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Share experiences and get support around labour, birth and recovery.

ELCS or VBAC? 34 weeks pregnant with bipolar 2 and in pain - help!

10 replies

Rones · 29/06/2013 21:02

I'm just over 34 weeks pregnant (although feel as though I could drop any minute I feel so huge!). I'm also in a lot of pain which started about 6-8 weeks ago but has become much worse over the last couple of weeks. I'm sure it's a hiatus hernia (I had a suspected one 11 years ago and suffered with it with my first dd although not this badly). At best it's uncomfortable but at worst it's agony and I feel totally incapacitated. I also have bipolar 2 disorder (off meds since just before falling pregnant) and my mood has really lowered these last couple of weeks, mainly because of the pain I think.

Before all this pain, I was sure that I wanted to try for a VBAC but now I'm not so sure as I'm finding it all so hard. At least with an ELCS I would know (hopefully) the date I'd give birth and could avoid a potentially difficult labour (who knows?). I'm really torn and could do with any advice or experience anyone may have. My first c-section was planned (breech baby) just over 5 years ago and I recovered well physically but there's no medical reason why I couldn't try for a natural birth.....but the closer it gets, the more scared I feel and I'm not sure if I cope given the pain I'm already in (I've been given omeprazole and told to take paracetamol but it's not making much difference so far) and my fragile mental state.

Any comments much appreciated!

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carlyvita · 29/06/2013 22:47

Not sure I can offer much help, but for what it's worth, I think it's great that you're still considering both options!

It sounds like a pregnancy that's been real hard work and can see the appeal of a repeat caesarean and, indeed, a VBAC.

I have no experience of your conditions/background either. I found water very beneficial for a ridiculously long VBAC. I also found massage useful, and it was a very positive experience for me.

Hopefully, someone slightly better placed to offer their thoughts will come along shortly! All the very best for whatever you decide.

Rones · 30/06/2013 09:21

Thanks carlyvita - any thoughts are greatly appreciated! It's interesting that you say that your VBAC was ridiculously long as I thought they didn't like letting VBAC ladies go to too long before suggesting another section - was that your choice to carry on? If I do decide on VBAC, I am definitely all for going in the water and I would ask for intermittent monitoring as they usually recommend continuous monitoring with VBAC. I'm also a big advocate of massage and I've actually booked to do a massage in labour workshop with my husband in a couple of weeks (I'm a massage therapist myself and have been for lots of pregnancy massage which have been fantastic). Just out of interest, did you have an emergency section first time round? I posted somewhere else on mumsnet (the mental health section) and everyone seems to have had emcs followed by VBAC or ELCS and not had a planned section first time, which was my situation.

Anyway, thanks for your thoughts.

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Jollyb · 30/06/2013 13:23

Hi Rones - it's a tough decision.

I had an EMCS with my DD after a 3 day failed induction. I'm pregnant again and have been going through the VBAC versus ELCS dilemma. I also have mental health issues in the form of depression and anxiety. I'm currently on antidepressants and feel 100% better than I did with my first pregnancy.

In the end I've decided to have an ELCS. For me the control aspect is hugely important. I found going overdue and then the induction process hugely stressful and I am so much calmer knowing that I have a date to aim for. I'm also keen to avoid 3 nights with no sleep before the baby even arrives.

However as you mentioned the events of my section were completely different to yours . With a prior section for breech (rather than for failure to progress) you have a much higher chance of a vaginal birth. I doubt they'd let you go to 42 weeks either.

Another factor to consider is whether you'd like any more children as the risks increase with the number of sections. So if you're planning a large family it might be preferable to aim for a VBAC.

Rones · 30/06/2013 22:34

Hi Jollyb, you're right it's a seriously tough decision! In your position, I think I would do the same and opt for a ELCS. I'm sorry to hear that you also have mental health issues but glad that the medication is helping. I've actually been OK off the meds since just before conceiving which has been great. It's just since this pain really kicked in that my mood has dipped which is a shame......

We're definitely not having any more children after this one and so having another section wouldn't be an issue from that perspective. I must admit that the control element is a big factor and would help in terms of planning sleep, childcare for dd and husband's work. I just can't imagine having a really difficult labour and then not losing it due to lack of sleep, exhaustion etc....having had a planned section, I know what's involved and it's a routinely performed and relatively safe procedure.

Lots of food for thought.

Good luck with the rest of your pregnancy and your ELCS.

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KeefRegina · 30/06/2013 23:32

Had both and def prefered ELC sooo much better.

Rones · 01/07/2013 09:19

why's that KeefRegina? I'd love to know the details!

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Jollyb · 01/07/2013 16:04

Good luck to you too Rones. My section is in 2 1/2 weeks so will report back!

Rones · 01/07/2013 18:54

Yes good luck to you too Jollyb - and yes please report back on how it all goes - smoothly I'm sure. I can't believe how many times I've changed my mind, I am seriously in 2 minds! Very frustrating - I wish I could decide one way or the other. Take care!

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carlyvita · 02/07/2013 14:23

Wow, the massage in labour course must be worth it's weight in gold! Amazing- hope you come away with some good stuff!

In answer to your questions: yes, I had an emergency caesarean first time round. I was told my baby was in mortal danger and consented to it on that basis. On the notes however it clearly says "failure to progress" as the reasoning. But that's another story, as was my journey in deciding that a HBAC was my best option 2nd time round.

Yes, it was a long stretch. But so much more enjoyable and easy, if they're the right words! The labour with my first was induced, in hospital, strapped down, with a number of random midwives and doctors coming and going, ending in being coerced into a caesarean and a long recovery.

With my second, it was a long labour at home with 2 known midwives(who provided one to one care throughout pregnancy, birth and beyond), endless massaging from one of the midwives, a ball, a birthing pool. I knew and trusted the company and environment I was in. Yes, the NHS would probably not have been keen on me doing any the above.

In the event, I stuck at 8cm (again!) for about 7 hours and I made the decision that enough was enough and transferred in for my back up c section, still supported by my lovely midwives. But the ride in or maybe all the stair climbing I'd been told to do by midwives must have helped, and almost on arrival I could feel my sons beautiful velvety head, the rest of him following anout 15mins later. I'd gone from 8cm to holding my baby and drinking tea in less than 2 hours! Crazy!

I hope you decide on whatever is best for you, because that is all that matters. Whatever you decide, be aware there are both VBAC and Caesarean support groups out there should you need them.

Rones · 03/07/2013 16:54

Wow what a story carlyvita - thanks for sharing it! I'm pleased you managed to have a natural delivery second time around despite the drama and change of location! I will definitely look at the support groups....I'm hoping I won't need a support group for PND this time around but who knows? I'm STILL undecided about what I want to do but I'm going to just see how I feel in the next few weeks and wait for my obstetrician appointment on the 18th July for a further discussion about options....I can't quite believe I'm due in 5 weeks time, it can't come soon enough now although I'm going to make the most of my dd's last 3 weeks of school to rest up (despite work in the house not yet being finished!)....Thanks again for your story and advice.

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