Potential VBAC, when to schedule ELCS

[newbian]

I'm 29 weeks and had ELCS for first pregnancy due to breech. It was at 39 weeks and fully planned, I never had a contraction or started labor.

I think I want to try for VBAC this time but I will book an ELCS if labor doesn't start naturally by a certain point, as my doc/hospital do not induce women with previous c-section due to increased risk of uterine rupture.

The thing is, because I never went into labor with DD I'm sort of like a first time mother here and it's typical to go over 40 weeks right? But I'm told it's riskier to book ELCS after 40 and that 39 weeks is actually ideal. Any thoughts or experiences to share? I don't want to put myself or baby at risk just to get a VBAC so if I am happy for another ELCS if nature doesn't take its course - I just don't know when I should aim for!

Most hospitals do not do elcs before 39 weeks unless there is a specific problem with you or baby, i would aim for towards the 40 week mark esp as you want to try a vbac. Also do remember elcs lists have a lot of people on them so you actually may not get the date you want anyway due to the list being full.

I should add I'm not in the UK and have private health care so no issue with wait times for booking ELCS. They can get me in within a few days or I can book a date now to secure it as a backup.

I had an EMCS first time after a shocker. Because of what happened they told me they weren't happy to induce me again and they didn't want baby to go over 40 weeks.

If I went in naturally beforehand they would let me have a go but only for a certain time.
In the end I was scheduled for 40+1... however the consultant was off sick so ended up having dd2 at 40+2.

Hope that's helpful

AnnaT45 that sounds similar to what I’m being told. I can go into labor naturally but they will monitor carefully and there’s a very low threshold for moving to EMCS compared to a normal vaginal birth attempt. I want the chance for it to happen on its own but they discourage me purposely going over (e.g. booking at 41 or more).

Did they offer you a membrane sweep? Or did you try any natural methods to jumpstart labor?

I had an EMCS with ds (I won't go into the gory details). I wanted to vbac with dd but booked a ELCS at 39+4 had her at 39+2 as I started Labour and had complications again so they called it an emergency ELCS . Had a horrible pregnancy so I was just relieved it was all over.
Not having anymore children so will never experience a Vbac but I really don't mind.
Good luck OP!

Newbian they didn't offer me a sweep but I guess you could ask that? I tried to have one with my first at 40 but they couldn't one as my cervix was high and closed. They just about did one at 41 but it didn't do much.

I think they get really nervous over 40 weeks as the placenta starts to become less efficient and with a previous section it can be worse I think?

If you really want a vbac then push it with your consultant and have a plan in place. Because I had an awful first time first I wasn't bothered about it particularly!

Honestly I don't know if I really want a VBAC or not! I never labored previously so it's a complete mystery how it would go. But with a toddler at home, I imagine a vaginal birth is easier recovery - assuming a straightforward one.

Trouble is with vaginals birth there's no guarantees you'll be up and about easily. A know a few people who were worse off than me after an ELCS.

You can just try get family and friends to help out with toddler or nursery. Will your partner be off for two weeks to help out? I found after two weeks I was ok and my little one was 19 months so quite little and needy herself.

I was in a very similar situation OP, although my first was a c section following a botched induction; never felt a contraction, just went from nothing to full on over-stimulated uterus (constant pain) then an epidural.

As time went on in my second pregnancy I found myself wanting to feel just one contraction, just something at least, just to know what it was like! I thought I might even be up for a vbac... but not a vbac with any additional risks, like having a bigger baby (bump measured big and so did baby on the subsequent growth scan) by going overdue, or the greater risk of stillbirth in late pregnancy that comes with having had a previous section. So I booked my ELCS for my due date, and I honestly thought something would happen before then.

But it didn't!! So I burst into tears when I arrived at hospital and they offered to break my waters to see if anything would happen (had had some reduced movements lately too so didn't want to leave it), and I really was torn. But had the section in the end. That was four weeks ago and I don't for a second regret not feeling a contraction or any of that; I just couldn't justify the risks for me personally. And life post section with a newborn and a 2 year old has been waaay better than I expected, although granted no walk in the park.

To me due date seemed a good compromise but it's completely up to you. Without the "big baby" factor and the reduced movements I may well have been happy to go another week. Good luck with whatever you decide.

RatPoly I'm also sort of curious about a contraction, as strange as that sounds!

AnnaT my husband gets 1 week paternity (we're not in enlightened Europe!) but my mother will be here for a month and my toddler is in nursery in the mornings - we have a childminder for the rest of the day. So I will have a lot of help but I just can't see explaining to my little girl why she can't hug mommy in bed for weeks if I have a section.

I had an appointment with an independent midwife who knows my doctor and hospital, she basically said they'll have a very low threshold for EMCS in a VBAC and I'll be monitored really closely. Basically as medical a vaginal birth as you can get - hooked up to monitor and drip so can't walk down the hallway or get in the bathtub in early labor. She suggested some things I can do to encourage natural labor but otherwise to book a section in week 40 for safety if that doesn't happen. Kind of makes the choice easier bc I'm not going have the earth mama natural birth in any case!

I'm in a similar boat. 35 weeks and aiming for VBAC, but as well as the normal risk associated with VBAC I also have a blood complication which means I am strongly advised not to go over my due date. ELCS is booked for 39+6. I have been offered a sweep at 39 weeks and I have also been told that when I come in for ELCS if my cervix is favourable enough they would be willing to break my waters, give me some time to labour and if necessary give me a low dose of the syntocinon drip. I am not sure if I will take them up on this - bad experience last time, but according to my consultant it's a possibility.