3rd pregnancy: another attempt at VBAC or planned section?

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Until today i was of the persuasion that a planned section would be the way forward. But maybe I need to open my mind.

So please share your advice and experiences. Am seeing the consultant about this matter soon.

my history:
1st pregnancy: everything went well (e.g. dilation, pain management), but ended emergency section because baby was breech (last moment discovery..)
2nd pregnancy: attempt at VBAC ended in forceps delivery + tears, because had no idea how to push (epidural in place at 8cm.. probably too late).

My concerns with this impending birth are:

• I had a psychologically really difficult pregnancy (lots of relationship problems, partner asking me to abort until 24 weeks ) so I am not in the frame of mind to "prepare" for the birth. And I think for a successful vaginal birth you need to do some breathing exercises, relaxation etc... I am not able to do that mentally. In a way I feel I have no strength left for the birth.
• I have a hernia in my groin and even though it shouldn't impede pushing I just worry that it might rupture when I push too hard. (this was also a mental problem for me with birth 2)
• I was worried about scar rupture and didn't feel the hospital gave me the treatment I would have expected for a woman attempting VBAC. There is no reason to believe that they will support me properly this time
• I healed in a snap from my emergency section, but was very down about my tears from birth 2 which took much longer to heal than the cesarian recovery.

I would love to get some input!

Planned section IMO. You've had one emcs then a traumatic vbac. I would push for an ELCS. Will you have some help afterwards?

Of course this is up to you, but I would opt for ELCS with this history.

I'd probably say different you'd ever had a successful vaginal birth ... but you haven't.

Hi,

I had two similar births - first one an emergency cesarean (failure to progress) and second, an assisted delivery (forceps). I also found my cesarean easier to recover from (maybe because I was only looking after one baby?) and my second birth a bit of a nightmare (and I still haven't been able to move past it).

The only reason I am trying again for a vaginal birth is because I want to avoid the risks associated with cesareans (I know everything has risks!) because I want to have more children (although I have heard of people having several cesareans in a row with no problems) - and also because I have two children, and so will need to be mobile - something which a cesarean may limit?

I would love to hear what others think as well - my main issues have been, like you, getting myself mentally prepared - I still feel so unprepared for this birth.

I have read around on different websites, how we have to trust our bodies, that they know what they are doing, but at the same time, I didn't manage very well last time with the pain, some bits are still unclear!

Maybe you can take some classes? Like hypnobirthing? Or can anyone suggest good ways to get mentally prepared? I am still tempted to take some classes just to meet other pregnant women and share things, just as a therapeutic thing...

I don't think there is any harm in going for an elective cesarean due to your birth history, but personally, (in addition to my reasons) I want to try one last time to see how things go...

Remember that this decision lies with you - sometimes, it really depends on the hospital, and which midwives you end up with in terms of how it goes on the day.

My first birth, although a difficult one, was a pleasant experience because I had such nice, supportive midwives who were checking up on me often, and asking how I was. My second was made worse by busy wards, and I had to ask for someone to check me, as I was sure I was in labour, and when they checked I was 4cm - I could have been on gas and air! And no one really checked on me, I didn't feel supported much... and then everything went pear shaped...

It is upto you, and I hope others can also share their stories if they have been in a similar position, because this is something I spend a lot of time thinking of myself.

Thanks for the replies - really appreciated!

bonzo - yes, the midwife also called my VBAC "traumatic"? a word I wouldn't have used myself, but there you go. Thanks for pointing out that I'll need help. I guess that would be easy to arrange with a planned cesarean, knowing the birth date etc?

Jules - yup? I think ELCS would be easier

UML - yes, Hypnobirthing is awesome, I have done it for birth number one. Totally recommended? should had refreshed for birth number two though (I didn't prepare at all).. and this time around - like I said - I am barely coping day to day with our marriage crisis. It sounds really bad, but I am glad that I kept this baby alive, that is all I can do for it THIS MOMENT.. so, no energy left for hypnobirthing.

I also don't want any more kids and if I would I'd also avoid another section? From what you write I can highly recommend hypnobirthing for you though.. worthwhile investment? but you need to spend at least half an hour per day "practising" it IMO Good luck!

In my case I had a EMCS for first and desperately wanted a successful VBAC with my 2nd,but it wasn't to be and reluctantly was persuaded into a ELCS. If I were to have a 3rd (but I won't) I would 100% try VBAC again.

But your story is very different from mine,and from the next woman,and the next woman. If given a choice you can only base it on your own experience and feelings.