Birth pool and VBAC

[ICompletelyKnowAboutGuineaPigs]

Currently pregnant with DC3 and planning on VBAC.

Had vaginal delivery with DC1 and bad tear (needed 12+ months of physio but no problems after). Had elective CS with DC2 (3 yrs later) and this birth will be 3 and a bit yrs since then.

I really want a VBAC but am not keen on continuous monitoring because I'm worried it will be restrictive re. labour position etc. I've done some research and the outcomes between CEM and intermittent monitoring seem to be the same.

I've spoken to the hospital and they have very begrudgingly agreed to intermittent monitoring but have said no to birthing pool. Just wondered if anyone has experience of labouring in water during a VBAC and how you managed to negotiate it with your care providers. I'm toying with a home birth but don't want a birthing pool at home so would need one in hospital (I know they're not guaranteed but my first step seems to be getting the Drs to agree in principle).

Incidentally I don't want to birth in the water, just labour in it. Possible to get what I'd like or am I being unreasonable?

Sorry no experience of VBAC just HB at home in a pool with DS and planning another if possible (DC2 due on Thurs). It just seems ludicrous to deny you this option especially as you don't intend to birth in the pool. Are you consultant led? Can you request a second opinion? I highly recommend the pool: it was an amazing experience, so calming and I think it's ideal for you. Wishing you all the best and I hope they agree to your wishes. Also you could consider having an independent MW if funds aren't an issue... (I did with first but am with NHS this time...)

Thank you for your reply. Funds are an issue unfortunately. Yes I am consultant-led. Everything has been straightforward so far though, so I am only really 'high-risk' because of previous births. The problem with NHS consultant care is that I never actually see the same Dr twice and haven't met a consultant. Might see if I can speak to her next time.

I hope you get the birth you want for DC2 (enjoy your newborn baby snuggles).

Hello Icompletely

You could challenge why they've said no to you labouring in a birth pool, is it hospital policy? what evidence is it based on? Is there a deep bath you can use instead? You're in their hands though, so even if they begrudgingly agree it may be in use by someone else on the day.

That's partly why I'm going for HBAC, my home and my birth pool!

Good luck with your VBAC!

speak to the supervisor of midwives, its her job to be her advocate and if you are informed enough about your choice she'll overwrite the policy for you

you can have underwater doppler to check heart beat in the pool, and some say the water takes pressure off the scar and prevents it from tearing

you might have more luck getting a home WBAC than a HBAC so consider both options

supervisor of midwives is the secret code to getting the birth you want! its the magic password!

FWIW I'm planning a VBAC and have been told not to go to hospital at all till I'm 5 cmsish (3 contractions in 10 mins) so won't be monitored at all in early labour so there is no reason whatsoever for not being in water in the beginning even if you are agreeing to constant monitoring, they don't constantly monitor early labour anyway

Of course YANBU.

If they have 'agreed' to intermittent monitoring, why are they saying no to labouring in water? It makes NO sense. Your temperature, heart rate, BP and Doppler can all be done while you are in water. Do they believe labouring and/or birthing in water would cause a uterine rupture?! I really can't understand their reasoning, or lack of .....

I had two HWBAC, but had an Independant MW so I didn't have any of the negotiations that you are having to endure.

Just a point, an underwater Doppler isn't necessary. You can just kneel up in the bath/pool and your stomach will be out if the water. Just thought I would mention, so that a lack of an underwater Doppler cannot be used an excuse.

I second speaking to your head of midwifery. I had several frustrating conversations with my community midwives and consultants - all refusing water birth and intermittent monitoring . My community midwife even went as far as to say "if you end up with a dead baby because of your birth choices, it's me that will be blamed "

Amazingly everything I wanted was agreed when I met with the head of midwifery. She was fantastic and even gave me an impromptu tour of the birthing pool and showed me all the equipment that would be used etc.

Unbelievably, even after meeting with her and having confirmation of a waterbirth in my notes my consultants still didn't believe this was going to happen and were a royal pain in the bum .

Er things to think about....

How many pools are there to use?
How many people asking to use?
How do u book for ur birth if waiting for natural seeing as u have no idea when that will be?
If in use and u r forbidden how disappointed will u b?
Any other alternatives?
What if broken?

U seem quite fixated and I think u need to know more about management of it not just if u could have one.

I will get on to the Supervisor of midwives in the new year. Hopefully she will be more supportive than the Drs I've seen so far (I really had to present the academic peer-reviewed evidence to get them to concede that CEM was not absolutely necessary).

LaCiccolina I understand your queries ... I'm not particularly fixated on a pool but would like it to be an option and because I am considered high risk I feel that I need to 'clear it' with the hospital first rather than waiting to see how I feel on the day/availability etc. I know that if I absolutely feel I must have one my best option is to hire a birth pool and have a HBAC. I suppose it's an 'agreement in principle' I'm after at this stage but definitely worth thinking about those issues.

Goodness me Wilts can't believe any HCP would say something like that to you - it does make me think that some many of the protocols are for convenience/litigation avoidance rather than because they are medically appropriate in each individual case. I know protocols are necessary in any large organisation but I really believe that there should be some flexibility to be negotiated on a case by case basis.

Thanks for the advice re (underwater) Doppler HoHoHo, definitely will bear that in mind when I recommence negotiations in the new year!

I may still opt for a HB as it really does appeal (DC1 was a planned HB but I was routinely induced so it didn't happen). DH would prefer a hospital birth so if birth pool was a possibility I would think about it. I could have a birth pool at home but it would be a pain to fill and practically neither me nor DH fancy the hassle/extra job when we will have 2DCs to look after/dispatch. There's alwasy the bath I suppose

Ilovesalad is totally right - consultant MW is who you need to see. I had 3 VBACs and the last 2 were WB. Never planned on having babies in the pool but no way I was getting out as great for the pain so they were both born in the pools. Calm, easy, lovely compared to first VBAC which was stressful (due to hospital letting me get to 8cm in reception as apparently I wasn't in labour and they were too busy - all those consultant plans for monitoring seemed to go out the window in reality).

So speak to MW and tell her what you want. She can liaise with your consultant as its YOUR choice not theirs.

Good luckx

It's amazing how different areas have such different ideas. I have been told to come in right away, have half an hour on the monitor, and then assuming all ok I can labour as a first time mum with no CFM. And can go in the pool. I didn't have to argue my corner or anything. And that was the consultant! I'm actually more nervous about individual midwives having different ideas once I get there.

Hi. I am 36 weeks and hoping for a VBAC. Also very keen to avoid continuous monitoring this time. I asked to go on midwifery-led care which means I can use the pool in the MLU and don't have to have continuous monitoring as long as all's going well. I definitely agree with talking to your supervisor of midwives - I had a chat with mine at 20 weeks and she was supportive and even encouraged me to use the pool.