VBAC or ECS....scared and unsure!!

[becksmumtobe]

I know there has been lots of threads about this and which to choose etc but I just wanted to get things off my chest and see if anyone had been through the same and what decision they made!

With my DD (now 6) I went 13 days overdue before I went into hospital to be induced. I didn't have any contractions prior to this, I didn't lose my plug, there was absolutely nothing to indicate she would come at any time. So 13 days over they sent me to be induced.

Once at the hospital they said they didn't need to give me the pessary as they could manage to break my waters which they did at 9am. I was only having mild contractions so they gave me the drip to speed things up. However, by 8pm I still wasn't having proper contractions, I was only dilated 3cm, my DD's heart rate was dropping and to top it off she was back to back and had her head on her shoulder so was not in the best position to come out naturally..so they whisked me down for an EMCS and out she came all perfect at 7lb 9!

The recovery from this was fine, after the first day I wouldn't say I was in major pain or anything. The 3 day stay in hospital was not good (wanting to be home with my DD not anything else) but I wouldn't say it was a traumatic time.

Now I'm 31 weeks with another DD and have said that I would like to try a VBAC...however I'm now having second thoughts and questioning everything.

My first labour has been noted as failure to progress and I've heard that it's harder to have a VBAC when this is true?

Also, I'm scared of a normal birth as I've never been in proper labour, never had contractions just start naturally.

I'm worried about trying for a VBAC and then it not going right and I end up with another EMCS, which I don't want (would rather it be planned than the mad rush to theatre like last time).

Also when I saw my consultant she wasn't much help really, she said that they wouldn't induce me but they wouldn't let me go over 40 weeks again, so stupid question but what happens if 40 weeks come and I haven't gone into labour?! I asked her this and she couldn't really answer me?!!

Has anyone been through anything similar or can anyone just talk some sense into me?!!

[AliceInHinterland]

Congratulations - I went through this decision recently and it was so hard! I attempted VBAC because my risk factors meant that I had roughly the same chance of success as a first time mum (I wasn't induced last time but didn't really progress). Ultimately though I had a low threshold for moving on to a CS and said that if I went past 40+6 or if my labour was longer than 24hrs then I would want to move onto a CS as less of an emergency scenario. I also asked not to have continuous monitoring which they were very anti but it was my choice. I think you can ask your consultant to write that stuff in your notes.
What helped me was having a doula as additional support.

[becksmumtobe]

Thanks for your reply Alice, so did you end up with another CS?

That's another thing I forgot to mention, they said about continuous monitoring and I really don't want to be stuck in the bed all the time like last time as I don't think it helps the situation!

[AliceInHinterland]

I had a VBAC at home (planned) so for me that helped (since they couldn't monitor me continuously!)
That was a very personal choice though, again with a very low threshold to transfer to hospital if necessary. If I had ended up in hospital though I would have wanted someone to argue against the continuous monitoring for me (hence the doula). It just didn't work for me last time and I know I wouldn't have progressed so might as well skip straight to the CS. I'm an introvert so need quiet and privacy, and I was very uncomfortable staying still and in agony when lying down. I also asked for minimal internals (just one when the midwife arrived) and not to know the result so that I wasn't fixated on a number.

[WellErrr]

Breaking your waters pre 3cm probably set you on a cascade of intervention which led to the section. Although impossible to say for sure.

There weren't any 'problems' as such. In your position (been there!) I'd try a trial of labour. You can always have a section if it goes tits up, but you may as well try if you want to.

[WellErrr]

You can decline continuous monitoring if you want, or you can use telemetric waterproof monitoring, where you can still walk around and have a water birth.
Most hospitals have it but they tend not to tell you for some reason.

Get a meeting with your hospitals Supervisor of Midwives to talk it through. I was approved for a water VBAC (didn't happen for other reasons) but you don't have to accept lying on your back strapped to a monitor!

[becksmumtobe]

Oh that's good that it worked out for you Alice. I like the idea of a home birth but I also like the clinicalness of hospitals if you know what I mean!!

I wonder if that was the problem then WellErr..I'll never know but I just don't think she was ready for coming out at all!

I really don't want to be continuously monitored though I'm not very confident and can be easily swayed by professionals telling me its the right thing to do! I think I may have to gear my DP up to make sure I don't get railroaded into things!

I suppose I do deep down want to try a natural birth, I'm just worried if it goes wrong again. If I do try and it doesn't go as planned with not progressing again, do you know if the CS is as rushed as a EMCS or is it more in between planned and emergency? It just seemed last time it was literally 2 minutes from them saying I needed to have one to being whisked down while my DP was out making a phone call and didn't even know I'd gone to be prepped.

[AliceInHinterland]

I think that's a question worth asking your consultant.
Regarding being railroaded, I am normally fairly confident but during labour I just could not advocate for myself at all (funny that) so I really wanted someone there who could do it for me. I don't think my partner had the confidence to go against medical professionals, he was amazing in other ways and I wanted him with me, not arguing with the doctors. If I hadn't had a doula I would have wanted a really good friend there, it does apparently statistically increase your chances of a VB to have a third person there.

[WellErrr]

With my second (the planned vbac) I ended up having to be induced. After 2 days nothing was happening, so on the 2nd evening they said I would need a section of no progression by the next day, and provisionally booked me in for one. So I had a night to get used to the idea and it wasn't rushed at all.

[laughingGnomette]

becksmumtobe - I'm in a similar boat to you. Failure to progress past 3cm, ending up with an EMCS due to distressed, stuck baby. The only difference is that my waters broke spontaneously and I was contracting...but not progressing at all.
I'm keen to attempt a VBAC but I don't feel like an ELCS would be terrible.
Hospital policies do vary so I'd try and get as much info from them as possible. WellErrr's suggestion to have a meeting with the supervisor of midwives is great. My hospital do VBAC clinics each month lead by a consultant midwife which were a great source of information and reassurance. Ask your hospital if they offer anything similar. I was told that there wouldn't be continuous monitoring and a water birth (on the labour ward) would be possible. There would need to be a high level of monitoring though as they'd need to be able to tell if you are at a risk of rupture so labour ward rather than midwife-lead. Another important point they made is that if I wasn't happy with the way things were going then I could then elect to have a c-section at any time.
That said, I am fully aware that the statistics are not great for ladies with failure to progress in subsequent vbac attempts.

I'm currently 39+3. I've decided to go for an ELCS booked in for 40+2 weeks but if I go into labour before then I'll attempt a VBAC. They were willing to let me go further past my due date but my baby is measuring on the large side and I really don't have the confidence to attempt to push a 10lb baby out! :)

Good luck with your decision, it is a really tough position to be in. I''ll let you know how I get on next week! Eek!

[AnnaT45]

I think it's all so dependent on you and your consultant and hospital. I was similar to you but was induced 11 days over due date with pessary, then drip, then waters broken. Was only 5 cm after 30 hours and got an infection and poorly baby too.
My consultant advised not to go over it be induced again. It will only be just 19 months since my last c section. We've agreed I'll have c section at 40+1. If I go into labour before I have to go straight to hospital and if I'm not dilating quickly after 4 hours I'll have a section. I'm happy with that to be honest. I don't have an overwhelming urge to have it naturally and just need to avoid how awful I felt afterwards last time. I'm dreading the recovery though with a toddler but it's only a few weeks and DH will be around.
I think you just have to go with your gut and then advice you get.

[Wheredidsummergo112]

It sounds like the idea of an unsuccessful VBAC turning into an EMCS is the only thing that's putting you off VBAC. If that's the case it might help you to think a bit more about that scenario. At what point would you be willing to move the EMCS? Would EMCS really be that bad so long as you felt you were being involved in the decision and you and baby were being kept safe throughout the birth? EMCS only needs to be a rushed decision and rushed procedure if there is a danger to you or baby. In most cases they should be able to talk things through with you. You could put details in your birth plan about things you would like if there was a need for EMCS. You could talk this through with your midwife. On the other hand if you really can't get used to the idea of EMCS and it really would feel like the worst thing in the world no matter how it was done, then I think you will be better going for EMCS. The first few weeks are a very emotional time so if you think an EMCS will be hard for you emotionally maybe it's best not to take the risk.

In terms of going overdue. They can't force you to have a CS at 40 weeks. You always have a choice. I would ask them what the risk is that they are trying to mitigate. Most trusts don't induce until 41 or 42 weeks so what's rush for you? There are ways that they can induce for vbac but some increase the risk of uterine rupture so I would take your Drs advice on this.

[Doje]

Similar 1st experience to you, only 3 pessaries, and post waters being broken and drip I got to 1cm...

With DS2 I said I'll go to 42 weeks, and won't be induced. If nothing happened by then, I'd go straight for a section.

At 41 wks and no sign of baby (his head wasn't even engaged) I said 'gimme a section' and I was booked in within about 4/5 days.

It was a massive relief to be honest. I'd got so fed up of being pregnant, waddling after DS1 (19mo), not being able to sleep, walk, etc and I just wanted the baby out.

C-Section was calm (as was the first one) and I knew I had plenty of help whilst I recovered. DH was around for 2 weeks. After that I could pick up DS1 to get him into the cot, and my in laws were around to take him out whilst I had some time with the baby. They stayed 2 weeks, which was great, but didn't 'need' them for that long IFSWIM.

[Frazzled2207]

A friend was in a similar situation, wanting a VBAC she went into labour naturally but failed to progress so had an EMCS but it was not at all panicky and she's pleased she gave the vbac a shot.

[becksmumtobe]

Thank you all for your replies, its really appreciated

I do think after reading all your stories etc it has made me realise that I do really want a VBAC, I am just scared of the EMCS but have no idea why! Like I said last time wasn't particularly traumatic.

I think I will have a good chat with my midwife next time I see her and maybe put a few ideas in place like a few of you seem to have done, will help me feel more prepared then I think.

Thank you all for your replies, it's really helped put some perspective on things

[CottonSock]

I'm 39 weeks tomorrow. Last time I had a failed induction and emcs. I've opted for elcs at 41 weeks no signs. Baby still very high and not position and is large for dates , but I guess she has two weeks to move. My consultant was supportive of this, but did push me towards a vbac. I'm little and dh is large, I'm pretty convinced it will be A C section, but giving it a chance to happen naturally

[AliceInHinterland]

I know it's not for everyone but I used a couple of hypnotherapy CDs to prepare me for VBAC, one by natal hypnotherapy (Amazon) which emphasises that every birth is different, and an induction track for the last week or two here
I thought that even if it didn't work, the relaxation would help. Good luck, remember that you have pretty much the same chance of VB as a first time mum, so you are going in there with a fresh start.
Cotton I'm also little and DP large and my babies were both under 8lb - I heard that the mother largely restricts the size in utero.

[AliceInHinterland]

But of course you've done this once already so you know the kind of babies you grow!

[CottonSock]

I grow babies with big heads :) a family trait on both sides

[AliceInHinterland]

Oh really! People I know with the biggest babies have had some of the most straightforward births - I heard they 'help themselves' a bit more. I hope it all goes well for you either way.