Vbac need some honest advice

[LadyPug]

I am planning a VBAC and was told by the consultant that as dd got stuck In previous birth, it’s unlikely it will happen again and he supports vbac. However, I will not be allowed to labour in the MLU (one corridor away) and will need to give birth in the delivery ward having continuous fetal monitoring (on machine) and a cannula in hand in case require it. I have done research on this monitor and it results in higher chance of Caesarian, it is only useful for monitoring c section scar and has no benefit to the baby. I believe I should be allowed in MLU down the corridor for a water birth and I’m freaking out as last (induced) experience was horrific and was in a small bright room with a rude midwife, no continuity of care and surrounded by cannulas and machines. I believed as this isn’t an induction I would have more control but it sounds like I’m being put in a similar position eg no water birth, no active labour etc. Can someone please tell me they had a VBAC without being continually wired up to a machine or that they were allowed into the MLU or a water birth? I’m getting very anxious!

Thanks stickyhands that’s good to know!

Goodness ginger thanks for commenting, good to have a real case of it here to talk to! Please let me start by saying I most certainly do not think it’s just a stat but I want to know if I can manage it other ways than cfm for which I can’t find effectiveness stats to back it up. Could I have occasional monitoring etc allowing freedom of movement. Can I ask, did the machine help you? At what stage in your labour did it happen and what took place?

If your consultant has a far far lower rate of rupture than the general statistics, don't you think that's even more reason to do exactly what he advises?

I had no idea you were the same poster who had already posted asking MNers for anecdotes to weigh up against medical advice.

My issue is that his answer is “it’s how we do things” and I just need more than that to go on. I want to really know the risks involved, properly to make an informed decision. It makes no sense to me that he’s saying on paper I’m high risk but he’s not worried and that everyone is advised to stay home (with no monitor or midwife even!) before coming in and being on a monitor. I’m going around in circles because I don’t have enough facts from him or his team so I will collate more research then sit down with him and debate it thoroughly. Sorry if I offended you Sycamore I just didn’t feel it was v constructive and I’m very anxious and nervous about it all. I’m totally open to hearing your personal experience or any info you have to help me make further decisions. On a lighter note, my mum was told by her doctor that she would die if she didn’t give birth in hospital (he actually said that) because she had small feet and having red hair would cause her to haemorrhage! Hopefully consultant advice has improved a bit since the eighties!!!

How long ago was your vbac? That will have some impact on your individual care.

Sorry emcs not vbac!

2.5 years ago reallyanotherone

I am not in the least offended. I don't have an agenda other than I think women should not be mis-informed by the frankly often dangerous chatter that is pushed on pregnancy and parenting forums. Your post came across as if you had understood scar rupture to be no big deal, hence my response.

I understand that and sorry it came across that way, trust me, I’m researching this so thoroughly I’ll be able to write a thesis once I’m done! And please do give more info on anything you might know that will help me in my findings, the more I can learn the better!

I've had two straightforward home births following a crash section with my first baby. I think I read somewhere that there is no evidence that cfm is better at detecting rupture than intermittent monitoring (which I had at home with a dry land birth then subsequently a water birth). You might want to ask about the possibility of that as then you could be mobile? Assuming your hospital doesn't offer the mobile type monitor.
I was in a similar position to you in that I was advised the reasons for my c section (severe foetal distress) were unlikely to recur so I was a good candidate for VBAC.

That’s so inspiring emsy I would be much happier with intermittent monitoring. I had no idea this would be allowed at home? Thank you, this is at least some hope that I might not be strapped to the bed for the entire time or unable to walk up and down which really helped me cope last time (until they strapped me down that is!)

It may well be hospital policy to put you on cfm and site a cannula but it is still ultimately your body and your choice - you can refuse. I planned a VBAC for my second pregnancy and this was what I was planning on doing (ended up being induced though due to unforeseen complications). My midwife (who was a Supervisor of Midwives at my hospital and v.experienced) said that she didn’t see any issue with this. As you say research has shown that there is little difference in outcomes with cfm and intermittent monitoring except for an increase in c section rates with cfm. Any midwife worth her salt would be able to spot signs of any serious uterine rupture.

You could ask, under the Freedom Of Information act if any previous VBAC attempts have been made on the MLU at your hospital. If there have been then this may give you some bargaining power.

And you obviously have the option of home birth.

Thank you Teamakesmehappy it is my dream to refuse really as in my gut I feel that is the right thing to do but I’m scared of what could go wrong hence arming myself with facts. I think some middle ground would be good eg intermittent monitoring or being allowed in the MLU which is a corridor away. My worry with home birth is that I’m a 30 Min transfer time so it’s not really viable but the mlu I think should be. Freedom of information act is a great idea but our MLU only opened 3 months ago so I’m guessing it’s not really going to help as I would most likely be the first to do it this way (if they ever let me!) thank you so much for your helpful comments

There's evidence cfm doesn't help babies in your typical Labour but where is the research on detecting scar rupture...that's the key question!

Hopefully your consultant will be able to answer that.

I had an attempted vbac with my 5th baby after 3 previous vb's and then an elcs with my 4th due to oblique lie. I had continuous monitoring with a monitor on the baby's head and a strap round my tummy measuring the contractions. And 2 cannulas. I don't know how much of that was because I was trying to have a vbac or because I was being induced at 36 weeks or because I had pprom and an infection. I think the reason it failed was because of the induction rather than the vbac attempt. I had a lot of different complications but I didn't rupture.

If you want to agree something for your birth that isn't the 'standard' thing that the hospital do in your circumstances the best thing you can do is sort it out well in advance. I had my second baby within days of a good friend of mine having hers (also a VBAC) - she was much more organised than me and met with her consultant several times during her pregnancy to go through options and what she wanted. She agreed a birth plan that she was happy with but which deviated from the 'standard' VBAC pattern at that hospital.
My local hospital doesn't have any mobile monitoring devices (the main reason why i didnt go in) but they are fairly common now so worth asking about them as well as the option of intermittent monitoring. I found intermittent monitoring unobtrusive - it was done under the water for my pool birth so I was able to stay in situ.

I'm currently 30 weeks and debating VBAC - my hospital say you have to be on delivery suite not mlu, but that you can still have water birth! The wireless monitors are waterproof so can be used wherever and you can move as much as you like. They want you to have a cannula but won't force it. Do you have a hospital that offers the wireless monitors? That seems to be the biggest hurdle for you!

Wow thank you ohhgreat I don’t actually know if hospital have wireless monitors as haven’t asked yet but plan to at next appt. I can’t believe you’re allowed a water birth, that’s amazing!

Thanks Emsy that’s really helpful!

I had a VBAC in January. Previous 4.7kg baby, emCS at 9cm for infection and abnormal CTG. baby had meningitis, I had a Pph and blood transfusion. I was desperate for a vaginal birth 2nd time round.
I ended up with an induction at 39+4 for acute polyhydramnios. X1 propess and I was off. Had a bit of synto in 2nd stage as my contractions were rubbish, pushed him out eventually, all 4.5kg of him but had a 3B tear and lost 2.1L of blood requiring 4 units transfused. Short term I was wishing I had an elective CS but long term I was happy I had a VBAC.
If you want to discuss place of birth a bit further, see if your unit has a consultant midwife/professional midwifery advocate to go through this and help you make a plan