Idiots guide to VBA2C - how frequent are they? Are consultants supportive?

[MummyTheGregor]

I am bit overwhelmed by the information from googling.

I am not pg yet but ttc dc3 if am lucky enough to get pg again I'd like to try for a VBA2C....

What are the NICE guidelines? Is it a regular occurrance? What are the risks? And is there risk data out there?

I was under the impression that its fairly normal but when I went to have my coil taken out the gynecologist I saw said very plainly that I would definitely have a elcs and in the same breath said should also be sterilised at the same time as they do the cs - I was quite shocked at the suggestion.....

After my attempt at VBAC turned into EMC2 the consultant said to me when I was still in hospital that a third child would have to be born by CS. I have had no occasion to test this or find out more as my family was complete, but in my case I would concur with him. This was 8 years ago if that's relevant.

I believe it's recommended you have no more than 3 sections in total, but really it depends on your scar and how likely it is to rupture; I think that would require an ultrasound to check it.

There is no 'limit' on number of CS - each woman is different. There are women who've had 6 or 7.

Regarding VBA2C, chance of success would depend on many things, such as the reasons for the past sections and the state of your womb afterwards. You would need to go over your past notes with your consultant.

People do have successful VBA2C, but for many women an ELCS would be the safest route.

I had a VBAC. Had to fight for it though - and I changed to a more supportive consultant. Best thing I ever did. I also had a VERY supported midwife and I hired a doula (was in Oz though). I did loads of research beforehand so I knew the stats on previous CS scars tearing during induction and I could counter any arguments thrown at me with the mist recent research evidence. The vaginal birth was fab, despite needing induction.

The facebook group vbac support group uk was brilliant for getting info to help me decide whether to vbac. Has lots of information and there are quite a few people on there who have had vbac after 2 sections. It's definitely worth a look as there are some very knowledgeable ladies on there.

thanks all....

So first was a emcs after induction, induction was due to pre eclampsia at 40+2... emcs was due to failure to progress and several fetal heart rate decelerations.

Second was a elcs at 38wks as I had gestational diabetes and they were sure that ds2 was huuuuge, he was 8lbs7.5oz so not as big as ds1 who was 9lb9.5oz....

re scarring / state of my uterus, fod my second cs the Dr bleeped the consultant after opening me up as there was lots of scarring from the first emcs and she wasn't happy proceeding on her own. I don't know much about it but I was told that there were no complications due to the existing scarring....

To me this isn't all doesn't sound very straightforward....but not the most complex pregnancy / births I've heard of....

What's the thoughts on vba2c given that history?

Also has anyone got any good links to data etc?

Thanks.

There is a history here - seems to me that rather than take generic advice on vbac you need to speak further with professionals who understand the exact nature of your scarring. I've had one EMCS and one ELCS and was told next would have to be ELCS. My hospital is actually really pro-vbac but the decision was made on how my scar was and the amount of blood I lost in the second op. I wouldn't feel confident going against that advice, personally, though I appreciate others might feel differently. But shocked at the sterilisation comment though - sounds like you should definitely get more information/a second opinion on that. Good luck.