How does anyone ever achieve a VBAC?

[Hothead]

Moved to Scotland nearly 2 months ago. Had my first visit to my now local hospital on Wednesday last week at 29 weeks - had the usual bloods,urine check, BP etc. before talking with the consultant about my birth options.
I had a Caesarean nearly 2 years ago following a failed induction after my waters broke and nothing happened. I had a bloody awful time of it, labouring for over 24 hours before all the instruments came out and then they gave up and I was sent to theatre.......anyway, c-section was down to 'failure to progress'. I have thought this through long and hard and would like to try for a VBAC this time round, just so that I am not walking around like an invalid for weeks with my 2 year old daughter expecting her normal Mummy to be around. However, having spoken to the consultant I now feel like it is so unlikely that I might as well plan for a c-section right now.
Apparently the hospital has a 60% success rate with VBACs (which ofcourse means 40% fail) they will not induce you (thank god) but they will not let you go much over your due date - which I think means they might give you a day or so, but nothing more, and if you are not dilating at a rate of 1cm per hour then off to theatre you go. So given that the odds are stacked against you right from the start, how on earth does anyone manage a VBAC?
I know what to expect from a c-section, and I know it is not the end of the world, but I must admit that there is a small part of me that wants a VBAC just to prove to myself that I can do it - truth be told I felt a slight sense of failure last time - like I just couldn't finish the job, but now I just feel like I am unlikely to even get the chance, which seems so unfair. I am reading Ina May-Gaskin, and Sheila Kitzinger in the hope that they can 'help' me achieve the successful VBAC, but now I am wondering whether it's all been a waste of money, and no amount of reading about visualising, positions and ripening will help overcome the hospital policies.

Thoughts please?

hello Hothead, sorry to hear you had a rough time of it with your first baby. Your experience sounds similar to mine with DD1 and I know exactly what you mean about the slight sense of failure.

I have posted before about this, but DD2 came so fast that she was born before they could get me to theatre, so that's how I got my VBAC. Then, because of that, when I had DS they let the labour go on longer, although it was monitored, and he was another VBAC.

Hope someone else has some useful advice for you and all the best.

I too had c-section 6 months ago after being induced and nothing happening. I know what you mean about a sense of failure, it was all a very odd and dreadful experience and I really wasn't expecting it. However, after some thought I really do believe that I would opt for a c-section next time if I possibly could, I admit it would be very hard indeed with a toddler but after reading various reseach studies it seems to be the safest option. You're no failure!!! Be proud of what you achieved after major abdominal surgery looking after your baby.

why won't they induce you? is there a medical reason why previous c-sections mean no inmduction?

tbh, they can't force you to have a caesarean. if you want a vbac then push for it.

I had a c-sec last year instead of the home birth I really wanted.

Next time I plan to have an independant mw who won't be pressuring me to dialate a cm every hour!! If the whole independant thing does not come off (probably due to the money) I plan to have my sister with me (she's very informed about labour and childbirth)and I will be more forthright with the mw's and ob's (as I am sure they will feel they will need to stick their nose in even if it is not needed!)

In your position, I would research VBAC as much as I could, and stand up for myself instead of letting the bullying 'professionals' decide what is going to happen.

Good luck!!

ps and remember hospital policies are not the law - you still have the right to say no.

I had a VBAC with dd after a section with ds ( same reasons as you). I made my feelings very clear to the consultant and to my m/w again and again.

You do have to do the broken record bit, but it's worth it.

I had dd in the Princess Royal in Glasgow and the m/ws I had were great ( I had 3 shifts They were real bossy wummin and took no nonsense from the consultants. Dd was born while I was being prepped for a section - the consultants had a bet going - I could hear them , but the m/w were fighting my corner and insisted I had a real go at pushing. And dd obliged It was fab and the difference in recovery couldn't have been more marked - I felt like I could actually enjoy my baby rather than constantly ring the bell to ask someone to lift her for me!

The consultant will have to tell you all the scare stories so that you can be informed, but the likelihood of scar rupturing etc is sooooo miniscule that you musn't worry. The national success rate for VBACs is more like 70%.

I got a sweep when I was 4 days overdue which worked for me.

I was monitored a lot during labour. I do wish I'd been more able to get up and be more mobile, but some hospitals are quite insistent on hooking you up to every machine on the planet for a VBAC. You can move around, but I just kind of ended up on the bed and stayed there which probably prolonged things a lot.

Be stubborn and google VBAC - there are loads of encouraging sites out there.

My hospital had similar policies, and I had a VBAC last July.

My waters broke, and they wanted to induce me, but I held out for 96 hours to give my body a chance to do it by itself. No joy, so I went for the induction. They started pressuring me to have a c/s after 4 hours. After 36 hours of induction, I had only got to 4cm. DS2 was born naturally 3 hours later with no intervention other than an episiotomy as he was getting distressed.

Know what you want, and stick to your guns if you really want a VBAC. If you're not that bothered either way, then you might as well try, in case you have an easy VBAC - they do happen Good luck

What does your midwife say? Unfortunately it's fairly common for a consultant to quote a load of statistics at you, which are tailored to suit his argument. I had a similar first labour and outcome to yours and achieved a successful vbac 20 months later. I researched it all very carefully, discussed in great depth with dh what I would and would not accept on the day and found an excellent antenatal midwife who counselled me beforehand. It meant quite a bit of saying no and standing my ground on the day, but I did it.

Do you have to go to this particular hospital? Are there others in the area whose protocols may seem more flexible? I can't bear this language of "allowing" women to labour for x hours or dilate 1cm every x hours - it sucks and frankly, sets you up for failure.

If it's what you want you can do it. Get yourself informed and shop around a bit. Good luck

Hothead, they can't give you a CS without your consent. They can't induce you without your consent. So just keep saying no to everything. Read as much as you can, make informed decisions and then stick to your guns. Remember it's your choice and you don't need to agree to anything - they can only suggest things but they can't force you to do them. For instance, you don't need to agree to continuous monitoring. Do some reading and make a good detailed birth plan. If you can, get a doula to support you and do all the fighting while you concentrate on labour. You could even consider a homebirth! A VBAC is still statistically safer for mother and baby than a CS.

Hairymclary - you asked about inductions after CS. They shouldn't induce you if you have a previous CS because it increases the risk of uterine rupture significantly. Still in many hospitals they fail to tell women about this. You should be given the facts and then you can make a decision as to whether you want to be induced or not. But being over 40 weeks is not a valid reason to be induced. A term pregnancy, according to WHO, is between 37-42 weeks, so you're not overdue until you're over 42 weeks. And if you're overdue you can still ask for a scan to check fluid levels and the state of the placenta and if everything seems fine there's no reason why you can't wait until labour starts on its own. I know someone who's just had her vbac baby at 42+5 - all perfectly normal.

Hi Hothead - I went for a VBAC recently, in Glasgow,and would echo what was said further up the thread about intervention - I was told that they'd offer me a sweep at 40+3 if I wanted one, and they were quite happy to leave me to 42 weeks to go into labour naturally. If you want to go for it, I'd insist on this. in my case ds2 came early anyway so wasn't an issue.

I also quite agree with franke re unhelpful comments on how dilated you have to be in x hours - I think that's what did for me in the end - it puts ridiculous pressure on you that you have no control over ).

I would definitely give it a go if I were you, but also wanted to say that it's not that bad if you end up with a CS. Of course it's more difficult with a toddler (my ds1 was 14mo), but it isn't as bad as I was fearing. Would you be able to get some help (paid or otherwise) during the recovery period? I remember from another thread that your family aren't nearby, are they? Did you solve that problem btw? Where are you in Scotland?

Hothead, one way to avoid the X cm by X hours is simply to avoid VEs, then you/they won't know how dilated you are and it won't put any pressure on you. Also if your last CS was for failure to progress then VEs might affect you negatively psychologically if progress is slow. You might be one of those women who take ages to reach the first 4-5 cm and then have their babies in their arms within the next hour!

good VBAC thread

if you search the archives, there are some great VBAC threads,,,

i was given 50 -50 odds, and achieved a VBAC! my first c.s was, same as you, failed indcution / failure to progress

you can refuse constant monitoring, you can refuse VE, you can refuse consent for a section , if you are labouring well, baby is happy but you are simply not dilating at the required level,

being stuck on a bed, strapped to a monitor, lying down is not conducive to a good birth, and you do not have to go along with it, simply becasue it is policy

intermittent monitoring, mobilising, and working with your body will help

there is no medical reason your body cannot dilate and birth this baby, and it sounds like you are doing all the right things to prepare...

i was determined to have my VBAC, and read a lot, like you are doing, and found it sooooo encouraging, and helped me think of my body as normal and able to give birth

it also gave me a greater understanding of why my first labour ended the way it did,so helped get rid of the negative feelings i had regarding that birth..i notice you say you had a slight sense of failure last time... personally, i found that too..well, i went to pieces after my c,s....part of the issue is, the language used, failed induction, failure to progress, which you automatically think mean you have failed,

the way i see it is, i was sat on a bed, with synto drip, ARM, constant monitoring, diamporhine, epidural, did not move for 8 hours, of course my labour did not get going ! and none of that was my fault ! i see that now !

there is a good site here with excellent advice re VBAC and of course, lots of support here...

i would look into having a doula, who can support you at home, keep you confident in what your body is doing,and carry on giving you that support in hospital ... or an independent midwife, if your budget allows....and have a home birth

you sound like you want to go for it, but have been out off by the negativity..

my VBAC went really really well, the hospital encourage me to get off the bed, as i was not dilating , as baby was OP, and once labour go going, it was 3 1/4 hours from 3 cm to holding my baby, so the time limit was not an issue !

HTH! x

Thanks for all your encouraging words - it's what I really wanted to hear. I will certainly do more VBAC research before my next visit to the hospital, and certainly before the 40 week mark looms. Unfortunately I am unlikely to be able to build up any kind of relationship with a midwife before the birth as we are currently renting in Glasgow but hoping to buy a place in Stirling and move in before the birth......so at 34 weeks-ish it'll be a whole new set of midwives and consultants - but you never know Stirling hospital might have a slightly more helpful set of 'policies'. I will look into the independent midwife aspect as I think it would be a great help......just thinking of the purse strings though.

I must start to practice saying no.

Midnightexpress - no not solved the problem of no family nearby - I think we'll just have to put the in-laws on stand-by around the due date, and then just wait and see what happens.....I guess that issue could be solved if I had an independent midwife on-call; wouldn't need my DH with me from the start then.......hmm, still pondering all the scenarios - just hoping to be allowed to get to that!

Hi Hothead,

Just wanted to say hi! I have had a VBAC and I'm SURE you can too! I am in Angus, my son lives with his Dad in Stirling, just over an hour away, If you want any form of Doula support or Birth Choice classes I'm willing to help. Whilst you're still in Glasgow you can access YourbabyyourBody for more info.

Email me if you wish and I can send you a word.doc I have compiled of loads of links relating to VBAC and birth in general. klaw @ macmail . com (no spaces)

Another couple of books you might like to read are Gentle Birth, Gentle Mothering or Birthing from Within . But you can't go wrong with Ina May or Sheila Kitzinger!!

HTHs

Hothead - I haven't read all the replies to your post so forgive me if I am repeating what others have said. I had a vbac with dd on the NHS in 2003 after an emergency c-section for ds1. My c-section was because ds1 got stuck during 2nd stage and was v disappointing as I felt I had laboured well and then fallen at the last hurdle, as it were. I was keen for a vbac and would have tried for one at home except for my own medical history (blood probs years ago so not fully relevant to pregnancy at all) which made the medical folk worry. Anyway, one thing I did that really helped me was to go to see my consultant (I had to ask for an extra appt) WITH MY BIRTH PLAN. It was just a simple document saying that I wanted to be given time to labour, and be allowed to sit on my beloved birth ball with the monitor strapped on my belly so I was upright but still monitored as the hosp wanted. And other stuff like that. Then my consultant wrote all over the birth plan, Yes this is okay, please allow this etc etc, and she also, crucially, wrote that, as long as the baby was not in distress, i was to be allowed an extra hour during 2nd stage to push and not be whisked off as soon as my time was up. The effect of her handwriting on my birth plan when I got to the hosp was magic - even though, as it turned out dd was coming v fast and I didn't need the extra time, it gave me the confidence to ask for what I wanted. Right at the end of 2nd stage, they were worried about the heartbeat and so we ended up deciding to use a v small amount of ventouse which just brought dd out a bit speedier - it was on her head for about 3 minutes and although it was painful for me with no epidural, I didn't mind because she was coming out the right way. It was not a perfect birth (v fast and we took the midwife by surprise so there was a bit of panic re heart rate monitor etc) but it was tremendously satisfying and I'm glad I went for it. Following that, ds2 was born at home with no intervention whatsoever .

I hope you get your vbac and I'm sure if you do some research and go in armed with some facts (I found the internet full of great sites about vbacs) you may be able to persuade your hosp to be little more flexible. And remember, even if you do end up with another c-section, even a partial labour will have given your baby all sorts of good hormones and signals that it's time to be born. Good luck!

Hi again Hothead

After my experience with attempted vbac, I'd definitely look into getting a doula if you can afford it - I really think I could have managed if I'd had someone who knew what was going on once I was away with the fairies and dilating v rapidly.

I have a friend who gave birth to her 2 (not vbac) in Stirling - most recently in Nov, so I'll ask her for any gen on the hospital (is there only one in Stirling do you know?). In the meantime, do come and join us on the 'Bulging bumps and bonnie bairns' thread in Pregnancy

Hothead,

Birthchoices site for Scotland.

Scottish Doula Network . I am not listed there yet as I still have to submit my written assignment to get my Certificate. You will see from that site that you do have options with regards to choosing a Doula, if you so wish one.

Stirling Royal Infirmary actually looks like it is not too bad, you'd need to ask them their VBAC stats. They certainly have a better stats figure than my local Consultant led unit.... Pah!

My offer of support is always open. But the important thing is to choose someone that you feel a rappor with, can trust and instinctively like.
But if you just wish to talk VBAC I am also here and can be on the other end of the phone at any time!

Sorry, I've come over way too keen! OOpppps!

But VBAC is a passion of mine.

Careful what you wish for, I wanted (and got) a VBAC, but the whole thing took so long and was so painful that I was shouting for a caesarian by the end of it!!!

I'm not sure if it's a VBAC thing or just a general VB thing, but I know a LOT of VBACers in particular who begged for a CS when it came to Transition!!! It takes a good mw and/or a good Doula to support the woman, let her know that she is doing well and that she will get through it.

I think that VBAC hopefuls tend to have less faith that they can do it because of past history and definitely need that something extra to help them through the really tough bits at the end of labour. Labour is hard in most cases, we all need to be shown faith and support, not to feel alone and struggling.....

Oh dear, I think I'm beginning to go off on one, best finish for now.

Makemineaginandtonic, I do hope that you feel a sense of accomplishment, pride and empowerment that you achieved your VBAC in spite of your labour being hard. You did very well and deserve to be very proud!

I personally can't imagine ever wanting a VBAC, but clearly you do. You said that the hospital won't let you go more than a few days overdue. What do you mean they won't let you? I personally wouldn't give them that much power in the decision. You can go a week overdue, even two, if you want to. I mean, when they tell you to come in for section and give you a date, say "no, I want to go 1 (or 2) weeks past due to increase my chances of going into labour naturally." If they try to talk you out of it, tell you'll think about it and get back to them at 41 weeks.

Klaw, I'm off to look at the websites you recommended and will certainly be back in touch as you seem like an invaluable resource! You don't come across too keen either - just VERY helpful......watch this space.

Thanks again for all the rest of the advice - I think any VB has its risks - I have read with absolute horror some of the posts about 3rd and 4th degree tears and I must admit that it makes me think that a few weeks with a c-section stoop is not so bad, but then I think of all the women who do give birth vaginally and don't have horrific stories to tell (especially the accounts in Ina May's book) and I think, no it doesn't have to be that way, and I should have faith in my body's ability to do it..........just have to convince the health professionals to let me have the time to do it. Will definitely look into Doulas, the more I think about it the more it makes sense.