re CS's, i am also still undecided. I have another consultant meeting this Friday and hoping to be certain by the end of that. DS was cat 1 EMCS, very scary, under GA so i have no birth memories, DP wasn't allowed in room, add in a 3 pint major PPH, a botched canula in my arm, a catheter that blocked, an infection caused by they don't know what, and DS being APGAR 1 and then needing transitional care, involving twice daily visits to SCBU...and its something i'm keen to avoid (was meant to be a calm home/water birth).
So i can choose ELCS or attempt VBAC, entirely up to me to decide. Consultant quotes 70% chance of VBAC working...but that is generic stats. Greentop guidelines suggest i won't be successful - raised BMI, i am short, male baby, expected to be over 4000g, less than 2 years since previous CS, no previous vaginal births, maternal age 35+. Growth scan suggests he will be 87th centile/ 9lb 4 if makes it to term (unlikely as DS was over a week early). Abdomen bigger than head. Had GTT last week and as didn't receive a call, assuming that i haven't got GD. Midwife who was present during DS labour has said if this baby is back to back like DS was, she feels there isn't a cat in hells chance of me delivering within the restricted time they will allow me to push (30 minutes, posssibility of extending to 60 minutes, but depends on if they think baby is almost delivered by end of the 30 minutes, as increased risk of scar rupture the longer you push, and if then end up with EMCS, more likely to suffer PPH the longer you've contracted/pushed for). With DS i pushed for 4 1/2 hours and ended up having CS. So my current plan in my head is that if baby is back to back, get taken to theatre asap for what would be a lower category EMCS. If not back to back, think it is worth attempting VBAC as i went into labour spontaneously last time, waters broke, and i fully dialated. All factors that might mean i stand a chance (although the greentop guidelines suggest otherwise). If at any point i am not progressing at a speed they are happy with then they will take me through for an EMCS. Again, if baby not delivered within the restricted pushing time, then will end up as EMCS.
If i attempt VBAC and it doesn't go well, my birth plan states that i do not want forceps to be used under any circumstances as do not want to risk prolapse/incontinence/injuries to baby, i just think they are barbaric. I have also stated i would prefer an EMCS to be carried out under spinal not GA, so that we can be present at the birth.
If it ends up as EMCS then for future babies i will just opt for ELCS (we wanted 4, might possibly settle for 3 depending on how next pregnancy goes/how old i am by then). But i think if there is a chance of VBAC working, i'd like to try else i'd always be wondering what would have happened if i had tried. Plus it would mean i could still drive and lift DS into his cot, high chair etc. (my insurers said that i could not drive until i had been signed off by the doctor at my 6 week check up - and that i should be able to do an emergency stop as an additonal criteria).
However, it could be that following consultants meeting on Friday, they remove the choice from me and recommend ELCS due to abdomen being bigger than what is already a big head....as i have been told that the head should be the biggest dimension and if the abdomen is larger, there is a considerable risk that the baby can get stuck.
Anyone got a crystal ball??