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Childbirth

Share experiences and get support around labour, birth and recovery.

Vbac vs cs: can you

265 replies

PollyParanoia · 09/11/2006 11:49

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.

OP posts:
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Toady · 12/11/2006 20:56

But whatever you do, don't go for a home birth ...

Errr PollyP may well not want a home birth but there is no reason why she shouldn't.

One to one care
own environment
no bumpy car ride to hospital
no beeping monitors
etc etc blah blah etc etc

Toady · 12/11/2006 20:57

like you said "controversial"

lulumama · 12/11/2006 20:57

twoisenough......you are a bona fide mum...more to it than pushing a baby out.....you carried, nurtured and grew your babies for 9 months and have cared and mothered them ever since...xx

twoisenoughmum · 12/11/2006 21:09

Toady - I'd only say "don't go for a home birth" to someone whose already had an emergency c-section and is feeling none too confident about her second birth. To anyone else I'd say "of course you are entitled to try a home birth, go for it". But if it was a really good friend of mine I would without doubt quote them the statistics re. home births I have totted up amongst the people I know - because a constant refrain on Mumsnet is "Why did no-one tell me so and so re. births?, why are we all lead to believe that if we have a good pregnancy, are healthy and brave, that we can give birth at home and all will be lovely?". 1st time pregnant mothers are pretty much in the dark about all this, I believe, especially if they go no further than the NCT.

fridayschild · 12/11/2006 21:22

PP, I tried for a VBAC after Ec/s, with a private midwife, and tho I ended up with another section I felt i had given it my best shot and so there was no "failure"

more prosaically, it is harder to recover from a section with a toddler underfoot. how much can your Ds do for himself that means you wouldn't need to lift him? I was lucky in that DS1 was very mobile. Ds2 by contrast talks rather than walks and if they had been the other way round I would have been in a bit of a fix...

good luck however it goes

Toady · 12/11/2006 21:31

Personally I think you are more likely to give birth at home after a previous caeserean, like I said own environment, one to one care, no time limits, no interventions.

After two emcs I stupidly went into hospital to have my third DS (VBAC2). As soon as I went into hospital I was surrounded by panic, even though I was assured beforehand that I would be supported in my decision to have a vaginal birth.

Luckily he came out while i was in the theatre ready to be cut open again!!

If only I had stayed at home.

lulumama · 12/11/2006 21:35

FWIW..i agree toady.....but it takes a big leap of faith and huge inner confidence to go for a home birth after emergency c.s.....

not everyone has that......

knowing what i know now, i should have gone for a home vbac,...after the event it is easy to say! but at the time i felt the hospital was where i felt safest....BUT....pro VBAC obs and midwife left me to it with my birth partners..

trincarm · 13/11/2006 00:22

I have not read all the posts but I did want to say that with my first baby I was fully dilated and had a failed ventouse and then ended up with a c-section. With my second baby I ended up with an elective because the hospital scared me silly and made me believe a vbac was impossible. In July this year I gave birth to my daughter at home and it was fantastic. I also did loads of research and I read that the failure rate may be slightly higher for people who had reached full dilation before.But we took avid interest in optimum positioning of the baby because I thought this is what went wrong with my first (a back to back labour)We also borrowed money for an independent midwife and it was worth every penny. My waters broke on the Thursday night but I did not give birth until the Saturday morning, no hospital I know of would give a vbac mum that much time. All my babies have been 9lb's and although I tore this time (no stiches needed) my recovery rate was incredibe. I wanted to play with and pick up my 3 and 5 year old without any trouble and I would not have done that after a c-section. The decision is yours to make and no body elses. I just wanted to let you know that I had been through the same shall I shan't I dilemma and I am really glad I attempted a vbac. We still talk about it most days as it was such an amazing day. Good luck which ever path you choose.

3andnomore · 13/11/2006 13:21

Toady...well, all I have read is, that with induction the risk of Uternie rupture, especially after previous C-section, is higher, as the contractions tend to be more "forceful"...and that therefore a Induction with VBAC is not advices, but maybe I got that wrong of course!

Toady · 13/11/2006 13:40

No you are completely right, makes sense really sudden fast contractions are going to put more pressure on your scar. Was very naive before I attempted my VBAC1, did everything I was told to do.

PollyParanoia · 13/11/2006 13:49

Hello, PollyP back from the consultant's. Well, actually an underling rather than consultant because all was actually straightforward. We've booked an el cs for almost a week after the due date. The baby's quite far down the pelvis already and looking like a normal size, so I'm going to go for a vbac unless I go six days overdue (hence elective). I feel positive about it, but equally positive about having an end date in sight. I think it's worth trying for a vbac, because I think I'd regret it if I didn't (though shan't regret a cs if that's what has to happen). Sounds a bit shallow, but part of me wouldn't like to miss out on that sort of drama and excitement that accompanies going into labour. I think I'd feel anti climatic if I didn't.
Nowe bring on the curries, nipple tweaking, acupuncture, raspberry leaf etc. Not sure I can face the sex though...

OP posts:
blueshoes · 13/11/2006 13:54

Hi PollyP, it does sound like the best solution for you. All the best!

lulumama · 13/11/2006 13:54

Hi polly.....sounds great

you have a plan

you are happy with it

all is well!!!

i know what you mean about the drama...that was partly why i waned a VBAC..to have the full experience..screeching to a halt outside the hospital....staggering down the corridor....biting through the entonox mouthpiece....waters exploding across the room and ruining my shoes...>!! oh yes...never a dull moment!!!

and you have an end date...so now you can relax and get on with enjoying the last few days of being pregnant...if that is possible...

sex ( sorry! ) is the best way to ripen your cervix..but nipple stim will do !!

all the best poll...xxxx

Toady · 13/11/2006 13:57

Well done Polly, you sound a lot more relaxed about your decision.

Toady · 13/11/2006 13:58

But remember if you have any more wobbles and change of mind (which you are entitled to) please rant away.

3andnomore · 13/11/2006 14:25

PollyP...sounds like you have a great plan there, and wish you all the best of luck

PollyParanoia · 13/11/2006 15:13

Just one last question for those in the know. I've been booked a membrane sweep next week, when I'll be about 39 and a half weeks. This seems a bit early to me (dr had recommended it mid week or towards the end of the week, but they only do it on Mondays). Is it a bit ineffectual this early or, worse, opening path to intervention?
Pol

OP posts:
Toady · 13/11/2006 15:19

can you get you dh to have a bit of a wiggle

Daisymoo · 13/11/2006 15:20

Sweeping the membranes has only been shown to shorten pregnancy by about 24-48 hours ie it will only work if you are more or less ready to go into labour anyway. Considering the potential risks to membrane sweeps - accidentally breaking the waters which sets the clock ticking for the baby to be born, introduction of infection and possibly inducing labour before the baby is in a good position which can lead to assisted delivery or emergency cs, I would be wondering what the benefits are going to be to you. I can't remember when NICE recommends sweeps be offered - I think it's from 41 weeks, but not 100% sure.

Toady · 13/11/2006 15:23

I had a sweep at 39 + 3 days because my midwife & pro VBAC consultant did not want pressure from above about me going overdue, i went into labour 3 hours later. Wrong reasons I know.

There is a small risk of infection, if you do have this done make sure they wear gloves

tiredandgrumpy · 13/11/2006 22:38

I was told my midwife could only do a sweep once I was due, since it was only likely to work if I was just about 'ripe' anyway.

I also booked a reflexology treatment in for just after due date in the hopes of getting things going, but as it was, labour started spontaneously at 40+1 day anyway.

lulumama · 14/11/2006 09:33

what daisy said basically....!

i had one at 39 weeks ( i cried when i saw the obs and demanded ther baby come out NOW!!!) didn;t wnt to go overdue as this was my VBAC baaby..... had a show 24 hours later and contractions.

not born until her due date...!!

there is a lesson in there somewhere i think!

PollyParanoia · 14/11/2006 10:40

Yes, I'm sure you're all right about early sweeps. Slightly irritating that the only do it only Mondays, maybe I could get my scary gp to have a go later in the week (she will definitely give it some James Herriot style action...

OP posts:
newgirl · 14/11/2006 10:52

hi polly p - sounds like an ideal plan - how exciting - good luck x

Guard · 16/11/2006 10:03

Realise that this thread is well advanced but very good luck anyway. My 2 pence worth is that your state of mind (eg feeling relaxed and supported) is key and you can birth really well - but you need to challenge your fears and feel happy and positive. eg the one I liked was the m/w telling me that I had more chance of being examined by a bogus doctor than scar rupture and there are lots of signs that they monitor anyway with a VBAC. I had em CS with DD1 but DD2 came so fast she was born at home (m/w was with me but we had no time to get to hospital - 30 mins of pushing, no stitches/problems, great experience !). However I had my sister in law to hold my hand (husband too traumatised after DD1) and I had read loads of positive birth stories. Have you seen the AIMS booklet on VBAC or the VBAC website ? Also Emma Mahony "Stand and Deliver and other great ways to give birth" has lots of good stuff (v friendly book...) [GRIN]