VBAC v planned C-section

[alicet]

I am 7 weeks pregnant and due in October. My first son was born by emergency c-section for foetal distress after a relatively quick labour (I got to 9cm in about 5 hours before the decision was made). There was no obvious cause for his distress and he was well when he was born - apparently there is no reason to suspect I would be more likely to have this happen again. And although it was a long way from my birth plan (water birth with gas and air) it was none-the-less a very positive experience as everything was very clearly explained to us during it all and we were included in all the decision making. I alpso had a relatively easy recovery afterwards.
Just wondering if there are any other mums to be in a similar situation and what you are planning this time? I am totally undecided at the mo! Cheers, Alice

oooohhh.....VBAC is my pet topic !

have had one myself, found it to be marvellous and inspired me to start training as a doula !!

anyhoo..need to make supper and do some family stuff, but will be back later with some info for you ! xx

Hello, It its a hard decision to make and no one will be able to make it for you...
I had an emergency C-Sec with DS1, I too got to fully dialated but he then got stuck and after loads of pushing and beng in established labour for 16 hours its was decided that we were both getting to tired and had to have a C-sec.
I have now decided to have another one as it can't be guaranteed that this wont happen again and this time round I have SPD so am worried about how my pelvis will cope.
Even though I am entitled to it I am being made to feel very guilty as I have been told that I have a very good chance of having a successful VBAC. I am now 34 weeks pregnant have a C-sec booked on babies due date but am still undecided as to what to do as keep feeling guilty...

In the end it is your decision and you need to do what is best for you. Read up about all the pro's & con's of both and take it from there... its not an easy decision to make but Good Luck

have a read of this!

dilation does not always follow 1 cm per hour..labour can pause, dilation can suddenly go very quickly...it can stop when you are scared or anxious or you have someone telling you you are tired and need to get the baby out

what happened when you got to 9 cm, did labour stop....?

VBAC should be offered , according to the NICE guidelines...where appropriate

foetal distress / failure to progress are diagnosed an awful lot and can have no bearing on the outcome of a second labour and birth...

BTW..MistieK.SPD is not an indication for a c,s, sounds like you are a bit uncomfortable with your decision....you could move the date of your c.s to after your EDD...

I had an emergency section with my DD1 after she became distressed, when I had DD2 they gave me the choice, to either try for a natural birth or have a planned section. I chose for the natural- so they gave me scan(you know like half a dome shape) to see if my pelvis was big enough- they were worried this may of caused DD1 foetal distress! It was ok. I have a healthy happy DD no problems a few stitches and 12hrs of pain. I was amazed at how easier it was than DD1 birth, I recommended this to a DF of mine because she was in the same predicament as me a yr later- she had an awful time delivering but felt it was worth it because the recovery time is so much quicker! I have since gone on and had another DD making that 3, So I have had 2 natural deliveries!

I would definately have a section. So much nicer when it is planned. No way would I ever even consider a VBAC. I can't really understand the attraction.

Actually there is one circumstance where I might try it, and that is if I wanted four or more kids -- which I most certainly do not.

fair enough, but women are physiologically designed to give birth vaginally..the more i read about birth, the more i believe it

c.s used to be a last resort for saving maternal or foetal life...now somewhere between 20 and 28 % of births are caesarean..and the WHO says that a c,s rate of 10 % is acceptable

so something is stopping women giving birth vaginally.....and i don;t believe it is the women themselves

for me personally the attraction of VBAC was to be able to give birth..rather than have my baby surgically removed from me....which is how i felt after my emergency c.s.....

Whilst the risk of uterine rupture are small, the consequences are potentially catastrophic. I would never never risk it.

uterine rupture story

A caesarean section is also know as "giving birth". To say it is merely having the baby removed is frankly insulting.

"rather than have my baby surgically removed from me....which is how i felt after my emergency c.s..... "

I know caesarean is a birth, that is why i said that is how i felt. not that that is how it is for everyone.....my c.s triggered severe PND, because of how i had felt...not saying it is the same for everyone, by any means.

a woman can make an informed choice about VBAC, and rupture is a risk, and yes , can be catastrophic. the real, but small risk , needs to be weighed up in context of the circumstances round the c.s and potential VBAC,

if you don;t feel comfortable about VBAC , fair enough,but a lot of women do want to know more about it

I'm just presenting the other side of the debate so the poster can make an iformed decision. If everyone comes on saying how wonderful VBAC is and no one says otherwise she might get a biased view.

And not all women are physiologically designed for birth. I think that was true when we were apes, but now that our hips are smaller and heads are bigger, caesarean is medically necessary for many of us.

I sat with my sister at her consultation last year. She had an emergency c section in 1999 following 2 days of attempted induction and went through a pretty rough time. She got to a point where she wouldn't dilate anymore with no explanation

The consultant said she had a choice. If she were to wait until she went into natural labour they would monitor the situation and if she stopped dilating they would perform a c section. Because of previous problems and the baby becoming distressed, everything would be monitored more regularly and the slightest sign of any problems then they would take action. He said they would never let her get to the emergency situation so even if she did have to have c section again, it would be very controlled and not distressing or panicky at all. He also said she would only be allowed to go to about 39 weeks too

Even though she knew she wouldn't have to go through what she did before, she opted for a planned c section. She liked the idea of knowing and she hates suprises so knowing the date was nice for her. Everything was fine, she felt great after and her recovery was much quicker. She particularly liked preparation on the day, straightening her hair etc and making herself feel good before going in.

well, i take your point, eluesis..and i hope you realise my point was not meant to be insulting, it was purely based on how I felt after my c.s

RE the point that babies heads are bigger and we are too small.....

true cephalo - pelvic disproportion is really rare. we are better designed to give birth now than a hundred years ago when rickets had deformed the pelves of many women.....the vast majortiy of women have a gynaecoid pelvis, the best shape for birth, and we do tend to grow the size of baby we can birth..on the whole

a lot of how we feel about birth, and our ability to give birth has a lot to do with the confidence we have in ourselves and the people providing our care at the time of pregnancy and birth.

having a doula, for example, can cut the chances of a c.s by around 50 % , and that has been proven to be due to the continued on e to one support element, as a doula does not have a clinical role.

so the fact that emotional support can have a radical effect on the birth experience shows how much of the birth is governed, IME and my opinion, by how we feel..if we are scared or supported

there is a birthing 'commune' for want of a better word, run by this midwife, Ina May Gaskin , in the USA , their c,s rate is about 2 % IIRC.....

i have no problem with the pro elective section POV being presented, that is part of an informed decision...

i guess as pro VBAC i am, you are pro elective c.s....for some women, a c.s will always be a preference, for others, like me, that was a terrifying thought..

am very supported and nothing really scares me - about to have my 3rd section because that is what works for me and my family.

Had one emergency and one elective up to this point. About to have second elective in about 5 weeks.

I was considering a vbac 2nd time round as I had a child with special needs to care for and would have no support in that dh started a new job ( the day after dd2 was born in fact) and most of my family work or live a distance away. HOWEVER when it came down to it - in order to best care for dd1 - I had a c-section. I recovered very quickly and well. We were able to organise for my SIL to come to where we lived with her two little ones to care for dd1 the week I was in hospital. After that - I was on my own during the day.

I do not feel I have missed out on 'giving birth' to my two children and for me - each birth ( despite no1 being an emergency) was very calm and fine. I feel no less a mother and woman because I have never been through a vaginal birth.

I think you need to do lots of reading and talking with your health care professionals and decide what is best for you.

gosh only 5 weeks to go ! !

aliceT - definitely read as much as you can , about labour and delivery, if you can ,see if you can go through your notes from your last birth to see why things happened they way they did, that can help you make a decision..

good VBAC and c,s website

I wouldn't say I'm pro elective. More like pro choice.

the way I saw it with my vbac, I had nothing to lose by trying cos the doctors wouldn't have let me labour overlong with no result. but I didn't enjoy my c section at all or recover quickly afterwards so I was quite motivated to try for a vbac. my vbac was a much better experience and recovery quicker by weeks.

I have learned from bitter experience that a high-risk ( after previous CS or for multiple birth) hospital vaginal delivery is only as good as the staff on duty to attend it. I imagine that the same can be said for a VBAC home-birth. A maternity unit on a week-end or at night can be a dangerous place, short-staffed and populated by incompetent agency-staff as was true in our case.

One of my healthy, full-term twin boys was still-born two years ago after a bungled labour and eventual emergency CS.

I became pregnant again and a VBAC was suggested by my consultant. I replied that if I could be sure that I would go through labour and delivery at a time when there were enough competent staff around to monitor me properly and take action if needed I would try but I was terrified of ending up back at the hospital at 4am with another team from hell who might kill another of my children through their actions.

I opted for a planned 'surgical removal' and my son was born alive and kicking nearly 4 months ago.

I realise that mine is an extreme case but I, personally, would not take the risk of rupture, given the current state of UK maternity services.

I had a uterine rupture while attempting VBAC after ds2. However there were 2 midwives there, one fully trained, the other in training. I described the sort of pain that that lady in in eleusis' link described, the MW's gave each other a "look" and within a few minutes the obstretician was there and I was being whisked away for a CS. It hadn't torn badly, just meconium seeping out.
Now I think this could have been avoided if my VBAC had been allowed to progress naturally. I had a wire leading out of my fanjo to a monitoring device which made walking about difficult. This, I'm sure, hindered my cervix from dilating. When it failed to dilate, I was given synotocin, which is not recommended for VBAC. In fact I knew it was not recommended and should have said something myself at the time, just assumed the doctor in question knew what she was doing.
In the end I had my CS, was stitched up neatly and went on to have ds3 by CS.
If I were alicet I would go for VBAC because it seems clear to me that her cervix is well capable of dilating. What is different about me is that ds1 was born by elective CS ( breech) and my cervix had never dilated. It seems to me that alicet has an extremely good chance of pushing one out herself.
Also, all going well, a vaginal birth is better for the baby. Fluid gets squeezed out of their lungs that can otherwise lead to problems.

I must admit, though I'm not pregnant , if I ever were to have another one, I'd definitely have an elective. I had an emergency c-section 1st time and the relief I felt when they told me they were finally going to give me a section to get him out..! There's no way I'd put myself and dp through that again, so I'd definitely have an elective and breathe a big sigh of relief that I knew what was going to happen!

Hi Bubble

Hello, Mrs New Name.

I was hoping you'd know who I was. Are you ever coming to a West London meet-up?!?!?!?

thank you eluesis

Bubble99- i am indeed very sorry to hear of the stillbirth of your son.

i would like to reiterate my description of c.s as having my baby surgically removed, was how i personally felt after my c.s...not that that how it is for everyone.

chipmonkey...synto is usually not given after a c.s as overstimulation of the uterus can cause rupture..i am glad you had a positive outcome

off to bed now, alicet- all the best making your decision

Sorry Bubble, didn't realise I'd crossed posts with you. TBH I do feel that the competence of the MW's attending my VBAC played a huge part in making sure the rupture wasn't a total disaster. I'm in Ireland and private healthcare is much more widely used than in the UK. I wouldn't use the public healthcare system to give birth here unless I was in extremely poor financial circumstances. I was stung too much on ds1's CS, which was badly done by someone inexperienced. Perhaps another reason why that same scar ruptured?