had birth options appt, now confused!!

[flootshoot]

I had an emcs with DS as I had slow progress (meconium in waters so was being monitored etc.), and I failed to dilate further than 9 cms - when I tried pushing DS went into distress.

Now DD is due in March, and I've just had an appt with the birth options team. My community midwife's opinion is to have another cs as I am very small and she just feels its the best option for me, bearing in mind she has seen me through both pregnancies, palpated me, did my sweep with DS etc. She thinks there is a chance of the same problem recurring as there's no way of knowing if the shape of my pelvis had anything to do with it. DS was in the perfect position prior to labour and turned back to back during labour. I should point out that she did go through the VBAC option with me and said she would support whatever I decided, she wasn't negative about it at all.

The birth options midwife said there is no reason why I can't go for a VBAC, and that they would encourage me to do so. I mentioned what my midwife had said with regards to the possibility of the same problem and she just shook her head at me (she was a bit patronising actually!) and said that that was wrong.

My community midwife is as qualified as the birth options midwife - and yet they are completely contradicting each other, and it's made me a bit cross. TBH I am still leaning towards an elcs. I had issues bonding with DS after the traumatic birth and I don't want DD's birth to go down the same route. I also don't want to be coerced into a VBAC because it's hospital policy to encourage them, rather than it being the right thing for me and the baby. I don't like the idea either that I will be under pressure to 'perform' to a certain timescale to prevent another emcs. But how can I make an informed opinion when the two HCPs I've seen have totally different viewpoints??

Aaargh. WWYD??

Can you speak to the Supervisor of Midwives? Maybe that would help to allay your fears and help you decide on a plan.

Thanks for answering - I'm seeing the consultant on 1st Feb for a follow up where we can make the big decision.

It's not fear as such - I'm more annoyed at the conflicting information I've been given!!

I wish i could wave a wand and know the answer!

It's hard when they're saying different things. What would you like to happen.

I don't know dessen - I really, really don't.

An elcs would eliminate the potential same problem and hopefully the bonding issues I had with DS.

A VBAC would be an achievement, would hopefully ensure my milk came in quicker (took ages with DS and ended up bottle feeding). And the receovery would be quicker. But there's the risk of ending in another emcs - so I'm thinking what's the point of going through all that and ending up with a section anyway?

A natural birth seems like such a huge ask for me. It honestly feels like someone is atelling me to run the marathon.

It's quite possible that the MWs are pushing their own beliefs/agenda; it's equally possible that neither of them know the right answer but like to appear certain of their facts to be reassuring.

Difficult to say - because one may be more experienced than the other, or not.

I'd wait until you've seen the consultant - these things are rarely as black and white as the birth options MW appears to have suggested. But then again, no two babies behave the same way, so there is no reason to expect that your current DC will do what your DS did!

TBH, I prefer your first MW - far more open minded and open to the possibility of -roblems - and the birth options MW should be taken to task for "dissing" the information given by another health professional - very unprofessional of her.

It's tricky to know what's best. Most important is the outcome for you & little one. Agree on talking it through with a midwife or what about a doula - just to go though things. Best wishes.

Thank you thumbplumpuddingwitch (sincerely hoping that isn't your real name, lol), for saying what i've been thinking! I think the hospital midwives do tend to see it as black and white and I've no doubt they're told to encourage VBACs too, which makes her advice a bit iffy IMO. Not necessarily her fault, but not helpful to me.

I think it is relatively unusual for women to have something wrong with their pelvis that precludes vaginal birth.

I do, but it relates to trauma (we think) and was only confirmed when my VBAC attempt ended with emcs when DD2 got stuck in exactly the same position as DD1. My (very experienced) consultant considers me something of an oddity.

I should add that although my first birth was highly traumatic (nightmares for months afterwards, flashbacks etc), my second was infinitely better, mostly because I had prepared properly for all eventualities and stayed at home until 10cm, thereby reducing the scope for unnecessary meddling.

The more I experience the NHS the more I realise medicine is as much an art as it is a science (people all being different etc). And some of the midwives I have met have been utter loons (although of course many are not).

So, my advice: speak to your consultant. If he or she advises VBAC and you think you can get comfortable with that, hire the most experienced doula or IM you can to help you debrief from last time, prepare for this birth and to give you someone to talk to afterwards.

Whether you try VBAC or go for ELCS, chances are it will be a whole different experience to last time, not least because it won't be so utterly overwhelming.

Good luck with whatever you decide.

Thanks for the advice everyone. I'm only 28 weeks but part of me just wants it over with ('if I'm going to do it, let's do it NOW!').

Wouldn't life be so much simply if the stork just delivered them??

Stock would be just fine! Was thinking about recovery after a cs as you have an older child. Will be harder in terms of running around after them & picking them up. If you have help afterwards would be ok but it depends how your older one takes to having a new sibling. If they are clingy & you have to say ouch. Could also be ok and no issues with new baby. if only there was a crystal ball as well :)

Don't forget that from 1 - 9cm you'll be labouring like a second time mum - ie probably MUCH faster than first time round!

I think it's very sad your cm has been so negative. She really CAN'T know - no matter that she's done a sweep, whether you are likely to be able to push this baby out. She should have been more neutral with her language so as to leave you feeling your options were open.

Re: difference of opinion - you do get this in midwifery. In my experience the more mature, experienced and intelligent the midwife, the more likely she is to have confidence in a woman's ability to labour where there is no clear clinical indication that a c/s is needed.

Hi all, still mulling this over.

I've ordered the VBAC handbook from Amazon and I've decided to start my maternity leave from work a bit earlier so I can have some time while DS is at nursery to do some yoga etc. Sounds barmy, but having a time limit at work has made me feel better....!

I went in for a trace last week and got to try out a new type of monitor that allows you to remain mobile. I'm feeling more positive about a VBAC, but a big part of me still wants a elcs. Not least the part that thinks it'll be over with quicker as they'll operate at 39 weeks!!

Will keep you posted....

Thanks QT, it's really good to hear the other side of it all!

Decisions, decisions......