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Did anyone VBAC AFTER 41 weeks?

(10 Posts)
oldebaglady Thu 10-Jan-13 14:26:17

Hi, consultants and midwives are saying they won't "let" me go over 41 weeks, but not really explaining why! They say "increased risk" but does that mean 0.01% more risk or 75% more risk?? again they won't specify!

they have booked me for an CS at 41 weeks, I've questioned this with them at every turn, at first they kept fobbing me off saying "well there's loads of time and we can see how it goes" and now it's "well it's too late to have another consultant appointment (which it is! but I have been saying I didn't understand why 41 not 42 weeks for months!)

AIMS gives stats for still births but doesn't give separate VBAC ones, I don't see how being a VBAC could affect the life of the placenta anyway? so the risks are IMO fairly low

and the stats given for scar rupture (between 2 and 3 %) doesn't differentiate between serious scar rupture, and slow rupture which can be dealt with???

What happens next if I refuse the CS?

Has anyone gone over 41 weeks and had a VBAC and what advice were you given by your HCPs?

Thanks

newyearsday Thu 10-Jan-13 15:29:26

Hi Olde, sorry to hear you're under so much pressure :0(

I'm 32wks but already preparing myself. My strategy will be to avoid meeting an obstetrician until 42wks 1) because they stress me out and the adrenalin won't help me go into labour, and 2) because I will not consent to induction due to it increasing the chance of scar rupture.

You are quite right to question their evidence (if you find any do share!). Full term babies are born 37-42wks so you are not overdue until you reach 42wks. EDDs can be inaccurate too.

You don't have to do anything you don't want to do. They can book you a CS but if you don't want to go ahead with it, that's completely up to you. See how you feel on the day! Or tell them you won't consider a CS until 42wks. Ask what the alternative is e.g. daily fetal monitoring? When challenged, I have found the response "because it's my decision" works well.

I was told the stats for scar rupture is 0.5%.

All the best for your forthcoming VBAC ;0)

oldebaglady Thu 10-Jan-13 15:40:29

thanks newyearsday

I'm supposed to go in to consent for CS at 40+5 and booked to have a CS at 41+1, consultant has discharged me back to CMWs

I won't see the consultant again, the consent apt is with the nurse and a reg or someone will pop in with the form, I'm expecting a lot of pressure at that to go ahead with what has been booked which obviously isn't helping me relax and go into labour naturally. I've been told that none of the consultants at my hospital will do any form of induction other than breaking waters (not that I want an induction at 41 weeks either

I'm sure of my dates which is one thing at least, but still, DH was born at about 43 weeks, DS1 was born at 40+1, and I have no idea when anyone in my family was supposed to be born as all including me were induced or CSs. Noone ever goes "early" anyway

I'm finding varying stats about scar rupture, but not one of them differentiate between ruptures that resulted in serious outcomes, and ones that were spotted and dealt with with no long term problems. As I don't plan any more children I'm not bothered about the latter

hellsbells76 Thu 10-Jan-13 15:53:27

I delivered a lovely vbac baby following a spontaneous labour only last night! In our trust, vbacs are offered induction at 42 weeks like everyone else. I'm currently doing my dissertation (am 3rd yr student midwife) on the evidence base behind induction for postdates, and to put it bluntly, it's crap! Conflicting, contradictory, poor quality ... I've just had a squizz through my notes and can't find anything about a prior caesarean increasing any risks, and uterine rupture can occur at any time. I suppose theoretically the longer you stay pregnant, the longer your scar has to rupture, but one thing that definitely does increase the risk of rupture is induction so if it's increased risks they're worried about, that would be one thing to avoid! Always worth asking the consultant what evidence they're basing their ADVICE on (because that's all it is) because I'd certainly be interested to know what the robust evidence base is behind this recommendation wink. Good luck!

hellsbells76 Thu 10-Jan-13 15:54:35

Sorry, meant to say last night's baby was (I think) 41+1 and wasn't booked in for induction for another week (was v happy to cancel that appointment for her!)

oldebaglady Thu 10-Jan-13 16:12:01

congratulations hellsbells grin

I won't see the consultant again, I saw the consultant once very early on, then the registrar once, who rushed the appointment through and then discharged me to CMWs and booked the CS. The CMWs were all wooly about it, first saying "oh you can change your mind later" and now saying "oh its too late now for us to do anything about it" hmm I have been chasing up supervisor of MWs for weeks but as yet no call back so won't be seeing her either :-S

louschmoo Fri 11-Jan-13 22:46:39

Hi there. I am planning a VBAC and have been told that they will let me go to 42 weeks as with a low risk pregnancy. The only difference is that i have the option of selecting balloon induction at 41 weeks if I want (as opposed to pessary/synto). I am at Lewisham hospital in London.

louschmoo Fri 11-Jan-13 22:47:31

Sorry, don't know what the risks are but thought it might be helpful to know what other trusts will/ won't allow!

oldebaglady Fri 11-Jan-13 22:58:05

thank you
as an update I haven't been able to get to see either my consultant or the supervisor of MWs but another consultant has changed the date for me to be 41+4, which I'm much happier with smile

noone could properly justify why it had to be 41 weeks other than that's what the first consultant had put so there must be a reason hmm

Olpol Sun 13-Jan-13 07:31:14

I had a vbac at 42+1. I was booked to go in to see if they could break my waters at 41+5 (a friday), but I had a sweep a couple of days earlier and knew that my cervix was still closed and if they couldn't break my waters then it would be another cs (the pessary wasn't an option due to the previous cs), so I asked to come in after the weekend instead and they booked me for the tuesday (42+2) as they couldn't fit me in on the monday, but I had to go in every day for monitoring. Then contractions started sunday afternooon, they were able to break my waters around monday lunchtime and dd was born monday evening.

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