To go against DH (vbac)

[idontknowjacques]

Had a csection with DS - we had him under a consultant in a private hospital and although it was classed as an emergency cs, the obs was v pro cs and v anti instrumental delivery so I often wonder whether I would have ended up with a VB of some sort under different care

Now pg again and consultant (different guy but a colleague) says I should have a CS this time because of the risks of VBAC and because he thinks my pelvis might not be the right shape (??) but this seems to be just a hunch - I suspect DS got stuck as I was on a strong epi and not mobile. I want to attempt a VBAC but DH is horrified and says he won't have it under any circumstances, he puts all his faith in the private drs and "can't believe I would risk baby's life for the sake of pride" (he can't understand why I really want to experience a VB)

So anyway, I am pretty sure I won't stand a chance of VBAC in this set-up and considering opting out of private care and doing it NHS with an independent midwife or doula. You can imagine what DH thinks of this!

The reason we were private last time is I was very scared about childbirth and we could afford it, but second time around I am a lot less anxious

Any thoughts?

I kind of agree with Zora. (Let's hope that doesn't get me called a cunt too).
This is not your birth, it's your Childs.
The goal needs to be getting the baby out as safely as possible. If the consultant really believes that there is a risk then I would suggest that you get a second opinion.
You don't give great detail about what happened first time, but do mention that he got stuck and they are now questioning the shape of your pelvis. This could indicate that there was some form of shoulder dystocia, or they believe that they prevented it.

If that is the case you have an increased risk of that happening again.

The risks (if there really are issues with your pelvis are not minor). Potential birth asphyxia to a stuck baby can result in brain damage and death. I know this from experience.

My beautiful natural birth "experience" was the worst of my life as my son gave no signs of distress before he got stuck. He passed away a week later.

Due to the risk that this could happen again my other children have been born by c-section fourth will be in November (all being well).

Good luck however you proceed. But please remember that birth is not just about the experience of that day, it is the moment of giving life to your child.

There is a degree of middle ground available. You could could devise a plan that you have a c section at say 40 weeks but if you go into labour before that you give VBAC a try.

If you are in south London I would seriously think about private at st Thomas- I presume you're at the Portland now?

I had an emcs with dc1. With dc2 the assumption was basically that vbac was the likely and most recommended option (midlands nhs). So advice varies massively from consultant to consultant and area to area. Research it and make your own decisions - no one has the right to tell you what to do. Might be worth passing some stats via DH though, you'll need him onside whatever.

I just wondered given your name, and also the French from my experience are very risk adverse. I thought that maybe why they are so keen for you to have another cs?

Best of luck whatever happens.

mootime

I agree, and I am so sorry for your loss

But this is a second opinion of sorts, it's the second consultant who thinks csection is safest.

Child birth, though an amazing, straightforward experience for many, is also one of the most dangerous situations you are ever likely to voluntarily put yourself or your baby in. Women and babies die in childbirth everyday, because it's dangerous. We can minimise the risks massively here in the uk compared to other parts of the world, but we can never remove them.

It's entirely up to you, and I would certainly suggest you talk to other professionals to get as wide a view as possible, but as Mootime says, it's not about you having a wonderful experience, it's about getting your baby into the world as safely as possible. I hope it all goes well, however you chose to go.

So sorry to hear of your loss mootime, wishing you well with number 4.

I'm sorry for your loss mootime.

I called Zora up because of the tone of her post.

I get really angry at the conclusion that any woman who dares to question anything regarding her medical care in childbirth does so because she doesn't care about the outcome for her baby. The plain fact is the OP doesn't trust her doctors opinion in which case she should seek a secod one, her husband should be supporting her in this.

Wanting to experience natural birth is a totally normal thing to feel, if this isn't to be for the OP then at least she will have been able to discuss this with open minded professionals along the way.

mootime I am so sorry to hear what happened to you, that's a reality check right there

haha no it's a paraphrase of my favourite nail polish shade (opi)

I'm also considering whether to try for a vbac this time, following a very positive cs experience as dd was breech. My DH also had the same initial reaction as yours when I mentioned there was a (tiny) chance of the scar rupturing.

In my opinion the main disadvantages of cs are:

1. Longer recovery time than vb - especially when you have an active toddler & their needs to take into account.
2. Increased risks to the mother with each cs due to scarring, which may be important if you are planning on a big family.
3. Overall safer for baby but cs still carries risks of respiratory problems as baby's lungs aren't compressed in the way they are with vb.

Problems with vbac:

1. Small but potentially catastrophic chance of scar rupture.
2. 30-40% chance of needing to switch to emergency cs - probably not going to be the calm experience of a planned cs.
3. Risks of tearing, blood loss etc that leads to similar pain/recovery as cs.
4. More monitoring so less mobility therefore more chance of a 'difficult' delivery.
5. Induction increases the risks of rupture so may end up with a cs if go overdue.

Personally I'm going to book for a cs at 39wks (other medical reasons not to go past due date). If I go into labour before then I'll try a vbac if the a baby is in a good position, but with a low threshold for switching to a cs. When I discussed this with my NHS consultant she was happy to go with this plan, but was slightly more pro section than vbac.

Do some research of your own. I think your consultant has your best interests at heart, but doctors are very rarely involved in easy straight forward deliveries to tend to err on the side of caution.

My two vbacs were in a hospital with specialist care facilities. To claim that any birth is safe just because you happen to be in a hospital isn't very sensible, particularly given the experience of mootime and myself, so I found that comment quite crass, tbh.

I also agree that this is about your child's birth, not an experience.

I lost a newborn 2 hours after an emcs (nothing to do with cs) and have discussed future births at great length with consultants. I was told risk of rupture during vbac is around 1 in 300. Personally, you are more than entitled to get a second opinion but IF the outcome is the same I wouldn't take any risk. I also think the reaction to your DP is harsh- he's worried, understandably, and although it is your body it is his child too and the risks of a vbac are not just to the child, you are at risk aswell. The likelihood is that however you choose to give birth there will be no complications, but, to me, putting myself and a child at risk would not be an option. I would listen to recommendations from people more knowledgable than me.

I just want to put a word in for the NHS! I'm lucky enough to live near an exceptional teaching hospital, but when I had a very complicated and dangerous pregnancy with DD2 I was supported by a team of first-rate consultants that I simply could not have paid for access to even if I had wanted to.

You might not have a private room with home comforts but why not get a second opinion from the NHS - they do tend to be more pro-VBAC and surely you've got nothing to lose? If you choose a c-section in the end you can still go private.

I agree with your DH. I'm medical myself, and I have just had a section for twins. Personally I would never consider a VBAC, too risky for me I'm afraid.

I had instrumental vb then emcs. There won't be a next time but if there was it would be cs. I wouldn't take the risk and would keep my fango nice.

It's entirely possible that what your DH is hearing is "danger" and "risk" and is not in fact trying to control anything other than reducing the dangers and risks to you and the baby he is hearing about.

Entirely possible.

I think you need to find out more OP.

So that you know in your own mind that you explored properly the possibility of vbac.

It does sound as if you are being "fobbed off".

And that may not be the case-but the reasoning is sounding a bit wooly.

Although of course there are no certainties, but "thinking" that your pelvis might be the wrong shape surely isn't good enough-if it can be determined either way?

Plus if you will have a toddler & a newborn, then a CS might not be the way to go if possible.

I think that OPs post makes her husband sound a bit controlling tbh, which may not be true, but perhaps why people aren't feeling too sympathetic towards him?

First of all your husband has absolutely zero right to declare that 'he won't have it' it is not his decision to make, and his wishes certainly do not count more than yours do

I disagree also that it is all about the baby, giving birth in any way also carries risks for the mother both physical and mental up to and including death, though obviously the safety of the baby for most is paramount it is not the only consideration

I think you should look into this further, maybe go and see an NHS consultant - if they agree a section would be best then you have your answer but if not you could do more research

You need to feel happy with your decision and I would not be happy going on a 'hunch'

To be fair to the husband, I can imagine that hearing two medical professionals (who you're paying for, so I imagine he values their opinion quite highly) say, "This is risky, bad idea, pelvis, baby get stuck", and then for your wife to seemingly wish to ignore their advice would be scary as fuck. He's probably just worried, and has visions of you being in pain or distress playing through his mind. His experience is important too.

Whatever you do, second opinion or no, keep him well informed. Have a "plan" or agreement to move to CS if things aren't going well; I'm like him, and if I have a plan B I find it much easier to cope with stressful situations, even if the plan is balls and things are out of my control.