Pros and cons of VBAC

[verytiredmummy1]

I have my consultant appointment this week to start to discuss birth choices. I had an emergency c section a year ago as baby got stuck. I know everyone's situation is different but there's so much on the internet about this that I wondered if anyone had just basic pros and cons for vbac over an elective cesearean? I want to go to consultant appt prepared!! X

I have never had an elective c section but the emergency section I had was very routine, failure to progress, all very calm. I was pretty young and I sprung back with a very quick recovery. However the VBAC was so much easier to recover from. I had to work hard to get the vBac because the default was really another section in spite of all the talk being vbac but it really was so much easier. I have had another normal delivery which was not as smooth as the previous one but still again way, way easier recovery than vbac. I personally would never have another section if I could help it. They are not for me after having a normal birth experience.

Way easier than section I mean doh.

Hey, probably not the simple pro/cons list you wanted...but... I just wanted to say I know many people who went for VBAC & it worked & then there's a few of us that no matter how hard we tried still end up with a second EMCS. So I just wanted to say that it may help to see an EMCS (if you have to have a second) as a planned one if the VBAC isn't working. It also depends on your reason for wanting a VBAC. I personally wanted the VBAC because i wanted to push my baby into the world & some people want it for recovery time. Some people on other hand would just rather have a special day planned & be calm & ready by going for the elcs. Nothing's wrong & all are special.

Sorry. I have been no help!! Just a matter close to my heart. I've been told next has to be elcs. X X

I imagine most women would probably rather a VBAC if possible unless they have had a traumatic birth. The recovery is quicker (if all goes well) but as long as if you go for VBAC you are prepared for all eventualities it will be fine X X

Thank you. My first labour was very traumatic and long. Then failed ventouse. Failed spinal block so cat 1 c section under general anaesthetic. Physically I recovered quickly but mentally took a while.
So many different pros and cons!! X

Verytired that sounds really tough

I got a cd called natal hypnotherapy to prepare for my VBAC because I knew that getting epidural/pain relief might make a VBAC less likely so I wanted to hold out pain relief as best I could. They had a pretty good section on getting over a difficult first experience which was not relevant to me but might be good for you whatever route you ultimately choose. They have ones for staying relaxed during sections too. I actually have put the hypnotherapy to much use since it is great for relaxing anytime.😄

Very tired I would agree that the biggest struggle I had was mentally & that's kind of why I went for VBAC. To get the birth I dreamed of & what other mummy's could do so easily yet I couldn't. But it wasn't meant to be. I thought if I had the VBAC & pushed baby out I wouldn't suffer with the thoughts & feelings I had after EMCS.

I'll be honest. I'm still gutted that I didn't get my VBAC & to be told my next one has to be elcs makes it so final. After what I went through for VBAC I wish I had elcs & then wouldn't have felt as deflated.

What did you feel after EMCS??

I'm not a medicinal professional but I've researched VBAC a bit so here is what I've found out.

ELCS pros - you are more in control as the date is planned. They can take you through how everything will happen in advance. You can plan a family friendly one complete with music and skin to skin. Most women I've met who've had ELCS have said they were lovely experiences. I had Emcs and other then DC being in danger (obviously wouldn't want that again but that's why Emcs was needed) the CS experience was nice. Pain free too for the actual surgery bit. removes the unpredictability of labour and the pain. less likely to cause injury that can result in incontinence later in life (tears etc).

Cons of ELCS - Pain for longer afterwards and more severe than a straightforward v birth. Can't lift for 1-2 weeks. As much as u can plan things don't always go to plan. Hospital might be busy and could change date/time of ELCS. Risks to mother increase with each CS. With CS are at higher risk of things like hemorage and baby is at higher risk of needing help breathing when born (maybe because lungs are last to develop and they tend to do ELCS before due date but I'm not sure)

VBAC PROs - the experience (some people just want to experience it). Go into labour naturally so baby is 'ready' to come out. Safer for you and baby if all is straightforward. Easier recovery if its a straightforward birth. Easy to get baby straight into your arms and do skin to skin etc. More likely to be able to breastfeed (not sure why? But read this a couple of places).

VBAC CONS - labour of course is unpredictable you may end up with instrumental delivery or EMCS. Also an emergency would be more risky for you and baby than ELCS. I read on a thread that the safety of delivery methods goes like this.

Safest is first:
Straightforward vaginal delivery
ELCS
Simple instrumental delivery
EMCS
Problematic instrumental delivery

It's important to be aware that vaginal delivery doesn't always mean quick recovery. I was shocked at how long some friends took to recover from tears, epilstomies and forceps deliveries.

Personally I'm also worried that a complicated VBAC could be traumatic whereas with ELCS I would feel fairly safe (surgeon there and anesthesiast there with me) even if things went wrong. At the mo tho I'm thinking I'll brave it and let labour start naturally on the condition that we can move quickly to CS if anything looks not quite right.

If there are any medical pros out there id be interested on you thoughts especially if there's anything I've misunderstood as this is based on what I've read. Like I said I'm not a medical pro

Thank you for all of your responses :)

Last time I felt disappointed that I'd been in labour for so long and then pushing for a long time only for baby to get stuck when they thought one more push and she'd have been out. I was disappointed I hadn't had a birth that other women get. Silly I know. My daughter was very unsettled after the emcs and she struggled to breastfeed. We got there in the end but it took weeks of teaching her and lots of tears from me and lots of expressing!!

For me my main worry is scar rupture. I read somewhere that VBAC is safer for me but elcs is safer for baby due to the risk of scar rupture.

I'm likely to have to go through labour on my own as I don't have anyone to come with me. DH will be looking after DD for the pain part. DD has spent a long time in and out of hospital in her first year :( consequently she's developed a fear of people coming too near her. We think because of the amount of tests and needles etc she's had. So leaving her with someone apart from dh is looking unlikely.

For this reason I think DH would prefer an elcs so he can be there as its planned. At the moment I'm leaning towards a vbac as I don't want another big surgical procedure so close to the last (it will be 16 months between them).

However I change my mind on a daily basis!!
Xx

Could you afford a doula if you go for VBAC? Then you would have someone with you even DH can't be there. I've heard they can be really good support.

Scar rupture is very rare and it is probably one of the rarer complications faced by VBAC mothers, not that I didn't worry about it either .

I don't think you are being silly at all wanting to have experienced a normal delivery. I actually really was not bothered by that but I really did not want to spend another 5 days in hospital which is standard for sections where I am. We all have our reasons for our choices. I would look into getting a doula, as suggested above, if your DH cannot make it. I have seen that work really well in similar circumstances. It is fantastic that you are working through your options now because you will be able to set everything up over the next few months.

I'm going ELCS this time after a fairly traumatic EMCS last time. I was looking forward to childbirth last time and felt disappointed that it had 'failed'. However, to go against the grain here, I really appreciate that I've had no tearing / damage / continence / sexual issues, having avoided vaginal birth. The levels of this amongst women I know are far higher than I'm comfortable with. The way I see it, you can have a messed up stomach or messed up foof. I've got a messed up stomach (c section scar), I'm not going to risk a messed up foof as well. Oh and I didn't really find the physical recovery from c section that bad.

I like your logic pannacott!
I recovered quickly from my c section. Walking around that day etc but I'm worried that I might recover slower this time and will have a toddler running around too!! :)

I had a VBAC and it was fairly easy and straightforward. EMCS with dc1, I felt like a complete failure and it took me ages to recover. VBAC was a walk in the park compared to that.
The risk of scar rupture is there, but not that high.

Do you know Pannacotta that was exactly my thinking before deciding that the overwhelming determining factor for me was not 5 days in hospital. That was why I never particularly felt like I missed out. However I am pleasantly surprised to have had a vaginal birth and fully intact foof to boot. I suppose I had underestimated at the time that was what a vagina was designed for and obviously not true always but it pretty much is as good as new . Then again I never got saggy boobs from BF so maybe I am just a miracle of nature although my stretch marks over my tummy tell another story entirely.

Pannacott - I totally agree. So glad not to have any of those problems. Still considering VBAC but if it gets complicated I'd happily take CS over forceps or anything else that's likely to cause those kind of issues in later life!

I would like to avoid a long hospital stay too. Although I was discharged the day after my EMCS last time.
It would be good to be able to start a VBAC and then change to elective cesearean if things started going wrong. Is this possible or would that be an emergency? Xx

It would be classed as an Emcs as its not planned in advance, but that doesn't mean it would necessarily actually be a emergency. You would be monitored very closely as VBAC so if they see anything unusual I'm sure they wouldn't wait around. Maybe with the consultant you could discuss the circumstances in which you would want to switch from VBAC to CS. So things like poor foetal positioning, any early signs that there could be feotal distress, progress of less than Xcm in Xhours, whatever would worry you based on last experience. You could agree to VBAC on condition that you will be offered CS if any of those things happen. ive heard they listen to you a lot more during VBAC so I think they would be open to this.

One thing on the hospital stay tho. I was also out 1 day after Emcs. Standard stay for Emcs here is 2 days. The women I know who stayed the longest in hospital all had breastfeeding issues. So CS doesn't necessarily mean a long hospital stay.

One of your main questions to the consultant has to be if you are at an increased risk of scar rupture given your small age gap. I had that same gap, went for a planned section after EmCS first time, at consultant's advice. I had been having pains I thought were braxton hicks but at my elCS, my scar was found to be breaking down. I'm extremely glad I did not go into proper labour at home or attempt a VBAC.

Cons of another section which I don't think are mentioned in a list above are increased risk of adhesions.

For what it's worth my elCS was great and very easy to recover from.

Congratulations on your pregnancy.

Thank you.
I saw the consultant. She's said that the choice is mine but that I have around a 65% chance of successful VBAC.
Still so undecided!!

I found the recovery from my emergency section much easier than from my VBAC. I had an episiotomy and am still sore four months later.

What I found most difficult was that after a section the pain lessens the more mobile you are. After my vaginal birth the pain increased if I moved around too much.

Interestingly all of the medical people I know went for elective c sections.

dixie thanks for being honest about this. I have to pick between VBAC and CS too. I found emcs a really good experience last time and recovered well. dC1s birth sounds really bad on paper but in reality I was happy with the experience whereas plenty of friends who had complicated vaginal births seem a bit traumatised. I feel like I'm being told that vaginal is always better but I find that hard to believe given I was happy but other people aren't with their vaginal births. I could be trading my nice experience for something traumatic. It's a tough call.

I dreaded the idea of a section but the emergency one I ended up having was nowhere near as bad as I feared. I recovered much quicker than I'd expected. I was out shopping a week later.

With my VBAC I found even sitting down uncomfortable for several weeks. I also had zero control over my pelvic floor so if I needed the loo I had about ten seconds to go or I risked an accident. I also couldn't control my farts which was embarrassing.

I'm four months down the line and still feel sore and not quite right down there. I suspect I may have a prolapse of some sort. Given my experiences I would never opt for a vaginal birth again.

Having said that there are probably people who would say the opposite and who had bad experiences of a section, and who had no problems after their VBAC.