VBAC vs elective cs - how much such practical issues influence your choice?

[ceebee74]

I am 30 weeks pg and will have to decide in 6 weeks whether to attempt a VBAC or have an elective c-section.

I am really struggling to make my mind up but am definitely veering towards an elective cs - but the main reasons for this are practical reasons, such as it would make childcare for DS so much easier if we have a planned date (we don't really have any local family who would be suitable to call on at really short notice). Also, DH works away a lot so if we have a planned date, he can inform his boss and ensure he is not going to be down the other end of the country, or even worse, out of the country.

I did suffer with my first birth - was in labour for 24 hours and DS was 'back to back' so the pain in my back was excruciating so I am also a little scared (even though the sensible part of me knows that is unlikely to be the case again).

I also realise that the practicalities after a cs of having to stay in hospital not being able to pick DS up, drive etc also need to factor.

I am confused - any help would be greatly appreciated?

[MrsMattie]

Not much help, as I am feeling really confused, too. But at least we can share in our confusion!

Also 30 weeks pregnant with no.2.
I had a failed induction after going overdue last time around and ended up with a c-section. I was all for a VBAC until a few weeks ago, when I started to realise that the reality might not be the lovely, natural, holistic experience I was dreaming about. Hospital not that supportive. Got really bad SPD and huge, horrible bartholin's cyst (don't know if you know what that is? It's a big nasty cyst on the lubrication duct just inside the vagina...soooo tmi!), plus looks like I'm having another whopper (last baby was 10 lb) and I'm frightened of it all ending up in a hideous, painful, medicalised birth with instruments and tears and all sorts of dramas. On the other hand,I dread the slow recovery time after a c-section (was slow for me last time, anyhow) and generally hate the idea of more surgery.

I dunno..

[Ellbell]

OK... well, I've had an elective cs and a VBAC, so here are some pros and cons (but quite subjective, obviously)

PRO-CS

• You know the date in advance and can plan
• No risk of long/difficult labour ending in another CS anyway
• Elective CS less likely to lead to complications than emergency CS
• Takes all the uncertainty out of the process

PRO-VBAC

• CS is major abdominal surgery and not without risks
• Shorter hospital stay (was in and out with my VBAC in under 12 hours!)
• More able to care for other dcs afterwards without help (may be an issue if dh working away/no family nearby)
• Able to drive straight away (ditto)
• May increase chances of successful breastfeeding (elective cs doesn't release hormones as effectively or something... [not-v-well-informed emoticon])

Both my births were great. My elective cs was for placenta praevia, so no choice in the matter. It was calm and peaceful and felt very 'celebratory' (iykwim - not panicked!). DD was very small (4lb 12oz) and didn't feed, but that was more to do with my medical problems than with the cs itself. I recovered well and wasn't in inordinate pain, but was definitely wobby for a month or so.

My VBAC was also fantastic. I had a very pro-VBAC consultant, though, who agreed to no continuous monitoring and that definitely helped. If I'd have been strapped to a bed throughout, I think I might have preferred the CS. As mentioned above, I was out of hospital in under 12 hours and was able to put dd1 to bed that night as normal. I had help at home for a few days, but was looking after both dds (dd1 was 22 months when dd2 born) at home alone within 5 days. I don't think I could have done that after my cs.

Good luck.

[VictorianSqualor]

I wanted a VBA2C for my last child, but ended up having another CS partly due to practicality issues.

I had one planned for 40weeks and was aware that up until the date it was planned for I wouldn't have too much of a problem with chidlcare etc, after that time we weren't sure. At 40weeks I pushed it back to 41wweks at which time I sat in hodpital crying only to be told my DP that if I really wanted the VBAC he would support me in not having the CS but by then so much had been arranged and practicality was a big reason I didn't leave the hospital and go home. How about booking a CS for a certain date and seeing how it goes?
One lady on my thread went into labour the night before her planned CS lol.

[lulumama]

hello you ! ask around at DSs nursery for staff who would be willing to help out.. ask friends if they are willing to help, most are more than delighted to helkp for something as importnt as a birth

could your DH not ask for his boss to be more flexible with him not going anywhere from , say, 38 - 42 weeks..?

you also need to think about how you will feeel emotionally after a c.s or VBAC

there is no easy answer, and no guarantees for either birth, but you need to make a decision you will be happy with after the birth too, IFYSWIM

[norksinmywaistband]

How old is your DS.

I had an ECS with my son all planned to drop dd at nursery in the morning then go have DS pick DD up and have her visit -She had other ideas cue massive D&V bug on eve of c-section, therefore no nursery stress at trying to find alternative care or DH could not have been there for birth of DS.

In the end I left hospital less than 48 hours after having DS as I was develpoing D&V symtoms and they didn't want it on the ward and I was desparate to get home to my baby( she was not quite 14 months)

However this was the exception and normally the practicalities would have been good for us.

BTW I had no choice of normal birth and had to have the c-section so not quit your situation

[witchandchips]

i'm planning an elective. reasons

there is about a 1 in 2 chance of having a crash section even if i try for a vbac (compared to an 1 in 4 for first timers) and if i am to have a section i need to plan for it

if i was to try for a vbac i would need to trust that the hospital would
a) call time if i started to go into problems
b) allow me the move around during labour
no way would these happen in our local hospital.

[lulumama]

why is that witchandchips?

for all those planning any sort of birth and are concerned they won;t be 'allowed' to labour a certain way, please contact www.aims.org.uk for assistance

[witchandchips]

why because have had previous experience of a failed induction most of which was spent strapped to an antiquated monitor + forced to lie down even though ds was op (ow ow ow). After 18 hours of "failure to progress" waters were broken (even though ds was not yet engaged). Nothing happened, put on drip 4 hours later + given epidural, 2 hours later midwives realised that only 1 in 2 contractions were being picked up by said monitor (epidural did not work by the way) + that ds was getting a bit panicky. wheeled into theatre + my lovely son was born. made everything worth while but do not want to go trhough the same again

[ceebee74]

Thanks for the replies

Ellsbells - that list is very useful and I have been putting together a similar list myself.

Norks - DS is 2.2 so will be 2.4 when baby is due. Like you, I have an idealised picture that we can drop DS off at nursery in the morning, me and DH go and have the baby, and then DH can go and pick him up and bring him to visit - but you have shown that that is not necessarily going to happen.

I think it is the uncertainty of a VBAC which is making it hard to decide what to do - for example, if I went into labour at a weekend, that would be the best option as my sister would be available and DS would have the time of his life with his cousins. But midweek, it is a different story - and there are so many different scenarios as to when I went into labour and trying to put into place childcare plans for each scenario is making my head spin!!

[norksinmywaistband]

I agree with Lulumama, I regretted never having a normal birth. First was a traumatic forceps and second the ECS.
I often wonder what if - but I have 2 healthy DC and that is the most important.
Personally although once I knew the CS was going to happen the practicalities seeemed ok. If I had had a choice I would have gone for a ND. Sorry now waffling about my regrets.

[lulumama]

you can't plan each eventual possibility.. but you can try !! it is not just about convenience, it is about the best birth for you, mentally and physically, and your family. and c.s , elective or not, is a big deal. as can a complicated VB be aswell. so you cannot plan it to the last possible scenario , but i can understand why you want to. ask around as many nursery nurses, friends , everyone ! !

[lulumama]

that sounds bad witch. my first labour ws like that in some respects, failed induction, immobile , waters broken with baby not engaged, synto and epi and no progress. so c.s

DD was very easy VB

history does not always repeat itslef birth wise

if you would like t VBAC< but are concerned the hospital would not respect your wishes, AIMS is a really good resource.

but i understand exactly why you would want an elective this time

[Ellbell]

ceebee... forgot to say that I was in a similar situation about childcare for dd1 when I had dd2. All family at least 4 hours' drive away and all my friends where I was living at the time worked. In the end a friend agreed to be on call if I went into labour in the middle of the night (which I did, of course) and I discovered that nurseries are allowed to go over their legal maximums 'in exceptional circumstances'. My nursery (which dd was only going to one day a week while I was on mat. leave) agreed she could come in if I was in labour, so friend came round at c. 4.00 a.m. and got dd1 up in the morning and off to nursery and then she stayed at nursery till my parents arrived to pick her up. Worked perfectly in the end.

[Buckets]

Ceebee I also had a horrible back-to-back 1st baby and emergency csec. Had my 2nd by elCs which was fab.

I'd planned an elective last month for #3 but I ended up with an accidental vbac! I went into labour spontaneously and managed with gas&air to 4cm before they got organised for a semi-emergency CSec but I ended up having a VBAC on the operating table. Luckily they'd just got the epidural in so everything was fine by me (inc forceps & stitches). The labour was not quite as painful as he wasn't back-to-back, scar hurt though. Only benefit as far as I'm concerned was being able to drive sooner, at least I could sit down after my CS.

Good luck.