Help - What's the best way to get a VBAC?

[Kitsilano]

Hello all

I hope some of you can help - I had an emergency C-section with my dd who is now 23 months (24 hour labour, syntocin drip, epidural, full dilation, pushing, attempted ventouse but she was chin up and sideways).
I had her at Queen Charlottes, went through about 5 midwives during my labour and was given no support or encouragement, left alone most of the time. I am now 5 weeks pregnant so early days but want to maximise my chnaces of having a VBAC this time.
I dont know if I should

1. Go private all the way - if so which hospital best (I'm in SW London). Do I need a consultant? Or is midewife led care at a private hospital sufficient? St John's and Lizzie's looks good but is 7 "central London" miles away - is this too far? 2)Go NHS but with a private midwife? If so - which hospital? I am aware I may end up with a c-section and would rather be somewhere with good aftercare (preferably private rooms available)
2. None of the above...doula? Just trust NHS?

Please help - I am confused by all the options and although only 5 weeks have just been told by my Dr that the local hospitals get booked very quickly. I want to do the best thing to maximise my chances of a positive experience this time - and hopefully a VBAC.

Any experience, advice and encouragement welcome!

Thanks

Kits

Thanks Loopymumsy. I definitely don't want a home VBAC (too anxious) but an independent midwife might still be able to provide support and continuity I guess.

I will start looking through all the other VBAC threads as well.

HI - my hospital (Wipps Cross, East London) is very keen on VBACs and encouraged me from the word go - although to start with I was keener on a planned c sec (similar first labour to yours), they 'convinced' me to try for a natural birth.

They were very supporting throughout the pregnancy and I have met with the consultant many times to discusses processes so I don't expect any surprises. I put my 'conditions' down - for example, I don't want them to try ventouse or foreceps, I would prefer to just skip that part and go for C sec if there are any complications. They are very supportive and I am confident that I will be able to achieve a VBAC.

A middle of the road option would be to hire a Doula. Many people I spoke to have commented that they made a real difference. The cost is a lot less than an independent midwife.

I had a fabulous VBAC on the NHS. Couldn't have gone private anyway, so had to just cross fingers, but it couldn't have been better if I'd paid $1m for it ! Main piece of advice would be to get consultant on side and avoid being strapped to a machine if possible.

Do a search on my name and VBAC on here and you'll find my birth story all over the place!

I think before you write off a home VBAC, you might want to do some research first. (Sorry, I don't mean to sound bossy or unsupportive - I was in the same position and after doing a bit of research I decided that a home VBAC was way more likely to succeed than one in either of my local hospitals.) Also, find out exactly what your various hospitals' policies are on VBACs - I don't mean whether or not they support or 'allow' them, but because their policies may be sufficient to hamper your chances from the off. And from what I've seen heard and read, private hospitals can be even more scuppering than the NHS variety.

Thanks Ellbell - will look for it now.

Thanks Blueberrypancake - too far from me I think but good to know that NHS hospiatls can be supportive. I guess I assumed that they would push you towards the c-section option and that private would be more likely to listen to what you wanted. Looks like I need to do more research.

Corriedale - Fair point and I will look into it a bit more. I have already seen a few stats showing that home VBAC can have a higher success rate...but I really dont think I could cope with being further away from medical assistance if something went wrong. I know I couldn't forgive myself afterwards.

Thanks all for your replies!

I had a Emergency section with DD who is now 4years. I am now preggy (14 weeks) and have seen my consultant and midwife due to complications in previous preggy. My consultant is very positive about doing a VBAC this time, if all is well. Im happy with that, but know some would need more reassurance. My friend is a doula (SP?) and she sounds wonderful, maybe that might be good.
Lisa

I used a doula for my vbac and would recommend that route 100%.

I think there are complications using an independent MW in a hospital. I think they can't actually deliver babies in hospital(something to do with insurance) but I may be wrong.

My memory is that that one's chances of a vbac are supposed to increase depending on the reason for the first c-section. I know that my consultant and all the midwives in my case were confident that as I had dilated fully the first time, I'd probably be fine.

Good luck.

Kits,

My advice for the best chance of a VBAC is to wait for labour to start spontaneously, avoid augmentation, no epidural, active labour, listen to your body, no Continuous Foetal Monitoring but intermittant with a hand held, Doula or similar (trusted female friend/relative), do your research, know your rights and tell the HCPs what you will and won't allow....

but that doesn't answer the mw question

A home birth seems to give you the best care ticking all of the above boxes. check out this to see if HB would indeed be an option for you.

Check out this to see what facilities there are in your area and this for maternity stats

You must do your research and make your own informed decisions. As you are only 5 weeks that means you have loads of time to do this and plan the best possible birth for you.

Happy planning

Thanks Klaw - all sounds very sensible but who are HCPs? Sorry for ignorance! Am off to check your links.

Kits

health care professionals

get the stats for each hospital you are interested in re VBAC

definitely have a doula and / or Independent midwife....

research, research , research

believe that you can do it ! read all about birth , not just a genereal book, but a specific one, anyhitng by ina may gasking, sheila kitzinger , janet balaskas, penny simkin.....IMO

and as your c.s was due to a malpositioned baby, look at optimal foetal positioning and the spinning babies website!

Sorry Health Care Professionals! Consultants, usually, and some midwives tend to treat you like a rupture waiting to happen, impose ridiculous hospital protocols that make labouring nigh on impossible and tend to have to be fought all the way to be 'allowed' to labour normally. Thankfully, there are many VBACers out there who can support you to stand up for your rights and there are also organisations such as AIMS which can help in the event of a crisis with HCPs.

Stay strong!

X posting! Hi Lulu!

Doula UK if you want to look at doulas

I don't know where you are based but I think there is some discrepancy in the level of enthusiasm and support for vbacs by consultants/midwives etc. My hunch is that a big London teaching hospital is your best bet. They will be up to date on research and there is greater likelihood that they will have delivered other vbacs. Mine were fantastic. No need for any battle at all. The attitude was "of course, why not."

I don't know that NHS hospitals do force women to have them. Many women who've had bad first labours and emergency c-sections opt for elective fthe first time. You get a choice I think but I am a bit out of touch now.

And a doula can be a wonder. Really and truly. I would never ever consider giving birth again without one.

Thanks all. Which hospital did you go to NKfffff?

I am in SW London so Charlottes/Chelsea and Westminster/Kingston are my nearest

Kits

The Whittington so not much use to you, I'm afraid. But I doubt if it's the only hospital where you'd find a positive attitude. Your midwife should be able to tell you. Don't you go to get booked in soon?

Yes - I need to get booked in but until I choose an independent midwife (if that's what I do) I'm finidng it difficult to know which hospital. I'm afraid if I leave it longer though I wont have any choice...

might be totally wrong, but an IM might not be able deliver the baby in an NHS hospital, not sure re private.....

No, I think you are right. But the idea was she could help me labour at home for as long as possible (I'm thinking this is better than being in hospital) and when I get to hospital continue to support on a one to one basis and help make the right decisions in a way that supports my desire for a VBAC rather than just being processed. I went through at least 4 (5?) midwives during my last labour and felt that it didn't really help me to feel confident.

Do you think that makes sense? Other option would be doula but I was thinking that a midwife would have more medical clout that I might find reassuring if things got unclear.

Makes perfect sense, however she will charge maybe 3 times what a doula might charge..so worth looking into both options..when it comes to doing the best to get the birth you want, and an IM is a viable option, go for it....have a chat with doulas and IMs, you;ll get a feel for what will suit you best...