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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

AIBU to have try for a natural birth after 4c sections?

126 replies

ClareBear2019 · 10/09/2019 11:01

I've just found out that I'm pregnant with DC #4. My previous 3 DC were all c sections, the 1st emergency, the next 2 elective. I want to try for a natural birth this time, as I know c sections get progressively more risky the more you have. DH says I'm being ridiculous and says a c section is the safest option. I see both options as having risks, so why not take the least damaging one?
AIBU for wanting to at least try for a natural birth? WWYD?

OP posts:

hormonesorDHbeingadick · 10/09/2019 11:29

It is completely your decision and the hospital can’t stop you trying to a VBAC because that would mean forcing you to have an operation without your consent. If it is a good idea or not is something you need to discuss with your consultant and midwife. Ask for specific risks and the % that they may happen.

MerryChristmasHarry · 10/09/2019 11:30

Sections do get riskier the more you have, but a vaginal birth also gets riskier the more sections you have. There isn't a risk free way to do it after you've had three sections already.

Generally the odds of rupture of the uterine scar increase the more sections you've had. Obviously this is on a population level, so some women experience rupture after just one and others have 4, 5, 6 sections with no issue.

There's not a limit on sections either. A woman may well be advised against having any more, but if she again gets pregnant, the baby is going to have to come out somehow, and ELCS is often the safest choice. It would be a foolish obstetrician who tried to deny a woman eg a 5th section and forced a VBAC attempt instead.

What's your reason for wanting to try VB OP, is it safety, the experience, recovery?

autumnkate · 10/09/2019 11:30

What I’m trying to say is that the nhs can’t stop you getting pregnant and having c sections.
They recommend you don’t have more than 3 (maybe 4) which means they are recommending that you don’t have any more babies.

Dinosauratemydaffodils · 10/09/2019 11:31

I see both options as having risks, so why not take the least damaging one?

What was your reason for the 1st section? How old are you? Was there any particular reason why you chose electives for the following 2 deliveries?

Bear in mine, it's only the least damaging one if everything goes okay. Part of the reason I went for elective with my 2nd was the fact that the risk of tears etc goes up as you get older and the statistics at 40 which was how I was when dc2 turned up, made for uncomfortable reading.

Original poster

ClareBear2019 · 10/09/2019 11:31

I don't think what I'm proposing is horrible, I just want my body to have the chance to do what it's meant to naturally do instead of risking life long complications fron multiple c sections! I've never had partial rupture or any of the other things that would put me at high risk of a rupture. The risks either way seem to be about equal, hence asking WWYD

OP posts:

autumnkate · 10/09/2019 11:32

After my 3rd section the surgeon said if I wanted anymore (I don’t) that it would have to be a consultant next time as I had quite a lot of internal scar tissue and to leave it at least 2 years before getting pregnant.

CandyLeBonBon · 10/09/2019 11:32

I'm surprised the midwife suggested induction after 3 c sections. I was under the impression that induction after a section is a no no?

Whattodowith · 10/09/2019 11:32

I would personally have a CS but that’s just me. I had two traumatic births and an ELCS which was by far the easiest of the bunch.

autumnkate · 10/09/2019 11:33

I would honestly be surprised if they let you vbac after 2 sections. They will certainly be advising a section because it is safer after 2 sections.

SleepyKat · 10/09/2019 11:34

Induction with a previous section is not normal procedure so I’m surprised the midwife suggested that as an option. I believe some hospitals are more open to try and break your waters and see what happens....but generally no synto. And I can’t imagine anywhere would induce after 4 sections.

I’ve seen some really thin uterine walls around scar sites when women have been opened up for a 3rd or 4th section. To the extent that it would be very easy to imagine any contraction force would cause a rupture. Obviously everybody’s uterus is different but nobody knows until afterwards!

Original poster

ClareBear2019 · 10/09/2019 11:35

I was very very young the first time, late teens, and after 3 days of labour it was obvious my baby wasn't going to come out. 2nd section was 18 months later, 3rd was 5 years later. They were elective as I was traumatized by my 1st experience of labour and birth. I'm in my early 30s now, and would like more children, but obviously I cant keep having c sections.

OP posts:

CandyLeBonBon · 10/09/2019 11:36

I didn't have a partial rupture either op. But rupture I did. It's a very very real consideration and you really don't know how your body will behave. I didn't dilate beyond 3cm, my baby got into distress, my waters broke in the car on the way to hospital, and was full of meconium. And the hospital I was booked at couldn't take me because it was full and they had staff shortages, so we had to be diverted to a hospital further away. All this would be bad enough with an uncomplicated birth but where it's a vbac, it's significantly more worrying.

MerryChristmasHarry · 10/09/2019 11:37

You're risking lifelong complications whatever you do. This would be true even if you hadn't had three previous sections. With ELCS vs VB attempt it's always about which parcel of risks is more acceptable to you.

The risks vary depending on other factors too. How old are you, what's your BMI, was the reason for the previous elective sections something about your body or not? You probably know which answers will make a VBAC more likely to work. In your shoes I'd be more likely to consider this if I were 31 with a normal BMI than 40 and obese, for example.

Interesting that they were talking about induction. NHS can be very dicey about augmentation on scarred uteruses. I have heard of people being very time limited with it and even refused it after just one CS.

Original poster

ClareBear2019 · 10/09/2019 11:37

Not induction via synto, induction via the gel and waters breaking.

OP posts:

Ohmygoodnessreally · 10/09/2019 11:40

Your midwife must not be very knowledgable, I don’t know if any consultants who would be happy to induce after 2 c sections, and I’m in this field. The risks are absolutely not even so please think again. A 1% chance equal size 1 in every 100 women. That’s such a high risk (death to you and baby) no consultant would advocate for a vba2c.

maccaroni · 10/09/2019 11:41

Think of the 3 children you already have, the most important thing is you come out the other end. I think VBAC would be mad. I’m sure your consultant had the attitude because he’s seen the consequences before. It sounds like you should stop at 4 children....

Original poster

ClareBear2019 · 10/09/2019 11:41

I'm fit, healthy weight, early 30s, its been 7 years since my last section, I'm not high risk other than previous sections. I think being induced gently at 38 weeks and fully monitered is as safe as I can be.

At the end of the day, the baby has to come out somehow.

OP posts:

cocomelon23 · 10/09/2019 11:42

My mum had 2 c sections then got pregnant again and they wouldn't allow a natural birth (because of the 2 sections).

MerryChristmasHarry · 10/09/2019 11:43

Is there any chance you could get an idea what state your uterine wall was in when they did the last CS? Perhaps the notes? Worth asking anyway, seems to be this is the sort of decision where you want as much information as possible.

Original poster

ClareBear2019 · 10/09/2019 11:43

@littlepaddypaws, how did you manage 6 c sections? Were there any complications?

OP posts:

Ohmygoodnessreally · 10/09/2019 11:44

I despair, I really do. There is no such thing as ‘gentle’ induction. Oxymoron. The intensity increases the risk Isla of rupture threefold. Read up on your stats. You won’t be induced, sorry.

OrangeSlices998 · 10/09/2019 11:45

@Ohmygoodnessreally I didn't post it and tell her to go for an unassisted homebirth for goodness sake. Women have VBAC's after multiple CS' - those stories and the evidence that supported them aren't invalid because you don't agree with them. I clearly stated that the OP should read up on the evidence and talk with her consultant and her midwife.

Original poster

ClareBear2019 · 10/09/2019 11:45

I had an internal uterine scan earlier this year, they could see the scar tissue but said it looked in good nick considering I've had 3.

OP posts:

PurpleDaisies · 10/09/2019 11:46

At the end of the day, the baby has to come out somehow.

It does, but not not all routes out are equal. With so many previous sections, there’s a real risk of complications.

I wouldn’t tryst what your midwife said about induction. That needs to be discussed with your consultant.

Drum2018 · 10/09/2019 11:46

I've had 4. Didn't want anymore but there was no talk of advising to stop at 4. One consultant said he's know women to have 6. One woman on my ward was after her 6th section (she'd also had 8 vaginal births prior to sections ) Personally I wouldn't have even considered a vaginal birth after my 2nd section and it wouldn't have been supported by the consultant anyway.

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