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VBAC how long do they let you labour in total?

(28 Posts)
Crumbsinthecarpet Fri 01-May-20 20:09:34

I'm going for a VBAC in September, or hoping to anyway! Also hoping to do hypnobirthing so please no horror stories if possible, want to keep my positive mindset, positive birth stories very welcome! smile

Anyway, I had my appointment with birth consultant and they mentioned that you should go into the hospital as soon as you're having contractions regularly even if they are ten minutes apart! Also mentioned that they won't let you labour much more than 24 hours or push for more than 1, does this mean I have to do my entire labour in hospital or can I have the beginning at home? I had a 52 hour labour (from first contraction which was mild) to c section with my son so 24 hours wouldn't get me far!!

I'm hoping they count 24 hours from when you start properly surging like 3 in 10? Help! smile

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FirstTimeBumps Sat 02-May-20 09:16:22

I'd be interest to know too. 32 hours from waters going and early labour starting to my section but baby was breech so I'm.hoping that's why he wasn't coming out, convinced his head was wedged under my ribs and he never descended.

Maryam18 Sat 02-May-20 10:13:06

I'd be interested to know this too. Currently 29 weeks pregnant with 2nd baby and thought I wanted vbac up until now. I'm worried about going through a long labour again only for it to end in another c section.

Crumbsinthecarpet Sat 02-May-20 11:34:39

Yes I'm nervous about the prospect of it but trying to be positive, I'm fairly sure I stopped progressing once I'd had my epidural as I was lying on my back and was so tired, and that I was slow in progressing in the first place because I was so panicked! VBAC is hard because you've got the best and worst situation that can come from it, safety wise as well, elective c section is less risky than emergency c section after failing to progress, but 75% chance of being able to have a vaginal birth even if it is assisted! The stats on brain damage to baby scare the bejesus out of me but I know that it's not much higher than the chances are from a first time natural birth, and chances are very low anyway. My head knows that overall the risk is worth it due to most likely outcome being healthy baby plus easier recovery for me, but keep having a little wobble over it being the right decision or not

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ludicrouslemons Sun 03-May-20 20:39:45

I think the 24 hours is from you being in established labour, which I think is 4cm dilated and 3 contractions in ten... anyway from when it gets full on rather than the doing crosswords between contractions phase of things.

I had a vbac, it was a very positive experience. I worried about the limitations they impose but then realised I didn't want a bloody long labour anyway!

In my birth plan I wrote that I didn't want to be told about how long I was allowed this or that, how dilated I was etc. I'd rather not be clock watching.

Good luck!

ludicrouslemons Sun 03-May-20 20:42:34

Btw I had long labour first time then emcs, second birth about 8 hours of slow and steady then three hours from when I got to hospital to birth. So it does happen.

Selfsettling3 Sun 03-May-20 20:45:54

I was told is was fine to stay at home until 2 in ten minutes with high risk vbac.

Remember there is no allowed. They can recommend a course of action and you can choose to consent or not, medical staff obviously get to choose which medical procedures they offer you.

Spoons1987 Sun 03-May-20 20:59:20

@Crumbsinthecarpet what was the reason for your first LSCS and how many centimetres did you get to?

It often makes a difference to future labours. For example, If you laboured to full dilatation last time and had the LSCS because of fetal distress then it’s likely your body will be much quicker getting to full dilatation this time. However, if you never progressed beyond 2cm and the LSCS was because of lack of progress then it’s more likely to be a long labour again, as your body is technically doing all the dilatation for the first time.

And time limits are very loose ‘guidelines’. The whole clinical picture at the time would be taken into account so try not to get bogged down thinking about times. I think the main messages are that increased and earlier monitoring would be recommended because of the small risk of scar rupture and it also probably wouldn’t be recommended to have a very long, slogging labour.

Crumbsinthecarpet Sun 03-May-20 21:20:55

@ludicrouslemons thank you so so much for telling me that, just what I needed to hear! And glad that it's not 24 hours start to finish as I don't know if I'd make the cut haha! Think that's a good idea not having updates on dilation, I was thinking about not having internal examinations unless strictly necessary as they were unpleasant last time and quite traumatic.

@Selfsettling3 yes keep trying to remind myself that, hypnobirthing of using BRAIN (benefits risks alternatives instinct nothing I think?) Hard to get used to not just saying yes to whatever doctors say!!

@spoons1987 got to 3cm and had epidural and then never went any further, I think due to labouring on my back and it being not an enjoyable experience at all so not having any oxytocin going round at all! Yes I'm happy to have the increased monitoring definitely as I think I would be more relaxed knowing that if a scar rupture was imminent they would be more likely to know

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FirstTimeBumps Sun 03-May-20 21:30:18

What you've said about being on your back an.no oxytocin is what's worrying me. Concerned being on the delivery suite rather than in MLU I'll be pressured into interventions and ending up in this position and then nothing happening and ending up with another EMCS. I'm still undecided if I'm going to go VBAC or not

Mummyme87 Sun 03-May-20 21:32:10

There is no limit as long as all remains normal.
I was induced with propess and had synto drip in second stage for my VBAC. Every trust does its own thing. However, going into hospital with first contractions is a bit crazy. We know early admission to hospital results in more intervention. I normally advise women wait until 3:10 still as long as no bleeding, no pain in between contractions, baby moving and feeling well

busface999 Sun 03-May-20 21:36:26

I came on to say what has already been said, they don't get to decide what is 'allowed'.. your body, your baby, your choice. There is no set limit at which they can wheel you off for a c section if it's not what you want. They need your consent.

I appreciate that is easier said than done!! I wish you all the best. I hope for a VBAC next time too (first baby was planned c section due to breech presentation)

Spoons1987 Sun 03-May-20 21:41:58

Yes, oxytocin will make all the difference. Women have successful VBACs all the time and you’ve definitely got the right mindset. Wishing you all the luck and positive thinking!

Incrediblytired Sun 03-May-20 21:43:38

I don’t know how long but my friend had a really successful VBAC and she said hypnobirthing made all the difference!!!! Go for it!

barneymcgroo Sun 03-May-20 21:53:01

Hoping for VBAC in a few weeks time.

The NICE guidelines are worth a read -
https://www.nice.org.uk/guidance/ng121/chapter/Recommendations#previous-caesarean-section

I was in for a chat with the doctor the other day. They said they like to have a cannula in your hand automatically, and continuous CTG, both of which are no longer recommended by NICE.

Also AIMS booklet - https://www.aims.org.uk/shop/item/birth-after-caesarean

Really useful - I'm only half way through at the moment.

They can't stop you doing anything. They can recommend, and offer you options. It's up to you to decide. There's lots of chat about you being 'allowed' to do anything - if your labour is progressing normally, and is just slow, that's perhaps just how your body does it.

I'm worried I'll be bullied into induction, as nobody in my family has ever had a baby on time. Keen to wait it out.

Good luck, whatever happens.

Bollockingfuck Sun 03-May-20 22:07:02

I had a home water birth after a no-labour emergency section.

If your waters haven’t gone and contractions are spaced out you’re probably better not going in too soon.

I think the time restrictions are more to do with possibility of infection when waters have gone but they are guidelines and you can advocate for waiting longer if you accept antibiotics and monitoring.

If you have any specific questions please ask.

Bollockingfuck Sun 03-May-20 22:14:23

Just read whole thread properly and wanted to add I also did hypnobirthing course (for the first one that I didn’t get to use but brushed up for second!)

I used tens machine and breathing at home before getting in the pool and that was all the pain relief I had.

The whole reason I went for a homebirth was to avoid cascade of intervention - scar rupture is very low risk dependent on how close pregnancies are.

Have you thought about a HB?

Crumbsinthecarpet Sun 03-May-20 22:21:25

@FirstTimeBumps me too, however I had an appointment with a birth consultant who said even if you do go into labour ward rather than birth centre, they can make it relaxing with dimming lights, room sprays, electric candles, music, so hopefully the setting shouldn't have too much negative impact, and you can still use birthing balls and pools etc, you're just close to theatre if it needs be!

@Mummyme87 yes I agree and of course want to be in hospital minimum time possible!!

@busface999 thank you ❤️❤️❤️

@Spoons1987 thank you fingers crossed!! Come of cervix you can do it! 😂

@Incrediblytired I've only heard good things about hypnobirthing, it makes so much sense! I'm hoping it ends up as a positive experience this time!

@barneymcgroo best of luck! Thank you I will read those! They mentioned canula and continuous ctg to me too, I'm ok with monitoring but the cannula maybe not so much, last time I had 3! 1 went in painlessly but others were super painful and annoying!! I also do not want induction, or augmentation if possible, luckily went into labour spontaneously at 39+3 last time, hopefully similar this time! Hope you have a lovely birth ❤️

@bollockingfuck I'd love a home birth! The hospital I'm going to said straight up no to a home birth for me sad interesting to know that it's to do with infection too! Definitely need to be armed with all the knowledge possible!!

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FirstTimeBumps Sun 03-May-20 22:26:51

@crumbsinthecarpet I think the pool is dependent on continuous fetal monitoring. I'm going to ask if they have the wireless units that can be used in the pool but even then it's going to dependent on the one pool being available compared to the several in the MLU 😔

Crumbsinthecarpet Sun 03-May-20 22:50:49

@firsttimebumps yes I assumed that too, I think there's 2 at my hozzy, but as you say whether they have 2 wireless monitors available is another story! She did say that they can listen in periodically with the Doppler with few interruptions to you in the pool so that's an option

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FirstTimeBumps Sun 03-May-20 22:58:08

@crumbsinthecarpet yeah I've heard that an option so going to speak to MW about it at next appt. I know they're not keen on it though and it's a bit of a push to get your way and I worry that going against medical advice would make me anxious and not relax and then there's the whole oxytocin thing all over again. Can't win 🤣

Mummyme87 Mon 04-May-20 07:28:36

You can request to have a consultation with a consultant midwife or whatever they have in your trust if there are things ‘outside of guidelines’ which you would like to discuss, such as monitoring, cannula, using MLU/homebirth. Many many women have these discussions and create plans, the straight up no is according to the policy which is fairly stringent and the same across the board but not necessarily completely up to date with current evidence.
And I say this as a midwife.

Mumdiva99 Mon 04-May-20 07:38:57

Hi. I had ecs with baby 1. Labour was so long and drawn out.

With baby 2....it was different right from the start. Once I knew I was in labour and contractions were regular enough to want to go to hospital. We tried to get grandparents to get son. Their phone was off so they didn't wake. So we took a little while faffing. Then I realised we needed to go.

My husband dropped me at A&E door - that was the way into maternity. I felt baby drop down and wanted to push. Was rushed onto a trolley (all very dramatic). Hisband parked and came to find me (still with son)....I asked him to take son to grandparents. I was taken to labour ward. Had a wonderful midwife. We all calmed down. I started to push . Baby came. Then husband came back. Lol.

No time.for my fears to come into play. I was worried about the continuous monitoring as I find the belt painful. Etc etc.

Baby 3 was also reasonably easy. Although when I got to hospital they made.me lie on my back when I was happy standing. On reflection I should have stayed upright as a much more natural feeling for me.

ludicrouslemons Mon 04-May-20 08:15:56

If it's useful, here's a bit more detail - I got OBSESSED with VBAC before DC2 and had arguments debates with the consultants etc.

I wanted monitoring on arrival only then periodical monitoring rather than continuous monitoring, unless there was a clinical need. I was worried they wouldn't have mobile monitors and I'd get stuck on my back in bed, have an epidural etc.

I also look lots of things to make it smell nice and look nice in the delivery suite room. I wanted a water birth if possible. Did the online hypnobirthing course and used the Freya app, clary sage, etc.

When it came to it, I was only 3cm when I got to hospital, which was disappointing as I'd left it as late as I could and was sure things were well on the way (DH having to take a detour over bumpy roads on the way to the hospital didn't help!)

As I was not very dilated, they left us to get on with it. After 20 mins or so my waters popped (all over the floor) then I rapidly went into transition (by which I mean lost my shit and started acting like a stroppy toddler). Couldn't have cared less that I was in a delivery room rather than MLU, sights and sounds etc.

The monitoring belt didn't bother me so I kept it on. Ended up giving birth on my back on the bed and having an episiotomy, but I didn't mind as the whole thing was ferocious, I just wanted to get the baby out.

The whole thing was with a midwife and student midwife (and DH), I think delivery suites are still staffed by midwives unless you need a consultant to be involved.

No regrets about any of it. I think the shock of birth (by any method) first time is something you don't experience again, I found everything much easier second time. I'm pretty sure that would have been the case if I'd needed another EMCS.

Crumbsinthecarpet Thu 07-May-20 19:41:13

@Mummyme87 I will ask my midwife about that, that would be great! Bit weird at the moment with all appointments being over the phone!

@Mumdiva99 @ludicrouslemons love both stories, hopeful of getting one of my own like this 😂 glad to know long first labour doesn't necessarily mean long second one

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