Can I have a natural birth after two Caesarians?

[Elf]

DD was born 3 and a quarter years ago by emergency Caesarian. DS was born 12 months ago by elective Caesarian for various reasons but mostly because I lost my nerve and thought that would be easier.

However, the next one is due in September and as life is much calmer now and we are more settled and I am in a different place in my head, I would like to try a homebirth.

Has anyone else been in this situation? With DD, my cervix dilated to nearly 10cm , does this mean things might be slightly easier this time? Or might it be as if it were a first birth ie pretty tough. I know all births are different but just wondered if anyone had any similar experiences.

[biglips]

sorry cant be much of help, but i dont think you can have a home birth after you've had the c-section(s), but i may be wrong.... im hoping to have a natural birth on my 2nd one as i had c-section on my first one.

[Eva3]

Hi, I had a DD1 by c-section, then DD2 was natural but had to be tied up to the monitor. The risk of scar rupture is quite serious, albeit rare, so no OB or midwife would let you go unmonitored. Hope that helps

[Amanda3266]

Hi Elf,

You can indeed have a homebirth if you want one. However, be prepared for alot of opposition from your GP, midwife and obstetrician. Alot depends on the reasons for the previous ones and how long ago they were. It might help to go through your notes for your DD birth to see why you needed an emergency caesarean when your cervix was nearly 10 cms dilated. If it was something particular to that birth then the chances are it won't happen another time.
A website which might be of interest to you is Angela Horn's homebirth site at www.homebirth.org.uk.
She will have up to date information on having a homebirth after more than one caesarean and probably links to other sites with specific information.
If you really want this then read up and go armed with information to back up your request. They cannot make you have a hospital birth the decision is ultimately yours and previously when I was a midwife I helped two women to birth at home after more than one previous caesarean, both had informed themselves but still faced opposition (AIMS were very good in supporting one of them). Both births were straightforward with no problems.

Have a read up, discuss it with your midwife with relation to DD's birth and then make your decision - and remember it's your decision not theirs.

Mandy

[Elf]

Thanks both of you. Eva3 can you be monitored at home?

[Amanda3266]

Should add that Angela's site will have up to date info on the risks of scar rupture.

Mandy

[Amanda3266]

Yes you will be monitored at home - just not continuously. There are specific signs of scar rupture which no midwife will ignore - a scar rupture is very different to a general uterine rupture which can be a rapid event. Check out Angela's site for more info.

[Uwila]

Efl, what about a natural birthing unit that is connected to a hospital just in case you need the medical attention. That way you could have the natural birth without so much risk. They can transfer you very quickly there. But, if you are at home, how far would you be from the hospital?

[suedonim]

A friend of mine had a home water birth after three CS's, so yes, it can be done.

[pupuce]

Sorry to come to this late.
Continuous monitoring is NOT necessarily the best idea.
Search websites like AIMS.org.uk or radical midwives website and you'll see - plenty of evidence !
I often support VBAC (as a doula) - only one out of 6 has been continuously monitored - their choice. The risk of scar rupture is 0.3% and often NOT seriousn (in this country) - there are signs (pulse, pain, woman's responsiveness,...) of scar rupture BEFORE a monitor would pick it up.
BTW- you can have a ruptured uterus without ever having a section !!!

Many women want a VBAC (even after 2 sections), it is very much do-able, just get the right team to support you!

[pupuce]

Uwilia- birth centre would not take a previous section (usually).

[oatcake]

You can try for a natural birth, that's your right, however, the risk of a uterine rupture is higher after 2 csections.

Check out www.nice.org.uk for their guidelines on vbacs. all their stuff is evidence-based.

[Uwila]

If a birth centre won't take a previous caesarian, how can it be safe at home?

[Gwenick]

You right you DON'T have to be monitored all teh time with a VBAC -I was but that was because I'd been induced, if I'd have gone into labour naturally the consultant had already agreed that I wouldn't need constant monitoring

[PuffTheMagicDragon]

The birthing centre in my local hospital took me on for a vbac (consultant midwife supported my decision despite consultant being opposed).

[pupuce]

It isn't because it's unsafe it's do with protocols, policies and categorisation.
You can have a breech at home too !
Usually if you want a birth centre for a VBAC you need to do some talking with the bosses. SofiaAmes did that and had heras at QC birthing centre.

[Uwila]

Well, I am quite the pro caesarean advocate (as pupuce will confirm) but I think that if you really want a home birth, then you demand one. I think you are crazy less than two years after a second caesarean. But, if that is what you want and you can find medicalprofessionals to support you, than what the heck, it's your birth. Good luck!

[motherinferior]

I have to warn you that you'll find it very difficult to get a community midwife to support a home birth - the RCM and the Royal College of Obs&Gynae both recommend against, on account of the (very slight) risk of rupture.

I'm not saying that I agree, I'm just relaying what I've been told when I wrote about this recently.

[Jimjams]

I had a trial of labour (in hospital) following 2 sections. i was told that I would need continual monitering, but in the end the midwives didn't do that- they let me walk around etc. I still ended up with a section but I think my labour was probably the same as anyone elses.

[Eva3]

Continuous monitoring was not that bad. I could lean over the bed, stand, move around a bit etc, and I managed to avoid a section. What I HATEd was lying back to be examined. I needed to be forward all the time. I will refuse to lie back this time!

[pupuce]

Eva -
The monitoring is allright IF you don't get stuck to the machine for 12 hours or IF the machine doesn't keep loosing the baby's trace which makes it all very much more stresful to all involved !
A good MW should be able to do a VE (vaginal examination) standing up or on all fours (the mum that is!!!)
Having said that..... do you need a VE for a susbequent birth ???? Now that's an interesting question!

[nightowl]

im interested in this as the doctor told me when i asked (begged?) for my second cs that i could not have any more children vb. at the time i wailed "i dont care, im never having any more". but of course, once the pain is gone you think differently. im not planning more kids at the moment but im not going to rubbish the idea completely. if i had a third i would love to not have the cs again. dont think i would get any support at our local hospital though.

[Uwila]

I too was told (by Queen Charlotte)that if I have a second caesarean, then they would never again allow a vaginal birth. I guess it depends on the hospital policy more than anything.

[pupuce]

Yeah as Jimjams was allowed a VBA2C in her local hospital....

[Elf]

Sorry everyone, only just managed to get back onto the computer (DS starting his fun 4.30am starts again - tends to cock up one's life) , anyway, thank you so much for all your informative replies.

Of course I love the go for it ones - Amanda thanks for the website I shall certainly start my research there.

It is interesting to hear the different opinions about likelihood of scar rupture. And SueDonim It is great to hear about the vaginal birth after 3(!) Caesarians. Pupuce thank you too, great to hear from a Doula.

Well, I shall now start arming myself with info - thanks everyone.