VBAC after breech ELCS

[newbian]

I'm 12 weeks pregnant with DC2. DD was born by planned c-section due to breech presentation. I know it's early but I'm really torn about whether I should consider VBAC or just go with ELCS. In theory as my first baby was breech I am a good VBAC candidate. However I have a narrow pelvis and fibroids. My mother also has both and her second birth was an EMCS after failed VBAC.

As I never went into labor with DD I feel I'd really need to commit to preparing for labor with childbirth classes and possibly a doula because the odds aren't in my favor for a successful one naturally. Which means I need to start thinking about it soonish.

I have the niggling feeling that I'm taking the "easy way out" if I just go for ELCS. At the same time with a toddler at home I feel my recovery from VBAC would be faster and make my life a lot easier.

Anyone who's made this decision? Love to hear your experiences. Thanks.

(Note: I'm not in the UK so NHS protocol etc not relevant for me)

My first was an EMCS after a failed induction - 5 days of interventions were insufficient to make my body labour. I also have a narrow cervix so don't know what part this played in it all.

DC2 is due in 2 months and, given that I couldn't labour last time, I've decided on an ELCS even though I'll have a toddler at home.

I don't consider it an easy option - birth is not easy whichever method you use - it affects you physically and emotionally differently each time.

There are definitely pros and cons to each - the idea of being up and about quickly if a VBAC works well is enticing. In my case the controlled risks of an ELCS outweigh this, but that's based on the personal experience of having attempted labour once before.

Whichever option you choose, you need to be comfortable with it because you'll be doing the work and the recovery! Perhaps factor in the support you'll have access to post-birth. It might also help to write a birth scenario for a VBAC so you can get a sense for where your boundaries are.

There should be no wrong answer here - I hope all goes well

Hi newbian,

Recovery after a vaginal delivery is not always faster than after a c-section. If you have a spontaneous birth without serious injury yes but otherwise it might take longer.
This article highlights this issue. Even though it's not a good birth and I thought I'd draw your attention to it so as to balance the arguments
www.google.co.uk/amp/s/amp.theguardian.com/lifeandstyle/2017/may/07/i-cant-forget-the-horror-of-my-sons-birth-post-traumatic-stress-disorder-childbirth

I don't believe ELCS is an easy option. That's certainly not what my friends who had one said. But it's controlled and the risks are different to vaginal delivery. I think you need to ask what the risks are for you with each option and they decide what you're more comfortable with.
Good luck 🍀

*then decide

DD was EMCS as she was breech. DS was VBAC. To be honest the VBAC was not the wonderful experience that some people made it out to be - it bloody hurt and only became in any way bearable after the epidural. DS was reasonably straightforward - got a tiny bit stuck and had to be freed up a bit with forceps but they were removed and he made his own way out in due course. A couple of internal stitches. It took about a fortnight to be reliably fecally continent after the VBAC which no one warned me about. Recovery from section was very straightforward.

Main benefit of VBAC was no stomach wound so no issues with lifting older child.

Meant to ask I lived and breathed hypnobirthing during both my pregnancies and it made not a jot of difference to either of my two labours.

I like your straightforwardness VeryPunny and no, faecal incontinence after childbirth is never mentioned

Thanks ladies really useful feedback.

My recovery after DD's ELCS was OK, my friends who did vaginal births seemed to snap back more quickly but as you point out of course mixed experiences as some had episiotomies etc. And yes I'm definitely concerned that trying for VBAC and ending up with EMCS is a worse outcome than just planning ELCS.

It is hard to read stories of women's vaginal births being "empowering" and "magical" and then struggle with whether to try it for myself or not.

I'll have help from my mother post-birth (she will come stay for about a month) so that should make dealing with a 2 year old a bit better.

I had 2x VBACs after an ELCS due to Breech presentation. I guess I was lucky as apart from a couple of stitches I recovered much more quickly than after a c-section. With Dd2 i went in to hospotal at 8am and was back home at 5pm! It was important for me to experience a natural birth so I am glad I made that decision. I suppose if I had run into difficulties then I would probably have regreated not going for another ELCS. You just need to work out what you feel would be right for you.

I haven't had a CS but will probably for my second. Recovery from the vaginal delivery of my DD is slow and I will probably not recover in a lot of ways. I had a straight forward waterbirth and tore some of my pelvic floor off my pubic bone. I couldn't sit without significant pain for 3 weeks. Couldn't walk for 5 days after labour. I have 2 prolapsed organs and now use a pessary to keep my organs in place and to allow me to feel comfortable on a day to day basis. I limit how much I can pick up my DD and don't carry anything heavier than she is (she's 6 months old). As soon as she starts walking I don't think I will pick her up again unless I absolutely have to. I need to make many adjustments to my daily life to accommodate my injury.

This sort of injury is really common- 1 in 3 women who give birth vaginally will tear a hole in their pelvic floor. The numbers go up to 1 in 2 for forceps delivery, and with this baby being your first vaginal delivery you have a higher chance of needing forceps. If you google Prof Peter Dietz he has done a lot of research on this.

OMG smellsofelderberries I'm so sorry to hear about your experience. Hope you are recovering and yes sounds like an ELCS will be the right choice for you for next time.

I'm in a similar boat, ds was planned elcs due to being breech. Currently 18 weeks with my second and flip flopping daily on what to do! Things are complicated by ds being big (can increase risk of rupture so I'll want to know how big this one is going to be), and because ds had breathing difficulties after the cs and ended up in scbu for a week. So I'm a little wary of elcs though I know the chances of it happening again are small.

Problem is I have no one who can come and help if I do have a cs as my mum has arthritis and can't really lift my ds or get up and down stairs with him. Dh has started a new job so won't get paternal leave but will try to take at least a week's holiday. But I might end up with an emcs even if I do try vbac. So the quicker recovery issue isn't exactly guaranteed! Especially not with some of the things that can go wrong with a normal vb anyway.

I genuinely have no idea and spend half the time hoping this one will be breech again so at least I don't have to decide!

Good luck. I think it's such a tough decision and so many factors to take in.

TippetyTapWriter totally relate, DH and I talked about it last night. His attitude is, if ELCS is safer and more straightforward just go for that, as my mother will be on hand to help me afterwards during recovery and can entertain DD.

I'm also kind of hoping to end up with a second breech so I don't have to make the choice either...

Hi, I've had both! First was breech so elcs. Was gutted, wanted vbac. 2nd baby was normal presentation so opted for vbac. Had to be induced and mobility was restricted to the bed as baby was being monitored for distress as previously had an elcs (this was torture as I really wanted to move about). Once labour was in full swing I was wishing I had of had an elcs and begged for an epidural!! (induction makes labour more intense oh and btw I couldn't eat because of the risk of possibly needing an emergency cs!). I tore, forceps were needed, blood everywhere, baby in distress, total nightmare!

I was so glad baby 3 was breech .
Now, when I look back I'm actually glad I had the vaginal experience but it's taken me 6years to conclude that!

It's a difficult decision. Good luck with whatever you decide to do!

Hi there,

My first was an ELSC due to baby being breach. I was advised to have a further ELSC with my second (only because I'd had a previous CS) and practically had to beg for the VBAC. I was absolutely obsessed with doing it 'naturally'.

When I went in to labour I was very lucky to have a wonderful midwife who was 100% supportive of the VBAC (I was begging for the section by about 6cm).. and I did manage it (with a lot of gas and air and some pethidine).

I'm glad I did it .. but.. I found recovery after the VBAC actually tougher than the recovery from the CS.. the soreness and stitches and the agony of going for a wee.. really ruined my first few days.

Honestly - there was no difference in bonding...feeding etc.

Like blue diamond.. I'm glad I did it..(there's a sense of achievement) but if I were to have a 3rd.. I'd almost certainly opt for a CS..

I hope that helps - it's such a personal decision.. if you go for the VBAC definitely make sure you have someone with you who is experienced in helping ladies through them.. that made the difference for me.

Hi OP

It's a really personal & difficult decision to make- there are no guarantees whichever choice you make.

I had an ELCS for my first baby- but this was for maternal request- although baby was in funny positions until quite late on!

Last summer I was pregnant with no.2 and at the booking appointment I was so surprised when the midwife asked me whether I wanted another ELCS & if I did I could probably have one.

We discussed the VBAC clinic etc and I felt it was really balanced- think I was expecting a fight on my hands to have another CS.

Personally I would've opted for another ELCS (didn't get the chance as shortly after, the dating scan showed a MMC & I've not been able to fall pregnant since)

Read as much information as you can, talk to as many women as well (you're doing that now on here) but at the end of the day it's what suits you and your circumstances.

If you are really keen to experience a VB then it's maybe worth pursuing the VBAC route. at least you have time to think it all through.

Good luck

Pinguina

I read that Guardian article the other day and it made me

Definitely worth bearing in mind that a VBAC (or a vaginal birth in general) will not necessarily guarantee a faster recover time or no birth injuries

If it helps, some of us who've had VBs didn't find it at all empowering or magical. I've done both and I don't give a fuck that a baby exited my vagina. It's possible that you will be the same. No mode of birth is intrisincally positive. There are as many different viewpoints as there are mothers.

By all means go for a VB attempt if that's what you decide is optimum, having weighed everything up. I just wouldn't do it on the basis that you worry you'd be missing out, though I do see why people might feel that because there's quite a powerful narrative out there.