Please give me your VBAC stories now!

[PaulHollywoodsSexGut]

Have appointment with Supervisor of midwives at 3pm today after shit consultant meeting at 16w re birth options.

Am 19 weeks and have had

• one actually great EMCS (failure to progress CS’d at 42+1)
• one pretty fucking traumatic ELCS (long op, baby came out barely breathing, Midwife didn’t believe my dates at point of delivery, baby readmited with sepsis at 12days old, CS’d at 39w).

This baby will not be my last and I’m in a quandary as to whether to explore going for a VBA2C or to press home the point I want an ELCS again but at 40w this time. Consultant has already said no to the latter.

Please can anyone tell me their VBAC tales especially if you ended up with a previous CS for failure to progress and especially if you had a VBAC after 2 CS’

I am considering VBAC to maximise my chances of being able to have a 4th child without going through more CS hoopla again re scar rupture etcetc. I also kinda want to have a go at a natural delivery (but would never do anything to really risk myself or baby’s life).

I just need to know that the lines I’m thinking along are not crackers. I’m just so confused.

anyone??

Your consultant has no to VBAC. I didn't think they could refuse you another c/section if you'd previously had one.

I had a VBAC after EMCS. Very easy birth, I did need stitches but probably because he was a big baby and cane out quickly. 13 years ago now. I know of a couple of people who had VBA4C - rather out of the loop on VBAC chat now but used to be in a couple of groups.

Sorry I mean said no to a subsequent C/section not a VBAC.
My friend had a C/Section and When she was having her second. She said I want another C/section. Agreement given and no questions asked.
Her reason was failure to progress.

@Awwlookatmybabyspider

No she hasn’t as I didnt raise it with her.

She said no to waiting until 40w for a CS.

It’s the “no to 40w” thing that’s really bent my brain plus she seemed really appalled this will not be my last baby.

That’s why I’m now wondering if I should be entertaining a VBAC.

Just looking for all experiences as I seemingly can’t have an actual convo with a medical professional as so far it’s all been very “stonewally”

DS was cat 1 CS when heart rate dropped in response to rupture of membranes after very slow progress. DD was VBAC in 45 min! Though then spent 1.5 hours in theatre for manual placenta removal.

Could you go for a VBAC but with the option of an ELCS at 40+ weeks if the baby hasn't made an appearance by then?

This is what I did for DC2 after an EMCS for DC1 - booked an ELCS at 40+10 as a backstop, since I was adamant I didn't want another induction. I ended up going into labour on 40+9 and having another c-section for failure to progress, but it was quite smooth and not as stressful as my first EMCS).

I had one. I also was pretty much told that my trust would say no to an ELCS in my situation. However, I had a very different first labour to you. The labour was normal, I dilated to 10cm fine but then when I was making no progress with pushing they discovered that she was in an unusual presentation and would be difficult to deliver.

I think VBAC are least likely to be successful if you had a previous EMCS for failure to progress, but that doesn't necessarily mean it would be unsuccessful.

I would push for a meeting with the consultant - you may need to be pushy. Ask for the success rates of a VBAC after two CS's and ask about the possibility for future births.

For info, I hated my VBAC and it ended with a very long pushing stage, 3rd degree tear, stitches and manual delivery of the placenta in theatre. However, despite all that I recovered more quickly than after the EMCS, even though I would have said I had a good recovery from that.

To add, I would have refused to consent to an induction due to the increased risks of uterine rupture, even though they tried to tell me the risk was "not that big".

@caitlinsyellowsocks so was your first baby delivered by CS as a result of your induction not working out?

What you are presenting is almost my ideal: chance to go for a VBAC but if nothing happens by 41w then relent to a CS.

But if the consultant won’t even entertain me going to 40w for an ELCS chances are she would never agree to a VBAC/41w ELCS combo.

That’s why I’m seeing the SoW as I’m getting nowhere with the consultants. They seem to be really bullish and bombastic at my trust.

@DippyAvocado I’d only consent to an induction if they blew a balloon up my vag (a Foley catheter?) but the level of clinical risk my trust appears to entertain is nil so that’s probably not an option either

@PaulHollywoodsSexGut yes, the first ELCS was the result of an induction not working out.

I think different hospitals have different policies but I was told that if I chose an ELCS it would be at 39 weeks, but if I wanted the chance of a VBAC I could go to 41 weeks or even 40+10 before having either an induction or a c-section as a backstop. I think the idea is to give you the best shot of a vaginal delivery if you want one (assuming there aren't any medical reasons for delivering early).

I wasn't too worried about having another c-section but didn't want at 39 weeks - partly because I thought the dates were out.

Sorry, first emcs

I had a vbac this week, Home birth. Baby over 9lb, born in an hour and a half.

Surely you can plan for vbac but say you don’t want to go post dates and book elcs at 40 weeks?

Hey @IfYouLikeALotOfChocolate why was your first delivery a CS? If it was failure to progress I’m all ears as that seems to be the main reason that providers can be cagey about (as a PP mentioned above).

And @IfYouLikeALotOfChocolate

Congrats on the baby!!

I had a VBAC after failure to progress. Somewhat difficult and emotionally traumatic birth culminating in forceps delivery but in the medium term it was successful insofar as baby was fine and my recovery was a lot quicker than with my prior birth which was an EMCS after 24 hours labour. Stitches from episiotomy healed fairly smoothly and no long term birth injuries.

Why have they said no to an ELCS at 40 weeks? Is it because they don't want the risk of you going into labour beforehand? If so, they would probably be reluctant to agree a VBAC? For what it's worth, for DC1 I had a cat 1 EMCS for failure to process and baby in distress then an ELCS for DC2. It was meant to be around 39 weeks but they were quite busy so it ended up being 39+5 anyway... I was told ELCS are never before 39 weeks (unless obviously there are special circumstances) but could be any time in the 39th week..

That's also interesting that VBACs after failure to progress are not as likely to be successful.. all the HCPs I dealt with were really pushing me to have a VBAC (including some almost emotional blackmail from one consultant who when I said my DH was able to take a month off after the birth to be able to lift etc DC1 replied "Yes, but she'll still probably want you." ). But after such a traumatic time with DC1 (inc a 70+ hour labour), there was no way I was going to chance it..

But my ELCS was pretty much fine and I've had no issues whatsoever.. Sorry yours was difficult, but it doesn't mean another would be the same (though I appreciate it would make it harder for another after).

Good luck with your meeting

Why have they said no to an ELCS at 40 weeks? Is it because they don't want the risk of you going into labour beforehand?

Exactly that @silversun83 which is why I know the consultant at least would not be the right person to examine my options around VBAC with.

I mean I went to 42w with DD and DS had real problems when he was delivered at 39w.

A blind man in a darkened room could see the chances of me going into labour between 39 and 40w are next to fuck all.

I’m just annoyed about having to go all around the houses - again - to get heard. My hospital is classed as one of the ones you want to give birth in but their antenatal support is shit.

They really should try and take individual circumstances into consideration rather than applying a blanket rule..

And surely they can do an 'emergency' csection on the small chance you did go into labour before 40 weeks.. after all that's what they'd do should women go into labour before a planned csection date regardless of when it was (unless obviously they agreed to try VBAC first).

And I was the same.. DC1 was born at 41+5 and I just knew DC2 wouldn't arrive before my ELCS date (which is why I agreed to try a VBAC if that were to happen ). Though in different circumstances, I was more happy to try VBAC earlier as I think DC1's size was partly contributed to the difficulties I had (she was 'only' 8lbs 8oz but I'm quite petite). As it was, DC2 was 8lbs 1oz at 39+5 and still seemed pretty comfy in there so reckon I would have gone to a similar gestation and probably had a 9lbs-er.

The uncertainty is quite stressful so I feel for you.. And there's no way of knowing which is the right decision.. I found all the 'birth choices' meetings about as useful as a chocolate teapot (it didn't help that they had lost my birth notes and made no effort to find them despite me asking specifically for a birth debrief ). What also didn't help was other HCPs disagreeing with the consultant at DC1's birth (who at the time had specifically guessed DC1's weight before she was born and said because of her and my relative size, I would have difficulty with a natural birth).

Anyway, bit of digression there! I really hope you come to a resolution that you're happy with

How did the meeting with the SoM go? I had one before my VBAC and found it much more helpful than the official consultant line.

Have you asked them whether their line on this relates to the fact you're trying for a VBA2C? As you probably know the chances of a successful VBAC are somewhat lower than after 1 CS and the risks are higher.

Have you asked specifically what the statistics would suggest about your chances of spontaneous labour between 39 and 40 weeks? It's easy to extrapolate from previous experience, especially when you're pregnant and worried, and think 'my body always does this', but in reality every birth is different. (I was similarly stressed about whether to continue trying for VBAC if I went over dates again with DC2, which I and the midwife were fairly sure I would... She turned up spontaneously at 35 weeks!) Similarly it's really quite unusual for babies to have significant difficulties at 39 weeks, so try not to catastrophise about a possible delivery at that gestation.

Hope you can find someone who you feel is really listening to your wishes and concerns.

DS1 was a EMCS after a 40hr labour. Dilated to 10cm (so, so slowly!) but we were both exhausted after 2 hours of pushing.

DS2 was a VBAC (jury was open on a bigger family, and having come so close, wanted to finish the job "properly".) Unfortunately, compared to me, my babies are pretty big and have a nasty habit of being back to back. There was a panic over monitoring and we were rushed to theatre for EMCS but they decided that he was past the point of no return and the forceps came out, leaving me to sit on frozen sweetcorn for the next month. The whole thing was 4x quicker and I did feel some mental healing from the experience largely because I had a great MW who did what she could to keep me mobile and comfortable as much was posdible with the monitoring and my SPD (was on crutches)

I'm not planning more, but if I had to choose again, a ELCS seems like the more reliable bet. I'd love a low key, fairly natural birth but don't have much confidence in my body's ability to pull it off. Forceps and SPD did not mix well. Both births took their toll on me, so I'd rather be fresh from a ELCS than exhausted from EMCS.

It is hard when your concerns are brushed over. I sobbed at the cons appointment when he poo-pooed my preferences and basically wanted to put me right back into the flashbacks I suffered from the first birth. On DS1's 2nd birthday I ended up ringing the MWs in tears because of my fear of repeating being beached up and monitored, and they arranged a 1:1 visit to labour ward to talk through what was viable (was monitored, but was comfortable over a birthing ball on a mat, and nowhere near the bed).

Met with the Supervisor of Midwives for a full 40mins.

WHAT A DIFFERENCE. Was listened to, the state that DS was in when he was born was explained to me properly, she listened to me, took my wishes on board, has referred me to a more “right on” consultant and now I have a birth plan for VBA2C/ELCS if no baby by 41w.

For the first time in weeks I’m grinning ear to ear. I feel so much happier than I’m not being made to feel like a twat and that I’m getting supported.

Ladies, if you ever EVER get crap dismissive treatment from one HCP never hesitate to request a fresh hearing and even request a switch x

I had a vbac after emcs. Dd1 was back to back and a big baby and nobody noticed that she was the wrong way round until it was too late. My epidural wore off and I had a 9lb baby stuck back to front in my pelvis. Was bloody horrific. Whisked off to op theatre and spent the rest of the day unconscious. Left me quite traumatised.

Dd2 was totally different. Decided half way through the pregnancy that I’d try for a normal birth with the explicit instruction to elcs if it wasn’t progressing. She came out like a bullet in about an hour, I didn’t even get time for the epidural. Totally different. It can be done! Good luck.

Such a brilliant outcome. Hurrah for midwives!