planned section or vbac?

[Saj1980]

Hi,

I'm looking for advice from anyone that's been in a similar situation to this:
I'm currently pregnant (27+4) and have had 2 emergency sections in the past. Both times I have gone into labour but there have been complications with not dilating enough, causing the baby stress and then finally being rushed into operating theatre for emergency c-section.

Both times it has taken me 6+ weeks to recover to a point where I can manage without assistance. I'm apprehensive about having another section, because of the recovery time and because there's increased risks. We don't have any family nearby so it's difficult to manage childcare etc which is making me think I should opt for a vbac?

I've spoken to the senior midwife who has said I can go for either option, and that there have been no problems to indicate I can't have a vbac.
I want to know if anyone else has been in a similar situation and how you've dealt with it, or from anyone with any advice really...it's making me stressed and sad :(

Many units don’t do induction on previous CS, but management for lots of things changes across various different trusts based on experience of staff, the type of unit it is and it’s facilities etc. Spontaneous labour for a VBAC is 0.5% risk ofnrupture, with syntocinon augmentation is 1% and prostaglandin induction is 1-2%, this is RCOG. Success rate of VBAC in spontaneous labour is 70-80%, the rest have CS for fetal distress, failure to progress, maternal request.
Lacerations to baby are from the scalpel used at CS usually to the bum or head. Also often use forceps on CS babies so can get brushing and lacerations from those also.

Definitely not overly rosy about VBAC, it has its risks but so does an elective cs. I would potentially like more than two children and the risk of two previous CS dramatically increases risks of placenta acreta/percreta in a 3rd pregnancy.
Recommendation for an elective CS due to previous is fairly rare. Advice is usually VBAC unless something else going on due the risks of elective CS still being higher than that of a VBAC.
I am in a lucky position of being able to have different discussions with my consultants (I have two) with the benefit of knowledge and experience, and also being able to get further opinions from other consultants. I am also very lucky to be on a unit which is a level 3 tertiary referral unit, with an on site blood transfusion bank, ITU, level 3 NNU, interventional radiology and a multitude of specialist consultants. Also having some of the best obstetric consultants in the world, who are teaching worldwide about fetal physiology and pathophysiology and managing those with complications caused by CS

I found the stats really helpful, thanks. Wish the rest of us got to see these more easily or felt able to ask for them. I find the professionals really reluctant to discuss this sort thing, but I really think it helps to put choice in the patient's hands - if they want to hear them.

Openly accessible stats on the RCOG website. A lot of information provided by HCP is selective depending on practitioner... vaginal breech birth being one major example