VBAC or second c section?

[ParsleyCake]

DS1 was breach and I ended up with an elective C section.

Now 2 years later only 4 weeks pregnant with my second child I have been asked whether I would like a C Section or VBAC. I was assured I have plenty of time to choose but to be honest I didn't realise this would be offered to me and I honestly don't know what to choose,

My C Section went like a dream. I was up and walking 12 hours after, and the three day stay in hospital it necessitated gave me enough time to master breast feeding , something I'm sure I wouldn't have managed without the midwives and nurses popping in to help whenever I needed. My baby was perfect and healthy. Being in hospital for so long also made parenthood start off a little easier , not that it didn't hit me like a speeding train though. I didn't have PND or anything but it was a big shock to my system.

I am so scared of tearing down there, or my baby getting stuck or something. I won't even begin to talk about the pain. Last time, I never even got to experience contractions or my water breaking, and while I do kind of wonder, I don't necessarily regret it. My mum gave me dire warnings about getting a section, she terrified me actually...but in the end, it was bloody brilliant and I'd do it again.

Except now that I'm being asked, I feel guilty. It's probably a very expensive operation which the NHS is paying for, and I also feel like choosing one when I don't medically need one is selfish as a mother too. Being all medicated and having a baby surgically removed...certain kinds of people would judge me for it, and I worry about whether their reasons are right or not.

I'm also worried about my sex life. I already experience pain during unprotected sex as I have a rare allergy to semen and I have heard of women, including my mother, who experience pain now after getting cut during childbirth and it would just kill sex altogether for me if sex itself hurt, not just my husbands semen...because then even condoms wouldn't stop the pain.

Has anyone made this choice? Specifically people who are like me and not fiercely for natural childbirth, no pain relief etc. I admire those people but this is a modern age and I don't see the harm in making use of available technology. But a C section is a big choice to make lightly.

[Mumchatting]

You are only 4 weeks pregnant OP so you still have time to think and decide.

I had my first EMCS due to failed induction.
I wanted to try for a VBAC with my second but ended up with another EMCS due to placental abruption during labour. The cesarean was done under GA as started bleeding all of a sudden. Thank God was in hospital and they could act fast.

If I had known I was going to have ANOTHER emergency cesarean I wouldn't even think about VBAC and went for elective cesarean. Unfortunately no one could predict the outcomes.

Vbac wasn't for me but it works for some women.

I know it's a hard decision. I hope you decide what's best for you OP.

[Bdog1]

Sweetpotatoaddict can i ask at what point you were induced with your VBAC? I am 40 weeks on friday and discussing with the consultant tomorrow about whether to be induced/section if I don’t go into labour naturally. Thanks

[ItWentInMyEye]

I had an EMCS with my first followed by two vaginal deliveries. I was worried about VBAC, but in the end they assured me they'd intervene much sooner because of the EMCS than they did the first time round. I wouldn't personally judge you for having an elective caesarean, but a vaginal delivery can be easier to recover from. I was walking about more normally much sooner than after the section. You've got a while to decide though, I wouldn't rule it out just yet if I was you. Whatever you choose, good luck!

[TippetyTapWriter]

It's a hard enough decision without worrying what other people might think. Concentrate on you and your own specific situation and risks. I had elcs at 39 weeks because ds was breech, but unfortunately we got unlucky and he had breathing problems that took a week in scbu to resolve. I also had a bad recovery and felt crippled for months. The pain was horrendous! I'm now 41 weeks with my second and had been planning a vbac (after lots and lots of research and thought) but because I'm overdue and baby is predicted to be 95th centile I've been booked in for another elcs at 40+10. If baby had come on time or been under the 4kg predicted weight that might cause delivery problems I'd still be hoping for the vbac. Still might happen if baby comes this weekend. What I'm saying is that your decision might change depending on circumstances, so do your research and be prepared to be flexible. Good luck!

By the way most of my decision making was based on the RCOG vbac green top guidelines: www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf

[skankingpiglet]

Oh and as for a CS meaning a lower chance of no pain during sex post birth, it was painful for me for about 9m after DC1 and 4 or 5m after DC2. I'm not saying it's certain or even common (I've not researched it), just wanted to put it out there that a CS won't necessarily dodge that bullet.

[skankingpiglet]

DC1 was an ELCS due to breech. With DC2 I opted for a VBAC as I was a good candidate for it and the potential risks associated with it were lower than the known risks of a CS. Plus I found the CS recovery very difficult first time around, and think there are a lot of benefits to the baby from a vaginal birth that they just don't get from an ELCS. Unfortunately I suffered a ruptured uterus during labour and ended up with a cat 1 EMCS. Obviously had I had a crystal ball and known the outcome would be a rupture I would have opted for an ELCS, but on balance the risks for me of a VBAC were lower (despite ending up being that 1 in 250 IYKWIM?) and I feel I made the right decision with the information I had available.
If I were to choose to have another DC now (I won't!), it's recommended I have an ELCS at 37wks as she was also a week early.

[Sweetpotatoaddict]

EMCS for my first birth, induced VBAC for my second. Tore with my vaginal delivery, but it still healed much quicker and I felt so much better almost straight after the birth. I almost had to shake myself about how well I felt.
Everything in life has a risk, and it's what risk is acceptable for you and what isn't. It's too early in your pregnancy to assess how you feel. You should be issued with the guidance from the Royal college of obstetricians to help you make an educated choice.
Congratulations OP, wait and see how you feel closer to the time and what your circumstances are. No point deciding one thing, and you don't realistically have a choice.

[tarheelbaby]

Have a second CS! Don't think twice. Don't pay any attention to the NHS pressurisers they are just worried about short-term bottom lines.

For a minute there, I thought Leaves might know me in real life! The details are slightly different but the 2 births were similar.

First time I laboured for nearly 24hrs but was encouraged to have CS 'due to failure to progress'. That wasn't strictly true, I learned later, but rather DD1 was not lined up properly and we would have both had a miserable time of it. So I had EMCS the first time and it was fine.

The second time I was heavily pressured to go VBAC, not least by my midwife who raved on about what a great, quick recovery I'd have. (what a pack of dangerous lies!) So I acquiesced , fully expecting to labour a bit like a good sport and then gracefully agree to a CS. In the event, I ended up being induced and DD2 was a VBAC and, yes, I was cut (that was the least of it). BUT!!! I had placental adhesion (not unusual if previous CS) and nearly bled out on the delivery bed! I spent the first 3 hours after birth under anesthetic in theatre not bonding with DD2! Also, DD2's (97th percentile) head stretched my bits nearly beyond repair. Quick recovery, my arse! I spent 5 days in hospital post birth and 3 weeks on a catheter because all the nerves down there were numb. Not only could I not drive but I even couldn't walk any further than our parking spaces at the end of the garden! Then I had to waste time on ' physical therapy' before I was recommended for reconstructive surgery. So I had to take 8 weeks off work for that (instead of recovering from a CS during mat leave). Post surgery, I am more comfortable but I am not supposed to lift anything heavy and I don't dare run or jump. (Fortunately, I'm pretty lazy so this not life restricting but ... )

[Junebugjr]

Had an EMCS first time around, second time around I really wanted a VBAC.
Ended up with a 'successful' VBAC which left me with a botched repair I had to have further surgery on (this was a injury just going into a 2nd degree tear so nothing too serious, but they still didn't stitch it properly)
The recurrent infections were fobbed off by the GP's for months afterward, leaving me with Vulvodynia and coccyx pain for about 2/3 years later.
Only 6 years later am I able to have pain free sex and not be in constant pain, go to the loo pain free etc etc.
Before anyone tries to flame me for scaring anyone, my experience is also valid.
My experience wasn't a usual one thank god, but reflects what I see as the NHS view of women sucking it up and shutting the fuck up when it comes to childbirth issues.
Am fine now, but it was a long hard slog to get better.

[Kentnurse2015]

I absolutely wasn't bullied into my choice.

And the OP is asking for experiences to hel her. Experiences of people in the same boat. So she can make an informed decision

[BadgerFace]

Leaves I so agree with you about balance and equal information being needed.

The information I was supplied with about the potential benefits of a VBAC and the potential recovery problems with an ELCS did not seem to mention ANY of the downsides to a vaginal birth... Which was fine for me as I'd read up independently on it (plus knew plenty of mums who had experience tearing, incontinence, being sewn up wrong etc...) and so I could make an informed decision relating to my situation but it makes me very cross that it was not presented in a balanced way. And this was in a very pro-choice teaching hospital who didn't even ask my reasons when I said ELCS, the consultant told his student it was entirely maternal preference as the risk factors did not heavily suggest a best way.

At the time I was horrified by some of the threads I read on MN about other hospitals bullying mums into VBACs and them having to fight for their right to choose (as per the NICE guidelines). Yet another post code lottery for hospital care which shouldn't happen.

[Kentnurse2015]

But why are you saying there is no choice? People are giving their experiences. No one forced me to try for a VBAC. It was my choice (mine and my husband's). I did it and was glad to have the quicker recovery time to spend with my toddler.

I didn't see an ELCS as the WORST thing that could happen. Nor did my consultant. I don't get where you are coming from. Women suffer complications regardless of birth method.

[Mummyme87]

That is very short sighted. ELCS are far from risk free.
So I’m China right now they have slackened their 1 child policy. When women were having babies in previous years over there the CS rate was huge because women weren’t planning on having 2nd children. Now women are coming back with scarred uterus’ and major complications which are life threatening. Doctors are not trained to deal with this so hysterectomies or at their highest ever.

[Wetwashing00]

I had an ELCS due to breech with my first and chose ELCS for my second.
I had the same kind of feelings that you did about it, but I also said if I went into labour before my scheduled c-sec then I would give VBAC a try. But labour never happened.
I don’t feel guilty about it at all, and I had great c-sections both times. I had a larger gap in between my children (5yrs) so 1st born didn’t need quite as much looking after whilst I was recovering.

[BadgerFace]

I had an ELCS with DD2 after an EMCS with DD1 three years before. For me the thing that swung it was that I hadn't really laboured with DD1 (got to 2 cm dilated during a placental abruption) and so my second birth would have been like a first birth. Most of the VBAC research I did suggested that the successful percentage of VBACs was much higher for those who had got further through their labour and then ended up with a EMCS.

I didn't want to risk a long labour and then EMCS at the end. As it was we ended up with a "semi" ELCS as DD2 started to come under her own steam the night before my elective date. The whole thing was very calm and straight forward and I was out of hospital the next day (which I pushed for as it was DD1's birthday). If you've got help at home then definitely go for an ELCS!

But also, don't worry about it too much now. You can state your preference and change your mind 100 times before your due date if you want to. I wasn't booked in until 37 weeks even though I'd said I wanted a ELCS at my 24 week consultant's appointment. Even on the day they checked if I still wanted it and I could have changed my mind to a natural labour at the last second.

[LeavesinAutumn]

of course they should kent but with the background of choice not rapid ideology ramming natural birth and candles down our necks presenting elc as the worst possible thing that can happen to you.

Its not at all. I enjoyed mine once we got going . When there is balance, truth and equal information on all of it - then there is true choice, there simply isn't that choice right now.

Every single friend of mine except me conversely had a life threatening first labour, they would have died a hundred years ago. Every single lady in my NCT group had a harrowing birth except me when I had my ELC.
Its luck, how it happens is purely luck.

[Kentnurse2015]

So no one should have a vaginal birth ever then?

[LeavesinAutumn]

Swan8 Thu 19-Oct-17 18:01:46

Speak out swan, I try too! If we dont speak out then no one ever will let them judge away but one day I hope its a choice all women can make without judging.
Their other speciality is gynaecology, and dealing with injuries after birth


^^ This is the hidden side of CB because not many women share these stories or let others know they are incontinent, have severe damage below but there are thousands and thousands of them.

we all need to be more honest and talk more about it all.

[Kentnurse2015]

An ELCS isn't a 'gift'

[LeavesinAutumn]

Many natural births result in years of follow up procedures and support because things often go wrong - these costs mount up but are much harder to see

Several Billion actually.

www.independent.co.uk/news/uk/home-news/negligence-by-maternity-staff-has-cost-nhs-31bn-over-10-years-8228832.html

Botched care in pregnancy and childbirth has led to more than 5,000 successful negligence claims against the maternity services over the last decade – costing the NHS £3.1bn.

The sums paid out would be enough to build a dozen new obstetric units and hire thousands of extra consultants and midwives which could make childbirth safer.

The scandal of the maternity care payouts is revealed today in figures from the NHS Litigation Authority (NHSLA) which show the current system is unfair, inefficient and a gross waste of NHS resources. It reflects the growing burden of medical negligence on the NHS which is diverting scarce resources from patient care.

"In 2014/15 the NHS Litigation Authority paid out £325m in obstetric claims on behalf of 146 trusts nationally."



op in my NCT group one lady was the same as you, had elc it was fine no problems but her MW friend got her all psyched up about doing it properly second time round. She was bouncing off walls in every nct meeting talking about fighting so she could move during labour, not being hooked up, candles - her dh was lined up to massage her.

But when it came to it - baby got stuck, she was cut, had tons of stitches, bladder damage and had to have catheter for weeks, then do it herself at home, couldn't exercise for months...She said it wasnt the right choice for her and obv she wised with her heart she had just takenthe ELC
But how do you know its the right or wrong choice until after when it too late? So I would say dont take the massive "risk" you have been handed a gift on a plate, take it.

[Fragglewump]

I had an elcs with my first due to breech position and a vbac with my 2nd as I wanted to recover faster and drive faster due to having no help from friends or family after delivery. I'm really pleased I did.

[ThatsWotSheSaid]

I had an ELC for my first because she was breech. For my second I had another ELC it was the right decision for me and no regrets.

[LapinR0se]

My private obstetrician told me he would opt for an ELCS every time. That was enough for me and am booked in for ELCS #2 in December

[superking]

In very similar circumstances I had an ELCS with DS2. No regrets at all.

[Rockandrollwithit]

I had a vaginal birth with DS1 and ELCS with DS2. The ELCS would have been much cheaper and also required a much shorter hospital stay.

I had an ELCS the second time because I wanted one. Don't feel guilty.