Asking for VBAC after Emcs at the Whittington

[waitinggirl]

i am 36 weeks. because of my em cs in 2008 i have been seeing doctors (consultants/registrars) at almost all of my antenatal appts (they also suspected GD, but that was a false alarm). basically one of the last registrars i saw said "there is no reason you should be seeing doctors at your antenatal appointments, you're completely fine, it's just that you had a previous cs". as far as i am aware, i have as much chance of a vaginal birth as a first time mum, albeit with a 0.5% risk of uterine rupture.

i found myself at my 34 week meeting with yet another registrar, basically being told that i had to have continuous monitoring because i had a previous cs. i am not a doctor hater, i love medical science, but i also know that if i am going to give this vbac a chance, i need to be able to move around at least a little bit (and having had continuous monitoring after my epidural with the previous birth, i know that any suggestion that i could move as far as the length of the lead is disingenous as the machine kept losing the trace). someone i know is also thinking of attempting a vbac at the whittington, under a different consultant and has been told she can have intermittent monitoring/water birth/birthing centre admission, as long as she knows the risks. this was an option not made known to me.

any advice on how to handle talking to the mw at my mw appt on tuesday (i haven't seen a mw since my booking in appt at 13 weeks), so i want their opinion, too? will i need to get my consultant to agree to this?

many thanks

Hi Waitinggirl

I'm a VBAC coach based in Mill Hill and Swiss Cottage.
Every hospital has different policies regarding procedures, including VBACs but it's your right to decide what type of birth you would like - you don't have to ask for one.

With regard to monitoring, again you can choose to opt for intermittent monitoring, rather than continuous monitoring. You've mentioned that you're aware of the very slight risk of uterine rupture and quite correctly stated that it's not really any different to a non VBAC birth. Continuous monitoring is very unlikely to pick up a problem with your scar - what the monitoring does is keep an eye on the health of your baby. THe indicators for scar rupture are: maternal fever, raised BP and heart rate of the mother - so don't let anyone scare you into thinking otherwise!

There are a number of other policies to challenge - I'm more than happy to give you a top line if you want to PM me.

If not, lots of luck and I hope you get the VBAC you deserve!

Mads

hi bumptobirthbeyond - thanks for your reply - i messaged you last night. let me know if you didn't get it. thanks.

I had a VBAC at the Whittington a few years back, after an emergency CS 3 years earlier (at a diff hosp). In general, they were very supportive re. my wish to have a VBAC. Though at one of my appointments I ended up talking to a more junior doctor who didn't really have a clue and made me feel really unsure - I stood my ground and asked to see my named consultant who was absolutely lovely and reassuring (thankfully I'm under the same consultant now, third time around). In my experience, midwives are pretty supportive of VBAC attempts so hopefully yours is too. And if you have to see a doctor again, it might be worth asking to see the consultant rather than someone more junior - in my experience the consultants are often more open to discussion - perhaps as they have less to prove?

And just to reassure you, when I did arrive at the Whittington in established labour with no.2, there was no suggestion of anything other than intermittent monitoring until I had an epidural, at which point they swapped to continuous monitoring as standard with epidurals. In fact, I remember worrying that they had perhaps not realised I had a CS last time, such was their lack of concern at first!

Hope it all goes well :-)

thanks, sunflower - that sounds really reassuring. i think the last doctor i spoke to was pretty junior and said some pretty crass things (was told i had to have a "near perfect birth" in order to avoid a second em cs).

have my mw appt today and think i will ask to see my named consultant again just to make sure. i'm 36 weeks so cutting it fine - everything seems so rushed this time round.

good luck for number 3 - how exciting!

Hi Waitinggirl

Just PMd you.
Best of luck for the MW appt today - let me know how you get on.
BTW - I've worked with a number of mums who have actually declined all appointments with doctors/consultants so they can't be persuaded that they have high risk births! The only time appointments took place, were with midwives for regular antenatal checks and any conversations about VBAC labour were avoided!
I'm not suggesting you do this but ultimately you are the boss!

Sunflower - really pleased you had a good VBAC and the hospital were (mainly) supportive.

Mads
Bump to Birth and Beyond

Bumptobirthbeyond could you point me in the direction of research that shows indicators for scar rupture are maternal fever, heart rate and raised BP? The only thing I've seen is research that found continuous monitoring did give an indication of uterine rupture - and this is what my consultant has told me as well. Would be interested to see other research I could take with me to next appointment for my VBAC.