HBAC or ELCS - opinions please?

[moaningminnie2020]

Had a very traumatic crash CS last spring, all in big rush, general anaesthetic, the lot.

Was truly horrible. Now I'm 7w pregnant with DC#2 and starting to think about my options for the birth, I know I don't need to make a final decision for aaagggeeess but am truly up in the air.

I know I could get a repeat CS if I want one. But I have realised I always refer to it as "when I had DD", not "when I gave birth" and I still hate that she was plucked out of me while I was unconscious.

I definately don't want a hospital VBAC, labouring against the clock, fighting their protocols to get anything resembling a normal birth...and my lovely DH has surprised my by saying that if I really want a HBAC, I can hire an Independant Midwife

He would love prefer me to book an elective section but knows I am quite keen to try again for a normal delivery.

So can anyone give me any suggestions? If nothing else, if I go the HBAC route I would like to start having my antenatal care with the IM sooner rather than later.

[Elasticwoman]

I know VBAC is vaginal birth after caesarean, but what's HBAC? Hairy BAC, Honorary BAC? Hippy BAC? Heavenly BAC?

Must tell you, OP, that my friend had VBAC and even though she had to be induced at 42 weeks, she still had a safe vaginal unassisted delivery in hospital. But her previous CS had been elective due to breech, so not traumatic.

[aquababe]

wow is hbac a home birth after caesarean.

I'd love one of those but am not that brave (nor am I pregnant yet)

[Elasticwoman]

Oh, sounds like it. Good idea in that case. More chance of successful delivery, and if things go pear shaped you can still dash into hospital.

[PortAndLemon]

What was the c/s for?

A hospital VBAC doesn't have to be as you describe -- I had one a month ago and laboured at home with TENS until I felt I really had to go in, was only examined once (which showed I was already 9cm), didn't have any monitoring until I had settled into position for pushing, managed on TENS alone until I got to hospital then had gas and air but nothing else. And I didn't have to fight for any of that (probably it was against hospital protocols, but the midwives sensibly just let me get on with doing things the way I wanted when I actually got there). I know bobsmum has just had a very similar VBAC, with midwives who took the same attitude.

So, just to say that there may be a third option -- hospital VBACs don't have to be "labouring against the clock, fighting their protocols to get anything resembling a normal birth".

[maxbear]

Hospital vbac's can be against the clock, but if you feel that ultimately you would be happier doing it in hospital but without all of the interference you could discuss it with a consultant midwife or supervisor of midwives in the pregnancy and arrange that you would do things normally. They could help you to write a very strong confident birth plan.

[ILikeToMoveItMoveIt]

I have opted for a HBAC (with an Independant MW) after a emerg. cs with DS1.

I wanted a hb the first time (with opposition from the Obs), but ended up with a cs. I was very unhappy with how I was treated by my local, so I swore I would never set foot in there again if at all possible.

This is the reason why I have opted for a HBAC with an IMW, as I know I won't get the birth I desire at my hospital. Much like you, I don't want to experience labouring by the clock, or the constant battles with the Obs. I can stand up for myself, but I really don't want to bother wasting my energy on them!

I adore my IMW

[moaningminnie2020]

Hmmm I kind of felt like I had a confident strong birth plan last time, for all the good it did me

The CS was for undiagnosed brow presentation, didn't know til she was out. Had also had very long latent labour with waters breaking nearly 60 hours before the eventual delivery. GA because epidural failed and wasn't time for a spinal block.

The immediate cause was fetal bradycardia that they said was 'fetal compromise' but Apgars were 7 and 10 so she was born in good condition.

I have been through my notes with someone, which helped.

What I would prefer is a HB with supportive NHS midwives but they weren't enthusiastic even when I ticked all the low risk boxes, I know I can insist but I would rather have someone who's actually keen to support me, iykwim

[whomovedmychocolate]

I'm planning a HBAC following a traumatic cs in 2006. I'm using NHS midwives. Once they have booked you they get much more enthusiastic!

One thing you could do is call a few independent midwives and just talk to them. You may find it helps make up your mind and they won't mind.

I found Nicky Wesson's homebirth book helped me make up my mind and I also found a VBAC handbook on Amazon which was really good in helping me understand all the issues.

Whatever you choose to do - it is bound to be better this time. Good luck

[ILikeToMoveItMoveIt]

I know exactly what you mean.

My IMW has faith in me. Everytime she see's me she tells me how she can visualise the birth, in my pool at home. I can't tell you how much confidence that gives me, as I truly believe I can birth my baby vaginally.

But also I know that if I do need to transfer to hospital, my IMW is advising it with no agenda or targets to meet. Cynical, me?!

[moaningminnie2020]

DD was a planned homebirth too - I never wanted a hospital birth then, and after my experience I certainly don't want to try that again.

So for me I would honestly rather have an elective than try a VBAC in hospital.

Part of the problem last time was sheer bad luck, ie the brow presentation, but it was compounded by shoddy care and general unhelpfulness.

[moaningminnie2020]

WMMC - I have that homebirth book, it's fab and it was my bible last time I was pregnant! It was an IM who went through my labour notes with me - she said she would take me on as an HBAC anyday but at the time I thought DH would never agree!

Moveit - The faith in you bit is so important, I feel if a transfer was advised by the IM it would be because of geniune neccessity rather than a lack of confidence/enthusiasm on the midwife's part.

[maxbear]

At least your reason for a cs is extremely unlikely to recur, as far as having a vbac is concerned that is a real positive. You have time on your side. I would suggest testing the water with your nhs midwives early on, seeing if you can see a supervisor of consultant mw. At the same time have an appointment with an independant mw to discuss things and I have to say I reckon you will end up with the im if you do all of these things.

[moaningminnie2020]

Maxbear - sounds like an good plan, I am booking in tomorrow so I will find out how the land lies. My main concern is that I had very unenthusiastic care from the MW's last time.

Eg when I phoned them to let them know my waters had broken I had to virtually beg them for someone to call round and check on me, it was like a broken record 'Ok well just come in and we'll have a look at you' 'well actually I'm booked for a HB, not really wanting to come to the hospital' Oh...
Someone evetually came out approx 19 hrs after ROM and they confirmed baby was happy at that time and then tried to persuade me to be admitted for IVABS just in case.

I just felt they weren't actually interested in helping me to have a HB at all.

[moaningminnie2020]

And I wasn't even trying to have a VBAC then!

Still, I'm quite happy to talk to the Supervisor of Midwives to ask them to provide suitable care, I just don't fancy having a battle over it, and can't help thinking it will be