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

prissyenglisharriviste Sun 26-May-13 00:01:11

Thanks for thoughts - she's doing pretty well these days, considering. We were told that being offered a subsequent CS was largely dependant on the reason for the first one, and as the issue with dd1 wasn't likely to recur, we couldn't opt for ELCS. And then, with dd2, because I had already had one vbac (however horrific) with a live baby, that there was definitely no need for ELCS.

Needless to say, I now have a letter from the consultant which states for any subsequent pg, I am to have an ELCS.

I'm just generally a bit crap at childbirth, I think!

amazingmumof6 Fri 24-May-13 16:26:18

or more likely that it is just very difficult to get it straight....

amazingmumof6 Fri 24-May-13 16:25:22

cinema if that makes you feel better, my scar is lopsided a bit, despite CS being Elective.
surgeon couldn't be bothered? she had the time! makes me cross.

CinemaNoir Fri 24-May-13 16:09:50

Oh, recovery time with my crash cesarean was a week maybe. But the scar is very lopsided.

CinemaNoir Fri 24-May-13 16:08:58

Pros and cons are really subjective as we can see on the thread.

My logic was this:

Did hypnobirthing with DC1, came late to hospital (10 cm dilated and ready to go), and got the news that baby was breech... So straight onto EMCS. That moment I was very relieved that the docs could take care of the labour for me. Recovery time was a couple of days - almost!

Was told that women who progressed easily with their first labour would be great VBAC candidates so I got lured into a VBAC with DC2. Well, I didn't even do one breathing exercise before labour and baby was back to back. I was in agony this time around and got an epidural at 8 cms dilated (should have had a better prepared birthing partner..) so this epidural stalled the whole labour.. Basically I couldn't push and DC2 was born via forceps. It took me about a month to recover and I was depressed about that because I expected a speedy and easy recovery...

I had a nice ELCS planned with DC3. But labour started before the date and luckily I vowed to get to the hospital in good time after my experience with DC1. Again I made it just in time to the hospital (almost fully dilated when I arrived) and a midwife asked me to just try a vaginal birth. But I wanted my cesarean. Then I had to have a crash cesarean due to placental abruption, under general anaesthetic. They had DC3 out in 12 minutes.

It is nice reading about all the births on here :-) brings me right back.

My advice would be: if you go for a VBAC I'd do some hypnobirthing and get a great birth partner. But IMO VBAC isn't all it is cracked up to be.

Good luck!

attilascupcakes Fri 24-May-13 15:04:31

My first birth sounds nearly identical to Marbles. I don't have a clue what to do next time. I didn't progress past 6cm, so I assume that could happen again with a VBAC, but I don't know how big a family I want so the thought of having to stick to two due to cs scars worries me. Its such a minefield. I wish there was one "correct" answer to it.

jellybeans Fri 24-May-13 15:01:47

I had massive PPH with my 2nd c/s which was the second baby of twins. But it was in recovery I ruptured-lost many litres of blood and had multiple transfusions-was lucky to make it. Thankfully another op sorted it out. I went on to have a 3rd planned c/s and was so scared of PPH and had no PPH. So it doesn't always happen again especially if they take measures to prevent it. Eg I had a senior consultant (last one was a junior early hours of morning) etc.

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!

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.

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 11:01:20

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.

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.

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!!!!

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

*know nothing even

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

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

(Never offered ELCS, btw. No clinical reason)

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.

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?

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!

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!

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.

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

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

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.

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.

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!

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