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Attempt vba2c or planned section

(12 Posts)
4men1lady Thu 24-May-18 18:52:20

Evening all..

This is a more wwyd..

I am due dc4 in 4 weeks, first dc was 36 hour labour and delivered normally.
Dc2 was emcs after not progressing past 5cm, dc3 was emcs after attempted and failed vbac as didn’t progress past 9cm.

So I meet with my consultant next week after a growth scan to discuss what I want to do this time around. Doctors have already said that they would only trial me for a vba2c for a really short period, mentioned labouring up to 4 hours only, and if no baby then straight for emcs due to the risk and pressure on previous scars.

NICE guidelines state there is no greater risk of uterine rupture with less that 4 previous sections so no reason to not try for vbac, but what puts me off is only being allowed to labour for 4 hours? That’s nothing with my history.

Any experiences and advice very welcome.

HerRoyalNotness Thu 24-May-18 19:04:44

I had a planned after only one EMCS. I liked knowing what was going to happen and when, and did not want another EMCS. Recovery from my planned one was so much easier I have to say. I felt butchered after the EMCs.

4men1lady Thu 24-May-18 19:13:49

Yes, the recovery is so hard. After my first emcs I was fine after a week, but the second I found really hard and far more painful.

Doctors have said they have an enhanced recovery with planned sections, not really sure what that means but they said they will encourage a quick discharge all being well otherwise.

I just keep thinking, but what if I can do it this time and get home with a 6hour discharge and can drive almost straight away instead of waiting 6 weeks.

Waitingonasmiley42 Thu 24-May-18 19:25:17

Elcs! You will be relatively well rested and calm. I found recovery very easy for elcs in comparison to emcs.

Littlebelina Thu 24-May-18 19:30:44

I'm going for planned section (one previous emcs, one elcs). Planned section and recovery were fine so have no qualms about going for it even though it means I'll never have a natural birth. In my case my previous section was very recent so suspect I would have met resistance for a vbac anyway.

HicDraconis Thu 24-May-18 19:35:39

Risk of uterine rupture with vbac after 1 Caesar is around 0.5%. After 2 Caesars it increases to around 1.3%. The risk of needing a hysterectomy with vba2c is 0.5%, and of needing a blood transfusion is 2%. Success rates generally 71% vs 76% with vba1c.


Personally a rate of just over 1:100 ruptures is too much risk for me.

If you could be guaranteed to be in the success group then fine, but if you’re one of the 30% where labour doesn’t go so easily then you are risking more complications with having a third Caesar in labour than electively. It also depends on where your placenta is (front / back / high / low) as to your risk of blood loss.

I would be cautious, as your team sound like they are. I’d also be going for elective CS at 39 weeks (38 weeks if you have a history of going into labour earlier).

Awwlookatmybabyspider Thu 24-May-18 19:39:19

I don't want to scare you but isn't there a risk of the scar cutting as you're pushing.

Awwlookatmybabyspider Thu 24-May-18 19:39:39

ripping sorry not cutting

4men1lady Thu 24-May-18 20:02:35

Wow thank you Hic..that’s exactly what I needed, I didn’t realise the risk was actually so high. I suffer from anxiety so the worry alone is enough to sway a decision with those stats.

Aww..yes that’s the risk and also risk of rupture while contracting. That’s why they’ve said only labouring for 4 hours.

Thank you everyone for replying. Dh is great and wants me to do whatever I feel but doesn’t really understand the risks.

MorningsEleven Thu 24-May-18 20:03:28

DC1 I had a planned section, which went very wrong. Second time I attempted a VBAC, which went even worse and ended in a crash section and a child who was born flat. Fortunately he was resuscitated but, after a lot of help that included being sent to a bigger hospital, he pulled through. In retrospect I should have gone for a section in the first place. So I guess I'd go for the section. I was told I wouldn't be allowed to attempt a VBAC for a 3rd child and DH skipped off to the urologist to get himself snipped.

He wasn't skipping on the way back and I treasure that memory 🤣

4men1lady Thu 24-May-18 20:04:12

Also they ruptured my membranes at 38 weeks with dc3 to induce labour so would waiting until 39 weeks be ok.

4men1lady Thu 24-May-18 20:05:24

Yes no more children for us so I think it’s dh turn to take some responsibility to make sure it doesn’t happen grin

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