Help - first VBAC consultant's appt and my mind has gone black!

[Poppet45]

Argh!! So I've spent the 22 months since DS arrived pondering over what went wrong during his delivery and yet tomorrow is my VBAC appt for this DC and my mind has turned to a panicked mush.
To summarise, I laboured well for the first 10-15 hours or so in a birthpool at hospital - didn't need gas and air til 7cms - coped fine. Then pain started growing at top of pelvis, things slowed and I got through 6 bottles of gas and air . Things got worse when the nightshift MW took over, broke my waters against my consent (she actually cornered me to do it) and gave me the full on unwanted directed pushing spiel - rolling her eyes and telling me I wasn't trying hard enough and ignoring me telling her I had no urge to push and thought DS was stuck. Two hours later I had an emcs as he was indeed stuck sideways in deep transverse arrest. I then had a 1300ml PPH and ended up in HDU and spent my first weeks as feeling utterly anaemic/shocked. No one ever told me why I'd had a cs and I had to buy my notes to find out.
So I know about what I want in my birthplan, mw led, water again (so no cfm unless they have telemetry), no ARM or directed pushing unless there's a good reason.
But at this meeting what should I be asking about their VBAC policy in general? What else should I ask? I need details so I can make a list and have a proper discussion with the consultant and not burst into tears/ sit there like a docile veg type. Thanks so much for reading.

[VeryHungryKatypillar]

You've obviously given this a lot of thought already and I think it may not help you if you start off talking about their VBAC policy. It might be better to start off with telling them how you would like to play things. It is likely that their policy will require CFM from established labour, not allow you to use the pool and they may not be happy with mw led care... these are all things that my hospital said to me when discussing my VBAC. I didn't feel very strongly about water and CFM to be honest so it wasn't much of a problem. And although I delivered in the consultant led delivery suite versus the mw led birthing centre, I only encountered a dr early on after waters had broken but before established labour, was cared for entirely by mws for the labour itself.

You might want to start off by explaining what you would like, allow them to respond by going on about risk etc, tell them that you have considered risks (if you have) and that you are aware of them and accept them but that you would still like to go ahead as planned. Perhaps after that conversation (depending on how things go) you can ask them for a copy of their VBAC policy so that you can see how they view things, and then you can work out how best to tackle them to get them to agree to the birth plan you are happy with.

I don't think the above answers your OP, but I think you've done the hard work already and you need to focus on what you want and not their policy...

Good luck with the appt, I hope it goes well.

[Poppet45]

Thanks for your reply, much appreciated.
I think you have a good point. I've already spoken to my MW and she's happy for me to be in the midwife led unit (which is on the other side of the corridor from the CLU) and also happy for me to labour in water and she actually suggested that continuous monitoring would not be my friend as given that DS was a biggun (9lb 6 oz) I'll need all the help gravity can offer. I'm thinking of saying I'll have CFM on my arrival, then if it's okay I'd like intermitant with a doppler, and if I do have to have CFM then I want it to be continually monitored by someone in the room. I don't want DH having to run off and find someone and they then read the trace and find out too late something's gone wrong. I'm scared if I have it they'll spend more time looking at a sodding screen than me. I've also said I'm not fussed about delivering in water, just labouring, and am happy to be wheeled into the CLU as soon as DC arrives and they can prepare to pounce if I haemmorrhage again. She's warned me the consultant will sound negative, but is just trying to give the other side of things, however another mw I spoke to said no to water or MW led unit so I'm worried things are very ambiguous and it will depend who I speak to.
Does anyone else whose had this appt ask any pertinant questions? That I can steal

[MummyAbroad]

I was co-erced into CFM with the birth of my first (VB in a midwife led unit) and in my experience, once you are strapped up to the machine it probably wont come off and it does make it very difficult to then do anything "your way" I was forced to labour on my back which I really didnt feel comfortable with (and it I tore, I believe, because of this) and anytime I protested about anything, the screen readouts would be used to justify their actions ("the baby's heartrate just dipped" - every time I moved! etc..) DS was born 9 pounds and very healthy though, no signs of distress when born whatsoever, I really did feel that the screen got more attention than me and the "results" were being used against me in order to get me to be compliant! (Another midwife did look over the traces two days post birth and agreed there were no signs of real distress, just places where the heartbeat could have been lost due to normal movement)

You might be better off asking for things the other way around, i.e. start with intermitent monitoring, CFM only if it becomes necessary, because it does restrict you a lot.


As for questions, you could use the BRAIN acronym for any difficult issues =
What are the Benefits?
What are the Risks?
Is there any Alternative?
Use your own Intuition
What happens if we do Nothing?

both in your appointment and during the labour. Hope it all goes well.

[VeryHungryKatypillar]

How did it go Poppet??

[Poppet45]

Consultant was on holiday!!!! I did however speak to a lovely mw instead, who told me to rebook rather than speak to the registrar because they don't have the say so to write the letter to the MLU letting me go. She was great used to work at the MLU and said she'd done loads of water VBACs. Said the PPH will be the big issue for the consultant, gave me the address for AIMs and told me to read up and said if all else fails change consultant.