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Childbirth

VBAC vs Elective C-Section - Totally confused & FED UP

16 replies

MrsMattie · 04/09/2008 16:44

Apologies in advance, as this is bound to be a long one.
I am feeling so utterly confused and pissed off with it all today and could dearly do with the advice and support of some wise MN-ers.

First birth was 3.5 years ago. Straightforward pregnancy with the exception of late-onset but quite severe SPD. Pushy midwives gave me two sweeps early on (one on my due date and one at 40+5), then super-pushy hospital doctor insisted on me coming in for induction at 41+3 (which turned into 41+5 because of lack of beds!). 4 doses of prostin pessaries and 4 days of me languishing on my back, hooked up for continuous foetal monitoring, had no effect (perhaps unsurprisingly?). Horrible, bullying doctors told me I 'had' to have a c-section at 42+2 and I did (I know now I didn't 'have' to do anything). Straightforward delivery, big and beautifully healthy baby (10 lbs 2 oz) born. My whole experience in London NHS hospital hideous. Very poor ante-natal and post-natal care, some of which was dangerously negligent. Struggled quite badly after the birth, slow recovery in some respects, never got on well with BF-ing, and suffered with full blown PND for a while.

Fast forward to now. I'm 28 weeks pregnant with no.2.
As soon as I found out I was pregnant I did a bit of research into hospitals (couldn't face going back to same one) and VBAC. Chose another big London NHS hospital, but one which I had been led to believe was supportive of VBAC. Had my heart set on VBAC from the start - mainly because of slow recovery after section, and because I felt there was no real reason for me not to attempt it.
At my booking in appoitnemnt I had a long chat with a fantastic, supportive midwife who helped me to 'debrief' my last birth, was supportive of the whole VBAC thing and reassured me that I would be able to stay mobile during this birth in order to give me the best chance of labouring naturally, and that if I went overdue again this time they wouldn't push me into coming in too soon and that it would be 'up to me' to decide, on the basis of all the information available, when would be the right time to go for a section if nothing was happening (as they don't induce with VBACs). I've been feeling pretty positive about the whole thing since then. Of course, this being London and the NHS, I haven't seen the same midwife or doctor twice, but all of those I have seen have seemed pretty supportive of VBAC and I have been trundling along through this pregnancy feeling Ok about it.

Then yesterday. Had an appointment with a doctor at the hospital to discuss the birth (their idea, not mine). I prepapared by doing lots of research into VBAC, and also had some questions for the doctor, who turned out to be a very young looking guy (very nice young man, but slightly off putting, him being a man and so young). Anyway...first of all I was told I would 'have to have continuous foetal monitoring' and that 'if he was honest, there wouldn't be much of a chance for me to be mobile'. I pressed him what 'have to' meant, and he said it was hospital policy and that 'a few women are adamant they won't have it, but they are ignoring the risks in my opinion, and would have to sign waiver forms to say they understand that risk'. OK. Pushed him on the fact that correlation between CFM and better outcomes not established. He pretty much admitted it, but said 'If we didn't do CFM on VBAC-ers, most would be fine and a small percentage would die/their babies would die. An that percentage would be greater than women who hadn't had previous c-sections. So there is a risk'. Right Great start. Made to feel really jumpy at the first hurdle. He also pretty much agreed that without being mobile, I had less of a chance of a successful VBAC, but that weighing up the risks, CFm was the much more sensible option. So...moved on to talking about other stuff that might make the birth more likely to happen straightforwardly. can I use water? 'NO'. What, not even a bath? 'Not once you are hooked up to the CFM, NO.' Great. So what will happen if I go overdue? 'You will need to have a sweep or two from 40 weeks + and we would bring you in for a section at 41 weeks.' I would need to? (When pushed) 'Ok, it would be up to you, but we would strongly reccommend it'. OK. He then went on to say my chances were 'about 50/50' maybe slightly less because I had never laboured at all in my first pregnancy. He then smiled patronisingly at me and said 'Look, it;s worth a shot, eh?'

So - that is the support I am going to get with a VBAC.

I am just so hacked off. On the way home I thought, 'OK, so I could go and get a doula or independent midwife at vast expense, then argue my points again at my 34 week appointment and then have to argue them constantly (probably) during the birth with a load of unsupportive, constantly changing shift staff.' But have I got the fight left in me to do this? To have to fight for a shot at letting my body do what it's supposed to do, and to have to put up with the constant scare mongering and conflicting information manipulated by hospital staff to suit their own agendas? Arghhhhhh. I am just so tired of it already and I haven't had a single contraction.

Started to think maybe I should just go for a section. It would cut out all the mental stress (and distress), although dreading the physical recovery afterwards and feel sad that nobody except me is even vaguely positive about VBAC in reality.

Sorry to rant on and on. can anybody help me clarify things in my mind? Does anyone else know what I'm going through? I know it's not a huge drama or anything, but to me it is all consuming at the moment.

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LackaDAISYcal · 04/09/2008 16:53

MrsMattie, I'm in exactly the same place as you are at the minute, and I'd just like to say, that it is a huge drama and you're allowed to feel this way

this thread is great; lots of advice and support, including links to the NICE guidelines and the Royal College of Obs and Gynae green top guide on VBAC. There are also links to some good reading material as well.

At the end of the day, they cannot make you do anything; even the CS at 41 weeks (I have been given the same advice btw). You need to find out whether the consultant in charge of you is pro or anti or ambivalent to VBAC and actually meet with him/her to discuss options. And you are perfectly entitled to change consultant to one who is supportive.

I've also had the CFM chat from my registrar, but I'm arming myself for that argument at my 36 week appointment.

I have gone down the doula route and think it will be £500 well spent for getting the birth that I want, or, if I do end up having a section for whatever reason, that she is there to interpret the medical jargon and help us make the best decision given the circumstances.

Good Luck