Are your children’s vaccines up to date?

Set a reminder

Please or to access all these features

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:
Are your children’s vaccines up to date?
rainbowgirl · 10/11/2006 22:55

scary!!

but i did ask

so the skill of the midwife is absolutely paramount then..

at my hospital they don't give epidural or syntocin or any form of induction if you've had a previous c/s that must be why..

is that also why they don't let you labour for longer than say 12 hrs in stage 1 if it isn't progressing?

presumably they almost always catch it in time to do the emergency c/section?

rainbowgirl · 10/11/2006 22:55

LM what do you think about continuous monitoring do you think it is a bad idea?

lulumama · 10/11/2006 22:58

yes..yes..yes & yes!!!!! remember..it is very , very rare..and the worst utcome is also rare......!

Daisymoo · 10/11/2006 22:59

Anyone who doesn't want graphic explanations please stop reading now!

Rainbowgirl, yes the risk of scar rupture is very small. The figures I quoted also include scar dehiscence which is a symptomless separation of the scar rather than a true rupture where the baby may actually come out of the uterus into the abdominal cavity and the placenta starts to detach, depriving the baby of oxygen. In this scenario it is essential that the baby is delivered very quickly - research suggests that if a c-section is done within 20 minutes of rupture there is around a 90% survival rate for the baby. I do not know the survival rate for the mother offhand but it is higher than this, even if there is a delay getting to section.

There may or may not be any warning that a rupture is about to happen. The most common sign is a fall in the baby's heart rate and for this reason NICE recommends continuous fetal monitoring. However this has disadvantages in itself because it can restrict the mother's mobility which can make contractions more difficult to deal with, leading to an epidural and associated problems such as needing an assisted delivery (ie ventouse or forceps) Additionally, I believe there is some evidence that a rupture is more likely to occur with a prolonged second stage. Because of this some people prefer to monitor closely, but intermittantly, to allow more freedom of movement but still pick up potential signs of scar rupture.

Sorry, that was a bit of an essay, but was hopefully useful to you

lulumama · 10/11/2006 23:01

thanks for that..i was obviously confused about dehisence! thanks for clearing that up!!

rainbowgirl · 10/11/2006 23:01

thanx daisymoo yes v useful! there is so much to take in. am seeing the obstetrician in 2 weeks hope she is nice

lulumama · 10/11/2006 23:03

good luck rainbow!!

MKG · 10/11/2006 23:07

3andnomore
As far as I'm concerned a natural birth is one where a living being exits through my vagina. I don't care if you suck it out, pull it out, it slips out on its own. I'm on the fence about painrelief, I mean I'm sure that centuries ago women were probably given some hallucenigenic mushrooms or something.
I was induced, so I didn't have a natural labor, but I had a natural birth.

MKG · 10/11/2006 23:11

rainbow,
When I was induced I was continuously monitored, but had a walking monitor. It was funny to see me walking around with my husband pushing the drip and the monitor.
Ask if one is available, because if there is one it may put the whole monitor/mobility issue to rest.

rainbowgirl · 10/11/2006 23:18

thanx MKG. will have to go armed with a list of questions, for sure.

LYNNETTE · 10/11/2006 23:37

I had an emergency c-section with 1st child. Pregnant with 2nd I was 100% sure that I wanted VBAC,unfortunately the same problem occured (both babies lying OP) and I ended having a second section. I'm glad I tried for a VBAC. I have to be honest and say I was really disappointed at not being able to deliver naturally. So for me I say while you have the option on delivering your baby by whatever means then I say let nature takes it course and if you help then so be it. Try not to worry too much the end result is the same, you get a beautiful baby.

PollyParanoia · 11/11/2006 09:56

Lynette, that's really useful to know that despite having a em cs you're still glad you tried.
Rainbow girl - I have got a doula since my husband took one look at the birth plan I wrote for him and turned green. (When I asked him what he'd do in various situations, his answer was always "I'd ask the doctors to go straight to a cs", when I was thinking more along of the lines of some gentle encouragement or a back rub).
And I was very concerned about continuous monitoring, but I decided to try to work with it to a certain extent. a) senior mw told me if they got a good trace, they'd go to intermittent monitoring. b) I went to visit the labour suite and the leads were really long, about 2m, and the mw who showed us around was very adamant that I'd be encouraged to stay upright and mobile. Yes you could reject monitoring as the risk of scar rupture is v small, but I'd rather find a way of making it work for me rather than wasting my energy railing against it.
Not long to go now...

OP posts:
NAB3 · 11/11/2006 11:17

It seems a lot of people are worried about trying for a VBAC and worrying that it will end in a stressful section. Does anyone know the odds on that? Having said that, statistics are only numbers to a point. We are all different and know one can predict 100% what will happen. I am sure no one thought I would be stuck on 1cm for hours and then jump to 10cm in 10 minutes. I had en em section and then two VBACS.

A retained placenta with a vaginal delivery is quite common after a section.

lulumama · 11/11/2006 11:21

quite common? really.....?

odds on having a succesful VBAC are 60- 40 , as opposed to 75- 25 for first time mum ( approx!)

and yes...number are certainly meaningless after a point...

lulumama · 11/11/2006 11:28

not being rude nab3.....! just interested..i.sounded a bit harsh there i think!!

jabberwocky · 11/11/2006 12:48

Good point about the numbers. After my experience with ds, since there is no assurance that I would not go down the road of labor then emergency section, I personally cannot risk the chance. 2 years of therapy after ds's birth has convinced me of that, at least.

3andnomore · 11/11/2006 13:01

oh lulu, I know Doulas receive specific training, and a Birthpartner scheme can never be used "instead"of Doula...but maybe an extra Birthpartner, that isn't emotionally involved and has Birthed herself so knows some of the emotional factors etc... could be helpful to some extrend.
With ms, dh was only able to get to me in the Hospital an hour before my ds was born, I had a friend with me at Hospital and it was fabulous, we had a right ole laugh and listened to a few cd's from our Clubbingtime out in cyprus (me bouncing on the Birthingball, lol) and oh, one must not forget also listened to Enrique Inglesias (yum)...she gave me backmassages when I needed it ...just fabulous

3andnomore · 11/11/2006 13:06

MKG...for me a true natural Birth would be one without any Interventions or Painrelief....if you have intervention, etc...then it is a vaginal Birth, imo...

lulumama · 11/11/2006 13:32

sorry 3and...didn;t mean to imply only a doula can give emotional support! friends, sisters, mums also do a wonderful job!

lulumama · 11/11/2006 13:34

i think there needs to be a distinction here...

it is not a question of c.s or natural birth for Polly

but

c.s or vaginal birth.......

and vaginal birth is still vaginal birth with pain relief or forceps.....

giving birth vaginally with no pain relief & no intervention is a different ball game entirely....

MKG · 11/11/2006 13:35

3andnomore,

Let's agree to disagree (I agree on pain relief). I like to separate labor and birth though. I couldn't control the circumstances of my labor, but I was able to control the circumstances of the birth. It just makes me feel good.

MKG · 11/11/2006 13:36

lulu,

I know, I think that 3andnomore and I got off on a tangent.

lulumama · 11/11/2006 13:38

fair enough!! all very interesting, no?

MKG · 11/11/2006 13:41

I fascinates me how there are so many opinions, and experiences, and we are all basically doing or have done the same thing.

lulumama · 11/11/2006 13:45

me too MKG....i. could ( and do!) go on for hours!!!