Repeat section or VBAC? Advice please

[pucca]

This is for my cousin, she is due with 2nd baby in July and is torn as to want to do so could really use the advice please ladies.

1st birth she went into labour and had a epidural (which i think may have contributed) ended up wasn't dilating any further and baby's heartbeat dipped quite badly and didn't pick back up so she was rushed in for a emergency section, which she had a bad time with so is anxious about having another.

This time around she has been told she can have another section if she wants or she can go for a normal delivery...what does everyone think?

1st baby wasn't small as was 8lb 9oz.

I have told her that a elective section is a much calmer,nicer experience (been through one myself lately), but then if it was me i think i would try for a VBAC and just not go for a epidural (can slow or stop contractions) but i don't know lol.

Has anyone been in this situation and can you say what you chose and your opinion if you did the right thing please?

Thanks i will print this off to let her read afterwards.

[uwila]

Her first birth experience sounds just like mine. I had my second (and last) baby by planned elective. It was worlds better. Definately recommend the elective section. Oh, and arnica by the bucketload.

And I would never never never consider giving birth without an epidural. I'm just really into pain.

[uwila]

I'm just really not into pain.

[Isa11]

I am really NOT into pain either. HAd my first birth naturally, and for my second there was no way I would not have an epidural/spinal.

Having said that, second births are often much quicker, and easier.

I have not had a C-section, but I can say that second time around I got to 8 cm almost completely pain free and it all went very fast, despite havign a spinal when I got to 8 cm. In other words, even with an epidural, the birth will probably not be hugely slowed down when it's a second birth because they tend to go so fast anyway.

So, if you chose not to have a C-section, I would still have an epidural. Each birth experience is so different that it is very hard to extrapolate from your earlier experience to your next one.

[tron]

pucca, your cousins experience sounds exactly like mine. I was adamant that I wanted a VBAC for DD but i was 12 days over and no sign of labour starting. After examination doc said it was too risky to try induction. I was really gutted, i still feel i've missed out on the experience of childbirth. I would advise your cousin to bear in mind that even if she choses a
VBAC don't set her heart on it as things never go according to plan

[uwila]

Second births don't go faster if the first one was a section. The process will go like a second birth up to the point where the section happened the first time.

[pucca]

Thanks for the replies everyone

uwila...that is a very good point about 2nd labour won't be quicker (depending how far progressed last time) i had never actually thought of that.

Does anyone else have any other advice? or experiences? would be nice to have a number of replies to show my cousin, thanks ladies.

[lulumama]

had a very postive VBAC


my first c,s was for exactly the same reason...failure to progress

so there is no medical reason to give her a section...at all !!

it is widely acknowledged that an epidural , especially if given in early labour or before labour is established, can slow or stop labour..

will link to some other threads where vbac has been discussed in more depth , as otherwise i will be repeating myself

having confidence she can give birth is important...

i'm afraid i have to disagree with uwila

no two labours are the same, and where you stopped in the first labour, might not dictate how the second one goes at all.

so many factors influence a good labour...and part of that is how you view the first birth and are feeling about the second one

[lulumama]

like this thread!

[lulumama]

and this one!

[lulumama]

this is a cracker.,..make a cup of tea..it is long!

[lulumama]

last one!

you'll notice i am on those threads ! a lot!

vbac is a pet subject of mine....

there is also some debate in there re elective c.s too !

[twoplusone]

I went for a VBAC with DS.


DD was an elective cs due to probs in the pg.

I was given a sweep on my due dtae with DS as vconsultant wanted to cs me again.. I did a deal with her that if by the Tuesday (this was thursday) I hadnt had the baby thenI would have a cs.. I had him on the sat morning.. I was adimant I wanted to to do it myself, and I felt so proud.. will do everything I can to avoid a cs with this pg to..

Good luck to your cousin in whatever she decides..

[uwila]

"i'm afraid i have to disagree with uwila

no two labours are the same, and where you stopped in the first labour, might not dictate how the second one goes at all.
"

This is medical fact. When you pass the point where you had the section in the first labour, from that point on it is a first labour/delivery. Queen Charotte midfife and doctor told me this. It doesn't mean this labour/delivery is redictable. It just means it will be like a first one.

I personally believe even the slimmest chance of a scar rupture is reson enough to have a section. Some of the advice here is very pro vaginal delivery and not at all unbiased medical fact, such as the claim that it is widdely acknowledged that epidurals slow and stop contractions. I think this is disputed in many kedical circles. It is also believed in many.

Anyway, I haven't really got time to get sucked into this thread. My advice it to talk to your consultant and get some good sound medical advice. And also talk to people who had repeat planned sections and of course also people who had a VBAC.

[Laura032004]

I had a VBA1C for DS2. I planned a hb, but ended up in hospital due to GBS.

With no 1 I had failure to progress, so syntocinon augmentation, with which they said I should have an epidural as no-one can bear the pain of an augmented labour. The epidural caused DS1's heartrate to slow, and resulted in an emergency section.

DS2 was induced as well due to PROM (5 days) and the GBS. I didn't have an epidural until I'd been on the drip for over 36 hours. The pain was definitely copeable with (wish I'd known that first time). Again failure to progress. Got to 4cm after 36 hours. No progression for 4 hours. Then epidural to prepare for c/s. Wanted to wait for c/s (v.tired and emotional), and suddenly I dilated, and DS2 was born naturally.

He had to go to special care, but this was only a precaution, mainly because of the Strep B. Don't regret any of it. I was in pain for two weeks due to episiotomy, but I could pick DS1 up the next day, and 6 months later, no pain at all. Very different to first time round.

VBACing in hospitals is not always easy. They wanted to do a section after 4 hours on the drip. I was told a lot of times that the baby would never be born naturally and I was wasting my time. If you want to do it, you have to be 100% certain in your mind that is what you want. Or try it and see how it goes, but be sure you won't regret having a section at an early stage if you are pushed into one. I wanted to be sure that if I had a second c/s, I knew that there was no other option, and couldn't think 'what if'.

[NAB3]

I had a section followed by two VBAC. All depends if the first section was a problem with the baby, ie not likely to happen again, or with the mother.

[lulumama]

no, i don;t speak from unbiased medical fact. although all i have read about birth , over the last 2 years has indicated that epidural does slow and stall labour...not always..and being active is a good thing in labour..and i speak from my own experience..which is a valid viewpoint.

i was at a meeting yesterday where the head of midwifery at the local maternity hospital was certainly pro VBAC.....and home birth and vaginal , intervention free , midwifery led care as much as possible

i think the information you get from your consultant or midwife can cary depending on whether they are pro VBAC or elective

so medical fact might not be unbiased , ifyswim

i personally believe that women are physiologically designed to birth their babies vaginally, UNLESS there is a strong physical / medical indication that this is dangerous to the mother or baby. and a previous c,s and scar is not necessarily a reason, ifyswim....


Dasiymoo and toady have some excellent stats on the odds and possibilities of scar rupture ...

will point them this way if i see them!

i don;t think uwila and i will agree re this issue...nor should this thread be a debate between us..

there is a risk of scar rupture, a small risk, that you can make an informed choice about, same way there is a risk of cord prolapse with every delivery..but you have to weigh up each risk against the benefits and decide if it is an acceptable risk.

yahoo VBAC & HBAC Group is a good source of info

[NAB3]

Scar rupture risk is small but can happen. I think I was very close to it with my 2nd VBAC.

[Lullabyloo]

diverting a little from the subject..should probably start a new thread..but..
Having so wanted a vbac home birth,I was 14 days overdue when taken in to be induced.49 hours and many ghastly interventions and internals later I was still only 2cm dilated ,exhausted and hysterical because contractions were so strong I couldnt rest.When they broke my waters it was very obvious that babe was in great distress & I didnt feel like I could go on-totally against my birth plan I pleaded for a c.s.
I couldn't believe the words were coming from my mouth-nor could d.h.I was terrified,I felt everything had gone wrong,I had no control and my babe was at risk-I just wanted him in my arms..safe.
I had had no continuity of care,numerous carers-nobody longer than an hour at a time-nobody to reassure and comfort me.
I was told I couldn't have a c.s just to relieve my pain.I sat on the floor completely hysterical and begged d.h to take over-he knew that a c.s was really the last straw for me.
At 57 hrs they did another internal & finding I was still 2cm dilated,was then signing forms and being rushed for an emergency c.s.
D.s was wedged in my pelvis with the cord around his neck 4 times.They had to use forceps to yank him out and he was blue.They told me on the table that I had an android pelvis & would never have been able to give birth naturally.
That was 2.5 years ago & am still in shock.
When re reading my hospital notes I found the third entry read-Android Pelvis?
Why was this not followed up or questioned?
Having longed for a large brood,I am now terrified of getting pregnant again as def couldnt cope with another c.s.
Does anyone else have an 'android pelvis'?
Does this mean I have absolutely no hope of a vbac?
Sorry this is so long-would really appreciate hearing other people's experiences though.This is the first time I've broached the subject as I still feel so raw.
Thanks for listening & sorry to jump on this thread-novice m.netter!

[lulumama]

hi lullbayloo

firstly

please contact

birth trauma association

to be debreifed on your births and gt some 'closure'

i am so sorry you had such a hard time, and i can tell from your post how distressing this still is for you

i know little about an android pelvis..but as far as i know, there are 4 'types of pelvis....and a gynaecoid is the one most women have and is suited for delivering a baby vaginally. an android pelvis is , i think, more 'male' in shape and not well suited , physically to birthing a baby vaginally

i think it is a shame that this was not picked up on , if it is the case .

i had an MRI scan after my c.s to determine if my pelvis was normal, or not...also , an experienced midwife and obstetrician can assess the pelvic outlet and diameters by feel ....this is something you can ask for..

it might well be worth getting in touch with the hospital to go through the birth notes with the head of midwifery or another appropriate person at the hospital to determine the events of the birth

if you do want to have more children. then it would be a terrible shame not to do so due to fear of another traumatic birth

if you do have an android pelvis, then it might well be you can carry more children, but need an elective c .s or a differently managed labour to have deliver the baby......

also a doula can really help you prepare for another birth and be with you , however baby arrives.

there are ways to get to the bottom of this, please don;t think it is hopeless..

hope that helps x

[Toady]

Hi pucca's cousin

failure to progress this seems to me to be a very common reason for a section, this was the reason for my second emergency secion. In other words failure to progress within the hospital time limits.

When I tried to have my VBAC1 DD was OP (stargazer). I had strong contractions every three minutes from the word go and they lasted 30 hours. I did not research anything beforehand and did everything I was told thinking I must because I was such high risk at having a previous section.

During those 30 hours I had pethadine, gas and air, syntocinin to speed everything up (great idea with a back to back baby) and an epidural. Eventually I had an emergency section after failed ventouse and forceps.

Bloody Hell no wonder I failed to progress, if you were a baby would you want to come out, is it not possible that you may go into distress. I know I did.

When I had my VBAC2 I stayed at home as long as possible to avoid any intervention (would have stayed at home to birth if DH was happy with it). When I arrived in the delivery suite the consultant (who should have known I was coming in) nearly pooed her pants when she heard that I had had two previous section. She was convinced that my scar was bursting open there and then because I was in so much pain, eeerrr no its called labour. Anyway to cut a long story short I gave birth to my DS3 with no problems at all.

Anyway that is my experience. If you do decide to go for a VBAC please make sure you research extensively. You have to believe in your body and that you can give birth to your baby.

Will try and get some links later, there is probably quite a few on the threads that lulumama posted earlier.

[Toady]

Maybe worth going to an osteopath as well. I have spoken to a lady who did this after she was told her pelvis was not suitable for birth, she went on to have a VBAC2/3, can't remember.

[Toady]

That was for Lullabyloo by the way but also good to go anyway I think when you are pregnant.

[lulumama]

[Lullabyloo]

Thanks lulumama
Can't believe I'm sitting here shaking like a leaf & crying 2.5 years later.
I feel I failed d.s miserably and was totally unprepared for how brutal it all was.I havn't been able to leave d.s at all since he was born even with d.h.I held him non stop for the first 3 months &I still sleep next to his cot at night.He's my world & I so very nearly lost him.Sometimes I'm so overwhelmed with anger & other times feel wretched that maybe somehow I could have prevented what happened to us.
Thanks for listening,I guess it's a good sign that I can start talking about it all now.x

[ivelostmyboobsboohoo]

hi, i too had a dreadful first birth and was very very scared of going through that again so had elective section next time which was brilliant and after the birth, although ob v sore from surgery i had loads of energy and felt really well in myself because i hadnt gone through hours of labour. HOWEVER.... my third and final baby, i had a VBAC (induced, which was not what i wanted, but it went quicklyish- 6 hours). i was monitored throughout my time on labour ward(all of 1 and a half hours) but could move about quite a lot. the vbac was the best feeling ever. i felt truly liberated. would love to do it again!