going for VBAC for 2nd child - terrified!

[mummysnoops]

Hi everyone - my first was born c-section for various complicated reasons. I'm going for vbac in september - am terrified as I don't really know what to expect, what sort of monitoring are you hooked up to? will it work?? any words of wisdom or advice gratefully received!!

Please Please Please go on to these websites, if it had not been for the wonderful ladies on there I would never have had my VBAC after 2 sections.

You can find out more about VBAC and how to have a good one and the evidence, around hospital policies by looking at www.vbac.org.uk which was written by two experts in the field - one of them was asked to sit on the government's NICE panel on Caesarean Section guidelines for hospitals. This is where I went first and spoke to Gina and Debbie who helped me no end with my worries, concerns etc.

If you definitely want to VBAC or to find out more about it then there are some wonderful women on the support group called UKVBACHBAC which you can find on www.yahoogroups.com.

I used this group and still do to offer my experiences. I think you will find it of great help and will give you confidence in your body.

I had a vbac with my dd. There was no extra monitoring during the labour but I felt looked after by the midwives. Considered being prepped for an epidural just in case I needed a cs again but it all went fairly quickly and was very straight forward and she was delivered after 4 hours labour with just gas and air. Am pg again and hoping for similar birth.

Here I go again... with apologies to those who've heard it all before.

You do NOT need to be continuously monitored when you have a VBAC. It is done as a precautionary measure, but it is enough to be monitored every 15 minutes with a hand-held sonicaid thingummyjig. Obviously, had there been any doubts about whether my baby was in distress or not, I'd have agreed to continuous monitoring (as I would have done with any birth, VBAC or not), but she was absolutely fine throughout, and I was able to move around, kneel up, sit in the bath, whatever... The hospital may try to tell you that continuous monitoring is compulsory, but you really can insist on not having it. I am convinced that this made the difference between me having a successful VBAC or not. If you don't want to be continuously monitored, it may help if you can get your consultant (or whoever) to write this in your notes. Certainly the midwives on the labour ward when I went in would have liked to have hooked me up to a machine straight away, but the consultant's signature on my notes saying it was unnecessary made all the difference. (I know this won't work if your consultant isn't sympathetic though.)

I would not, under any circumstances, have had an epidural with my VBAC (it amazes me that hospitals offer this... though I'm sure that the experts know better than I do... mine is just a gut reaction). An epidural completely numbs your abdomen. The danger with a VBAC (albeit a very very rare one) is the danger of the scar rupturing. If the scar ruptures one of the signs is continuous pain, in between contractions. But if you have been numbed by an epidural you can't feel if the pain goes on between contractions or not. I found the pain reassuring (in a way... it was still painful, obviously) because as I felt it come and go with each contraction I was able to tell myself that my scar was holding out.

I would also not allow myself to be induced, since there is evidence of an increased risk of scar rupture with induction.

Be prepared to have a cannula put in (in case of emergencies) and they may want to take bloods to cross match and save (again in case of emergencies). I was prepared for all this, and used to it from my first very problematic pregnancy... but in the event my labour moved too quickly for them and by the time they came with their needles dd2 was almost ready to be born, so they didn't bother.

Good luck!

thanks everyone - I'm seeing my consultant next week so will see what I can do re: monitoring - I really don't want to be hooked up to machines for the duration......good tip on epidural too - I'll keep you posted!!

I've had 3 vbacs, the last one at home, after having had 2 sections.
Ellbell has said everything I would have said. Good luck

mummysnoops, do speak to the consultant and find out what is hospital policy and what they are prepared to relax on under certain conditions (eg continuous monitoring). Apparently my hospital even allows water births if initial monitoring indicates all is well!

My hospital also held a VBAC clinic and I had an hour chat with an experienced midwife. This is what I was told about VBAC:

Continuous monitoring but prepared to allow intermittent monitoring once base trace has been established and all is well.
Don't recommend induction and an appointment with the consultant is automatically offered at 41 weeks to discuss options then.
Time limits on labour:
16-24 hours for first and second stage (I think).
1 hour for second stage or if have epidural, 2 hours
internal exams every 4 hours

Also, ask all the usual questions about how much support you can expect as for any vaginal birth eg one-to-one midwife? Do they use agency midwives? Shift patterns? Availability of anaesthetist/full surgical team if you need an em cs again. What sort of epidural ie mobile or not?

They should also look at your notes to see how far you were dilated for your first (the greater, the better, obviously), the reasons for your first cs and ultimately your risk factor for a successful VBAC.

I had a vbac in hosp with dd followed by a home birth for ds2. I took my birth ball in with me to the hosp for dd and insisted I sat on it so they just strapped the monitor round me and I sat near the unit. It was fine (although in the end they had placed the monitor wrongly, not because I was upright but because they didn't check carefully as they thought I was not as far along as I was). So if you do decide to opt for monitoring, you can always sit up - they are telling porkies if they say you have to be lying down. I also had my consultant check my birthplan and write various "ok"s on it which worked wonders when the staff on duty that night saw her handwriting. Things like being allowed longer in 2nd stage for the baby to descend naturally (this had been prob with first baby). Worth asking your consultant when you see him/her if he/she can do this.

you're all great - thank you. Don't relish thought of another c-section - last time I had a suspected pulmonary embolism on the operating table and ended up rather dramatically in intensive care (as it turns out, due to some mystery thing, and even though they don't know what it was, I'm told it won't happen again - ha ha). and the thought of doing that again concerns me!! I now feel armed with some good questions for my consultant appt - cheers all!!