VBAC fact/fiction?

[Ralphstar]

I am pregnant with my second child - it took 3.5 years to get here so we are currently walking on air! My son is 6 and was born via an emergency c-section which was due to a variety of factors but ultimately I was induced at 41+5 days, my contractions were strong but I never dilated beyond 4cm and I went in to theatre as soon as my son's heart rate dropped.

We would really love to try for a VBAC this time around. I'm not getting hung up on it because I went so overdue with my son that I would suspect I would go late again and if I did, I know I will be booked in for a c-section before 41 weeks which is fine.

BUT let's say I go into labour naturally and labour progresses relatively well and we arrive at hospital, does anyone know the restrictions placed on us at that point? We met with our midwife again last week who said:

• absolutely no water birth - no discussion (gutted!)
• constant fetal monitoring from the moment labour begins
• I will have to lay on the bed - on my back - for the entirety of the labour because that is all the machine monitoring wire will allow
• even if we get blue tooth fetal monitoring machine, they advise laying down

This seems so counter intuitive to me - when I explained that labouring was far more comfortable for me in a standing/all fours position, I was met with comments that I wanted to endanger my babies life.

Can anyone confirm that the advice we were given is correct? Has anyone had a different/same experience during their VBAC?
Thank you so much lovely mumsnetters!

Hi, I had an emergency section with my son after a prolonged labour and lack of progression. So not dissimilar to you although I was only a couple of days past due date.

2nd pregnancy, after ivf and at age 41, I was told I could basically have whatever I liked. Water birth, normal labour etc. It ended with another emergency section unfortunately but that's another story! But the message I got was that there was nothing about my health that would prevent a normal vbac. Do you have any health conditions or known risk factors that might be influencing their approach?

The reasons for my c-section were different from yours (severe foetal distress, so a 'baby-related' reason rather than a 'mum-related' one) and the advice I had was that I was at no greater risk of having my labour end in c-section second time around than a woman having a first baby.

I was told by the local hospital that I would need consultant agreement for a water birth. I am not sure how easy this would have been to get as I opted for midwife-led care with the One to One service. I was also advised that I would 'have to have' foetal monitoring, although I'm pretty sure they couldn't force you to have it. I think I have seen somewhere a statement that there is no evidence to show that continuous foetal monitoring offers improved outcomes as compared with intermittent monitoring - there may be information about this on the internet somewhere (with details of where this info has come from) if you wanted to have a discussion with your hospital about it.
I would suggest you meet with the consultant rather than the midwife, and make a nuisance of yourself. I think you are best to explore your birth preferences well in advance of actually going into labour, and get it on your notes what you want and what the consultant agrees with.
FWIW I had two very straightforward home births after my crash section, one of them a water birth - however your reasons for having a section do, I think, have an influence on your chances of having a vaginal delivery subsequently. My understanding is that 'mum-related' reasons are more likely to recur than 'baby-related' reasons.

In general, the interventions that you are being told are 'compulsory' by your midwife are things that you would have to consent to. They can't force you to have them, although of course once you're in labour it is much harder to advocate for yourself and refuse (such that they take any bloody notice).

I had a vbac after an emergency c-section, I did have to be monitored constantly through the labour, and went to hospital earlier than if I had been a non-vbac, but I moved around and wasn't told to labour in a certain position. What no one told me until I was pushing, was that I was only allowed to push for an hour due to the risk of my scar rupturing. I did end up pushing for an hour, and then had a episiotomy and forceps to get DS out.

Good luck with your pregnancy.

Yes, good point about the only pushing for an hour issue. My midwife told me during DD2's birth (my first VBAC) that I had been pushing for 45 minutes and I had to get the baby out in the next 10 mins or else we would need to transfer to hospital. I stood up and she shot out (thankfully).

first birth was emsc due to fetal distress. had a vbac 3 weeks ago. did have to have continous monitoring and laboured in triage (labour was really quick) so wireless ctg not available. was able to stand up though through each contraction. laboured really quickly and rushed to delivery suite when baby became distressed. pushed out in 10 mins and had go have ventouse due to emergency nature of delivery so all pushing done on back but was so quick I didn't care.

was this conversation with your community midwife or the specialist birth options midwife?

Congratulations on your pregnancy!

If I were you I would try and discuss the issue with another midwife, time is on your side. I am sure you will find another who would be more supportive of a VBAC.

I had an EMCS with my first. I was induced at 40+5 with no sign of labour and she got distressed before the contractions even started and I was rushed to theatre.

DD2 arrived spontaneously by VBAC 2 weeks early which I never expected given that the first showed no signs of wanting to arrive. Both were IVF babies so the pregnancies were correctly dated. So things can be very different second time round!

I had to have a continuous CTG but once the contractions ramped up the midwife and Dr were happy for me to labour standing next to the bed. I had maternity leggings on which were useful to keep the belts in place. At one point I decided I'd had enough of the CTG and insisted they took it off. Turns out I was fully dilated and the midwife wanted me back on the bed. I got on all 4s and DD2 was born in 5 minutes.

I didn't have any pain relief at all and know that I managed without purely because I'd had an active labour which helped me deal with the pain and also sped things up.

Like you I couldn't contemplate trying to give birth flat on my back as I'm convinced it lowers the chance of a successful natural delivery.

I don't see how you would be endangering the baby like this - the point of the CTG is to ensure the baby's safety.

Good luck! I really hope you get the delivery you're hoping for as I know how strong the wish for a successful VBAC can be!