Anxious about second birth

[archersfan22]

I'm 21 weeks and starting to worry about the birth - I wasn't at all worried the first time, but ended up with a number of issues and I have to go back to the same hospital (rural area, no choice). I also have to choose VBAC vs ELCS which is another source of stress.
Some background:
-Family a long way away, very willing to help but not at short notice.
-EMCS (Cat 1) with first due to fetal distress during attempted forceps delivery, no factors as far as I know which would make it more likely to happen again.

Some specific factors from last time that I think are making me anxious about this one:

• There was concern about fetal distress as soon as I arrived, which meant they needed to monitor closely (I have no problem with this decision). However to enable them to monitor I had to lie on my back and keep as still as possible - if I moved at all the monitors kept coming off and they couldn't monitor the baby. Not really the ideal scenario for labour! I ended up having an epidural so I could keep still enough - although when the anaesthetist came to do it he said I wasn't using the gas and air properly so they obviously hadn't shown me properly. They will presumably want to monitor closely again this time due to the previous Caesarean so I am concerned that I will be stuck motionless on my back again.
  

• The postnatal ward was a really stressful experience: apart from general noise levels etc which meant I slept for about an hour out of the 36 I was there, some specific issues:
  
• Baby arrived about midnight so husband was sent away asap until 11am the next morning.
  

- I was made to feel like a nuisance for asking for soluble paracetamol (solid paracetamol makes me throw up although I'm fine with other tablets). I saw afterwards they'd put in my notes 'pain relief declined'...!!

• Breastfeeding was promoted but actual support seemed to be non-existent: nobody came to help with it, baby's latch appeared fine but nobody checked he was actually sucking properly - turned out later that he wasn't (probably a posterior tongue tie I think), but I didn't realise as a first time mum. They kept wanting to check his glucose levels pre- and post-feed but he was just grazing off and on. I had to try to predict when I was going to feed him so I could give them some notice to come and do his bloods before I fed him. His glucose levels kept being borderline, which with hindsight was a sign that feeding wasn't going well, but nobody gave me any advice to improve his milk intake. At the time I was just desperate to get out of there, and didn't realise there was a problem so thought the glucose levels were just them being overcautious.
  

Hopefully I won't have the same feeding issues this time - I ended up feeding my first for almost a year so will hopefully know what I'm doing a bit more, and milk should come in quicker etc.
Also husband will probably be looking after toddler so I'll be on my own anyway.

But does anyone have any thoughts on the monitoring issue which was a problem last time - how closely do they need to monitor if I attempt a VBAC? I'm wondering whether to just ask for an epidural at the beginning to a) avoid a GA if I need another EMCS and b) so that the lying still on my back bit isn't an issue. Baby's safety comes first and I haven't fully decided on VBAC yet but I want to make sure I've considered all the options.
Any thoughts welcome!

[archersfan22]

Ps ooops sorry didn't realise I'd written such an essay!

[EdgarAllenPoe]

Similar situation here. I'm 9 weeks with my second. 1st came by emcs after 3 days of waters gone, 22 hours of induction and only 3cm dilated. Not what I'd hoped for. We never managed to establish breastfeeding at all, even though the staff were actually quite helpful. Macrosomia was deemed to be the main cause (10lb baby).

I'm requesting a csection this time. I found continual monitoring very difficult to handle (but think it's necessary). I'm not a particularly good candidate for a vbac. It will be much easier to cope with cs recovery if I can plan for one and I will have a 22 month old to take into account.

That's just me, you have to do your own research.

I've had people say, 'aren't you disappointed not to even try for a natural birth?' I don't associate having a cs as some kind of failure on my part any more than I'd think wearing glasses is a sign of weakness. So no, I'm not disappointed. Relieved that it's an option more than anything!

[archersfan22]

Thank you for sharing your experience: sounds like you had a more difficult time than me the first time (and fresher in your memory too - my son is 3...) I would have no issues in principle with going for another Caesarean and totally agree about ELCS being much easier to plan for, esp as all family are far away. I will definitely be choosing ELCS if there are the slightest signs as pregnancy progresses of anything that would make VBAC more complex - eg if it's breech or seems to be big, or if I'm overdue and need to be induced anyway. However with my first I ended up fully dilated and he was on the small side for dates so as far as I can see I am a good candidate for VBAC, it's just whether I want to put myself through it for the chance of a quicker recovery afterwards. I really don't want to spend the next 19 weeks worrying about it but I'm a bit of a natural worrier!

[DirtyDancing]

A couple of thoughts for you OP.

I too had a difficult first birth, different to yours in someways but essentially had a v v long labour, ended up induced, epidural, immobile on my back and continuous monitoring, so some similarities.

First piece of advice is, get your midwife to request your notes ASAP (it can take a few weeks to get them) and request a meeting with her to go through and discuss. Then go away write your birth plan, and then discuss with your midwife. I have done this and it's been very helpful, almost therapeutic.

Then, take control of the things you can. So it took me 3 hours to get a paracetamol on the ward post birth. So I am taking my own this time! I also have ear plugs, although admittedly for pre not post as I want to hear my baby when they wake. Can you afford to request your own room after? Not guaranteed but would be more peaceful.

My husband was allowed to stay after all night and all day so I can only sympathise about this, I think it's terrible partners are made to leave straight after

[archersfan22]

Thank you, some sensible suggestions there :) I'm not sure how much the midwife will be willing to discuss with me until I've seen the consultant (wouldn't the consultant need the notes too?) but I will ask her - I think it would be much easier to talk to her than the consultant, who I saw last time for unrelated reasons and wasn't the easiest to talk to.
I did have earplugs last time but I'm a really light sleeper and even with earplugs I couldn't sleep - my neighbour was snoring while her baby screamed, plus the call buzzers were ringing all day and night (they were set up so once pressed they buzzed until a staff member came - I can understand the reasoning behind that but I'm sure there must be a better system!)
I have wondered about a private room - I will ask the midwife whether that's an option at this particular hospital.
I will take my own soluble paracetamol though!

[DirtyDancing]

It's so incredibly noisy on the post natal ward!! The downside of partners being allowed to stay is the additional noise. Woke husbands were snoring really loudly! Everyone on their phones at all hours and I agree the buzzers are so annoying.

My main worry is that I can't be away from home for 5 days again this time, as I will not be away from my DS for that long. The closer I get the more induction worries me.. it took 2 days of waiting in hospital for them to do it last time, plus the induction time and 2 days after. I am literally going to refuse (some how!) to be in for that long this time.

[Ladypug]

Following (as to anxious to even get pregnant but discussing it!)

[archersfan22]

I was out within 48 hours and still really struggled with the postnatal ward so I'm very glad I didn't have to stay 5 days!

[Rockandrollwithit]

I feel the same way OP, I had a traumatic forceps delivery resulting in a 3 litre haemorrhage after having DS almost three years ago. There were various complications that took almost a year to recover from.

I'm only 18 weeks but definitely anxious!

[Pineapple80]

Hi OP, I'm in a similar (but also quite different) situation as you.

I'm 32 wks with my second baby. I was induced with my DS as he had suspected IUGR - on the smaller side and they wanted him out by 38.5wks to be on the safe side. The induction didn't really progress, was 3cm after 6-7 hrs and after breaking waters he became distressed. So I did not even labour and he was born via emcs safely. I recovered absolutely fine and the experience was actually alright.

It's been 4 years and here I am at 32 wks wh my next DC. I decided on attempting VBAC quite early on but was in two minds for a long time. My hospital is really supportive and I am able to change my mind and opt for elcs up until 36wks if I change my mind. I was very anxious about the whole thing but have recently become comfortable with the idea and have been trying to research and prepare for this vbac as much as possible. I think the unknown of labour was putting me off and not knowing what to expect. I will accept that it may end up in another section but will be in the best place for both our safety etc. my hospital has wireless monitoring so hoping to still remain active during labor if possible.

Good luck with everything, I understand how stressful the decision can be. I hope you have a better experience this time around and would recommend as others have suggested to maybe bring along your own paracetamol if allowed and ask as many questions during your appointments coming up to ensure you don't go through similar stresses this time round .

[BurningGubbins]

I was in the same sort of position as you OP. Had an EMCS with number 1 as the induction went tips up. Took a long time to even think about having another as it was so dreadful.
The hospital really pushed me for a VBAC but I really wanted to feel in control of what would be happening and when, so decided at my final appointment (39+2) that I wanted an ELCS, which I had 2 days later. It was definitely the right decision for me/us.

[BurningGubbins]

• tits up, obviously.
  The prospect of continuous monitoring, not being able to move around etc really put me off as I was certain, rightly or wrongly, that I'd end up with some sort of intervention, so preferred to do that on my own terms.

[archersfan22]

It's good to hear from other people in the same position :)
I think I may ask about VBAC with epidural because actually last time it was quite nice and peaceful once I'd had the epidural (until the fetal distress and EMCS bit....) and if I'm going to be stuck on my back anyway, I might as well be comfortable!

I do find it weird that they advise not to sleep on your back or lie on your back for yoga etc because of the weight of the uterus compressing the circulation, and yet for scans and treatment during labour they lie you on your back. I wonder whether either the advice about not lying on your back is overcautious or doctors are just used to treating people lying on their back and so feel more comfortable with that.

Last time the stay in the postnatal ward was actually more stressful than the delivery, even though the delivery was not exactly straightforward, so I think I am partly trying to work out whether ELCS or VBAC will get me out of the place quickest, which of course is not predictable because it depends on how the VBAC goes.