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Help re vbac baby not engaged...

(20 Posts)
Gangie Sun 13-Jan-13 15:40:26

Feel like I'm stuck between a rock and a hard place at the moment. I'm due on wed but baby had not engaged, my consultant does not want to let me go past 40+7 I want to push it to +12 my partner is on the consultant side. Baby is happy as larry where he is, iv had an easy pregnancy no problems what so ever just that he had not engaged.

This is 2nd baby but had planned section on first due to being admitted for 2 wks before due date due to polyhydronomos (sp?) and unstable lie @ 39+5. On reflection I feel I
should have waited it out to see if I would go into labour naturally.

Gangie Sun 13-Jan-13 15:43:41

Sorry on iPhone! Anyway just wondering if anyone has been in the same situation? I really want to have a vbac, the section was horrible last time and I ended up back in hospital after 7days with pph cue d@c, blood transfusion, stress, severe anaemia then an allergic reaction to antibiotics!

NormaStanleyFletcher Sun 13-Jan-13 15:59:36

Oh. I know nothing about this (helpfull)

Hopefully someone who is some use will come along.

<<settles down to wait for lulumama>>

NormaStanleyFletcher Sun 13-Jan-13 17:22:09

.

Hello
I had a vbac with my second. The plan I got everyone onside with was that if by 40+14, ds had not arrived, then I would have a c-section.
DS turned up at 40+9. He did engage but no where near fully until I was in labour.
I can recommend lots of sitting on a birth ball, lots of time on all fours and perhaps try and find a reflexologist/acupuncturist and tell them that you need your baby encouraged into engaging.
I take it your last section was an emergency? In which case it's worth baring in mind that electives are much calmer and generally much easier on the body in comparison with an emergency c-section.

Oh and I wasn't engaged before due date either.

ArrEmm Sun 13-Jan-13 17:29:43

Ok, so baby not engaged yet.....but this isn't unusual if it's not your first baby. Have you looked at the Spinning Babies website at all? (www.spinningbabies.com) The basic premise being that if you want to move baby you have to move Mum!! Have you been trying to maintain an upright posture, used a birthing ball etc. Try to always keep your legs hip-width apart to have an open pelvis (i.e. if lying on side place a pillow/cushion between knees AND ankles) It is worth bearing in mind that second and subsequent babies often do not engage until labour begins......so ways to naturally induce labour would be worth trying e.g. raspberry leaf products, nipple stimulation, intercourse, eating 6 dates a day? Obviously as a VBAC you need to be guied by the advice from your hospital as you are under Consultant led care for being "high risk".
Also, it's worth bearing in mind that although your caesarian section last time was a nightmare and the post-partum period horrendous (by the sound of it) this is unlikely to re-occur. (Make sure your iron levels are good prior to delivery by eating an iron-rich diet)

Hope this helps and the very best of luck with your birthing, whichever exit baby uses!! ;)

Gangie Sun 13-Jan-13 18:49:52

Hi thanks for all replies. I had a sweep @ 38wks so that's when I knew baby wasn't engaged so have been trying everythin since then....walking, bouncing on ball, cleaning floors on hands and knees, marching with my toddler smile clary sage baths, lavender oil, foot rubs, raspberry leaf tea, spicy food and sex but maybe not enough of that blush

My consultant might let me go until 10 days over but that is at a push and ad it lands on a sat when they don't do elective sections it wud actually be 9 Days over. I know it shouldn't matter how baby gets here as long as it's safe but I want to know that I tried everything to make vbac happen. I guess I just want to know that it's possible for baby to engage just before the big event!

Gangie Sun 13-Jan-13 18:59:02

Ment to say also, am scared that even if I do go myself that I won't progress quick enough and will end up with a section anyway. I'm in Ireland and its a bit backward in some ways!!! For instance, I have to get to hospital (40 mins away) as soon as labour starts, then I will be monitored continually and given 8 hours to progress to there expectations! No birth pool sad am wondering If I should just book the section and I could have baby as soon as I like! In fact I could have it by now had I wanted. Sorry if I am all over the place, having an emotional day!!!

The advice on successful vbacs says that you are more likely to suceed if you get to the hospital well after you are four cm's.
The reason you have been told to get there quickly is because they will want to monitor in case of scar rupture.
The thing about scar rupture is it is very very unlikely to happen but if it does you have less than thirty minutes to get the baby out using an emergency c-section.
How long would it take to get there if you were bluelighted? Less than thirty minutes, if it normally takes forty but how much less?
For me I would be weighing that versus trying to stay at home for as long as possible because the longer you are active, moving around, in a home setting, the more likely you are to get what you want.
This is of course contrary to thr medical advice you have been given so you want to be thinking about that too.
Also sweeps, I was having one done every two days as soon as I passed forty weeks, as well as putting three capsules of epo up my chuff twice a day.

Gangie Sun 13-Jan-13 19:53:43

I'm doin the epo but only 1 capsule so i should try more then? The problem with gettin to hospital is that there would be no time for an ambulance they nearest one is a good 20ins away and there is no guarantee it would be available! We are rural! The only thing I can think of is to go towards the hospital but not go in but how logical is that when im in the middle of labour?!! I'm probably over thinkin the whole thing but I can't help it at the moment! I would have loved to be able to
Labour at home for as long as possible I have no experience of labour at all but I have a hunch that a bath and being able to potter round at home would be a help smile

Gangie Sun 13-Jan-13 19:56:42

Oh ya wrt sweeps I don't know if I can have more than one a week? I will have to ask that at my apt on thurs as it is the consultant that had to do it, the midwifes don't! That's kinda what I mean about being a bit backward! Midwifes in uk seem to do a lot more. There are some midwife led places but not in our area sad

You could always google doing it yourself, as there are websites out there that explain the process, if your partner would be willing?
And yes, three capsules in the morning, three in the evening, prick a hole in them before putting them up.
If you really wanted to get things moving you could try this:
natural castor oil

Don't know how likely you are to find it where you are but it might come through soon if you ordered it express delivery.
Now generally castor oil is not recommended but using this stuff as it's cold pressed shouldn't be a problem ( I used it before my vbac) as long as you are sensible and don't chug down half a bottle in one sitting.
From memory, I did a couple of soup spoons followed by a lemonade chaser and then no more until at least twelve hours had passed.
It can make you vomit and the diarrhoea is one of the things that can stimulate the uterus, quite frankly though, I felt much worse after the really strong curry that I had tried the week before!
Good luck!

One of the things I considered doing was booking into a hotel room nearer to the hospital...

ICompletelyKnowAboutGuineaPigs Mon 14-Jan-13 10:19:53

I am also planning a VBAC after one vaginal delivery and an ELCS due to polyhydramnios.

When you say the consultant won't 'let' you go over, are you aware that you can refuse? If at a later date you change your mind they cannot hold it against you and say 'you missed your chance, sorry' - if you're happy baby is happy (movements ok etc) then you can tell (not ask) them that you need more time.

Also, CEM (versus intermittent listening by a midwife) has no better outcomes for mother or baby but as it is standard (and in my opinion requires less staff) CEM is procedural. I am not planning on having CEM unless it is medically required. There are other indicators that all is not well with a uterine scar (such as maternal heart rate, maternal temperature and pain). It is also worth remembering that unterine ruptures are not common and serious complications arising from these ruptures are rare. That is not to say it shouldn't be taken into consideration but I do sometimes think a lot of emphasis is placed on uterine rupture that may be disproportionate to the statistical risk.

Our trust also has a policy of requiring immediate admission to hospital at the start of labour, CEM, no labouring in water, and a 'trial of labour' that involves 1cm per hour dilation or c/s. IMO this is setting women up to fail. There is no evidence that 1cm per hour indicates a good progression of labour - dilation from 2-8cm, for example, can happen quickly or slowly but necessarily at the 'prescribed speed'. CEM generally requires static labouring which is likely to result in a slower progression and therefore more likely to result in intervention.

These are issues that are often not presented to women planning VBACs.

That being said, if you do end up choosing to have an ELCS (or end up with an EMCS) don't feel like you've failed. I've never had an EMCS so not sure what they're like but my ELCS was a very dignified affair and the healing was fine.

Good luck OP, with whatever you decide. For me, I know that this time I will be the one in charge of the decisions about my baby and my body and that the HCPs are there to provide guidance/advice/opinions and not to tell me what to do. This means that I am already going into my birth feeling much more in control of the process and so I feel more confident that if my best laid plans don't go to plan then I won't feel disappointed. With my first birth (post dates induction) I really feel like I had stuff done too me and my main priority this time is to avoid that. Other than that I feel like I want to give myself the best chance of having a successful VBAC but otherwise I'm willing to be flexible and see how things evolve.

ICompletelyKnowAboutGuineaPigs Mon 14-Jan-13 10:22:14

Sorry, I've just realised that I've wittered on about VBACs and not really answered your query re engaged baby.

As a PP said second babies often don't fully engage until labour. But with your history of polyhydramnios, have they checked your amniotic fluid index this time? With the best will in the world my DD couldn't engage because she was floating around in her own little swimming pool! Might be worth getting it checked out?

ghoulelocks Mon 14-Jan-13 10:40:46

My second was finally found to be engaged engaged at 8.04 am when I was 4cm, born at 8.32am if that helps!

ICompletelyKnowAboutGuineaPigs Mon 14-Jan-13 10:44:36

Wow Ghoulelocks 4cm to baby in less than half an hour - that is certainly fast work!

FrustratedSycamoreIsNesting Mon 14-Jan-13 11:29:38

I haven't had a cs but with both of my vbacs they weren't engaged until I was well into labour so not before I got into maternity ward, which was after contractions got to about 4 mins apart.

Gangie Mon 14-Jan-13 19:06:01

Thank you everybody for your replies. I'm still not totally convinced on what to do but I am meeting my consultant on thurs and will have another sweep and see how that goes... Until then the oh is delighted with all the sex, toddler delighted with walking marching and dancing round the kitchen and the house is sparking! Off for another clary sage/ lavender bath now grin would be wonderful if the decision was made for me and baby came if its own accord! Thanks again guys wink

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