Mumsnet Discussions - "Support for imminent VBACers" thread?

Haven't posted on here, but lurked and used it greatefully for advice on researching my VBAC which I had a couple of weeks ago, and wanted to share how it all went. Labour seemed to kick off in the morning, 4 hours on contractions getting stronger and more frequent, but stalled utterly (due toi stress?) after got call from creche saying dd had had a playground accident and was being taken to the doctors. Dh went and joined them, got dd home, banged up nose/front lip, on alert for suspected concussion and very woebegone. Once I'd seen she was bascially ok, labour started again, and I spent the first few hours alone in bedroom as dh was looking after a still upset dd until she was feeling cheery enough to go happily with our neighbour. Not an ideal start but things went very smoothly from there, once I was convinced things were for real this time and not going to stop again we called the doala, and spent the next 3 or so hours at home, until contractions we going every 3 minutes or so, when we transferred to the hospital. The dynamic at the hospital was interesting - the midwife, who was quite young was trying to insist on " protocol" and internal monitoring etc, while the much older nurse was really supportive in my staying upright and mobile - got the midwife to agree we should at least try external monitoring and only use internal if they couldn't get a good reading that way, said " nonsense" when the midwife said I had to at least lie down to have the monitor put on, told me to get comfortable standing/learning agiainst the bed and fitted the monitor, and later when I wanted a shower went directly to the gynacologist with the readings and confirmed there was no need to stay wired up and I could do so. Was only 3cm when I went in, which disapointed me slightly as the contractions were really close and strong, but 90(very intense and painful) minutes later, just when I was starting to think the whole epidural-free birth idea was insanity, both the nurse and doala looked at me and said I was obviously feeling the urge to push, (although I can't say I recognised it as such). Midwives examined me again, and said I was fully dilated, stayed standing to push learning on the bed until they got worried becasue the babies heartrate spiked and some meuconium also then showed, at which point the gynocologist asked me to get on the bed, and said she was going to do an episiotomy to get the baby out quickly - she came a couple of minutes later, it was an amazing moment - I felt euphoric, compared to my other birth when on delivery all I felt was utterly drained, and releived it was over and the baby was healthy. In terms of things that I think helped, I think having the doala, and also a birth plan that stated what I wanted were vital, the doala provided so much support, and the plan meant that the nurse, who was fanstatic, knew what I wanted and could help get it for me, at a time when I really couldn't speak for myself as the contractions were so strong. All in all I was in hospital for only six hours, leaving with a healthy baby, which was all I could have ever asked for!

Hi Bex

I'm also preparing for a VBAC (38 weeks today) and have also had unpleasant pressure from consultant to have an elective. I just laughed at him (his reasons were laughably ridiculous actually) and told him in no uncertain terms that under no circumstances would I be booking an elective and furthermore, I would not consent to continuous monitoring, canula, or any of the other hospital protocol for VBAC. I have a great midwife and doula who will accompany me to hospital if a home birth doesn't seem wise or likely at the time (trying for an HBAC if things feel relaxed and easy going enough). My take is, tell the consultant don't ask and if he makes things awkward, do anything you can to find a consultant or a midwife to support you in what you want.
For some women an elective is the way to go and that's fine, but those don't want to be supported in VBAC should do all they can to assert their needs and ENSURE they get met.
Can you get some support from an experienced doula? I have found mine invaluable so far, as I have my midwife too. What do you need to say to make your point? That you want a VBAC and on your own terms. Just say it several times if you have to, it shouldn't have to get more complicated than that. Good luck, just stand your ground and i hope you get met at the level that you should, being the birthing women and the only one who really knows what you should have or not have.

Hi all,

I had an EMCS nearly 16 years ago and am pregnant with twins 25w + 4d. I had a very unpleasant consultantation banging on about how as its a twin delivery it would be better to be induced and planned for cs, regardless of anything I said or asked--the consultant seemed to take it as if it was a forgone conclusion that it would be a cs. I really, really want a VBAC. I can't imagine twins with the recovery needed for a cs. I tried to say that if there was a serious risk to either baby then fine cs has to be medically necessary, not just a standard proceedure. What do I need to say to make my point? How can I approach the consultant to make my preferences be taken seriously?

Bex

p.s Am 36+5 and feel so close and yet so far away. No, more close than far away actually....

x

mrsbabookaloo yaaaay! You did it! Certainly a VBAC. A little assistance perhaps but you did manage it. Huge congrats to you. Are you feeling well, apart from the inevitable soreness? How is the transition from one to two (children?)Wishing you all the best with the downstairs recovery and much happiness with new DD.

Thanks Poledra and mummygaga for the support and advice, and good to know that things down there will recover at some point!

Hello Mrsbabookaloo and many many congratulations on the birth of your daughter.

I had a VBA3C back in Feb (I was called Nevil then), and although I had a ventouse delivery and was slightly disappointed at the time that I needed an assisted delivery I absolutley consider it a successful VBAC. Remeber you pushed the baby down the birth canal all on your own and even though you had forceps you still had to push while they pulled her out.

The recovery was sooo much quicker even with an episiotomy and 4 months on everything down below is back to normal after thinking my nether regions will never be the same again.

Congrats again and very very well done.

Congratulations on your new daughter, mrsbabookaloo!! And well done on your VBAC. My DD2 was a forceps birth, and I count that as a VBAC myself smile

Try some lavendar and/or tea tree oil in your bath - both of these are antiseptic (so help prevent infection) and I found they eased my episiotomy. Or maybe that was just the hot bath with the lovely smell of lavendar round me...... wink

Enjoy your new baby.

Hi, Just to update on this thread: had baby last Thursday: she did come out of my vagina, but although that is technically a VBAC, I don't really feel like I did it myself, as I didn't push her out.

Don't want to put anybody else off: definitely go for a VBAC: I wouldn't and couldn't have just scheduled a c-section and not even tried to do it myself, and of course there are advantages afterwards to not having had a c-section (she types through gritted teeth, before going to search for threads on episiotomy pain!).

On the positive side, I dilated fully in about 6 hours (after only getting to 7 in 30 hours last time), and it was just the pushing I didn't seem to be able to get the hang of, so I ran out of time and they had me in theatre all hooked up and anaethetised for a section. She was right there though, and they said they would have a go at pulling her out first, so I pushed, or tried to push again, and they got her out with forceps.

Only stayed in a day and a night, rather than the three days at least that I would have had to with a section.

So all in all, not without its dramas, but a positive outcome!

Will do! Due today and no signs. Fell asleep listening to the cds again!

Hi there MrsBaboo.Ooohh only 2 days, you must be excited! I've also got the Natal VBAC cd's. I like them, been playing them whilst relaxing in the eve, doing the laundry, sitting on train etc just letting the language sink in. I find myself saying "3-2-1 relax" in all sorts of situations now!
Wishing you all the best, keep us posted!

Thanks, queen of puddings, that's good to hear. Just returning to this thread after a manic phase of dd's birthday and all in-laws, illness and plumbing probs. Baby due in two days, so need to focus!

Got the natal hypnotherapy for VBAC cds and have been writing down positive thinking phrases, breathing techniques etc.

mrsb, I have just had successful vbac after a ceasarian 3 yrs ago and i also had managed to labour to 7cms.

so good luck, its posssible

mrsbabookaloo great that you made it to 7cm as that bodes really well for your VBAC prospects I believe. and better late than never with the CD's! I've been listening to mine as I do the laundry, the cleaning, lying down at night etc. 1-2-3 relax!
ManyHatson I'm crossing fingers for you!

This thread is great. Roll up Roll up everyone else preparing for a VBAC....

x

just - my hospital's (Royal Surrey County in Guildford) policy is only to go to 41 weeks before plan B which would be a c/s. They're not keen on induction and even the most liberal of consultants (which I have) will only allow 4 hours on a drip and only IF the cervix is favourable at that point. So it's especially important that I don't go overdue...

Not got much time to write now, but just wanted to join this thread: 38 weeks too and hoping for VBAC. Think the baby is head down and have rather belatedly ordered the VBAC Natal Hynotherapy Cds, so hope they arrive before the baby!!

Had CS three years ago for lack of progress and fetal distress.

Made it to 7cm before CS, so hoping I will dilate properly this time, but it feels like a bit of a black hole of unknowingness in front of me, not knowing when it's going to happen or how it will go or what the result may be.

Fingers crossed for me and everyone else!

Hi manyhatson...... sounds like you're doing really well getting baby in the right position.
I'm crossing my fingers for you that she makes an appearance over the next four weeks so that you can avoid induction, though I'm hoping you would love to see her even sooner than that! There are lots of tips for stimulating natural labour if things go over time and you want to speed things up. I'll be looking out for your updates anyway so keep us posted ok?

And if there are any more imminent VBAC'ers out there, come and join the fun!

x

I'm 38 weeks and waiting for things to get started for our 2nd. I'm concentrating on getting the baby into the correct position so that labour will start as soon as possible. On Thursday baby was head down but ROL i.e. head facing into my left leg, which apparently is not ideal as is quite likely to go OP. So I saw my reflexologist yesterday and yesterday evening spent the whole evening either on hands and knees or lying on my left side watching telly, then the whole night propped up on my left side. Woke up this morning stiff as a board but I can't believe it, but baby is now perfectly in the middle as far as I can tell.

The main thing for me is not go go overdue as it will most likely be straight into for a C/S if that's the case. And apart from my hopes for a natural birth, I would have wasted over £1k on Hypnobirthing classes, reflexology and a doula!

Hi there
Just thought I'd resurrect this thread...I'm 33 weeks and planning my HBAC. Got a great support team - my acupuncturist is my doula and she's also a trainee midwife. The head midwife is very lovely and extremely supportive so I'm feeling in a great space about it all. Baby is head down and though she could turn I'm told it's not likely. Fingers crossed that she'll make an appearance before 42 weeks as I plan to avoid induction at all costs.
Seems like not long now so happy to hang out on here with others in a similar boat.

How's it going for other VBAC'ers?

Wishing you good luck and hoping to hear your fabulous VBAC birth announcements soon.

x

Aquababe hi, I am also in Kent and must have seen the same consultant midwife as you did, this morning. As she emailed me exactly the same VBAC waterbirth letter (Risk Assessment) as yours a few pages back on this thread.

I will (hopefully) be laboring at the sister hospital to you, but it is fantastic news to me that your VBAC waterbirth went so well.

I am 41 weeks today (officially) by my own dates I am a little over that but shhh don't tell my consultant as it gives me extra time to go into labor.

I have been in latent labor now for over a week due to numerous sweeps but am doing everything possible now to get the irregular contractions to turn into the real thing.

I know you are now busy with your lo but hope you get to see this message and can get in contact with me soon.

Let us know how you get on.

Thanks for the advice ladies smile

I've asked my IM to get on the case and hopefully she can help me find a way through.

Worst case scenario is that I find myself labouring so happily at home that I omit to go to hospital...

It's good to hear that some units allow VBAC in water. I might ask around and find out what London units do so, in case it makes sense to move hospitals. Also I know hospitals in London are supposed to "compete" so it might induce my lot to rethink if their competitors offer more flexibility.

I'm just about to VBAC (all bits crossed, or uncrossed as the case maybe) and have been told I cannot do this or that by my first consultant... I asked to see someone else, who understood how important it was for us to try and keep things as simple and straighforward as possible.

I'm hoping to be a natural earth mother and breathe through everything, whilst day dreaming of being in the open air - it aint going to happen I'm sure, but if I can see it - it might help. Same with the interventions and monitoring and being able to choose to have a go in the water if I wish!!! We'll see, but at least the hospital have told me that I will be able to make those decisions myself on the day...

Be firm, it's your body!!! Listen to your instincts... good luck!

MrsHappy second what mears said (though I think she's better qualified than me!). I found my consultant MW at the hospital invaluable in getting the agreement for the type of birth I wanted (planned labour in water, birth on dry land due to repvious PPH). Didn't happen as I had to be induced, but having that agreement made the last weeks of my pg much less stressful.

MrsHappy - women are able to use and birth in the pool who have had previous CS in my unit. Definitely contact supervisor of midwives if you have no joy with consultant - your IM will be able to find that out too as she must have one of her own.

Hello.. haven't seen this before and just wanted to say good luck to you all.

I had two VBACS, the latest ten years ago, after an emcs. I was told I was too small, that I would need to be monitored, that I should rush to hospital and so on.

It's hard, they do talk up the risk, but what aquababe said is the truest thing ever -- you don't have to do anything, which amounts to -- you don't have to do as your told!

I discharged myself while in labour, I stayed at home as long as possible, I used avoidance tactics when in hospital to not be seen by a doctor and be put on the clock ("Ooh I think I need to pop to the loo" etc).

The doctors and midwives are naturally concerned, I don't knock them, but while being as nice as can be it is possible to defy all their expectations!

All power to your elbow. And if it doesn't work out, don't feel like a failure for God's sake. There are worse things.

best wishes xx

Thanks Mears. I've asked my IM to find out if there is a consultant midwife (she does agency work in the hospital so should know) and then I will go that route.

I just find it hard to believe that a small risk of rupture is cause to medicalise a birth so highly when other risks - which potentially affect every woman - are not. Makes no sense at all.

MrsHappy - you are certainly entitled to have the type of labour you want. Find out if your unit has a Consultant Midwife - she will be able to help you. If not, then contact the LSAMO (Local Supervising Authority Midwifery Officer) for your area and she will help you too.

Oh, and congratulations to the aptly-named Aquababe. smile

Hi. Can I join?

I've dipped into this thread over the last few weeks and now I am finding things confusing and could really use some help from fellow VBAC-ers. smile

My DD was born by emcs after a 30-odd hour labour. She was stuck and trying to come out looking at my thigh. I spent the last 12+ hours of my labour on my back, hourly VEs, had an epidural etc, none of which helped, I think.

This time I want things to be different. I want an active labour and would love to spend some time in water. I want peace and quiet and minimal internals. I'm adament that I don't want CFM. The thing is, that my DH and I want to have the back-up of being in hospital in case surgery or a NICU is needed (much as I would love a homebirth in many ways). I'm in London and find continuity of care a bit patchy so I have an independent midwife who is coming to the hospital with me to act as doula and before that will be helping me to stay at home as long as possible.

Anyway, this brings me to the bit that has me confused and a bit upset. I had an appointment with a doctor (a Snr Reg) at the hospital. I asked about hospital protocols for VBAC, explained what I went through before and emphasised that I want an active natural birth. I was told I would "not be allowed" to labour without CFM or in water (it's not safe, apparently), but in the next breath she was going on about possibly using drugs to speed up my labour (WTF? - every case of rupture that I have read about involved these drugs) and giving me an epidural. She suggested I would be able to mobilise until then because I would be able to walk around the bed!

I am going to request a meeting with my consultant, but seriously, how on earth am I going to get these people to not treat me like some sort of medical timebomb? Do I have a legal right to refuse treatment I believe to be unnecessary? If I turn up with a strong birthplan will the staff stick to it or will they question it unless the consultant has signed off? Any practical advice would be really welcome.

That's great news aquababe - I wonder how everyone else is getting/got on

Thanks very much to those who helped me on this thread.

I got my waterbirth VBAC and have a beautiful little boy. I totally recommend water to anyone whose 'allowed' it. though I did have a tear and end up having to stay in hospital for a bit the waterbirth part was so beautiful i didn't really care. (Don't get me wrong the bit before bloody hurt!)

Hi, i have had a brief read through and i am still confused. I really want a home water vbac and dont feel i am asking to much as my 1st was cs for breech, so i didnt even labour. Therefore i feel i should be ok to have a home water birth. I am thinking an independent midwife might be my only choice because the NHS dont seem to be that supportive even if they would like to be and not sure i can do with a fighting and being scared by consultants. However we will then have the cost of a independent midwife but then i wonder how much value do you put on a positive birth experience that doesnt give you nightmares for months before and after childbirth. I am already losing sleep and i am only 20 weeks!!

Has anyone been in my situation?

thanks aquababe - I guess the hardest thing is that the consulatnt holds the trump card - 'do it our way or your baby will be hurt/die and it will be YOUR fault'. I will try to get an appointment with the consultant midwife.

I have a lot of reading to do! thanks again.

After doing some reseaerch it's probably worth having a chat with the consultant midwife or senior midwife at your hospital as they are generally a lot more supportive of vbacs and can help you show the consultant that you are serious and that you are aware of the risks etc

Found this helpful:
http://www.caesarean.org.uk/articles/VBACScarMonitoring.html

http://data.memberclicks.c om/site/wi/LabourandBirth.pdf

someone links from earlier:
VBAC in general
www.childbirthconnection.org
www.caesarean.org.uk/
www.vbac.co.uk/
www.vbac.org.uk/
www.storknet.com
www.aims.org.uk/

birth plans
users.picknowl.com.au
www.storknet.com

optimal positioning
www.homebirth.org.uk
www.spinningbabies.com/

"natural" induction
www.caesarean.org.uk/0

hmmm you don't 'have' to do anything. It's all about choice and weighing up risks verses the benefits.

There was lots of helpful data back at the beginning of this thread that I've used to persuade my hospital that I'd like a water vbac (or wvbac).
It does help if your consultant is pro-vbac

I have refused cfm in favour of intermittant monitering

Hi, posted this on a seperate thread, buut maybe you VBACers can help...

I am 24 weeks+, and have had a previous emCS (will be just over 2 years ago when I have this one). This pregnancy is like the last one, uncomplicated, and I am not high risk.

Can anyone direct me to some sort of evidence based resource about VBACs?

I have just had a meeting with a consultant, and now I am full of questions - specifically, re:hospital policies...how much is for the hospital's convenienec, and how much because it is good practise?

My quibbles are:

1. I have been told I will have to have CFM (or the scalp clippy thing). I am concerned at how this will limit my mobility, and thus impact on how successfully I can labour. I feel as though I am being 'set up to fail' by potentially having to labour flat on my back + immobile.

2. I have been told that I will need to come in pretty much as soon as the contractions begin - again, I am concerned that having to spend a big chunk of time in a labour/antenatal ward will have a negative impact on my ability to labour successfully.

3. part of the labour process will involve me having my waters broken artificially, to check for meconium. I have just read on another thread that artificially breaking the waters can lead to a v painful labour, and is there not an infection risk anyway? Are babies born by VBAC more prone to meconium leaking? As far as I am aware, breaking the waters is not standard procedure for a regular vaginal birth.

basically, if anyone can direct me to any resource which can deal with these questions so that by my next appt I am in a position to challenge/question things and be taken seriously rather than brushed off with 'well that's how we do it, the dr knows best, like it or lump it'.

If it has to be this way, ok, but it just seems to me to be not v conducive to a good labour/birth experience.

Thanks for sticking with this, any help is MUCH appreciated!

Congratulations Superjump on the birth of you baby boy.

Congratulations, superjump!
I have not posted on this thread, only lurked, I am sure will be posters who "know" you soon to help you celebrate.
Well done and enjoy your boy! smile

Hi everyone

Havent posted much here but have read with interest & got lots of info on here that helped me decide to go for a VBAC. Thought I'd let people know DS2 arrived 12 March by emergency C-section, all happy & healthy & home now.
Wanted to post as one of my concerns about trying for VBAC was that it would end in emergency section & I would feel I'd had the worst of all worlds - pain of labour etc & the mad dash/stress of emergency op. For what it's worth, it didnt feel that way in the end. I felt immensely happy I went into spontaneous labour, & got all the way through just like clockwork - it was thrilling & laid to rest lots of demons from my last birth. Ended in section as I'd pushed for over an hour with no progress, & they didnt want to risk rupture of scar. Turned out his shoulders were very wide & I would have had trouble getting him out.
Anyway, I felt proud to have tried & philosophical that it didnt end with natural birth. Have my healthy gorgeous boy so that is all that matters. Hope that might be of use to anyone with concerns like mine - best of luck!

Ginger suz
I'm trying for a VBAC waterbirth (due may 1st)
I know what you mean about not wanting to be pigheaded. I've refused cfm and said I would refuse it if they allow me in water or not.
to be sensible I'm allowing monitoring upon arrival, so long as that's clear I'm ok to get in the bath with a taped up canular.

Many Consultants do like c sections, I asked around and got my self an anti-c section consultant.
My consultant has prescribed lots of sex and spending at least 20mins of each day with my bottom in the air so the baby stands more chance of being in the right position for labour so it doesn't have to turn whilst in labour. Therefore minimising the length of labour & subsequent stress on scar. Apparently 3rd trimester woman spend far too long sitting in front of computers wink

The sex he explained prepares the cervix and softens it so that babys head has less work to do and the sperm has similar chemicals to those they use when they induce you.

Not sure if all this helps, but it does seem to be pot luck as to who you have caring for you, as to how you are treated and what you are 'refused'.

Go with your instincts!

Looking for advice about VBAC... Consultant has previously recommended c-section at 39 weeks due to me being age 41 and previous c-section.
DD was almost 3 weeks late, 4 years ago, when after 2 failed sweeps, I reluctantly agreed to induction due to the then daily monitoring giving "odd" data, and the tales of the placenta potentially failing without warning. The planned waterbirth was out of the window because of being late. Pregnancy then, as is now, perfectly normal, blood pressure good etc. Induction worked alarmingly quickly and painfully and eventually led to epidural and emergency c/s due to dd pooing in womb. DD was 9lbs 3, and after a bit of oxygen was perfectly OK although we did ask to see the placenta and it was quite shredded... The c/s itself was actually a very positive experience... standing within a few hours, and home the next day, but... I don't want another 6-week recovery.
Consultant has just agreed to do elective c/s at week 41 if "nothing has happened", which I'm happy to agree to.
But I want a waterbirth in the run-up to week 41 if labour starts naturally, and they've said no to this because they need to "monitor previous scar". I think statistically risks of rupture are scaremongering... but I don't want to be so pig-headed that I put myself and baby boy at risk. I'm due at end of May, so have plenty of time to listen to anyone who wants to give advice.
So... do I just turn up and demand a waterbirth?! Are there many other waterbirthers out there who are also VBACers? Or am I being too stubborn and should do as I'm told?

Let me know how the reflexology goes smile

I'm 37 weeks and have just had the hottest curry I've ever eaten courtesy of DP hmm

I couldn't even manage half it was so spicy.
I've been sniffing clary sage oil like it's a drug and devoured a whole pineapple on
Friday. Not sure I can face naughties yet grin

- I feel most unattractive!

Gonna get DP to get me some raspberry leaf tablets tomorrow..............

oh really - they don't want me to use it unforetunately. But they do also cite my wobbly blood pressure as a reason (because they can't monitor bp in the Malden suite hmm

). Ah well. Kind of just want to get on with it - and have already started to get the 'how are you - any news?' texts and phone calls which is all very nice but slightly irritating.

Tried pineapple today - gave me serious indigestion. Am also having reflexology to try and start things off.

I'm surprised because Kingston have relaxed their guidelines on using the Malden Suite. I tried to get in there but they were fully booked for March sad

Don't lose courage! I almost did today and though, sod it, just cut me open and get this baby out (as he's probably huge!) but I soon thought otherwise, thank god!

Hi Fruity - no I am at Kingston but they seem similar in attitude !

Hi Wheely aren't you at St.G's like me?

May I join in ? 38+3 here and hoping for a VBAC. I have until 23rd March to go into 'spontaeous labour'. Haven't been able to persuade them to let me use the MW led unit despite it being through a door from the consultant led unit.

Having said that, I have had position issues of late. At 37 weeks baby was oblique although only stayed like it for a bit and at 38 weeks was noted as head down but floating free which the consultant seems concerned about. Have been offered sweep at term but only if engaged. Blood pressure is a bit dodgy (but just about remaining ok) so part of me is beginning to lose courage and thinking I should just go and have the c-se but think I'd regret not giving it the best shot !

Well, I think we put an end to that thread then! haha, I'm glad it was you and not me Turtle!

BTW..Fruity...what happens to the ladies who have a PPH in the MLU? Are they too far away from medical help?????? Do they never have emergency sections from the MLU? I think as they are not offering the big bath upstairs as it's "closed" youhave every right to ask for a pool...ask your doula to help you with that one. grin

Definitely call their bluff! [klaw is a wicked girl!] you'll be surprised how they change their tune!

Also see this YouTube video of HBA4C for inspiration wink

I'd like to tell them I'm prepared just to labour in water but then not get out grin

My consultant reckons being one floor away from the labour suite is too far away hmm

Just going to have to see what they say when I say I'm registering for a HB.
Do you know they even told me at the very beginning I wouldn't even be allowed a HB - I nearly fell for that line as well.

FruitynNutty, my hospital was prepared to allow me to labour in water for my second VBAC (or, as my community mw said, my VBAVBAC) but wouldn't allow me to give birth in water. This was because I'd had a PPH with my second birth, nothing to do with my c-s. However, they had telemetric monitors (wireless and can be used in water) so would have been doing CFM that way. Is this a possibility for you?

In the end, I didn't use the pool but that's another story smile

Hello ladies, can I join the thread? Am 35 + 5 and hoping for a VBAC. Saw the consultant last week and he said hospital policy is to come in earlier in labour than normal, CFM, and a cannula. Am seeing my community midwife on Friday and want to ask about hospital policy about progress and length of first and second stages, but am struggling with the thought that I might be immobilised and under pressure.

DS was induced, and ended up with every intervention under the sun - pessaries, breaking the waters, syntocinon, continous monitoring, epidural, and then em c/s, so was really hoping to spend lots of labour at home this time round.

Not keen on a home birth, but would like to use the pool or at very least a bath, and be able to move around at will.

Am going to read down the thread to see what's already been said, but any pearls of wisdom gratefully received! grin

I've already said I'll have to have a HB although I haven't officially registered it yet. The HOM said that's up to me. I thought she might have backed down then!
Thank you for that article Klaw, I'll print it off and take it with me to my appointment next week smile

I've told them I know another hospital allows WBAC but the HOM said that because their MLU hasn't been open long they need to follow guidelines.
They are very adamant that I won't be let into the MLU (Carmen Suite)
I'll be registering my HB next week.
I'd much rather be in hospital in case I'm in that tiny 0.3% that has a rupture though hmm

FruitynNutty as they are not 'allowing' you to use the facilities at the MLU state your intentions to plan a home birth then.

Be strong, don't back down!!

I'll bet my bank account contents (not much admittedly) that they will suddenly and miraculously be able to offer you the MLU, the pool with intermittant monitoring etc

wink

Seriously, do it!!

Also ask them to take a note of WBAC experience in Fife MLU. Your HCPs could do no better than to contact this unit for their guidance on faciltating WBAC.

Stay strong

Hi everyone,
Can I join in?
I'm 36+2 weeks and am going for a VBAC.

I've tried my hardest to fight for a water birth at the hospital's midwife led unit but they have point blank refused me. Sodding guidelines angry

So! What are your opinions on a homebirth? has anyone here had a HVBAC? My consultant has made it quite clear to me that he doesn't approve but I feel like they haven't given me much choice sad

I'd rather be in the bath at home than on their labour ward.

I'm sorry, I haven't read any of the posts as there are so many!

Nevil how FANTASTIC! well done grin

I also found the ventouse was also so much better than a cs for me.

bumblbee if you are progressing steadily I would hope they don't set a timer against you. Are they suggesting you only have a specific number of hours to deliver?

I am going for a WBAC in hospital also at the moment. As I am rejecting EFM this is a viable option and preferable for me to the use of drugs.

The hospital has agreed to the WBAC but now must discuss their progress/slow labour policies.

Does anyone have an opinion on this?

Congratulations Nevil!!!!!! How inspiring!

xxxxxx

Wahay! Fantastic news! grin

[sm ile]

That's made my day. Congratulations and welcome to your new baby.

I GOT MY VBA3C!!!! Baby Boy born on 17.2.09 (40+4) at 4.03am weighing 6lbs 3.5oz. Had to have a little help c/o a ventouse but still waaay better then having a CS.

I'm sooo happy, will try to get back on with a birth story soon but wanted to say a big thank you to everyone on this thread with their stories, advice and support without which I would definately be sitting here recovering from a 4th cs oblivious to the fact that a vba3c was possible.

Thank you, Thank you, Thank you. grin

oooo it's gone all quiet. Shall I try & get the ball rolling again? Still hoping for my VBAC, being monitored for fluctuating BP & had to pop into Day Assessment Unit today as my legs were swelling up, but all is fine, so still on track. I keep thinking I might be early (due 8 March) as I'm having diaroeaha (sp? + TMI...) & cramps etc, but probably wishful thinking....hope everyone else going well.

Morning Nevil - any news??

<<Pol ducks as she knows well the inadvisability of asking a very pg woman that question wink

Don't forget the old nookie for starting labour Nevil (if you can be bothered) wink

good luck nevil.
hope your on here with good news about your vbac v soon.
my consultant has suggested lots of bending and spending 20min with my bottom in the air. not sure if that'll help you, but i figure everythings worth a try

Good luck Nevil! I woke up in labour on my due date when I had my VBA3C so fingers crossed for you (I'd convinced myself that it would be at least 42 weeks and I'd be having to fight them off with a pick axe) (well, ok, maybe just a shovel.........)

Keep us updated

Good luck Nevil, sending going-into-labour vibes smile

hope you get your VBAC, nevil.. fingers crossed x
thanks jamila , that is great. i will CAT you x

Hi everyone,

I'm now 39+5 and delivery plan is in place for my VBA3C just waiting anxiously for labour to begin. DH had a bit of a wobble last week about whether we're doing the right thing but I guess nerves are expected at this stage, plus if I'd agreed to ELCS would have had baby by now.

I'm due a sweep on Thurs (due date) if nothing happening by 41 wks will book section, at least I've given my body a bit of a chance to go into spontaneous labour. Due to these pesky antibodies I haven't the luxury to hold off past 42 wks and opt for expectant management as was original plan.

Have been walking loads, bouncing on birth ball, nip stim, etc but apart from increased BH and dull period pains at night no indication what-so-ever that labour is imminent <sigh>.

Will keep you posted and good luck to everyone else planning a VBAC.

Lulu email me, i've got a bunch of references for you, can look up most of the journal ones if they're what you need

hey all just wanted to offer my support. i had a sucessful VBAC, good luck to all xx

Very good point. My last elective was a great experience and I'm not 'afraid' (cant think of the right word) of another CS. My only fear is one under GA and not being able to see my baby straight away. Gawd, lots to think about. Will chat to DH and MW.

*Spotty shoes*, if you are unsure re epidurals, I was offered the choice of having the synto without an epidural, and seeing how I got on. The obstetrician did play devil's advocate and ask me what if I needed another section? Then he and the mw left the room to let DH and I discuss it. I decided to take the epidural as
a) I am a wuss
b) if I did need a section, having an epi already in and working greatly decreased the chances of needing another GA
c) I am a wuss
d) DH wasn't sure that he wanted to watch me in pain again.

Oh, and did I mention that I was as wuss?? grin

That sounds fab! She said she would do ARM then drip but no gels or pessaries or anything. I hope my experience is as positive as yours smile

Thanks for sharing it.

Course I don't mind you asking, Spottyshoes. I think I probably need to give you a little background - I laboured in water for my first birth and things were going OK then started to slow down. The mw broke my waters that time. However, I failed to progress, ended up on dry land with a syntocinon drip, epidural that wasn't working and in a lot of pain. Final outcome, em c-s under general. Opinion of the cons was that DD1 was brow presentation.

So, second birth, I really really wanted a VBAC, but was terrified of the level of pain I had had the last time. I had CFM (DH talked me into it, as he was too worried/scared not to do it) but still got up and about (mws just cheerfully readjusted the monitors whenever required). MW broke my waters when I was about 8cm to try and keep things moving for me - TBH, am a bit hazy about exactly why I needed this. I did get to a point where I was asking for another section (had it in my birth plan that I was NOT having another synto drip after the last time). Then had a successful epidural, synto drip and DD2 was born with a forceps delivery.

When I said ARM 'did nothing', I meant for my third birth. As I had a histoincompatability with DD3, the Foetal Medicine consultant did want me to go overdue. Reached 40 wks, no real signs of labour. Went into hosp, ARM to try and get things started but it just set off some very irregular contractions which did not progress into established labour. Was then induced by synto drip (after an epi was sites) and DD3 was born with no further intervention. Was absolutely fantastic and still makes me smile when I think about it (DD3 6.5 months old). If you are induced like this, it can be an absolutely wonderful experience. A lot of it was down to the MW - once the epi was sited and the drip running, she turned the lights down and instructed DH and I to sleep. After about 4 hours, I told her the pressure was getting quite intense, she did a VE and said 'Yes, I can feel the baby's head, it's time to push'. So when I say no intervention, I mean it!! The benefit of the epidural was that I actually waited for about 5 minutes with DD3 out only as far as her eyebrows as the MW tried to ease scar tissue from DD2's birth over her head (and mostly succeeded). COuldn't have done that without the drugs smile

.

I'm rambling on here - can't help myself! Please let me know if there's anything else you want to know.

So what actually happened after the ARM with your 2nd Poledra - if you dont mind me asking. You say it did nothing?

Hosp due to get a wireless monitor but not in time for this l.o's appearance sad

Cor, one spelling mistake and a missing '?' - can you tell DD2 is helping me at the moment smile

Spottyshoes I have had ARM in both my VBACs (and before my em c-s, but that's another story smile

). However, the first time, I already had an epidural so they borke my waters to help me progress. I did have a successful VBAC with forceps. Second time round, they broke my waters before I was actually in labour as it was the first step in inducing me (for reasons to do with the baby's health, nothing to do with VBAC). It did nothing.

Your consultant seems to be a hindrance rather than a help - is it worth trying to see the consultant mw, or recruiting your community mw to hepl you get to try for the birth you want? I did have agreement for labouring in water for my third birth, with help from both the mws mentioned. It didn't happen, but that was because of the induction. Also, does your hospital have telemetric monitors - these are wireless so let you move around and also can be used in water.

Certain hospitals seem to have certain policys.

I have a note on my file now which ells who ever i get that i want to try for a wvbac so when i arrive in the thorws of labour(fingers crossed) i don't have to debate it with the midwife on duty.
I would suggest trying to sort it out before hand.

remember that you can refuse cfm, but you should be aware of all the facts/risks. I would try and arrange a meeting with your supervisor/consultant midwife asap

I have refuse cfm in favour of intermittant monitoring so long as theres no problems

not sure about arm as it's not something i've looked into yet

So it's more an individual thing than hospital policy and you just have to hope you get the right person on the day/night?

I asked to speak to the consultant midwife who did a risk assessment for me and talked me through everything.
It seems I'm quite lucky as I'm at maidstone, which is 'apparently' very pro wvbacs(someone needs to tell that to the first registar I saw).

Hi everyone <waves> Can I join please? I'm nearly 38wks and hoping for a VBAC after ELCS for breech in April 2007.

When I met with my consultant at 36wks she was very negative and basically said the only way I was getting my VBAC was CFM, no active birth, water birth or homebirth and then booked me an ELCS for 5th March at 41 + 2 angry

I went in to DAU yesterday with pains and saw the same consultant. She examined me and although the Cx were coming 5-7 mins my cervix was not ready. She could get her finger in though and did a sweep and said that as she could touch the baby's head she would be happy to ARM & drip me just after my DD so that I dont have to have the ELCS. In theory I'm really happy about this as I feel the 5th March I hanging over my head and worried i'd be forced into another ELCS. But today practicality has set in, and I wondered if any of you had any experience of ARM in VBAC?

Any tips for pursuading them to 'let' me have an active birth without CFM (or even better WVBAC) would also be much appreciated smile

Lulu - re WVBAC, I did a lot of searching on this & the only UK "research" I could find was this if it's any help?

<waves hello>

lulumama said:
need so hospital WVBAC info grin

It came up a bit ago on SMS and slightly more people said their units didn't have a problem, than those that did IKYWIM, probably to do with more awareness of the best way to monitor, more women knowing their stuff,etc, of those that had a negative policy, most would change their minds when given the ultimate threat wink

if DH stops whining about me computering for long enough , i'll see if there's any actual policies or evidence out there, back on OU now so lots of yummy journals to go at

great your friend is around for you.. can she help answer any questions? am sure that the doctors will be more cautious, but you can always ask for second opinions . maybe due to silent labour and short first stage you might be offered induction when stitch is removed?

definitely gather lots of info yourself

Re the care plan, yes, but a fair bit of tactical disengagement from the docs iyswim - partly I think because I have still got a long way to go and am still relatively high risk for early delivery. And to be fair, no-one can predict what will happen. Although the view of my cons is that with a cervix as short as mine (20mm in early pg, compared to "normal" range of 30-70) and history, a protracted first stage is not that likely. So have been working on the assumption that epidural might not be an option.

Can't escape the feeling that no-one but me has any faith that my body can do what it's built for.........

Yes, lovely friend has happily agreed to be my birth supporter smile

it is hard, isn;t it? you can feel so alone and out of control and vulnerable , at a time that you need to feel supported and strong.

maybe once you get further towards term and having the stitch out, things will become clearer

have oyu discussed a specific care plan seeing as you have had an unusual situation last time?

is your CMW friend going to be with you for the birth?

thanks Lulumama, have been working on this and very supported by a friend who is a community m/w. part of the problem is that due to history I have NO idea when I might deliver - my earlier delivery was due to short cervix so things may kick off before stitch removal, after, or who knows?????

Don't get me wrong, I really have no problem with how my first delivery was managed, nor did I have any issues with recovery. Having had a lot to do with hospitals and hcps(dd was in for 10 weeks in total) I know a lot more than I did about needing to be an advocate, it's just <small voice> it can be quite hard when it's the middle of the night and your're standing there in a hospital gown with no pants on. Really don't know how dh will react, last time he wasn't there during the worst bits, in fact barely got to theatre in time. He point blank refuses to consider antenatal classes so while he is no wuss I worry that he will find it hard to cope......

also, if oyu search the archives on here, thre is some good stuff about refusing CFM for VBAC , have a look for posts my daisymoo

lizzy, i would definitely debrief that birth immediately.. and get yourself a www.doula.org.uk doula to support you

or look at www.nurturingbirth.co.uk for a list of doulas too

one to one emotional support before, during and after labour is such a benefit

superjumper, an epidural and lack of the urge to push /directed pushing can mean difficulties, as can a malpositioned baby.

sounds like with a bit more help , you could go for it, as these things not necessarily likely to recur

i VBACed an OP baby, it is possible grin

Can I join you? I'm currently 30 weeks with dc2, had emcs with dd at 27+5 due to footling breech detected near the end of a largely silent 1st stage of labour.

I'm consultant led care all the way as I had a stitch placed in this pg at 12+4 so won't be discharged until the stitch comes out at 36-37 weeks, assuming I get that far. The type of stitch I have is placed low so can be removed fairly easily so having it in place doesn't automatically mean another section.

I have wanted to go for VBAC since the beginning, have seen a very good cons midwife and asked lots of questions of the obstetricians but remain worried that I won't get enough support to go through with it. Pluses are that the hospital I'm booked at offers mobile epidurals and will do a sweep plus one lot of gel if I go overdue (as if). the mere idea of CFM pees me off, if only because I was hooked up for about 4 hours before dd's birth and that didn't seem to tell anyone very much.

The more I think about it, the more I wonder how much of this is about stuff I never debriefed from last time.........any thoughts?

totally agree that failure to progress is such a downer of a term. Cant remember much as it all went on for so many days & we were green as grass so mentally noting things like how many cm's dilated never occurred to us. Cursing myself now of course!
I do remember not ever really feeling the need to push but just being told to do so, then some hours later being told the pushing had done bugger all & to give up. I presumed my partial epidural meant I couldnt feel what was going on properly but I could feel contractions & move around, so maybe I just never got to that stage of labour last time.

even if you have CFM, which you can make an informed decision to refuse, you should definitely be able to stand, lean on the bed, use a birth ball, and of course you have to be detached from the monitor to go to the loo. whihc you will need to do in labour.

failure to progress is such a big catch all term, and it can mean women who got to 2 cm or 7 cm and then nothing happens. it is a bit crap IMHO and makes women feel they have failed.

it is a shame that your birth notes are lsot, does your Dh remember much?

do you remember much?

so many little things can make a big difference in labour.. simply being off the bed is the biggest thing you can do in terms of helpng yourself, being upright or at least sat on a birth ball with your legs apart is so helpful

thanks very much lulumama. Think I am brave enough to go for VBAC just need to find out my hospital policy on CFM & keeping active. Fingers crossed.

yes, a MW should absolutely be able to tell you if the baby is OP or not

some do turn in labour.

also if they are OP , it can take hours of contractions for them to turn OA, or they don;t turn at all

my biggest tip is don;t lie on your back in labour

be upright, mobile and active !

DSs position was never made clear to me, but i am sure he was not in a good position as he was not coming down much and the first part of my labour was so simialr to DD, who i had next.

having the waters there makes it easier for a baby to turn and move

also there has been some research that i shall try to find that shows there is no benefit to ARM during labour

also, i know that immobility was a huge factor, as was fear, in my labour not going well

i feel very much that if i had been able to move, had not had the epidural, and been encouraged to move, things would have happened , as with DD it took 15 hours to get to 3ccm and then only 3 hours 15 to deliver her

and she was OP and born OP

hi everyone, wanted to join in with a question for lulumama if I may....

Am 35 + 3 & 'have' to decide next week whether to go for VBAC or trial of labour. DS1 (now 3) was born by EC after failure to progress. There was a bit more to it but hospital has helpfully lost my notes from 3 years ago. One thing I do know that presumably didnt help was baby being OP.

Lulumama - you mentioned earlier that you thought the fact your waters were broken for you contributed to your OP baby not being able to change position? Curious about this as my waters were broken for me. No one seemed to realise DS1 was OP until the very last minute - is this common or was I unlucky? Also do you happen to know if the chances of DC2 being OP are higher because my first baby was, & can a clever midwife tell by feeling that they are OP?

Thanks in advance for any help! This thread is incredibly useful & already have long list of questions for my consultants appt next week!

ok so had my consultants appointment he's ok for me to go ahead with labouring in the water, so long as alls well when i get to pool, but isn't so keen on the waterbirth aspect as he doesn't see the point, but accepts that no one can force a labouring woman to move.
has given me some exercises to do in order to aattempt to get baby to go into a good postion ahead of labour so its as short as possible, therefore the least amount of pressure on scar.

he was surprisingly anti c section

hellooooooooo jamilla ! <<blows kisses>>

need so hospital WVBAC info grin

Oh dear oh dear -I've been very naughty, just been reading back and realised i've not been on here for nearly a year, i'll have to call it Mat Leave grin

Ella is now 1 and has been walking since november, here's me thinking, goody it'll be into the new year before she's walking, so i can get looooaaads done - shes the world's lightest sleeper, so the bags under my eyes are spectacular.Sorry for being neglectful LuLu and klaw, but I've neglected everybody this year. Anyway, where were we?

Hello - have posted this elsewhere but can I jump in here and ask you VBAC experts what you think my chances are this time round - I'm 36 weeks today.

I had an emergency section with DD (now 2). My waters leaked two days before my due date - went into the labour ward that night and my BP had gone through the roof - was induced twice and contractions started v strongly the next morning. Went through four hours of full on labour - had a BP monitor, bump monitor, two drips and a catheter so no chance of being active, and no pain relief. Then the crap monitor kept slipping off my bump so records were showing that the baby's heart rate was going down. A consultant came round and recommended a section due to fetal distress, so I was wheeled into the theatre, where the epidural didn't work so DP was ousted and I had a general. Woke up next to a fully clothed baby an hour or so later.

I'm still not sure if my section was necessary but I'm really worried the same thing might happen again - it was a horrid experience and took ages to recover. I'm wondering if there's anything I could do differently next time that wouldn't in any way put the baby in danger.
Like:
Should I go to the ward the moment my waters break or wait until contractions start?
Can I refuse to be induced if I don't want to be?
Can I refuse to have a catheter if I have high BP again?

Thanks

camgirl, i don;t really know enough about how an extra tear on the uterus would affect things, so best speak to the consultant obs and midwife

bumblibee.. i made my birth choice based on the fact that i understood how my last birth had ended up in a c.s . i was induced early and immobile and had an epidural before labour properly established. my baby was also i believe OP and having the waters broken meant eh could not shift easily into a better position. so i educated myself and learnt a lot

and then second time round i made sure my birth partners knew how to support me and i had a normal ,straighforward VB

also, i knew without a doubt if i had a planned c.s i would always wonder, 'what if i had tried a VB' and that would have been a big regret

SORRY ITS SUPPOSSED TO SAY LARGE BABIES

HELLO THERE KLAW JUST THE PERSON I BEEN LOOKING FOR BASICALLY HAD 2 SECTIONS LAST ONE WAS JUST OVER 4 YEARS AGO AND BABIES NOW THEY TRYING TO GET ME TO HAVE A THIRD WOULD DESPERATLY LOVE TO TALK TO SOMEONE WHO EXPERIENCED VBA2C. NOBODY REALLY SUPPORTING ME FOR NORMAL DELIVERY ANY ADVICE ON HOW TO GET LABOR STARTED PHYSICALLY AND WHICH POSITION TO DELIVER. ALSO HAVING SOME CHNESE MEDS FROM PRACTICING HOMEOPATH FOR SAFE LABOUR AND DELIVERY.

HELP DESPERATE NOT TO HAVE SECTION TOO LONG
RECOVERY AND GOT YOUNGSTERS TO LOOK AFTER.

Thanks for the responses Nevil and Lulumama.
Nevil, I will look up those links.

Lulumama: what happened is that the consultant made the usual vertical cut, but as my son's shoulders were so broad as he was coming out I also got a small horizontal tear in my womb, which is an additional risk factor for a VBAC as this might tear again.

I think I need to talk to the medics some more.

No probs Poledra, hope your DC is well recovered.
Thanks for info, I have now got my head around antibodies (I think). The antibody I carry can cause HDN although very rare, more likely to cause mild to moderate jaundice which can be treated with phototherapy. Have decided as titres have stabalized at 1:32 and the fortnightly scans for hydrops have all been normal I will not agree to section at 39 weeks (im currently 38 wks) & wait for spontaneous labour. Now worried that the more I prolong the pregnancy the more chance of increasing the severity of the jaundice, have to really make up my mind how long im willing to wait for spontaneous labour to kick off, my initial plan was to wait till 42 wks but don't know if that's wise IYKWIM, may consider sweep at 40 wks. In the mean time will look into natural induction methods to get this baby moving (none of which seem appealing TBH especially sex!).

Thanks for your info will keep you posted.

Shit shit shit, Nevil, just seen this and remembered that I was supposed to some back to this thread ages ago to talk to you about my VBAC with anti-E. I am so so sorry.

Right, here we go. I had anti-E ABs during my third pg, highest level at any time was 1:64, fluctuated between 1:16 and 1:64. I was scanned by the Fetal Medicine guys every 4 weeks (and sometimes more often, depending on the results) to check the cranial artery blood flow. On one occasion, this increased quite dramatically (though still within the limits of normal) so I was scanned weekly until they were convinced that it was an aberration. There was never any suggestion that I should deliver early, though they did not want me to go over 40 weeks. There was no mention of the placenta, just that it would be easier to treat any HDN outside the womb rather than in. I had my final scan 2 weeks before the baby was due, they booked me for induction the day after my due date and sent me off, saying they hoped to see me before then. Oh, and they also said that for Anti-E, there was no correlation between titre levels and the incidence of HDN, so I could have high titres and have no problems.

I tried to discuss my birth with the Fetal Medicine cons, and he was hopeless grin

. However, he admitted this, and sent me off to talk to the consultant MW and obs about it all. Both the MW and the Obs saw no reason why I should not labour in water with the telemetric CFM equipment (though they did point out that the pool/monitor might not be available if someone else was using it). The Obs did want me out of the pool for delivery, but this was because I had post-partum haemorrhage with my VBAC with DD2, rather than anything to do with the scar rupture etc.

In the end, I did not go into spontaneous labour with DD3, so was induced at 40+1. They tried ARM first which did bugger all, then went to syntocinon drip. I had an epidural first though. I dozed through my labour (and DH slept) until the pressure became quite intense. MW checked, 10cm dilated, DD3 born after 29 minutes pushing. I had 2 small stitches, mainly because the scar tissue from the second degree tear with DD2 would not stretch.

DD3 was wonderful for the next 12 hours though with hindsight she was very sleepy and did not feed well. She was taken to SCBU approx 12 hours after birth and placed under triple light theapy, where she remained for the next 4 days. It was not easy - she was fed by NGT, so I had to express milk for her. I also wasn't well-prepared for it as I had thought the HDN would be immediately apparent on birth - it is not, it can develop over time. She came out of SCBU on a Bilibed for 2 days then we spent another day in hospital while they made sure that her bilirubin levels did not bounce back up once she was off the light therapy. Finally, we went home.

I cannot see why you need to deliver at 39 weeks - can I ask what hospital you are at? This post has turned into a complete epic, and I'm not sure if I'm giving you the infor you want/need, so I am going to stop here and you can let me know if there's anything you would like to ask me.

Hi all,

I am 31 weeks and trying to decide how to have this baby. All the options seem poor!

They all seem terrifyingly risky and everytime I meet someone new they seem to have a convincing argument for either HBAC, WBAC or even elective CS!

Feeling totally overwhelmed.

Can anyone tell me how they made their birth choices?

xxBB

I don't think you're crazy wanting a waterbirth at all but can understand that you may think that when you see it written down. I have read many successful birth stories of hwba2+c that have taken place at home.

At least the figures that have been quoted by your Consultant Midwife are correct, at my appointment last week at my hospital I was quoted (by the Clinical Director no less) a uterine rupture rate in excess of 10% and apparently I only have between 20-40% chance of success hmm

. I know a vba3c is riskier than a vbac or vba2c but not that much riskier.

aquababe I used this MIDRIS study as the basis for discussion of my VBAC waterbirth request, don't know if it helps?

It is scary seeing the risks down in black & white, but remember there are stacks of other things that can go wrong in ANY labour. Sorry that came out wrong grin

I'm not trying to scare you, what I'm trying to do is put things in perspective, if they wrote & told every pregnant woman she had a 1 in 100 risk of cord prolapse that could potentially put baby's life at risk, there would be a queue at the theatre door for c/s's!!

I got it agreed (eventually) that I could labour in water but would get out at first hint of trouble or for actual delivery (whether they can actually get you out when you are just about to deliver is another issue!! grin

) Ended up with an el c/s at 40+10 though, long story...

Also worth asking if they have telemetry equipment (wireless CFM), I'm told some types are waterproof so can be used in the birthing pool, allowing the best of both worlds.

Pendulum - good luck - I managed a VBAC 3 months ago with DD2 after emergency C section due to breech for DD1 and it all went fine and midwife v supportive (unlike consultant who was dying to whip me in for a c section!. Was monitored throughout though which was a pain as it meant I was on the bed all the time and couldn't move around.

all she is basically saying is that you have been made aware of the potential risks of labouring in water... which you know, but seeing them written down is kind of eeeeeeek !!

look, you can start your labour in water, and if you are unable to continue for whatever reason, get out onto dry land..

it is your choice still, even when in labour

and she is ensuring that those caring for you in labour don;t start questioning your requests when you are in labour

Camgirl.. i am not sure what you mean, that the size of your baby actually damamged your uterus? or there had be a larger cut to get him out? not something i am familiar with, and i would say you need to discuss your previous birth notes with a mw perhaps, so you can make the best decision for next time...

I should add that it hasn't gone to my consultant yet and that she views this as a draft, so i can request to change stuff if i want.

I've had a meeting with my consultant midwife discussing having a VBAC Waterbirth. She's agreed to send the following letter to the consultant. Suddenly it all seems very real and scary. I am beginning to doubt myself and my convictions.

Am I being crazy wanting a waterbirth?

heres the letter...

I recently met with AQUABABE to discuss her request to have a vaginal birth after caesarean section (VBAC) and to labour and possibly give birth in water in the hospital. She is 31 years old and has no significant medical history.

Her obstetric history is as follows:

2005 Maidstone hospital 42 weeks Induction of labour. Emergency caesarean section for fetal distress at 3cm. Girl () 8lb 5ozs

Mrs AQUABABE is currently 24 weeks pregnant (EDD 5/5/2009) and her pregnancy has progressed well so far. She is aware that Maidstone and Tunbridge Wells NHS Trust recommends VBAC for the vast majority of women and that approximately 70% of women who opt for this achieve a vaginal delivery. She understands that the risk of scar dehiscence and rupture is approximately 1 in 150 and that the risk of the baby dying from this is about 1 in 3-5,000 and the risk of brain damage is about 8 in 10,000. (Figures from ‘Birth after previous caesarean birth’, Green Top Guideline 45, Royal College of Obstetricians and Gynaecologists, 2007).

At our meeting we discussed her request to labour and deliver in water. I have explained that, in line with NICE Guidelines and the Joint Position Statement for Water birth from the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives, the Trust does not recommend water birth for women who have had a previous caesarean section, as it is not possible to perform the recommended continuous electronic fetal monitoring. This may theoretically cause up to 15 minutes delay in detecting a fetal heart rate abnormality.

On discussion, Mrs AQUABABE would still like to labour and possibly give birth in water, however she has agreed to have an admission cardiotocograph recording (CTG) and to have further short recordings performed at regular intervals during labour. She would like to have care provided by a midwife only, unless complications arise, such as meconium stained liquor, fetal heart rate abnormalities detected on external auscultation, scar tenderness or delay in labour. In these circumstances she is happy for the midwife to take medical advice and to abandon her plan for a water birth. We also discussed the fact that scar rupture may not always be preceded by these signs and can be therefore be unpredictable.

Mrs AQUABABE has the Trust information leaflet on vaginal birth after caesarean section and also a copy of this letter. I am satisfied that she is aware of the risks involved, but also understand that this may cause some anxieties for the professionals involved in her care. I therefore think it is important that all staff are made aware of her requests before labour occurs and would be grateful if you could help disseminate this information to your medical colleagues.

TIA

Hi Camgirl and welcome to the thread.

Can't really help as not heard of a tear occurring as well as cs scar but didn't want your post to go unanswered, check out the links on page 2 of this thread, a wealth of information which may address your situation. I will keep this bumped for you and hopefully a wise mumsnetter will be along shortly with advice.

Hi everyone,
Another possible VBACer here, but very nervous about it. I'm 14 weeks.

A bit of background: I had my son by emergency CS after 20 hours established labour. He was big (9lbs 6oz) and has very broad shoulders which meant he never moved down, even though I was fully dilated. Because of his shoulders I have a tear in my womb that happened during the CS, and so have been advised that an elective CS is the probably the way to go.

I've agreed with my consultant that we'll wait until closer to the time to make a final decision. Apparantly second babies are usually larger .. but sometimes they're not [hmmm]

I was wondering if anyone else had any thoughts about this situation, or similar experience?

there have been a few questions lately baout VBAC, so we could keep this bumped smile

That will be a no then........ sad

Just bumping this thread as it has gone terribly quite lately. Surely there has to be some imminent vbacers out there.........anyone??

That is good Nevil that you have her support.

Remember also though, that although spontaneous labour is the ideal for VBAC - induction of labour can be successful too. The NICE guideline on induction of labour includes previous CS. Just another option to consider if you have to.

Have no idea why they are pushing for early delivery either Mears hmm

.
Had my appt with consultant midwife she will get me some independent, unbiased advice/evidence re my situation. Have decided that as long as no increased risk to baby if I continue past 39 wks and monitoring continues to show everything is normal will plod on with my plans for VBA3C.
Consultant midwife has been amazing, supportive of whatever I decide, she will be getting the biggest bunch of flowers I can lay my hands on when all this is over smile

Nevil - I really don't understand why you are being pushed over this. If all monitoring is good then there is no reason why you can't wait for spontaneous labour IMO.

How did you appointment with the consultant midwife go?

Congratulation mppaw smile

Quick update, i will be 35 wks tomorrow, had appt at hospital again re antibodies today, scan was normal and bloods were taken to check titre levels, last results showed titres are now down to 32 which is good since they were 128 at beginning of pregnancy. Have to repeat scan in 2 and 4 weeks.

Quick question, even though my antibody titres continue to decrease and no signs of anemia in baby fetal medicine doc recommends for delivery to take place no later than 39 weeks, their reason being HDN harder to detect the closer to term the pregnancy reaches, even though they keep saying anti-s is a low risk antibody, does anyone know if this correct?? Mears?? My only chance of achieving a vbac is if i go into spontaneous labour, unlikely before 39 wks since this has never happened before.

I have an appt with consultant midwife tomorrow to discuss mode of delivery/birth plan so will discuss antibodies with her but beginning to feel my chances of a vbac is becoming less and less likely and don't know if i have the energy to push for vbac anymore, it's just so exhausting sad

WOW! Congratulations mppaw and well done on achieving a super quick VBAC, absolutely fantastic and welcome to the world George. smile

MPPAW THAT IS AWESOME! CONGRATULATIONS!!

Yaaay! Congratulations Mppaw. Wonderful news! And an inspiration. Enjoy your new DS.

I did it.....
Just to let you all know, I had DS (Was only 37wks+5) early hours Saturday morning. 2 and a half hours start to finish !!!
11:30 waters broke
12:45 got to hospital fully dilated
1:30 started pushing
1.58 George was born, 7lb, 52cm
Apart from the constant monitoring, it was the VBAC I had hoped for, albeit early and v v v quick.
Thanks to all on this thread, totally inspiring.

Thanks for update Nevil.

Hi all, Just a quick update....had another growth san today (Am 36+1) and my fluid has reduced, HORAY, so hopefully full steam ahead with my VBAC. Although the little mite is measuring top end of average...they have estimated it's weight at 6lb 10oz already !!! Ahh, still got another 4 weeks to go.. wink

Was talking to DP today, and I dont remember feeling nervous about DD's birth. I suppose it's because you dont know what to expect, but I am starting to get really nervous with this one. Some days really confident about a VBAC, then other days, really nervous and thinking what the hell am I doing !!! No doubt this is normal.... smile

Hi everyone and welcome to all potential new vbacers, this is a great thread with lots of information with which ever decision you go for.

Mears, apologies for not updating sooner, LO has chicken pox so busy playing nurse. Had appt with fetal medicine consultant last week scan results were normal no signs of anemia and bloods were taken to check titre levels, they will only call me if titre levels have risen, not heard from them so no news is good news. I have appt next week at local hospital for repeat bloods and scan and follow up appt with fetal medicine doctor in 3 weeks. Like you said he stated anti-s is not one of the more riskier antibodies and unless titre levels rise dramatically and even then would not be looking to deliver baby early if no signs of anemia in baby. We got onto subject of delivery and their were raised eyebrows when i mentioned vbac he asked what i knew about rupture rates so i told him and he responded with "mmmm you've been on the good old internet" with a sound of sarcasm. Im past caring about such comments have decided will only discuss antibodies with consultants not delivery and will meet with consultant midwife in new year to discuss my vbac plans if everything is normal with antibodies. It is becoming a bit draining and have questioned whether its worth it or not but all i have to do is come back to this thread and re-read posts to believe i can and will have the birth of my choice.

FLFS fingers crossed you make it to 37 weeks.

Glad scan went well last week Mppaw hoping everything continues to progress well.

Racka - that figure really isn't that high. Another way to look at it is 0.5% There are risks associated with repeat CS too - it is just weighing them up.

this information may be helpful

Thanks for your positive support ILikeIt....
Still haven't managed to read your story...off to find it...
x

HI Racka

Congratulations on your second pregnancy. I'm sure more experienced people will have more to offer on your post but I just wanted to say, that maybe it could be a good idea to have an experienced doula to support you? Also, have you considered opting for a vaginal delivery and only having the CS if you run into trouble? As I understand it, there are quite certain signs if you are heading for a rupture so perhaps it's possible to stay rational if you're well informed as not every feeling and sensation you have will mean you are rupturing. i.e if you're well informed and supported you can stay in control of what's happening rather then end up in the theatre just because of some sensation and "freaking out" because of it etc. Remember though ultimately, it's not really the birth you have but how you feel about it that matters in the end. If you feel most comfortable and empowered in your process with opting for the CS then that in itself can be a really positive place to come from.
Wishing you all the best with your decision and birth.....
I'm sure other's will have some useful input.

Hello,
May I join? I had an em cs two years ago and am now 35 weeks pregnant. I wanted a VBAC and had made my mind up to go for it until today. I went to the hospital to tell them and whilst they said I could they reminded me (at my request) that the rupture rate was 1/200 and that jsut seem astronomical. I know not all ruptures mean catastrophe but still, she said they take them all very seriously. Add to this the fact that I am not someone who can summon up a positive mental attitude and given my existing concerns I am quite likely to freak out at the slightest unusual development in labour, I now think I should have a planned cs. This really doesn't fill me with joy. Don't really know what I'm asking here, have just been in tears all day and am very tired and confused. Any words of advice would be really appreciated. xx

I remember your labour thread over the New Year last year. You were so strong and brave and I believe you are able to have the birth you want. Have faith in yourself and your baby, you can do it. You will no doubt have the odd wobble and crisis of confidence, but that is normal and can be overcome with knowledge and surrounding yourself with positive people and thoughts.

I'll be keeping an eye out for you and if you have any questions put a shout out for me on MN smile

thanks ILikeitHoHoHo
I'll check out your story, very interested.
And congratulations, so nice to hear it was fantastic! Might come back if I have any ??? this forum really is great.x

lillimama - i believe the signs of uterine rupture are any of the following:

scar pain
raised blood pressure
raised heart rate

If you would like to read my birth story of HWBAC it is in the birth announcements section (my usual name is ILikeToMoveItMoveit). It was in September this year and it was fantastic.

It sounds like you have a great MW.

Wow Milkmade! Would absolutely love to chat. You can mail me at lifeonwater@gmail.com if you like. Whenever you're ready but I'll be back online from tonight.

lilmama - am also going for a vbac in the netherlands, would love to chat to you in more detail about which midwifes, hospital etc you are going to. Am also slightly non-plussed by how medicalised they seem to want it to be from the off here. Let me know if you;d like to mail me.

I'd like to join too..althought it's very early for me, only 8 weeks.

Can I tell my story? Maybe someone has experience or feedback?

DS born by Em CSec 11 months ago, after 72 hours at home, no pain relief (don't have Gas and Air here) and further 13 hours in hosp. Only reason for CS was sheer exhaustion on my part, no foetal distress. Have a lot of processing to do as it was a really painful experience resulting in 6 months of PostNatal Depression and I still get tearful about it.
Amazingly enough so soon am totally ready to do it again, but hanging out on here for support is already proving immensely helpful as I feel confident about going for VBAC, with all the right information and support in my hands. Thanks Mumsnet!
Have enlisted experienced VBAC doula and am allowed to have all checks with midwives until 36 weeks when I must switch to being under the care of a gynae. Was very disappointed that in Netherlands you can't HBAC. There wasn't a midwife in the country who would support me HBAC, not even my extremely radical Ina May Style midwife for DS1. Here HBAC is absolutely unheard of, which is surprising for one of the most forward and liberal thinking countries in the birthing world. Further to that, I would be immediately placed in the medical room at the hospital, i.e not allowed to try in the birthing centre which is within the hospital, therefore no waterbath possibility. Basically all bright lights and flashing wotsits and a room full of people.
Talked all this through with my midwife yesterday (extremely experienced and somewhat famous in these parts) and she gave me a nod and a wink and said, "No one can make you go to the hospital can they?" And if you just happen to have the birthpool set up at home and you just happen to be in it, and it just happens to be too late to get out the door to the hospital then you can't expect any of my colleagues to be happy about it, but what can they do?" She finished off by saying that in 6 months time I might not care where I give birth, and that we can keep talking about it.

So naturally I have some questions..like, if I feel some scar pain and things are looking dodgy, would an ambulance and a transfer happen quickly enough? Etc... Are they warning signs for a rupture? Is this another thread? Sorry if I've gone off on one. Have so many questions etc etc.

My support and best wishes go out to all you mumsnetters who are going for VBAC/HBAC.

Great film that I saw last night by the way is " Orgasmic Birth", The Best Kept Secret, by Debra Pascali Bonaro. Not VBAC specific, and not even orgasmic birth specific but a really good look into natural birth and how women are transformed by their incredible and sometimes ecstatic birth experiences.

ooh. good luck for tomorrow!

You can hang in there FLSF....

Had a midwife appointment today, all seems ok. Got another growth can on Monday, I will be 36 weeks, then another meeting with the consultant on New Years eve to go thru the scan, when I will be 37 weeks then.
The midwife said today that there is no reason why I should be induced at the moment, as the fluid is not massively excess, just slightly above average.

Fingers crossed, the scan shows a deduction in fluid.

Hi mppaw, just been in for overnight observation. I've got 'tightenings' every 20 mins but they don't hurt unless I'm walking around. They think it should be ok as the cervix is closed and so have let me go home. No idea whats going on, but just have to hang in there another 8 days and get to 37 weeks!

Hi FLSF, How has the monitoring been going ?
smile

quick update; went into new hopital for monitoring this afternoon and they want me to go back again tonight.

have asked about monitoring and though they would have been relaxed about labouring without cfm for vbac, premature labour is a very different thing, so if these really are contractions it sounds like all my hospital swapping was in vain! grrr

good luck for next week mppaw. I've got my midwife appt with the new hospital on thurs. Sounds like its going to be an hour long booking appt, like you usually have at 12 weeks! I'm going to have to take DD who won't be impressed, I fear.

I've also spent the whole night with 'tightenings' that stopped me from sleeping. They are still going on so not really sure what to do as am still really registered at the old hospital until thurs! I've had the roto virus with dodgy tummy so think that may have kicked things off but not sure whether thats it now and this is pre-labour at 35wks, or whether they will go away again and let me get on with Christmas! grin

. Lol the first time I typed that I typed [gin]. says it all really.

Glad scan went well mppaw, all the best with your appt next week.

Hi, Had the scan today and all is ok with the baby, it's measurements are all within range for 34 weeks, but I do have more than average fluid. Was due to see the consultant next wednesday re my VBAC, but they have bought this forward to this Wednesday. No one seemed overly bothered, so am thinking the appointment change is more to due with a Christmas schedule !!!!
I am booked in for another scan in 2 weeks time and they are hoping the fluid has reduced, definately not increased.
Will give you all an update after Wednesday.

Anyone had anything similar and told they can not go for a VBAC ?

smile

Thanks FLF, will update on Monday

good luck mppaw. I'm measuring a couple of weeks ahead too; am sure tis all good smile

and they are just being extra cautious.

Just a little update, Am off for a growth scan on Monday as the MW I saw today thinks I have alot of amniotic fluid and wants to get it checked out. Fingers crossed it is nothing serious. Am measuring 35 weeks and am 33 weeks, so nothing mega.
Will keep you posted after Monday.

i did a maternity audit last year. very useful. good to get your face known at these things too

smile

Thanks all; Mears I'll check that out too, just in case smile

Thanks for that Mears, shall take dd with me and take it as it comes grin

At our audit the LSAMO (Local Supervising Authority Midwifery Officer) who is undertaking the audit spoke to the mums in a group for just over an hour. It was schedules as 30 minutes but I knew it would last longer. It is an open discussion really. Might be best to take DD with you.

I wasn't sure if you were there as the lay representative who will be there all day as part of the audit team.

It is very common that women do not know who the Supervisor of Midwives is so that is what they want to find out too, as well as how you have found the maternity service.

I think you will enjoy it.

Sorry for the drunken slobbery hugs.... I have missed you.

Not sure what to expect on Thursday. In terms of time required...... Lay people required from 11 am at birth centre. DD needs collected from playgroup at 12 pm, about 40 mins from birth centre. Do I keep dd out of playgroup and just hang out at audit until my opinions recorded? or Can I get there and make my opinions known and get out in record time?

My opinions being that I've absolutely no idea who my local SoM is, or was when I was expecting dd. therefore how would anyone else know?

But I do know who the MTL is at local birth centre, and who the HoM is, as we all meet up at MSLC and have a good relationship. But that's down to me being hugely interested in childbirth and being a doula.

as a pg woman i wouldn't have had a clue!

srry for digression..........

Hiya Klaw

I co-ordinated our audit a couple of months ago - well done you for participating. Blinkin' hard work.

Haven't been around for ages but wanted to add my midwifery support to the ladies on this thread smile

drops in to give Mears a hug!!!

Got a request to give tupenneth worth at supervision audit locally on Thursday.

OMG, as I've been MIA a lot on MN for many months I've not seem some important people for ages!!1

Gives Mears an extra speical big hug! sorry, been on the VC tonight blush

Apologies if this has been mentioned before but do you know that if you have difficulty getting the type of care that you want you can contact the Supervisor of Midwives? (SOM)

All maternity units have SOMs and part of their role is to support women in their choices. [[http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=4373 see here]

Sounds really positive FLF....well done you.

Still only flitting in and out, as nothing really to report my end at the moment.

Have an appointment with the midwife on Wednesday 17th Dec. I think this is to go thru my birth plan etc and probably hospital policies, blah blah blah....

speak soon chicks.

Great news FLF, sounds like the perfect outcome.

Thanks Turtledove23.

Fantastic!!!
That's really great.
I had that turn around from two different appointments with one consultant, lol, but I think she had chilled out a bit by then grin

So, in future if anyone wants a VBAC in East London ask fourlittlefeet which hospital to use!!

Afternoon all, just popping in with an update. Went to see the other hospital's consultant midwife today. The appointment couldn't have been more different! She asked me my expectations of the birth and then went on to say they sounded reasonable and that as long as I was prepared to be intially monitored and examined to make sure all was well, she didn't see why they couldn't then do intermittent monitoring, no cannula and even some labouring in water in the pool was free. I'm more that happy with that. She also mentioned that they did their best to get one on one midwife care, and that they would be flexible with the timing of 'active labour' as some women start at 3/4 cms and others around 5, so the countdown wouldn't be hugely enforced provided that labour was seen to be in progression. She also said they'd probably only check dilation every 4 hours which sounds reasonable to me. She also said that she would come along to my consultant appointment once I'd swapped to make sure that our conversation would be recorded in my notes and I wouldn't be back at square one. Result!

Right, now need to get on and do all the hospital swapping paperwork! Shows it is worth asking around though; the two hospitals are only 2 miles apart and couldn't be more different!

nevil- Mears was the one who gave me info and she kindly posted it as well.

thanks VS, I will. My dad lives in Oxford, so if all else fails maybe I should 'accidentally' go into labour up there!

Good luck fourlittlefeet. smile

Make sure to ask if they can borrow the underwater monitors from another hospital if they haven't got any.

I've got an appointment with the consultant midwife of another hospital tomorrow at 12. They think they can help me so lets see what they say smile

Don't worry about it Poledra I'm also nursing a poorly LO, wishing yours a speedy recovery.

Turtledove23 I've just checked my registration details and the email address was incorrect, i've changed it now, if you've got time could you re-send? TIA.

Mears, many thanks for your post which have made things much clearer and i'm beginning to understand things now. I have received an appt to attend the Fetal Medicine Centre at another hospital in 10 days time for a detailed scan, bloods and a consultaion with a fetal medicine doctor. The baby's health overides any desire for me to have a vbac, if my titres rise or scan shows signs of anemia in baby then i will of course opt for early delivery of baby. I will also call consultant midwife after my appt for her advice before i make any further decisions.

Thanks to everyone for their advice its been invaluable, will update after my appt.

Sorry, Nevil, will be back but have too many poorly children to do a thought-out post. Soon, I promise

Hello Nevil - I am really sorry that you are having such a difficult time over your VBAC. I am a midwife and have also had antibody problems myself. I had high risk anti-D antibodies and needed to be induced, once at 35 weeks and then next pregnancy 37 weeks with DD who needed 3 exchange blood transfusions.

Anti-s is not a high risk antibody but it will still be capable of causing a problem with haemolytic disease of the newborn (HDN).

You antibody levels will be monitored and the baby will be scanned regularly for any signs of fluid gathering around the abdomen and brain - this is what hydrops is. The fluid is caused by severe anaemia in the baby.

If the baby is fine on scan and your levels do not dramatically rise, I see no reason why you cannot wait for spontaneous labour. However, if induction of labour is recommednded because of rising titres, then VBAC is not the best option due to your previous 3 C sections.

Don't lose heart completely. Discuss your options with the consultant midwife and obstetrician.

The typrt of delivery will not have an impact on the baby regharding the antibodies - it is the timing.

At delivery, cord blood is taken to check if the baby might be affected by doing a coombs test. If the coombs test is positive, the baby may become jaundiced so will be nursed under phototherapy with jaundice levels monitored. Sometimes the baby goes under phototherapy as soon as possible after birth until the cord blood results are known.

Sounds as though the consultant midwife will support you well - why not arrange to meet her again sooner?

Nevil- have CATed you.

Nevil, the book is here.

Also, the placenta thing is bollocks.

I have problems with placentas anyway and I went to 41 weeks with no extra monitoring. It is different with each baby, each pregnancy and each placenta so they can never be sure. It is more likely that the placenta will be of less use for the baby from 42 weeks but the only way they can check is with regular monitoring.
You are not even classed as overdue until 42 weeks so they are making absolutely no sense.

fourlittlefeet could you try transferring hospitals or finding a hospital that would lend you monitors for underwater? I know my hospital has them but I'm in Oxford.

I have read 'vbac - on whose terms' is that the one?

I know if i insist on vbac I will be supported by the consultant midwife at the hospital whose care i will be under, but am now really worried about the risk of HDN to the baby. I only have the specialist midwife & consultants advice to go on at the moment about the risks of HDN and based on my previous experience, with the consultant in particular, that doesnt fill me with condidence to be honest.

Turtle, no worries I'm off for the weekend anyway, so feel free to call on Monday when your wee mite is feeling better. Hope everyone has a nice weekend. Nevil, sorry can't help you, but hope you get the support you need so good luck.

Nevil- Have you read the AIMS booklets on VBAC and "Am I Allowed?"

Thanks for your responses Poledra and turtledove23.

Poledra, look forward to hearing more about your experience and its good to hear that vbac may still be possible. I didnt think induction was an option & was only going to attempt vbac if i went into spontaneous labour which i never have. I had planned to wait it out until 42 wks before considering other options, ie daily monitoring, sweep, etc but if baby needs to be out sooner rather than later i would have to go for another section at 40 wks latest.

Turtledve23 any info you could get would be great, thanks.

flf-will ring you today. Have poorly baby, so am waiting for a lull!
Nevil-if you don't mind I know someone who knows a LOT about your situation and (as part of my own education in these matters as well) would you mind me going and finding out about it? Will CAT you with response I get.

Nevil I will come back to this later as I need to be quick now (DD3 has a v heavy cold and is miserable) but I had anti-E antibodies with DD2 and 3, and these births were both VBAC. The antibodies were below the level of concern for DD2 so it made no difference. I was induced for DD3 as the AB levels were higher (between 32 and 64) at 40+1. They will want to induce you as the baby can be safer outside than in, IYSWIM, as it's easier to transfuse then. DD3 was in SCBU for 4 days under triple light therapy as she had severe jaundice though we managed to avoid the transfusion.
Got to go, will come back tomorrow I promise.

Evening everyone,

Looks like my vbac is looking unlikely.

Had a phone call from the hospital yesterday regarding antibodies. Hospital discovered i am producing anti-s antibodies at my booking in appt and discussed this with me at my 20 wk appt. Was told my titre level was pretty high 128 threshold level is 32, was told as titre level high this could cause Haemolytic Disease of the Newborn (HDN) basically jaundice and anemia in baby which can be pretty serious, in very rare cases may have to give baby blood transfusion to baby in utero or deliver baby early.

At my appt last week they took more blood to check titre levels and had scan to check baby developing as it should be. Spoke to specialist midwife regarding this, she said it's not one of the more serious antibodies and to wait to see results of bloods, she said docs would speak to me about it futher, i didn't mention my intention of vbac to her. As you know my appt with docs and consultants didn't go well when i mentioned my vbac plans so they never got round to discussing antibodies.

So specialist midwife called me yesterday with results of blood tests, my titre levels have gone down to 64 which is good but still over 32 so still a risk of HDN. She told me she had heard my appt with consultant went pear shaped and he had thrown me off his books (not the way i would have put it), she was concerned about my intention to try for a vbac and being under midwife care only, she said with antibodies I would need to be under consultant care or find a consultant to take over my care if i still intended to go for vbac. I explained that i will only go for vbac if risk of HDN is reduced. She also mentioned that it would not be advisable to go over 40 weeks as placenta doesn't work as well once you pass 40 wks,i asked is this due to the antibodies or generally, she said generally, is this true, i thought it was 42 wks? Anyway she has arranged for me to have futher blood tests in 3 wks and to have a scan to check for hydrops, not sure what this is. I will also have to see consultant again (not looking forward to that) to discuss results.

I just get the feeling that at appt last week antibodies was played down and it was wait and see, and now since i mentioned vbac it's very serious and i have to be under a consultant, or maybe im just being paranoid. I don't know enough about antibodies to make a decision, and i feel bad about saying this but after last week i don't think i can trust what the hospital tells me anymore, i feel as if i had 3 unnecessary sections under their care and now I may be pushed into 4th section because of these bloody antibodies, im very confused to say the least.

Sorry about long post but needed to get it off my chest, if anyone has any experience of this or advice it would be greatly appreciated.

turtle, I have emailed you just now smile

flf-Lovely! If you could email me on hopewelldoula@googlemail.com we could set something up.

I'm in east London smile

. More than happy to meet up for a chat?

Carshalton...cover Surrey/London.

where are you based Turtle?

Please excuse me for crashing, but trainee doula here desperate to get some experience!

Thanks Daisy, you give me renewed hope smile

. I'm thinking about a Doula too, so that if I lose it at the hospital, there is a sane person there to make my wishes clear (had dreams last night of ripping out cannula's and locking myself in the loo at hospital and refusing to come out. blush

. Its so sad as I want to be happy and excited, not scared, angry and confused.

Nevil, keep your ear to the ground for trainee doulas looking for clients for their training portfolio as they often offer their services for free or at a reduced rate. Try looking on the doula UK website. I'm glad my story helped smile

.

fourlittlefeet, they cannot refuse you intermittent monitoring, they can only offer it to you. It's entirely your risk and your choice whether or not to accept it. Same goes for induction. I was scared by all the "poor maternal and infant outcome if not continuously monitored" stuff they spouted, but when you get it into perspective, there is more chance of a cord prolapse in a healthy term pregnancy than there is of scar rupture in a VBAC patient, but they don't bang on about prolapse do they?

I was also told they would want me in sooner rather than later, but my consultant did say that they had no control over when I decided to turn up! As it was I wasn't convinced I was in labour until quite late on, then my waters went just as I was telling the hospital I was on my way and I was 6cms when I got there. Staying at home was definately the best option for me as I was calm and relaxed and in control....and playing scrabble and MNing wink

I also played the mental health card at my consultant appointment blush

. I have suffered from depression on and off since having PNS after my first labour and CS. It was important for me to achieve the birth that I wanted in a bid to put to bed the ghosts of my first labour. My consultant was very understanding about it.

As it was, although it wasn't the intervention free birth I had hoped for, I remained in control of everything that happened and was consulted and given time to think about what was being proposed, and was never forced into making a decision.

and my depression is much much better for it as well smile

Hi FLF, mppaw and monkeydrops and anyone else lurking.

So sorry your appt didn't go to plan FLF, you mentioned a home birth and if you have researched the pros and cons of a HBAC and feel confident enough to go for it why not? I know it's not an easy decision to make escpecially when you're not being supported by your caregivers, the last thing you need is an unsupportive MW during the throws of labour. I really hope things work out for you.

Good luck with ecv monkeydrops lets hope it works for you.

Daisy, congrats on your recent vba2c and on the arrival of your DS2. I read your story and found it very inspiring I just hope i do as well as you (piles and all grin

). Unfortunately can't afford doula since giving up work to be SAHM (but wouldn't change being a SAHM for the world).

Thanks Poledra. They don't have telemetric machines and she refused intermittent monitoring and any kind of water labour as they couldn't monitor me whilst in there.

fourlittlefeet, I'm sorry your appt didn't go so well. Have you asked about telemetric monitoring? This is a machine which does continuous monitroing wirelessly, so does not restrict movement. I was supposed to use one for my scond VBAC, but an induction and epidural put paid to that grin

(not too negative, it was a fabulous birth).

Also, the consultant midewife at my hospital (and the cons, FWIW) did support labouring in water for VBAC, but preferred you out on dry land for the actual pushing (though I had also had PPH, so that was a factor in this too). Would labouring in the pool but getting out for the actual birth be a compromise for you? The telemetric monitors work in water too.

good stuff Monkey and good luck!

Well, my appointment didn't go that well. I ended up in floods of tears and with no results to show for it really! Consultant midwife is going to talk to the labour ward manager to make sure they understand my previous horrible experience there in order to try and improve it. She did say if I insisted on a homebirth they would have to support me, but that it was against guidelines and they wouldn't encourage it. Other than that if I go in, and they'd want me in as soon as labour started, I'd have to have the cannula and have to have CFM, but be encouraged not to stay on the bed, but movement would obviously be restricted by wires. Also they don't support vbac water births. Am now feeling highly stressed about the whole thing. sad

thanks all - hosp have now agreed to try ecv on thursday despite prev section - we'll see how that goes!

good to see this in active convos smile

Good luck to everyone, especially Nevil. I've just had a wonderful VBA2C and although the scar rupture seemed to be the big thing at all my AN appointments, once I was in active labour (got to the hospital at 6cms dilated) no-one paid any attention to monitoring me for signs of potential rupture.

I was given a risk of 5 in 1000 for a VBA2C by the hospital; their view was that the risk doubles for each section you have had. i think this is a bit conservative, but even if it was this high, a risk of 10 in 1000, ie 1% is still pretty low in the grand scheme if things.

I also pushed for intermittent monitoring and they were happy to do this. However I did end up having a scalp clip attached to the baby's head as there was a problem with his heart rate dipping. But, as my waters had already broken and my SPD had rendered me pretty immobile, I felt it wasn't going against my birth plan, which had been for no ARM and to stay upright and mobile, but rather a change in plan due to circumstances.

I think if you are open-minded in your approach to it all and let them know that you are willing to be flexible depending on how the labour progresses and that you are aware of and accept the risks, then they have a duty of care to support you.

One thing I did though was hire a doula. Because she works with the hospital on a regualr basis (and is also on the local maternity services liaison committee) she knew which consultant and at which local hospital would be more amenable. Local knowledge is a good thing to have.

Agree that the registrar's were useless, and stuck to the "hospital policy" line so always speak to the organ grinder and not the monkeys wink

Oh, and can I also say that my mental health has improved vastly since the birth of DS2 as I have finally put to bed the ghost of my labour with DS1 six and a half years ago, and I feel physically so much better than with my last section (sleep deprivation excepted of course)

phew that was meant to be a quick post...sorry blush

Hi FLF, I am due 18th Jan...2 days after you....

Good luck with the midwife tomorrow, let us know how you get on.

Eeek. off to convince the GP now, consultant midwife tomorrow.

monkeydops - DD2 was breech until 38 weeks. I had been trying everything for a few weeks and was going completely mad. In the end I decided to relax and let it be - I reckon that's when she finally decided to turn.

mppaw, we must be due within days of each other..I'm due on Jan 16th. smile

Hi Nevil, FLF and Monkeydops, glad to see the thread still going as it is so empowering and full of really usefull stuff.
Am 32 weeks tomorrow, but so uncomfortable!!! Not enjoying this at all.
Have been working on my birthplan using what VS posted, so please with it.

monkey have you been on the spinning babies website? Get it turning now! grin

hi - can I join? I'm 37 weeks pregnant with DC2. DS is now 2 and was born by emergency cesarean after a failure to progress following induction. I was really hoping for a vbac this time round but am currently breech. I have been using moxibustion (form of acupuncture) for 8 days and have been told that the hospital won't try and turn the baby using ecv cos of the previous cs and that if baby doesn't turn by 39 weeks I'll be looking at elec cs. Any thoughts? experiences?

Hope you're feeling less crampy this morning fourlittlefeet. Good luck with the appt, will be watching out for an update.

went to hospital this morning after a night of crampy pains. all ok, but did manage to make sure that my vbac appointment next week is with the consultant midwife and mentioned vbac homebirth a couple of times during the convo and no-one actively said 'you're joking' but did get some slightly widened eyes.... watch this space. have the green tops ready and in a little celophane envelope.

I followed your story VS and even though you didn't get to vba2c you gave it your best shot. All the best with TTC and look forward to comparing notes on our successful vba3c's grin

Nevil.
FWIW, I cried to get the ok for my VBA2C blush

it just didn't happen in the end, bloody stubborn baby!

Good for you Nevil, sounds like a harrowing experience, but worth it!

Nevil well done it sounds like you have done really well today grin

. Keep reading and any questions just post them here and hopefully we can help.

Warning, this is going to be long.......

Well I had my hospital appt today and they made me cry sad

.

I was seen by a registrar and a junior doctor, the junior doctor was lovely and he was very sympathetic but the registrar was horrible. When I mentioned Vba3c the registrar just looked at me as if i was mad, she asked if i knew the risks i said I did and that i had researched vbacs throughly and that i'd bought evidence with me, she asked to see evidence but didn't take much notice of it. She kept on saying that i wasn't listening to her and tried to imply that i didn't understand how serious the risks were, that the baby could die, i could die, i'd leave my kids without a mother angry

.

She then asked if i was going to have a steralisation after the birth (i was thinking wtf has it got to do with you) i said i hadn't thought about it, if i end up with cs then i may consider it or maybe not, she then said that is why we advise women to have a steralisation after 3 sections shock

.

Lots more was said but to cut a long story short she said she would have to call consultant into room to see me who would never agree to it, i asked what would happen if he didn't agree she said he would refer me to another consultant and if no consultant would support me i would have to go to another hospital. So saw consultant and to be fair he was polite and respectful but stated that he has never heard of a vba3c hmm

, i said i have read many stories of successful vba3c's but he wasn't having any of it and stated he would not support me as he doesn't think it's right. He said he would refer me to the consultant midwife and to wait outside while she was called. I was exhausted at this point (had been there for over 2hrs) and had already made up my mind to change hospitals as i no longer wanted to be under their care.

So the consultant midwife came along and I thought here we go again, she took me into a room and she was sooo lovely. We spoke about my previous births and what my wishes were for this pregnancy and guess what..... she agreed to support me smile

.

It was at this point i burst out crying, i couldn't believe what i was hearing after all the negativity. She basically said if i agreed to transfer to another hospital under same trust where she is based we don't need consultants agreement and she would over see everything. We discussed CFM i said i would be ok with it as long i could stay mobile, active and upright (thanks to whoever mentioned those words of wisdom on this thread)she said no problem that would not be a problem. We discussed other things such as no epidural, no induction, etc and said she would see me in 7 weeks to prepare concise birth plan with all my wishes.

So what started off very very badly actually ended up on a very positive note thanks to this lovely lovely consultant midwife.

A big thank you to everyone on this thread for all links and advice I don't think i would have achieved what i did today without mumsnet. DH is well proud of me, im usually so shy, if anyone reading this wants to go for any type of vbac, believe me if i can do it anyone can.

I'm off to read about natural childbirth for the first time ever <excited>.

Hi Betsy[waves back]
Nevil, Good luck! Hopefully it won't be too bad! I shall be going through the same (hopefully, am TTcing) so let us know how it goes!

nevil

Unless there are other underlying medical reasons/conditions then they will probably use the increased risk of rupture after numerous c/s as the reason to go c/s again so also check out this (can't remember if this is in the links list or not)

table half way down has data from a study on risk of rupture after 1, 2 or 3 c/s - as you will see not that different after 3 compared to 1. (and a very small risk in either case)

Hi Betsyboop, Will definately ask about the state of my uterine scar, thanks for that.

Im currently collating all the info that I will take with me tomorrow and will probably see a registrar as I don't think I have ever met with the consultant with any of my previous 3 pregnancies. I really hope I end up have a discussion rather than a confrontation when I discuss VBAC but during all of my antenatal appts the MW's and registrars seemed to assume, once they've seen i've had 3 previous sections, its a full gone conclusion i will be having a fourth section <sigh>. Will ask for appt with consultant if faced with negativity.

My main argument will be that I feel the risks of a fourth section outweigh those of a VBA3C just need to get pros and cons printed as my pregnancy brain cant handle much these days.

Was feeling quite nervous but armed with all this info im beginning to feel quite empowered, roll on tomorrow grin

just to say I always found the consultants more willing to "bend" the "rules" (hospital policy) once they were happy you understood the pros & cons, than registrars who were always srictly by the book.

Nevil ask the consultant if there is anything in your notes about the state of your uterine scar. Very occasionally after a number of c/s you can get thinning round the scar which ups your risk of rupture. They can't "force" you to have a c/s under any circumstances (technically it would be common assault to do it without your agreement) they can just advise you what in their view is the best course of action & the reasons why, the ultimate decision is yours.

definitely take the green top guide with you. as has already been suggested

gosh Nevil, thats quite some history. I think some of the links show that its no more dangerous after one section than several. it looked to me like it was the consultant midwife who needs to be on your side to be successful in them agreeing. Look forward to hearing how you get on! I'm definitely going to threaten homebirth if they give me wanky excuses and am printing out the green top paperwork to take with me as back up.

Hello, I'm new to this thread and although not quite imminent (27+5) im hoping for a vbac after 3 previous sections <gulp>.

Have read through thread and found it fascinating, inspirational and informative, so thank you all who have posted experiences and general advice you have assisted me in believing that I may actually be able to achieve a Vbac after chickening out twice previously.

Fourlittlefeet - I also have my first 'battle' on thursday when I need to to in for a growth scan and appt with consultant which is when I plan to broach subject of Vba3c. The appt was originally booked when hospital discovered i was producing antibodies so decided i need to see consultant about that, i thought might as well kill two birds with one stone. Im not looking forward to appt at all, first DH can't make it due to work commitments (he has tried to get out of it but can't) so going in on my own with 17 month old DS and I'm not the most confident person and I know they will probably laugh in my face when I first suggest vbac.

From what i've read the consultant can't actually deny me a vbac as long as I am aware of the all the risks involved, or can he?? What do I do if it's an outright no??

I read somewhere on this thread that its important how i word my intentions i.e. I will not consider a CS without a trial of labour first.

My first pregnancy was a failed induction at 41+ wks, laboured until i dialated 10cm but never felt the urge to push, had emergency cs (they said DD was too big 8lb 3oz im only 4ft 11). Second pregnancy they wanted to book me in for elcs at 40 wks I asked them to give me further week to see if I went into spontaneous labour, I didn't therefore elective at 41 wks. They didn't give me a choice with third pregnancy and booked me in for elective at 38 wks. So after discovering mumsnet and this wonderful thread I have decided as this will be my last pregnancy it's now or never, I will do my best to achieve a vbac and even if it doesnt go to plan at least I know i've given it a good try.

It does p@** me off that if i had been given the option of a vbac after my 1st or even 2nd section I wouldn't have to fight for a vba3c which i know is not easy to achieve at all.

Good luck to all imminent vbacers and will give updates on my progress.

Thanks BB. I read you story... theres only so much you can do and after all it is more about a healthy you and baby in the end. I've read lots of the links, printed others out and will update you all once I've had my first 'battle'!

just noticed you new name VS grin

{waves hello}

hi 4LF & welcome

Just shout up if you've any questions & I sure someone will pop on to answer if they can.

As hedgepig said, this thread does go hot & cold, but it's been running a while & is still managing to hang on

(about 18months I think as I was one of the orginal "gang" & DS is now 1!)

There is some great info throughout the thread, but have you checked out the links on the second page posted when the thread started?

Glad you feel inspired to pursue the birth you want, you will need to be assertive with some medical staff, who think a VBAC is a walking rupture hmm

, but if you push hard enough (no pun intended grin

you can generally get somewhere close to what you want (I managed to get the consultant to agree a water birth with no CFM after an outright "NO" from his registrar!)

BTW - I ended up with an el c/s at 40+10 rather than my longed for VBAC, but that's a looong story...!

amazing read; took me a couple of hours or more last night! some amazing stories on here and have come out the other side armed with a birth plan (never thought I'd need one) and a desire for a home birth or at the least a go at a water birth. Feel completely inspired!

thanks for coming back to talk to me, it was a little lonely!

hi 4littlefeet how was the reading? this thread does seem to go hot and cold a bit, but has great info on it and so is good to keep going. How is your hospital viewing your VBAC plans? DS has just filled his nappy shock

so I best go and change him

where have you all gone sad

any more vbac'ers out there???

Hello, just seen this; am 31 weeks and hoping for a vbac... posting to bookmark... then off to read through!

MissMattie I hope the elective cs goes well and you get good recovery and your LO is OK. Hxx

Hi MrsMattie, hope you are ok, not long now til your LO makes an appearance.
Keep us updated.

grin

Loving your new name, VS grin

Just wanted to come back to this thread - as it's been such a great source of support for me - and wish all you imminent VBAC-ers lots of luck and send positivity your way.

Unfortunately, health problems mean I will now be having an elective c-section next week - but I will still be checking in here (and on the birth announcements board!) to see how you're all doing. I think you are all fab grin

.

xxxxx

hi poledara yes I was at the Rosie. I didn't have Anita but had really great support from Claire and Deborah, I went through a couple of shift changes!

No problem, it was hashed together from some links Klaw gave me. smile

Oh wow, squalor this is fantastic. Am going to cut and paste and use it if no objections.
My birth plan with DD was 1 line, DP to tell me the sex, and like you this made its way to the op theatre and when she was pulled out of the sun roof, the surgeon gave my DP a shout and he announced to me what it was.
This time round, it is definately going to be more detailed.
Am also thinking, if another CS asking for the screen to be lowered so I can see DC sort of come out.

Thanks again Squalor. grin

hedgepig, weren't you giving birth at the Rosie, or have I confused you with someone else? If yes, did you get the wondeful Anita as your mw (she delivered DD3 as an induced VBAC)?

Sorry for hi-jack smile

It's quite long so apologies for taking over the thread with it!

My Birth Preferences-<my name>.
Companions
•The companions I have chosen for my birth are my partner, <partners name> and his mother, <her name>. Both know my wishes, have read this birthing plan and are happy to support me in this.

Birthing Environment.
•If I am in labour during the night time, I wish the lights to be dimmed, if during the day I would like my curtains to be closed.
•As I am not overly keen on spending much of my labour in hospital I do not want the room to seem over-medicalised which is why I am asking for the above.

Labour
•Although I am a VBA2C, I do not want to be treated differently to any normal labour.
•I am willing to have CFM for the beginning of my labour but if I want to move around as long as the baby is coping well I wish to change to intermittent fetal monitoring.
•Please do not treat me like a potential rupture of scar. The statistics on this show the actual risk is minute so although I appreciate people being aware that it may occur I do not want it to be at the forefront of my labouring experience.
•If I am overdue I will not consent to induction unless my baby is compromised.

Pain Management
•Because I have been careful to not take anything that may harm my baby for the last 9 months I want to ensure that this continues in labour. I know that drugs cross the placenta rapidly and I wish to protect my child from this.
•Encourage me to vocalise my labour and not feel inhibited by this, as it can be surprising and confronting to hear myself like yelling or moaning.
•If I ask for an epidural or a caesarean section, please do not take me up on that immediately, I may just be scared and need support. I need to be informed when I can still have an epidural and when I must make my decision by but I really want to try to do it without.
•If I do require some pain relief I am willing to try gas (entinox) I understand it can help me to focus on my breathing and to get through each contraction.

Cuts and Tears
•I would like the midwife to assist me in avoiding a perineal tear by encouraging me to deliver slowly. I believe that delivering in a good position and waiting until I feel the natural urge to push will help me to avoid this.
•If at all possible I wish to avoid an episiotomy
•A small tear is preferable to an episiotomy
•I do not want stitching unless the tear is deep
•I want a local anaesthetic to be used if I need stitches.

The Birth
•I wish my partner to be present at all times.
•Forceps/ventouse only in an emergency and after consultation and discussion with me and my partner.
•I want my partner to find out the sex of our baby.
•On delivery I want baby to be placed on my chest, skin-to-skin and a blanket is good care if a cold baby and this is my preference.
•My partner is to cut the umbilical cord.
•If any extra care is needed for baby, I wish my partner to go with it. I do not want baby to be left alone without either of its parents at any time.
•I am not decided on which position I wish to give birth in, I would like encouragement to find a way that suits me best.

After the Birth
•I want my other children to be present as soon as possible, depending on the time of day.
•I want to breastfeed and also to allow baby to breastcrawl to initiate breastfeeding so skin-to-skin contact is extremely important.
•I am happy for my baby to have the vitamin K injection
•Baby is not to be fed formula at any point.
•Baby to be examined by any health professionals only with parents authorisation and in our presence.
•If there is any concern regarding baby we wish to be told immediately.
•I plan to keep the baby near me following birth and would appreciate if the evaluation of the baby can be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.

Caesarean Section
•Having had two previous c-sections, I do not want another without dire need.
•Caesarean Section can only proceed with my consent.
•I will not accept a Caesarean section for time limit reasons, if my baby is still healthy.
•I will not accept a Caesarean section for maternal tiredness, an epidural may be enough to give me a rest and try again.
•I do not want to be left without anyone I know before the operation, no pre-operative abandonment.
•I want my partner to cut the baby's umbilical cord.
•I want my partner to tell me the sex of the baby please do not announce it for him.
•I have already had a caesarean operation, please use the existing transverse scar.
•I wish to have skin to skin contact with my baby, please leave one arm accessible/unrestricted.
•I may be depressed about the birth and need to talk about it without any criticism for feeling the way I do.
Breastfeeding
•I am planning on breastfeeding my baby exclusively.
•I wish for skin-to-skin contact immediately for at least 10/15 minutes before any checks, unless checks can be performed whilst baby is on my abdomen.
•I do not want anyone to give my baby formula or to supplement its feeding.
•Although I have previously breastfed, I would appreciate full support with this baby.

Lastly, I would like to take this opportunity to thank everyone that aids me during labour incase I forget or do not get the chance later. I understand that in certain situations my birth plan will not be able to be adhered to completely and ask that my wishes are taken into consideration as much as possible. The main objective is to get baby out safely but I wish this experience to be one I look back on positively and not full of regret.
Thankyou.

Signed………………………………………………………………………………….

>>In the end I had a CS as there were placental issues but my care team were really good with my birth plan and everything I asked for was adhered to, the anaesthetists even told every person that entered the room not to mention baby's sex as Dad was going to do it.

That would great squalor.....Thanks. smile

mppaw, I wrote (what I think was)a pretty good birth plan for my VBA2C (it's been pinched and copied a few times wink

)if you want me to post it on here?

Lacky and hedgepig, FANTASTIC stories and thanks for sharing them. Really feels me with confidence that I am going to do this.

(Still no internet at home, Bloody BT, and I only work thursday and friday, hence the delay in posting).

hedgepig, Had not thought about checking the colour of my waters if/when they break, so that is going on my plan.

Milkmade, MY hospital wants CFM, have not kicked up too much of a fuss at the moment, as I am thinking once I am in the throws of labour, I would like them to try and pin me to the bed etc....NO CHANCE wink

Will definately keep this thread going as the info on it is SO VALUABLE.

Speak soon all.
xx

Daisy - thanks for your reply - am working my way through the history of this thread, and looking into the links.

Hedgepig: I know I can't just will a birthplan into being smile

but having had over 24 hrs of CFM last time I do know I am very keen to avoid it this time, it's not just the mobility, but also last time being able to shower really helped my back pains and and of course that's not compatible with cfm. Obviously if intermittent monitoring shows anything untoward I'd react accordingly.

Incidentally (and this is going to make me sound the vainest person out) is it true that if I have a planned c-s they can go in through the same place but in an emergency you end up with two scars?

milkmade although i did end up with CFM because I was induced; my case in my birth plan if I had had a spontaneous labour was that I wanted to be active and mobile and I was concerned it would CFM interfere with this desire. As Daisy says you have to agree to it they can't strap you down and tie it on! But my personal experience is that it is good to have a plan but you have to be flexible too, just reading as much as possible made be confident in the choices I made.

hi milkmade and congratulations smile

just a quick post and run from me as i have my hands full of baby, but there are some links on page 2 (I think) with info on monitoring, which although may be uk generated, will be just as relevant for you.

At the end of the day, they can't make you do anything you don't want to do, and you are within your rights to refuse any interventions offered (note the word offered, tis key!!) based on your assessment of the risks involved (something like 5 in 1000 of scar rupture in a VBAC1) and whether that rsik is liveable with.

Having just had a successful VBA2C with intermittent monitoring initially, I would heartily recommned a doula; mine was able to advocate for me when I was finding it a bit hard in the face of all the white coats.

the thread is a bit quiet some weeks, but i'll try and pop in now and again (keeps falling off my actvie convos) I might start a new thread so the information is all fresh and available.

Good Luck smile

All, I just had my booking in appt yesterday, so by no means imminent, but would appreciate some advice. Consultant and I are aligned in most of our thinking, i.e. VBAC preferable to another C-Section (and she was very positive about my chances) but on the other hand if they need to get the baby out early again due to recurrence of pre-eclampsia than I don't want to be induced (it really didn't work last time) so at that point I'd go for an elective. So far so good. Where we differ in views is the standard bug-bear of continuous monitouring. Now I'm not saying that was the sole or even main reason I ended up c-ection last time, I think the fact that it was 3 weeks early, my body wasn't ready, I didn't react well to the induction drugs and it was back to back all contributed.... BUT I do think being stuck in the bed labouring so long and not being allowed to get up in the pushing stage did play a significant part. So 2 questions, one long shot - does anyone know the dutch guidlines on CFM in a VBAC, and secondly, can anyone help me develop my case for intermittant monitoring? Thanks...

Another encouraging VBA2C story

congrats hedgepig grin

hi mwpaw I had my VBAC at the beginning of last month and I was induced with the drip only no prostaglandin gel. It was tortally not what I had planned but my waters went and there was meconeum so we had to get things moving. The cervix was not favorable at all.

For me I didn't labour at all for my 1st child and the induced labour was a very positive experience so I wouldn't discount it totally but depends on your previous birth experience I suppose.

full story in birth announcements here

Hi, Sorry for not getting back earlier, but no internet at home due to BT being complete idiots !! So had to wait til I got to work (I work Thursday and Friday).

Daisy, your meeting sounds really positive. Had a quick look back to see when you were due, but couldn't see anything, when is LO due ?

My meeting last Friday was really good. They had the notes there from my first birth and it was really positive going thru the labour step by step and actually putting times to when things happened.
I actually dilated to 7cm, ALL BY MYSELF in 2 hours !! They then moved to the delivery suite (I was on an obs ward being monitored as I was induced) which is when it all went pear shaped. Anyway, at least I know I can dilate/labour, and certainly remember what it felt like !! OUCH.
She listened to everything I had to say and did not spout hospital policies to me.
I questioned the CFM and she said that they will encourage me to stay on my feet etc, so I agreed, but will have to wait and see when I go into labour if they let me move about with the straps on or make me stay on the bed !!!
I can labour at home (As long as I feel ok etc) untill my contractions are 5 mins apart. I thought they would want me in ASAP once labour starts, but she said no. So that is V positive.
1 thing I was concerned about, she said they will assess me around 40w+10, and if cervix looks favourable (Supple?) and am having twinges etc, they will induce me. Told her am not happy with this, but she stressed only if everything looks like you will labour.
Thoughts re this girlies ??? Do you think an induction is a DEFO NO NO, no matter what my cervix is saying to them ??

mppaw....thanks smile

I hope you got on well at your appointment.

Just a quick update from me; I saw my new consultant today and although she spouted hospital policy at me (recommendation for CFM) she acknowledged that it was my decision and that I would be supported in whatever decision I made smile

. We discussed a post dates appointment and she said that although they routinely offer induction at 13 days post dates; as I wouldn't be considered suitable for induction there was little point making that appointment and she has left it to me to get in touch with them should I feel the need to discuss anything further. Leading on from this it is pretty much decided that if I don;t go into labour naturally then the best option would be for me to have a c-section. I'm OK with that, and when we discussed the need to make a date for that to happen she just said why not wait and see how things go. We arbitrarily talked about two weeks post dates, but she said that they would be willing to let me go even longer provided I was happy to come in for monitoring.

So, given that if she really thought that my decisions were endangering myself and the baby she has a duty of care to tell me that, the fact that she didn't tell me that says to me that she agrees with my decisions, even though trust policy dictates that she can't say that directly.

I hope that all makes sense; I'm still feelign quite giddy about it and much more relaxed and positive about it all......oh and that I've been having regular tightenings this evening accompanied by horrible backache and cramps this evening. My pubis symphisis joint cracked earlier (like knuckles craking) and although my SPD has miraculously disappeared; I think it's allowed the baby to slip further down into my pelvis and is fully engaged (was 4/5ths this morning according to the MW as she couldn't move the head at all when she had a prod) as I'm now waddling like a duck.

Can you tell I'm a little bit excited grin

For those of you in the Tayside/Angus/North Fife areas - The next meeting of Dundee Birth Choices is Wednesday 29th October and the topic is VBAC

grin

Sorry Lacksadaisy, just re read a few posts and I saw you asked when I was due and I did not reply. Apologises.

18th January 09.
Will be the size of a small house for Christmas, LOVELY. wink

Hi all, Off for my VBAC meeting tomorrow at the hospital, feel v prepared, so actually looking forward to it.
Had my 28 week check up with the MW yesterday and all seems in order.

Will post over the weekend on how the meeting went. smile

I think Temp is important in any case as it can be a sign of infection if it rises. As well as the fact that you get cold when you go into shock.

and thanks for that link....it's duly printed off and in my notes smile

that's what we thought BB, thanks smile

chock should of course be shock hmm

that'a great MrsM

LAD - I'm assuming they are doing temp as another sign of possible surgical chock (falling temp, rising pulse I think)

just checked Mary Cronk she doesn't mention temp, but she does talk about surgical shock.

<considers moving to wherever MrsMattie lives> grin

that's fantastic news MrsM; just the stuff that I wanted to hear from my registrar but didn't angry

, and am hoping to hear from the new lot at the new hospital smile

klaw, a quick question for you if I may?.......my DH was wondering why temperature is important in monitoring the mother for signs of scar rupture? He gets the pulse bit, but not the temp. Any insight?

Sounds fantastic MrsMattie...really pleased for you...

Bring it on, MrsMattie!!!!

Hi lackaDIASYCal and all other imminent VBAC-ers grin

Well, I had my 34 week appt yesterday with the consultant at my hospital to discuss VBAC (again).

(Background: I had a really unsuccessful appointment at 28 weeks with a negative, smarmy registrar who was happy to tell me in great detail about what I would and wouldn't be 'allowed' to do/have sad

. I left that appointment seriously considering going for a c-section....')

This appointment went so much more smoothly!
The consultant (who ahs the ultimate power, he he!) was lovely - very pro-VBAC. She told me I didn't have to have CFM if I didn't want to (she signed it off on my notes) but that if I wanted to give it a try for my peace of mind, I could and assured me that at any time I could ask for it to stop and they would monitor me intermittently. She said (quote) 'Women, especially VBAC-ers, generally labour better if they are happy and relaxed. How you feel is paramount.' (Thank you!) Also assured me that the leads on their new CFM machines are minimum 6 foot (in some cases 12 feet) long. She completely agreed that being able to keep mobile, to be able to labour in which ever position feels comfortable and for me to feel in control was infinitely more important than the CFM and (happily for me, just as I was ready to bring out my thick wad of research...) she said 'we monitor your pulse and temperature, too, and mainly want to know how you feel - these (along with some for of monitoring) give us a better picture of how you and the baby are doing than just leaving you lying on your back hooked up to a CFM.

She also said the registrar was 'incorrect' when he said I would 'have to have' a c-section at 41 weeks if there was no movement by then. She said she would happily leave it until 12-14 days before even bringing me in for 'that chat' and that as I had gone so overdue last time, that could well just be part of 'how I labour'.

She also poo-poo'ed stupid registrar saying I shouldn't stay at home for too long if and when contraction start. She said 'judge it yourself, and give us a ring if you want advice.'

Sorted!

So...feeling very positive about it all now. So relieved in fact that I had a good cry at the end of the appt., when she said 'You have a very good chance of a straightforward vaginal delivery. And any other course of events...well, we'll cross that bridge if it comes to that'. EXACTLY what i wanted to hear grin

hi klaw

I'm waiting to hear from the new hospital regarding an appointment which will hopefully be next week. My CMW is on holiday so one of her colleagues did the paperwork and grumbled about me leaving it a "little late in the day" but she would see what she could do!! My doula said she has had clients change with only one week to go so not to worry though.

37 weeks today though; so good to go!!

<will still be here at 42 no doubt hmm

MrsMattie

that's the spirit; it's amazing how much leeway you get when you mention a homebirth...or so I've been told. I never pulled that particular rabbit out of my hat

and a choice wee nugget is that the NICE guidelines say that a woman who is opting for a VBAC should be offered CFM.....nothing in there about you actually having to accept it.

Must get some sleep or I'll have no energy to deal with any sort of delivery come B-Day smile

Well, I guess it's time for me to join this thread smile

I'm 34 weeks pregnant and hoping for a VBAC - guess that makes me an 'imminent VBAC-er' grin

(Have been following your posts, LackaDAISYcal, and have found it really comforting knowing someone else is in such a similar position...!)

I am seeing a doctor (they say 'Consultant' but it never bloody is!) at the hospital on Weds. Last appointment with cocky young whippersapper at 28 weeks didn't go too well. Lots of guff about what I would be 'allowed' to do / not do
(I almost opted for a section at that stage sad

).

Planning on going in armed with lots of research (and my husband!) this time and telling them it's my way or I stay at home.

Hi again jellybeans smile

. It sounds like the resons for your previous sections were just "one of those things" and the chance of them recurring is slim to none.

I'm really not sure about the cervical stitch thing, but as lots of women have that done and then go on to deliver normally I can't see it being a real issue.

I'm really very sorry to hear about the loss of your DD at 20 weeks; that must have been devastating sad

.

Have you asked your community midwofe about things? she might know which consultants at your unit are more sympathetic to VBAC. Another alternative is a doula; I would've just gone along with everything I was "told" had I not had mine reiminding me that there were other options.

Good documents to start with are the RCOG green top guide, and the ceasarian.org website (won't link as I always spell it wrong). they are linked on page 2 of this thread.

The old adage, once a section always a section is very old school imo and according to the NICE guidelines and the green top guide is no longer necessary.

I hope you can get some local advice and get the birth expereince that you would like smile

Oh, I bought a book as well.....will hunt it out tomorrow and let you know what it's called smile

Hi am very glad to find this thread. Haven't read all yet as my PC is sooo slow today but I will tomorrow. (Thankyou to LackaDAISYcal for pointing me in this direction

) I am 34 weeks and have had 2 c sections already. My Cons, when I asked, just said that after 2 sections it is always a section, there was no discussion or choice. I have had 2 VBAC1's already but then had another c section (crash section for prolapsed cord). My original emergency section was for failed instrumental and my DD got stuck as she was very big, my other babies have all been smaller. I had a sort of VBAC2 last year when sadly I went into labour at 20 weeks, DD was too early to make it. I then got diagnosed with incompetent cervix. Hence I have a cervical stitch in place. Usually they are removed at 37-38 weeks (if you haven't gone into prem labour before then) but if you are having a section they leave it in until you are done having babies (which I will be if all goes OK!!) I did wonder though, if my cervix just opens with the weight of babies, if that would mean less contractions (I had none at all with my 20 week loss even though I was fully dilated) and less chance of rupture. I have an appointment in 2 weeks to discuss delivery but I know they will be rushing in and out. I am so scared of a section as I almost bled to death after my last one. Any advice or encouragement anyone? Good luck to you all xxx

didn't realise it was mumofdjandbabies. Lovely story grin

If I was still in the area Klaw I would've asked you to be my doula smile

As it is I have a lovely doula who has been moving mountains to help me get the birth I want and has given me the confidence to change units in order to do it.

it's tempting Klaw, but none of them have enough space to house us all anymore.

<ponders last minute visit to rellies in October hols>

It's a pain that in a city as big as Leeds the only options are one of two consultant led units, but OTOH I'm happy to be close to big surgical procedures if needs be.

Off to read your post smile

Daisy, scroll down till:

'By Klaw on Sun 21-Sep-08 15:00:46
I was the most amazing WBA2C .....'

THAT was at FP, btw! grin

Wanna come and stay with rellys so that you can book into the MLU? wink

I know there are a few others out there at the minute, so hopefully we can keep this inactive convos for a while again.....or I might even start a new thread but copy over all the relevant links etc.

When are you due mppaw?

Thanks for the bump daisy.
Just signed in, so am going to have a look back at this thread for some helpful info re my imminent meeting!!

Cheers grin

I was born at FP grin

...in the old stone building as the "new" one hadn't been built then!

no, Klaw.....I escaped left three and half years ago when DH and I got married. I'm in Leeds now smile

I do miss Fife though.

Daisy, you're not still in Kirkcaldy, are you?

I'm back at FP next Friday for a Study Day which I'm really looking forward to. Have to say that so far my experience with them has been totally positive as regards VBAC and I keep shouting it from roof tops.

People will be getting bored..... blush

as for the typo, that wasn't me, I'll report back to the webmaster. Can't believe I've not noticed for the last 3 months blush

thanks Klaw smile

Good Luck leading your meeting.

PS...wee typo there in the spelling of Kirkcaldy

<anal natural born Kirkcaldian>

Bring it on Daisy!!!!!

And just to let all those who may be in the Tayside vicinity that the topic of This months Dundee Birth Choices is VBAC!!!! Yay, I'll be in my element grin

Although I think my mw colleague is expecting me to lead the meeting [gulp]

She's too busy revelling in her RCOM Student MW of the Year award!!! Whoo hoo!!!

bumping this again as my VBA2C is......well.....IMMINENT <quakes>

After a disappointing 36 week appointment with registrar pushing for me to agree to intermittent monitoring as they don't deal with many VBA2Cs at all, my doula had a word with the top MW at the other unit here. She (the MW) has confirmed that they wouldn't treat me any differently from any other woman who was wanting a natural labour and would be happy for me to be monitored every 15 mins using hand held device grin

. I might even get to use the birthing pool if it is free! so I have her name, the name of the consultant I need to ask my care to be under, and then once I have swapped hopsitals, the MW is going to meet with me to draw up a care plan according to my individual circumstances.

I'm feeling very pleased about it all as I was starting to feel quite despondent.

Only stipulation is that I need to be full term.....so any time after next Thursday is fine for me young Virgil grin

Off to catch up since I last posted.

mppaw, hi there smile

. What sort of things did you have in mind? Have you looked at all the links on page 2 of this thread? Lots of good information there.

Have got my 28 week meeting with midwife at the hospital next week re my VBAC and am going prepared. Have started making a list of questions, but was wondering if anyone had any questions that I could ask that might not be on my list.....Thanks. smile

Klaw I am famous tee hee grin

do you know I had forgotten MOST of all that info!

A bit annoyed at myself for pushing at 8cm and thickening up my cervix but body just sort of did it boo hoo

anyway I have a little lady so all is well ,,,, xxx thanks klaw grin

3 evenings later and I have finally read this entire thread ! Only realised last night that this goes back to SEPT 07 blush

.

EMS with DD1 (Mar06) after being induced (41+3). Got to 10 cms and pushed for 2 hours but she was really high up and not coming down so was offered an instrumental birth or CS. Opted for CS.

Am now 23 weeks with DC2. Really want a VBAC so doing as much reading/research as possible and this thread has been great. It has the most wonderful birth stories, VBAC and CS's. Really feels me with such confidence that I will do this in January09.

Will continue to lurk and read, butting in everynow and again. wink

I was AT the most amazing...

I was the most amazing WBA2C that wasn't at the beginning of this week! K had two previous CS at her closest hospital but she decided to change Trusts to use an MLU that has won awards for faciltating VBAC and WBAC. She asked for the VBAC friendly cons, Dr U, and he did not bat an eyelid when she stated her preference for a WBA2C on the MLU. He simply wrote it up in her notes and signed it off. The MW she was in contact with there were fab and one in particular had emailed a few times and given her contatc details in case it was needed! smile

K called me in early labour on Monday morning and as I was due to take her to see cons that day I went down early. K had not slept much during the night or through the day, except for dozes and she eventually decided to go to the MLU, arriving at 4pm, to be told they were chocca and we had to wait in Obs unit till pool ready, She cried! She was eventually assessed as FULLY effaced but only 1 or 2 cms, again she cried! We pointed out how positive that actually was. K's mum and her dh arrived. She had first lot of IV ABs for GBS. Eventually she was taken to bath at about 6.30ish and I went out to speak to her mum. Came back in about 7 to find them coming out as 10 secs after she got in bath on MLU, her waters broke and mec was everywhere.

Quick assessment in birth pool room which was now ready and she had now got to 4/5 ish and mec was fresh. Blast!!! But progress was good.

Moved back through to obs unit and she laboured like an absolute star till 3.30am, she was standing by bed whole time, using G&A and had 3 lots of diamorphine. She was standing asleep by this point so mw checked her as she had been gutteral for a little while, and yes, unfortunately she had been pushing down on 8cms which then thickened up cervix. Mw suggested epi to allow her to sleep and hopefully cervix would thin again and then fully dilate. She and hubby napped, Doc checked her at 5am while i was out and it was still only 8cm. 7pm showed her still to be 8cm, she was knackered, GBS carrier, baby had been in mec for 12 hours and no progress for 4.... decision to move to calm CS. Mind you all obs had been perfect all the time and baby's HR never wavered through any contraction, It was steady as a rock!!!!!! so why had she passed mec? been wracking my brains for any sudden shocks/loud noises etc. Think it was just that she was a ready baby.

When I was sat waiting for news of op Dr U, walked passed, recognised me after me attending ONE appointment with K and asked how things were. I gave him snapshot and he went to get news. Came back and confirmed they were all perfect and arranged for me and K's mum to get on recovery fairly swiftly.

K had been so pleased to see him pop in on her, was delighted with labouring on her own terms, even with it all going to pot with the mec.

Parents elated with a 8lb 14 girl who was latched and chomping like she'd been around for weeks not barely 2 hours. K got skin to skin, which had never happened in previous 2 births, dad got to cut cord and they got to examine placenta. All their wishes were respected, and if only we had walked straight in to birth pool room from the begining and baby had not passed mec? Nothing we can do to change that.

I can truly say it was a very successful, empowering labour that she coped with with amazing strength, and dad and I worked together so well.. I can't really describe it.... i mean she moblised the entire time till epidual!!!

I have been hit by the anti climax now and mum is a bit baby bluesy too. I hope to see her soon and we can do a birth debrief.

Hi all. Can I ask for a bit of advice here please? Sorry this is going to be fairly long as I get my thoughts in order...

I'm 34 weeks with DC3. DS was a natural birth, back to back so very painful and had an epidural but pushed him out with no assistance aside from a little snip. He was born at 41 weeks and was 8lbs 7.

DD was undiagnosed footling breech which was spotted when I was heading into transition (had only just got into labour ward - everything went very quickly) and necessitated a crash section with general anaesthetic. She weighed in at a whopping 10lbs 5 and according to several midwives and doctors, did me a favour by being breech as they reckon I'd never have got her out naturally (I'm only 5ft 2 and not of very big build). Again, she decided to appear at 41 weeks.

Anyway, fastforward to DC3 and whether to attempt a VBAC or not. I have been diagnosed with gestational diabetes this time and am on insulin 3 times a day for this as I have been unable to control it with diet alone. I understand that I would be on some sort of insulin drip to control my blood sugars throughout labour and, due to the prior c-section, baby would be monitored as well. Also, I would likely be offered induction at 38-39 weeks but I don't think induction is particularly conducive to a successful VBAC.

The Diabetes Midwife I saw last week is keen that I try a VBAC but I don't see the consultant or have a scan for another couple of weeks. Last time I saw her she made a comment about the risk factors mounting, and having done a bit of reading now, I kind of get what she's saying. Baby is looking to be just over 8lb at 38 weeks according to scans but I know there's at least a 15% margin of error.

Previously I was worried about the possibility of shoulder distocia but now I'm starting to think about the potential of uterine rupture as I know that this is more likely with an induction.

My main reason for thinking of attempting a VBAC is obviously to minimise recovery time, having a 5 year old and a 2 year old to deal with. I don't have a problem with the thought of having another section as I recovered very well last time - it's just the inability to drive etc that's worrying me.

Does anyone have any experience with the above combination of insulin-dependent GDM combined with induction and VBAC?

All thoughts and advice gratefully received as this is starting to keep me awake at night now trying to figure out what to do.

thanks Hedgepig- it going to be very useful smile

e malled it, let me know if it does/doesn't turn up,

thanks so much Hedgepig- there is no rush smile

OK pinky I will send it to you. Probably tomorrow, my DH dose very complicated things with the computer so I need to go to a different bit of it and I'm too tired at the moment

that's kind words!

Hedgepig that would be great, thanks. pinkyminky at mac dot com. smile

I was guessing I would be allowed home. Spoke to a friend today who had a VBAC at the same hospital, and she said she would've but ended up staying in because she had quite a few stitches that needed pain reief (epidural), so had to stay overnight.

Thanks for your lind words, Hellymelly. I'm actually getting quite excited about it all now. I've had one emcs and one elcs and I'm not scared of either of those, I've just never had experience of a full labour, as you say, I would love to experience this.

I'm due on the 4th Oct, so it could be any time now. Gosh Kings sounds very enlightened supporting a home VBAC. Since you are going to be at home I think you are in a good position to not get trapped in a situation of being tied to a monitor, stuck in one position etc.

Thanks Helly (thats my name in RL!!) my last cs was a total shock I just went in for a check because of reduced fetal movement at 40 weeks to find I had a unrecognized breech baby and no amniotic fluid so the whipped him out that afternoon. The cs was completely the right thing to do but I still have a lot of crap in my head 5 yrs later, so even if I don't succeed this time I will have tried everything I can.

I tried for a VBAC but my labour didn't progress properly and I ended up having another section-but support to all you trying as I am SO glad I tried,it healed a lot of wounds from the first section,I had lovely labour endorphins and so felt fantastic afterwards,and if it comes to it for you a section is so much easier the second time around,so its all good!

hello hedgepig, my midwives are funded by the nhs and kings (in london).

i have my birth talk booked in a couple of week, i think they talk about birth plans then, after my last experience i haven't really wanted to think about it, hope they come up with some good tips, anyone got any they would like to share?

hedgepig when is your due date? is anyone due around end of oct.beginning of nov? i'm due nov 3rd.......

thanks VS I put it in the birth plan and have emailed it off, but I haven't had any feed back yet. The idea is the birth plan will be lodged on the delivery unit so they know what to expect when i come in. All I need to do now is go into labour grin

.
Pinky I could email you my birth plan if you want, I don't know if it is any good or not. I can't imagine why they wouldn't let you home in the same time frame as a "normal" delivery if you were to have a rupture it would be when you are contraction not after you have given birth. Home in 3 hrs what a fantastic thought, ds and I were in 10 days last time I though I would never get home.
selfemployedness are your mws independent mws or NHS ones? I have never felt a contraction either the thought of it is freaking me out slightly.

hello, i am 34 weeks and hoping for a vbac at home.

i had an emergency c section 23 months ago after failing to progress. got to 9 cm, they had me pushing anyway (that's not right is it)? and dd didn't come down the birth canal, i have my birth notes from last time and it says baby's head maybe too big for pelvis? my nice midwives have said that they couldn't have possibly known that and they are very into my trying for a vbac at home in pool. am lucky to have got them, i have 2 all to myself

so i'm hoping all will go well if it doesn't 5/10 mins to hospital....

i'm sooo scared i do't know what a contraction even feels like cos last time nothing started naturally i had an epidural in b4 they even broke my waters cos i was so fed up of having loads of prostins inserted, i didn't realise the implications of being induced cos i actually asked for it!! i was 41 + 3 days with spd and totally fed up, dd turned up at exactly 42 weeks and i was so totally exhausted and in pain and swollen and bloated, it was awful!!! i really hope to be able to do things naturally this time and recover quick and not have to go anywhere near the hospital

Hi all
I'm going for a VBA2C, I'm 33(?)weeks. My consultant is very supportive. He has told me what the hospital policy is but at every stage has said that it is my choice.

So I guess I need to develop some kind of birth plan?? VS I know you had a fabby one, I could just do with some realistic advice on what to put in it. I have another meeting with my consultant at 36 weeks.

If all went well, would I be able to be discharged in three hours like 'normal' births?

hedgepig, once I finally got my cons' support for my VBA2C she too suggested the wireless monitor and the pool, but I didn't get to have the VBA2C, however she said they used it a lot and it was good.

Hi daisy 37 weeks so now rather imminent I suppose

Has anyone heard of a telemetric CFM? I went to talk to the consultant MW last week about my VBAC and using the pool and the issues I have with CFM (ie. movemnt restriction) and she told me they have a wireless CFM whihc means I can move about as I wish. I was just wondering had anyone used one, for me so log as it is avaible it seems like a good compramise, the only draw back would be it picking up fetal distress that wasn't real I suppose

Using the pool is against the hospital policy because if you were to have a rupture they don't feel they could get you out of the pool and to theatre in time. But they will let me use it

moonliliy, I hope you read this.

I'm aiming for a VBA2C, only 17 months after my last c-section, so it is possible.

there are some links on page 2 of this thread, look at the RCOG green top guide which gives you their guidelines for VBAC. there is also a lot of info in the NICE guidelines.

My MW was very negative when I told her my plans (she is a bit old school "once a section always a section") but there really is no need.

I'm sure I read somewhere though that an older scar may have more chance of rupture, but not sure. Have alook at the links that have been posted; I'm sure there will be something in there about it.

I'm now less than eight weeks away from my due date and tbh, that elective at 39 weeks is starting to look more and more appealing (have SPD and baby is breech so horrendous heartburn and gastric reflux going on). I'm seeing my doula this week so hopefully she will be able to get me more grounded and confident again.

I think this thread needs a bit of a revival as I know there are a few of us out there who are getting to the imminent stage smile

Come along and chat one and all!

hi moonlily. I'm not one, but I the best explanation I can manage is that a doulah is a birth support person. They are not midwives but know loads about birth and are trained to give to support and empower you to make your decisions about your birth and support you and your partner in the hospital (or home). I'm sure Lulumama will be along soon to explain it properly. I'm really sorry the consultant was not supportive, have you discussed with VBAC your mw? is she supportive? Can she recommend a different pro VBAC consultant you can change to? A VBAC after 2cs is possible and you have had a long time to heal so hopefully you can find someone more supportive. If you go to the beginning of this thread (page 1 or 2) there are links to lots of good information resources.

hi there

firstly duh moment... what is a doula???
secondly can i join??? any support would be wonderful, im 29wks with baby no 3 had my heart set on a vbac after 2 cs last one was 11 yrs ago, saw my consultant last thurs who was totally unsupportive gave me no pros whatsoever and frightened me and hubby with horror stories. I left in tears thinking how stupid i was to even consiser the risks but reading some of the other threads with people who have had successful vbac am in turmoil of what to do
i really dont want another cs unless totally necessary but am now terrified of trying for a vbac in case i rupture.

Been lurking on VBAC threads including this one for a while. Thanks for all your posts and also your comments which I've found really useful (in particular Lulumama).

After terrible 50hr labour and emergency c/s with DS1 I've just had great VBAC for DS2 last thursday. I remember your words of wisdom - 'mobile, upright and active' and kept this in my head all the way through - I was off my face on diamorphone and kept shouting it at the midwife who thought I was mad .

Yes it was bloody sore and a section was threatened at points as he was in distress but this was due to a knot in the cord and not a rupturing uterus as I feared. I had CFM at the start and then they did some blood test thingy on his head and I had that on for the last bit and his oxygen perked up. I also only got 30 mins to push him out in as opposed to the usual hour but everyone shouted at me lots and he finally came out after 40 mins without any ironmongery involved.

I was up in the shower within 2 hours compared to 3 days after my section and I can't believe how mobile I am which is such a relief with a 2 year old at home to chase after. Anyone who thinks a section is the easy way out is having a laugh - I would take 7 hours of contractions any day over the pain of recovery of a c section.

I know I'm way too early to be "imminent" (due at Christmas so only 22 weeks) but can I lurk quietly please?

I had a CS last time due to my first twin presenting breech. Had a GA due to low platelet counts. Was very disappointed at such a clinical birth and heartbroken to be unconcious for the birth.

Would love a VBAC this time around but waiting on my 32 week scan as at 20 week scan my placenta was "a bit low" and they decide at the 32 week scan whether it's moved enough to have a VB.

Don't suppose there's any way of getting it to move naturally is there?

Anyway, am starting to think about the birth and very interested to read all experiences. Good luck, I really hope you all get your VBACs

Hello All, please can I join you ladies, I am due on Nov 6th nd had an EMCS with DS after induction. I haven't seen my consultant yet (35 weeks I think) to discuss anything but I am hoping to try for a VBAC this time round.

Had my consultants (it was actually the Registrar) appointment yesterday and it was pretty positive. I got my list out and he said "I like lists". I explained I was uncomfortable with the CFM and he seemed fairly relaxed about it and said I needed to talk to the consultant midwife and the same with using the pool. I felt like a bit of a damp squib to be honest as I was expected some sort of confrontation, so I need to wait for an appointment with the consultant mw and take it from there. Also finally someone took seriously the lack of fluid I had with DS (ie none) and they will do and extra scan at 36 weeks to measure fluid and placental function.

does anyone know if a cannula is incompatible with using the pool? Have consultants appoint on Monday and am thinking about this I don't have a particular problem with a cannula (thought it could be one negotiation point i would give way in IYSWIM) but now wonder if it will rule out using the pool??? thanks

My DH was looking too! couldn't help himself. I actually quite enjoyed mine as at last something was happening and there was some people around, I know that must sound weird!

My waters had broken naturally and then no dilation for almost two days. No beds on labour ward available, so I left the stiflingly hot antenatal ward and went home. Walked around, had hot curry, had contractions on and off. Went back into hospital the next morning, still no beds, contractions very painful and back pain in between them. Was offered paracetemol which didn't really touch the sides as I was hanging off the wall, chair, whatever I could find, but they told me I was only in early labour, implying it couldn't hurt that much! Eventually a bed was available and I was so knackered I grabbed the chance of an epidural and some rest. On the drip, still no dilation after 8 hours and I was happy to have a section then after almost 48 hours since my waters had gone. Don't feel I could have done any more, I was basically left alone to get on with it and managed to cope with the pain with very stoic DH. So on the plus side I've got some experience of labour and pain, but just don't want lack of dilation to happen again, but suppose I just have to wait and see! But keeping mobile and concentrating on the breathing was a definite lifesaver.

I was getting a great view of DDs section in the shiny chrome around the theatre lights.....made me feel very sick indeed, but the screen was low and DH could see over it quite well; he was fascinated by it all as well.

re DSs section, DH's never to be forgotten (by me anyway wink

) comment was "Bloody hell, you wouldn't put a dog through that; you'd just shoot it" shock

. Admittedly we weren't married then and the pregnancy had been a shock for him and we had separated (he wanted to be there for the birth though), but still.......I like to remind him of it sometimes, keeps him on his toes wink

cripes daisy it sounds like you really went through a bad experiance. it must be hard for a partner who is just looking on watching you in pain and distress. As you say hopefully your doula will be able to give him reassurance thais time and there is no reason to belive that it will be the same again. My DH is slightly weird he loves medical stuff, when I had my cs he was standing up looking into the incision over the screen shock

The surgen said "you can sit down" to him in a surgeney way meaning get out of my way!!

lol hedgepig......my DH will need one of those as well grin

although my doula should help us keep that in mind.

DH is scared witless about it all, as he was there during my labour with DS (I was off being high on diamorphine and other delightful concoctions wink

) and remembers how scary it got, whereas I just remember it all going on for a bit, being in a bit of apin and being witty (in my head anyway) and the fight I had over the gas and air when the epidural didn't take (they wouldn't believe me) and then begging them to cut off the cervical rim rather than doing a section blush

. My big sis was there as well and she is still traumatised six years after the event! DH is worried about me going through all that again, and him having to witness my distress and whether he will cope if things start going wrong again. Mind you at least with our doula there he can take a break, and she will be able to help explain things rather than the blind leading the blind situation we were all in before.

I need to get him to read up on my birth plan and all my paperwork though.

mobile, upright , active.. lulu that sounds like a good mantra - I will get DH a tee-shirt printed with it so we remember.

rexmum, my first labour stalled at 2 -3 cm.. something to do with being induced when not ready, given diamorphione and an epidral, being immobile and frightened! i had c.section for failure to progress

with DD i had spontanoues labour at term, stayed mobile , upright and active as long as i could, had gas & air and a bit of pethidine, and went from 3 - 10 in 2 hours 45 and pushed her out with no intervention or tearing in 30 minutes .

and she was back to back and remained so , born face up!

my VBAC watchwords are:

mobile, upright , active.. and get a doula if you can...

Daisy hindsight is a wonderful thing - I wish I had never believed the mw who told me the baby was head down @32 weeks - the word "boney bottom" bring shivers to my spine wink

I laboured fine with DS inspite of being induced. Had third dose of prostin at teatime, waters broke naturally just after midnight and dilated well; the only problem was I wanted to push too soon, MW didn't examine me, just told me I couldn't possibly be ready as i had only been 4cms an hour previously and went back to her notes. I couldn't stop myself from pushing and developed a cervical rim, was told I could "push past it" hmm

and tried for over three hours to do so.

I bloody well wish that I'd known then what I do now and things could have been so much different.

Rexsmum, come and join us on the November Antenatal thread now that you have taken the plunge smile

I'm off for my hols right after the appointment so may not be able to post for a couple of weeks after. I did the same about the CFM at my early appointment but I think this is the appointment to "discuss" it. I am having difficulty getting DH to see why I think it is important not to have the CFM, he thinks all monitoring is good ,but I have a few days to knock him into shape. grin

I think that you should be able to negotiate to be monitored more closely (placental function etc) if you go over 41 weeks rather than straight to a CS if you want. I have never laboured before so this does concern me but I will have to wait and see.

Thank you for your encouragement Hedgepig and Lackadaisycal, it's the first time I've posted on mumsnet although I've read it for years!

I saw the links on the other page and will definitely have a read up before my appointment next week. Quite pleased that the midwife suggested I see the consultant at 28 weeks to coincide with my Anti-D injections as gives me some time to consider the options although I do feel pretty pro-VBAC, probably more to do with recovery and looking after a 3 year old than anything else.

Good luck with your appointment on Monday hedgepig.

thanks lulu smile

good luck for your appointment hedgepig and keep us posted as to how you get on. I'm not seeing them again until 36 weeks, but in the meantime have hired a doula, and have read as much about it as I can and filled my notes with my birth plan and copied the RCOG greentop guide 45 and NICE guidleines which are in the back of my notes.

The registrar I saw at 13 weeks was fine about a VBAC, but said I would need CFM (decided to argue that one later), and that they would only want me to go to 41 weeks and if no spontaneous labour by then they would recommend a section. Not sure how I feel about that or whether to fight my corner and hold out until I go into labour naturally. I know they can't force me to have a section, but there are some scary statistics out there regarding still births and previous sections. My CMW isn't exactly supportive of my choice either, so I hope it isn't her who delivers me as they now do one hospital shift a week to keep their hands in (so to speak wink

)

Rexsmum, there are some great links on page 2 of this thread. Are you on the November AN thread? I think you are on the stats list anyway, you should drop by and say hi. there are a few of us there planning a VBAC/VBA2C smile

just to add I just realized that cripes I am fairy imminent, when I stated looking at the thread it seemed ages away ekkkkkk

wocha daisy I'm still here. I have the consultants appointment on Monday next week (I will be 32 weeks) I have had lots of encouragement so far from my community midwife, the midwife counsellor and have been to a VBAC workshop this morning run by the physios so I am hopeful I can have a positive experience on Monday. I have a list of questions and my community MW thinks I may even be able to make my case for a water birth, we will see on Monday although trying not to get too fixated on things.
rexsmum there is no reason to think you will not dilate this time so if a VBAC is what you want it is worth a go at least. I have a VBAC book I got from NCT and an AIMS book both of which have some very positive information in them.

Hi, I was originally planning an elective c-section after my son was born by emergency c-section 3 years ago, but the nearer I get (I am 27 weeks) the more I am thinking that VBAC would be a better option for recovery afterwards.

Have got an appointment with my consultant next week, who is apparently very thorough, and I have ordered a book on VBAC to give myself some inspiration! Am also considering going to the Active Birth Centre in Archway for a labour workshop just to remind myself of breathing techniques and get myself pysched up for labour again. Was in early labour for a couple of days before the emergency section due to no dilation beyond 3cm so I am not afraid of the pain, but can't remember what to do or how to breathe!

bumping for you daisy ! 28 weeks already ! wow...

there must be some more VBACers out there..

come in, don;t be shy grin

heehee...takes medal for longest gestation ever grin

I meant nearly 28 weeks!

Just catching up with this thread again as i'm now nearly 268 weeks and the date is looming ever closer.

Robino, it's great that you got the birth you want; sounds like it went well and a nice quick labour is what I'm hoping for too. Am starting to have a few wobbles about it all though, and need some reassurance that things will be fine (the thread the other day about anal bleaching and planned vaginoplasty made me wobble bigtime.....not the bleaching; the possibility that things will be a bit mashed down there for ever more grin

)

is hedgepig still around?; it'll be interesting to hear how you got on with your consultant..you said you were seeing them again in August didn't you?

anyway, I know a few more bods who are hoping for a VBAC so fingers crossed they see this thread in active cinvos again and come on over.

I got my VBAC! With fewer arguments than I expected but it did go rather smoothly anyway. Another story of hope for VBACers, thanks for all your support recently - now the proud owner of a second baby girl!

V brief details: put DD to bed at 6.30, cooking at 7, thought "hmm", at 8 said to OH "might be having contractions but not sure", went to bed at ten, decided at 11 def having contractions and couldn't sleep, at midnight decided I'd better call my mum so she could babysit DD - had bath, cleaned bathroom and did some laundry (!?), mum arrived at 2,at 5 decided that I needed gas and air so off to hospital.

Midwife said "well, you're dealing with this fine - I bet you're not in established labour yet but I'll just examine you (eek!) to check - ooh gosh, you're actually
4cm dilated, we'll give you some codeine (haha) and we'll give it an hour, see how you are, might send you home yet, could be hours". She stepped out the room, my waters broke, I was instantly in agony and an hour later I was fully dilated and ready to push, Hour and a half of pushing/resting/ nearly falling asleep, out "popped" DD. Only G and A, 2nd degree tear but well enough to go home 4hrs after gave birth - very pleased!

Thanks for all your advice/ help over last few weeks and I hope those of you who are planning a VBAC enjoy hmm

yours as much as I enjoyed mine!

Hi Hedgepig

Have you thought about doing hypnobirthing? I did for my first labour and found it enormously helpful. I was in first stage labour for only 7 hours and was at home - when the midwife arrived she was amazed to find that I was not even sure I was properly in labour but was in fact 9cm dilated. So I would highly reccommend it. Really glad I have now spotted the potential issue re: CFM as this is something that I really don't think will help, and as far as I can tell is simply unnecessary in most cases. I really don't think it should all be as complicated as this! Good luck.

Ericam I'm plannig a VBAC for this pregnancy I have had one appointment so far with the consultant. She was very supportive of a vaginal deliver but wittered on about monitoring etc. The hospital is a large teaching hospital which has a target to reduces its cs rate. As it was only at 16 weeks I just smiled and didn't make an issue of the details. I have another appointment in August (32 weeks) where I think we will have a more in depth discussion wink

. For me it is the CFM that I really don't want. I didn't labour at all last time (breech) and so I am worried if I am restricted in my ability for an active birth I will be timed out so to speak, as this will be the 1st time my body has gone through the birth process.

Thanks BetsyBoop that is really helpful. I will make sure that I read some stuff before I go so that I am well-prepared.

I should have said links are on the second page of this thread, which is of course page 21 (at the moment) as we are going backwards...

Ericam

most seem to be fairly supportive of VBAC (but want it on their terms grin

)

Mine just said "do you want to try for a natural delivery or would you prefer another c/s?" I said "natural delivery" & he wrote "trial of scar" (lovely term - not angry

) on my notes & that was it!

However getting a VBAC on YOUR terms is another story. I would suggest you have a look at some of the links on page 2 of this thread before your appt.

for example

no you don't HAVE to have CFM (but may choose to)

yes you CAN be mobile (even with CFM to some extent)

no you don't HAVE to have a cannula in your hand/arm "just in case"

and if you fight your corner you can even get them to agree m/w led unit, water birth or even a home birth if that's what you want!

The consensus of experience seems to be if you are prepared to be doggedly determined & can demonstrate you understand the risks (or not) of what YOU want to do for YOUR ideal birth versus what's an "ideal" birth from their perspective then generally you can get what you want...eventually!

Good Luck

Have just started reading this thread and am (naively) astonished! Had c-section five years ago due to face-brow presentation after a very easy first-stage labour. Was planning home-birth and had to transfer to hosp after hour of second-stage labour cos ds refused to budge. Am expecting number 2 in November and was just assuming would try for VBAC. In fact was rather surprised to be referred to consultant since in all other respects pregnancy is straightforward. Have ante-natal appointment at hosp at end July - should I expect a fight to try for VBAC? As far as I can tell there really is no reason why I shouldn't try for VBAC - although like last time would of course take advice once in labour about best thing to do. Are consultants generally very dubious? Any thoughts gratefully received!

I understand that you want to get everyting agreed before you go into labour so good luck with the mw on monday. You are making informed choices and they should respect that.
I assume you are planning to stay at home for a long as poss before going to the hospital? I think it was port and lemon a few pages back who stayed away as long as she could and by the time she got there she was so close to giving birth that she didn't get much hassle at all.
I had a cs last time because my ds was an unrecognised breech. Althought I hadn't started labour, I just went in for a check at 40 weeks, because of reduced movenments, and they found he was a footling breech and I had no amniotic fluid so he was whipped out post haste. I keep freaking that I won't go into labour cos I have never done it before and I know I won't be induced so I will end up with another cs by default. anyway I've got 15 weeks to go. Goodluck again

Thanks for comments - it's not the room as such, it's that I'll automatically come under consultant care in that room. The consultant I met was so begrudging in her agreement to keep her hands off me that I am a bit worried that when the time comes and I'm in labour I'll have to keep battling for what I want when all I actually want to do is concentrate on giving birth. Does that make sense?

I haven't met the midwife in charge yet, that's on Monday and we're going through a birth plan but I'm getting the feeling that she's a bit of a stooge for the consultant.

With DD1 was booked into a stand alone MLU and was unable to go because of staff shortages but I felt completely confident in their ability to care for me, baby and any issues that would have arisen whilst attempting to give me a natural birth (and believe me, I know things can go wrong - my entire family are a disaster when it comes to natural labour!). This time, because the stand alone unit is a 25 min blue light ride from nearest maternity unit if problems do arise I'm not even pushing for it. I'm going to a different hospital all together but it means that, at the moment, I am less convinced in the midwives' ability, and desire, to help me achieve what I would like.

My birth partner does know and understand my wishes and will fight for them but I'd rather it be understood from the get go so that we can, hopefully, concentrate on a natural labour, a less stressful recovery and an easier start to a family of for with our 17 month old and a newborn. Guess I'll have to wait til Monday and go with gut instinct on midwife!

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"Support for imminent VBACers" thread?