VBAC after 2 CS - is it even possible?

[hinkyhonk]

I've had two elcs with both my DS'. DS1 because he had severe growth restriction and needed to be delivered at 31 weeks and wouldn't have survived an inducement. DS2 as he was overdue and induction wasn't an option due to risk of scar rupture.

With DS2 I was very keen on having a VBAC as I hadn't even had the chance to go into labour with DS1 and so much of what followed his birth wasn't in the range of normal as he spent a very long time in NICU before eventually coming home. However, I didn't have any signs of labour approaching so at 41 weeks I had another elcs.

Now I'm pregnant with my third and the consultant has already basically said that I'll definitely be having CS to deliver this one. I had pretty much assumed as much but had wanted to at least discuss the scenarios around what if I went into labour before the planned CS date. However at the initial consultant appointment, he blindsided me with something that totally hadn't even crossed my mind (not related to the pregnancy or birth) so my thoughts were all over the place and I don't feel I really had a chance to talk it through with anyone. Having checked out the hospital's guidelines, they say that a vbac after 2 cs is possible after all.

I've now had a 24 week mw appt and talked it through with my amazing mw. She has basically said that we can put a planned cs date in the diary but if I did go into labour before then, we could head into hosp and wait and see what happened. If it wasn't going well we could switch to a CS or if it was we could give it a go.

I know things can go wrong with any type of birth and there is a wealth of people on the internet of the opinion - your body, your baby, your decision which I don't agree with particularly.

Not really sure what I'm looking for - I guess some reassurance that I could give it a go and that I wasn't being reckless for wanting to do this. So if anyone else had any ideas of questions I should ask or things I should be thinking about in helping to make the decision that would be great. Have another consultant appt on Friday so would be good to go prepared with questions.

Yes, it's possible. Women can and have done it. No idea whether it's sensible in your situation or not, and there's a reason why women who've had 2 sections are often advised against VBAC. It is true that your risk of scar rupture is generally greater the more sections you've had, but then you're going to be in the CLU, right? They can watch you like a hawk and if there are any issues you'll be in the right place for an EMCS.

In your shoes, I'd want to ask about my risk of rupture: the average is 1 in 200 but that varies according to various factors like number of sections and age. I'd also want a rough idea about my odds of VBAC. Again that varies a lot, and with you not having had a vaginal delivery at all before your chances are lower than someone who has. If your odds of VBAC aren't that great anyway, you might decide it's not worth bothering. I also wonder why you feel you'd like a vaginal delivery. Do you feel you missed out, think your body hasn't worked how it's meant to, view it as better for you and/or baby?

Thanks for your thoughts muff.

I don't feel I missed out on a cb or that my body failed me although there is a very small part of me that is a bit sad that I've never experienced a contraction etc. The main reason that id like to give vbac a go is the generally reduced recovery time. I am aware that it's not always the case but in most cases I'd be up and about again much quicker than a cs. With two older children, school runs etc it would be much easier plus who wants to have a sizeable surgery if it can be avoided. So def better for me and I think better for the baby in straight forward circumstances.

Will be asking to talk it through with the consultant on Friday and see what they advise. Risk of rupture high up on list of questions.

My DW is trying for a vbac after two previous sections. Her great MW has said its possible and no greater risk than after one section. She is currently term plus 3 and hoping for something to happen (pineapple, curries, sex and bouncing balls all in use). Her MW said she had another lady in same circa who delivered two days ago after two previous c's.

Reduced recovery time is a good point. I had an EMCS and it did take me longer to recover than after my complex VB. Of course, the problem is a difficult VB will probably be tougher on you than an ELCS, so it's whether you want to gamble on a straightforward one really. You could get the best option, or one of the two worst, whereas ELCS is sort of middling so I'm told.

Contractions are pretty much like period pains. The uterus is contracting in both cases, so that's why most women find them quite similar. Sometimes different if the baby is lying in an unusual way. The ones at the very start of labour are like very minor period pains (I would say I have averagely painful periods) and they normally get worse as you dilate until they're like period pains times a hundred. Basically hinkyhonk if you've had periods, which I am going to guess you have, you know what a contraction feels like! Best of luck tomorrow.

Thanks for your comments. The consultant was generally positive so if I go into labour naturally then we'll see how it goes for a vbac. If I don't, we have an elcs booked for 39+5.

I think that is a good compromise but totally take the point re worst of both worlds possibility. Will think on a bit more