Am feeling pressured into VBAC, terrified, any advice?

[MWestie]

Am 35 weeks pg with DC2. 1st birth was crash emergency section under general anaesthetic, was fully dilated and they were trying to get him out with a ventouse when it all went pear-shaped as apparently he got into distress. I was incredibly traumatised afterwards, felt couldn't bond with him, that I hadn't given birth at all, was unable to breastfeed and was diagnosed with PND.

With this pg I stated to the registrars in the consultant-led team at the hospital from the start that I'd like to request an ELCS, as wanted to minimise as much as possible the possibility of a similar emergency scenario. All fine, request was written on my notes and that date should be set at 28 weeks.

Fast forward to last hosp appointment, where I saw the consultant himself for the first time. He was incredibly dismissive, said as I had fully dilated to pushing that there was no reason why I shouldn't attempt a VBAC. He flicked through my previous labour notes, read out "presumed foetal distress" in again a very dismissive way, and said I needed to speak to a specialist midwife about a VBAC.

I was so taken aback, it was all so unexpected (I was at this last appointment to discuss a growth scan as baby measuring small) that I just left at the end of the appointment and came home to my DH in floods of tears.

5 weeks on, I have my follow up appointment with this consultant on Monday and I am dreading it. I've read the NICE/RCOG guidelines and really feel that I have to press the mental trauma issue but am dreading just breaking down in tears and being unable to talk.

It's really affecting me and I feel permanently anxious about this, waking at night etc. I had to go to the hospital last Tues evening for monitoring as I had started bleeding and it brought it all back to me.

Does anyone have any advice or previous experience of anything similar at all?? Thank you so much for reading this far!

How you plan on delivering your baby is YOUR choice. Please remember that and don't go into any meeting feeling you have to plead or beg or summat.

If you can show that you are well informed, understand the risks and benefits of either mode of delivery and have made your decision, any reasonable and experienced consultant will accept that IME. If you encounter an unreasonable one (and there are loads some), politely ask for a second opinion.

I am so sorry that this pregnancy is tainted by being stressed by this issue - that cannot be good for your serenity either . Is there any chance that your DP/DH or sister or best friend can come with you to your appointment? For moral support, so to speak...

I was in a somewhat different situation in that I had an ELCS (which was not particularly traumatic) and then wanted a VBAC and was all poised to have to push/fight for it, and was v surprised when my consultant was instantly supportive (she would have been either way, whether I'd wanted a VB or CS). You know that feeling when you are about to push against a door in the exact moment as somebody opens it from the other side and you kind of fall into the room?? Well, that is what the lack of resistant felt like .
I am just saying this in the hope that you will have a very positive meeting even if you do not expect this at the moment.

And remember the old chestnut about 'how you deliver the baby is the smallest part of being a mother' - cliche, but true.

Wishing you lots of strength and calmness and hoping you'll get the delivery you long for.

Thank you for your lovely reply Pacific. I think I suffer from "white coat syndrome" a little, so am definitely taking DH with me on Monday to help fight my corner. He does have a quick temper which I think could count against us, so am trying to instil in him that we should be firm but calm, but emotions are so close to the surface with this issue, for him as well as I know he was really freaked out by the circumstances around DS's birth too.

I know what you mean about gearing yourself up for a confrontation and then having the wind taken out of your sails, am crossing fingers that this happens on Monday, am glad you had a positive outcome yourself.

Oh, I am glad your DH will be with you .

When dealing with HCP, try not to come across as defensive or gunning for a fight. Put your cards on the table, listen to what they have to say and go with something like 'I understand your reasons for suggesting VBAC, but have decided I would prefer an elective CS for reasons X, Y and Z' or some such guff.

You are right, all this is such an emotive issue and I appreciate it is all very well for me to say stay calm etc etc which you might find impossible to do. I am sure any obstetric consultant has experience of crying/upset mothers-to-be .
Did you have a chat with a senior midwife about VBAC vs elCS at all? I am just asking because you wrote in your OP that you felt like you had not given birth at all after your previous delivery? Obviously with a nice planned elCS you'd be awake and able to see the baby immediately and usually also hold her/him (or at least your DH can while you get stitched up), but it is a somewhat 'passive' experience IYKWIM. Sorry, I am a bit clumsy in explaining what I mean. I was just wondering why you did not feel the 'need' for a VB in order to feel more connected to this baby (which was my reason for wanting a VBAC).
You obviously don't have to answer this, really don't want to be insensitive, you've clearly thought long and hard about this. It is just funny how different people have different responses to, on paper, similar situations.

Right, I'll shut up now.
It will all be fine, you know, it will, honest .

I completely understand what you mean about some people wanting a VB - that was me before I had my first DS! My worst case scenario then was a section, I had a great pregnancy and an OKish natural labour until everything went haywire. My mental state this time is just the polar opposite, I think I'm viewing the birth in a much more functional way than previously and just want the baby out safely, with minimal trauma all round, so I can draw a line under pregnancy/birth and concentrate on being able to look after my little family.

Perhaps this is why I feel defensive about arguing for my choice, that I "should" want the healing process that a successful VBAC could be. But I just don't want to risk it, I feel I lost faith in my body's ability to give birth and without that faith my ability to VBAC successfully would be compromised...

MWestie, I really feel for you. I would recommend getting other HCPs onside to help you, so this doesn't turn into 'you versus one very unsympathetic consultant'.

Go and see your GP if you can, and explain how worried and stressed you are - or ask to see a Consultant Midwife at the hospital urgently. I think you will need to push the mental trauma aspect of all this, but rather than dealing with all that in one meeting with a consultant who, tbh, sounds as if he isn't listening to you anyway, you can try and flag things up in other ways.

I had an ELCS for my 1st, because of primary tokophobia. I dealt with a consultant MW and community MW who were wonderful once they realised what a state I was in, and after being referred to a perinatal psychiatrist, for a chat that wasn't as awful as you might think! then they acted to take the heat off me, and make sure I didn't have any encounters with hostile or dismissive consultants/registrars etc.

So if you have dealt with a doctor or MW you feel comfortable with, then talk to them. If you are feeling permanently anxious and having trouble sleeping because of this issue, raise that first so they can see that having the threat of a forced VBAC hanging over you is a major problem. It is also fine to say you find something very hard to talk about when you go and see a HCP. Sounds obvious, but it should prime them to listen to you better.

(I think NHS VBAC policy is a total mess. It's a lottery - depends on individual hospital policy, and on individual consultants. These boards are full of women who either really want a VBAC and are being discouraged from trying, or women like you who want an ELCS and are being pushed into VBAC against their will. It's just insane. Just LISTENING to individual women seems to be the last thing HCPs do.)

Good luck.

Just wanted to say thank you, Pacific and fruitybread, for your replies and helping me feel a little less alone when I was freaking out over the weekend about this. I saw a different consultant in the end today, who was much more sympathetic and has given me a date for my ELCS. I can hardly believe it!

MWestie I am so pleased for you, you can relax a little now. Good luck!

glad you got it sorted.

MWestie, I am really hugely pleased for you. Phew! Well done.

Thanks everyone. Feel as if a huge weight has been lifted from my shoulders and can actually try and enjoy the rest of this pregnancy!