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Home VBAC on the NHS

(7 Posts)
MrsThePoint Thu 02-Sep-10 11:39:26

DH and I have two beautiful DC and we are considering a third. Beyond the financial implications, which we will consider (although you can never really afford children) the birth is an issue.

I had such a traumatic time with the completely unnecessary iatrogenic emcs of DS. I had an IOL due to suspected IUGR, followed by a placental abruption caused by my sensitivity to prostin, followed by an emcs. Don’t get me wrong, by the time I had the cs, it was necessary, but if it hadn’t been for the damned interference in the natural process in the first place, there would not have been the cascade of intervention. DS was actually born 5lb and half an oz, a very respectable weight. My treatment in hospital was, I guess, standard. I wasn’t asked before my membranes we artificially ruptured, they just did it. No-one introduced themselves or explained their role, people walked in willy-nilly, there was a shift-chance and people talked over DH and my head, and when talk of cs came up, no explanation of why was given. I was actually told it was for baby’s distress. Afterwards, in a room on my own, I was left for hours. No-one came when I pressed the bell, I waited for over an hour for help with changing DS, cleaning his sick etc. In the end I was getting up, 12 hours post-op, to lift DS myself to clean him, change his nappy, attempt breast-feeding (which did not go well at hospital, probably due to the drugs and my stress, and I was pressured into giving him formula as he was ‘so small’ and ‘needed’ to feed). I discharged myself early as I had my DH and mum staying, so one-on-one care for DS and myself at home.

After I came home, and had got over the physical side of the op, I then researched IUGR and came to the conclusion that I never should have agreed to the IOL. My dopplers had been fine, blood flow good and movements strong. Hindsight is, of course, a wonderful thing, which is why we hired an IM for what turned out to be a delightful and serene home water birth, obviously VBAC, with DD.

When pg with DD, our lovely IM came with us to our hospital appointments, and sat with us as we weathered the consultants dramatic predictions of maternal demise and infant mortality, scar dehesion or separation and uterine rupture (all of which I know are real and serious risks, but we compared it to the real and serious risk of crossing a road, the consequences of which can also be catastrophic) and she calmly pointed out we’d have one to one care, and she would not take any undue chances and would bring us in as soon as she noticed any problems. As it was, I bled a lot, and our IM was able to make an experienced, educated professional judgement that this was the way I laboured, as it was fast and furious, and kept a close eye on me. There were no untoward issues that arose from this. However, our IM said to us later, with our after-care, that had she been an NHS midwife, she would have insisted we go in as it is policy that anything unusual, like my bleeding, needs to go into hospital. I know, of course, that we could have refused to go in, but the stress obviously would have kicked in, fighting against the system at such a vulnerable time, and I just wonder if we’d tried to homebirth with the NHS alone would it have ended with another cs?

Does anyone know if the NHS still considers me high risk, and does the fact that I have successfully had my trial of scar/labour and no longer have an ‘untried pelvis’ make me any less high risk?

Would the NHS support another homebirth and would they consider the fact that I bled a lot in my last labour or just transfer me in regardless as it’s ‘not by the book’?

We just don’t know if we can afford an IM again, but I detest the thought of going into hospital.

What would you do/will you do/have you done?

A really rambling post that invites all comments, my mind is such a muddle on this! Please excuse spelling mistakes and parts that don’t make sense.

mamasunshine Thu 02-Sep-10 14:08:59

I had a home VBAC last summer - NHS. DS1 had been EMCS at 34wks due to IUGR, sub-optimal CTG, pre-eclampsia. I had to fight for the HBAC through NHS, but as I was fully informed my consultant signed my notes grin It was brilliant, I had excellent 3-1 care throughout!! They were with me from 3/4cm's and I had 2 mw's and 1 student with me throughout a very long labour. At the end I actually had 3mw's and 1 student! The mw's were v supportive and respectful of my wishes.

I'm due dc 3 in Jan and have yet to see consultant. I think as I've now delivered vaginally there's no-way they could refuse my homebirth wishes this time!

MrsThePoint Thu 02-Sep-10 21:59:19

Am I concerned about nothing then?

jaspersmum29 Mon 20-Dec-10 14:36:37

Hi MrsTP,

thanks for sharing your story - I had a similar experience with my first son (probably unnecessary induction, emergency section, horrible time with hospital staff). I really want a HBAC for the second one! IMs are expensive and there aren't many in my area; but the local hospital told me after the first that they'd insist on all the chains next time, no chance of water/ home birth. But of course if you're ready to sign against medical advice 20 times during contractions then they can't force you...

My next step is going to be to search for a doula with experience of VBAC, that might give me and my partner the confidence we need to do it at home without an IM. Still not sure what we'll do...

Good luck!

Bumptobirthbeyond Mon 20-Dec-10 20:50:29

Hiya

I'm an antenatal teacher and VBAC coach. In the NHS, you are 'allowed' to have an HBAC but finding a truly supportive midwife can sometimes be a challenge.

If you haven't already found it, there's a great yahoo group, called ukvbachbac.
This is a great resource for mums, doulas, antenatal teachers and also midwives and I'm sure you'll find some useful info on there.

Best of luck and PM me if you'd like any specific info.

Mads
Bump to Birth and Beyond

squiggleywiggler Tue 21-Dec-10 00:19:57

Mrsthepoint you aren't concerned about nothing, but rest assured noone can 'allow' or 'not allow' you anything on the NHS. You have the right to have you baby at home whatever the circumstances.

Saying that it is wise to think about the potential points of conflict in advance like you are doing.

The AIMS book 'Am I Allowed' is worth getting hold of (only £8 from www.aims.org.uk).

Have you thought about hiring a doula (www.doula.org.uk or let me know where you are and I can send you some names)? As a doula myself I know that we can provide good support for VBAC couples - both in terms of support at the birth itself and in advance with pursuign the birth you want. At my most recent birth (a first timer having a homebirth) there was quite a bit of negotiation to be done with the MWs but we managed and she had a lovely homebirth despite pressure to give in to various protocols.

Mumcah Tue 21-Dec-10 08:07:43

Hi.although you have had a vbac you would still be classed as 'high 'risk' as technically your scar could still rupture and all the other things they are worried about.

My friend had a home Vbac and the midwives were very supportive.She pushed for ages (about 3 hours) but the midwives were confident she could get the baby out so didn't transfer her.Her first baby was c section due to being breech.

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