Crib sheet for appointment with Consultant re:VBAC

[AliBean]

I have appt with consultant tomorrow and need some help streamlining my questions for him as I am feeling slightly hysterical and scared about VBAC or not to VBAC...

A bit of history...after spending first pregnancy focussing on a natural, non-interventionist home birth and learning all about effective natural birthing techniques and utilising everything from hypnobirthing to water I ended up rushed to hospital, blue lights and all and it all ended up in a emergency c-section.

Subsequent conversations with my community midwife suggest that my labour did not progress due to the "mis-management" of the attending midwives (her words not mine) and that there are no physiological reasons why I can't give birth naturally this time.

But naturally doesn't appear to feature too heavily in the VBAC stories I have heard/read (I know there are some lovely stories on a few sites about home VBACs and the odd water VBAC)...all I seem to get is that you are basically on your back, strapped to a monitor and expected to stay that way and get on with it...I know this is not the best way to give birth, I know that this is extremely un-natural, uncomfortable and not going to help labour progress and as non-progression was the reason I was transferred to hospital last time and thus into every intervention possible...I just don't want to give birth like this.

I feel like if I will be expected to ignore everything I know about natural, active birth then I might as well just have an elective c-section and be done with it...

Please can someone help me get some perspective!

Hi AliBean

I am 40+2 and still waiting for my VBAC baby! Seems all the best laid plans don't always work!!

Your consultant should be able to offer you a tour around the labour ward and show you how much movement you will be able to have while being monitered. It is always useful to remember the monitoring and timing of your labour won't start until you actually go into hospital so you are free to labour naturally at home, in the bath etc until you're ready to go in.
I have no intention of being on my back - the beds on the labour ward are quite adjustable and you should be able to have a fairly active labour. I know constant monitering isn't great (and nothing is stopping you asking them to remove it for a while) but it is hard to get them to agree not to monitor at all!

For the record, I have had 2 unsuccessful sweeps so far and if nothing happens by Monday then I will have my waters broken and 24 hours later a c-section if baby hasn't appeared.

I have been through the mill emotionally over all this too - my twin pregnancy resulted in a v.easy natural birth followed by a crash c-section due to a prolapsed umbilical cord. I didn't see my babies for 9 hours and a repeat of any of that scares me. I am happy having a c-section but on my terms (after being allowed the time to labour naturally and having a plan in place for when it doesn't go to plan!!)

No-one will blame you if you opt for a repeat c-section, have you been offered counselling on your previous birth, I found that even after 7 years I had a lot of anxiety stored up and the VBAC counsellor was fantastic.

Also different hospitals have different ideas on VBAC, I am travelling 40 miles extra just to be assured that the team working with me on the day is on my side!

Remember too, that you are always free to change your mind, just make sure it says on your notes that you are CONSIDERING VBAC and that it is not set in stone! (I changed my plan yesterday after they decided I should have sweeps twice a week until week 42 THEN a c-section). Sod that!!!! Like you I thought a planned c-section would be better for me mentally.

Here for any questions (unless giving birth!!)

Good luck

x

Ah, just remembered, I have specifically asked NOT to be induced as this can lead to weakening of the scar tissue.

AliBean

You can have an active birth if you want to, the hospital guidelines will be to recommend continuous monitoring, possibly the siting of an canula "just in case" and possibly an epidural.

You do not have to agree to any of this if you don't want to. You can ask for midwifery care, and not see the consultant at all, you don't need his/her permission to labour how you want to.

There is a really useful VBAC Support UK page on Facebook where you can aske questions and get info and support from other VBAC mums.

Continuous monitoring won't necessarily pick up any problems with your scar - monitoring of your pulse is more likely to. You could insist on being treated like any low risk woman - intermittant monitoring and no interventions unless events suggest another route may be a good idea.

you don't have to get them to agree not to use CFM - you just say no! You can also refuse the canula and the epidural.

You can request an appointment with the head of midwifery or a supervisor of midwives and ask for an individualised care plan to be put in place for your labour. I know women who have had VBAC births with CFM, without CFM, on the bed, off the bed, in the pool, at home....the choice is yours - the person doing the allowing is you.