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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

VBAC or not?

78 replies

Jadefeather7 · 27/01/2020 13:29

Hi

I can’t seem to make up my mind about whether to try for a VBAC or have another ELCS.

I had an ELCS about 9 months ago for my first due to breech presentation. According to my midwife many women who had ELCS for this reason have successful quick VBACs (not sure if she’s just saying that to encourage me to try Hmm).
ELCS recovery wasn't totally straightforward for me in the short term but I’ve been fine in the long term. I had a bad reaction to one of the drugs they use to stabilise blood pressure but luckily the issue resolved quickly and I’m fine now. I did find that my mobility was really bad even though I tried walking around as soon as I could the next day (I had my surgery around 3pm and the numbness didn’t wear off that evening). My husband had to help me off the bed for about 10 days. I just couldn’t manage it on my own for some reason.
I think I’m probably a good candidate for VBAC however what really puts me off is having examinations or any interventions where I might feel something being inserted into me. If I’m going to be totally numb and unable to feel anything then I’m ok with having an instrumental delivery. I cannot imagine having forceps without the epidural (that’s my worst nightmare). I possibly have some sort of vaginismus. Although I’m fine with sex I don’t like medical professionals examining me down below. It’s possibly because I’ve had horrible examinations when I’ve had thrush, bad smear experiences etc. I’m also really worried about having an EMCS as the recovery is supposed to be much more difficult. I’m so torn and I just can’t make up my mind so I would love to hear some opinions.

OP posts:
Sceptre86 · 27/01/2020 22:55

As a previous poster asked, are you actually pregnant op? If not, try not to think too far ahead as not everything can be planned for. Most hospitals will not medically induce you after a previous section as there is a small risk of uterine rupture. I had a first section due to a failed induction, the second time round I was given up to 40weeks to go into spontaneous labour, it didn't happen and due to lost fluid levels I had to have another section. Recovery was worse with a baby and toddler but i knew what to expect pain wise and made sure I was discharged with appropriate pain relief.

I don't think your previous midwife was rude just insensitive.

Original poster
Jadefeather7 · 27/01/2020 23:10

Yes I’m 5 months pregnant.

To consider the VBAC option seriously I think I would need to have some degree of certainty about the epidural. I’m meeting with a consultant soon to discuss what happened to me last time as I wasn’t debriefed. If they try to push me down the VBAC route because they don’t fully understand what happened to me last time and how to avoid it happening again with another c section, I will have to see what they can do about ensuring I can get an epidural.

OP posts:
Jamiefraserskilt · 28/01/2020 00:04

The thing is, the epidural is down to how busy the anaesthesia staff are at the time. The midwives may not think it is necessary for any internal exam. If that happens, you may become anxious if things don't go to plan.
I had a second section with ds2. DS1 was breach and it meant I could plan down to the last detail with the consultant, the anaesthetic team and the midwives. I had the choice of vbac but having a very nasty experience with labour after a miscarriage, I discovered I was a vomiting, crapping labourer and did not want to go through that again.
Having an elective allowed me to plan care for my three year old and to ensure my husband was around (he worked away Mon to Fri). I was out of control with DS1 but in control with DS2.

mamabear2409 · 28/01/2020 00:20

I chose an ELCS after ECS and had a lovely experience. They even had me off home the next day. I was up and about a lot easier this time and just felt a lot happier in myself

Original poster
Jadefeather7 · 28/01/2020 08:28

Hmm I know a lot of people have really positive ELCS experiences. I guess I was unlucky. Not only did I have a rare and poorly understood reaction I also really struggled with the mobility and I don’t understand why because I did try walking as soon as I could.

I do understand the point about epidural not being available though. That would be a nightmare in my opinion (if I later had to have an Instrumental delivery). Would much rather have the ELCS than go through that.

OP posts:
Crunchymum · 28/01/2020 09:00

5 months pregnant with a nine month old baby? Are there no medical risks with having 2 c sections so close together? (Or vice versa are there higher risks of scar rupture if you have a VBAC)

I'd be looking at what is safest for you and baby.

NemophilistRebel · 28/01/2020 09:02

In my vbac class they said in our trust they wouldn’t allow a vbac to someone who gives birth within 12 months of a c section and it would have to be an elective the next time

So op will have a 13 month gap which is just over the safety net but it still holds risks as will be discussed in the 34 week appointment with a consultant

WombOfOnesOwn · 28/01/2020 09:04

I did a VBAC and thought the recovery was an incredible breeze compared to the c-section I had for breech presentation. I had no pain medication and felt like superwoman half an hour after the birth, could do stairs easily a day later when I got home, oh, it was heaven. And the first post-birth poo was also easy by comparison (sorry for the TMI but I assume you wanted the full picture!).

LGY1 · 28/01/2020 09:10

@nemophilistRebel that’s interesting. I had a EMCS due to failure to progress.
I’m pregnant again and had to see a consultant for my “talking out of a c section”
They were so bias - apparently 20% chance of womb rupture is nothing compared to “longer to recover”
She never mentioned such a low chance of success of Vbac!
I already knew my answer but had to sit there listening to skewed percentages!!

Original poster
Jadefeather7 · 28/01/2020 09:12

Well the midwife that I am seeing was encouraging me to have a VBAC (although she did keep saying it was totally my choice). She knows that there is a small age gap. I haven’t been referred to a consultant (not yet anyway). I will be seeing anaesthetist soon to discuss the drug reaction and whether that can be avoided if I have a c section again

OP posts:
NemophilistRebel · 28/01/2020 09:14

@LGY1 it annoys me the way they encourage into one by giving incorrect statistics

Successful vbac rates have much higher percentage (75% or so) if reason for EMCS was down to things like breach presentation.

This skews the figures overall.

Failure to progress leading to EMCS first time or failed induction the figures drop massively

VestaTilley · 28/01/2020 09:17

I can't comment on the rest of it, but I highly doubt you'd have forceps without an epidural at least. I had episiotomy and forceps in theatre, an epidural earlier in the day then a spinal.

If it comes to it ask for a spinal - you won't feel a thing, not even movement!

SmileyClare · 28/01/2020 09:20

Compared to the pain of dilating and childbirth, an instrumental delivery would feel like nothing. You'd be fully dilated, pumped with adrenaline and would barely notice. Bear in mind that assisted delivery isn't negotiable- it would be deemed essential or life saving.

With a very young child already, I would encourage you to go for a VBAC. Simply because recovery is much quicker and easier.

However, I think you need counselling. You have clear issues with child birth and medical interventions. It's not your fault, but they should be addressed. Your issues won't go away on their own.
Therapy may well improve other areas of your life, particularly your sex life.

LGY1 · 28/01/2020 09:23

@NemophilistRebel I think mine was both! 2 days labouring at home with home birth midwives, 2 days on an induction drip - only got to 8cm.
In that case shall we say my chance of success is 1%?! Grin

SmileyClare · 28/01/2020 09:27

Whoops, sorry just noticed you are fine with sex. My mistake. I was assuming you had vaginismus.

I still think you need to sort through all your issues around childbirth. I'm not really understanding why you couldn't get up off the bed for 10 days after your first, and you say that was a side effect of the epidural?

Whatever you plan, ensure you have as much support and help in place as you can post birth.

Original poster
Jadefeather7 · 28/01/2020 09:50

@SmileyClare I did get off the bed but I need help every time. I couldn’t manage it alone without someone holding my hands or at least having a rail to hold on to which I didn’t have at home. Even then it would take me some time to get up. I asked the midwife about it and she just said people recover differently.

Although I’ve never given birth to a full term baby I did have a late stage miscarriage with contractions etc that happened naturally. Obviously was very painful but I still don’t think it was as bad as when a doctor tried to stick a speculum up me when I had thrush.

OP posts:
Original poster
Jadefeather7 · 28/01/2020 09:57

Could have been as a result of weakeneas as I had over a litre of blood loss which again no one explained the reason for.

OP posts:
SmileyClare · 28/01/2020 10:06

It's possible you were immobile due to your CS? It's major surgery so understandable. If you experienced paralysis days after an epidural then something was wrong there.

Ultimately you have a right to a choice and if you feel an elective CS is the best option then don't feel ashamed or pressured otherwise. All you can do is go into it as informed as you can be.

As I said, it is major surgery with all the associated risks. You will need a lot of help and support post birth- particularly with an older baby at home.

Medical issues aside, you seem to be suffering from the trauma of childbirth and other past procedures so consider protecting your mental health. If you're likely to spend the rest of this pregnancy torturing yourself about a vaginal birth then perhaps it will be a huge relief to decide on a CS now.
You're then taking control, please don't see that as a failure in any way.

Original poster
Jadefeather7 · 28/01/2020 10:15

Yes the immobility was because of the CS but a lot of people who talk about CS recoveries talk about how great it was for them and how they were running marathons straight after! That wasn’t my experience.

I really don’t know if a CS again is the right choice but at the same time I know I would only really want to attempt a VBAC if I knew I could have an epidural and not feel anything being inserted into me. There doesn’t seem to be any guarantee of that to another CS is probably the way to go. I really hope the anaesthetist can shed some light on how we can avoid the reaction that I had last time to the blood pressure controlling drugs that they used. There’s very little research on this issue as it is so rare.

OP posts:
SmileyClare · 28/01/2020 10:27

I see your predicament. It's fucked up that you feel forced to choose major surgery because you can't be guaranteed an epidural. Such is the mess of our NHS Sad A CS would cost a hell of a lot more to the NHS than employing sufficient anesthetists.
I suppose you could go private, thus ensuring your epidural?

As for the people you know showing off about how great they were feeling after their CS and going out running? Liars Grin

BlueBlazerBlack · 28/01/2020 10:38

I had a VBAC with DC2 after an EMCS with DC1 due to breech presentation. Both times I went into labour spontaneously at 36 weeks.

For me, the VBAC was a much more pleasant experience, it was a very quick labour and I managed with just gas and air. I felt like superwoman afterwards and was up on my feet really quickly. Recovery was also much easier, and I was glad not to have had a CS with a 3-year-old at home.

But in your case, the smaller gap would worry me. After my CS I was advised to wait at least a year before getting pregnant again, and when I looked into having a VBAC, I found a lot of information suggesting the risk of scar rupture increases the smaller the age gap.
Also, at my hospital they tried to push an induction on me, which I absolutely didn't want, so I had to hold firm, much to the junior doctor's annoyance! I am also still annoyed that they wanted to induce me so soon after my waters broke. By letting my labour progress naturally and moving around I was able to avoid a cascade of interventions (epidural then assisted delivery).

Original poster
Jadefeather7 · 28/01/2020 10:50

It’s interesting that a few of you have mentioned the small age gap, I thought the same too about it being risky to go for a VBAC but then my midwife was talking about how great they are so I really don’t know whether the gap is considered an issue. I do remember the advice being to wait a year before conceiving again... this was an unplanned baby!
I wish I could afford to go private.

OP posts:
PooWillyBumBum · 28/01/2020 10:59

My midwife has told me I can decline vaginal examinations and they’re purely for the midwives’ benefit, not mine. Some women progress much faster than others so dilation isn’t a great measure of anything really.

I just wanted to chip in with that in case you weren’t aware. Good luck whatever you choose!

Urkiddingright · 28/01/2020 11:08

You’re not supposed to get pregnant for at least a year after a c-section, everyone is warned about this. I had a CS 15 months ago and the consultant was very stringent about this, there are so many risks involved. Horse has already bolted for you but I think a CS would be safer. You need to speak to a consultant though and weigh up the risks of both. Neither will be risk free, giving birth less than a year after a c-section.

MrsArchchancellorRidcully · 28/01/2020 11:11

Just a small comment. No one, not even hcps during labour, can force you to have an internal exam. It is your choice to consent.