What's wrong with me? What would you do? (long)

[TheBreastmilksOnMe]

I am 13 weeks pregnant with baby no3 and I have, up until this point been determined to have an elective c-sect. Here's why:

Baby no1: I origianally wanted a home water birth. Ha! 'Labour' started on weds morning, went along to the hospital for 5pm as wasn't sure if I should or not as being 1st time I didn't know what to expect.

Contractions weren't very strong but they felt it to me. Stayed for a few hours on the antenatal ward trying to sleep and taking several baths. DP sent home. Was examined and eventually reached 2cms so popped over to delivery ward, DP called back in.

At some point waters were broken, had diamorphine and couldn't stop vomiting. Had an epidural which only worked down one side, was repositioned 2 or 3 times but never fully took effect and didn't touch the excruciating pain in my back with each contraction. 2 spinal anaesthetics worked but only for an hour each time.

I was put on a drip to speed up contractions, eventually reached 9cms when they found out after examining me that baby was OP and getting tired so they prepped me for a c-sect and he was delivered at 13.30 friday afternoon.

Baby no2: I wanted a VBAC and to do it 'naturally' this time. Labour started 3am friday morning, contractions more regular and increasingly painful so popped along to the hospital for 7pm.

Examined upon arrival was found to be only 2cms which was so dissapointing so left delivery suite and advised to walk around.

After 40mins of walking up and down the hospital corridors with what felt like no break between contractions I walked back up to labour ward and upon examination (during which I had another contraction and she broke my waters, so painful) I was 7cms! Hooray!

By 8cms I was begging for an epi, anaesthetist arrived, me very sceptical it would work this time, and of course it didn't, I jumped off the bed 15mins after having it as it was more painful lying down then standing up. (What is wrong with my back that epi's don't work for me?)

So had to go without pain relief which was totally terrifying. Reached 10cms and started pushing leaning over bed but midwives persuaded me to lay on my back with legs up in stirrups and after an hour of pushing with the help of a kiwi extraction, baby no2 was born. I was lefy with a 2nd degree tear but so relieved it wasd over.

So here I am pregnant with baby no3 and from the beginning I've said I never want to do a vaginal birth again as the pros for a c-sect far outweigh the pros for a vaginal for me.

I'm terrified of the pain of labour and not being able to have relief from it, if I knew I could have an epi that would work then I might be more willing to try it but from my history, they just don't work for me.

I also found the c-sect recovery much easier then the vaginal.

So now. I'm thinking of trying a vaginal again (3rd time lucky maybe), like I want to prove to myself that I can do it? And being a 3rd I'm hoping things will be easier? I'm crazy aren't I?

What would you do?

[TheOrchardKeeper]

I'd go for the C section tbh. You know what you're getting with that and it's not like you get a medal for a VB.

I had a bad birth with my DS, had an episiotomy that fell apart a few days after having him, had an infection, took months to recover whilst a friend that had an EMCS only took 6 weeks and though I'd love to experience a 'good' birth I just wouldn't risk it again.

Only you can make that choice though.

If you're ok with the risk of another bad birth then go for it, as it may turn out fine!

[Theyoniwayisnorthwards]

Your first birth sounds very like mine and I opted for an elective c section the next time as I was not going through that again. The recovery from the c section was much easier with an elective but 7 months later I am still numb in places and my scar is still uncomfortable at times. That said, I've never had a VB and I imagine there can be long term issues after that too.

[bonzo77]

Hmmm. I've had one emcs and one ELCS, so my experience is limited. But.... You have a "tested" cervix. You do manage to get into labour spontaneously. In an ideal world i would be aiming for a vb with a very low threshold for proceeding to CS (ie if you feel you need an epidural, if you are not progressing). This was my plan that I'd agreed with the consultant with DS2. (I ended up with a CS as he needed to be delivered a month early and it was felt that induction was not safe for me, or likely to work, and baby was too compromised to cope with labour).

In reality, getting this will be entirely dependent on the staff and theatre availability on the day you need to make that decision.

OTOH if your fear of history repeating is really affecting you, and you actually do not want to try for a vb (which is utterly understandable), go for the CS.

Out if interest, how did they anaesthetise you for your CS?

[Minifingers]

There is absolutely NOTHING wrong with you. It sounds like everything that was done to you probably impeded your labour rather than made it easier to cope with. And yet second time around you still managed to have a vaginal birth. Your body can do it.

Honestly? You need a shit hot doula. Or an independent midwife. Or a home birth. And to stay the fuck away from CLU's where they have high rates of assisted delivery, induction and supine births.


Or have an elective C/S. One of the two!

[dopeysheep]

C section no question. Obviously only you can decide but I woukd drfinitely opt for a section over a difficult vaginal birth.

Proving you can squeeze a baby out of your bits really isn't such a great achievement it's how you nurture the kid afterwards that counts.

[Minifingers]

dopey - "I woukd drfinitely opt for a section over a difficult vaginal birth"

The thing is though that having had one vaginal birth, the OP has a VERY high chance of her second birth being completely straightforward, quite possibly involving no perineal damage at all. Even with an epidural. And the right sort of care would optimise her already good chance of achieving this. A first vaginal birth after c/s is always going to be more complicated because the mother has a second stage which is similar to a first time mum's (because she hasn't pushed a baby out before), and perhaps part of her first stage she's doing for the first time (depending on how far she got in the labour which ended in c-s). And yet she also has continuous monitoring, often high anxiety levels and an expectation of things not progressing, and a limit on how long she'll be 'allowed' to push for. All this makes first vbacs a real challenge, with a higher than usual chance of ending in an assisted delivery. Not so 2VBAC, which are most likely to end in a straightforward and spontaneous vaginal delivery.

[carlyvita]

Nothing's wrong with you! Sounds like you did really well to me! Flat on your back is the hardest, longest, most unhelpful position to be in, where your instinct was spot on, letting gravity do some of the work for you. I'd recommend an Independent Midwife to offer one to one care and to make sure you are supported and protected (if you decide to go to hospital). I'd also recommend looking into water births and, if you can't afford an I.M, then find a really confident, informed and experienced Doula, as mentioned above. In fact you may as well have just copied Minifingers post right here! Ditto.

[TheBreastmilksOnMe]

Ok lots to think about. Thankyou to all of your replies I already feel more empowered but still swinging between the two options. An independant midwife is a nice idea and probably the way forward for me but it's also out of my budget so unfortunately not an option.

Carly- it angers me now that I was 'persuaded' by a consultant ob to labour and push on my back with my legs up in stirrups as it would 'open up my pelvis' and being delirious with pain and exhausted I went against my instinct! Grr!

I think a Vaginal birth this time around is likely to be quicker and more straightforward however I really don't want to take the risk or feel that level of pain without any relief! I am coming down on the side of c-sect but also feeling a sense of 'loss' that I'll never have the waterbirth I wanted in the beginning.

But like dopey says it's how you care for your child afterwards that's important. I'll get over it!

[carlyvita]

Well do what is best for you, obviously! Sorry, but don't understand why not water birth? My VBAC was really helped by water, and I got in and out throughout labour. Found it soothing and supportive when getting tired too. Re Independent Midwives, many have plenty of payment options. Best wishes. C x

[TheBreastmilksOnMe]

Carly- I wasn't 'allowed' a waterbirth as it was a vbac therfore high risk and needing continuous monitoring. I remember pleading several times during the course of the labour to be allowed a waterbirth but they said no and that they had run out of liners for the pool! [Hmm]

I've researched into an independant midwife on the independant midwives website and had a look at the costs somewhere in the region of £2000-£4500 which even on a plan is waaaay over our budget. Also there are no independent midwives within a 100 mile radius of where I live so it's just not an option sadly.

[carlyvita]

Aw, I see. Makes me hopping mad that they wouldn't let you in the pool! What meanies! Real shame IMs are out of the picture, but get it. It's a lot of money to have lying around and we were saving for 4 years to ensure one to one support for my 2nd pregnancy. That said, I don't begrudge them a penny. I do resent the system for not giving me an alternative care model itself though! Totally understand dilemma.

I did a load of research re continuous monitoring and made the informed decision to decline it. Think that my immobility contributed in no small way to my long labour, my stress and discomfort and my eventual c.s to be honest. Once I had made this choice, the pool was back as a good option for pain relief (phew!) and dived in and out whenever I needed. Was monitored regularly, even in pool.

Have you come across AIMS short book called Birth After Caesarean? That is brilliant read, whatever you decide. Even available as kindle I think!

Pools are cheap and nobody can tell you what's "allowed" in your own home! You can always transfer for a c.s and arrange that you will not accept other instrumental deliveries. We decided to transfer for a c.s in the end for number 2, when nothing seemed to get baby down and I halted at 8cm for over 8 hours. I used the stairs, the doorways, the toilets, the pool and eventually went in for my back up c.s plan! I would have been happy with this outcome, as it would have been my choice and would not have involved a difficult instumental delivery. Fortunately the journey in loosened something or jogged something and baby arrived in good health on the floor at the foot of the bed, where I squatted after I found that I could feel his gorgeous velvety head. No intervention, no fuss and back home within a couple of hours! Just glad I spent my labour at home, where I had everything I needed to support and relax me.

There is another choice of course, which my friend opted for when faced with similar situation. Plan for a c.s. but decline an appointment for the booking in date. Arrange that when labour starts you calmly pick up your bag, phone a few people for child care and make your way to hospital. Unless your labours are mega fast (I wish!) you should have time to get there calmly and safely. Added bonus is your hormones, your body and baby are all ready for the day. My friend felt happier knowing that the time was right, and I can see her thinking!

All the very best, chose what you want and then make sure you get it! AIMS is brilliant at supporting women in getting what they want from the maternity services, so a good one to contact if you come across stumbling blocks too!

[TheBreastmilksOnMe]

So pleased to hear that you got your birth pretty much as you'd planned carly! Can you explain again to me what your friend did? I'm not sure I follow?

[Ushy]

Do what's right for you and what makes you feel most at ease.

In your position I would opt for repeat c/s because it limits the downside risk of a repeat horrible vaginal birth but I'm not you so in a way that's not much help.

You're doing exactly the right thing by looking at the options others would choose so you can see what feels right for you. Good luck and hope 3rd time really is lucky whatever you choose.

[TheBreastmilksOnMe]

Thanks Ushy I think I'm 95% sure that I'll opt for a c sect I feel a sense of relief when I think of this option so I'm quite sure it's the right one.