repeat caesareans and the risks - advice gratefully received

[paz1]

i had a pretty traumatic first birth experience which ended in an emergency c section in very early labour because of fetal distress and then also discovered she had been undiagnosed breech. this time round am faced with choice between vbac and elective. the whole experience of the first birth which almost ended in disaster because problems with the baby were not picked up until it was almost too late has left me pretty traumatised and totally fearful of what might happen this time. my gut feeling is that i should opt for an elective. but the consultant i saw this week told me i couldnt have any more children after 2 c sections (am sure this isnt true) and then reeled of the list of risks - placenta accreta/previa/adhesions etc etc. i completely understand there are serious risks involved and wouldnt take the decision lightly (ive worried about what i would do next time round practically since i came out of hospital last time) but also can see there are risks both physically and also psychologically in going down the vbac route. he told me i have at most 60% chance of vbac being successful. which doesnt sound that great odds. given all the trauma last time/the fact that it will be like a first labour and so i have no idea at all what my body will do/and the odds are only 60% at best so it is really likely it could end in emergency section anyway (more trauma!) i am thinking maybe an elective is the way to go. but to be honest he's totally scared me silly about the risks involved in repeat caesareans. does anyone have any advice? is it really the case that lots of people suffer from adhesions after 2 c sections and spend a lifetime in pain??? am not planning to have ten kids or anything but maybe three or four at the very most....

[posiedullardparker]

I have had four c-sections. The first was long labour, emergency with epidural, the second was a GA the last two planned. I have had variable recovery, unfortunately, able to hoover after 6 weeks.

[mears]

You will get lots of replies here with personal experiences of repeat elective caesareans which may make you feel justified about deciding to have one yourself.

I think you should seek out more scientific evidence about the risks and there is a lot of information out there.

Your consultant has told you of evidence based risks. Placenta accreta is certainly one of them and cannot be dismissed.

I think one of the things you would benefit from is going through what happened last time - it may be that your perception of what happened and the risks involved at that time may not be as serious as you remember it. Have you ever done that? Is there a consultant midwife in your unit who could spend the time to fully discuss the issues?

It may be that after doing that, elective CS is the way to go for you.

[undomesticatedgoddess]

I found the AIMS VBAC book a big help when I was deciding whether to have VBAC or CS.

Try the AIMS website. My midwife loaned me a copy.

I ended up with an elective C section with my second one but it was definitely clinically indicated so I was happy with that.

[Andthentherewerethree]

i'm a qualified midwife (like mears i think?) and am due to have my third section in september. my first labour was a failed induction in that i ended up being prepped for section but had a forceps delivery after a failed ventouse.
in comparison the 2 elective sections i had for breech seemed like a breeze, however i didn;t go into choosing them wihtout lots of thought and consideration of the facts.
look at 'reputable' sites such as the nmc and niceguideleines for factual evidence on the risks of a delivery by section.
it is hard to not give your own stories on what happened for your own deliveries when answering a question such as this and as mears suggested i think it would be a very good idea to book an appointment with your midwife or consultant to go through your notes from last time and work out what happened and why.
if you are at all concerned about this baby being breech you can be scanned right up until the day you have your baby to have this confirmed.

[asuwere]

Not sure if this will help you but I found some of the information in this very helpful. It is from real research rather than personal experiences.

risks of cesareans

It's not specific to repeats CS but the same risks are involved.

Good luck

[Fanfare]

It's a really tough one isn't it? The statistics are out there on adhesions etc, yes some people do suffer from these very real consequences while others do not, but it still comes down to running the risks and making that decision! If only there were some guarantees out there!! I was faced with the same dilemma as you after v similar circumstances (undiagnosed breech, cord round neck multiple times) that scared me witless of attempting future labours. I also thought the odds of a successful VBAC were pretty lousy. My gut instinct was to go for an elective CS second time too, but like you am terrified of the complications of adhesions etc and the fact that I will feel like I have brought them on myself through my decision to have a c-section. But then, complications could arise with a VBAC, nobody knows how it will all turn out on the day. At this stage I second the advice to talk to someone about your fears of future birth as it did help me come to terms with some of mine, although I have to say not enough to attempt a VBAC. My CS is booked for next week, still questioning the decision up to the last minute, but feel more at peace with it than the thought of an impending VBAC that my heart and head would not be in.

[rhi75]

I will be having my 4th section in January and made the choice to have my 2 DD by elective following a traumatic emergency section with DD 1, I think you need to look at all the options I was 23 when I had DD2 and had no real support or advice when making the decision and was scared so went for the elective as a section was what I knew. 10 years later with 3DD now 11 months I was told I had no option but a CS at our hospital as I have alot of scar tissue and two scars even though I pushed and pushed for a VB they still said no. I wish in hindsight I had known about the resources and support available back then, as I would of been able to make a more informed decision and would of tried for the VB then at worst it would have ended in another section so there would be no harm in trying. Hindsight is a wonderful thing. Make the decision based on the information you can get and your own feelings you seem to be well informed. Whichever way you go good luck

[nickschick]

Ive had 3 and last time we had an excellent obstetrician who advised us to have no more babies,as he explained to Dh not because of any risk to the baby - but as a woman 3 major ops in the same site isnt a good idea.

Whilst the surgeon was delivering ds2 he commented on the scar tissue too.

I did want to try a VBAC but whilst the ob said he had no problem with me trying he did after Dh queried it say if i was his wife with my history he would say no!,and that was good enough for us.

[Hsl500]

Hiya I have had 4 c sections and 2 other operations using the same insision, the last one they removed all my old scarring and just made me one new scar,
I had sections for various reasons breatch, baby not well, placenta previa,baby to big ect
Good luck with what you decide
Hsl