Feel I'm being forced into VBAC - Help !

[DefNotYummyMummy]

Does anyone have any advice ?

In August 2006 I had an emergency caesarean with my first child. My waters broke naturally at 39+4 days, and they gave me a drip to try to speed things along as the baby wasn't doing so well. I had an epidural. With each contraction the heart rate was dropping. The drip didn't work and I only got to 3cm after 10 hours and so then they decided on a caesarean. Unfortunately I had a panic attack as I could feel them cutting into me when preparing for the caesarean and it is only after the fact I realise I had a poorly administered epidural. I could still feel contractions on one half of my body, but not having had one before I just thought this was how an epidural should feel and I never voiced my pain. Anyway, I ended up having a panic attack and had a general anaesthetic for the operation.

Luckily the baby was fine and I was out of hospital after 2 days (they needed the bed, but I couldn't wait to escape to be honest).

I am pregnant again and at my 20 week scan I saw the consultant. Well after a chat about my previous birth and no real other discussion (she gave me a leaflet), and just said that there is no reason why I can't try VBAC and walked out. So now that is written on my notes : 'try for vbac if all ok'.

Since then I have done a lot of research myself on government statistics and studies and I would prefer to have an elective caesarean. I want to try to have an epidural again as my pain threshold is low. This may slow down labour. I am terrified of having to go through an emergency operation again, and would prefer to have a controlled experience, especially as I am not planning to have any more children. An epidural (I read) can increase the likelihood of instruments which can put extra pressure on your scar, and I certainly wouldn't want any drug to try to speed along labour due to the risk of scar rupture (however small). Last time I had pregnancy induced hypertension which had to be controlled with drugs from 36 weeks, and they have been keeping an eye on me with growth scans. Last week my growth scan (32 weeks) was fine and I started talking about the birth with a doctor (not my consultant) and she just said 'you'll be fine, don't worry'. In my notes she just put 'wants an epidural'. I have another growth scan at 36 weeks.

So now I feel I need to be more forcefull to actually request what I want. I haven't written a birthplan yet in my notes. Maybe that would concentrate the mind. I don't feel I have had a proper discussion about what I want for this birth. It's my body, my baby ! I'm a person who doesn't like confrontation, but I am losing sleep over this.

Anyway, I was wondering if I have the right to ask for an elective caesarean and to ask to see the consultant again as I feel bullied into having a VBAC as it is convenient for them. (I know someone in the NHS who said they are trying to get their statistics down regarding elective caesareans).

Sorry this is long.

Louise xx

[Ewe]

You do indeed have the right to ask for a c-section, I would suggest seeing the consultant again and making them listen to what you want and why, given the history I can't really see why they would refuse to be honest.

It's possible that they just weren't listening and you weren't vocal enough as opposed to they are trying to bully you, I think you need another conversation.

[aurorec]

Just wanted to let you know, I had an emergency C section with my 1st (was induced, dilated very well and fast, but once I started pushing baby just wouldn't come out. I pushed for hours, they tried succion, that didn't work- so I got a C section).
I'm going for VBAC for the 2nd (if possible obviously) and the midwife made it very clear that there was no way they would give any drugs to speed up labour- as you rightly say, drugs would mean stronger contractions, which could cause a rupture.

She basically told me if labour wasn't progressing fast enough, or if there were any issues with the way it was going, they would go straight for a C section.

[expatinscotland]

Bump this during the day tomorrow, too.

You have the right to ask for an elective csection and, given the care you have, I don't blame you.

[DefNotYummyMummy]

Thanks for your replies. I think I just need another conversation. Maybe it'll even put my mind at rest for trying for a vbac ? who knows !? I have been to-ing and fro-ing about it for weeks now and now we are getting so close to the birth I am starting to panic. I just want to get ready to plan mentally for what may come.

The doctor I spoke to at my 32 week scan said I would be fine with a drip to speed things up in labour !!! . It doesn't give me much confidence in them. It's hard to know who to trust sometimes.

[expatinscotland]

Bumping, but from what midwives and doctors who post on here have written in the past, drugs should never be used to augment labour in a person who has had a previous csection.

[DefNotYummyMummy]

Well that's what I read in the research too (on the UK government site) and so I was pretty surprised the doctor said that. I need to have a stronger voice though as this is too important. My consultant is quite a forceful woman (no children of her own by the way) and I think I am a bit scared of her ! I will def. ask to see her again.

[lisad123]

this could have been me posting just over a year ago. Like you I had an EC section with my DD1 due to heart rate problems. I too had Pre eclampicia in my first pregnancy.
In my second I had blood clot, so was on thinners, plus also discovered a disorder where my blood doesnt clot, a high HR for me, SPD and bleeding. MY consultant made it VERY clear he was not willing to agree to a CSection. We talked at length, and he explained the risks ect.
I was admiment I wanted a Csection, I wanted control, I knew the risk ect.
However, my labour started while I was in hospital after after placental bleed, and it was 48 mins from start to finish and no time for a CS. They were preparing for one, as again had heart rate problems, BUT I am so glad I did have a VBAC, it was so different than a CS, and wanted to go home that afternoon.
If you have another little one to run around after it would be so hard after C section. I would discuss again, but if you could try for a VBAC, seriously I would.
HTH

[hughjarssss]

I had an EC section because labour wouldn't progress after pushing for hours.

I'm adament I want a CS next time.

What are the risks involved in having a CS?

[Ellbell]

Yummy... As others have said, you have the right to ask for an elective section AND to be listened to!

OTOH, a VBAC might go well for you. I have written about my VBAC experiences at length on here. I am desperate to go to bed now (have been away for work today and am knackered after too much travelling) but if you do a search on my name and VBAC you'll find lots of posts.

FWIW, I would not agree to any form of induction, nor would I want to have an epidural (though someone on here the other day told me that a low-dose mobile epidural is OK). I also believe that for a successful VBAC it's quite important to get your consultant to agree that you don't need continuous foetal monitoring.

I have had both an elective section and a VBAC and they were BOTH wonderful experiences (very different, but both wonderful). My section was not through choice but for medical reasons, but it was a calm and happy experience. My VBAC was amazing and uplifting and went very much according to plan. I was in and out of hospital in less than 12 hours (which was important to me as my dd1 was still under 2 at the time... and I felt I'd spent enough time in hospital - 10 weeks - when having her!).

I suppose what I'm saying is that only you can decide whether a VBAC or an elective section is right for you. But whichever you go for... it can be brilliant. Try to be as forceful as you need to be to get what you want. It's your baby, your body, your life. Good luck!

[lisad123]

uncontrollable Bleeding, difficulties with epidural, babies reaction to drugs, infections, scar difficulties, breathing problems the list is long, and the recovery (in my case) is long, hard work and omg sooo painful

There is also a link with CS and difficulties with BF too if i rememeber.

[Ellbell]

I think the problems with bf are particularly with elective sections, because you haven't been in labour so don't make the hormones that trigger the breasts to produce milk.

Did I say I was going to bed?

I really am now. Good luck all.

[Swedes]

Perhaps your consultant assumes you want a VBAC? I've had 3 c-sections and one VBAC.

[hughjarssss]

I'm so scared of a VBAC.

Are you defnotyummy?

Is it normal to be scared of a VBAC after a ECS?

[AnnVan]

You have the right to ask for c-section. Maybe they are just assuming you want a VBAC if you haven't said otherwise?#
However, that said, the best laid plans don't always pan out. One of the ladies on my ante-natal thread had her baby a few days ago - two days before she was booked in for her cs. Baby decided to come, and was too quick for them to do a cs. She also really did not want a VBAC, but that's just hte way it panned out.

[aurorec]

I want a VBAC (if possible) purely because the recovery for a CS is so long and painful (and mine was v quick!) Not to mention lots of stairs in the house and a demanding toddler, how could I cope with not picking her up AT ALL for 2 weeks?

My MW was v positive about it. She reassured me as to the percentage rate (80% successful for a VBAC if labour progresses normally). My concern was a repeat experience of 1st labour- baby heart rate stayed fine the whole time, but I was in labour for hours, pushed for hours for nothing. As a result I had 48 hours of no sleep/labour, and a CS at the end of it.
She told me there was no way labour would be allowed to go on that long 2nd time round.

I can't be induced (which is what happened the 1st time) and if labour is slow I will get a CS anyway.

She also mentioned that when you you chose an elective CS, baby's lungs at birth are filled with fluid, which would normally be expelled naturally through contractions and labour. As a result, apparently 1 in 20 babies born from elective CS might need special attention after birth with mild breathing difficulties. Nothing serious, but not something I'd be comfortable with.

So all in all it conforted me in the idea of going for a VBAC. She didn't say anything about an epidural being potentially problematic though. What's that about?

[rookiemater]

To the OP, I think its a crying shame that your doctors can't take 5 minutes to sit and discuss things properly with you.

You clearly had a traumatic first birth and it is understandable that you are frightened second time round.

I had a bad ECS experience with DS and should I be lucky enough to get pregnant again I would be very scared about my options. I would expect my Doctor or midwife, who are after all the professionals who are paid to care for me, to spend a moderate amount of time discussing my options and not to make assumptions about my requirements.

Could you perhaps bring DP along to your next appointment. I found that during labour DH was much more articulate and rational than I was able to be and perhaps if you brought him along to the appointment and discussed your previous birth then they wouldn't be able to minimise your concerns in the way they appear to be doing.

[lisad123]

also agree take your dh with you, and also write things down before you, you'd be amazed how much stronger you feel with a piece of paper to hide behind

[Littleface]

The removal of the placent triggers the hormones to make milk, Ive had an emergency and an elective and have breastfed successfully after both

[accessorizequeen]

DNYM, this all sounds v.stressful for you. Difficult that you haven't had any really good advice from a m/w and/or consultant as it can make all the difference. I had ecsection first time and vbac 2nd which I pushed for and consultant supported fully. But I was certainly under the impression that I could have gone for an elective if I had wanted. What you really need is for someone to go through not only this birth, but all the way through what happened last time. I did this (with m/w & consultant 2 years apart!) with notes there and it was incredibly reassuring. You have the right to request this review and sounds like it would helpful for you for 'closure' whether you decide to try for a VBAC or go for an elective.

If you're not happy with the consultant, switch. I had a different one with ds2 & it made such a difference talking to someone prepared to listen to me. She is my consultant again now for dt's due next month!

[hedgepig]

DNYM Acessorizequeen has said completely what I wantd to say. Before you decide what to do with this birth you have to understand the last one. I had a cs 5 yrs ago and am expecting in Oct I have pushed the previous cs experiance away until I got pg this time. I have been through my notes with a midwife as part of the birth afterthoughts service and feel much more reassured for my decision this time (to try for a VBAC) but if I had had an experince like yours I may well be more inclined to a cs. Its about making an informed choisce that suits you, and you should not feel pressuried into going for a VBAC if you don't want to. Hope it all works out H

[DefNotYummyMummy]

I am a bit scared of vbac, but I am more scared of a repeat scenario of last time and having an emergency c-section. Thank you so much for the stories. It is so helpful. I am blessed with this pregnancy, as I was the last time (two ectopics and a couple of miscarriages before), but I don't plan to have any more. I find pregnancy very draining - vomiting until 20 weeks, lost a stone and a half and needed medication. Just physically can't do it again. Also a lot of my friends have been so unlucky being sewn back up wrong, and ripped and torn to shreds by forceps etc - that also terrifies me. A couple took a year to feel OK again, if that. One of my friends says she has an extra flap of skin down there ! I know you can't predict the future, but I would love a vbac if it all went smoothly - (Wouldn't we all). Lisad123's experience sounds OK. I'll take that one !

I guess I was lucky last time as I healed so quickly and felt fine after just over a week.

I think DH should come along to see the consultant. That would definitely help. Brilliant idea as he wouldn't let anything pass.

Thanks again ladies. I feel a lot more positive.

[abbymeg]

DefNotYummyMummy I feel exactly the same as you about elective, with similar reasons. (DD born 10yrs ago, ECS, 3 days in labour and when she came out she weighed 10lbs 12ozs - they had drastically underestimated her weight. I was on a drip and very swollen up internally. My OBS consultant apologised to me - ahh, the joys of birth ). I'm really shocked to read about the attitude of your consultant, although I remember an old post that said they have target figures for CS that they try not to exceed, nevertheless if you want one, you should have one. I'm curious about which health authority you are under? I've got to go in September to ask for an elective and given that MW told me to take DH and be prepared to fight my corner, I'm not looking forward to it much !

[DefNotYummyMummy]

My hospital is the The Royal Surrey in Guildford. I hate the fact that we have this added stress to the pregnancy. I have lost so much sleep over it.

My friend is at St Richards in Chichester and she had an emergency c-section last time after getting to 9cm - she said her consultant is the opposite and is pushing for an elective c-section.

I think I read on one of these posts somewhere that you have the right to get the opinion of another consultant if you aren't happy with yours. Could try that, or change hospitals if all goes wrong with your meeting (quite drastic).

Good Luck !