VBAC with SPD/PGP, anyone done it?

[YankNCock]

I had an EMCS with DS 2.5 years ago, and am 15 weeks with DC2. Last time the SPD was bad enough that I struggled to walk more than about 15 feet, needed crutches at times. Seeing an osteopath did help a lot, they were able to put things back in place (and I could always walk better after seeing her).

I know when I was reading up on SPD that you were supposed to be quite careful about the positions you gave birth in. My pelvis never seems to have been right since, I continued to get some pain in my pubis symphasis and my hips up until now, and it's getting a bit worse already with the pregnancy.

I am still breastfeeding, and I've read mixed opinions on whether that affects SPD after birth.

I'm just trying to work out if the SPD will get even worse after a VBAC vs an elective section, I don't know what to do!

Hi YankNCock, I'm in a very similar position to you, and due to give birth next month (2.5 year old DC, EMCS, SPD in both pregnancies). I've chosen to go for ELCS this time, so not much help to you, but I was given the choice by hospital. Decided to go for ELCS for various reasons, not only SPD. Very hard to get any useful information from anyboy, but I wanted ELCS very strongly, so didn't have trouble making up my mind.

The midwifes and consultants I've seen this time round did say that if I went for VBAC, they wouldn't let me go on for as long - I spent a lot of last labour on my back with epidural, which was exactly what I didn't want to do, and even the '8 or 9 hours' they said would be their limit this time sounded like too long for me if I couldn't be in a more active position.

Can you get appointment with consultant to go through your labour notes from last time and try to pinpoint why you ended up with EMCS and see if it's likely to happen again? I just felt pretty sure that I would end up once again with long labour and EMCS, but that was based on my histor

I hope your preg and birth go well whatever you choose.

Thanks duzida, I've got my consultant appointment next week actually, so I'm planning to ask loads of questions.

They said there was no medical reason I couldn't have a VBAC, but from what I understand, they'll want to monitor continuously, and that probably means on my back in bed, which isn't going to help anything really, is it!

I had monitoring last time, they kept losing the heartbeat through the belt thing, so they stuck a clip on his head (not good for moving around obviously). I was just so bloody tired after having not slept for two nights, I sort of forgot all about having an 'active' labour.

I'd really like to use a pool for pain relief, but I am pretty sure they won't let me. I wasn't allowed last time, and can't remember if it was due to my weight or the SPD (something about how they didn't trust I could get in and out safely ). I just remember feeling like there were no options and being too tired to argue.

I never dilated past 4-5 cm last time. I think the key for me if I do decide to do it will be staying at home as long as possible. I did try to do that last time, but I had no idea what to expect, so was in and out twice before they kept me in the third time.

My mom reckons she was in and out of hospital so many times with my brother that they gave my dad some gloves and told him to check she was actually dilating before they came back again!

Hi Yank, well you probably know what I'm gonna say! Bugger constant monitering, flat on your back, not 'allowed' in a pool, etc etc
Get yourself a nice Birth Pool in a Box from ebay (or new one if you're feeling flush!) and a supportive midwife and just stay at home!
You can get past 5cm, you can avoid major abdominal surgery and all the crap that comes with it and you know what to expect this time so you'll know how to prepare and you'll know what you want/don't want when it comes to labour etc.
Put it this way, if the thought/logistics of a home birth aren't for you, don't tell the midwives/consultants that because you'd be AMAZED what they'll 'offer' if you say you're having a homebirth ... "Ms YanknCock, why not come and see our lovely birthpool here at the midwife led unit where we don't mind if you don't want monitering, infact you can have whatever you want just please don't homebirth ...." etc
Win win!

I didn't see this before I went to the appointment, but wish I had!

I did protest about the continuous monitoring and got agreement that it could be taken off for a bit if I wanted to walk around, and that I wouldn't be stuck in the bed even with the monitor on.

Was told 'no' on using water for pain relief, as expected.

Consultant mildly worried when I said I wanted to stay at home as long as poss to avoid interventions, said I must come in straight away if in labour due to the chance of the scar rupturing (which is apparently why I need the continuous monitoring). Makes my wonder why they did it last time when there was no need for it!

At the end of the day all they can do is offer their opinion - it's up to you what you! There is nothing to stop you saying you've changed your mind and want a home birth... you can even do that when in labour and they HAVE to send you a midwife to assist
I have done boringly huge amounts of research into this topic and I can safely say very very few consultants actually know the true up-to-date comprehensive figures and studies on this subject - CFM does not improve the outcome for either mother or baby, increases your chance of a c-section, and distracts from labour. As well as being a right royal pain in the arse! IF you do rupture (and it is so so so rare) the signs are in the mother (pulse, skin tone and you feel it!) NOT the baby. I know of women who have ruptured and all through it the monitor said baby was fine so you may as well wear a tea-pot on your head for the good having a monitor will do!!!

And as for getting you into hospital straight away, all that will do is set time limits on you and your labour - which will probably be stressful and stall things anyway. Your instincts are right in that staying at home as long as possible DOES reduce interventions... but if you feel safer at the thought of being in a hospital (it's the opposite for me but that's me, some people instinctively feel more at ease in medical surroundings in which case hospital is the best place for them to birth)

Be where you feel happiest and surround yourself with those who support your wishes 100%. Consultants never see 'normal' births so they rarely trust womens bodies to do what they are designed to do, they fear the worst because that's what they see - oddly it's mostly down to the restrictions and mointering and crap THEY impose on women and labour that cause it to go wrong!

Oh and they monitored you last time when there was no need for it because having the monitor on means the midwives can bugger off and do something else cos they were probably short staffed. (cynical? Me?! )

I'll shut up now

No, don't you dare shut up KatieJ! All that is actually really helpful. I swear I'm going to get DH some latex gloves and make him check I'm actually dilated before I go near the hospital. Apparently my mom and dad did this when they had a load of false alarms with my brother!

Ha ha that's not a bad idea!! or you could check yourself (if you could reach, might take a little bit of gymnastics!
If your Mum has a history of slow/stop-start labours it could be that you have too?? And those that say you dilate 1cm an hour are talking rubbish! Everyone is different and if left alone will progress at their own pace (probably much faster without constant interference/intervention..)
Have you ever thought about hiring a Doula? or having someone other than your DH there to act as your voice/advocate who knows your wishes so that if you are in labour they can be the rational lucid one who can stand up for you if needs be? Even better if you could find someone who has experience/knowledge of VBAC.... could prove very helpful?

Looks like I'm going to be VBACing with PGP too as mine seems to be cranking up a notch (so annoyingly painful at night/early mornings, hate it!) but I will NOT let it hamper my home VBAC - pain? what pain?

Please ask me if there is anything more you'd like to know about or if anything is worrying you, I'll do my best to share my knowledge and help if I can. It means so much to me that ladies like us get the births we want despite the clock watching/fear inducing/intervention loving NHS rubbish!!!
Knowledge is power so if I can share, please holler!

If we had the money, I'd think about a doula or an independent midwife, but we're on a debt management plan as it is so no chance really.

I do appreciate all the encouragement/advice, I'm sure I'll think of more things soon.

Hi Yank,
I have had PGP for about 18 months now, since having with DD. Have seen countless healthcare professionals including an osteo and 4 physios, and the consensus seems to be that next time a c-sec would be worse for my PGP because your transverse abdominal muscles are cut through, and these muscles are key to stabilising the pelvis.

Ooooh Pixie that is really interesting..... I wonder if that could be contributing to me having it this time and not at all in my last pregnancy??

Yank I would've gone for an Independent Midwife but they are a LOT of money (worth it I'm sure if the money was there!) If you write a really comprehensive birth plan and staple it to your notes they should take notice of it and see if you can get your DH totally on your side and up with your wishes.... not easy if my DH is anything to go by - he 'gets' it but still believes doctors know best (!) which is why I had to get a Doula as I don't think he could've handled the pressure!!
Maybe you could sweet-talk a close friend/family member to just 'be' there as your advocate? Sometimes just having someone there for you (other than DH) can work wonders.

Hope your DS naps for you today!

I was told they no longer cut through muscles, but that they push them apart, I didn't have mine cut.