To ask for honest opinions of vbac after emcs.

[Rubberyduck]

Crappy first birth, 4days long resulting in failed forceps and ecms. Me and DS then had septicemia so we had a 10day stint in Hosp. I am now expecting no.2. Mw said straight up 'you will want another csection then' we have a consultant appointment in a few weeks to discuss the choices. DH seems keen to have a elective c section as it would be 'easier' to plan around our 2year old obviously worrying we will have a similar long experience. I am concerned about recovering from surgery with 2 little one's.

Experiences please?

Speaking as someone who had 1. a waterbirth and 2. an elective section, have the elective section. I swallowed all that guff about natural births being amazing and empowering and assisted/caesarean births being horrors and, frankly, it’s a load of bollocks. I would have ten c sections over one natural labour.

My natural birth ended in third degree tear and the recovery and postnatal care was horrific. Begged for an elective section for #2 because I was so terrified of another vaginal birth and it was a dream. It was fantastic. So stress free. I walked into the operating theatre healthy and well rested (as opposed as battered and sleepless after X hours of labour) and everything was just textbook. Recovery was no worse than a third degree tear. It was arguably slightly easier, and the midwives took better care of me afterwards too.

EMCS after a failed induction followed by an ELCS. DS was also 2 whilst I was pregnant. Wasn’t interested in entertaining the idea of trying for a VBAC with the various complications, and didn’t want to end up with another EMCS.

ELCS - although I was really sick after (which is no fucking joke with stitches across half your body) recovery was significantly quicker. I knew my limits this time and was prepared with all of the recovery items.

Whilst pregnant I taught 2 year old to climb in and out of bath, on and off toilet, on and off step up high chair, etc with the use of a step to minimise the temptation to lift them/pick them up in those first few weeks.

My 4th DC was a VBAC however a very risky one given I was only 34weeks, had an EMCS 19months before and was induced using the hormonal drip at a reasonably hefty dose ..all of which I have been told are indicators NOT to have a VBAC.

The delivery itself went well although little one was born with sepsis and pneumonia and we almost lost him as a a result of other negligence

I think it's so personal. My first sounds like yours, long labour with a back to back baby, failed forceps and then an emcs at full dilation. I still don't consider myself to have given birth to him and I really struggled emotionally with that. It felt like I'd failed motherhood 101 and that I didn't deserve him so I tried to leave him in NICU (I was rather ill at the time).

I flip flopped all over the place with dc2 and in end, having been told that my issues likely stemmed from my flatter than optimal pelvis/his giant head I booked an elective as this baby's head was also measuring 90 plus percentile. I went into labour ahead of my section date and ended up with a lovely semi elective section where I got to see her come out and have skin to skin virtually straight away. The bottom line for me was I just couldn't go through that again, all that pain, the NICU stay that dc1 ended up with, the uncertainity, the guilt and whilst it might have worked, there was no guarentee. As it happened, dc2 came out so wrapped in the cord (around her neck, arm and torso about 3 to 4 times) and was already starting to show signs of distress with each contraction, they said even if she could have made it through my pelvis, I'd more than likely ended up with an emergency section prior to that.

I was lucky with both as I had 2 very easy physical recoveries and with no issues/infections.

Was your septicemia due to your waters have been gone a while? Mine were 81 hours from breaking to dc1's delivery and that's why he went to NICU.

My vbac was fine. In on Thursday, came home on Friday (because madam took her time in coming out, so they offered me a bed for the night to have a kip), was doing the school run and carrying the pram up and down the five flights of stairs to and from the front door on Monday.

It just felt so normal, compared to the experience of a planned section, wound infection, pain and trying to BF with a grouchy, jaundiced baby, an incision that reopened two days later and a generally shit hospital.

Had it been like that the first time, I'd have had my second about five years sooner, as it took me that long to even contemplate the idea again.

I had a vbac birth with my first and it was a horrible experience I had to be induced because my DS didn't want to arrive was two weeks overdue and was put on the hormone drip having had my waters broken because of the failed induction resulted in a long drawn out labour with lots of pain killers and then finally going to theatre for forceps which almost failed and went to go onto an emergency c section I lost over 2 ltrs of blood and ended up with a 3rd degree tear and having a birth experience which wasn't all that great the amount of stress and upset it caused

My second birth was a planned c section and it was amazing i was so calm and with it the staff were amazing and I got to cuddle my DD and actually remember her birth wasn't out of it on drugs and we were all home within 24 hours I finally got to experience a happy birth

So please don't feel like you've failed in any way there are so many things that can go just as wrong with a vaginal birth it's not always smooth sailing and the most important thing is mother and baby are good not how the baby arrived all the best OP with the rest of your pregnancy

It is a long time ago now - DS about to go off to university - but DD was a 'textbook' vbac after DS was an emergency c-section.

We have a habit of moving house around due dates, so having moved when DS was 6 weeks old (and yes, I did lie on the operating table thinking 'and I'm due to move to another country in a month and a half...how is this going to work???') we were also due to move 2 weeks before DD's due date. I know that, with everything that goes around a house move, the stronger and more mobile that I could be post delivery, the better.

It really helped that there was a clear reason for my CS with DS - he had (still has) an exceptionally large head, and simply got stuck. We're talking 'head the right size for a 6 month old, way off the centile charts' here, not the odd cm or two.

So we had a clear plan, put together and documented with the initial consultants and then reviewed by the consultants in the new hospital after we moved. DD's head was scanned in a late scan. If it had been large, I would have had an elective section. If it turned out to be average, I would have a trial of vaginal labour, with a very low threshold for going straight for c-section.

DD's head was 50th centile, which gave me huge 'yes,I can do this' confidence going into labour. She was born about an hour or so after we reached hospital, absolutely textbook delivery, and I was home within 24 hours.

[Then she refused to feed and DS got first severe croup and then a really scary chest infection and we ended up in and out of medical care for quite some time, and I ended up with PND and hallucinations due to sleep deprivation, but the BIRTH bit at least went to plan!!]

My first was back to back and arrived by emcs after getting stuck.

I went back and forth about what I wanted once I was pregnant with my second. I had similar feelings to you about the previous birth, like I had failed and that some how having a vbac would fill this hole. On the other hand I knew what to expect with a csection and I would be able to know the date, which would make childcare much easier.

The consultant appointment was very reassuring, I decided on a vbac and we went over what would happen in different scenarios.

Once I went overdue the doubt started to set in and I was worrying that it would be the same as last time. Also not knowing when it was going to happen was stressing me out.

I went in on the Wednesday and was at 4cms but nothing progressed so I was sent home. I cried and said that I was starting to feel like I should have just gone with an elective so the midwife booked me in for an appointment in the morning to discuss my options.

The next day I was still having the same mild contractions that I had the day before. At the appoinment we agreed that I would come back the next morning to break my waters then see how things went. She said she needed to check me before letting me go and I was at 6cm by that point so they said I couldn't go home.

4 hours later I was holding my baby. The vbac ended up going very smoothly and he was out after 15mins of pushing (its easier if you were fully dilated the first time round).

I do have to say though that once he was there I was just happy he was there safe, the way he got there didn't matter in the slightest. Having a vbac wasn't a fix to what I had been feeling.

Thanks. I am 33 and my bmi is just over 30. Having not had a successful vaginal delivery despite being fully dilated according to online NHS advice there is less than 40% success rate for vbac. Something to discuss with the consultant.

I had three VBACS after ELCS no problems at all tbh and much preferred the easier recovery. Had continuous monitoring, with two I had syntocin drip as waters went and no contractions and one I had prostin as was ten days overdue but all deliveries were unassisted.

My first was 48 hour labour and ended in emcs when I got to pushing stage and wasn't progressing plus the pain relief had only worked down one side.

Fast forward 3 years I had a very quick labour with planned natural birth. Start to finish was about 5 hours, gas and air and a very quick push.

Recovery was not much different to the first time to be honest. A very different experience to my first labour though. Some of it was managed by more realistic expectations.

I had a vbac for dc2 with continuous foetal monitoring and it went really well and I would do the same again. Saying that I had spoken with the consultant and midwife before hand and was100% sure it was the right choice

Having gotten to fully dilated is a helpful factor for a VBAC - if you want one of course. Ultimately, don’t make a decision based on MN or people’s experiences here, what matters is the evidence (look up the RCOG guideline for VBAC if you haven’t already) and speak to the consultant and/or midwife about your own risk factors and decide based on that. As a former midwife, I’ve seen lots of successful VBACs and some that weren’t, based on lots of factors. One thing to bear in mind is that opting for a VBAC obviously doesn’t guarantee it. And an ELCS doesn’t automatically mean you’re absolutely risk free either, you could still bleed heavily, for example.

Good luck, whatever you decide

I had a vbac after emcs. I had limited recovery time after the 2nd as had to get back to work swiftly (self employed) so I did a lot of research. I was very surprised to read the high percentage of emcs that happened if you were induced with your second baby, if your first was an emcs. I stayed very active during my second pregnancy, I took raspberry leaf tablets from 37 weeks and I had planned to use the birthing pool at the hospital when the time came. I also had an appointment to book a cs if I hadn’t gone into labour by my due date. As it happens, I went into labour at 38weeks and my baby was a very quick, unplanned home birth. 2 hours in labour and I was up washing floors and cooking dinner later that day!

Good luck ☘️

@Rubberyduck

Thanks for this thread.

I am facing the same decision. I'm leaning towards VBAC due to the horrendous recovery from EMCS. I took 5 months to heal

I just can't make my mind up and sort of hope the consultant will find something that forces me either way.

I had a VBAC. It was great. Bloody hurt but was great.

My odds were good though - I was fairly young, very healthy and the reason that my first birth was a C-section was baby related rather than my body related. I had also got to 9 cm dilated with my first birth before the clock ran down and so my body knew what to do up until that point. (And I very much had a “second birth” ie much quicker and easier - up until 9 cms.)

I'm having this same debate, 33 hours failed induction, sepsis and 14 days in hospital, external pacing etc.

I wanted a home birth this time but MN have talked me out of it (I posted in another forum about it), I'm still considering a VBAC though but it scares me.

My last birth was 13 years ago so a lot has changed I imagine in that time including my body.

I had emcs the first time (twins) and all the drugs in the world leading up to it during a looooong labour. When I got pregnant again I begged for an elective section but consultant was reluctant. As it turned out DD came quickly and was born by vbac - with no drugs at all, not even gas and air!

So one extreme to the other, but both turned out fine and I have 3 lovely children. I understand your concerns... ask for a mw appointment to discuss it all properly.

The statistics decided it for me. Over 50% chance of a failed vbac after my first emcs. If I was going to end up with a section, I decided that a planned one would be much better. And I'm so happy I chose the planned section. Was a completely different experience to the first emcs , recovery much quicker and easier. And no feelings of not having a 'proper' birth because I chose it. My consultant fully supported my choice and said I would have likely ended up with another failed induction anyway.

Vbac for third after vb for my first and emcs at 34 weeks for my second. I had my vbac at home. Continuous feral monitoring is no more effective than regular monitoring by a one on one midwife so I was comfortable that with two midwives at home they would spot anything amiss. I had a good chat with my midwives about the what ifs and you need to do the same. I can tell you what I took away - rupture is rare, even rarer to be a complete rupture, and even rarer still to be not spotted before it happens if you’re being monitored well. Decision to delivery time is the time from when a c section is called for to when the baby is delivered and it’s surprisingly long even in hospital environments for an emergency situation - I was comfortable that if it came to that my transfer would not delay that timeline.
At the end of the day the risks associated with a section are higher than a vb - there are people who’ve chosen both routes and regretted it but hindsight is a wonderful thing.

Good luck with whatever you choose and I hope you have some great midwives to support you in your own decision making process

OP, if you haven't already I would really recommend having a debrief with your notes from your first baby.

Because I had an Emergency c-section with my eldest, I was booked in to see the vbac midwife with my youngest. Together we went through my notes from my first, she explained what had happened because I didn't actually fully know everything that had gone on. She explained the risks of it happening again and what options were available to me. It was extremely helpful in allowing me to make an informed decision when I was deciding how to have my youngest.

I went on to have an elective section. An elective is much better than an emergency. Everything including the recovery was much more straightforward. It did also help being able to plan when I was going to have him as I also had a 2YO. Although don't rely on that too much. I had to have him a week earlier than planned because I had pre-eclampsia and bells palsy!!

Echoing that the recovery of EMCS and an elective, was world's apart. Elective a totally different, better experience.

Popping in to say, I had an EMCS almost 6yrs ago and had PTSD after, planned home birth, terrified of hospital birth. At the time I felt I would never get 'my first birth' experience and I grieved it. I have no more kids, but I will say I had EMDR and that combined with time have led me to completely forgive myself, and I can look at the experience in a more detached way. I don't have a different view of it, but I don't have that desperate emotional heave connected to it. I don't know whether we will manage to conceive again (ectopic last year after much trying) but I would be much less averse to an elective. I think part of this may be related to a good friend having a vbac (she went into labour before her elected and couldn't have a section), she had issues for quite a while after,and was needing to self catheterise to fully empty bladder. I think it depends on the detailed reasons for the first section. If you can book a Birth Afterthoughts session to really break down your notes, that might give some insight. There was stuff in mine I didn't even know (he was back to back for eg).

I had an emcs with my ds in 2017 after a failed induction, baby in distress and failure to progress. When I was pregnant with my dd, I was consultant led due to the csection. They told me it was my choice. My only stipulation was not being induced again. At 39 weeks they booked me for an elective section 5 days later, but I went into labour the next day. I laboured from the fri night to mon morning, when I delivered her, with the help of forceps. I was keen to have a vbac. Everyone kept telling me it would be an easier recovery. It wasnt. The recovery was harder. My wound opened and became infected. I was on strong pain relief and anti biotics. DD is 15 weeks old now and I am glad I managed the vbac, although it was assisted. But I only wish I had been fully prepared for the recovery. Also, I had a 2 year to look after as well, whilst being quite unwell. Do whatever is best for you. If that's an elective section, go for it. If you want a vbac, go for it. Lots of luck x

I had a vbac after an emcs under general anaesthetic. It was important for me to try having been completely out of it for DC1's birth, and in the end it went absolutely fine.