What is the consultant likely to suggest?

[OhWhatAPalaver]

I am currently 25 weeks and am seeing a consultant for the first time next week due to previous c-section.

I had a bit of a horrendous first birth experience, 9 hours of agonising contractions, getting nowhere, then they finally realised dd was breach, bum first. Had to wait another 13 hours before they could do the section so had to have diamorphine as I was so exhausted.

It is not something I would like to go through again... That said however, I'm still undecided whether I would prefer another section or to try for a vbac. I was very anaemic afterwards last time and midwives thought I should have a transfusion but the Dr ended up just giving me iron tablets. I'm on iron already with this pregnancy and I've got pretty bad spd.

So given my history, I was wondering if anyone has any idea what the consultant is likely to suggest? I would like to be sort of prepared for when I see her/him!

The consultant is unlikely to make you make a decision at that appointment, as often the birth plan is sorted nearer to 36 weeks, unless you really, really wanted a section date sorted now.

Personally, you had a section for baby related reasons rather than maternal, so for me, I think I'd be inclined to consider a VBAC until say 40+10 (or something like that - perhaps earlier given SPD!) and then book a section for then.

The other thing to consider is that an elective section is very different from an emergency section. It is all much calmer, easier on the surgeon so easier on the patient etc, and I think elective sections are a very good option.

As for the anaemia, there are very good reasons for not wanting people to have blood transfusions, particularly in women who are likely to have more babies in the future. There is a risk of developing antibodies that can cause problems for mother and baby in future pregnancies and of course, while the blood in the UK is incredibly, incredibly safe, there are risks involved. Obviously it is for anyone who doesn't have your notes to say impossible to say who was right in the end, but that is just a thought about why the doctors might have been reluctant.

It might be helpful to read through some of the guidelines that doctors use to allow yourself to consider the risks and benefits either way and to come up with questions:

RCOG Birth After a Caesarean Birth

RCOG Choosing to have a caesarean section

NICE Guidance on C Sections

Based on that info consultant is probably likely to suggest VBAC, however depends on your consultant and the trust you are booked with. Some hospitals are very scalpel happy and suggest CS where others wouldn't. It's probably going to be a personal decision down to you

Thanks for the links Countess, I guess we'll have ten weeks or so to decide then hopefully! It's such a difficult decision... Sometimes I look at the odds that 1 in 4 will end up with a section and think I may as well just have a planned one!