Are these normal restriction for a VBAC?

[LissyGlitter]

Had an antenatal class last night. Apparently, as I am a VBAC, I will be strapped to those annoying monitors (so stuck in bed, on my back), hooked up to a drip, internally examined every two hours, not allowed to eat, not allowed a bath or to move about and encouraged to have a full on epidural. Oh, and I have to rush into hospital at the first sign of labour so no waiting for labour.

I obviously don't want to put me or the baby at risk, but I had visions of walking about, eating lightly, spending time in the bath and being left to listen to my body. I was also quite keen to stay at home for as long as I could. I'm quite keen on an epidural (wasn't allowed one last time as I apparently didn't look in enough pain ) but would like to at least try the other methods first.

I had an utter nightmare last time, feeling completely out of control and being told I couldn't be in as much pain as I was (only got gas and air and they seemed to think I would refuse paracetamol because they wanted to put it up my bum!) before they made me walk between two delivery rooms and, from my walk, decided to examine me and found out I was 10cm with a very trapped breech baby. Cue a section that I barely remember as I was in such a state they had to pump me full of morphine just to keep me quiet and still! So I don't have much trust for midwives I'm afraid.

I dunno, if I am going to be full of drugs and led on a bed the entire time, it feels like I might as well have another section, then at least it will be over quick and I won't have to rely on my body doing its stuff in very unnatural circumstances.

What should i do?

[rubyslippers]

i am not an expert but what they are describing seems an ideal way to have a crappy labour

any internal needs to be done with consent BTW so you can always refuse - every 2 hours seems invasive to me

being active, squatting, standing etc are all much better than being flat on your back

hopefully lulumama will be around or another VBACer

[alwayslookingforanswers]

well...............

that's pretty much the labour I had for my 2nd VBAC( except I was induced)

2nd VBAC I left it late to go in, told them no continous monitor and I insisted on moving around.

[alwayslookingforanswers]

oh and I only had one internal for 2nd VBAC as well - just after I went into the hospital.

[LissyGlitter]

It was pretty upsetting, because first of all they described a "normal" labour and it sounded lovely, then they got on to VBAC and it was so terrible

Part of me is hoping the baby is breech or something at the next appointment, then the decision gets taken out of my hands.

I had such an awful time last time that I got flashbacks and ended up with PND that turned into PNP. I barely remember DDs first year of life

[Wilts]

I had a Vbac nearly seven years ago now

I was woefully lacking information and just went along with what they were saying- I would research my options far more next time.

I was continually monitored, given an epidural when I was coping with pain well as ' it will get far worse soon and you may not get one then'

I was told I would have a 'trial of scar' and would only be able labour for a few hours- I wasn't and had a fairly lengthy labour.

I didn't go into hospital early though, I stayed at home until I was ready.

I still choose a Vbac over C-section again though.

Have you spoken to your consultant yet?

[LissyGlitter]

No, I only have an appointment at 36 weeks, which is when I had DD, so I am not confident at getting that far. I had a very brief meeting with him at first, he just gave me a leaflet that didn't really tell me anything and said he would write to the hospital where I had DD for details.

After I had DD, the surgeon said I would be unable to ever have a vaginal birth, as he had cut my womb in an upside down T shape due to her being so stuck, but no-one else seems to think that will be a problem.

[LissyGlitter]

Thanks Riven, I will!

[CarmenSanDiego]

I've had two VBACs. First one was a fairly normal labour in hospital, with occasional monitoring but I had to state that was what I wanted.

Second one, I had a home waterbirth and a fantastic midwife who specialises in VBACs and was happy to monitor the baby underwater with a doppler.

Lissy, it's entirely up to you how you labour. You can refuse anything you want (although I realise that's scary when a doctor's telling you to think of your baby). But be aware that the risks of uterine rupture are grossly overstated. You have more chance of a non-VBAC related emergency such as a cord prolapse which is still very, very rare. Yet they obsess on rupture - it's a leftover from when women had vertical scars and ruptures were more frequent and catastrophic. Now, they tend to happen more slowly and with warning signs that a good midwife can spot. Indeed, relying too much on monitors may mean that a midwife misses the signs of a rupture as she is too busy being falsely reassured by the monitors.

My personal choice was for intermittent monitoring which gave me my best chance at a successful labour and allowed me to keep active. I was very happy with that choice.

Do your research and arm yourself with information - there are some great VBAC sites out there. Also, don't think you're being selfish or risking your baby by giving yourself the best chance at a good birth. There are considerable risks in lying flat on your back to give birth - both to you and the baby. There is no risk-free way of doing it, so you have to weigh it up either way. But don't let consultants with outdated information scare you unduly.

[CarmenSanDiego]

Oh, just seen the bit about the upside down T. That's outside my immediate sphere of knowledge. Riven's advice is good!

[moaningminniewhingesagain]

Those things may all be the hospital's 'protocol'. You are not their staff and you are not bound by their protocol. I booked a homebirth for my VBAC so that I wouldn't have to refuse all those things!

IMO, I would decline continuous monitoring and say you are happy to have frequent checks from a doppler with one to one care from a MW. You should have one to one care if you are a VBAC anyway but it rarely happens, and good care is the best way to spots early signs of problems - ie they will be concerned about scar rupture, extremely rare.

Being immobile will reduce your chances of a successful birth, you can decline routine VE's - I had one when MW arrived and another 4 hours later, but I could/would have declined them if I felt they were not needed.

The yahoo group for VBAC/HBAC is very good too for further support.

Must add, I hoped my VBAC baby would be breech so I could have an elective too but he wasn't, I did have another section for failure to progress though (My choice, I refused their kind offer of ARM/epidural/mess with things til it all goes wrong)

[Persephoponce]

I went for a VBAC with my second baby (in the end I had a c-section for a totally unforeseeable complication).

At my first consultant appt they came out with all the usual crap - I had to have CFM, had to labour on the bed, had to have a canula, would only be 'allowed' to labour for a certain amount of time before a section etc.

Over the months, through lots of research on my part and conversations with various Registrars and eventually the top Consultant at the hospital, I got them to agree to letting me labour on my own terms. The only concesson they refused to make was to give me a water birth. Other than that, they agreed to intermittent monitoring, an active labour etc. I got it all signed off on my notes, too.

Do some research, be prepared for a bit of a fight and keep in mind that to have the best chance of a successful VBAC, it is REALLY important that you are allowed to be as active as possible...

[CarmenSanDiego]

Although I am a rabid pro-VBACer, I think with this type of scar, I would go for a repeat caesarean. The risks are quite high - according to vbac.com, they're between 4% and 9% risk for rupture - and the rupture is likely to be very serious. This is compared to a 0.5% risk for a horizontal scar

[l39]

I'm planning a VBAC, currently 37 weeks.
My consultant and midwife both mentioned going in to hospital straight away and having continuous monitoring.

The midwife was of the opinion that if I ended up with one of their wireless monitors I could be mobile and even use a birthing pool (I'll believe it when I see it) and neither of them mentioned an epidural at all. Having had two agonising labours when I only didn't ask for an epidural because I couldn't do anything but beg for death, (and wasn't offered one) I will be livid if they force one on me for no good reason. Third labour (twins, ended in section for twin2) I was offered an epidural, didn't need it so didn't have it. If they just offer this time that will be ok.

I think a lot will depend on who is on duty while you're in labour. I don't expect to have any luck saying 'This isn't what I was told' if the people in charge disagree with the midwife and consultant I've seen so far, but equally it could work out better than you've been told for you. Good luck.

[CarmenSanDiego]

It's not a bad plan to get your consultant to sign your birth plan, l39. Might give you a little more ammunition

With my first VBAC, I was prepared for a fight but once they were happy I'd signed off all the forms, it was all quite straightforward and they treated me as low risk except for a little extra monitoring (and I agreed to a cannula in my hand).

[LissyGlitter]

Brill. I thought I was being daft, I am somebody who quite likes things like pain relief and so on, and reasonable amounts of monitoring, but I have read so much about how important it is to move about and so on, and being in the bath was about the only thing that got me through DDs birth (even though I didn't exactly cope well, although I must have looked like I was coping I suppose, for them to refuse me proper pain relief)

I am going to arm myself with good info, from respected sources, and demand a better labour. I just don't want to end up mentally ill again.

I'm nearly in tears now, just thinking about DDs birth. It's not the section, I was kind of prepared for stuff like that, it was how I felt that nobody was listening to me, and I knew somehow that things weren't right. And then when she did come, she was all bruised and tiny, and had to have a canula and be in an incubator, and I had to have a transfusion, and she wouldn't feed properly for ages, and it was just so different to how I'd been told it would be. At least if I'd had a section straight away I wouldn't have spent 14 hours in pain and panic, throwing up and being told off for doing so, and with the midwives saying I wasn't in labour and should go home, and I might have been better able to cope with the tiny, skinny, yellow, quiet baby that came, and not end up blaming her for all the trouble.

I know it could have been a lot worse, but I am petrified of it all happening again.

[CarmenSanDiego]

Oh Lissy

I had a traumatic first birth. The next two were wonderful though. History doesn't have to repeat itself, and hopefully won't. Even if you end up with a section, you can probably do it with more of a sense of control this time around.

[LissyGlitter]

Carmen - I had no idea there was so much of a heightened risk with this kind of scar. The only person that has even said there is any more risk was the surgeon just after the section, everyone else has either not known what I am talking about or has said it makes no difference.

I am now leaning towards a repeat section. I know there is more risks, but I'm less scared, I think because I know it will be quicker and there will be more professionals on hand, and the VBAC they are suggesting sounds so awful.

At least that way I will be able to plan properly, and make sure I have plenty of help with DD and the new baby in the first few weeks at home.

I'm not being too posh to push am I?

[LissyGlitter]

Right, I think I will show DP this thread later today. He is one for scientific evidence, does anyone have any recommendations for respected medical journals etc that I can point him towards? I have an ATHENS password through uni, if that is any help.

He has said he will go with whatever I want, but I want him to be fully informed so he can stand up for me if need be.

[Persephoponce]

If you do end up with an elective section, I can talk you through all of that Lissy . It ended up being the best day of my life and far far better than my emergency section first time round...

[LissyGlitter]

that sounds like what I want to hear. I will freely admit I am a complete wimp with medical stuff, so may need some virtual hand-holding!

[CarmenSanDiego]

No, you're definitely not being too posh to push, Lissy

My personal bias is usually towards natural birth, but I really wouldn't take a 9% risk of a seriously life threatening event, balanced against the risks of a caesarean which are somewhat higher than for natural birth but nowhere near that level.

The VBAC.com website has a long list of references, hopefully there should be enough to satisfy him there!

Good luck whatever you choose. At least this time, you can be the one in control!

[Persephoponce]

Oh God, I am the biggest wimp in the world. I didn't want to have a c-section or a VBAC .

I think the control issue is very important after you've had a traumatic first birth, as Carmen points out. You need to feel like you're calling the shots to some extent, or at least that your opinion is listened to and valued. Accept nothing else!

[paz1]

Lissy you aren't being a wimp at all. Sounds like last time was really traumatic and I can totally understand why you feel you need to have a lot more control over how things go this time. From what you've said I get the impression you are looking at VBAC because its what you feel you should do and what everyone else is pushing you to do. You need to go with your instincts and make a decision that you feel is right. Don't let other people push you into something you don't want to do. Obviously c-section isn't something to go into lightly but it isn't a cop out at all. Sounds like you should do lots of reading about both and maybe talk to a doula who has experience of hospital vbacs in your area and find out what the reality is in terms of continual monitoring etc etc. if you choose to go down the VBAC route it might be worth having a doula who can support you and help to make sure you are being listened to. Ultimately tho - it is your decision and as long as everything is fine in the end it doesnt really matter how the baby comes out.