just to check he was head down.

My recovery from the VBAC was much better than from the EMCS.

There is no right answer, I felt comfortable that the risks of a VBAC were low for me because I had successfully gone into spontaneous labour with DS1 etc and the only reason I had had a CS was that he was breech and showing some limited signs of distress. I did agree to continuous monitoring even though I am not convinced it was strictly necessary.

If you are not comfortable with the risks of a VBAC for you or fear of a VBAC will leave you unsettled for the rest of your pregnancy then don't have one. How you give birth really doesn't matter.

am988 Thu 23-May-13 20:49:53

Had emcs with my first, vbac was encouraged for my second.. all started well on due date but... they were worried for baby so ended up in emcs again... done hypnobirthing which helped but... I wish I eliminated the emergency part!

BirdyArms Thu 23-May-13 22:50:33

I also had a CS with my first due to breech and had a very successful VBAC with my second. I felt that all the obsessive reading up I'd done about VBACs on mumsnet and elsewhere really helped me. I was in a very positive and determined frame of mind and was very fortunate that everything went very smoothly.

This next bit is based purely on conjecture rather than medical opinion - I think that the fact that your CS was because of breech also goes in your favour, ie you didn't have a CS because your labour failed to proceed which might be more likely to happen again. At least with breech you will know whether it is happening again or not rather than going a long way into labout and then having an ECS which must be harder on your body. With my first I spent the whole of my pregnancy chained to my desk 12+ hours a day and I think this is probably why he ended up upside down. With my second I made sure I did lots of exercise and he was the right way round.

Good luck whatever you decide!

amazingmumof6 Thu 23-May-13 23:11:08

birdyarms don't youmean DOWNSIDE down?grin

I'm not convinced about the whole babies will turn if only you were on all fours etc. or whatever.

they tried to turn DS4 with external manipulation, but it didn't work because his foot was stuck. had to be ELSC.

for what it's worth I've been told by a few different people (and books) that you should sleep on your left side as that is a position both you and baby benefit from.
can't really remember why, something to do with internal organs?

prissyenglisharriviste Fri 24-May-13 01:32:15

dd1 - ELCS for macrosomia. They told me she was giant. Se was 8lb 6oz.

Ds1 - vbac1. They prepped me for emcs for failure to progress (he was back to back, tried external and internal rotation - it was like James bleeding Herriot) but I managed to squeeze him out just as they arrived to wheel me to theatre.

Dd2 - vbac2. She has cerebral palsy as a result of birth hypoxia.

I absolutely support all you ladies who are against CFM in a vbac scenario. But for me, thanks all the same, I prefer the NICE guidelines to be followed. If they had been, there's a pretty good chance dd2 would have escaped serious brain damage.

prissyenglisharriviste Fri 24-May-13 01:32:45

(Never offered ELCS, btw. No clinical reason)

amazingmumof6 Fri 24-May-13 07:28:30

oh prissy sorry to hear about your DD2!

when was this? (and where?)

I was told that once you have CS, EL or EM you pretty much "qualify" for another one.
sorry, not meaning to add insult to injury, just can't believe that the information/policies can varies so greatly depending on where you live/who's your MW etc!
it's sickening that, in your case this oversight or lack of information caused your DD2 to suffer unnecessarily (most probably as a result of the birth as you say)

I no nothing about the condition she has, I hope she is ok. and you.
thanks

amazingmumof6 Fri 24-May-13 07:29:08

*know nothing even

Marblerun35 Fri 24-May-13 09:08:18

I am 36 weeks pregnant.
I had EMCS with first baby. This was due to the stopping and starting of the induction process due to a busy hospital. Eventually after messing about for 4 days I got to 8 cms. Bby was back to back and did not progress from here. Very painful!!! After baby became distressed was admitted for EMCS.
With second baby I opted for planned CS due to expecting a very large baby.This went smoother but it was a very long op and I lost blood and had a big scar.
Now i am expecting third baby and I dont know how to have it:

1. Consultant says there is no reason why I cant have VBAC but I have to bear in mind the risk of scar rupturing.
2. The baby could be big. I am waiting for another growth scan.Does this really affect your chances of having a successfull VBAC? Can doctors tell the position of the baby before I get going?
3. I will be continually monitored. I dont like the idea of not being able to move around.
4. I do not want to end up with and EMCS but I also dont want to end up with a forceps delivery and stitches etc.
5. If I have another c section I have heard that a third one can be complicated ie hysterectomy, bleeding etc. There is a chance we may want another baby.
HELP!!! I need some answers!!!!

DC1 was ELCS due to developing pre-eclampsia plus DD was breech.

DS was VBAC, but I don't think I was ever given the proper info, it was assumed that was how I'd proceed. Which was okay by me anyway. It went really fast for a first labour which is something that seems to run in my mum's family (ie fast labour and birth). Midwife still had to break the waters though, and things went from 0 to 60 so quickly I felt a bit shocked after the birth.

But apart from stitches for some very deep scratches caused by DS and his sharp nails on the way out, I had no problems and would have a natural birth if I ever had another child.

amazingmumof6 Fri 24-May-13 11:01:20

the hysterectomy thing is very rare, and only needed if womb is not starting to contract to shrink itself back down - mum could literally bleed to death.
if I understand correctly that is generally not a concern until you've had at least 4, but I don't know.

as you had PPH they might worry that you are a higher risk, but I had forceps with DD1 and PPH and I thought those two things were connected!

the injection in the thigh that helps deliver the placenta helps the womb to contract down

so hard to know what to do.

do you have pregnancy diabetes?
that could cause baby to grow too big.
so perhaps ( and I know it might sound silly) but if baby's a good size and you have a good nutritious diet cutting down on sugar could help not to "overgrow" baby?

that might make a successful VBAC more likely?

I'm clutching at straws and might be talking utter rubbish so check this theory with MW.

amazingmumof6 Fri 24-May-13 11:02:18

position of baby - yes, they can, reqiest a scan or two if needed

amazingmumof6 Fri 24-May-13 11:07:59

and re the hysterectomy, I told DH before going into labour with DS1 that I'd rather have that to save my life and have no more babies, so he knew what to decide if needed.

had 6 so far, DS4 ELSC, then 2 VBACs, feel very blessed.

I had ELCS with DS1 because he was footling breech and desperately wanted a VBAC second time around. Then for a long time DS2 was breech as well so I was just coming round to the idea of 2 CSs. Finally DS2 did turn though and I did have a VBAC with him.

I didn't want continual monitoring but agreed to put it on at the start, the idea being that it would then be turned off. In the end, everything happened so fast that we all forgot about it! I did manage to avoid a canula though - hated that with DS1.

For me, I wanted to experience labour, despite being scared by it. Also, I really didn't want to be recovering from major surgery with a newborn and a two-year-old to look after. Whether it was related to the CS or not I don't know, but BF was much easier with DS2. Mind you, he was also a much bigger and generally hungrier baby!

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