VBAC vs ELCS

[archersfan22]

Background:
DC1 - spontaneous labour at 41 weeks, as soon as I got to hospital they were concerned about baby's heart rate, so I had to lie completely still on my back otherwise the heart rate monitor came off. Had an epidural as lying flat v uncomfortable (also so they could easily do section if necessary). Although when the anaesthetist came to do the epidural it turned out they hadn't shown me how to use the gas and air properly... All progressed ok under epidural for some hours, ended up fully dilated, but then baby's heart rate dropped so alarm bells, brief failed attempt at forceps and EMCS (Category 1).

I have no underlying health problems, was well during the pregnancy and recovered well from CS so as far as I know no medical reason why I shouldn't try VBAC. Midwife is supportive of either choice. I can't go to a different hospital this time as I'm in a rural area (though am sorely tempted to go and stay with a relative for the few weeks in question...).

I'm only in first trimester so plenty of time to think about it (and in some ways am sort of hoping it might be breech or something so I have to have a section anyway and don't have to decide).

My thoughts were:

• I worry about failed VBAC and EMCS anyway, which is the worst of both worlds.
• Planned CS would mean I can organise relatives to help (family lives a long way away). VBAC means I don't know when it will happen so family help will be harder to plan.
• Planned CS will be at 39 weeks - I suspect due date will be on August/September boundary so although this is obviously less important than health considerations from a school year point of view a September birthday is better.

-Successful VBAC would mean I could go home asap after birth - last time I really really struggled with staying on the postnatal ward - breastfeeding support was useless and it was really noisy all day and night so I got no sleep at all. Also baby was born at midnight so husband was sent away as soon as I got back to ward and I was on my own until 11am the next day. -I worry about recovery from a second CS in general and especially with a toddler.

I know you can't decide for me, but any other factors that you think I should consider?

I'm 38+1 and still.undecided. The last consultant I spoke to said not to think about recovery, family etc, but what is best for getting this baby out. So far the plan is, wait and see, if no movement by dd I can have a sweep or book elcs. I had elcs last time due to breech so no labour, which I think decreases chances of successful vbac, as they won't let me go to long before doing cs anyway.

I was really worried about making the 'wrong' decision, but the fact is you will never know how it will pan out. I'm sure this baby is going to be big, ds was 9lb 1, and I think.ill end up with cs.

My bp is high so it may be taken out of my hands, kind of wish someone would decide for me!

I had a horrible time with dd and had a EMCS.

This time round i ve refused a VBAC. I just dont want to take the risk.

Just posted on similar thread. I had an ELCS after a bad vaginal birth. It was great - calm, not painful/stressful and I didn't find the recovery any worse than the vaginal delivery.

Two things to consider though-

• not being able to drive as you live in a rural area, can you manage this?
• could you book a private room for after the delivery? Avoiding the noisy postnatal ward might make all the difference and your DH could stay over?

Thank you :) yes I have heard that ELCS can be a very different experience to EMCS.
Not driving wouldn't be too bad as there are buses, playpark etc within walking distance. Last time I was so exhausted I wasn't safe to drive anyway even after my 6 weeks were up, so I would be avoiding driving for a while either way. (I'm not the world's most confident driver at the best of times).
I have wondered about a private room, I will enquire about this as I think that would take a lot of the stress out of the postnatal bit (even if husband couldn't stay).

I had an emcs with dd1. For dd2 I had a sextion booked at 41 weeks and would have tried for a natural delivery if I naturally went into labour before then. In the end I had the planned section.

Recovery was a billion times easier. Like you- I had gotten to the pushing end part of labour with dd1 and it had been a long drawn out induction over two days. So the planned section with DD2 was a breeze in comparison.

As a second time mother, I was allowed home the next day- only one night in. I know of others in other health boards who have been allowed the same. (And unlike the first time I was actually well enough to leave quickly).

Weigh up the risks and decide what suits you- but don't factor in the recovery and hospital stay too much as it will be better this time I am sure. Good luck.