To consider a home vbac

[allotmentgardener]

I'm pregnant with number 2.
I wanted a homebirth with ds1 but I never went into spontaneous labour. Ended up with an induction on + 14. Then a section on +15 due to foetal distress.
At the time i was sad about the section, but the main thing is that ds1 arrived healthy.
I want to try for a vbac this time round. Running about after a 23month old after a section doesn't fill me with joy.
Am I crazy considering a vbac? Especially a home birth? I suppose it all depends on whether I go into spontaneous labour....

My vbac was great and YANBU to try for one.
However, I don’t think a home vbac is a good idea, no. Perhaps if you have a third after a successful vbac?

Yadnbu
I'm currently preparing for a home birth against medical advise.

I would suggest you join as many fb groups as you can. Home birth UK, boss your birth, all great starting points.

It is your choice. I cannot express this enough. Find out the facts specific to you. How long since birth 1? What are the risks of scar rupture with that gap since births? Get researching, talk to other women and make a choice for you based on your personal situation.

Risks of home birth are a lot lower than in hospital. I think you'll ace it ♡♡

YABVU. As others have said, yes to VBAC, no to VBAC at home.

My experience: DD1 was as good as an ELCS gets after a very low risk pg. I was the perfect candidate for a VBAC and keen to try for it. DD2 was a very low risk pg (apart from the risks from previous CS). I went into spontaneous labour at 39wks... A while into labour I felt the classic 'signs' of rupture. The midwives didn't believe me. Fast forward to 3 HOURS later and I was screaming in a room with minimal pain relief (because I wasn't far enough along to 'qualify' for anything stronger) surrounded by HCPs scratching their heads at what was wrong. I had made my suspicions strongly known but wasn't believed. Finally DD2's stats crashed and we were raced into theatre. By the time they got to her, her head had pushed out into my abdomen. I don't know how long they would have had to save me, but they had 7 minutes to get DD2 out. If we'd been at home I have no doubt we'd both be dead. I lost a lot of blood.

Please don't do it. It isn't THAT rare, and if it goes wrong it would be catastrophic if not next door to an operating theatre. I can well believe the midwife upthread who said you never forget it once seen. My DH was deeply affected by it, and I remember it like yesterday.

To address some point on here:

You might not have the option wrong. You always have the option. You don't have to be given permission to do anything.

you might both die umm how useful is that to the op?! Find out about how soon rupture presents itself and what the symptoms are. You might negotiate to go in as soon as and if any symptoms present.

It's also not an all or nothing. You could labour at home for as long as possible and then go in for delivery.

Yadnbu
I'm currently preparing for a home birth against medical advise

Against medical advice? Why would you put yourself and your baby at risk? Not trying to be argumentative but I just don’t understand why if a dr has told you not to you would ignore it

The rcog have guidelines. Have a read before making any decision and involve your midwife, consultant etc in the discussion. Ask for a referral to a senior midwife and talk through your options.

www.google.co.uk/url?sa=t&source=web&rct=j&url=www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf&ved=2ahUKEwjnrJn235fcAhVsI8AKHR6sDO4QFjABegQIAhAB&usg=AOvVaw27I35pSh83nk5rTFPC_6pK

Buddyelf because the "risks" are so tiny and I know my body better than any medical professional thinks they do.

I understand you know your body - I just can’t imagine the nightmare of having a uterine rupture at home. Especially when you have been advised to be in the hospital

I can completely understand why you would want control over your birth of choice.
But from my own experience (always wanted to deliver normally, had 3 CS) I would say no, absolutely not.

You said yourself in your OP : whilst you were disappointed about the birth the important thing is the baby (and you) emerge unscathed.

The word risk is widely misused when it comes to birth particularly homebirth.

If I have an increased risk of things going differently what does that actually mean?! Does it actually mean I should go straight to consultant ward and have a medical birth?

Let's look at it another way. My increased risk of things going differently is now 1.5% rather than say a normal labour which might have a risk of 1.3%. I still have an increased risk but it's only very slight. (I've not used real statistics but my point remains-look at the word probability and the number rather than the generic word of risk).

You might not have yo birth at home to avoid continuous monitoring.

The language you use to speak with your health professionals can help. You seem pretty clues up so I'd assume that you know you can have a home birth regardless of risk and they will have to send a midwife to you. I wouldn't recommend this but - what you can say if you want to is to be honest with them:

I am extremely concerned that the continuous monitoring recommended is going to reduce my ability to move around which will hinder my pain relief and ability to progress in labour significantly. I am so concerned about this that I'm considering giving birth at home even though I'm concerned about the risks of that too. Obviously I want to minimise the risks as much as possible, but if it comes at the price of hindering my birth process I wonder what is the point. Is there any way you would be prepared to compromise on the continuous monitoring? Are there any other options which would be available to me or is my only option to avoid the monitoring to give birth at home?

buddyelf because I've done my research. I know my risk factors and my birth choices will be planned around the things that could go wrong whilst all the time stacking the odds in my favour for a normal delivery at home. Stats show your far more likely to birth normally if you're at home compares to in hospital.

I'm NOT putting me or my baby in danger through my choices and I'm absolutely not suggesting that the op should just read all the responses on here and just go with the majority. Everyone is different and the op needs to find out the actual real probability of things for her situation to enable her to make an informed choice.

Here’s the thing, for me even the slightest possibility of having something as dangerous as a uterine rupture happen is enough of a reason for me to listen to medical professionals. I couldn’t care less if I was monitored to high heaven if it meant my baby was delivered safely.

buddyelf and that's fine. That's you and you've made informed choices based on what's right for you. I truly think that's great. But not everyone thinks and feels the same.

I get frustrated with blanket suggestions of people birthing in hospital just because on the surface there appears to be a risk. Women need to feel empowered to decide what is best for them based on all evidence available and that includes having discussion not around the word risk but on the actual figures. The op asked if she was bu to consider a home birth. She is definitely not bu to consider it and do her research.

I wanted a home vbac too but the midwife said no. I ended up staying in hospital for a few days and it was lovely to be able to bond with my New born without a toddler bellowing in my ear about peppa fucking pig! so there are benefits to hospital births too xxx

Some really interesting comments Thank you. What people are saying, the most important thing is to end up alive, with a healthy baby. There are a lot of factors to consider and a proper chat with the midwife is in order. If I get the same one as last time, it was she who suggested homebirth to me.
I suppose time will tell and perhaps the best situation would be to labour at home as long as possible then decide to transfer in. Hospital is 20 mins away.

Good luck OP, I hope you are able to arrange something you are happy and comfortable with and get the birth you want. Hope all goes well

Echo buddyelf
Good luck :)

And buddy...thanks for the discussion. So useful to get other people's perspective sometimes to make you evaluate your own position and I certainly take on board and respect your comments this evening.

AmazingGrace of course home births tend to get better outcomes. Those that attempt it are usually the lowest of the low risk.
And do you really consider a 1.5% risk of something catastrophic going wrong, no matter what the risk may be for other patients, is worth taking? That's 3 in 200 women if everyone took your advice . If it was 1.5% for something minor then fair enough, but that's a big risk for something life-threatening when it could easily be avoided (the consequences not the original risk obvs).
Actually the risk of rupture is around 1 in 200 for otherwise low risk VBACers, but that is still a notable risk for a complication that is so serious.

OP as advocated by others, speak to the birth options clinic and discuss your concerns. I never made it past the assessment room on L&D, but had been signed off for a water birth in the MLBU using telemetry to monitor me whilst in the water. Your options are not just between home birth and strapped to your bed with a consultant permanently lodged up your fanny.

@skanking but even if you compare a same group of low risk people in hospital vs at home the chance of you having a normal delivery is higher at home.

You've misunderstood my discussion over %risk. My point was that you need to find out the actual numbers and compare them to low risk people to establish exactly the risk you are facing. Then make an informed decision. I've not once said that the risk is only 3/200 So go for it. I just feel it's important for women to know they have choices and as you've rightly pointed out it doesn't have to be one extreme or the other.

I've no doubt the op will make the decision right for her :)

I had a lovely Vbac following a traumatic first birth. I was monitored all the way through and even had to get on my side when my babies heartbeat went down. It was lovely. Personally I think it’s a bad idea to risk a home Vbac having known at least 3 friends with serious ruptures and one with a complete hysterectomy too.

I would try to work out how u can make your hospital room as homely and relaxing as possible instead. Good luck

i don't think you'll ever get a balanced opinion on MN, it's just too emotive a subject.

You'll get the anti-HBs who are against HB's in any circumstances and could never imagine choosing to birth at home, and people who are adamantly pro-HB even in the face of medical professionals advising them to reconsider.

I'd speak to your consultant and/or head of midwives and ask them to speak plainly about the risks and how you can work together to get the birth you want safely in hospital if needs be.

One thing I would say, that it's not just your health, your baby's health, your existing child and partner that's at risk, but there's also an NHS midwife who would be duty bound to attend if you chose to go with the HB. I can't imagine the stress as a medical professional having to attend a high risk home birth, having to factor in all the increased risks and knowing that you can do your job perfectly, but if a catastrophic event happens there'll be very little you can do.

Ive read some rubbish on MN over the years but this has to take the absolute
"Risks of home birth are a lot lower than in hospital. I think you'll ace it"

Either you haven't read the OP or you aren't very good at calculating risk if you think this is true

And you 'think OP will ace it'? Based on what? You have no idea who she is or her circumstances other than her previous experience of birth suggests she doesn't 'ace it' (sorry OP)

Posts like that make me so cross. You don't validate your own HB choice by doling out bullshit to other people, especially when it's dangerous bullshit

@tenbob

Research here. I'm not spouting bullshit.