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

[ClareBear2019]

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?

I'm absolutely not having a homebirth. I just want to pick the option that will give me the best chance to have more children. I'm scared a c section will limit that.

I would think the potentially catastrophic consequences of a uterine rupture during a VBAC far outweigh the risks associated with another elective c-section. Have you discussed potential outcomes in either scenario with your consultant?

Also - you can persevere with a VBAC but the poster above who said the medical team would whisk you to surgery at even the hint of anything going wrong is correct, and they’d be right.

My sister had a VBAC after 2 c-sections, but she was the first to do so in that (very large and busy) maternity hospital. She had to speak to a consultant throughout, and encountered a lot of resistance to the idea. It went well, and she was glad that she did it. I don't know how the additional c-sections would affect the outcome. If you are seriously considering it, then maybe do some research into the potential risks, and how they will have increased. As you say, 7 years is a long time from your last c-section, so maybe if you can find enough research to back you up (assuming it is doable - I honestly don't know!), then maybe you can find a consultant willing to support you.

@drum2018, were the any complications after your 4th section?

Interesting. Were you pregnant then OP? I wonder if another scan to get a view on suitability for labouring might be possible. Privately even.

I'm surprised you've been offered an induction. I was told induction was a big fat nope after just one c section, VBAC or ELCS were my options. Not that I would have chosen induction anyway as my first experience of it was horrendous.

Anyway, only you can weigh up the risks to yourself and your baby OP. Write down any and all questions or worries you have and see your consultant again. She might seem abrupt and rude but they do know what they're talking about, if she is advising an ELCS then I'd probably take that advice on board.

I had a VBAC after 2 c sections (one emergency and one elective) and it remains the biggest regret of my life. I had no big risk factors myself, and I knew the risks of a VBAC after multiple c sections and felt confident. But labour did not go smoothly and my baby was severely brain damaged due to lack of oxygen during birth and died 21 days later. I'd have surgery ten times over to have him again. I've since had another baby by ELCS and don't intend to have more but, if I did, they would definitely all be c sections.

I am absolutely ok with being whisked straight to surgery at even the slightest hint of anything going wrong.

I'm even happy with going straight for another elective c section if I know it won't damage my ability to have another child.

Isn’t it more sensible to focus on the safest way for you and your baby? Also having more children could put you at risk so shouldn’t you focus on being healthy for your existing children rather than on having more future children?

Jaseyraex, I'm so sorry. That is my worst nightmare.

@drum2018, were the any complications after your 4th section?

None at all. I can say in all honesty it was the easiest recovery. I had interthecal morphine (given at time of surgery), therefore no morphine pump attached after the surgery, I took every painkiller offered both oral and suppository, and I truly had no pain. I couldn't believe it when I stood up the next morning and could stand up straight without pain. I had dissolvable stitches too which was great and no drain. (3rd section I'd had a drain and non dissolvable stitches.)

Well, another section will potentially damage your ability to have more children in that the more you have, the greater the risk of miscarriage, stillbirth and future rupture. However, with VBAC comes the risk of an emergency section, which is less safe overall than an elective. For both you and the baby. Essentially, the ELCS is the option in the middle risk wise. You can choose that, or take a punt on an option that could be safer or more dangerous.

I would imagine they'll also want to place an epidural early in proceedings too, so something to be aware of. Not necessarily a bad thing depending on your perspective of course!

I'm even happy with going straight for another elective c section if I know it won't damage my ability to have another child.

There are no certainties- but if you have an early induction/ VBAC and your uterus ruptures there's a risk to you and your baby, and I've cared for women who have had to have emergency hysterectomies to stop bleeding. An elective section is a safer choice for this pregnancy and potential future pregnancies.

Thank you to all of those who have responded kindly. I'm scared, so thank you for helping me to see that an elective is the best way forward. I was told horror stories by the midwife of women who had a 4th section being left with torn bladders and bowels and life long complications. However theres been no posters so far who have mentioned any issues with multiple sections, only issues with VB

It may not be advisable for you to have more dc op. That must be a hard thought, especially as you were young when you had your first. I think the best thing to do though is to get this baby out safely and then see what the information is from the fourth section. Ask for a detailed debrief from the surgeon and then weigh up the risks in your own time. Don't let this decision now be clouded by future hopes and fears. Do what's right for you and this baby now and then see.

What are the risks of repeated c sections?

Thank you Northern.

It's understandable that you're scared. You're facing a potentially risky delivery whatever you do, and you're coming to terms with the possibility that your obstetric history might dictate that you can't get pregnant again. Those things are difficult to come to terms with. FWIW I'd focus on this one and go for the elective in your shoes, and I've had both a VB and CS.

Risks? Bladder and bowel injuries ,adhesions, placenta problems if it attaches to the scar tissue, infertility

Honestly. with three children at home I would be going for the safest option for them and your unborn child and not planning around hypothetical future children. People posting anecdotal stories on the internet do not constitute medical advice.

Your consultant was probably rude and abrupt because you were told previously not to have more C-sections, which was them telling you to stop having babies, but you've disregarded it and put your own health at risk, which has direct consequences for the medical staff too 🤷‍♀️

YABU to be having 4 children and considering more. Think of the planet!

Ive got 3 and am pregnant with number 4. Ive had one vaginal birth and two fucking awful emcs. I will be trying for a vbac with this baby.

I was very disappointed with my hospital because not one dr was even prepared to discuss anything other than an elective c section at 39 weeks just citing 'hospital policy'. This pissed me off as I am still a person and allowed to have an informed discussion about all options regarding my treatment. I saw my consultant who was very nice and we went through everything and he is happy, after a long discussion to allow me to try for a vbac on the basis of my personal history and with caveats.

(Consultant was very impressive actually, not impressed by his staff's actions and dismissive attitudes, says I will see only him from now on and gave me a letter about the proposed vbac in case I come in in labour and he isnt there, that I wont be pushed around.)

Basis of allowing try at vbac- early 30s, healthy weight, previous successful vaginal delivery, spontaneous labour with natural progression, 9 years since last section, never reached 39 weeks in any of my pregnancies, so likelihood of getting the smooth elective section is practically zero, I would always be an emergency.

Caveats- pregnancy has to be going smoothly with no significant problems, definitely no bleeding before labour, any bleeding in labour (the cause of the EMCS) will be immediate section, labour has to be spontaneous, cervix has to be ripe and behaving itself, baby has to be head down and coming at a reasonable gestation (my EMCS were two and three months early).

basically everything has to be textbook or I will have a section. Im happy to agree to all of that. Highlighted the previous vaginal birth thing because that was the thing that was most important to him.

Have to say I am very surprised about any form of induction being considered. Going into labour and progressing without interference was a big consideration.

You won’t get anything like a proper induction. I imagine they’ll only be able to break your waters or potentially go straight to drip.

OP- how many more kids do you really want?

I think lots of women want more kids than they end up with. There are lots of reasons why we don’t have more- finances/ other children/ relationships- your reason is your health (and the health of your baby). That seems to be a good reason to stop having more. It is a hard thing to realise and come to terms with but maybe you should try.