CFM and more advice re VBAC

[Reggiee]

Another person looking for advice about a VBAC for dc2.

Bit of background, had emergency section under general with dd after an almost perfect labour, as she was undiagnosed footling breech. I laboured well in the pool (went from 5 - 10cms in 2.5 hours), and it was only when the midwife broke my waters at 10cm that her foot popped out and all hell broke loose. Cue waddling down the corridor with foot dangling out, three attempts to push foot back in with no pain relief, followed by CS under general.

Have met with 4 different consultants so far, who all say that I can go for trial of labour but I must be continuously monitored. I am not allowed in the pool again. The thought of being stuck to a bed with CFM turns me cold and I think may impact on how my labour progresses. I am also worried that this will lead to unecessary intervention. I am due to meet the consultant for a final meeting at the end of the month.

What compromises have people reached with regard to CFM, and what is reasonable for me to demand? Any advice or support appreciated.

TIA.

[LackaDAISYcal]

Hi Regiee

I managed an un CFM'd VBA2C at LGI last November. It was also ony 17 months since my previous section so I was a bit of an obstetric hot potato

I hired a doula quite early on in my pregnancy and she is very familiar with both Jimmy's and LGI but prefers LGI as the births there tend to be less medicalised than at Jimmy's. I was originally booked in at Jimmys and she had me change at the last minute.

She knows the head of midwifery well who advised us to ask for a particular consultant, whose name escapes me at the minute.

anyhow, she (the consultant...who incidentally has had two water births herself and as such is a bit more relaxed) realised that I was aware of the risks and had written in my notes that the CFM was entirely my decision and I should be monitored intermittently unless things were going wrong.

As things panned out, I laboured at home for about four hours before my waters broke and when I got there I was 6cms dilated. I was fully dilated an hour later, but for whatever reason, I was struggling to push my DS out. I also was crippled with SPD pain so didn't get too mobile, but I leaning over the back of the bed and then kneeling on the floor for most of the labour. I did end up with a scalp clip on the baby but as my waters had already broken I had no real objection to that. I was still able to move around with that in place. Eventually I was taken into theatre for an assisted delivery (forceps), but my doula was a great advocate and persuaded them to dim the lights and deliver him onto my chest (the anaesthetist helped me get my tshirt off so they could do this )

Anyway, if you want to CAT me, or email me at daisybump at yahoo dot co dot uk I can dig out the names of the relevant people and put you in touch with my doula if you like. I've also got a couple of books which have good information in if you wanted to borrow them, or if you want to meet for a coffee and a chat

there is also lots of advice and support on this thread with relevant links on page 2 I think.

[Reggiee]

Many thanks for your reply Lacksadaisycal . It's really good to know that they do allow intermittent monitoring (presumably if I press hard enough), and that the monitoring itself didn't impact too much on your movement.
Going to look at your link now, and will email you soon for that coffee!

[LackaDAISYcal]

I've got the name of the consultant now so please get in touch (not sure whether I can post it on an open board??). You should ask to be transferred to her and feel free to drop my name in the conversation (although it isn't lackadaisycal ).

Also, insist on seeing the consultant rather than their registrar....they just repeat scary statistics at you over and over. Don't let them bully or scare you as the risk of scar rupture is really very small after one section. I can't remember the staitistics but it's all on that link.

Just remember that they can't do anything that you don't want them to do as that would be assault! and if all else fails, tell them you want a home birth

Good Luck

[Lulumama]

you can be advised what to do, but you can make an informed decision to decline or accept any or all facets of your care.

you can have some mobility with CFM , you can lean against the bed, sit of a birth ball, lean on a partner, but you won;t be able to walk far.

i think the thread Daisy has linked to has some useful info and research re cfm

AIMS.org.uk is a good place for help

the supervisor of Mws should be able to help you too

i had a VBAC with CFM , as it happens, but i did not know then what i know now but it was a normal straightforward and intervention free birth

[LackaDAISYcal]

I have the name of the consultant MW too . she was actually meant to be writing up a care plan for me. I had spoken to her on the Thursday and she was going to email it to me on the Monday....but I went into labour the next day so it never got as far as my notes. thankfully my consultant had written in them though!

[Reggiee]

Thanks Lulu.

Daisy - I've just emailed you

[ernestosmum]

Hi- the aims book ' am I allowed' is a really good way to get your head round your position (if you know what I mean?!?) It's what YOU will allow- not the other way round. The thing with EFM is that sometimes you can move a bit as the other lady has said, but sometimes you can't- depends on position of baby.I spent my whole first labour on my back with EFM like a bad game of twister, am sure it led to my section. Second time round I had a great homebirth on the NHS which I know isn't for everyone, but as the other lady says if you start mentioning homebirth you mightbe surprised at how many 'restrictions' are suddenly lifted if you agree to come in (I was suddenly offered 'domino' care- i.e. starting at home with community midwife who travels in with you (never ever heard it offered to anyone else), the pool, intermittant monitoring etc etc). Worth a go maybe?? Good luck Rachel xx

[toddlerhip]

Domino sounds really interesting.

Having been told by the midwives / consultants that VBAV meant monitoring next to a bed I was surprised when i got to speak to the consultant midwife (on the hospital visit that i was originally told i wasn't allowed!) that in fact if you want to use the pool you can. There is apparently no research saying it increases risk.

I am paranoid about shoulder dystocia (had 11.5lber on elective section last time) and uterine rupture but have an active toddler this time and lots of stairs so don't want a long recovery. My consultant said risk of uterine rupture was 3/1000 and shoulder dystocia 1/1000. If anyone is obsessive enough you can phone www.midirs.org to do a literature search for you for 18.00 and get a long long list of medical article abstracts on your chosen specialist subject!

Can't get much of an answer about how long it is safe to stay in early labour as a VBACer - no-one is prepared to say except that 3 days is too long. Anyone got any info on this?

[toddlerhip]

PS - what are EFM, CFM and HBAC? My brain isn't engaged today...

[Reggiee]

Thanks ernest. I'm having a scan to check position at 38 weeks, so that that should help.

Toddler totally agree about wanting to avoid a long recovery. It took me a while to get over my Em CS. (HBAC = home birth after CS; EFM/CFM = electronic / continuous foetal monitoring).