Can't decide re vbac/elcs. Really struggling!

[Sparrowlegs248]

I've posted before but trying again to see if my mind becomes any clearer. Had elcs July 2015 due to large breech baby. It was fine, really good, calm, quick and I recovered well.

I'm 33wks with dc2. Have to decide between vbac and elcs. Have seen midwife who gave me 'the facts' as follows and said she wasn't there to persuade me either way.

They won't induce, and don't like giving epidural (increase chance if scar rupture)
1in100 chance of scar rupture anyway.
No water birth.
Continuous monitoring.
If labour fails to progress, leave for 4 hrs then c section.
Not keen on me going overdue as likely to have big baby again, but if I do.....
Sweep at 41
Waters broken at 42.

So, I came away thinking I would be likely to end up with c sec. Never been in labour reduces the chances of successful vbac.

But, ds will be 18 months old, and I remember how I was when he was born, even with a good recovery.

But then recovery from a hard vbac/emcs could be worse.......

Also. Another mw has arranged for me to see the head mw as she feels I've been unduly put off, and said I can refuse the continuous monitoring etc.

Anyone got any positive stories?

If the midwife is just there to give you the facts then why is another midwife referring you to their head midwife? Is it to push you to have a VBAC? Can you see a consultant?

I had 3 successful vbacs after ELCS for breech. None of my babies were especially big (8lb12 biggest & im tall). Dc2 was born on due date, dc3 was a week or so late, dc4 was 10 days early.

Vbacs worked for me BUT had I been told I needed another ELCS I would have done as I found the recovery with dc2 similar to dc1 as I tore quite badly (and retore with each subsequent birth).

I was monitored on the bed with dc2 and it wasn't great. No monitoring with dc3 as we left it late to get to the hospital and I gave birth very quickly after getting there. Dc4 was monitored continuously but I was insistent that I had to be able to move around the room which was fine.

So probably no help at all but I have had the positive experiences you asked about 😊

I'm just giving a positive CS after CS too for balance.
15 months apart, went for a 2nd ELCS, high risk for pre eclampsia so may not have made it anyway but...
Recovery far quicker the 2nd and 3rd time. I don't know if it's because you know exactly what to expect, and what not to do etc as well as being that much busier with 2 tiny ones - you don't have the time to recuperate and be horribly aware of every twinge.
Selfishly, because DC1 was so small, it was a godsend to be able to plan childcare around the birth too from far away ILs.

Remember this is your choice, take your time, weigh up what is ultimately going to suit you best.

I had a vbac after emcs, but after a full labour, not because of breech. Both babies were large-ish but not huge (over 9lbs).

As I understood it, vbacs are less likely to be successful after a labour which failed to progress, which isn't the case with you. During mine, I was left to labour at home for the same amount of time as with my first labour. I was continuously monitored once I came in but was still able to move about and get into different positions. I wouldn't say I enjoyed the birth and I ended up with a tear that needed to be stitched in theatre, but even with that the recovery was definitely much quicker than with a c-section. And I had a pretty easy recovery from the section!

What is your hospital's policy on VBAC? I was pretty much told from the outset that there would be no chance of an ELCS as my first EMCS was due to baby's awkward position not because of problems with labour.

From what you've said, I cant see any reason why you shouldn't have a successful VBAC, unless the baby is breech again, which usually they would spot before? Maybe meeting the head midwife will help with your questions?

I tried for VBAC after an EMCS and had another EMCS (baby never descended, I never dilated, even on full whack syntocin the first time, and after over a week of regular, frequent, natural contractions the second time (I do not advise that!), so different circumstance to you). I found that what the community midwives said, the vbac midwife said, and what the midwives said when I was actually in labour were all entirely different.

They won't induce, and don't like giving epidural (increase chance if scar rupture)

I had to refuse induction, and epidural (I held out on gas and air for a spinal block - as I'd not liked the recovery from epidural the first time). I was clear that either it went smoothly, or I went to CS - that there was to be no mucking about with inductions or sweeps or any other interventions. They didn't like it, but it was absolutely the right decision (unlike the VBAC in my case, but, as I said, in hindsight my circumstances were such it was never going to work)

1in100 chance of scar rupture anyway

1/100 chance of cord prolapse too - honestly, if they listed out all the 1/100 chances you'd never do anything.

No water birth

I couldn't do that because of weight - otherwise they'd have had no problem with me because of vbac - check with the hospital.

Continuous monitoring

I was connected, but on long leads - I refused to stay on the bed because it really increased my pain (which all but one midwife was fine with, and I just told that one to get knotted with a slight legal/feminist speech between contractions! - I was a might grumpy at the time) - I guess I'm saying that managed well, this isn't as big a deal as it sounds.

If labour fails to progress, leave for 4 hrs then c section

At every point you can ask for enough information to make your own decision. You don't have to be bullied into anything (I know, easier said than done)

^Sweep at 41
Waters broken at 42^

Personally, I refused these two suggestions - but that's based on my previous labour experience, I felt they had no chance of actually helping, and much more chance of causing problem (for example, the aforementioned cord prolapse)

I had a section then VBAC. Opted to try for VBAC because I had an 18 month old to look after. Personally I felt more incapacitated by the natural birth. Couldnt walk or sit down properly for weeks and weeks. Every trip to the loo was a mess. I have a DH but he had limited time off work, no support from local but useless parents but I still think I would have managed better with the recovery from a planned section than what I went through with butchered nether regions.

Thanks all.

I think the dilemma is that I'm never going to know am I?

I'm being advised to see the head me as the one I saw the other day thinks I've been put off unnecessarily, and not given full options.

I don't want sweep or waters broken, and they have already said no induction (which I'm fine with) so seems to me the chances of me going into labour on time or early must be quite slim, having never done it before.

Ds will be 18 months old. I'm conscious that yes it will be easier to plan for him with elcs. Yet ice just visited a friend with a week old baby, who was in fine form, has been out to deal with her horses this morning, was up and down etc.

I do have husband but he's self employed and will likely be at work, I do have mum and Mil locally. Ds gets up at 5am though....h leaves at 7.

Hi OP

Read this document:

www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf

It should help you make up your mind - its from the Royal College of Obstetricians and Gynaecologists.

Ultimately it is your decision - however although not always recommended - some hospitals do have the facility to offer waterbirth with telemetry continuous fetal monitoring. Ask to speak to a Supervisor of Midwives if the Head Midwife cannot help you - although I would hope that they would be able too.

Good luck xx