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I can't decide whether to go for ELCS or VBAC - need advice/experiences please

(28 Posts)
pokesandprodsforthelasttime Tue 01-Oct-13 11:03:35

I've spent too many sleepless nights worrying about this! I've an appointment with the consultant midwife about a VBAC next week and I really need to be clear about what I want.

DC1 was born by EMCS after a very long latent stage and active labour, she was back to back and brow presentation but this wasn't discovered until the end.

When the brow presentation was diagnosed the obstetrician said I had a prominent sacrum which might be why DC1 had got herself into this position. I have googled this but there doesn't seem to be much info out there, so I don't really understand what it means. Also nothing was written in my notes about it so I'm not even sure if it's relevant.

The consultant I saw a couple of weeks ago said there was no reason I couldn't have a successful VBAC. The hospital are very supportive of VBACs. She said the risks of a CS are higher for me as it will be my 3rd major abdo op (also had surgery for massive ovarian cyst) and may result in adhesions. Which is why I initially agreed to a VBAC.

But I have so many worries:

-I don't have much faith in my ability to give birth naturally

-I'm quite short (5ft 2) and worried this baby will be 9lb going off DC1 weight and family history. I know plenty of short people give birth to big babies naturally, but I'm worried about the shape of my pelvis and the prominent sacrum thing.

-I handled my 1st labour fairly well with regards to pain, but couldn't keep any food or drink down even with anti sickness injections and a drip. I spent a long time in recovery after EMCS as I was so dehydrated.

-I would prefer an ELCS to a EMCS.

- I'm an old fart (38) -6.5 years older and definitely less physically fit than when I had DC1

- I did a VBAC success calculator thingy online which only gave me a success rate of 50%

- I have no urge to give birth naturally just to experience it, or prove I can. My main concern is that DC2 born safely with minimum long term damage to myself.

- I had IVF to conceive this baby (does that make any difference to anything? it's down as a risk factor in my notes)

- I have antenatal anxiety/stress and a history of depression - GP is worried about me developing post natal depression and is keeping an eye on me. I'm worried a traumatic birth may add to my problems!

Sorry for the essay. If you got to the end and have any advice about any of this I'd be very grateful smile

HatticusFinch Tue 08-Oct-13 12:02:30

I too had the same dilemma, following a traumatic first birth and a EMCS I was terrified to go through it again.

The hospital were very pro VBAC, to the point where the only way I could have a ELCS was if I went overdue or there was a medical reason (this was three years ago) I don't want to sound negative but I really felt like my concerns where mostly dismissed and the over-riding feeling from concerned was 'It'll be alright this time'

So I attempted a VBAC, and when the time came I felt calm and in control and it went really well to begin with. I was also worried that I'd be stuck on a bed unable to move because of the monitoring, but this proved not to be the case as I was still able to move around quite a bit.

I ended up with a crash section under GA so it wasn't a successfull VBAC. Although if I hadn't had the continual monitoring it could have been a very different outcome for us both. I still wish that I'd fought more for a ELCS or moved hospital to try achieve this.

I really hope Pokesandprods that you manage to come to a decision that's right for you and you are happy with it, all the best!

Gawd that's abit long, sorry for the essay!

Mumoftwoyoungkids Tue 08-Oct-13 20:19:58

Dd was back to back, turned wrongly and got herself completely wedged. There was an attempt with forceps but it didn't work so EMCS.

That's interesting about the skin to skin. I didn't get that but I had a major PPH so wasn't really conscious by that point.

In the interest of balance I should probably add that I spent early labour walking around the hospital grounds (it was a beautiful day) muttering darkly to dh about how if I'd had any sense whatsoever I wouldn't be trying to breathe through contractions but instead lying in an operating theatre listening to classical music with the only pain being the drip going in my arm. And two hours later have my baby. "And instead" stomp "I'm here" groan "wandering about a sodding car park having contractions leaning on lampposts! And it could be days until we get the baby."


pokesandprodsforthelasttime Fri 11-Oct-13 10:29:12

Just thought I'd update you with what happened yesterday at my appointment with consultant midwife.

He said I was a very good case for VBAC and my chance of success was roughly 75% based on their score chart.

I told him all my concerns based on what happened last time and he wrote me a birth plan for a VBAC attempt with low threshold for Csection if:

- very long latent stage
- no or slow progression (based on at least 1 cm dilation every 2 hours)
- if I go over 41 weeks
- baby is persistent back to back or other awkward position

No induction or syntocin drip
If I start projectile vomiting again I can go into hospital straight away for anti-sickness meds to avoid dehydration
Pain relief on request

I can change my mind at any point up till 38 weeks and still be booked in for an ELCS.

Seems like a fair compromise to me grin What do you think?

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