To ask what you would do - planned C or VBAC?

[Rebeccaslicker]

baby number 2 due in a few weeks and I need to decide if I want to plan a c section or have a VBAC.

First was technically an emergency c section following a failed induction (suspected large baby due to GD), but in reality there was no emergency; I waited a few hours between the decision and the operation, it was all v calm (apart from my epic projectile vomit, who knew they have a Henry the Hoover for sucking vomit off everything?!) and I had a quick and easy recovery. That was 2.5 years ago.

This time will be the second labour; the baby is so far measuring about 75th centile; and is so far in a good position for labour. The hospital calculate I'm low risk for rupture, blood transfusion etc.

Could I ask people who've had a similar decision what you did and why? I can't decide which is better!!

My first was an EMCS due to failure to progress following induction. He was also a big baby. With my second I had growth scans and xrays and was told I have a small cervix and large babies. Consultant told me I'd need a CS, though I did say I wanted a VBAC so they let me go to term in case I went into labour before the baby got much bigger. Didn't happen so I was then booked in for a ELCS. For 3 and 4 I wasn't given a choice, had to be CS even if I went into labour spontaneously. Recoveries were all fine though. Good luck whatever you decide.

Planned cs. Better the devil you know IMHO.

I had a vbac after my first was delivered via EMCS due to a failure to progress. EMCS was hard - I'd been in labour for over 24 hours, so I was exhausted, and I was out of it due to having had G&A and pethidine before an epidural, so finally meeting DD was more of a feeling of relief that she was finally out than a magical bonding moment.

With DS I opted for a VBAC after being reassured at a late scan that he was measuring at a good size - 50th percentile instead of DD's 98th - and it was great. I refused to go to hospital till my contractions were 3 minutes apart (much to DH's alarm - we weren't exactly close to it!) so they couldn't interventions too early (due to my medical history I was high-risk for both pregnancies, and they were very keen to have me lying down and continuously monitored, which is understandable but didn't help me labour). When we got there I laboured for about 3 hours using movement and G&A, then had a mobile epidural for the final stage as DS was back to back so it was quite painful. I finally pushed for about 20 minutes, and when they put him in my arms I did then get that immediate rush of love and bonding hormones. I wouldn't swap that moment for anything.

The aftermath of my second birth was much easier too. I was in a lot less pain, I could move around, I could pick up my baby...I had to give myself blood-thinning injections after both births, but after the VBAC it was at least only for 2 weeks rather than 6 after the c-section. Breastfeeding was much easier to establish too.

...And writing all that has reminded me why I am definitely stopping at 2!

I had a similar situation - a not very emergency EMCS after failure to proceed induction, however I think my babies just have longer incubation periods.

I said for DS2 I wouldn't be induced again as I felt that if I want overdue again with the second and there was no sign of him being ready it would confirm my belief that my babies/body aren't 'ready' at 42 weeks. However, if I went into labour naturally before 42 weeks I would attempt a VBAC.

I went over again, head not engaged, no signs of baby even thinking about coming out so I went with ELCS. It was a lovely experience, same as my EMCS and I don't regret a thing, and I was honestly a bit relieved I wouldn't have to attempt a vaginal birth. As a PP said, better the devil you know, I suppose.

If I was you, I'd wait and see how big this baby is. If you think history is repeating itself, opt for the ELCS.

If I had it to do over again, I would have had an elective c instead of a VBAC. I almost died in the VBAC and had a much longer recovery period than my emergency c first time around. If you are over the age of 35, I would definitely advise (as a non-medical person) an elective c.

I've had a long time to think back over this as my kids are now 6 and 8....I wish I'd gone for an elective for baby 2.

First baby was technically an emergency c section but only because he decided to come before the elective date and was the chubbiest baby ever at 10.5lb. I was determined to have a home VBAC for baby 2 but in retrospect I have no idea why....Anyway, was all set for home vbac with my independent midwives, waters broke on a Thursday morning. No labour and waited. Finally c section 4 days later and a week in hospital for baby who was fine but had to have antibiotics. Why I didn't have a nice calm elective god only knows, would have prevented the week in hospital and nearly 2 weeks away from my eldest. I still regret it.

Have done vbac after emcs. Best thing ever. Up and about immediately. But I have little patience and found the enforced rest after emcs really irritating.

I’d book an elective c section, particularly if you have GD again.
I’m curious - what caused the projectile vomit? Was it when your blood reside dropped? It made me feel very weird!

If I were to ever have another baby I would certainly opt for the planned C section over the (un)lucky dip.

Some outcomes from VB are better than for CS, but the huge range of badness for VB makes it not at all worth the risk imho.

Elcs with number 1 - breach. Choice with number 2. Chose elcs again because
Had an experience of labour after miscarriage and spent whole time spasming both ends. D &V.
Dh worked away so needed to ensure he was home
Ds1 sen so needed to ensure there was no spontaneous activity that would send him off on one.
Was calm, a great birth. Had a few post op issues but would not have changed it.

Vbac was my choice after em c section
I didn’t want surgery if at all possible
It was successful but baby was back to back so forceps delivery

I had elcs with dc1 (scanning large)
Vbac1 -dc2 back to back, attempted (failed) internal rotation, failure to progress, 12 hrs of syntocinon, prepped for emcs but vb with minutes to spare - lots of damage to me but baby fine.
Vbac2 - dc3 brain damaged.

Yeah. I’d go for elcs. Vbac is too much of a lottery for me. Next time one of us won’t make it.

OP I am in the same position as you. I had GD with DS and he was expected to be large (actually 8lbs) so went in for induction at 38w, 4 days of on-off contractions, tons of internals but only 1cm dilated I ended up having a CS which was actually a positive experience but still wished I could have had a VB.

This time I have GD much worse plus I'm 41 and have had several mc in between so from the start they've said not to go over 39w and possibly 38w. I had pretty much resigned myself to an ELCS but at my last appt the consultant started talking about induction & vbac which has thrown me into confusion. She seemed quite anti CS and mentioned certain cases recently in the news where there had been problems. She also said if I had a CS this time I'd have no choice next time (I said I'm 41, it's taken me 10 years and 8 pregnancies to have (hopefully) 2 children, I'm done now!)

If there was the option of a single go at induction followed by CS I'd take it but based on last time what they say in the consultants office doesn't seem to mean much in the induction ward. Plus of course I could go into labour but still end up with an EMCS due to unknown issues. So I am about 80% leaning towards going straight for the ELCS as every account I've read on MN has been positive. Yes I could have a straightforward VB and be home the same day but at 38 weeks or even earlier that seems unlikely, so the balance of probability seems to be that a calm ELCS will be the least risky option.

I don't know if any of this has helped you but writing it down has helped to clarify it for me so thank you for your post and all the best.

I was in the same position as you. In the end it was agreed if I went into labour naturally before 41 weeks I would try for vbac. If not, planned c-section. I didn’t want to be induced again.
I didn’t go into labour by myself, so had the planned c-section at 41 weeks and all was fine. Maybe you could ask for something similar?

Judging from this thread, it seems in retrospect, an ELCS would be preferable over a VBAC....

My first birth was similar to yours. Tried for VBAC with second baby. Ruptured. Haemorrhaged. Crash section. Was in so much pain before they knocked me out, that, when I came round, I was convinced the baby had died - she hadn’t, but she had a scalpel cut down her back. There had been no time for niceties! I then couldn’t stand up straight for 9 weeks.

I had been low risk for rupturing. The risk can never be eliminated though. I would chose elective CS.

I had vbac which ended in forceps , episiotomy , shoulder distocia and 10lb9 baby in agony for around 6 weeks . Had ECS for my second baby due to him being on 99th centile and it was perfect he was 9lb 12 at just under 38+5. Would have the c section pain again over vbac.

My first was full on emergency section due to my being very ill. I’d done horrific labour for a day under induction (waters broke but nothing else) and things got dangerous and they whipped DC1 out.

DC2 I would absolutely have tried VBAC not due to any natural birth ideals but because of recovery and my first was very scary due to illness.

As it was dodgy placenta meant needed section for DC2 anyway! However the labour was so different (DC2 came early) I wished I didn’t need the section. By the time I’d twigged I was in labour (only cos waters broke) I was very far gone and realised I’d been in labour a couple of days! Thought I had eaten too much...

My understanding risks of a second csection are similar to risks of one but if you want another child after the second the third pregnancy will be high risk. The data on this was only coming out a few years ago but a VBAC midwife should be able to tell you

Ds 1 was an emergency section. Ds2 a year later was a planned section as I was too 'scared ' to try for vbac.
DD1 was a vbac 18 months later, followed by 3 more vbacs. So 6 babies in 8 years.
Personally I was really glad I had had vbacs and much preferred them over having having sections. How I gave birth mattered to me. I get that for a lot of women it is not an issue at all.

by the way all my vbacs went without a hitch and no issues afterwards, the last 2 being born at home.

I had an EMCS first time round because they realised after I had been pushing for a while that DD was stuck because of an awkward presentation. She turned out to be fairly large, which didn't help. It was straightforward and I felt I recovered well and quite quickly from the section.

I had a VBAC second time as I hadn't had any issues with the labour, just the delivery. It was a ventouse delivery and I can't say I enjoyed the experience, although I did like being able to hold DD2 straight away. I also had quite a bad 3rd degree tear which needed stitching up in theatre. However, the best thing about the VBAC was that, despite the tear, I recovered much more quickly and was up and about more easily after the birth. It made me realise that a C-section is quite major abdominal surgery.

In your position op I would go vbac. I've had one emcs followed by 2 natural births, I know which I prefer!

I had planned a vbac for last dd but ended up with a c section. No regrets, easy and relaxed delivery, fairly easy recovery.

My plans changed as from my due date I would have to be in hospital waiting for labour to start (pre-existing health concerns) and as they can't induce and she just wasn't ready to shift we opted for the sunroof that day. I didn't want to be away from my other brood and didn't want to risk the wait.

Coastal - yep exactly that, my blood pressure dropped through the floor! It happened immediately when they put the epidural in, and I honestly thought they'd killed me; everything went really grey and I felt so weird. Magic drug in the IV and 30 seconds later I was fine. DP was terrified; he said I looked awful! But then it happened again when they topped it up for the c-section and this time it was bright yellow vomit. First and only time I've projectile vomited.

Juniper - we're very similar then as i'm 40 and this is definitely the last baby too. Must. Not. Google. Second. C section. Horror. Stories!

Thank you so much to everyone for sharing, it is so helpful.