If you could choose between a highly medicalised birth and an elective C-section, what would you choose?

[mazzystar]

Yep, me again with my endless childbirth questions.

Consultant encouraging (but not pressurising) for VBAC. I'd be happy to have a crack at it (as it were) if I could go for as active a labour as possible - coped very well with full first stage last time by dancing about like a loon. However hospital blanket policy is to practically immobilise you with drips/monitors/ keep you lying down. Don;t have to decide for months but want to prepare.

What would you do?

blanket policy?
name and shame
No way would anyone get a drip and monitor on me withotu damnjed good reason.
Neither would be my answer
I'd take a swerve and go somewhere else

Can you use a different hosiptal ?

Liverpool Women's
I was shocked too - in fact I nearly cried. Its a 3 star foundation hospital with v good track record too.

Hi, not sure I can advise you but wanted to post as am in a similar situation myself. Am just about to start a separate post re: scar rupture (VBAC).

I was pretty horrified to discover yesterday that if I want a VBAC I've got to be 'tethered' to the fetal monitor. Like you, I managed my first labour with lots of movement. I'm now trying to decide between the three hugely different options 1) elective c/s 2) limited movement VBAC in the hosp or 3) home birth.

I feel quite angry as what I want is to have a hospital birth in the nice midwifery led unit there - to me this is best of both worlds, labour with movement, yet access to surgeons fast if the scar ruptures.

Anyway, this doesn't help you.... all I would say is are you SURE you will be immobilised/kept lying down? From what I've heard, the monitors do allow a little movement - apparently you can stand, move within a small radius, lean on the bed, lean on a nearby chair etc. Is it possible for you to visit the hospital and see exactly what your range of movement would be so you know what to expect and can try and visualise whether you'll be able to manage to cope with labour in that setting?

Good luck.

It seems to be pretty normal practice IMHO that for a VBAC that a woman is monitored closely. I discussed this A LOT with midwives and consultants and was told in case of teh the scar rupturing etc And there was me wanting a water birth which I was just NOT going to be allowed.

I did get agreement that I would have close monitoring, a drip needle would be put in but not attached and provided there was not someone else using it I could use the mobile monitor (which meant I could walk around etc)

In the end it was all academic and I ended up with a c-section as my water started leaking, my BP rose (pre eclampsia previously) and baby was not engaged AT ALL.

So I decided rather than have a trial of labour etc, I would go straight for the section, which was the right choice in my situation as there was meconium in the water anyway.

Just keep asking, it does seem to be suggested as 'normal' but if you keep on, you should get what you want

As someone who has had two amazingly fast and fantastic births without ever sitting or lying down the thought of being "tethered" or immobilised seems anathema.

mazzy how long since your c section btw?

mazzystar I 'm sure I've read it on another of your posts, but what was the reason for your first c section? I don't understand why you would be having a drip/monitor for a vbac (I didn't have either of those things for my vbac last year) Are you in the UK?

Are you sure re actually lying down? Pain standing up/moving = sort of ridable most of the time, pain lying down = immediately impossible. And what will they do if you are standing up - rugby tackle you?

I wd go on a maternity unit tour and have a look at the monitors, get a midwife to try one on you and ask if there's anything they can do like, i don't know, add an extra strap or sticky-tape it to you. Certainly with me standing up the monitor strap kept falling off but they weren't that bothered in my case/at that hospital.

I was worried about all these things too (and I had mine abroad where, believe me, it is much much harder to tell staff that actually legally they can't just do what they want to you) but in the end it was all fine. i stayed at home as long as pos which turned out to be about 3 hours, then went in and had ds2 after spending the last hour at the hospital. It wasn't 'ideal' but it was pretty good. By the time I got to the hospital I was sick and tired of all this 'active birth' stuff and felt much better when I just lay down on the bed on my side, where I stayed for the next hour. I wasn't continually monitored but it wouldn't have made any difference anyway, as I didn't want to get up anyway. I agreed to the drip although I wasn't too chuffed, but again, it didn't interfere cos I was just lying in one position feeling well out of things.
That's just my personal experience, it worked well for me and I was pleased with how things went overall - it was much better than I had expected and the drip didn't make much difference in the end.
Stay at home as long as you can is my best tip -I waited til contractions were every 2 minutes before we set off. Of course, you would need to read up on that and be happy with any risks involved yourself. I guess the hospital might want you to come in earlier than that?

I had DD at LWH. I was induced at 38 weeks and they were quite keen on following the protocol to the letter.

I was labouring fine on my own but after a certain time (can't remember, not v long though) they wanted to break my waters. Looking back, I think the midwife was giving me subtle signals to decline but I didn't pick up on them. I wish I had declined as everything happened far too quickly after that. Anyway, what they tell you they want to do isn't necessarily the same as what they will do in the situation, and of course you don't have to consent. Can they listen to the baby with a doppler v frequently - then you wouldn't need to be strapped up?

Who is your consultant?

Having said all that, I thought LWH was fantastic and I had excellent care there.

I had DD at LWH. I was induced at 38 weeks and they were quite keen on following the protocol to the letter.

I was labouring fine on my own but after a certain time (can't remember, not v long though) they wanted to break my waters. Looking back, I think the midwife was giving me subtle signals to decline but I didn't pick up on them. I wish I had declined as everything happened far too quickly after that. Anyway, what they tell you they want to do isn't necessarily the same as what they will do in the situation, and of course you don't have to consent. Can they listen to the baby with a doppler v frequently - then you wouldn't need to be strapped up?

Who is your consultant?

Having said all that, I thought LWH was fantastic and I had excellent care there.

I had a VBAC last year and was told I would have to be monitored and have a drip put in. I agreed to 30 minutes baseline monitoring. After 30 minutes, as baby's heartrate was too high, I agreed to keep the monitor on. I refused the drip/cannula, but did say if they actually needed to run fluids into me then, obviously, I would agree. I reckoned that a consultant anaethetist (sp?) putting a drip in anywhere in a hurry was still better than an SHO putting it in in the back of my hand badly and having it there for hours. I did loads of reading on this and was happy with my decision, but I am sure I have STROPPY WOMAN written across my notes.

In the end, I didn't need a drip at all and although I had a monitor belt around my middle, they weren't bothered enough to check it regularly, so it wasn't picking anything up for long periods of time. I felt that if they were really worried about rupture, they would have checked more regularly.

I also decided that I would not have any interventions for failure to progress, ie not syntocin, not a sweep, etc. If I didn't progress, I wanted to go straight for a cs.

I am due in 7 weeks, and have been agonising over the same choices. Initially, I wanted to try for a VBAC, but no-one was willing to discuss what would happen to me in the hospital. Like you, I was bothered by the continuous monitoring and the venflon (drip needle) that I'd heard they would insist on. I was also worried about time limits. In the end, I had almost decided to go for an elective c-section as it seemed that the hospital were setting me up to 'fail' and I prefered the thought of a calm, planned section to a rushed, scary one (which I had last time).

In the end, I went to visit the midwife in charge of the delivery suite at the hospital, who was amazing. She explained about the reasons for the monitoring and venflon (in case of scar rupture, which we know is stastically slight). Apparently, changes to feotal heart rate is an early sign that rupture might happen. I have been offered a mobile monitor, which seems a reasonable compromise.

I sympathise with you, as it is a really hard decision, and every medical person seems to have their own view! My only advice would be to find out as much as you can (there are some good sites if you google VBAC) and find someone (anyone!) willing to have a rational discussion with you about hospital policy, the reasons for the policy and any compromises they can suggest that will still keep risks low.

Good luck with your decision, and birth!

Remember it isn't just the birth experience don't forget to keep in mind the recovery times as well for VBAC and c-section. It is a differnt prospect when you got another little one running around and you can't lift etc. Unless you've got lots of support. I only say this as my close friend went for the c-sec, then had a horrible time in recovery. Luckily her MIL just moved into the next village as was able to help loads as well as her friends.

BTW I was also told I would have to be heavily monitored, etc. But in the end, hosp did the baseline, then let me wander for a while, then back for monitor and drip when things got intense.

I feel so anxious about anaesthetic and recovery with CS that I would probably go for the hideous medicalised birth again. It was an ok experience for me - not so good for ds I think I will be honest though and say I am not brave enough for surgery even though I feel it may be less traumatic for the baby.

You just never know what's going to happen. The childbirth instructor we had when pg with ds had a c-section with her first b/c of footling breech. Then a VBAC with her second. But, the second baby had his hand on his cheek and she needed an episiotomy which she said was a more painful recovery than her c-section.

I think you just have to go with your gut feeling, after looking at all the stats on safety, etc. I am pg with our second baby. Ds was an emergency section and I have said from the beginning that I only want an elective, which is already scheduled as a matter of fact. I know that's where my comfort level is and so the decision for me was an easy one.
Everyone wants and needs a positive birth experience. I know that from the horror of ds's birth. But, at the end of the day, you mainly want a healthy mom and baby.

not sure how they can keep you still - they can't tie you to the bed!
Drips - I'm guessing that they might want to put in a venflon 'just in case' - this really shouldn't be that uncomfortable or restrict your movement at all as is just small plastic cannula in back of wrist. Wouldn't have thought that there would be anything running through it though, so no ties there.
Monitors - you can move around a bit even with them on, only reason to be stuck on a bed is if you've had an epidural and your legs don't work.
(having never been in this situation) I'd probably go for trying a VBAC with the monitoring. It will still only be you, partner and MW in there, and not that different to 'normal' birth apart from bit of monitoring - which you might in the end find reassuring and helpful - I found seeing the contractions start on the monitor helped me use the gas and air right as could breathe it in before I felt the contraction pain, also found it helpful to see that baby was ok.
Elective CS - still no guarantee that will be no problems, and you have an operation to recover from as well as a new baby.
Good that your consultant is supportive of VBAC.

As far as monitors go, you would need to know whether they were talking about internal or external to determine just how limited you will be. Mine was external and it still kept me in the bed.

I think I'd go for the c-section - in fact I've had 2.

Somehow I felt it was easier for me to have an op in a controlled environment than the unknown risks of vaginal birth

I had a venflon when I was having DD. It's fine, really. You can't bend your hand around the place so it might limit you getting into interesting positions, but really not bad at all.

I found it much worse having to have one in after DD was born, as it made me awkward picking her up.

A woman after my own heart, iota. That's my feeling about this pg. After all of the out of control trauma drama of ds's birth with subsequent emergency section, I have to have some calmness this time around. I can't face all of the unknowns with a VBAC.

I chose a vbac, after a vaginal delivery with no problems, and a crash c section.
The iv acces involved the venflon in my hand but not connected to anything. After seeing how quickly things could change when I had dd2 I didn't want to have to wait while a dr tried to get access if it was needed.
I also had continuous (external) monitoring, but was able to stand/ walk(with nurse or partner wheeling trolley behind me) within the room, and disconnect it for toilet visits etc. I spent very little time on the bed.

I had a ventouse delivery, but would still choose it again rather than c sec for the recovery time.

Good luck whatever you decide.

I chose an elective both times