ELCS after an emergency CS? would love some advice if anyone has time

[suzym1984]

Hi!

I have birth to my LO 2 weeks ago by emergency CS as he was an undiagnosed breech. For some reason the experience has left me terrified of future labours (I know its a bit early to be thinking about this!). I had a letter from the hospital saying that next time I would be a VBAC but what if I would rather have a planned CS? is the choice mine or not?

Thanks

I have been told I will be given the option but I felt the midwife was more trying to lead me down the VBAC path. But I am not making any decisions till I have seen my Consultant.

It's never too early to think. I have fallen (unplanned and stupidly) pregnant very close to my EMCS.

Thank you for the reply.

I am hoping to be given the choice, but nobody seems to be telling me, all the say is "a VBAC should be possible" but I am not sure I want a VBAC!

To some extent the choice is yours, but nobody in their right mind would "approve" an ELCS purely because you required a c-section first time round.

However, if you were significantly traumatised by the experience of labour and/or the way your labour was managed, then you need to get a birth debrief (offered by every hospital with senior personel on a 1:1 basis), go over all your notes, pour out your heart and get to the bottom of what went wrong, which bits were not to your satisfaction, ect.

Then try and figure out if there are steps you can take to ensure the next experience is a positive one in which you are in control of your birth; either by hiring a doula or IM, opting for home/waterbirth, care by a birthing centre or indeed requesting a repeat c-section.

As well as a debrief, be aware you can also request copies of your notes to take home and go through yourself in your own time!

Good luck!

suzy - I had the same thing after my emcs - everyone felt the need to reassure me that I'd be able to have a VBAC next time round, when it was the last thing I wanted to hear!!

I am 36 weeks with DC2 and while the hospital midwives are very pro-VBAC and did try to pursuade me, I made the decision that mentally and emotionally an ELCS was the right choice for me. The consultant seemed to realise that I'd made a very informed decision and agreed to it.

The NICE guidelines do say that maternal preference should be taken into consideration so it's worth reading up. That said - first things, first - have a debrief - I had one and it helped enormously - I at least considered a VBAC rather than just dismissing the idea and that was largely down to the debrief.

ds1 was emcs and when I was pregnant with ds2 they said it would probably be better to have a elcs but I wanted a vbac. It was 14 years ago so the rules might have changed. I think it was something to do with the scar rupturing.

went for the vbac but ended up with failed ventouse, forceps and a 3rd degree tear so when I was expecting ds3 they quite understood my request for a emcs

I thought theses days was all about patient choice but I suppose budget cuts mean they would be pushing for a vbac

The main reason for me wanting a vbac was that I was under the impression that once you had 2 cs you couldn't have any more and I wanted a large family

As a vbac carries a (very very very) small extra risk of scar rupture, then yes you would be 'allowed' to have an elective cs, once the consultant had chatted through the options with you. The reason no-one is talking to you about this is because it used to be only lentil weavers (like me!) who wanted to try a vbac (let alone, heaven forbid, a home vbac!); a c section was almost forced on you. Hospitals seem to be catching up with NICE guidelines and going all guns blazing for vbacs now. But your choice is still open, nobody is going to deny you a c section if you really want one. In your next pregnancy you should get a consultant allocated as you've had a c section, and should have an appointment to chat and start deciding about mid way through.

But - that's blooming miles away woman! Concentrate on your newborn and yourself; when you're up to it, think about using the hospital's birth reflections service to talk through the birth you've just had; and then, when you're pregnant again, start thinking about birth options. Congratulations btw!

I had a ES with my first and was offered a VBAC or a caesarian in my next pregnancy. I wanted a VBAC but in the end the same circumstances arose and so he too came out the catflap.

Thank you for all the replies.

So it seems like I should be given the choice, which is reassuring. I know that I shouldnt even be thinking about this, but I would hate to get pregnant and then find out that I would pushed into a birth that I had no control over.

suzy - you don't know how you will feel when it comes to it as well. I had an induction which didn't work and then a caesarian and when given the choice of a second induction or a caesar I took the latter because I had more confidence in it. But up until that moment I was planning a VBAC. It really does depend on the day - prepare for both routes and don't worry, the second one is very chilled in comparison because you've done it before, it's not as stressy and you aren't knackered like the first time round.

Oh and congratulations on the baby btw :)

I had emergency c section and after a vbac, I didn't decide what I was going to do until 37 weeks and saw my consultant.

Congratulations on your baby -

You should be offered the choice of vbac or CS with a future pregnancy, it's up to you which you go for.

One reason why they may be recommending vbac for a second child is if you're planning a 3rd or 4th. Multiple CS isn't great for anyone and more pregnancies with uterine scars are riskier (still only a small risk and I'm sorry I don't know the exact numbers). That said, an obstetrician where I used to work had 4 (1st emergency, subsequent 3 elective).

Presumably you weren't given the chance to labour for long and then I expect everything happened quite fast once they'd confirmed the presenting part. I'm not surprised it's left you scared of future labours and I agree you should probably ask for a debrief with obstetrician and midwife to address your fears.

You don't have to make any decisions now about future pregnancies - congratulations on your little one :)

I wish I wasnt left to labour for long! I think that is the problem, I was left in the assessment unit for 8 hours after my waters broke, with no pain relief for contractions, and then was told baby was breech and I would need a CS! Horrible times!

Thank you for the advice and congratulations, DS is gorgeous and worth all the hassle!

After my first baby with an emergency section, I was not offered a c section for baby no 2. 5 kids later; I have had 2 VBACs and 2 more c sections; 1 crash section and 1 elective c section.

I would choose a VBAC anytime personally (unless it was twins/breech) as it is sooo much easier and the sense of elation was amazing. BUT an elective C section IS so much better than a crash/emergency section. I had severe life threatening complications from my crash section, probably because it was a rush to save DS. Elective went smoothly, almost as wonderful as a natural birth. I found recovery much harder with a c section though.

It is up to you, I do know people who have pushed for, and got a c section and I feel it was for good reason as they were so very worried about having another emergency section. But there are things to consider such as do you want a big family as there are risks with multiple c sections. Once you have had 2 sections it is very likely you will be advised to have another for the next one...