VBAC Experiences?

[Camdenstyles]

I'm pregnant with number 2 and ended up having an emergency c-section with number 1 after failure to progress. The midwives are encouraging VBAC but I do need to see a consultant as my daughter was born a year ago so may need a section anyway. I am leaning towards another section as at least I will have a set date (easier to arrange childcare), I know what to expect and I've heard if something goes wrong in a VBAC it seriously goes wrong. I don't know anyone who has had a VBAC so would like to hear experiences good & bad to help me make a decision.

Cheers

[mummytime]

I had two VBACs, and really wanted one as six weeks no driving would have been the most awkward. They were fine, one was long and one very very quick. No complications.

I have heard a horror story (happened to a friend) of what can happen after repeat CS. If you need a CS then that is the route you need, but it is a major operation. Any birth after a CS has a heightened risk.

I would have a good honest thorough discussion with your consultant.

[ShowOfHands]

You can only make the decision that is right for you. No reason why you wouldn't be driving for 6 weeks post cs either. Most insurance companies are happy to let you drive much sooner.

I attempted a vbac. Labour went the same way as first time round. 3 days of labouring and no baby and I had a repeat emcs.

It was a very positive experience though and I wasn't as traumatised as first time round because I was prepared for every eventuality. I'm glad I tried for a vbac and my consultant was brill. We had clear boundaries of how long I'd labour for, what I would and wouldn't accept, how long I'd push for, how decisions would be made etc. I was happy with the amount of input and control I was given and not disappointed that it didn't work out.

I've had two easy cs recoveries too. You need a frank chat with your cons, your family, those around you and to make the right decision for you.

Congratulations.

[AnotherStitchInTime]

I had an attempt at VBAC last year. Ended up with another EMCS due to malposition (dd2 didn't rotate her head fully into position). I pushed, failed instrumental, but dd2 was absolutely fine. I arrived at the hospital fully dilated and had no CFM only doppler until we realised she was stuck.

Good info on the risks of rupture here. The chance of successful VBAC is around 75% post 1 c-section. The risk of rupture is around 0.7% , but only around 6% of those will result in infant death that is 1 in 16 ruptures or 0.042 % of all Trials of Labour (6% of 0.7% - 0.007 multiplied by 0.06 = 0.00042 then multiply by 100 to get the percentage).

Infant death rate for CS is around 0.18%, but there can be other birth injuries or complications too with either VBAC or CS, infant death is obviously the worst that can happen.

The NICE report is worth reading

This study comparing summaries.cochrane.org/CD006066/comparing-continuous-electronic-fetal-monitoring-in-labour-cardiotocography-ctg-with-intermittent-listening-intermittent-auscultation-ia continuous fetal monitoring and intermittent auscultation (doppler) is also worth a read.

I will be having a go at VBA2C in the new year with dc3.

[AnotherStitchInTime]

Forgot to say as well that the yahoo VBAC group is a great support, there are ladies on there that have had VBA5C!

[Camdenstyles]

Thanks for the info Stitch, that is brilliant. Another reason I'm put off is going through labour again to only end up with EMCS. Last labour was very long and I was just exhausted for weeks afterwards. I'm also worried that failure to progress will be an issue again too.

I will have a good chat with the consultant about all the pros & cons and success rates in my hospital. Don't need to worry about driving as in London and everything is close by, thank goodness. Good to hear you ladies have been through multiple VBAC's successfully.

[AnotherStitchInTime]

Which hospital Camden?

Just because you had a long labour that failed to progress the first time it doesn't mean that next time will be like that. My first labour was 24 hours, my second 7. Your body may well know what to do this time and dilate fully.

Recovery time after a VBAC is less than for ERCS. Managing an older child's needs after a CS is not easy, that is why I am trying for VBA2C. My youngest will be just under 2 when dc3 arrives. My recovery from my 2nd EMCS was easier because they don't hang about if you get into trouble and move to theatre faster.

Ultimately you have to do what is right for you, look at all the information and make your decision. Good luck.

[BikeRunSki]

I attempted VBAC, but had a crash emcs under GA due to uterine rupture. This caused my BP and DD's heartbeat to plummet.

[JamieandtheMagicTorch]

I had a VBAC with Ds2, afteer an EMCS with DS1

The two labours were pretty similar, although Ds1 was induced. Ds2 labour started after a sweep.

13 hours labour, long transition, epidural, over and hour and a half of pushing, then ventouse with DS2. Continuos monitoring. I was mentally prepared for another EMCS and it nearly happened.

Emotionally/ psychologically i was "satisfied" to have experienced a vaginal birth, but looking back, the feeling of more control and knowledge was the thing that made it better. Put it this way, if i ever had another baby, i would have no hesitation i going for an ELCS.

I had a toddler and that was one reason to try for a VBAC. As it turned out, I'd say recovery was not all that much better after the VBAC. I had a transfusion, a second degree tear, and horrendous piles so felt a bit crap, physically. Was happier though. But as i say, can't tell if thisnwas simply a result of feeling more in control.

[JamieandtheMagicTorch]

What helped me decide was a debrief about my first birth with a senior midwife. The consultant was also v positive about vbac.

[AnotherStitchInTime]

This is also worth reading Camden to put things in perspective.

Just to help you compare to the 0.042 % risk of infant mortality in TOLAC's I mentioned above, I have worked out the risks of other birth emergencies for you in the same format.

Placental Abruption 0.0026%
Umbilical Cord Prolapse 0.5642%
Shoulder Dystocia 0.0014%

As you can see even with no prior CS history the risk of umbilical cord prolapse in labour is similar to the risk of uterine rupture in TOLAC.

Uterine rupture can happen even in women with no previous CS.

When it does happen, so long as you receive care rapidly the risk to the infant is minimised.