VBAC after two C Sections - Is it possible

[livelifefortoday38]

I have two gorgeous little boys Jack & George aged one and two years. Jack was breach and they tried to turn him, I lost a lot of blood and ended up having an emergency Section at 37wks. With George, I had problems feeling him as the placenta was at the front and subsequently I had a lot of monitoring and they kept having issues finding his basal heart rate and I had a CSection, even though my preference was to have him naturally. However, heathy baby was the priority of course!
So now baby No 3 is on it's way..... What shall I do??? Is it possible to have a natural birth after two C-SECTIONS? Any feedback, experiences or advise would be greatly appreciated. Many thanks in advance ladies! xxx

Your consultant will give you all the risks. They can't force you to do something you don't want to do.

I've no experience but I would have thought it would be risky, especially as your children are so young so your scar will be quite new x

I have two small DC and had two csections. I feel I would go for a section if I had another as I would feel it would be too risky with all the scar tissue. But best to seek medical advice.

Thank you ladies xx

Are you on Facebook? There is a group called 'vbac support group uk' which I would highly recommend joining. There are many knowledgable ladies on there who can help you navigate the vbac process. It is surprisingly common but the support for it varies hugely depending upon your health trust.

As previously stated, your body, your decision. Plenty of people do go on to have a vbac after 2 c sections. If you join that group and put your post on there people will come along and give you plenty of research based stats to help you make up your mind with regards to risk.

I had a vbac (but after 1 c section) recently and it was utterly empowering. However, I did come up against some challenges from the medics along the way.

Best of luck!

Thank you everyone xx

Please talk to your doctor rather than a social media group. Your sections are very recent and very close together - both factors that might make your individual case very different from someone else on an Internet group.

Absolutely, I will be seeking professional medical advice - it's always interesting to hear other people's experiences in any case

I am not in any way suggesting that the OP doesn't seek medical opinion. Apologies if it came across that way, of course every case is different.
To directly answer your question, it is perfectly possible to have a vbac after 2 c sections and plenty of wine do have them. However, depending on what trust you are under and which consultant you are under you will be told different things about the risks and what you are 'allowed'. Vbac is relatively new phenomenon, the saying 'once a c section always a c section' was much more common. That is changing now, but be prepared that if you want a vba2c you may come up against some challenges. And that's where the Facebook support group I have recommended was invaluable to me. It wasn't a load of women on social media, it was very knowledgable people with firsthand experience of vbac who were tremendously helpful.

Women not wine

I have had 3 c-sec also I work in maternity. Honestly have an ELCS don't take risks! In my trust we wouldn't recommend a VBAC are you would highly likely end up emcs. Just make it easy on yourself plan a lovely ELCS. x

I went through this recently here in the US. My obn group are quite anti CS. They did everything they could to try and help me deliver the first two naturally, and they let me go 11 days over my due date with my 2nd. With my third they told me that with two prior CS's within the past 5 years they did not recommend I have a VBAC. They said if more than 5 years since my last CS they might consider it if scans of the scar showed no signs of 'distress'. I had the CS for my third and hated it but got a lovely little girl so very much worth it.

Please have a read of this document from the RCOG

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

And this one from AIMS

www.aims.org.uk/Journal/Vol14No1/VBACWhoseTerms.htm

Excellent stats in this one

www.vbac.com/what-is-a-uterine-rupture-and-how-often-does-it-occur/

The main risk with vbac is scar rupture. You need to speak to a health professional about what your specific risk is. In a woman having a vbac after one c section the risk is around 0.5%. I believe it is marginally higher than that for a vba2c but still very very tiny.

C section is not inevitable. Obviously there are many people for whom c section is a good option. There are those who have that itch that needs scratching about having a vaginal delivery. If that is you then I encourage you to explore the option of vbac. It is perfectly possible and does happen pretty regularly! But you will need to research it, look at the stats and work with your doctor and midwife to assess your individual risks and decide if they are happy with them.

The wine/women typo made me laugh.

A 0.5% chance of rupture is not tiny, that's actually a huge risk. One in two hundred. You could never get insurance for an event that had a 1/200 chance of happening. It may sound like a small number but it isn't at all, not for something as significant as rupture which risks the lives of both mother and baby as well as her future fertility.

We are generally rubbish at assessing risk unless specially trained so 0.5% sounds minuscule to an untrained ear. And that is the risk for VBA1C - VBA2 recent Cs would be even more.

For this reason, OP, I am so keen on advising people always to discuss with doctors. By all means, this may be a risk you are willing to take and that is entirely your choice. But that choice should be fully informed and with full understanding that 0.5% is not meaninglessly tiny.

I agree with you op that 0.5% is still a risk, but when you start exploring the risks of say, shoulder distocia or a post partum bleed they are higher and yet most people don't even know or think about them when giving birth, it doesn't seem so huge. And then you start looking at the stats for c section complications and if you want to compare, the risk of a serious complication for a c section is around 10%. So, for me personally, when I was making that decision, it put the 0.5% risk of scar rupture into a perspective that made it acceptable for me to accept that risk over another c section. Yes, if you are that one person and it happens to you then your risk has gone to 100% but it was a risk I was willing to take. i think part of the issue around vbac is that women often hear the stats and don't explore further. OP I found doing as much reading and research as possible really helpful in assessing and contextualising the risk and exploring what you are willing to accept. All birth carries risk. You don't need a PhD to understand it.

Sycamore54321 You and I are on the same page about taking medical advice on what the OPs personal risk is with a vba2c. Her original question was whether it is possible and I am just trying to point out that it is entirely possible and there are an increasing number of people who have achieved it.

But not all risks are equal. Risks of a shoulder dystocia from c-section are absolutely nil. And not all complications are equal - the consequence of rupture is not in the same category as wound infection for example but both are classed as 'serious complications'. Just because some risks remain and may be greater is no reason to promote a risky form of birth and add additional risks. I'm not saying don't VBAC, I am saying that it is wrong to dismiss the very real risks as a fatalistic just-as-good-or-bad-as-everything-else when making that decision.

And of course very many women have successful VBAC outcomes - if VBAC automatically equalled serious injury or death, then the decision would be much easier. But is 'very many' high enough when talking about the life and health of a baby and the life and fertility of a mother? For me it isn't, for others it may be. But that decision should be taken with a clear understanding of the whole profile of risks of both options, not by dismissing or downplaying one aspect of risk.

When it comes to risk and putting it into perspective, I was told cilest is 99.5% effective at preventing pregnancy. Well that didn't work and we have DD1. I was told mirena was 99.7% effective. Well that didn't work and we have DS. Thank goodness I didn't have any issues from the thing. I was told condoms, abstinence during peak fertility and emergency contraception if in any doubt of condom not working would be 99.9%. Well that didn't work and we have DD2.

There were lesser chances of me getting pregnant and it happened 3 times. I have a responsibility to make decisions which are best for my family, not just for me. With DD2 I really wanted a VBAC but I wasn't willing to put my wants before my family having to go through complications from a VBAC going wrong. When an obn says they don't recommend a VBAC based on your medical history listen to them. They tend to know what they are talking about.

I had 2 vbacs. First one was a nightmare with back to back baby and failure to progress - consultant suggested emcs but they managed to wrench him out causing all sorts of unholy undercarriage issues (he was fine, I was not). Second vbac (as apparently no clinical reason for cs) the baby was brain damaged due to hypoxia (cord likely trapped and squeezed somewhere during birth) and she has cerebral palsy as a result. Honestly, I understand the urge towards natural birth, but there are times when it just doesn't make sense. Can you unpick why you want a vbac?

OP this isn't medial advice but I'm in a similar situation in that I feel even if I start naturally I will be labelled "c section" the second I walk in the maternity ward and not given much opportunity to try but instead put on a conveyor belt towards c section.

Mine was emcs so I didn't really agree to it as such so I know how easily they will ignore your wishes even if you're strong

With that in mind, planning a section and regaining control is an attractive option. But it's soooo hard

Both VBAC and CS carry risks and I think you have to weigh them up and choose your poison!

Regarding the risk of uterine rupture - the statistics I've seen don't separate out how the labour was conducted. I live in Germany and my local hospital will not usually induce or let you have an epidural during a VBAC as both increase the risk of uterine rupture. Yet the statistics on do not break this down.

I recently had a VBAC after an EMCS and had a really easy delivery in 3.5 hours. I genuinely feel the experience has healed a lot of the issues I had after the shock of the EMCS. I appreciate if could have turned out differently but I was keen to give it a go after weighing up all the evidence and discussing it with my doctors.

For what it's worth my hospital would support a VBA2C but the prospects of success are lower than a VBAC. As others have pointed out, if really needs to be discussed with your own doctors.

Whatever you decide I wish you all the best!

I had 2 c-sections (one for breech baby, one for failure to progress) and a vaginal birth for my third DC.
I was in a diffrent position to you as I didn't want a vaginal birth third time round, but DS2 was premature and in a hurry. This probably affected how I saw the birth too.
I do remember a doctor rushing in straight after he was born and asking me if I had any shoulder pain. This is a sign of a ruptured scar and I did feel that the question came a bit late in the day!

Hi just thought I'd share my story, my dd is 8 weeks old tomorrow. My 3rd birth, all through pregnancy I had the support of midwives and consultants for a vba2c. Had a scan to check my scar etc, all was fine.

Went into labour, all of a sudden the alarms went off and I was rushed to theatre, after i was told that my uterus had ruptured, such a rush to get her out they actually cut her head. But I'm so so lucky that we are thankfully here and fine. I'm not saying this to put you off having a natural birth, but just to offer another view on it. I so wanted a natural birth, my other 2 sections were emergency ones too, and I know I'll ever be able to experience giving birth, but I have 3 amazing beautiful children and that tops my feelings of wanting a natural birth.

Good luck with your decision x

Ladies thank you so much for all of this information and your views and experiences. I'm sorry I haven't responded earlier but I've been quite poorly. Thanks again everyone xx