Questions about VBAC - any experiences please.

[Rugbylovingmum]

Hi,

I'm only 8 weeks pregnant with DC2 so it's a bit early to be worrying about this but I have a few questions after my booking in appt and hoped someone would be able to help me. I really want to have all of this straight in my head before I see the consultant at 20 weeks. Sorry if this is a bit long!

So DD1 was an emergency c-section. Essentially I got to 40+14 without a hint of a contraction, went in for an induction, pessary and gel didn't do anything then they decided DD was in some distress so they broke my waters and hooked me up to the drip. Many, many hours later I was only 2cm dilated and DD was still very high/not engaged, they took some blood samples from DDs scalp and decided she was distressed and I was unlikely to progress so they whisked me through for a c-section.

It wasn't the birth I had aimed for - I had really wanted a home birth - but it was all fine and I felt very well looked after and consulted throughout and have no issues about the c-section. My only complaint is that because they said DD was distressed I had to be monitored constantly which lead to me being made to lie on my back the whole time which was extremely uncomfortable - all my pain was in my back - and I can't see how that would encourage labour to progress. I was allowed to shift onto my side but everytime I did the sensor thing moved and it took them 5 min to get it all working again so they encouraged me to move as little as possible.

Today the midwife told me that I have to speak to the consultant about my options but that they would encourage a VBAC and that it would have to be in hospital and with continuous monitoring which, as far as I can see, means that I would be stuck on my back again. She did cheerfully say that the beds now allow you to sit upright but that's not the same as having the freedom to move and find a comfortable position. It's bad enough I won't be able to use a birth pool or at least a shower to ease the back pain. I know I won't be in hospital right from the start this time and I can deal with the idea of being stuck on the bed when I get there but I really don't want to be totally restricted - plus I just don't think being restricted is likely to lead to a successful labour. I'm really worried about it and would love to hear from anyone who had a VBAC - how was the monitoring done and how did it go?

Sorry for the long post!

I had a home VBAC. I got an independent midwife so I didn't have to fight the hospital (and because I was so shit scared nervous after the horrific birth I'd had first time around that the hospital caused), but I could have got them to agree if I'd fought hard enough. It is a possibility for you if you're happy with the (small) additional risk.

I've got friends who have had hospital VBACs. You can negotiate with your consultant what monitoring and extra precautions you are happy with, and get him to note it down. They weren't too restricted so far as I'm aware - attitudes are a lot more realistic these days in general (ie that VBAC isn't much of an additional risk) - depending on your hospital and consultant of course. You should be offered a chat with your consultant later on to go through all this.

Thanks lukewarmmama, that makes me feel much happier. The hospital were good last time so I don't really mind going in, it's just the monitoring I have an issue with.

Yes I had two vbacs and feared being "continuously monitored" so stayed at home as long as possible. I think continuous monitoring makes a section mroe likely. Also they do tend to put the timer on you, which is terribly sdtressful.

Anyway, 2 vbacs, no continuous monitoring, all went well. All the best.

Thanks Blueberties, I'm also planning to stay at home as long as possible. How did you avoid the continuous monitoring? Did you agree that with your consultant?

I recently had a VBAC with intermittent monitoring by hand. I didn't get it agreed with the consultant, I discussed it but he said the policy was for continuous monitoring. He did agree with me that they coudln't force me to have it! But just wrote in my notes 'recommend continuous monitoring'. When I went into labour I stayed at home as long as possible, when I went it I was in transition. The first midwife was apparently insistent on putting me on the monitor but my lovely doula fought my corner. Then there was a shift change thankfully and the second midwife just went along with my wishes, she listened in a few times by hand.

I had been in a few hours earlier for a check as was having unusually long contractions and had agreed to monitoring at that point (then went home again when all was fine with the baby) - the monitor only worked when I lay semi-upright. Which made contractions much more painful, and that was relatively early in labour. There's no way i would have coped in the later stages like that without having an epidural. Without the monitor on I laboured leaning against birth ball/over the back of the bed and managed with gas and air.

They did also want to put a cannula in my hand but again my doula stated I didn't want one and the second midwife didn't argue.

I've had 3 vbacs - last one last thurs for ds4. So vbac 1 was little cfm as got to 8cm in reception. Then distress so thingy on his head - some clip thing.

Vbac 2 was a waterbirth - intermittent monitoring with hand held monitor every 30 mins or so - great birth.

Vbac 3 was also wb. She was less experienced mw than vbac2 so a bit more cautious - was on monitor for 30 mins to get good trace whilst about 5-6cm before getting in the pool. I was on back on bed but was ok. He was fine and rest in pool with handheld thing again every half hour.

My friend is a trainee mw in my area. She found when doing her community placement mws were advising women that water vbac was not possible. She said it annoyed her as she knew I'd had (in the same area) a vbac wb so the mws in community were effectively out of touch with hospital policy. Ok my consultant did write on notes that I was aware of risks of no cfm but they were supportive of my choices - the consultant mw at the hospital was very supportive - said lots of women did it. So if you don't want cfm I would push a bit harder and discuss with your consultant nearer the time and also ask to speak to consultant mw (I just called hospital myself - my mw didn't know). Good luck with it.

Sorry went away.

No I was a bit rebellious. I didn't attend my last consultant's appt and discharged myself from hospital in labour and went back later. Not helpful I know but what really did help was informing myself with lots of VBAC support and literature. It was that which gave me the confidence.

I think confidence is the key. Lots of positive stories from here will help you I hope but also other sources, I guess on the net these days but then it was books and so on.

And the second vbac I stayed at home possibly too long and she was born half an hour after arriving at hospital so there wasn't any time. (I don't like hospitals very much!)

Thanks again for all the info! I am quite prepared to argue my case and refuse anything I don't agree with but it would be nicer if I didn't have to spend my labour arguing so I am hoping the hospital policy isn't too strict (prob unlikely as after my EMCS the consultant said "we might as well just put your name down for an ELCS next time and save all this hassle".

I've been looking into the info from NICE etc and it seems that there isn't really any increased risk with intermittent monitoring and the increased mobility will be a huge plus so I will refuse any monitoring that keeps me very restricted. I can't see why I can't be in the water for the early parts of labour so if they won't agree to that in the hospital I'll just stay at home a bit longer. If I am going to go for a VBAC I want to give it the best chance to work which for me means being as comfortable as possible i.e. not flat on back and being told it has to happen quickly or I'll be given a section.

I really just have to wait to see the consultant now so I can find out what the hospitals policy is and how strict they are. I'm sure I'll have loads more questions for you all afterwards!

"we might as well just put your name down for an ELCS next time and save all this hassle".

good luck, he sounds like a right one

Yeah, she was great . She was meant to be checking up on me after the op but didn't even ask how I was. Just said that she would put me down for a c-section next time then left.

A woman. Scuse my sexism.

Tbh that's why I missed my last consultant's appt. It was the appointment to give me a section date if I didn't go into labour by 41 weeks. I thought, if I don't have a date, they can't do an elcs and even if it turns into an emergency then at least the baby's had part of labour and was ready to come.

I hope you don't have to resort to such tactics, they're no fun.

I mean, nothng against elcs, it's right for some people but it wasn't right for us.

This must really differ from hospital to hospital. At my birth choices/VBAC clinic last week (22 weeks) I was offered a VBAC waterbirth with continuous monitoring using a waterproof, wireless monitor. I think you need to have these questions ready to ask at your appointment. My hospital couldn't have been more encouraging, TBH. (But I still want an ELCS!)

I really don't see why you couldn't do your full labour including delivery in the water.

Neither do I lollystix but my midwife seemed to think that the hospital would be totally against it because they couldn't do continuous monitoring in the water . I'm definitely going to ask about it.

Mandyville - that's really encouraging, maybe the hospital won't be as difficult as I think. The midwife seemed to think they encourage VBAC but then are very rigid about how that should go - continuous monitoring, no water births, no pool at all in fact, cannulae in ready for poss EMCS etc but maybe it won't be that bad once I actually speak to them. I hope you get your ELCS if that's the option you think is best for you!!

I had a VBAC last year with intermittent monitoring and spent a lot of my labour in the pool. I had a very sympathetic consultant midwife which was a big help. I'd recommend getting the book Ina May's guide to childbirth and reading the section on VBAC. There's also some useful stuff on the AIMS website. I have a copy of their publication on VBAC if you'd like it. Don't know how private messaging works on here but if you can figure it out get in touch and I'll post it to you! Just do your research thoroughly, be clear in your head (and make sure your birth partner is clear) about what you want. Mine certainly wasn't the calm, easy to recover from experience I hoped it would be but I'm so glad I did it. Good luck!

Dear chocolatejunkie, I'd be very grateful if you could send me the publication through. Thank you - it is very kind. The more research I can do before speaking to the consultant the better really. I have pm'ed you my address.

Hi chocolatejunkie,

the publication arrived today and I am going to have a careful read before my meeting with the consultant. Thanks again!