VBACS for suspected big baby..

[SkyeBlu]

Help...please. Any advice seriously appreciated as in a real state of quandary/anxiety and getting in quite a state about decision making...

I had my first baby nearly 4 yrs ago and it has taken a long time to feel ready to embrace pregnancy and the whole birth thing again as it was horrifically traumatic - high blood pressure, induction, serious emergency C-section, very nearly lost baby at birth, nasty post op infection that took 2-3 months to heal and depression....but so hoping all different this time around.....

Currently 38 weeks pregnant and I was (up until 48 hrs ago) very positive about going for VBACs as it was great ambition to do it all naturally first time and have minimal medical interventions, although under care of consultant and was offered C-section as elective procedure. The main reason for deciding against an elective caesarian was that I don't want to deny this baby a single day of the benefits of being in utero for as long as possible, as nature intended by being the one to decide when... I would love it to arrive when nature intended.

This time pregnancy has been pretty straight forward, blood pressure fine, oedema nothing like before however even though I am running around after a 3.5 yr old morning and evening, I am otherwise sat at a computer working hard so not as fit as I was first time.

2 days ago, I was not happy about how much foetal movement I had felt overnight and Friday morning so went to Triage and was monitored, scanned and thank goodness everything fine and now movements back to normal. Hospital could not explain foetal lack of movement but all the boxes were ticked and clearly all fine as back to normal now.

However during scan it was commented on as to what a big baby it is...the head circumference measurement is well up from the upper percentile, as is the abdominal measurement and they estimated baby to be approx. 8.6 lbs at present. My first baby was 8.1 lbs.

Our WONDERFUL NHS being as clearly stretched as it is (it was packed with women in labour in triage and phone non stop and clearly all staff trying to be as calm as possible but far too busy - and not enough staff/space/rooms/resources) is what worries me the most with leaving the plan to try for VBAC....The genuine terror of there being not enough staff/resources/space/surgery time to monitor and do a C sec if required at the time.......

Please advise on what you wonderful wise women would do?

Would you go for it with the VBACs? VBACs success rate being what it is, knowing that then we could be home asap as a family and with no risk of the post op infection from before?

Would you go back to square one and request an elective caesarean? - I would, I think feel I had 'wimped' out of trying and feel guilty.... however I now realise that guilt is everywhere and unavoidable in every direction of motherhood!

So grateful in advance.......please be honest. I would love to read/ know about anyone who has 'ruptured' with a VBACs - as I do have adhesions from before.....but consultant and brilliant midwives alike reassure me it is SO unlikely....I would love to hear from someone who has had a rupture/knows of someone who had a rupture.... and if they and baby are alright in the end.

Sorry I can't offer advice regarding VBAC but I didn't think 8.6 was particularly large? Have read of lots of women naturally birthing babies up to 10lbs. I think trust in your body and what it is capable of. Discuss your anxieties with your midwife/consultant. You won't be left to go it alone

Thank you! = cool and calm advice

Thats not big! You'll be fine! I've had 3 vaginal deliveries- 9lb 10, 9lb 12, 10lb 1- not even a graze with any of them 8lb 6 will be a breeze

That's not huge unless you are 5'. Did you dilate at all with your last labour? If you did, your contractions are likely to be more efficient this time. Which is more important than the size of the baby.
In my trust, women in your situation often negotiate an elcs at 41 weeks if labour doesn't start naturally. Maybe that's an option?

8lb6 isn't large unless you are teeny teeny tiny?

Big baby doesn't necessarily mean difficult birth. Other factors like babies position & contractions play a part too. I delivered 8lb 9oz no problem but tiny 7lb 4oz got well and truly stuck. Don't worry and good luck whatever you decide

8lbs 6 is average.

Once you're in labour you'll have 1-to-1 care. Triage can be a bit crazy as women in there won't be in full-blown labour, so there'll be one midwife to care for a number of women. But once in established labour and on labour ward you'll have your own midwife 1-to-1. She'll only be caring for you, and as you're a VBAC there's a low threshold for intervention.

If a EMCS is required then the Drs will drop everything to do it. If there's already someone in the obstetric theatre and you absolutely can't wait then they'll go to another theatre. Cat1 sections (the baby needs to be out NOW!) type don;t happen very often, as midwives are very good at picking up on early signs of things not being entirely fine.

Hope that helps (I'm a student midwife, currently working on labour ward)

Oooof this is a tricky one.
In regards to the size mine were both 8,9 one was much harder to deliver due to the position she was in so start getting on your birthing ball as much as possible to get them in a good position!

My worry would be the busy labour ward, if you need to be rushed off for a section.
I would maybe call and ask them more about it... such a hard call x

Two natural births here, one over 9lbs, one over 10lbs. Just gas and air. You'll be great!!!

To balance the above-you wouldn't be a wuss for having an elective section. And an elective is nothing like a crash section-I loved the elective-very calm and easy

Make the right decision for you and your family

8lb6oz may not be the biggest if you're expecting an uncomplicated delivery, but when you're only 38 weeks, could go 2 weeks overdue and planning a vbac IT IS big. A big baby, as much as it's a completely natural, healthy thing, does limit your chances of vbac success and it can be a reason to avoid it.

Saying that, there are no guarantees, just stats! And rest assured they will be watching you like a hawk during labour OP, if that's what you choose to do. I'm in a similar-ish position, trying to weigh up between a vbac and repeat section for number 2. Number 1 was 7lb16oz at 37+0 and this one's on track to be bigger, so I worry about the scar if she keeps cooking too long...

For me though I don't really care about a vbac, I just think I should, if you know what I mean. What I think I'll do is book a section for 39+ weeks, then I won't worry about stressing the scar if baby's big, and if i go into labour before.... well, I'll see where my confidence at if that time comes.

Good luck!

Whatever you decide please do not feel like a failure. I felt awful for my first birth not going to plan (induction, synotocin drip, epidural, episiotomy, suction cup and haemorrhage) but at the end of the day the only thing that matters is that baby and mother arrive safe and healthy, no matter what you decide you have nothing to be ashamed of but please don't centre your decision on you being a wuss or a sense of not doing it how you "should", because labour sometimes doesn't go to plan and sometimes it does. You could end up kicking yourself for doing the "wrong" thing when you could never predict the outcome. xx

My third was nearly 10lbs and by far my easiest birth. 1 a half hours from first contraction to her being born. I did tear pretty badly but it's two weeks on now and I feel fine, no pain. The first two were on the small side and total buggers to push out!

I'd go with an ELCS.

Had an EMCS because DS was breech, offered a VBAC with DD but as she was also breech I went with another section.

I just felt more in control and wouldn't want the panic of a VBAC that doesn't go according to plan and end up with an EMCS anyway.