Dilemma - DC4 by ELCS or another VBAC? Advise please

[Sezramum]

Firstly apologies for the long post!

I am currently pregnant with DC4 and just coming up to 12 weeks. I know I have a long way to go but I am already worrying about my choice of birth.

DC1 was a 48 hour labour that resulted in forceps and narrowly missed an EMCS. My labour had stopped and I ended up having to go on the drip to get things started again which is where I think the problems began.

DC2 needed to be induced as I was 2 weeks late. Due to a dropping heart beat I ended up having an EMCS. It was all quite traumatic and I felt the induction just spiraled everything out of my control. It took me a while to get over this.

With DC3 I opted for a smaller hospital. Based on my record, but also my determination to not have a CS the consultant agreed I could go 1 week over but then wanted me to have an ELCS. Thankfully the day before I was due to go in, my labour started. Although I had an epidural, this was my best birth with no other intervention. Third time lucky you could say

However, after this I ended up with a partial prolapse and I am scared that by going for another VBAC with DC4 I will make this worse. I really don't want this to happen. I am now weighing up whether to risk this or given my crappy record at giving birth I should should go for an ELCS. I am put off by the recovery of the ELCS though and just really not sure what to do especially as there is always the possibility of another EMCS anyway!

I am seeing my consultant at 20 weeks but would welcome any thoughts BTW I am 43 now so age may also be a factor!

You need to talk to your consultant about the prolapse. But as you had a successful VBAC before I think your chances of having another good VBAC are quite high.

Are you planning to have any more DC? One of the main reasons not to choose ELCS is because of the small risk to future babies. If it's your last then that doesn't apply. Also, how much support will you have at home after the birth? VBAC will get you up and active quickest if all goes well, ELCS will need slightly more recovery time, but a failed VBAC followed by an EMCS will incapacitate you for a while.

Having done VBAC and EMCS I'd probably play it safe with an ELCS in your shoes.

Personally I'd go elcs if this will be your last. It may save having to go through prolapse surgery later.

Thank you for your thoughts. This will be my last so I am quite keen to not inflict anymore lasting damage!

I feel a bit like I am robbing my DP of the whole birth experience if I opt for the CS but I guess it is better to have a good experience than a potentially traumatic one!

I thought I had made up my mind until I started reading some of the CS threads and then started to have serious doubts.

I have had neither, but talking to my friends their experiences were very different if they had an ELCS rather than an EMCS. Those that had ELCS found them very positive experiences, and mostly recovered very well.

Can I just butt in and ask what the risks are to future babies if you have a CS?
I have one DS and he came as a CS as induction failed and was 15 days over due. I would like more DC, what is the risk?

If you have had previous CS there is a small additional risk of problems with the placenta and if you had a VBAC there is a risk of uterine rupture of the scar tissue. Both risks are tiny with good medical care, but it's something you'd want to bear in mind if you had a completely free choice and were planning to have several more DC. Do try not to dwell on it Rattle though - huge numbers of women with CS scars have perfectly healthy babies perfectly safely by VBAC or ELCS or even EMCS every day of the week, I only mentioned it to the OP because she does have a free choice and for all I knew she might have been planning a rugby team

I have just googled this Rattle as I didn't know. Apparently you are more at risk of having a low lying placenta or your scar opening up with future pregnancies.

Just also found this article www.medicalnewstoday.com/articles/278978.php saying that there is a small increase risk of subsequent pregnancies resulting in still birth or being eptopic. It is tiny though and wouldn't effect my decision either way. I really wouldn't worry about it Rattle CS are so common and most women go on to have perfectly normal pregnancies and also VBACs. It was not something I was aware of though.

Oh no! No rugby team for me Anyone 4 is definitely enough! I was actually thinking that if I had a ELCS I might get things 'sorted' at the same time do that I didn't end up with number 5!