Questions to ask my consultant about VBAC

[calvemjoe]

I am seeing my consultant in 3 weeks to discuss the birth of my 2nd lo in september and could do with a bit of help on the questions that I should ask about my (hoped for) VBAC.
Past experiences and appropriate questions would be really appreciated. TIA

whats vbac????

Vaginal Birth After Cesarean

oh i get it now, thanks

Do you understand what happend last time ? Was it an emergency and did you get a clear explanantions as to what happened and could have beeen done differently ?
Ask what are their protocols (not that it necessarily matters as you can decline them!) but at least you know what they routinely do.... when they induce ? Do they induce "trial of scars" (which is what you will be)? How and when ?
What if you do not want to be induced
Would they consider you using a pool (some hospitals do!)
Don't forget that 1 consultant may be very pro VBAC and another not in the same trust... so don't despair if he/she isn't what you expected !

What pain relief can you have? Not all hosps allow epidurals after c/s's.

If no 1 was an emergency, was it a real emergency? I was under the impression that ds was, but another consultant reviewing the notes said he wasn't, and that he wouldn't have ordered a c/s at that point. Good to know ds was never in that much danger.

Is home birth an option for you? I discussed it with my consultant at about 20w.

Ask them about the risk of uterine rupture vs the risk from c.section surgery (my consultant was very clear that the risks are very similar, so this made it easier to say ' in that case I want to try for VBAC')

Ask what type of room/conditions you will be able to labour in - I was not allowed the 'birth centre', and was promised a room on the 'non high risk' labour/delivery side, but, when I turned up in active labour, the midwives stuck me on the 'high risk' side (less access to useful things like birthing balls, light dimmers - but I had packed the car full of stuff I might find useful including birthing ball, extra pillow, tens machine) - It's worthwhile visiting the rooms before hand so you can think about what might make it less clinical and more relaxing for you.
Something that i wished I had made more of a fuss of was, if, at some point, you decide you would rather have another section, will they listen to you.
My first birth (which ended in emergency section) was extremely long, painful( epidural didn't work), and traumatic. I had no intention of having a similar second birth, but def. wanted to attempt VBAC. I wrote in my birth plan, if labour is not progessing please c-section, and, if pain relief does not work sufficiently please c-section.....but when the time came, and after many hours and exactly the same complications that I had with the first birth, I had asked and asked for a section and been ignored....I had a VBAC, but delivered in an operating theatre whilst being prepped for another emergency section, after another immensely long, painful labour.
Def. ask about whether they will induce if you go past term, and if they will allow syntocin(?) drip if your labour is slow..(I would expect 'no's ' to these, but at least you will know).
And check on just how much monitoring of the baby they will want (although IME it depends on the midwive, I had one who was very nervous and anxious about 'what the doctor will think if there's a gap in the trace', which meant I could not be as active as I wanted without her stressing about it.
Good luck - the recovery after a VBAC is so much quicker than a section, I'd choose it again, for that reason alone!

Thanks for all of your replies.

Pupuce, ds was an emergency at 5cms due to distress and when they eventually did get him out he was well and truly wrapped in his cord so I think it's just a case of hoping this one isn't!

Laura, I don't think I'm brave enough to even think about homebirth, was pretty shaken up after ds and like the reassurance of machines and theatres all around me.

Bluebear, the recovery time is the main reason that I've decided to give VBAC a go. DS doesn't take too kindly to being stuck in the house all day with lame mummy!

Sounds to me like you'll be fine with a VBAC....
Did you have any drugs last times ?

See if you can have a scan to check the thickness of the uterine wall where the cs scar is. I had this with dd3 & ds4 - both vbac. Best wishes xxx

Just gas and air after about 29 hours. Was planning a water birth but only lasted about 10 minutes in the pool because it was all of a sudden really painful. Think my body was telling me all wasn't well with lo and the next thing I knew I was in theatre.
I am hoping to avoid any thing more than tens and gas and air this time because I'm worried I'll miss the signs if it all goes wrong again.

Thanks milward, I'll ask. Did you get any discomfort in you scar towards the end?

Good luck, calvemjoe, you sound pretty clear about what you want and need. Sorry to hijack, but...

milward, at what stage of pregnancy do they scan for scar thickness? Part of my wound re-opened and got infected, and I do wonder about its strength...a scan would certainly help ease my mind on that score if not a dozen others.

Wow I would love to have a scan to check the scar. Am SO scared about giving birth this time. Can't ever imagion this baby coming out and scar feels sore already.

Had the scan about 38 weeks. I can't remember the thickness but it was ok. I didn't have any discomfort from the cs scar.even though I was huge. I had the scan as well because dd3 was born in 1.5hrs & was big. My doc was concerned about fast labour - ds4 was born in 10mins!! I did have retained placenta with dd3 but not with ds4.

mower, how far gone are you?

lots of best wishes xxx

Milward, thankyou, part of me is so determined abd the other part is terrified

Get lots of info from your doc on if it's ok for you. Mine wanted to do lots of monitoring - which I refused & wasn't possible on the day even if I'd agreed. If they need to monitor the contractions see if you can be mobile to help labour along. For me I just went with what was happening.

Thanks, Milward...doubt they'll let me do a VBAC when it comes to it, but if they do I'll ask for a scan.

Calvemjoe, loads of luck to you!

That is my overall plan to just go with the flow and hope my body has it figured ot this time!

Thanks Elibean. Why do you think they won't let you?

Well, I had Pregnancy Induced Hypertension last time...and was induced at 39+3 weeks as a result. Also had excess fluid, so dd's head disengaged and she went floating off...cervix never dilated a millimetre, and I ended up with a section (after which my bp shot up even higher, and I had to be put on bp meds). I'm also in my mid forties which is reason enough to make most OBs reach for the knife!

Thankfully, I have a lovely woman OB who says if my BP is under control she thinks I have a 60-70% chance of a vaginal delivery, and she's not scared to let me try. But thats a big 'if' and if I'm on meds by then (very likely) they can't induce me. From what I've read, they don't induce with VBAC anyway?

Lots against me, there, really. I'm not as sad about it as I was last time, because I know how brilliant the end result is - and my section was a good experience. But I'd still rather like to try....

I'll be looking out for your posts, hope it goes well for you!

Saw my consultant on tuesday and just wanted to thank you all once again for the advice you gave me. It now says on my notes 'patient very well informed' thanks to you ladies and my big long list of questions. I got all of the answers I wanted apart from not being able to use the birthing pool. The hospital sound like they'll be extra cautious and that's fine by me,I'm scared that something will go wrong again and I'll miss the signs so I've got no problems with being monitored a bit more than usual.

Pupuce, an extra thanks to you for the advice of asking about last time. Hadn't realised I was also a failure to progress case and it has helped me to understand what actually went wrong.