to consider going against consultants advice?

[TiredofYorks]

DS1 (2.4) was born by emergency C section.

I am 36 weeks pg with DC2 and have just been to see the consultant. He said because of previous CS I am high risk and need to be in the consultant unit.

I asked if I definitely can't use the Midwife led unit (it is across the corridor from the consultant unit) and he said no, so I asked if that ruled out a water birth (there is one on the Cons unit) and he said yes as I have to be monitored throughout.

I then asked if I would have to be immobile, he said that there is one mobile monitor but if that is in use then yes I will be immobile and will have to stay on the bed.

I asked exactly what the risk is and he said 0.7%.

I know this is a low risk and I do think I'll cope better if I'm left to it (well I think so anyway) and also I really wanted a waterbirth.

So would I be unreasonable if I considered going against the consultants advice and opting to use the Midwife led unit anyway?

Sorry for the long post.

This is a very odd thread.

Some consultants routinely advise against VBACs as general policy. Some consultants encourage them.

They're all 'experts' but they have different perceptions of risks and different procedures they are comfortable with.

The risks of VBAC are very comparable to the risks of a repeat caesarean. In fact, many studies would suggest that a caesarean is more dangerous than a VBAC.

When you consider a VBAC, you're not weighing 'Crazy risk against no risk' you're weighing 'some risk against some risk.' The only additional risk VBAC carries to normal vaginal delivery is an increased risk of rupture. This risk is /very/ small, particularly in uninduced labours.

Similarly, caesareans carry additional risks such as surgical or anaesthetic complications, epidural complications, blood clots etc.

Personally, I knew that a hospital birth for me would mean a caesarean and I had a home VBAC (which is not really any more risky than a first time vaginal delivery, generally considered ok by most professional bodies).

If there are no specific reasons to expect problems other than it being a VBAC, I would certainly be getting second opinions about using the midwife led unit and getting a waterbirth from other 'experts.'

I find it very depressing that women are discouraged from even doing a little research or finding a second opinion because 'Consultants are EXPERTS.'

Yes. But have you never heard two experts disagree?

Interesting points Carmen. My consultant said "The current thinking - well, from the Americans - is that we should be doing more vbacs". He isn't sold on this. Yet the risk of perinatal mortality with a vbac is the same as that of first time vaginal delivery and there aren't hordes of experts suggesting sections for all first timers!

Just a couple of points... I have read about the first half of this thread but gave up when it turned into the usual mudslinging vbac v section debate which to my mind wasn't what the op was on about.

1. You can be mobile even with continuous monitoring. I was monitored in my first labour because my baby was distressed when I went in (resulting in a section for foetal distress) and was told by my midwife that I could stand up, squat, go on all 4s, move about close to the bed etc.

2. Talk about a horizontal lower uterine scar being less risky in terms of rupture than the traditional vertical scar is true. It is NOT however possible to determine this by looking at the scar on the outside as one poster intimated. Lots of vertical uterine scars are made despite having a bikini line scar on the outside. Vertical uterine scars are rare now but you would need to see your hospital records to be sure that you had a horizontal uterine scar and not just look at your tummy.

Good luck

carmensandiego - agree completely! I was just about to post similar. you've only got to spend a few minutes on google scholar t to see that consultants of any specialism don't agree on everything, different places follow different protocols, so how can people not question their consultant? what is his/her c section rate? how does that compare with others at the same hosp and at dif hosps? what's the comparative vbac rate? what kind of skills updating has your consultant done? how come some hosps offer vbacs in water or vbacs in mlu and your hosp doesn't? what is the evidence they base their respecive decisions on? questions questions questions.

my cousin is a medical negligence lawyer. believe you me, we question everything