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Childbirth

midwife led for VBAC?

20 replies

helloitsme · 15/05/2013 22:41

Has anyone managed to go midwife led for a VBAC? I've been told that I have to go for a full on hospital experience since my last one was a c-section, but I'm wondering if I can ask for the midwife led unit/water etc, since I've read that the risk of rupture etc is only 1 in 200, and if I was in a midwife led unit in the hospital, they could transfer me pretty quickly anyway. What do you think? has anyone done this?

OP posts:

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spiritedaway · 15/05/2013 22:49

Hope you get an answer. . My 1st was emergency section, i had to go full hospital for my second and it wasn't great. Wouldn't let me push and went for intervention. 3rd child i had moved and realised after a stress free labour they hadn't transferred my records or read my hand held notes. Number 4 a walk in the park. I know this isn't an answer. FWIW i always think a VBAC sounds like some kind of medal or award and i actually think they should award one and have a ceremony! Best of luck OP

helloitsme · 15/05/2013 22:55

ha ha, it does sound like a medal, you are right! what you are saying is kind of what i am thinking. since my first birth was stressful, why should my second one be? if i'm in nice calm surroundings, maybe i'll be more likely to get the vbac medal, right?
ps, congrats on your own vbac honours, you should ask your kids to arrange a ceremony for you when they are old enough...(ok, maybe not, they'd be very confused....)

OP posts:

vanillavelvet · 15/05/2013 23:01

I had a VBAC in a midwife led unit. I was allowed to labour in the pool, just had to get out for monitoring every now and again. I think it can sometimes depend on which midwife you get on the day though. A friend of mine, in the same unit, had a completely different experience. Good luck, whatever you decide.

spiritedaway · 16/05/2013 07:22

Go for gold OP ;) x

organiccarrotcake · 16/05/2013 09:09

If you talk to your midwife led unit, see what they say. There shouldn't be any reason why not, although you may come across barriers.

Many people homebirth after a CS and there's nothing in a MLU that you can't get at home so that might be an option for you.

You absolutely should not have to get out of the pool for monitoring as they should have waterproof sonicaids.

If you need an advocate, //http//www.aims.org.uk is a great place to start. Also Birthrights www,birthrights.org.uk, a charity run by barristers and lawyers who specialise in birth choices. Both free services.

helloitsme · 16/05/2013 09:40

thanks carrotcake :-) this starts to sound more practical. I love the idea of a home birth, but I think DH would suffer terribly from the stress, since he really thinks is should be in a hospital. If he is stressed, I will be stressed, so I think a midwife led unit would be a good half-way point. glad to know it's been done before vanilla!

OP posts:

organiccarrotcake · 16/05/2013 10:33

Oh I'm sorry to hear about your DH's concerns, but absolutely you need him to be unstressed. Is there a birth choices or homebirth group nearby that you can go to for support? I run a birth choices group which is really useful for dads who are unsure as they don't feel herded into homebirth. Our focus is on achieving choice, not any specific place of birth, but often it does help to discuss fears around different options in a supportive environment.

emsyj · 16/05/2013 22:05

I had a very lovely, uncomplicated homebirth VBAC - but only because we have a fantastic alternative midwifery provision in my area. If you're in the north west check out One to One Midwives (funded by the NHS, it's free, but you get to see the same midwife throughout your pregnancy and it's much more woman-centred than the standard NHS approach). I actually booked a hospital birth but they said I would have to have continuous monitoring and would not be 'allowed' a water birth so I decided to stay at home at the last minute - best decision ever.

I think it is generally quite hard to get the choices you're entitled to when having a VBAC, but I agree a birth choices or homebirth support group is a great place to get information and support to get the birth you want.

helloitsme · 17/05/2013 21:59

this is very interesting. would i be very silly to 'out' myself on mumsnet by saying roughly where i live? I'm not sure how to access this provision really, and actually thought i was being quite proactive by going to NCT (I haven't gone yet, but considering it), but i've never heard anything about alternative midwifery... I'm meeting the obstetrician for the first time on tuesday, so want to be clear about what to ask/ask for (i live near bristol, by the way, if anyone knows of anything good near here)

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emsyj · 18/05/2013 10:31

This is the service I used - I think they are only in the north west at the moment, but looking to expand nationwide.

poocatcherchampion · 20/05/2013 16:24

my midwife said I could push for the midwife unit for my vbac. I'm not fussed as we spent half my labour moving rooms last time but she seemed happy it could be done. Birmingham so no use to you

helloitsme · 20/05/2013 20:39

thanks poocatcher! it's good to know it's been done. I've just discovered there's a brand new mlu inside my nearby hospital. am seeing the doc tomorrow, so will ask as much as i can.
and emsy, I'm planning to phone one to one tomorrow. not sure if they're in my area, but worth checking.
anyone got any tips on good questions to ask the obstetrician tomorrow? it's the first meeting :-)

OP posts:

helloitsme · 21/05/2013 19:51

i just met the doctor. she point blank refused midwife led unit for me, even though it is just one flight of stairs above the main delivery suite :-( have called one to one and am considering options.

OP posts:

emsyj · 21/05/2013 22:27

I'm sorry to hear that OP - did you get much of an explanation as to why they don't think midwife-led is appropriate? Were there particular circumstances around your first birth that indicate this is necessary?

I don't know how open my local NHS service would have been to the idea of me having midwife-led care and a birth in the midwife-led unit (my local hospital has both in the same building, as yours does). I actually booked a hospital birth, although my One to One midwife said I could have a home birth - I stayed at home at the last minute because when my midwife called the hospital (your midwife comes to you at home when you're in labour with One to One, regardless whether you plan to birth at home) to say I was coming in and to ask them to set up a pool room for delivery they said I couldn't go in the water without consultant approval and I would have to have continuous monitoring i.e. be on the bed. So I just didn't go.

helloitsme · 22/05/2013 08:38

thanks for answering emsy, I'm so surprised how bad i feel about it. i thought i would be relaxed given that my last birth didn't go how i wanted and i was ok with it, but actually i felt really bad yesterday, the kind of classic feeling of something really important to me being sidelined and just being told what to do in a not very friendly way. she simply said that they can't do monitoring in a midwife led unit and as i've had a previous c section i need monitoring, and there's no discussion.

OP posts:

emsyj · 22/05/2013 08:57

Did you have a birth debrief after your last birth at all? If not, might it be worth asking for one now, to start a dialogue with the consultants and midwives at your hospital?

Because I had the benefit of the One to One, I didn't really go into the details of my first birth (crash section) with the hospital, but my friend who I mentioned in my previous post was determined not to have the same experience as before and chose to go consultant-led through the same hospital but had a birth debrief, multiple meetings with the consultants and agreed a birth plan with the medical team there that she was happy with. She also hired a doula to act as an advocate whilst she was in labour, and to do birth preparation and Hypnobirthing. I think largely because she was seen as a bit 'difficult' and demanding, she was treated with kid gloves during her birth this time around and felt that they actually listened to what she wanted and made sure she was happy at every stage. Sometimes 'the squeaky wheel gets the grease' and you just have to make a fuss to get taken seriously...

emsyj · 22/05/2013 08:58

PS The monitoring I had during labour was intermittent monitoring with a doppler. I'm not a midwife or doctor but clearly my own midwife was happy that this was adequate so worth looking at the options - it sounds as though you did not get a satisfactory explanation as to why certain procedures are necessary. Do come back and update.

Squitten · 23/05/2013 09:55

They wouldn't let me use the midwife unit for my VBAC either - although they said they'd support me for homebirth, which I thought was bizarre! I didn't feel confident to do a homebirth as I'd never given birth before.

I was in the hospital in the end and still had a great experience though. We're having a homebirth with DC3.

helloitsme · 23/05/2013 12:43

thanks emsy and squitten for sharing your experiences. I just met the local supervisor of midwives and she was superb :-) she really seemed to understand what i found difficult and to be interested in trying to help, which was already a big step in the right direction. she also seemed open to lots more options, though she said the midwife led unit was out of the question, it made me feel like other options might be better than i had thought, if there are flexible and open-minded people there like her. what a relief. she's going to find out some things about options and get back to me. i feel much better. (I too don't think a homebirth is going to work for us, but am keen to make the other options nicer if possible)

OP posts:

emsyj · 24/05/2013 21:24

That's great that you feel better and that you have got some options out there that you're happy with. I hope you enjoy the rest of your pregnancy and that you get a positive birth experience.

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