...to consider VBAC homebirth?

[Bibbo]

I am seriously considering this.... haven't discussed it with midwife or obstetrician yet though. expect they will tell me it's a ridiculous idea! I want a homebirth because I'm worried about unnecessary intervention, since I had a lot of unnecessary intervention when I had DD1 and I think that messed it up. Syntocinon drip whacked up high=foetal distress=em cs (have whinged on mumsnet about this before....)

I would be a lot more relaxed and in control at home, I think. I live about 20mins drive from hospital though.

Oh yes and I have a bicornuate uterus, as well as my previous cs, so no chance of me being classed as anything other than high risk.

DH originally thought I was mad, but is coming round to my way of thinking. Am I mad to consider this? I just want the best possible shot at a natural birth without all the horrible pain of dealing with the consequences of another cs....

I would be a lot more relaxed and in control at home, I think. I live about 20mins drive from hospital though.

The problem with a 20 minute hospital trip is if anything does go wrong it becomes quite risky very fast. Have you looked at interim options?

I think you'd be mad to have a home birth. As Stepford says, ambulances dont just sit outside your door, they can take a while to arrive. A GP friend of mine recently called a 999 ambulance for a child having a severe asthma attack, and it took over an hour for it to arrive.

I can't imagine being able to relax at home knowing the risk.

Having had two traumatic and difficult births, which would have resluted in the death of my babies and potentially myself if I 'hadn't' been in hospital, then I think YABU yes.
With my second labour, it was less 'emergency CS and more full on catastrophe - from the minute that the consultant announced CS, it was 2o minutes until the baies were delivered. I think '20 minutes to hospital' seriously understimates the time that it would actually take to get help for your baby if he/she needed it.
I would look at all of the other options - MLU, doula, pre birth meetings with consultants etc. given your history and your current risk factors, i would not consider a home birth. And ironically, my first vaginal delivery took me longer to recover from and left me with long term issues than the CS ever did.

I don't really understand why U would consider a home birth when u r so high risk. I was induced with my first and ended up having a section. My consultant was determind that i try vbac with second baby and i ended up having a placental abruption and me and the baby almost died. I'm not suggesting this will happen to u but trust me, 20 mins is a long time if There is an emergency. Imo u are putting yourself and your baby at risk, especially when chances are U may well need a c section again. Its just not worth it.

I have a bicornuate uterus... I think you would be crazy to have a home birth. I had a fantastic labour - but had a retained placenta... apparently the risks of this are far far higher with a bicornuate uterus due to its shape.

The midwife that delivered my baby said she had been a midwife for 25 plus years, and asked that I not deliver in the birthing pool. Afterwards she confessed this was because "all the times she had encountered a bicornuate uterus previously 'something' be it big or small had gone wrong". I'm glad she trusted her instincts.

You are classed as high risk for a reason.

I went for an elective CS in your position.
By the time rupture is noticed things have already gone horribly wrong, I wouldn't fancy that 20mins (or more) away from medical help.
Even if the risk is small why would you take it?
Elective CS was very nice too, nothing like emergency CS.

Bloody hell...! I have been reading too much Ina May Gaskin evidently

See, to my mind there are two sets of risks to weigh up. I don't want to put my baby in danger, of course I don't - but I also don't want to get mucked about with, shouted at and intimidated like I was during DD's birth - surely that is likely to lead to problems with delivery?

I can't help but think it will be counter productive to put myself in that same environment and try to relax and let it all happen when I don't bloody trust them after last time

There's been some great advice on this thread and I will definitely discuss things frankly with the ob/mw next week. There's a mw led unit (also an ambulance drive from hosp) and maybe that would be a sensible compromise - although risk wise wouldn't it be the more or less the same as homebirth?

Blimey this thread has made me doubt myself though - some of the comments are making me think that el/cs is looking like the safest most responsible option atm!

That spunds horrible Bibbo, I felt the same.
But honestly, elective CS was the most reasuring and calm experience - they even gave me aromatherapy to relax me first. I felt in control all the time and it was lovely.

Don't doubt yourself. It's perfectly natural to want a good birth. I'm sorry you were bullied before - that won't help anybody to birth well. The flip side is though that being relaxed and supported won't necessarily mean physical problems don't occur. Nothing with birth can be a certainty. If you lived much clsoer to the hospital I think it would be another matter.
You need a lot more information from the staff looking after you and then you can make an informed and balanced choice.

Don't doubt yourself. You're not crazy. Wanting a home birth is a reasonable and practical thing. Because you have a potential additional risk factor I think it's worth discussing it with a few educated people. Perhaps an independent midwife as well as an experienced doula.

If you can afford one then the great thing is they can also help you should you eventually opt for, or transfer in to, a hospital birth. You would probably benefit from a powerful advocate in this situation. You could also meet with the head of midwifes at the hospital ahead of time to discuss your concerns and birth plan should you end up there.

Just wanted to add to what others have said about ELCS - after an emergency CS under general for DC1, with all the distress/anger/trauma/ panic, I can honestly say that my second planned CS was such a calm, controlled, predictable and safe-feeling thing.

I was completely devastated that I was unable to VBAC (pre-eclampsia), but in retrospect it was absolutely the best thing for me and DC2. I don't feel any failure for not having birthed 'naturally'. We are both alive, safe and well.

I wish I'd had a planned cs for my second. I tried vbac and failed. 3 days labour(back to back) and loads more problems including forceps that failed then cs under a general. Horrific but at least dd2 and I are both here. That's all that matters surely. Ideally I would have loved both my children delivered by water birth. Neither of which managed it, but surely the fact we are all safe and well now regardless of the entrance to the world, is all that matters! Please, for the love of all that is holy, listen to experience. Be where you can get help if needed. Some hospitals have midwife led care which only changes if absolutely necessary. Why aren't you under consultant care if you are a vbac?
Good luck. I hope all goes well , but remember, those few hours matter little in the grand scheme of each of your whole lives.

I'd prefer the consequences of a CS rather than dealing with the pain losing or damaging my baby.

probably the most sensible post on this forum since its inception.

I'm another agreeing with Stepford "I'd prefer the consequences of a CS rather than dealing with the pain losing or damaging my baby"

I was in a similar position the second time and really wanted to try a homebirth but was considered high risk. My obs consultant said that he understood that women need to feel comfortable and in control of their birth options but that once you are high risk you need to just keep the end goal in sight and do whatever gives you the best chance of that.
My end goal was being alive with a healthy baby, so I decided that was way more important than having the homebirth that I wanted. I still think its a shame I didn't get the type of birth I wanted, but when I think of the options I had the hospital was the safest place for me.

But then that's like saying all women should have a c-section just to be safe.

We know that's not true, there are inherent risks in every birth choice.

No its not, Cervix. Every birth has inherent risks yes, but others have known high risk complications also. Anyone can have an unforseen problem whilst having a homebirth, thats just being unlucky, but if you know that you are much more likely to have problems then that changes things and that has to be recognised.

I don't think you are mad and I totally understand why you are wary of intervention after your first birth experience. However ,honestly, I think given your condition I wouldn't be looking at a homebirth.

mad, yes; selfish, yes; stupid yes. But hey, don't let that stop you having the 'birth of your dreams' until it all goes wrong.

ever ask yourself WHY so many Victorian women died in childbirth? and why this does not happen now.... Maybe you shoud

I can totally understand your fear of a repeat bad performance by the hospital staff. However putting your baby's life at risk is not the answer. Explore your feelings with a midwife, explore birthing options in the hospital, ask about that midwife unit, what have they got for highere risk patients. What else can you consider? mobile epidurals, elcs if that is a more controllable scenario for you etc. you must put your baby before your own needs sadly.

gosh, there are some really nasty people on this thread

Yes, quite quite mad, is a side effect of being pg though, certainly for me throughout being pg I had this intense focus on the birth, type of birth etc but really, compared to the rest of your life with your child it's just a blip at the start of a very long journey...

If I get to go for no 3 I have promised myself that i WILL NOT FRET about it...

Lemonstartree there really wasn't any need for that. The OP is not looking for the "birth of her Dreams" she is just understandably looking to avoid repeating what was obviously a very traumatic experience.

Bibbo sorry you seem to be getting such a hard time from some people on this thread. You clearly had a bad experience and it is completely understandable that you want the next time to be better. Some people seem completely unable to grasp that a mother wanting to not be traumatised in during labour and birth does not automatically mean that she cares not whether her baby lives or dies.

I hope the discussions with your midwife and obstetrician go well and that you manage to have a much better experience this time round however it all pans out.

OP I sympathise massively - I had loads of intervention with DC1 failed induction ending in emcs and I have always been convinced that it was the interventions led by the mw & drs that meant the emcs was necessary. I dreaded the whole thought of having to go anywhere near a hospital with DC2. However, I knew they'd be very anti a home VBAC1 (although I understand a lot of places are happier to let you have a VBAC2+ at home), so I went along with a hospital birth. I was told I could stay at home until my waters went. In the event, my waters went first, before any contractions. Contractions started 10mins later so we called the hospital and were told to come in. By the time parents had arrived to look after DC1 and I was ready to go, about an hour had passed. We got to the hospital at 9.20pm and DC2 was born by VBAC in 30mins. So IME going to hospital for a VBAC was absolutely fine. The staff were very pro-vbac and supportive and I definitely felt like they would have respected any decisions I made about how my labour would be managed second time round. I think if nothing else, they have to acknowledge that you've been through this once and know from personal experience what you're talking about. My VBAC experience was fantastic.

I had to have an appt with a specialist vbac mw as part of my AN care and it was one of (if not) the most helpful appt I've ever had with a hcp. She really got my fears from the first time round and was very encouraging and sensible in her suggestions. If you have the opportunity to speak to someone like this I'd recommend it wholeheartedly.

Finally, Almost every day of my second pg I thought to myself, why not just have an elcs that'll take all the doubt and anxiety away and you'll only have to deal with the effects of the surgery. But I am truly so glad that I went for the vbac as it was the most amazing thing I've ever done. Good luck.

I agree with what Thefurryone said, and Thisisyesterday. I think I have to bow out of this one as I don't think the OP really needs a debate vs. Support in making her decision.

I will give my final thoughts though. If hospitals were more reasonable in how they allow VBAC women to labour within the hospital environment more women might be willing to listen to them and feel comfortable laboring there. My consultant would not allow me to eat, insists on CFM, no water birth and immediately sited IV.

She was uneducated on the current studies regarding risk of rupture (but vocal on the 'high' risks even though they're very low) and unable to talk about the figures for my local hospital. In addition to all that she discussed inducing me which quite frankly raises my risk of rupture, the very thing she's saying is what I should avoid.

In addition to all that, after putting the fear of god into me, they would very likely send me home alone until labour is well established. Once I get there there's a shortage of midwifes, who will be monitoring the monitor?

So, after sitting on my back all day, with no food and potential other interventions I'm imagining my risks of c-section would be greatly increased. And the risks of c-section to mother and baby is likely worse than the original 0.04% of uterine rupture.

Funnily enough all the unnecessary restrictions and interventions mentioned above are most likely the reason for my prior EMCS.

So is it truly irresponsible that I, or a woman like me, might want a home birth in an environment where two midwifes will be listening to me and carefully observing and supporting me and my baby? Quite frankly I feel we'd both be safer.

If that makes women irresponsible and concerned only with a 'birth of my dreams' then fine. Telling women that as 'long as you're both alive' is the only consideration is callous. Some women's birth experiences are so traumatic they border on the feelings relating to being assaulted, would you say similar to an assault victim? Bad birth experiences also drive potential PND and PTSD, also not beneficial for the baby, let alone mother.

Many of the arguments on this thread to dissuade the OP from attempting a homebirth, are no different from the arguments currently used by many care providers in the US as a justification for refusing allow women to attempt a vbac, even in a hospital setting. Shameful.