VBAC?

[victoriassponge]

(had posted this on pregnancy thread first...)

I am going to be attempting a vbac in 5 weeks and was just wondering if anyone has had a c-sec due to 'failure to progress' followed by a successful vbac?

My midwife has suggested that previous csec may have been due to the size of DS1s head - apparently anything above 35cms in diameter can be difficult to pass through the cervix...

Positive thoughts welcome...

Hi victoria i'm afraid i have no advice to offer here as i will also be trying for a vbac. but i will be following your thread with interest, i hope it goes well for you.

i think that good support and low intervention (labouring at home as much as possible for eg) seem to be key to making it work. i read a book called The VBAC Handbook by Helen Churchill and Wendy Ssvage which was really good. i know you're pushed for time but it's a short book and might help a bit

xx

Yes I've had 3 successful vbacs (2 in water) following failure to progress with my first who was back to back. Difficult decision what to do but good luck. Mine went really well but I was fully (mentally) prepared not to beat myself up if I had needed another section.

I'd be really interested to hear positive stories about this too, not pregnant yet but had exactly the same as you with DS.

OP, were you given a choice over ELCS or VBAC?

Yes. Had my first VBAC a year ago, after an "emergency section" for "failure to progress" (I stuck at 8cm for about 6 hours) back in '07.

Second time round, I planned a home birth and stuck AGAIN at 8cm, this time for 7-8 hours. But midwife was fab, bossed me into a load of different positions and up and down stairs, in and out of pools and around the house (was there a place in our home I HADN'T laboured in?! ) and in the end (won't bore you with details) went from 8cm to holding my dear perfect baby in two hours flat.

I think next time I'll be less exasperated by the apparent lack of progress and just accept that this is how I labour.

In terms of reading-any of the AIMS material which you can browse through or order on their website-it's all informative and well researched I feel.

Enjoy your the rest of your pregnancy.

ps Never heard of there being a limit on baby's head size. Next time a midwife or any health prof. makes such an unlikely statement, I suggest asking where the evidence for it is published!

lollystix: how did you persuade them to let you get in water for a vbac? My consultant says this is not possible as they will need to be monitoring me all the way. Trying to be open minded about whatever the outcome definitely seems like a good idea!

Thekids: have had meeting with consultant today and agreed they will let me wait until 41 weeks before going with ELCS. Also agreed to a scan at 40weeks to check amniotic fluid levels etc. Hoping I will go into labour before that.

Carlyvita: interested to hear that you stuck at 8cms as well! Will google AIMS (?)

Now for some raspberry leaf tea and a pineapple...

me me me!

had unplanned section due to failure to progress/baby a bit distressed. turns out DS1 was thoroughly wedged back to back so i was dilating v slowly. i apparently got to 7 or 8 cm.

DS2 was born 4 months ago after a fairly quick labour. he had forceps assistance for the last couple of pushes but was otherwise a much better experience for me.

good luck!

Thanks Jaggy - good to hear positive vbac stories :)

On the 35 cm thing, I guess if you dilate to 10cm diameter then anything more than 31.4 cm in circumference is going to be difficult to get out. (2piR)...

Hi I also had an emcs with DS (induction, back to back, failed to get past 6 cm I think) and 2 years later had a vbac with DD. Started feeling contractions at 8.30pm, didn't really believe it at first (was convinced would be another very late baby and section!) waters went at 12.30, hospital at 1am to find out was 8cm and she was born an hour later. Needed ventouse but it was so much better than my section and I was on a total high afterwards (and in shock that she had arrived of her own volition and was a girl!) So all positive for me - I will say though tht I had prepared myself for a section and had written a (very short - left it on the printer!) birth plan for that if I ended up with one.

I know exactly what you mean hidinginthecupboard: I can't quite believe my bod is going to go into labour of it's own accord! Oh well we'll see :)

Victoria - my consultant said that too but I got the top/senior mw on my side. Made appointment independently to see her and she was supportive and said she'd tell him that's what I was doing. I had had a successful vbac before so felt less like being bullied. Same consultant didn't even question it with ds4. You can do what you want - they can only advise. I got monitorered every 20 mins in the pool and delivered both in the water. It was amazing and helped lots with pain. Get baby in a good position first

Just wanted to add another positive vbac story. Had a emcs with ds1 just over 2 years ago (very very long painful labour got to 8cm and failed to progress from there, back to back and large baby). Went into labour this tuesday at 5pm, sat in bath for a few hours and then went to the hospital at 10pm, was very happy to find I was 8 cm diated and got in the pool, had ds2 1 hour later. Went home the following morning feeling bloody brilliant. The birthing pool was amazing, was able to be monitored with a telemetric band in there. Good luck!

Oh Tigerwhocametotea if I could write a birth plan for this time round that is what I would like to happen! sounds like your first time round was very similar to mine too. Thanks for your post it is very much appreciated.

just wondering tigerwhocametotea: did you have to be very persuasive with medical staff about getting in water for your vbac? My consultant is saying this is not something they want me to do...

Victoria - mine said they didn't want me to do it. I would phone triage and ask to speak to head MW. Get meeting with her and see what she thinks. My mw told me loads of vbac ladies use pool - I said to them from pre birth I was aware of risks and if it was starting to go pear shaped I wouldn't fight them and would get out pool. I think me being conciliatory and pragmatic helped a bit. But even with ds4 consultant gave me the chat about risks etc and smiled and said 'but I presume you'll be going for a pool again'. I sensed a bit he was just arse covering

No persuasion at all about getting into the pool - ! saw a consultant midwife at 36 weeks to do my birth plan, I mentioned it then and she was really encouraging. They do recommend constant monitoring and luckily they had underwater telemetric bands at the hospital ( I think this is still quite unusual) so they can constantly monitor babies heart rate in the water. You don't have to have constant monitoring but my friend tried for a vbac the week before and sadly had an uterine rupture which was immediately picked up on due to the drop in babies heart rate and she had a crash section which all worked out fine in the end for her and her baby girl. I know these things aren't common but being so close to home I did find the monitoring comforting. Best of luck - I really hope things work out well for you!

37 weeks now. Went for another meeting with consultant today who was fairly blunt with me and basically reckons that, since DS1 was an emergency Csec due to failure to progress, and that from looking at the notes left by previous consultant it is very likely that he was too big for my pelvis, it is highly likely that (if i go into labour myself) i will end up with an emergency c-sec again.

Although she did understand my feeling that I "won't know unless I try" (IYSWIM) I ended up feeling a bit confused as to the best course of action.

Pros of planned section earlier rather than later are:

1. it will be easier to sort out arrangements for DS1 whilst DS2 is being born
2. it may be a faster recovery from an elec Csec
3. the doctor will be more awake (i.e. it wont be in the middle of the night as will very likely be the case with an emergency Csec.
4. I can get this VERY heavy baby delivered a couple of weeks from now, rather than waiting for another month and very possibly ending up with a csec anyway.
5. wont have to push a watermelon through a hole the size of a needle.

pros of trying original vbac plan still:

1. recovery time should be quicker and will be easier to cope with 2 kids sooner - this is my main worry with csec option.
2. Might just happen really fast as it is second time round.
3. might be able to avoid another epidural - (which I am very disturbed by)

Any thoughts welcome...

Hmm - that's v frustrating. Did the consultant offer any sort of guidance as to whether your pelvis is an unusual size ? "it is very likely that he was too big for my pelvis" - are you quite petite with a ginormously tall DH? .

How big was your DS1? If your DS2 is VERY heavy [and 2nd babies tend to be larger in the main] and the pelvic thing is a very real factor then I would be inclined to go with the ELCS despite the major con of recovery with a toddler around. You will need some proper help for 2/3 weeks though.
Mostly because delivering a v large baby vaginally (basically for the first time) may have it's own recovery complications and a controlled ELCS should leave you feeling less drugged up, and rested.

That's obviously a personal perspective - have to make the same choice myself fairly shortly but not in the know as yet re my own "failure to progress". DC1 wasn't particularly large though.

Hi Oscar, thanks for your response. No, they wont actually measure my pelvis, the consultant is just going on what the previous consultant had written down last time.

Am tending towards agreeing with the thought that a bad natural birth could still leave me fairly messed up - just feeling a bit resentful that this woman has put the fear in me, when really it's just a theory. Other people have suggested the previous failure to progress could have been down to being messed with so much (induction / 24 hr labour / student midwife meaning each examination happened twice etc) and my body could simply have frozen with all the adrenaline.

Then again there is a part of me that feels like I might just be really relieved to book an earlier elcsec and have more control over what is going to happen.

Just don's know what to do and keep changing my mind