Would a vba2c be possible with my history? Advice needed!

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I know it's early to be thinking about it - I'm only 13 weeks - but I just don't know what is for the best. The situation is that I have had 2 emcs, both for failure to progress, with dd I got to 4 cm and with ds (failed vbac) I got to 7 cm. I know this in itself is not a reason not to go for it, but the problem is that neither baby engaged At All. In fact, ds was moving around so much in labour that although I had a scan early in labour (they thought he might be breech) when he was in the perfect position apart from "bobbing around the brim", but when he was lifted out he had the cord twice around his neck and was face presenting! One consultant who examined me muttered something about an abnormal pelvic brim but did not elaborate.

I don't know from all this whether i have no chance of a successful vbac, and therefore an elcs would be best, or whether to go for it and cope with the probable disappointment. Any advice from anyone - especially midwives I guess - would be much appreciated.

Ohhh watching with interest. Am 14 weeks pregnant with #2 and trying to decide elcs or vbac after emcs with #1 due to failed induction (face presentation and also never engaged.) I was told they'd have to fish for him, grim!

Congratulations!

Have you gone through your notes with the Supervisor of Midwives, there may be something in there that expands on the consultants comments.
The pelvis moves during labour and birth, so whether you would not be able to birth because of your pelvic brim is debatable. Quite technical information here and here.

I am going for a VBAC2C in January, after 2 EMCS, but both mine were malpositions, I was fully dilated and pushing, failed instrumental so c-section both times.

You progressed further the second time, it may have been that you didn't progress further because your ds engage fully on your cervix and descend with the cord around his neck. Each birth is different, that may not happen again.

I haven't yet had a debrief, although will request one I think. Thank you for the links - very helpful.

Good luck with your vba2c - I'm encouraged by knowing women who have had successful ones irl.

Lots of info on vba2c here.

Also if you go onto the yahoo groups UK vbac forum there are people who have had vbac's successfully after multiple CS and failure to progress.

There was an interesting post on there the other day about cervical scarring and failure to progress, some info here.

Great links, thank you. Fuckwittery, best of luck with your vba2c, I really hope it is successful for you.

Have had a vbac after an EMCS for FTP. Couldn't sit properly for 12 weeks with "minor second degree tears". I would stick with an ELCS myself. Wish I'd had one in retrospect.

Ooh, ouch. Sorry to hear that ( and thanks for your honesty...). I hope you feel better soon

Fine now - baby is 9 months old Pelvic floor will never be the same again though.

I was initially as high as a kite that "I'd done it". Felt such a failure after my first CS and only found out during the notes review [2 yrs down the line] that DD1 was back to back, and constant references to my pelvic size but helpfully nothing conclusive. DD2 was also b2b but early so a full 1lb lighter - needed forceps in the end so we reckon it was only her size that stopped her stalling too.

In my experience, it all hurts, just in a different area and actually given that you spend so much time sitting on your bottom feeding in the first couple of months; not being able to sit comfortably or walk any distance due to internal bruising really impacted my first few months with her. I recovered far faster from a CS.

For what it is worth and this is just my opinion. You've had two CS's so your risk for uterine rupture has got to be higher. It might never happen but it just wouldn't be worth it to me just to have another go at the experience of a natural birth. You've had two CS's so they'll definitely want constant monitoring and you won't be considered for a MLU for example. Book in an ELCS [a date has got to be a good thing with two kids already], get lots of help for afterwards and get on with your life. Talk very nicely to the consultant and ask him to give you a tummy tuck while he's in there.

like the idea of a tummy tuck!

From research, the chances of a rupture after two uncomplicated lscs are no different to after a single one, but you make a compelling argument for the recovery, certainly. I recovered very quickly after the first two. I suppose one issue I have is that I am convinced it was the cs that sparked endometriosis, given the timing and the way that I scar, and the consultant has already refused laparoscopic surgery on the basis that it coud just as easily make it worse, so I suspect another cs could also have the same effect - the longer term effects do worry me a lot (but I guess there'd be possible long term effects with a vb too). Gaaah, not an easy decision!

I had a really interesting chat with a consultant who said that instances of incontinence/continence problems with older women is 40% less in countries with high rates of ELCS.

For the record I was booked in for an ELCS. It was the devil I knew after angsting over if for months and about 50% of my peers seem to have had some form of post natal surgery to patch up their pelvic floors. It didn't appeal to have a CS scar and a buggered pelvic floor/perinium. My DD2 had other ideas though.