Tell me about your attempt at a VBAC

[maamalady]

I'm currently 13 weeks with DC2, so early days, but am wondering about what to aim for. DD was born by EMCS at 40+12 (induction, got to fully dilated, then it transpired that her big head and awkward presentation was never going to make a vaginal birth possible), I recovered well, established breastfeeding, everything hunky dory.

A successful VBAC would hopefully make it easier to deal with DD (she'll be 20-21 months when DC2 arrives) as well as a newborn, but I really don't want an instrumental birth. I also fear that if I tried for a VBAC I'd end up with another EMCS anyway (especially as I've not had a previous vaginal birth, and am a bit fat - both count against the likelihood of a successful VBAC I think). I'd rather have an ELCS than a EMCS, just for the greater rest beforehand!

So, if you tried for a VBAC, did you have one, or a section? Did you have an assisted delivery? And most importantly, would you recommend giving it a go?

I remember when pregnant with DC2, I wanted a secret third option. I didn't want an ELCS because obviously I had DC1 (who was due to start school when DC2 was due), I really did want to have a go at natural delivery and the reason for the EMCS first time round was a positional issue (DC1 was an attempted home water birth. I got to fully dilated and 8 hours later I was in surgery having an emcs. They transferred me in after 4hrs, tried a ventouse and a manual rotation but her position and head circumference meant that she just wasn't ever going to fit through). I was told that the first delivery was just bad luck in terms of position and there was no reason not to try for a VBAC and no reason not to believe it would work. However, I didn't particularly want another EMCS because while the CS itself was fine, recovery fine, breastfeeding fine etc, the long labour and intervention prior to emcs meant that I was knackered.

So, like I said, I waited for secret option number three to present itself. I think I was hoping it would be 'a sneeze birth' or 'magic' or something like that.

After a while it became clear that I really did have to choose and actually, it was a very frank discussion with my consultant that made up my mind. I talked about exactly what his parameters were for VBAC, what was negotiable, what wasn't. How long each stage would last for before they intervened, his individual opinion and statistics, what would and wouldn't be available to me as options. What an induction would mean given the previous cs and on and on and on. I came away from that meeting feeling like a VBAC was more of a known quantity. Instead of dithering about and wondering about things in theory, I knew the team who would be with me and how they would act in each scenario. It was knowing this that gave me the confidence to have a go at a VBAC.

And I did have a go. For 38 hours in the end. DC2 was in exactly the same position as DC1 but not engaged when labour started. I decided to give him time to descend and see if he moved into a better position whilst doing so. He did no such thing. He stayed stubbornly twisted and we made the decision to move to EMCS.

However, because I had a team looking after me very carefully and because I knew that they wouldn't let me get to the point of exhaustion and I felt safe, I had a very calm labour and slept at home in my own bed for a large part of it. I think I knew it was heading for EMCS anyway as it was identical to first time round, contractions were atypical and it wasn't progressing as you'd expect. I felt really positive about it, pleased I'd had a go and actually, I felt quite in sync with my body, even though it was a surgical delivery. My 2nd EMCS was honestly the happiest, most positive experience and recovery was fab. I didn't have any problems first time round but second time round, I bounced back even faster as I wasn't tired. I was up and about by dinner time (CS was at 15.30 ish), had a wander and a shower, watched a film in my chair, another wander round and then a good night's sleep (with a few feeds in there for good measure), got up and went home. Four days later, I walked DD to school. 8 weeks later I was back running.

I have absolutely no regrets about my decision at that time. It was absolutely right and I'm glad I had another go. I'm a bit sad that I won't ever have that moment of delivery but at the same time, I know that I did have that, it's just not the one in the textbooks. It was still the day I met my boy and felt him snuffling on my chest. I grew him, I brought him into the world safely and I don't actively want a normal delivery anymore. I did have that need before DS was born. If I had a DC3 (DH would leave me tbh as his vasectomy would probably hint at me having accosted the postman), I'd have an ELCS. Without doubt. My body isn't designed for natural delivery. The shape of my pelvis meant that my babies couldn't fit their (fairly large) heads in whilst in a manageable position.

I'd have a chat with your HCPs, talk to the consultant team you'd be under and see how you feel.

Congratulations. It seems like a monumental decision right now and I know if you're anything like me you'll worry about making the 'wrong' decision. I think the wrong decision doesn't exist. You simply don't know and all you can do is choose based upon the information available and what is right for you and your family.

Thank you, that's really helpful :) I'm meeting with my midwife in a couple of weeks and will have a proper talk about scenarios. Like you, I suspect that my pelvis may just be too narrow, but DC2 might be smaller than DD was, so who knows. Her birth was very positive for me, but boy was I tired - labour for 24hrs or so and no sleep for two nights, followed by recovery from the section. It's small beer compared with many, but it'd be nice to avoid that sort of thing if I can.

I'd love a straightforward vaginal birth, but realistically I suspect instrumental delivery would happen if I try for a VBAC, which does not appeal in the slightest. Arrgh, if only it were possible to predict the future!

My VBAC ended in uterine rupture, Dd's heartbeat flatlining and a crash c section. We are both actually fine, but if I wanted and more DC (I don't and wouldn't want anymore anyway) I would demand a elcs. I actually wanted an elcs all along, but hospital policy was for VBAC and I went along with that. I was later told that, given the progression of my previous birth, I should not really have been pushed into VBAC.

I really get the convenience of a quick recovery from a straightforward VBAC, especially with a toddler to look after - the was the main driver for me going along with the vbac. But if you have any doubts or niggles, an elcs is probably easier recovery than an instrumental VBAC.

Eeek, glad both of you are okay, that sounds very scary! I have a suspicion that attempts at VBAC often end in CS - I'd rather just cut out the middleman and just have an ELCS, but the appeal of a straightforward VBAC is quite strong...

There are vbac stats around. I read them ages ago but I think about 25% end in another section do you have a good chance of a successful one. (That number might be wrong - I'm sure Google will correct me!)

I'm sure I've read that a huge number of successful VBACs are instrumental, though. My own birth was ventouse and my poor mother had a terrible time - really puts me off assisted birth. Forceps seem to be used very readily, I think I'd rather a section.

I had a successful Vbac, nearly 20 years ago. The painful part of labour was much shorter - about 5 hours as opposed to 15. My vag was a bit ripped up, as nothing had come down it before, and I felt like a had a bag of liver strapped down there for a couple of weeks, but it healed up OK.

Third birth was also vaginal, very quick and chise an episiotomy. It also healed up quickly and I had no problems.

The PDF on this page is good for explaining the various success factors www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg45/ it's long but informative and a reputable source - my consultant was pleased I'd read this rather than random googling

Does your hospital do a VBAC course? Mine did and it was good, they explained how they'd monitor, how long they'd let labour go on etc.

I'm actually opting for ELCS because I have a lower chance of VBAC working for me (small age gap, never had a labour) and my EMCS was traumatic last time.

But do what's best for you. I found I got a lot of pressure off midwives but the consultant was very open minded and pro women's choice.

I had a successful and very straightforward VBAC after ELCS for breech. So not quite the same situation, but the recovery was much easier.

I had a successful VBAC two years ago. Recovery was quicker than a c section, though I had a nasty 2nd degree tear that healed wonky with scarring and required an operation about 3 months after giving birth. It was quite nice going into hospital for the op though, I had a lovely nap!

I had a successful vbac after emcs due to malpresentation following induction. Dc1 induced at 41+6, ended up being posterior brow presentation and eventually facial presentation, emcs after 36 hours in labour. Dc2 spontaneous labour at 40+3, normal delivery after 12 hours, 3rd degree tear but otherwise fine. Very glad I opted for vbac as won't be having any more!

I had a VBAC earlier in the year after a previous EMCS. I had three consultant appointments throughout my pregnancy and had to make the final decision after the third appointment. The consultant left it up to me but did advise that there was no reason to treat it as anything other than a routine birth. I still could have chosen an ELCS if I'd wanted.

Labour and delivery were routine and I had a second degree tear, but I found it easier than recovery from a section.

I had a successful vbac 5 years ago. Birth from start to finish 2 1/2 with gas and air.
There is no reason why you shouldn't have a normal delivery, try not to think too much in it, some medical personal would suggest a c-section cos you've already had one but that is utter bollocks, they want the easy option for them not what is best for mum and baby, ( they won't even deliver breach babies anymore) your body is amazing and can adapted to almost anything.

I had a vbac for DS3 (DS2 was an EMCS, DS1 a VB albeit very long, epidural). Forceps were used and despite my repeated request for an epidural being denied in labour, I then had a spinal afterwards to repair a 3rd degree tear(!) DS3 actually had a true knot in his cord which caused the distress and thus urgent delivery via forceps rather than it being because of the VBAC iygwim.

Whilst pg with DS3 I was very back and forth as the consultant was great and said there was no point in her telling me to go for the VBAc if it wasn't what I truly wanted. In my heart of hearts I wanted to try and it was just bad luck on the night that the HCP involved were focused on avoiding a c-section. Driving was a huge factor as my eldest 2 were in a school 5 miles away that I had to drive to. I was readmitted for a blood transfusion so wasn't really driving much!

With DS4 I was planned c-section all the way but of course he made his bid for freedom the day before so ended up semi-elective. That labour progressed waaay faster than my other 3 but nothing was convincing me to try for a vaginal birth.

It is such a tough call, as a lovely midwife said to me after DS3, women don't have lots of births and it is a very big life experience to go through (she was genuinely upset for me over a few things). If I'd had the money for a doula I think that would have helped protect against the experience I had with the VBAC. My husband was a great support but a team of people ignoring you can be overwhelming. As were my outbursts over caravans!

Despite my VBAC actually being quite cack I was definitely euphoric immediately afterwards, and my semi-elective was a good experience also. I had no complications from my sections and my 3rd degree tear and repair was also uneventful.

My DS1 was 21 months when I had DS2 by EMCS and DS3 was 18 months with the semi-elective DS4 (big gap between 2 & 3) and I think I coped better then than I do now!

Thank you everyone, there really is a broad range of experience, isn't there? Hopefully my midwife is clued up and will be able to give me good advice.

Thanks for the link, Abbey, I'll read that before I see my midwife :)

My daughter was breech, so ELCS, wasn't as bad as I thought it would be, recovered ok.
I chose Vbac for my son but stressful 32 hour labour, forceps delivery and 3rd degree tear.
Pregnancy number 3 and I'm 50/50 which way to go?. The consultants veering me towards natural.
Must admit I'm scared either way?!.
Hope it goes ok for you!

I had an accidental vbac last week. Was booked in for elective but waters went and got to 8cm in assessment bay. Too late for a section at that point but ended with forceps and 3rd degree tear. Recovery still easier (so far) than a section even with tear.

Congratulations on your pregnancy.
Please please do discuss with your consultant about the risks of vbac and your age gap.
I have been told to wait at least two years before a potential third baby after my emCS scar was found to be breaking down during my elective CS. I had had contractions that morning and niggling pains all week. I feel very lucky that I went for my elCS. I had a 17 month age gap.

Ds1 was an emcs for failed ventouse (and I then refused forceps). I hoped for a vbac second time round, but had another emcs, as I was bleeding - it turned out to be a placental abruption.

I don't regret having kept it in my mind as an option and was pleased to have gone into labour at least.

I had vbac with ventouse 5 weeks ago due to apparent foetal distress again. Im a bit gutted by this as he was small and perfectly positioned so should have been easy to deliver. I think all the monitoring was the problem.. They even screwed a trace into his scalp at some point.. The ventouse was OK although not particularly dignified iykwim. The episiotimy was horrid.. Got infected but has appeared to heal perfectly now touch wood.
I'm in two minds about the whole thing. It was really undignified yet at the same time thrilling to go all the way.. To feel the crowning and baby go straight on my tummy. The midwife also showed me the placenta afterwards which I liked.
I want more children after this one so I'm glad I have the option to avoid multiple c sections.
I am slightly concerned about how sex will feel also I'm worried about pelvic floor issues in the future although all seems OK ATM.
Hth

I had successful VBAC at home with DS2,I ended up having to go in for stitches and blood loss, but the actual birth was fantastic.

I tried for a vbac with ds2. Ended in a scary emcs but tbh I wouldn't have gone straight for the elective. Just maybe not an emergency crash section under a mobile epidural! He failed for a different reason to ds1 - ds1 was tiny headed but got his shoulder wedged so couldn't birth. Ds2 has a giant head. Honestly, hard and alien sized I swear. Good job I love him :-)

I myself was a successful vbac though. My mum went on to have my sister naturally too.

I've had two CS - the first one prematurely due to complications with the pregnancy and the second as I went overdue and the hospital was anti any form of inducement due to previous CS.

Now expecting DS3 and I've been thinking about whether to try for a VBAC or go for ELCS. The hospital have been more keen for an ELCS due to 2 previous CS but have been supportive when I was talking of going for a VBAC. I was very keen on at least attempting a VBAC as I haven't ever even gone into labour and while both previous CSs were calm and well organised, I have bad mental associations with them due to the long recovery my first son had due to his prematurity.

I've had several conversations with consultants, midwifes, registrars etc. I think I'm now on the side of going for an ELCS simply because the more CSs you've had the longer it takes to get the baby out if the VBAC isn't successful and an EMCS is needed. This is due to the increased scar tissue. For me, I can't risk any delay if something was to go wrong with the VBAC. So despite dreading it, I think I'm on for another ELCS. The drs have been really good though and have offered tours and extra counselling to get over the upset I have associated with CS so I'm hopeful this one will be a more positive experience.