Anyone offered option of labouring naturally before deciding to continue or ELCS?

[Thandeka]

Hi,
I had an extremely traumatic vaginal birth last time and leaning towards ELCS this time (am 9weeks) (it's looking likely hospital will agree given my history and hysteria at discussing dd's birth at booking in appointment!) One option my MW mentioned was labouring naturally see how I feel and get on and if not coping then ELCS. However although I like this idea I have some worries and concerns about this-
a) wouldn't it technically be classed as an emCS and hence slightly riskier etc.
B) is this a big con to get me to labour naturally and then the ELCS offer would disappear?

Particularly keen to hear the stories from women offered this who haven't had a previous CS (like me) and I think this is a more common offer to women who want to VBAC but may end up needing another CS.

Hi Thandeka,

My first pregnancy was induced at 38 weeks due to high blood pressure and other complications (extreme SPD- which i then found out i had pelvic disproportion)- was induced with syntocinin, nothing progressed and it resulted in EMCS.

This time round, my consultant had advised me that the best thing for me and baby would be ELCS especially seeing that i have SPD again, and my first DS weighed 9lb 11oz at 38 weeks. He did advise me though that if i was "heart set" on a vaginal delivery then i am more than entitled to try this however, he did explain that there is over a 70% risk that it would result in EMCS again.

i have since been diagnosed with gestational diabetes and on insulin injections, i am nearly 37 weeks- so i am definetly opting for the ELCS

Also- meant to to say - you do what YOU feel is best for you and baby, and do what makes you feel calmer !!! Its your body, and your baby and it definetly doesnt make you any less of a mother if you need to have a CS.

I have had quite a few negative comments from people about my CS, mainly from women who have managed to give birth naturally without no pain relief- but at the end of the day- everbody is different and the most important thing is that you have a calm pregnancy (not spent worrying about another traumatic labour) and that you enjoy this experience.

I have been told that the ELCS are more "enjoyable" as they are planned and not as hectic as the EMCS- but to be fair , the EMCS wasnt too bad at all !

you do whats right for you and dont be bullied into anything by midwifes !

xx

Plenty of time to decide, don't feel rushed into deciding yet. I don't have to make my birth choice until 36 weeks, however I think I have decided but that may change.

I had and EMCS with number 2. Here the stats I was given for my local hospital were 70% success rate (however this doesn't explain the stats in those for assisted VB). Make sure you get all the leaflets you need and check reputable sites, this will help you make an informed decision. You have to feel comfortable in your decision.

The only worry I myself would have with the option you have been given would be if after labouring naturally you decide you do want an ELCS for whatever reason, but there is no theatre available. I don't know how common this is, and I suppose it depends on the hospital and number of theatres but it might be worth asking. Write all your concerns down and discuss them with your midwife or consultant (if you have one).

Good luck in your choice and the rest of your pregnancy.

Many thanks for the replies. Defo leaning towards ELCS with no labour as would be more in control then and no risk of a repeat of last time which is my biggest fear.

Bumping for the morning crowd to see if anyone was offered similar experience?

Hiya, I had a c section with my first baby and now i'm 6 weeks with DC2. I was looking at VBAC research and this article was quite informative.
www.bjog.org/details/news/591673/Risk_of_uterine_rupture_after_previous_caesarean_section.html

It talks mostly about uterine rupture risk but is based around a study in Norway where Trial of Labour was factored in which is what you are most concerned about.

I have been told that emergency cs is often more traumatic as the baby has usually already started to enter birth canal and pulling it back for CS can cause damage. Not sure of medical proof of this though. For me, I'd want to be in control but it depends how you feel about those caring for you. I would say, go with your instinct.

Have you considered a doula for emotional/physical support (whether attempting vb or for a planned ELCS).
I have a couple of stories on my websitre from women that considered ELCS after traumatic births, can post a link if you are interested.
S x

We're getting a doula this time as first time was so traumatic. (trainee ones are cheaper) I'm also considering a home birth even though first was a caesarean as we're not far from the hospital if I need to go in.

However I'm going to refuse to be induced as I think that makes things more difficult - if it goes past due date and they want to induce I will go planned c :(

i don't think they'll induce you anyway emsies but yes i am a vbac and will categorically refuse induction

a labour followed by a ELCS would be good as labour is supposedly quite good for you and the baby but like nunnie said, what if there is no theatre or something i guess

good luck thandeka with whatever you decide

I think the risks of an EMCS are probably related to the fact that they are usually done when baby or mother are not well in some way - that would not neccesarily be the case in your case
Have you had any counselling about your first birth? Sound like its still quite tough for you -

Am just finishing my second set of counselling. Now ampregnant again everything has gone very wobbly so new hospital are looking into some CBT for me too. Sigh. Previous counselling hasn't made that much difference.

CBT really worked for me when I was pregnant - different issue -keep pushing as there can be a bit of a waiting list - and what worked for me was both my GP and midwife kept reminding them