VBAC or ELCS?

[clicks]

Hi, I am 36 wks pregnant with my second baby and having difficulty making a decision over whether to have a vaginal birth or an elective caesarian...anyone had both and can offer some advice?
I do not have a positive first childbirth experience and therefore am worrying about the second. My first pregnancy ended with pre-eclampsia, 4 days of max.inducement, waters being broken, syntoxin drip, epidural (as contractions incredibly painful), and after 18hours labour and only 5cm dilation an emergency c-section with foetal distress and meconium. I was then kept in hospital for 10days afterwards with blood pressure complications...so in total 2 weeks in hospital (which I certainly do not wish to repeat with my gorgeous toddler at home). I also found the recovery from the c-sect very painful and was as described in my medical notes as 'in shock'.
Fortunately this time round there are no signs of pre-eclampsia, just that baby is a bit on the large side, baby predicted to be 9lbs+. My consultant has offered me the choice of a VBAC or ELCS. He says there is no reason why I should not have a successful vaginal birth however I have reservations as only dilated 5cm last time after 18hr labour and do not wish to have a repeat experience. He says I need to be totally up for a VBAC however that is easier said than done. To be up and mobile afterwards would be great however I do not wish to risk the baby's health in any way by attempting a vaginal birth that maybe my body is just not set up to do. I would be very grateful for any feedback from others that have experienced both?

[cupofcoffee]

Sorry to hear that your first birth did not go well. Were you full term when you were induced or did they induce you early due to the pre-eclampsia?

[clicks]

Hi, I was 39wks 2days when they induced me however after 4days inducement baby was born just 1day before due date!

[NellyTheElephant]

I haven't experienced both ELCS and VBAC, but I have experienced a horrendous emergency section (30 hrs of labour, then sudden rush into theatre when everything went wrong), compared to two elective sections and can only say that the electives were NOTHING like the emergency. They were calm happy experiences, I healed well after both (much quicker than after the emergency - no doubt because my body wasn't destroyed by long and exhausting labour pre op). I had exactly 2 yrs between each birth and had no particular problems with dealing with baby and toddler and 4 yr old. I was home after 2 nights in hospital. So if you do end up choosing an elective section, try not to let your problematic emergency section scare you too much as it is unlikely to be the same experience as an elective.

[clicks]

Hi, thank you for that advice..maybe planned is the way to go if your body copes much better with the healing process and that you are mobile quicker than after an emergency c-sect. I think the fear of my previous experience is putting me off and maybe it shouldn't if they are such different experiences. It is also reassuring to know you were able to cope with your 2 yr old and 4 yr old.

[ILikeToMoveItMoveIt]

I had an emerg csection with ds1 (failure to progress, etc etc) then I had a VBAC (home waterbirth, 9lbs 11oz) with ds2.

I actually recovered very well and quickly after my csection, however the recovery time after my vaginal birth was hours rather than days.

If I were you, one thing I would keep in mind with your previous situation is your body didn't fail when it was in labour, it was the induction drugs that failed.

Another deciding factor for me would be how many children you were planning to have. The more sections you have the higher the risk of surgical complications, higher risk of emerg hysterectomy, scar tissue adhesions etc etc.

Look into the pro and cons and make your decisions with the facts, not other people's opinions

[PacificDogwood]

Hi, clicks, it is a difficult decision to make and nobody can make it for you, obviously.

I had an induced VB (very medicalised, but not bad), then emCS, then VBAC x2. My VBACs were brilliant and I would opt for VB again - not that I am going to have nother, mind ! I appreciate that I had the advantage of a 'proven pelvis' ie I had already delivered vaginally once which statistically increases the chances of a succesful VBAC.

However as your current pregnancy sounds a lot better than your first, I don't think you should discount VBAC outright. Also weight estimations by scan are notoriously unreliable. And 9 squishable baby fat pounds are not as difficult to squeeze out than a large head on a skinny baby !

I'll go and find some links for you that I found useful when I was trying to figure out what to do when I was expecting DS3.

[PacificDogwood]

Don't be put off by the title of this site; you do not need to be planning a homebirth to find this useful

VBAC stories

More useful and evidence based info

HTH a bit. Good luck!

[clicks]

Hi, thank you so much for all this info...been busy reading for the past hour and am now swaying towards VBAC, despite reading some 'not so nice' VBAC stories there seems to be an overwhelming consensus that it is worth it and that the evidence suggests it is the better option. I did not realise there are so many risks associated with C-sects, especially with the more you have.

[PacificDogwood]

Elective CS is one of the safest types of surgery out there, but it is major abdominal surgery with all the risks that entails.

Any VB also has riks but IMO less so.

It is really good if your consultant is actively in favour of VBAC if you decide to go down that route and does not just pay lipservice to it while still giving you the face. I was very lucky with mine (2 different hospitals as we had moved) in that they were v enthusiastically behind my choice of VBAC.

NOT being induced is probably the single most important factor for a 'good' labour and birth; and as little other intervention as possible. I was all set for water as painrelief as I had found that helpful with DS1 (before it all went a bit technical...), but in the event everything happened too quickly this time.

Also, consider resarching the option of having an Independent MW if you can. They are not as bound by hospital policy/guidelines etc, often more experienced in not-run-of-the-mill births and are not as wussy as some hospital MWs .

Having said all that, a planned CS is often a really nice experience and most certainly not a 'failure' of any kind. And I know a woman (well, friend of a friend) who had 5 CSs... not sure I would recommend that though

[motherofsnortpigs]

pacific The AIMS article is very, very good. Thanks for sharing

[PacificDogwood]

You are v welcome.
It was MN that helped me make my decision.
Karma, and all that...