Struggling to know what I want, ELCS or VBAC- how can you figure out your own wishes?

[birdssuddenlyappear]

I had an ELCS with my first baby. I was petrified of giving birth and was put under the tocophobia clinic. My main fears were around loss of control, midwives and doctors not listening to me, or needing an intervention and staff being too busy with other patients and baby or me suffering.

The tocophobia midwife was lovely, really listened to my fears, said I could have an ELCS if I wanted, but no need to decide yet- I could state this at any time including in labour and it would happen (well, unless it was really late into labour!). With her support I was keen on trying for a vaginal birth.

Unfortunately she left before I got to my due date and her replacement didn't really listen to me, she kept interrupting me during my appointments, misunderstanding my worries. I felt panicked that the midwives in labour would do the same, and I shut down and asked for an ELCS.

I really liked my ELCS, it was a great experience and felt very special, I recovered well and breastfeeding was straightforward, my husband was very supportive and thought it was great, I had no regrets immediately afterwards.

However since then I've found it difficult when basically everyone disagrees with having an ELCS- from the HV who winced when I told her at my postnatal check, from midwives and doctors who criticise my decision, to friends who are kind but very "oh poor, you it must have been dreadful, my birth was such a meaningful experience".

I'm pregnant again and I have thought about trying for a VBAC. The pro reasons would be that I am curious to experience contractions and birth, I do worry about having three sections (we'd like three children), with a toddler the recovery from a section will be more of an inconvenience, I wonder if I might enjoy birth and have an easy birth, I've since read some articles saying that section babies have higher risks of lots of problems later e.g. autism. Also through breastfeeding and raising a baby I have more faith in myself and my body (not very logical, but that's the emotional reason).

The negatives would be the fear that something would go wrong in labour, and again the fear of loss of control, that professionals wouldn't listen to me, that I'd end up having a messy EMCS or a nasty tear which would be worse recovery wise than an ELCS. Also having to wear the monitor in labour, possibly be bed bound, not an enjoyable labour at all. My local hospital has a 50% "success" rate for VBAC (although their leaflet says "70-90% of women can achieve VBAC" )

We've since moved house and at my new local hospital you don't see anyone about an ELCS until your third trimester, which leaves me worrying about what would happen if the Consultant says no! I could transfer back to my old hospital instead, it would be a longer journey, but do-able.

I'm finding it so, so hard to figure out what my opinion is. Everyone I speak to is so opinionated. DH thought the ELCS was great and thinks I'm unwise to consider VBAC with the uncertainties, if I VBACd and it was complicated I would know he thought I'd made a bad decision. When I go to appointments the MW is clear that she thinks I'm wrong to choose an ELCS, like it's morally wrong, my friends are also v pro vaginal birth.

I just can't figure out what I think, or what to ask for.

I read the VBAC advice on the RCOG website and I felt terrified reading it, the thought of uterine rupture, of needing a crash c section to stop the baby being seriously harmed.

I have thought about hiring a private midwife for VBAC, so there is someone I trust there and to advocate for me if I'm having problems and my assigned NHS midwife isn't great, would that make any difference?

Sorry a really long ramble. Just feeling really lost and uncertain.

[mrsmugoo]

I had an ELCS first time but it was for breech. I'm 16 weeks with number 2 now and I'm definitely trying for a VBAC because I think recovering with a toddler would be very hard, especially not being able to drive.

Remember the VBAC success rates include those who had EMCS previously and that would have a knock on effect on their ability for a vaginal birth 2nd time around e.g. failure to progress. Success for ELCS where there is nothing to impact on success of a future vaginal birth will be much higher.

I am also concerned about being treated too medically and I want to be mobile etc... I will make this very clear to the consultant when the time comes. I know that I am a very confident and assertive person and my husband also knows his stuff so I'm not worried about being ignored in the heat of the moment.

Have you considered a doula?

[birdssuddenlyappear]

Thanks for sharing your experiences, mrsm, I hadn't thought about my chances possibly being better than the average VBAC woman.

My local hospital says it has mobile monitors that can be used in the pool, walking around etc, but when I went to my booking appt the midwife says they never work and she has never seen one successfully transmit from the water! So she said you will basically almost certainly be attached to a standard monitor, likely in bed. I wouldn't refuse monitoring.

Yes I am thinking about a doula. Would they know enough to be able to advocate for me if my labour was going badly and my midwife/ the Obstetrician wasn't listening? I'm actually more worried about under-medicalisation than over-medicalisation- that I might be developing a problem and the staff might ignore it/ not recognise it!

I've watched the VBAC videos on my old hospital website and I am going to try to transfer care there, as they have a special midwife who can see you all through pregnancy, and also the mobile monitors (perhaps theirs even work?).

I am just not sure if I'm going to really regret this, and I should stick with the straightforward option. It's harder because DH was really happy with the ELCS (although before that he was v supportive with antenatal classes, hypnobirthing etc), now we had one ELCS that went well he thinks we should just do the same again. Because he strongly has one opinion, I struggle to know whether I actually really want VBAC, or am just adopting the opposite opinion! Likewise in my midwife appts they are so pro VBAC that I can't tell what I actually think. Does that make sense?

Best of luck with the rest of your pregnancy x

[jamtartandcustard]

I would ignore what everyone else says and thinks and do what's best for you and your family.
I had an emcs first time and second time around decided on a vbac because I wanted a large family so didn't want to be limited to the number of safe operations and at the time I was a single mum and didn't feel I could cope with the recovery of the csection on my own plus having to do school runs (dc1 was 5 when dc2) was born and living in a first floor flat with no lift. A vaginal birth hurts, a lot, and it is not pretty. But I had no complications, no tearing, nothing went wrong, and on Monday morning (dc2 was born on a Friday) I was able to get in the car and drive dc1 to school so for me it was the right choice.
If you have support though and can cope with the recovery and want an elcs then go for it. Don't listen to anyone else, it is your body and your baby and you have to do what's right for you x

[jamtartandcustard]

Also just to add, whilst I'm glad of my previous vbacs I do wish I'd had an elcs this time around (number 4 and the final one!) as I'm 40+6 and blooming well fed up now wondering if I am ever going to go into labour. If I'd had the elcs I'd have a 2 week old baby now and would be nicely recovering.

[fruitpastille]

I know what you mean. I had elcs for breech for number one then a failed vbac for number two (no drama although recovery was a bit harder). I was going to try vba2c f for number three - did classes, read up on risks, good discussion with consultant. In the end that one was breech too! And it was a good thing as the surgeon told me my scar was paper thin and would have ruptured in labour. Now I'm really not bothered how my babies arrived and nobody else gives a toss either. I've been told any more would be v high risk but we're done anyway. In retrospect I'm not sure why I was so bothered about a vbac. I've had no problems with having three lots of surgery but everyone is different.

[Zoomtothemoon]

I feel exactly the same about this decision OP. It's like everyone else is so forceful with their opinions u lose track of what u actually want. The only idea I've been able to come up with is to enlist my husbands help to tell everyone we don't want their opinions and we don't wish to discuss it. The only people we will discuss it with are doctors or midwives who are willing to talk about the medical risks of each option and stick to the facts. We will make it clear we want facts not opinions. We want to pick the safest option for our circumstances and only medical fact will help us with that.

I'm not sure if that will help u at all but it's the only solution I could come up with and it's certainly going to be awkward to do (we've got some relatives who will certainly struggle not to give their opinion) so I'll be watching this thread with interest.

[Zoomtothemoon]

oh one other thing that came to mind. Does your husband understand how difficult you are finding this? If not could you explain it to him? if he was willing to support whichever decision u make you might feel freer to make the decision that's right for u.

hope it's sorted out for you soon

[JE1234]

The key thing is to ignore what everyone else says. They haven't experienced what you have so they have nothing to compare it to. You say your ELCS was a positive experience, that is no less valid than their positive experiences of VB. You have to do what's right for you, with medical guidance, and ignore the ill informed albeit well meaning opinions of your friends. One thing I would say is I am also under a Trust that only grants an ELCS in the third trimester. I have just had mine granted at 33 weeks and I really had to push as they normally don't decide until 36/37 weeks which is terrifyingly late. If you think you may want one try to get it booked in early and you can always change your mind. I have heard too many horror stories of people who wanted an ELCS but ran out of time and couldn't get it granted. My Trust is notoriously bad/ 'good' as far as the government are concerned as they have a very low CS rate.

[BooOzMoo]

I would really just like to point out that a c-section will NOT cause your child to have autism!!!!
Genetics are the only cause of autism !!!

I had 3 beautiful labours but I was terrified of having a CS. DS2 was breech abd I had a successful ECV to turn him. The thought of not having control of my body and someone else taking control was terrifying. Epidural was my worst nightmare. Id rather feel the contractions and listen to my body. We've been birthing children for years and that's what our bodies are made for!!! Unfortunately though there are situations where this is just not possible and the CS becomes a lifesaver for mum and child.

Congratulations on your pregnancy and I wish you the best of luck with your decision xxx

[mrsmugoo]

If your husband is dead set on a ELCS you could suggest he reads a natural childbirth book such as Ina May Gaskin so he an learn the positives of going the natural route.

[goodnessgraciousgoudaoriginal]

God, why is the UK so fucking obnoxious about VBAC?

I get that it is nice and cheap for the NHS. Especially if they "conveniently" leave it too late for an epidural.

I get that recovery can be much quicker (although that will also depend on how well a VBAC went so isn't a dead certainty). Overall a VBAC may well be "safer" for most women in good health (physical and mental).

HOWEVER.

Women are not walking little baby incubators - everyone will have their own opinions and preferences, all of which are totally valid and - to be honest - should be taken into account without so much pressure because of a person's right to bodily autonomy.

Look OP, from the sounds of it, you had a totally positive birth experience with the planned section, and it was only afterwards when you had a bunch of obnoxious twats sneering at your experience that you started to question it.

If you want to try for a VBAC because you really want the experience of it, then go ahead, but don't make the decision based on pressure from other people.

And for the love of god, caesarian's DO NOT cause fucking autism.

Wow. That's just the natural birth fascists all over - "we don't approve of this because we have a stick up our arse, therefore it causes autism".

For what it's worth, I'm full term and having a VBAC (unless something goes tits up).

[MrsHooolie]

Hi OP.
I've had two emergency C sections. However,they weren't 'emergency' just not elective. Both times there was no rush and neither baby were distressed. It was all very calm!
I did try for a vbac but in both of my cases I just didn't dilate.
Would you consider having a doula?
Good luck with it all.

[Sparklycat]

Following as I have to make the same choice after an EMC, I was put under though so have no positive section experience to compare/sway me. It's a very blind decision and I'm stuck!

[ThursdayLastWeek]

I'm sorry OP, I can't really advise better than trust your instincts.

I had an emcs last time and will be having an elcs this time. It was never an option for me (mentally) to try for a vbac. My instincts were strong

I hope you find some peace, and congratulations!

[ingenvillvetavardukoptdintroja]

I really sympathise. It's terrible that hcp are being so unsympathetic and not listening to you.
I really wanted a natural birth. Had emcsand it was a great experience. I've thought vaguely about no 2 and am pretty syre I will request elcs. Yes part of me wanted this 'experience '.... And I have one friend who had v successful vbac who is always trying to convince me. But most of the mums I met needed some assistance in labour. My sister tried for vbac and ended up needing a very emergency cs under general anaesthetic while her poor husband waited out in the corridor.
There will be hundreds of anecdotes likethis. No one can tell you if a vbac would be successful for you (and pleasebear in mind a speedy recovery is not guaranteed)
Listen to your gut, not other people's opinions. If there was no stigma attached to c section which would you choose? Make a decision for you and bear in mind it probably wont matter in ten years

[Raxacoricofallapatorius]

I had an emcs with dc1. With dc2 I didn't want a vbac or an elcs. I wanted a secret, hidden 3rd option. I guess I found it. I had another emcs!

I will say though that recovery was easy and my eldest started school 4 days post cs and I was doing the school run with ease, easy breastfeeding and I bounced back.

If I had a 3rd, I'd have an elcs, no contest. The known quantity would be the driving factor.

[superking]

I had an EMCS but it was fairly calm - I hadn't really gone into labour but they were concerned the baby was distressed. So there is no reason why I couldn't try for a VBAC this time.

I found my EMCS to be a positive experience. Yes I do have some curiosity about what it would be like to have a natural birth, but I don't feel like I have missed out in any way.

I am currently pregnant with DC2 and will be having an ELCS. Having found my first section fine, I see no reason to depart from what was a positive experience and try the unknown of VBAC. Yes it might be a wonderful experience, but it might not! I would rather stick with the devil I know.

I am also totally disinterested in the opinion of anyone else on the matter, from friends and relatives to health professionals (unless of course there was a medical reason why ELCS would be dangerous in my particular case - but I'm not interested in sweeping generalisations about how women should give birth).

Your decision on how to give birth will obviously be influenced by different factors than mine, but please don't let the perceived opinions of other people be one of those factors!

Good luck with whatever you decide.

[LumpySpaceCow]

OP, has anything changed regarding the tocophobia? Have you had counselling, cbt or anything? What I'm trying to get at is, what has changed for you mentally from being so phobic the first time that you had an elcs, to now considering a vbac? I think you need to really need to consider these thoughts / feelings before heading for.one or the other.
It is a very hard decision thar I have had to make. My first was was traumatic that led to PND, PTSD. My second was elcs for breech. Both times I wanted the 'all natural' home births. My elcs was a positive experience. However, after much deliberation, I am trying for a vbac, mainly because I don't have a good reason not to and that hopefully recovery may be easier with a 1 year old! If anything changes though, I won't have any qualms about having another section. I also have a very comprehensive birth plan and a doula!
Ignore what other people say and do what is right for you and your baby. My DH thinks I'm mad for not planing another section but is supporting the vbac!