VBAC after an ELCS - what's it like?

[SunsetSongster]

Hello. I am very early stages of pregnancy and already worrying about the delivery. DS is 2 and was an ELCS due to him being in a breech position. I had always been very scared about the idea of childbirth but during the pregnancy had psyched myself up for a vaginal birth and was really disappointed when I found out I had to have a CS. I'm now back to being scared of vaginal births especially as my body hasn't gone through labour before. I found the ELCS a really positive experience and would happily go through it again, recovery was fine and my scar is minimal. I guess I feel I know what I am getting and have heard all the horror stories of friends who had 3rd degree tears etc. DS was 8lb 3oz at 39 weeks as well so I am imagining that DC2 might be even bigger and I could go to 41 or 42 weeks...

However, I would like to experience vaginal childbirth and I do want to be able to pick up DS1 for a cuddle after the birth and drive around and see people sooner than 6 or so weeks. Does anyone have any experience or advice? Are VBACs generally more medicalised? I would prefer to be in a midwife led unit which is very close to theatre etc. if anything goes wrong. Sorry if this has been done to death and thanks for reading.

Hi sunset,

No doubt you'll get more positive vbac stories than anything, as most people on here and others I've known have had very easy vbac's with much quicker recovery than csection elective or emcs.
Not to frighten you, but just so you get the full range of opinions on vbac, I'd like to say, I found my csection fairly ok to recover from but am still experiencing chronic pain from my vbac 20 months on sadly. Apparently this is very unusual so probably won't happen to you. Personally, I think there's a reason why there's a 'ragged bits' section on general health related to childbirth, but there's no massive thread on c section trauma.
If you want a vbac, I'd defo stick my heels in for the midwife unit, it can be more medicalised, I had CFM etc but you can refuse. They keep a closer eye on you too. Have a good search on here and get a wide range of opinions. I'd say go with your gut instinct. Best of luck in whatever you decide to do.

I had emcs with DC1. Then an elcs with DC2. Looking back, I now wish I'd vbac-ed with #2. At the time I was still quite traumatised after the emergency situation of my first cs and we really thought we wouldn't want any more children after DC2 so I didn't worry about how another cs might affect subsequent pregnancies.

A few years later, we decided we would like a larger family. Conceiving took ages. I can't say for sure whether my scarred uterus was to blame but I had always fallen pg very quickly before.

Then, when pregnant, I had a lot of pain across the scar area. Not only was this sore and uncomfortable, it also squashed my new found bravery of trying a VBA2C. And the consultant wasn't keen to risk it. I trusted his judgement.

I'm now TTC #4 and there's no option for a VBA3C for me.

If it were me, and I was now pregnant with DC2, I'd go for the VBAC. Hope that helps.

Thanks for the reply Junebugr. Sorry you're still having problems 20 months on. I have a close friend who has had lots of problems following her 2 VBs and I think this is influencing me a lot. I guess I need to see what happens as I go along.
Am staying well away from the 'ragged bits' section - don't think it will help to know the specifics.

Thanks Melody - I think DC2 might be it for us but I guess you never know. I hadn't thought about the impact on future pregnancies.....

I had a VBAC 4 months ago. This was after an EMCS due to malpresentation, although I had laboured fully to 10cm so different experience from yours. Tbh, I didn't enjoy the labour and birth and did end up with some "ragged bits" - she was quite a big baby.

HOWEVER, despite finding it a generally very unpleasant experience, I believe it was the right decision as being able to have DD2 placed directly on my chest is the overwhelming memory from both my births. I still feel sad that I didn't get to hold my first child for nearly an hour after she was born by EMCS. Also, recovery was much quicker than after the c-sec, even though I had to be stitched up in theatre and I have breastfed more successfully this time, although I'm not sure how much of that is due to having a vaginal birth.

Thanks GraceGrape - that's really interesting and glad you had a quick recovery.

The thing is when I had my ELCS I got to hold DS pretty quickly - he was whisked off for a couple of minutes for oxygen and was then dried but was probably on my chest for skin to skin in under 5 minutes. I didn't attempt feeding until he was in recovery though. I am scared that I will try for a VBAC and end up with an EMCS where I will have less control and a worse experience than an ELCS (such as no contact for an hour as you describe and I've heard the incision can be less neat).

DS did have problems feeding though and I think this was because he had a lot of mucous (which is apparently squeezed out in the birth canal). We had to stay in hospital until feeding was established and I had forgotten how stressful that was at the time. I think I will try for a VBAC but I feel I have none of the advantages of experience that come with a 2nd labour and the added worry of things rupturing etc. Not even reached my 12 week scan yet though so should focus on that instead for now.

Hi sunset. I had a VB with DD1, CS with DD2 for breech and a VBAC 12 weeks ago with DD3. Textbook birth with DD1 so was keen or a VBAC with DD3, even though my CS was a really positive experience but it did take me longer to recover from.

VBAC went really well, although took a long time (compared to DD1) to get into established labour. Prepare yourself to be continually monitored once you're over 3cm but you can still stand up, make sure you tell them if you don't want to stay on the bed. If there is a scar rupture the first signs are the baby in distress so although rare it's important they check. I was very lucky that my midwife just checked putting the monitor on my every few minutes to listen to heartbeat rather than continually but I'd guess this is rare and I luckily went from 3 to 10cm in just over an hour so wasn't for long.

I suppose mine will be different to yours as it was my second VB and my first went well, but apart from being monitored a bit more frequently I don't think it would have been any different if it wasn't a VBAC.

My vbac was a v positive experience. I refused cfm and laboured at home til I was 8 cm so I was only in for an hour or so before birth. Each area has different rules about access to mlu so you could ask to find out

My vbac was a v positive experience. I refused cfm and laboured at home til I was 8 cm so I was only in for an hour or so before birth. Each area has different rules about access to mlu so you could ask to find out

Thanks again. I think if they want to do cfm and it means you can't move around there is no point in even trying a VBAC (but maybe that is a bit defeatist). I will at least have lots of questions for the midwife. I want to feel I have made a decision by myself rather than being railroaded into one option.

I had a very successful VBAC last year after ELCS three years ago (very calm and reasonably pleasant, also for breech presentation). I did lots of research and ultimately went for it for many of the reasons in your OP. At 40+5 I rang the hospital with regular contractions expecting them to get me in for cfm but instead asked me to try another hour at home. When I got to hospital an hour later I was desperately trying not to push, was fully dilated and had DS2 twenty minutes after that. It was a bit stressful at the end as they couldn't find his heartbeat so used ventouse and out he shot (thankfully he was fine). This was all despite warnings that I would be continuously monitored from early stages of labour and, because I had never laboured before, it could be slow and would treated like a first time labour. Expect the unexpected!

My episiotomy stitches split open so recovery wasn't as quick as I'd have liked but still much quicker than the ELCS. Also my pelvic floor is definitely not what it was but I'm still breastfeeding so not sure of the long term effects and also whether it is from the birth or just two pregnancies. On balance if we go for DC3 I think I would go for another VBAC if possible. Good luck!

I'll be watching this thread with interest. I am thinking about having DC2 and DD was an ELCS. I was dead set on having a natural birth and was more than just a bit disappointed when I was told I had to have a ELCS at 40+3 weeks because babies head was not engaged. I can't complain about the recovery, it was much easier than I imagined, but I hated the fact that I couldn't hold my baby for 45 minutes after she was born. It was the longest 45 minutes of my life.

I will speak to my consultant about a VBAC and see what he recommends, but I live outside the UK and I know my consultant doesn't like to take risks, so I'm going to mentally prepare myself for another section. I recently spoke to a doctor (not an OBY) who witnessed a VBAC delivery where the scar ruptured and the baby died. This has scared me to no end. ..I imagine this is very rare, but I don't know if I'd be willing to take that risk. I don't know if this person was monitored though.

sunset

its so difficult you dont know how each one would end up.
a lady I know had a section and wanted to experience child birth too and was badly damaged by it and said she regrets it.
I am really sorry to say it- you have to do your research.
You know what a section is like, its a known thing etc: if your Vb goes wrong would you still be happy that you tried it??

I am in the same position Sunset, except I desperately want to experience VB. I was absolutely gutted when they told me I need a CS last time, and argued hard for breech delivery but they were having none of it. Hospitals are very risk averse: if you don't do want they want they eventually start waving the dead baby card at you to get you to tow the line.

This time around they want me in the Consultant lead unit, flat on my back with CFM. I can't imagine anything more stressful and less likely to lead to a sucessful birth. I am arguing for Midwife unit and planning to stay at home as long as poss regardless of what they say. I know, absolutely know, that my body can deliver this baby itself, without intervention. All medics seem to want to take that control away from me. Understandably, of course. They want the best outcome for the baby. It sounds horribly selfish but no one seems interested in the best outcome for me.

Everyone's birth story is different, some go better, some go worse. But from everything I've heard it seems that if you want to deliver sucessfully vaginally then you need to be relaxed and feel in control of your surroundings and body. It is when you become frightened that things go wrong. So be careful of reading the scare stories, and be a little sceptical when they pull the dead baby card. Exactly how often does this happen? Ask you hospital for their stats. How many VBAC lead to EMCS? How many result in the scar opening? How many from the midwife unit have these complications? I've been advised to arm myself with information and be ready to fight for my right to birth the way I want.

All the best to you. I hope you get the birth you want, whatever that it.

I had an emergency section with DS1 and a VBAC with DS2. It was an unbelievably positive experience. My section was due to bad positioning which meant he got stuck.
My VBAC lasted 50 mins from first contraction to delivery. I felt so blessed to have it- I felt a bit robbed from my first birth and really wanted to experience vaginal birth. I hadn't chosen it- I happened to go into labour two weeks early so decision was taken out if my hands. It totally redeemed my first horrible experience, and after it finished I immediately said to DH that I'd do it again in a shot. Yes it hurt like you wouldn't believe as no time for pain relief, but it was BRILLIANT!!