Vbac vs cs: can you

[PollyParanoia]

Hello I'm 38 weeks pg and still haven't decided what sort of birth to go for. Change my mind on a daily basis and am getting quite irritated at my own indecisiveness.
Ds born 2 and a half years ago by em cs. I was fully dilated, failed ventouse, a bit of foetal distress, blah blah. Found cs recovery to be surprisingly quick (was cycling into town three weeks later, which looking back was a bit idiotic).
Anyway was all gung ho about a vbac and have very pro-consultant, but then his underling doctor was saying to me "what you really don't want is an em cs at full dilation" (and judging by quick dilation first time round is what I'd end up with if it came to a cs).
Anyway, it seems to me a successful vbac is the "best" I can hope for, followed by a planned cs, followed by an emergency. Oh, and a nasty vbac with loads of tearing is I think for me the worst option given that I've already got my cs scar, why have another somewhere else. What I don't know, in terms of safety, recovery, discomfort, is where these births come on a scale. If an elective is way better than an em cs and not much worse than a vbac, then that's an appealing option. If a vbac is way better, then I should go for it etc, etc.
It's such a blooming difficult decision without the aid of a crystal ball.
Arggh, Pol
ps have another consultant's appt on Monday to make final decision. They are being very patient with me. Oh and dh's work means that being on time or early would give us much better paternity leave. Plus he would much rather I have a planned cs as found the whole first birth terrifying.

Er, title was supposed to read
Vbac vs CS: can you "grade" birth?

Hiya! Funny, it's a small world, I'm in exactly the same dilema, and had an emergency C section exactly for the same reasons as you (but only one year ago).I'm pregnant again - 17 weeks - and I also change my mind every day, about VBAC and Csec. OK, I understand the risks of a C section. But it does look like a good option, doesn't it? Specially as I'm not 'hung up' on the emotional issues often associated with a Csec. I remember my midwife asking me if I felt dissapointed or cheated because of the section, and I responded 'why on earth would I feel dissapointed?' Now I know and understand why many women feel that way, but I just don't have an issue with the actual fact that I didn't manage to give birth naturally.

There are so many factors involved in why someone might need an emergency C section. We can try to predict but really there's no way of knowing if it would happen again. Also, my hospital is proactive with VBACS, which is great, but they have a 6-hour time limit on VBAC and if things are not progressing quickly enough they wizz you through theatre. Also, they insist on you spending the entire labour connected to monitors. This is not a very positive birth experience in my opinion, and I might just be better off having a planned c section.

Anyway, what I'm really trying to say is that in my opinion you can't 'grade' birth. Some go better, some don't go so well and it's not the mother's fault - whether you did yoga or visualisation or drank enough strawberry leaves tea or had a doula. And you can't always blame the NHS either. Sometimes it's just a string of bad luck. I will definetly be the last person to judge you on your decision.

PS My husband is studying and it would be so much more convenient if I'd have the baby on a planned date (i.e. easter holidays!!!)- I'd have much more help at home as he can't take time off his course!!

PP - I had a 'em' CS with DS1 (no labour at all - long story!). Had a HORRENDOUS time in labour with DS2 (induced, failed pain relief, episitomy and a 4th degree tear, ventouse delivery etc etc)........but you know what - I'm pg again and I wouldn't even consider a CS - after having DS2 I was able to sit up comfortably (all be it with the aid of a soft cushion ) I could laugh, cough, and walk normally within days.

I'm not overly familiar with my bits down there (not really been in the habit of sitting staring into a mirror at them either pre or post babies LOL) but they feel no different to they did before and I healed really quickly.

Oh - and I'm considering a homebirth this time round!

Q of Q, that is a very interesting perspective, in a way more helpful than a "I had a fantastically easy vbac" story as it's kind of my worst case scenario, yet you still feel very positive about it.
Hmmm, Pol

I have to say, though, I wouldn't go down the induction route for this one. That's at least one thing I'm sure about.

I am really shocked that having more paternity leave is a factor in which birth you have. You know having a section is a major operation and your recovery will be harder with 2 children to look after.

My first child was born by emergency section, my next was a VBAC with retained placenta and my third was a fully successful VBAC. If I had to have a section I am glad it was the first as I don't know how I would have managed 2 children and recovery from a major op.

My neighbour had an em section having been told she wasn't going to fully dilate (she went backwards) and her pelvis was too small. Her second child was born before her first was 2 and she had a natural delivery with no problems.

No one can predict what will happen in a delivery. You have to look at the whole picture and not just how much time hubby will be off.

When I had my last 2 children I wasn't permanently attached to minitors. What you will have is a monitor once you get to the pushing stage in case of scar rupture. If baby is fine, generally it means mum will be.

"I am really shocked that having more paternity leave is a factor in which birth you have. You know having a section is a major operation and your recovery will be harder with 2 children to look after. " that is only a very small factor, that's why both PollyParanoia and myself have put it right at the bottom of the posts. And yes, I would prefer having my husband around (and I'm sure he would prefer that, so would the baby if they could talk!!) rather than him not being there. What's wrong with that?? And yes, I know what's involved in having a C section but as it happened, I had a very quick recovery first time around. And both my friends who had natural deliveries had to stay at hospital longer than I did for various reasons, and one of them is still traumatised by her natural birth so much so that she doesn't want to have other children.

I am glad you had such a good recovery first time around. You were very lucky. I have had horrendous pregnancies and births and feel a little annoyed if it appears people are taking c-sections lightly. That's all. Sorry for any offence caused, however unintentional. I hope your birth goes well!!

And I'd just like to add that attempting a vbac is not the same as having a vbac ie there's a one in three chance that I'll end up with a cs anyway, in which case I'll be really scuppered without dh around, won't I? I don't think it's taking a cs lightly to question whether a planned one isn't a better option than risking having another emergency one.
Nab3 has very nicely apologised so I shouldn't go on, but I think "lightly" would be the last word I'd used to describe the vascillations, angst and research I'm putting into this decision.
Pol

Sorry. Lightly is the wrong word. I am not very good at expressing what I mean sometimes which is terrible for a writer!!

None taken!! It's such a difficult decision, that's all. Nobody I know would take that decision lightly. I don't, I change my mind every day, I've read I don't know how many books and articles, and I always read the posts here about the subject. I really did my very, very best to deliver naturally first time around, and to be fair the medical team was very supportive and encouraged me during that time, but the C sec was a question of life or death. When you are put in front of that decision and have only a few minutes to make up your mind (no brainer really) the worst thing that can happen again is to be put in the same situation again. I was so happy my son was healthy, and I am just really scared that I will have to make the same decision again. If I can avoid it by choosing a section, I might choose it.

Anyway, other point I'd like to make is that I have asked my hospital to send me my notes from first birth and go through everything with me, in detail, so that we can have a better idea why things went wrong and how to avoid/prevent if possible the same thing happening again. It might be too late for you to do that, Polly, but maybe not!

"What you will have is a monitor once you get to the pushing stage in case of scar rupture."

Sorry - I disagree - although I excercised my rights to not be monitored all the time - I was monitored on and off from the start of labour - as rupture can happen at any time.

PP - my induction certainly wasn't on my list of things I'd planned - mind you apart from the fact that DS2 didn't come out the sunroof none of it was as per my plans .

I'm sure you've already looked here - but I thought I'd post the link just in case you hadn't - I found it really useful when formulating my plans for having DS2.

I can understand the panic. I hadn't even gone in to labour with my son when it was a rush to theatre. He wouldn't have survived a vaginal delivery. My DD was fine (except for the placenta) but with my youngest son the pain in my scar was worse than the contractions and we were that close to not making it. I think that was because I had had 2 and 3 so close together.

Why did the underling say that about em cs? why not?

Can't offer too much myself. I haven't even got pregnant a second time yet and I've been weighing up the pros and cons of VBAC v. C-section since Son was a few months old! I like to be prepared ;o) I imagine whenever I have another kid I will be backwards and forwards right up to the end.

In my case it's a possibility I could have another 12lb+ baby and I think that would push me in the direction of a c-section. Son's head was tilted back which was why he wasn't coming down, never mind out, so I don't know if his size would have been a problem or not, I know people who've delivered large babies like that naturally.

Q of Q - It's good to hear your story, that even bad tearing wasn't as bad as a c-section. The tearing issue always scared me. Though for me, the worry about what might happen to my baby is first as I've read a few bad bad stories about very large babies getting stuck.

I think Blueberry's hit the nail on the head - it's the desire to avoid the emergency cs that makes the elective so tempting. It's that elimination of uncertainty. As we all know often nothing in birth goes to plan, though a planned cs is a little more certain than most options.
My notes didn't really help as I think there's so much that's unknowable about what goes right and wrong in birth. I'm not unduly worried about scar rupture as it's a) rare and b) I'm in a good hospital. Ultimately I think you just have to trust your instinct and I feel that my instinct has been analysed out of existence by all my angst.
But other's experiences are really helpful so thanks for all, Pol
ps q of q, wasn't meaning to suggest that you were chuffed about having an induction either! Just that for me, having to be induced would probably tip the balance of my decision.

Goblin, underling was arguing that a cs when you're only a few cm dilated is much better than one when you're fully as by then the baby's descended quite far and so has to be pulled right up again. Dh still shudders at the memory of obstetrician bracing her leg against operating table to pull hard enough to get ds up and out.
Pol

I say if you have any doubts about the VBAC get the C-section. If you really wanted a VBAC you would have known by now.

I only have two really bad memories of the operating room - first one is that this stupid technician decided to lower me on the table, my legs were in stirrups, and he litterally put his face inches away from my bits, put his hands under my hips, lifted me up and lowered me down, without a warning. I wanted to strangle the bloke, still do!(maybe I should say that on the web....) Other bad memory is when they tried a ventouse extraction and as it didn't work, they had to slightly 'push' the baby's head back up. Although I was drugged up to my eyeballs I still felt that, and god it was awfull. Not painfull, just just awfull.

You need lulumama's advice here. Keep bumping it and she'll probably spot it.

Polly - ah, thanks for the explanation. Son didn't descend so I didn't realise!

I had an emergency section, and then opted for an elective 2 years later. I found the decision pretty easy as what I really wanted to avoid was another emergency. My side effects (itchy scar, that's about it) are no worse than they were after the first section. So, I have no regets and happy I don't have to add tears and incontinence to the list of ailments resulting from childbirth.

Also, I think wanting the father to be there is a perfectly valid feeling. I don't think it is at all unimportant.

However, some people have a deep desire to experience childbirth. I'm not one of them. But, if you are you might consider that trying for the VBAC is worth the possibility of ending up in an emergency.

But, you will find many section veterans on this site who will tell you that a planned section is enormously more enjoyable (not that either is really "enjoyable") than an emergency. And,I'm one of them.

How was recovery with emergency v. planned?

I would say it was better with the planned. But, it wasn't too bad with the emergency either. Maybe it was down to knowing what to expect (as I had not even considered that I might have a section when I went in to be induced with the first one). Or maybe it was down to the arnica that I ate like candy for the second one.

Incidentally, deffo get arnica.

Hello Polly paranoia

a bit stuck for words which is not like me.

It really is a personal decision for you to make. I have had two sections and one vaginal delivery, for me there is no contest, being sliced open was horrific.

I find it difficult to understand why woman would prefer this option but each to their own.

One thing I do not agree with is to go for a planned section simply because it may end up in an emergency section, if we all planned our lives like this ........

The likelihood for you have a normal vaginal delivery is 65% - 70%, this is in spite of being continuously monitored and people classing you as a "risk".

Obviously I do not know all the details about your last delivery but I bet if you had been left alone to birth you would have been fine, this story is too common, fully dilated, ventouse, foetal distress.

When I had my VBAC2 my little one was supposed to be distressed, not suprising really fingers up my fanjo, flat on my back, being told that I would have to have another emergency caeserean, I was in bloody distress. Thankgoodness he came out when he did.

Can you focus on researching the best way to have a non medicalised, normal vaginal delivery. Have you spoken to Gina or Debbie on this website They really have a wealth of information and research to help you.