To ask what a midwife would do?

[rubyred84]

Posting for traffic, but i guess i cant decide if im being unreasonable to consider this.

To any midwives or doctors on here, would you have a hbac (home birth after c-section)? I keep getting told it's totally my choice, all hcp's are being super supportive, but at the same time I just want honest, no nonsense opinions on what a hcp would do themselves, considering what you know/have seen. I can't decide if this will be the best decision or the worst. So hit me with it!

So I'm not drip feeding, first section was elective due to multiple birth, both were head down, so no indications of issues I may have preventing a vaginal birth.

I'm not a midwife or doctor but my understanding of it is usually the main concern with having a birth after having a CS is that the previous cs scar could rupture and you could haemorrhage. They may be willing to let you have a vbac/home birth if you live near enough to the hospital in case of an emergency. You'll have a midwife present anyway so I'm sure they will be carefully monitoring everything and will know what to watch for. Good luck with your birth

I'm not a midwife but I'd never have a home birth. I like the idea of it but I wouldn't be here if I'd tried a home birth with DS.

I am a mw and honestly?? I personally wouldn't. My trust have pools on delivery suite and VBAC ladies can deliver there with waterproof equipment to record the trace on baby - that would be my choice.

One of the early signs of uterine rupture is abnormalities in the fetal heart which is easier picked up on CTG than intermittent listening with the sonicaid. It is a rare occurrence, but I honestly wouldn't take the risk personally.

I will add though that being at home - you obviously won't have an epidural and therefore will be able to detect the very early warning sign of scar pain which is a positive. Also labour is more likely to progress normally at home as the hospital environment can really mess with the hormones and there's less interference at home which can interrupt labour. What was the reason for your section and have you had a normal birth before?

Not a hcp either (but am a twin mum). My understanding is, as stop says, the risk of precious scar rupturing.

But; that can all change depending on how long ago the c section was and other factors such as general pregnancy health.

I had a home birth before I had my twins so things you will need to consider:
How long it will take the mw to get to you when you go into labour.

How far away from hospital are you if things do go lumpy. Realistically the mw will dial 999 if it's that much of an emergency. But I'd consider how long an ambulance might take, whether you'd go to your hospital of choice.

What are you going to do with your twins while you labour.

I'm not trying to be negative. I loved my home birth even though Ds1 arrived before the mw did. But it seems like your practitioners already err on the side of caution if you had an elective section with twins who were presenting fine.

I was keen on the idea of a home birth with my first but ended up needed as elcs due to breech presentation. With my second I had the same midwife discussed it with me at the booking in appointment. Very much along the lines of it being my choice and she was there to support whatever I chose to do. When I decided not to go down the home birth route she said that off the record she would never choose home birth even after the most straight forward of c sections.

Sorry I see you already explained why you have a previous caesarian - was it just your choice due to twins?

I’m a midwife and probably would consider HBAC. I’d certainly consider a VBAC without CTG monitoring (ie. potentially in a birthing centre).

I've done it, more than once. My emcs was due to malpositioned baby (and not being noticed by the mw until I was 10 days overdue!); I was in hospital overnight for a scheduled section the next morning but ended up going into labour that night and had a prolapsed umbilical cord.

It's never happened again, and my vbac homebirths have been completely fine.

All my medical friends (GPs, consultants, etc) have gone to the hospital for birth.

Also, not wanting to scare you but I did VBAC after Caesarean and nearly bled out in the hospital! If I had been at home (only 5 miles from good NHS hospital) I would have died. Unsurprisingly, due to my C-section scar, I had placental adhesion - a normal consequence of Caesareans.

Also, V birth is not that special so don't feel pressured by any of the many reasons people give to talk you in to it. Having done it both ways, I can assure you that if you have a second C-section you won't be missing anything. V birth is more uncomfortable and can have plenty of complications which drag on well after maternity leave is finished.

MissDuke yes the c section was my choice, consultant was happy for me to try naturally. I went into labour at 34 weeks but still had c section. I have tokophobia which honestly is the main issue. My fear is based around intervention, hence with twins, I felt c section was my only option.

Honestly, im so petrified of any intervention, staying at home feels "safe" to me, as I'm far away from hospital where that happens. But logically, I know this might not be the case.

Minisoks, my trust has a dedicated home birth team who I've been told are experienced in vbacs, but I haven't met any of them yet. I'm only 10 mins away from hospital.

I just don't want my fear to win, I'm working with a hypnotherapist, consultant, consultant midwife and a doula. The issue is, I've done so much research during my pregnancies (chochrane review's etc) I'm well aware of what can go wrong. But equally, totally agree that a hospital setting csn shut down labour, and for someone as terrified as I am, I may never even get going if I'm not at home.

I know a phobia is irrational anyway so this is probably pointless to say, but the logic and statistics of history show that pregnancy and childbirth has become profoundly safer for women and babies in the last 40 years - ie since proper medical support. If you really think honestly that you are safer away from highly trained, hard working, brilliantly clever people supporting you then research the reality of childbirth in places like Somalia which still have no healthcare.

Suggest you also do hypnobirthing as the meditation can help build your confidence about pregnancy.

You really need to speak to your home birth team then. You can change your mind as your due date approaches.

But if the home birth team have experience of and are comfortable to do it, then I would recommend it if it will help you feel happier and therefore safer. So there would less likely be problems.

Problems occur when people panic! I am sure my section was as a result of the hospital going 'oh shit she is in labour' and me having incorrectly been sent to day assessment. Over a lunch time too so not as many staff around as would have been potentially on a labour ward. However, I cannot fault the care during and after.

I had a uterine rupture during an elective c-section (5th baby, 1st section) and went on to have a vbac but chose to have it in hospital purely because of the rupture. I’d already had homebirths before the section.