Anyone heading VBACwards and wanting to hand-hold?

[Unbuffy]

There WAS a VBAC support thread on here, there WAS. And now I can't find it, so I thought I'd kick off another one.

I am 32+2 weeks pregnant. DD was ELCS for breech positioning (diagnosed at 38+some). I am very keen, no, determined, to do my best to have a natural birth with DC2 if at all possible. And now the nerves start to kick in...

So if anyone feels like joining in the panic nervousness, sharing stories or just hanging around and waiting together, jump on board and keep me company!

I would- I think birth plan stating very clearly to refer to letter attached from consultant midwife (but containing key points) can only be helpful!

HI Ladies, I'm 27+4 and planning to try for a VBAC after emcs for failed induction last time round. I'm really terrified of going for a VBAC and having the same experience as last time, but I know that I definitely don't want to go for an elcs (unless there's a good medical reason of course). My biggest anxiety is that they'll impose timefrmae son things like you've got x hours to get so far otherwise it'll be a section. I hope I have the resolve to stand up to them but will be giving DH a serious talking to about what I do and don't want and make it clear he's to back me up at all times. I had an appt with the consultant a while back but in the lead up, the full effect of my last birth experience really hit me and I was a complete blubbering wreck. I couldn't discuss anything constructively with him as I knew I'd break down. I really need to get a handle on this before I see him again. Could definitely do with some hand holding!

Hi everyone

Glad to help! Like to think of myself as a VBACtivist as well as a coach!!!

And, no I'm not male.
Semen contains prostaglandins which, when ingested (swallowed)help to ripen the cervix, which in turn can stimulate the start of labour.
Prostaglandins are absorbed more efficiently through the gut than through the vagina, hence why oral sex is recommended over vaginal sex.
And this is why I think god is male!!!!

I believe it's really important for you mums to have your partners onside. Any waivering they have and your support is 'out the window' especially when you're faced with a situation regarding a decision you need to make when in labour.
This could typically be something such as the ob saying "we'll only let you labour for 10 hours (called trial of labour)and then you'll have to have a cesearean as it's dangerous for your baby". If your partner is aware that the baby is tolerating labour well (from intermittent monitoring) and that your BP and temp are okay, there's absolutely NO medical reason to go under the knife at this stage. If you get full support from your partner, you'll feel much more confident in making your choices.

Hope this helps.

Mads
Bump to Birth and Beyond

PS. a birth plan is always a good idea! Make sure your partner knows what you want and understands what you want

I prefer to think of it more as a wish list.

Can I ask what will happen to you all when you reach term? I have been told I will have a sweep on my due date (regardless) even though I know when I ovulated and my due date is 4 days behind (I could have understood the scan putting my dates back, but not forwards IYSWIM).

I will then be offered a sweep a week later. Then cervical dilation using a balloon, then an elective cs. They mentioned putting the cs in the diary on my dues date, though...

I don't know what to do. I have strepb, so want to avoid too much internal intervention and from everything I've read a sweep only works if your body is ready anyway...

So do I decline the sweep, and the ballon (in the info it mentions a risk of infection - don't want the strepb to take hold)

BUT if I turn down the sweeps and end up with a cs (I really, reaqlly don't want one) will I always feel I didn't do enough???

Sorry if I have repeated myself a little, I am starting to get fixated on the next few weeks. I'm 38+6 (or 38+4..) put apart from a couple of cramps I've felt no signs of labour. I know I'm not term yet and babies are born from 37-42 weeks, but they won't 'let' me go that far (don't know how I'll feel about fighting to go on longer without support - dh wants to take the line of 'least risk' but what is the risk)

Also on the lione of CFM - they brushed off my question about imtermitent (sp?) monitoring, but mentioned a fetal scalp monitor. I don't like the sound of it. What if I stand on the lead and the lead is pulled off. Or what if it hurts the baby anyway?

Sorry for the long post...

the 2nd date shoul read 38+2!!

I have been talking about this with my mw. I have said that I do not want to be chemically induced if I have not gone into spontaneous labour. I have agreed to a sweep and ARM if possible. No one has mentioned the balloon thing - I only read about that yesterday online, so perhaps it is not something they do at my hospital. She mentioned "booking in" a sweep at 40 weeks, but this doesn't mean I have to have it on that day - last time I had it 10 days after my due date. You don't have to have anything you do not feel comfortable with - it would seem a bit unproductive to just say "Oh it's your due date, let's get things moving" - perhaps you should request that they examine you (is the the Bishops Score that tells you how successful a sweep is likely to be?) and see if your cervix is favourable to a sweep?

I think you should ask to speak to a consultant mw ASAP to clear up your confusion about fetal monitoring, esp if they have not answered your questions properly. It has been agreed that I can have intermittent monitoring, not constant, and no one has mentioned the scalp method.

Why will they not let you go to 42 weeks? I have not been told that I can't do this. If the induction methods do not work, I will have an elcs at 42 weeks. Well, this is what I said to my mw and she didn't disagree! I am really hoping I will just go into labour before 40 weeks and avoid all this, as are you I am sure! Good luck, and speak to someone again.

Yes, calling it a "wish list" is a good idea! I will do it today.

One thing I am a bit unsure of is the administering of Syntocin for the delivery of the placenta. My mw said that the placenta can get stuck on the c-section scar as it comes out. But there's a risk of using Syntocin for VBAC's? Or is the injection a really small dose? I tried to ask her this but didn't really get the answers (doesn't help that she hasn't had a VBAC patient/client before.

Hi,
I had a VBAC last time and hope to have another one this time.
Was swept 3 times last time but nothing happened. Was pencilled in for a cs at 42 weeks but had ds at 41+5.

I did have a doula with me and cannot recommend highly enough! She was fantastic and got me through without an epidural or anything. Just 10 mnts or so of gas and air.

This time round am also booked in for a sweep on my due date. Hopefully will not need it!

Hi everyone

The 'foley catheter' (balloon) is a fairly new way of inducing labour without using medicine, so not commonly used across the UK.
Some studies suggest it is a fairly safe method of induction for the pregnancy and doesn't greatly increase the risks of uterine rupture for a particular VBAC pregnancy. However, some research suggests that there is an increased risk of problems for future pregnancies. You can google foley catheter - there's lots of info available.
What I will say is it is still an intervention and you should make sure that your consultant doesn't 'start the clock' once you've had it.
If it's not successful, you don't want to be pressurised on time.
The same applies to having a sweep. It will only work if you are going to go into labour anyway.

I would avoid artificial rupture of membranes (ARM) at all cost, especially for a Group B + mum. Once your waters go, the clock WILL start ticking as the risk of infection increases.

With regard to scalp monitoring, you can refuse this. I would always recommend intermittent EXTERNAL monitoring. You have limited mobility with any other type of monitoring and the only valid reason a physician needs to put a monitor on the baby's head, is if the baby is not tolerating labour. It will NOT pick up problems with the uterine scar (see my previous message on what indicates problems with scars).
In addition, a fetal scalp monitor increases the risk of infection as does any form of internal examination.

Finally, everything is YOUR choice. You do not have to agree to anything you feel is not right for you or your baby.

Do the research and feel knowledgable in your decisions. If you are confident that you know your stuff, you'll be in control of your labour and for a VBAC mum, this is particularly important!

Any of you ladies who are in North London and want help in an official capacity, please contact me.

In the meantime, I'm browsing the boards and will try and help where I can!!

Mads
Bump to Birth and Beyond

Oh this is interesting. I'm 36+5 and hoping for VBAC after emer csect with DS (44hr labour didn't progress-made it to 7cm dilated after 7 hours of syntocin) turns out DS had cord around neck & head so couldn't get down! My consultant has been really supportive, only thing I'm not too pleased about is he said as soon as I'm admitted to hospital the baby is to be monitored. But I was violently sick on g&a with DS & my coping mechanism for contractions was to walk briskly on tip toes through delivery room to the ensuite touch wall & back again! If I'm being monitored I won't be able to do this & he said that it's likely I'll be sick with g&a again. So can I refuse to be constantly monitored & just ask for periodic monitoring?? Of course I want to make sure baby is tolerating labour but I really really don't want to be strapped to a bed.
Other than that he won't intervene until at least 40+12, but has said I can ask for sweeps from 39wk onwards.
Another question, has anyone had syntocin for one labour & not another. If so did the syntocin make it that much more painful than no induction chemicals?? Just found syntocin extremely painful but worried that's what labour is actually like & won't cope!!! Thank you & good luck VBACERS x

bubbakin, do they have wireless monitoring at your hospital? Yes, you can certainly request periodic monitoring instead, if things are going well. I couldn't tolerate gas and air either - I will have another go, but I imagine it will be the same.

I had syntocin last time, but had already had an epidural by that point, so couldn't tell you, but have heard the contractions become much more intense. I think it is very difficult for them to get the amounts right - certainly last time they gave me too much, and the contractions became too strong for DS. This was before they discovered he was brow presenting, so pretty much unbirthable. So I am would be very wary of syntocin, even if I wasn't a VBAC case. I've said I do not want it for induction, and will only consider it during labour under certain circumstances.

Mads, what do you think about syntocin for third stage?

I am 37 weeks and im planning a VBA2C, my 2 previous emergency c sections were after induction for pre eclampsia. i have really had to work on the hospital to allow me to have a vaginal birth after 2 sections, part of me wanted to give in and have an elective section but my blood pressure has been perfect all the way through this pregnancy. there are some rules tho, they wont allow a water or home birth, or let me go over 40 weeks they have also said induction is a no g, will have to wait and see if baby puts in an appearance of her own accord on time!

Sorry - forgot to address the syntocin injection in my previous post!

Delivery of placenta
A managed third stage of labour as opposed to expectant third stage (ie. injection rather than let the placenta come out naturally) doesn't really have additional risk to a VBAC mum. It's a fairly low dose. There are advantages and disadvantages to both types of third stage.

Labour itself
It's very unusual for a VBAC mum to be administered synoticin in labour to induce or speed things up, simply because of a very slight risk of uterine rupture.

Wireless monitoring is great, if available (often isn't), so a good compromise is intermittent (periodic) monitoring. Continual monitoring is counterproductive to a VBAC labour so AVOID!!!

I know I keep banging on, but everything is your choice, no matter what the doctors say.

Mads
Bump to Birth and Beyond

Hey - just to say I had a fab VBAC with low level synto and CFM so it an be done! DD came very fast in the end (after 2 days of v painful early labour) but when I still wasn't in established labour 36 hours after my waters broke, they gave me a little bit of synto to get things going.

Even with CFM I kept upright and mobile, and my mw was very happy for me to move around as much as I could (I was v tired!). It was fab, and even though I ended up with a few stitches, it was so much better than the cs.

Good luck:)

Hi all,

Had a mw appointment today, fortunately baby is still the correct way up (had been spinning busily but fortunately no flips and I honestly thought it was now breech). Also now have birth plan sorted and on the way to the hospital. They have agreed to use of birth pool (stage 1 only) and intermittent external monitering, and limited internals. I have agreed to let them stick a cannula in me arm and to listen to advice given at the time. It's a compromise, but better than nothing. Best thing we can all do is walk up hills, take raspberry leaf, and do everything possible to get the dam' thing to come on time! I think going into it saying, 'i'll so this but is there a way around this' seems to be a good way of getting a reasonable response by hospital. I'd advise anyone to have it all agreed in advance though, so that you don't have to fight while in labour...

So saying, will probably all go to pot in the end anyway

Keep positive Unbuffy - you CAN do it!!

You're absolutely right about getting things agreed upfront. What I will advise you, is to keep open-minded. Things don't always go to plan but being fully informed, particularly with a VBAC birth means that you'll have the confidence to make YOUR OWN decisions during your labour, should you be thrown a curve-ball or two.

Best of luck and please report back!

Mads
Bump to Birth and Beyond

Thanks for your info Mads. I don't think it is unusual for syntocin to be used at our hospital for VBAC, but I think feel uneasy about using something that is NOT used in other hospitals, iyswim. It seems there is not a standard for this.

That's great Sparky!

Just one thing - I bought some raspberry leaf tea, and everything I have read online says "do not use if you have had a previous c-section" This has freaked me out a bit - I mean, if drinking some tea is going to be a threat, then what on earth is going to happen during labour??? So, I don't know if anyone has any more info about this? I haven't made a cup as yet!

It sounds like a good outcome to your meeting Unbuffy, good luck!

Oh no DomesticG0ddess, I was planning on hitting the raspberry leaf tea this time round to tone up. Don't want to have to resort to giving dh an even better time than he expected!
I'm going to have to start monitoring my posture now. I really don't want another breech baby. I remember in the 80's my family went mad on posture kneeling chairs, there don't seem to be many around these days. May have to resort to sitting on the dining chair backwards...
Good news on your appointment Unbuffy. Going for mine today, I've only a 15 minute slot so going to have to do some fast talking...

No, me either!!

Apparently though, raspberry leaf tea does not bring on labour, just make it quicker when it happens.

Gosh, 15 mins is not very long to give you, good luck.

I had my 12 weeks scan today, all fine, one baby in the right place and spot on for my dates :)

No discussion re HB or anything today though i have been referred for a consultant appt - undecided if i will even attend that or just cancel it.

Great news JKS! I'd love to have a homebirth, that would be ideal, but live too far away from any hospital should it all go pear-shaped. If i had the chance, I'd check in with the consultants out of curiosity, to see what the current thinking is, and then ignore and take on board as needed. But you know what you want!

Spoke to midwife, and she says raspberry leaf tea is fine from 36 weeks as a toner. Huzzah!

Had a welcome surprise when she said she would refer me to the Super midwife at the MLU, as a prospective vbacer. Which isn't usual policy. So i'll be able to discuss whether I can go there, rather than the hospital labour ward. I'm a little shocked at how little time i would be given at the mlu and hospital between onset of labour to dilating to 7 - 8cm before they suggested a caesarean. It seems there's little room for negotiation also. Anyhow, will see how the appointment with Super goes!

saucetastic, how long did they say you would have??

max 6 hours from 3cm to 7or8cm. At 4 hours they'd become concerned and would start making plans about options. Again, i asked if it were neg if monitored, bp and temp ok to carry on - but it seems not. On reading all those Gaskin birth stories, it seems normal for it to take longer at times. But the risk of severe UR seems to be HUGELY at the front of their minds. I guess if you've seen it once, that's one too many times.

Saucestastic - my little monkey was breech so I knelt on the sofa with my forearms flat on the floor & head on floor - it's on spinningbabies website. DH had to help me down & up & I only ever managed a minute or so at a time, but baby is now right way up! Worth a shot! As for time, I've been given 8hours to get from 3 - fully dilated, but surely if there is no discomfort in scar area & no fetal distress they'll let you keep going a bit longer, assuming you are definitely progressing albeit just a bit slower than they'd like. Well that's what I'm hoping anyway!!