Meeting consultant to discuss VBAC/elec C-s: what do I ask?

[hopefullypregnant]

I had an emergency section with DD - foetal distress. I'm seeing a consultant next week to discuss birth plan for DC2 who will be born when DD is about 18 months (I'm 12 weeks now so ages away, but they wanted early apptment). What sorts of things should I be thinking about asking in relation to a VBAC/another section? Does the consultant decide what we go for or do I have input? And are there NICE guidelines on this?
Thanks for your help.

[lulumama]

you decide, it is ultimately your informed decsion to make

if you have no medical reason for another c.s, i would seriously consider a VBAC

there are some very good threads on here re VBAC if you search the archives.

[jonquil]

I had this exact scenario. Agree with lulumama that there are some good threads on here to have a look at.

Essentially, I was so distraught after first birth experience which ended in emergency C section I was convinced I wanted to have a C section straight away with my second birth to avoid any further birth trauma.

I had to go to see the Consultant Midwife and really fight my corner to have one. I eventually convinced her because she told me significant mistakes had been made first time round and that she could see I had been psychologically affected by the birth.

The NICE guidelines are worth a read and despite what people say, noone can make you have a natural birth if you do not think you are able to do it.

HOWEVER, having "won" my right to an elective c section, I started doing further research. I found that there was a team of midwives near where I lived who were exactly that .. a "team" of 7 midwives who would all see you at some stage during your pregnancy. I switched to this team and found that the care I received in their hands was marvellous. I came to really trust them and their views. They persuaded me to try for a VBAC and eventually I agreed. I went to relaxation classes, listened to relaxing music and had the most amazing birth. I bonded with my new daughter instantly (unlike with my first child). I knew the midwife who delivered me.

Anyway, all that to say, that it is totally up to you.. speak to people, read the threads on here and read the NICE guidelines. And whatever you decide to do after all that will be the right decision.

[hopefullypregnant]

Thanks for your replies. I'm not anti VBAC at all, in fact am thinking would go for that but would not accept induction again and/or expectant management, so would want a C-section at say 41 weeks. Dont know if that is an option, but going over by 2 weeks really made everything awful last time...

[TuttiFrutti]

They won't induce you anyway if you've had a previous c-section. Some hospitals will do the first lot of prostin gel, most won't even do that, but none of them will do the whole syntocin drip thing because there's too big a risk of scar rupture.

I had an elective cs for my second birth and it was a fantastic experience, miles away from my traumatic first birth with long labour and emergency cs.

Good luck in whatever you decide.

[mppaw]

Have been on the other VBAC thread which is VERY good.
My appointment is next Friday (Will be 28 weeks) so have started putting together my questions.
If labour starts can I stay at home ? As long as I feel ok etc.
If I go overdue can I wait 14 days ?
If I go overdue can I have a c-section rather than be induced ?
IV drip, will you put one in just in case ?
Restriction of length of first stage of labour ?
Restriction of length of second stage of labour ?
As long as me and baby are good, can we proceed at our pace rather than be governed by a clock and hospital rules ?
Hospital rate of successful VBACs ?
Will my midwife encourage me to VBAC ?

Am hoping alot of these questions will be answered once they start talking about hospital policies.
Also, there is a good website worth looking at www.caesarean.org.uk
PS...all this info I have found on mumsnet.

[MrsMattie]

mppaw's list is excellent.

Remember - you have choice in the matter of most elements of your birth. Repeat it yourself like a mantra.

[mppaw]

MrsM, Have seen you on the other thread, but a quick question for you as I know you are nearer birth than me....Is your hospital willing to induce you if you go overdue ? what are your thoughts re being induced.
At the moment I do not want to be induced, I want to go 42 week (Clearly as long as me and baby are ok)and then have a c-section if I do not start naturally. Am wondering if this is normal to want this, or should I attempt VBAC whatever.

[MrsMattie]

Hi mppaw

Most of the research I've done indicates that women with a previous c-section scar shouldn't be induced, due to the risk of scar rupture. The hospital I'm booked in at won't induce VBAC-ers full stop (think that's fairly standard practice - although I think some hospitals will use prostin pessaries? Don't think many will use a syntocin drip these days, though...)

I'm like you. If I go overdue I want to let it go as long as I can (providing me and baby are both OK), and then will opt for a repeat section if it doesn't happen naturally. I think the bit lots of potential VBAC women have is getting the hospital to relax about letting them go up to 42 weeks (or even more) over dates. Some hospitals start to get arsey about it after 41 weeks. I saw two doctors at my hospital who both said I would 'have to have s ection at 41 weeks) before finally seeing a 3rd doctor who agreed that 12-14 days would tbe the earliest they would want to discuss a repeat section, providing all was well.

I got to 42+5 with my first pregnancy (failed induction, had a section, although both me and the baby were well...), so I am prepared for it to happen again!

[MrsMattie]

Sorry, should have said 'I think the problem lots of potential VBAC women have...'

[LackaDAISYcal]

just bookmarking as I'm logging off now, but will be back later if that's OK

[LackaDAISYcal]

Goodninformation on page 2 of the Imminent VBAC thread, plus lots of anecdotal stuff throughout the thread

[mppaw]

[nodding along reading the MrsM's post]
I went 10 days over with DD1, induced, Epidural, dilated, head high up, pushed for 2 hours then offered instruments or c-section.
So would like to go 42 weeks this time and if nothing then c-section it is.

OP, I think it is all about doing reseach and gaining as much knowledge about VBACs as you can.

[MrsMattie]

I love that thread@lacka!

[LackaDAISYcal]

hi hopefullypregnant and congratulations

As others have said, it's your decision what happens. The hospital might prefer you to have a CS, and some registrars in particular might try and scare you with tales of scar rupture, neonatal death and still birth , but if you do your research and accept that the risks are just that, and can get those risks into perspective, then you can make an informed decision as to what you want to do and what feels right for you.

The links on the VBAC thread are very usueful and there are other bits and pieces around out there as well.

It's my understanding though that VBAC is the preferred option for women who have had a single section (is this in the NICE guidelines? anyone?)

And, at the end of the day, as someone else has said, whatever you decide you want to do is the right decision . Just don't let them bully or scare you into accepting interventions that you don't want and remember that you can change to a more sympathetic consultant if you want to. I'm doing this at the minute at 37 weeks pregnant!!

I hope you can find something useful in all of this to take with you.