Does anyone feel positively about VBAC even if it all goes wrong?

[3flightsofstairs]

Just asking as I'm due to have one in 7 weeks-ish and have just read a uterine rupture story!

I'm feeling largely ambivalent about the whole thing - what will be will be I think. I understand the birth process and the pros and cons - and did the first time too. Not being told that my baby was back-to-back (they didn't know either until I was 10cm and they broke my waters - ouch) and the midwives mistakenly telling me that he had descended were the reasons why we ended up with an emergency section. I was also told that I was small for dates and baby was 8lb15oz - so not that small either!

Slightly distrustful of NHS staff these days (apart from the people in theatre oddly enough) but not enough to not use the NHS. Was told that I couldn't have the dedicated midwife team as I was in the wrong area - even tho I'll be at St Thomas's again and they have a team - as the bloody Health Minister kept on harping on about the other week on the news. Grrr. Stupid woman.

Anyway - why am I still up? Should have been sleeping hours ago!

OK, I understand your worries. I went through a similar pregnancy and delivery ending in an emergency ceasarian section with my first! The Midwives gave me the option with my 2nd delivery what did I want to do. I had heard so many stories Good and Bad that I really didnt know what to do, so I left it to nature. I am so glad I did, because I had a natural delivery in 12hrs(start to finish) and a healthy girl. I also went on 2 and a half yrs later and had another daughter naturally. (Ok this time it wasnt so quick, but at the end of the day it was by far easier than having a C section.)

Being back to back with waters broken makes it very hard for baby to manouevre, and being on your back makes it even harder.

Best chance of successful VBAC is to be active, spontaneous labour, not recline, intermittant monitoring until or unless there are indications that warrant CFM (research shows that CFM does not improve outcomes for baby but does increase risk of mother getting instrumental or CS delivery, which I can vouch for ), and using your body's own hormones for pain relief. See Dr Sarah Buckley to give you confidence about your body's abilities.

Optimal Foetal Positioning might give you more confidence that you are being proactive to minimise risk of OP baby but not essential, baby will turn, it just takes much longer and does not conform to protocols of 1cm per hour... hospital protocols are what we have to fight against a LOT, cos none of us are average, we are all special!

I have many more links for VBAC info if you would like me to send a word.doc. Just ask

And Yes I am very positive about my VBAC even though they cut me again and used forceps, my episiotemy got a haematoma, had two courses of antibiotics and ultrasound therapy for the haematoma....

Couldn't imagine contemplating a CS, major abdominal wound with infection likely, restricting your abilities for weeks, just recalling first one is enough to make me shudder...

Although if I HAD to have one for sound medical reasons, I am much better researched now to make it a better experience...

Listen to your heart and follow your instincts.

think about getting yourself a doula, at leasy you will know her, if you don;t know the midwife..there is no reason this birth would be a bad one, you can pinpoint the reasons the last one ended up the way it did....stay at home as long as you can, which will give you and your body the opportunity to work to get baby in a good position, without being restricted by monitors etc...read Ina May Gaskin and Sheila KItzinger if you haven;t already!

yes, uterine rupture is a risk, a small one, and one to be taken note of when you make a decision

there are risks in every birth, but on the whole, when women can labour how they need to, rather than how a doctor or hospital wants tehm to, things go well!

Thanks for your responses, v helpful to hear other experiences.

Part of my problem is, I think, that I did labour the way I wanted to last time... I was in the home-from-home unit, didn't arrive until I was 4cm dilated (had been having contractions all of the previous 24 hours), monitored intermittently, bouncing on my ball, on all fours, in the birthing pool to get to 9cm, just using gas and air, etc. etc. Had quite an OK labour to get to 10cms actually! Granted I did have a desk job which might not have helped positioning but walked 4 miles each day to and from work for most of my pg and am a fairly active person anyway.

These days I spend at least an hour of every day on my hands and knees - changing nappies on the floor, crawling after my 18month old round our flat to his screams of delight and have put on half the weight that I did last time without even trying! And I'm a different shape and think I'm more aware of how this baby is positioned - now I think he is head down with his bum sticking out of the top of my tummy!

I've read Sheila K but not Ina Whatsit and am still not convinced either way. I am going to give it a go and know that informed patients have better outcomes than uninformed - and that being positive is a key factor. I was really positive last time and even said to my husband "we're going to have a baby in an hour" 9 hours before DS actually appeared in theatre! What a fool to presume!

I do think that if last time they had told me that DS was posterior I would have asked to see if they could turn him - but my notes tell me that they didn't know. This time I've asked to be scanned and a registrar told me that they just don't do that - however my midwife has said that they have a portable scanner for scanning eg obese ladies. So I'll be having a scan! If he's in the right position I'm sure we can do it, if he's not, then I feel that we're buggered. So to speak! DS did not descend last time despite the midwives telling me to push and we spent 6 hours in stage 2 (which I know is way beyond recommendations) waiting for a spinal and theatre. I'm really not planning on doing that again!

If I set an elective date for a week after my due date is that mad? I went into labour on DS's due date and I don't expect to go over, but they're not inducing me. Any thoughts anyone? And apologies for ramble...

Just caught this thread and your situation sounds similar to mine 3flights, but I ended up with a c-section for different reasons....I'm due in 4 weeks with No 2 and have been happy with the idea of VBAC, but as the date looms closer I'm starting to have a real wobbly attack and am thinking that an elective would be the better option.

Klaw...could you send me some info on VBAC like you suggested for 3flightsofstairs, please. I'm seeing the consultant on Wednesday to discuss my options anddon't feel like I'm well enough informed.

Email is daisybump at yahoo dot co dot uk.

Thanks

Certainly Daisybump! ;-)

And 3FlightsofStairs, you did do everything right but were probably let down by having your waters broken, that first step of induction so often leads to more intervention. YOU did not fail, it was not your fault. OP baby's need their waters to cushion them and make turning easier, stands to reason, doesn't it? Wish I hadn't been so naive going into labour with my undiagnosed OP baby whose head was not tucked in and allowed my waters to be broken... didn't have a clue then! But I do now!

Ina May Gaskin may seem very much a hippy when you start reading her book, but what she believes makes absolute sense and if she can have a CS rate of less than 2% in 35 years, and she doesn't refuse to take on VBACers, then she must know what she's talking about!

I wish I could give you some faith that you can do it, I do believe that you can and hate to see how obviously you feel that you are 'broken'.

HUGS!!!

Cheers Klaw..

daisy..if you want a bit of morale boosting VBAC talk you can get in touch!

[email protected]

it is my pet topic! Klaw has some amazing links about it too..she is a star !

Thanks Lulu...I'll try to e-mail you soon

Yes Lulu and I are VBACtivists!

PMSL!! will get that put on my next lot of cards!!

I've got a badge, Lulu!

VBACTIVIST
My Body
My Birth
My RIGHT!

A VBA3Cer from my other forum made them for us all when we had a big meet up in February...

note the 3, yes THREE.....

Don't know whether I'd fit your description of "all goes wrong" - I had an em CS for ds because of foetal distress. 18 months later, dd was born by vbac - it was a very long drawn out labour, as I had a false start caused by a severe stomach bug, and in the end it was a forceps delivery with an episiotomy. I'm really glad I had the vbac so that I had the experience of a natural(ish) birth, though I did find more discomfort further down the line with stitches than I'd expected. Personally I recovered really quickly from my cs so didn't feel it was that bad, but I'm glad I didn't have to deal with the stomach wound etc when I had a toddler! Fine for a first time birth, but kind of impractical for second or more - entirely my experience though, maybe that's a bit flippant.
Very glad I vbac'd though, feel like now i've "done" birth properly, despite epidural and intervention.
I found it really helped my confidence in the hospital staff to go through the labour notes from the first birth. After ds was born (bright red and screaming, no sign of distress) I wondered whether the cs had really been necessary, but going over the labour notes, I'm really glad the midwives / doctors made the decisions they did, and I can completely understand their reasoning. My recollection of the labour was rather different from what had actually happened (timescales mainly) and dh confirmed what was said in the notes, so it really put everything into perspective.
Sorry to have rambled, all the very best when the time comes.

Klaw, I don't feel like I failed and I know it wasn't my fault. My notes also say that my waters broke spontaneously which is, frankly, a lie and the consultant midwife hurt me by doing whatever she did to break them. And I know now that it was only then they discovered DS was OP so all of the dancing around that they had me do wasn't going to shift him! The consultant midwife was clearly wanting me to get a move on. Which is, I guess, now part of my mistrust of the medical profession!

I must be working on some kind of numbers game - the chance of me having another back-to-back presentation is

Crossed posts FromGirders - watching a DVD at the same time! Thanks for the info - my DS is going to be 19 months, that's why I'm going to give it a go, otherwise I might go for another c-s! I know what you mean about that sounding flippant, I feel the same way!

3flights- my VBAC baby was OP

OP is not the end of the world in terms of vagainal delivery

OP presentation occurs in about 10 % of births, but from what i have read here, i reckon it is more!!

OP does not mean you cannot deliver vaginally...what it can mean is a slower labour as there is not equal pressure exerted on the cervix by the baby;s head....but good strong contractions in conjunction with being upright, mobile, active and able to work with your body..rather than flat on your back, is much better

also , as Klaw has said, once the waters have gone it is harder for babies to turn, so they longer you stay at home, the longer time baby has to turn, without you having your waters broken...

you can also put in your birth plan that you do not want artificial rupture - intermittent monitoring, and the ability to labour actively, and upright

my OP baby turned, and once she did , labour went very quickly and very well..she was born face up, but i did not tear, had a tiny graze....

lulumama - I know that a good active birth etc. is the best thing and that's what I did before. I also know that what the midwives said in terms of spines was completely wrong and DS's head had not descended at all - and they also said that he was OA and then the notes change after my "spontaneous" rupture of membranes! I believe his chin wasn't tucked in and that's why nothing then happened - despite it being given another 6 hours of strong contractions (not to mention dancing and swaying with my DH, some time on the birthing stool, one leg on the sofa, the other leg on the sofa, etc. etc) DS wasn't at all distressed - he just didn't budge. And surely this is just what happens sometimes? And why so many women used to get high forceps rather than a CS?

If someone had told me initially that baby was OP then I think I could have tried to do something about it. I now think I can tell myself whether this baby is OP - and so far he's not been fingers crossed! Although there's plently of time for that to change. I do trust my body to deliver a baby. I don't, however, trust the medical profession to give me straight or accurate answers! And it seems to be that employing someone else is the only way to ensure that.

I suspect now that the midwives did not tell me that DS was OP was because they'd missed it for 12 hours and were protecting their own credibililty. And the doctors don't give a monkeys about people's feelings, they just want live babies - and I can fully understand both sides. I just don't appreciate it when it's me in the middle!!!

Thanks for your advice and support. I will give it a go and 2nd babies (according to my sis from the most recent research on mednet) are less likely to be OP as there's more womb-room to wriggle around in. I also found out that it's a 33% 3-way split between vaginal deliveries, forceps/ventouse and c-s for 1st baby OP presentations. I'm hoping that my extra wiggle room helps this little fella out...

3flights....sounds like you have really got this all sorted in your own head, and that is really good !!

definitely give the ofp stuff a try, and give it a whirl !

hope that whatever happens it is a positive experience for you x

hi everyone, I'm new to this thread tho it's a topic i'm particularly interested in at the moment. I have 3 children, all via c-section (the first was emergency after being in labour) the 2nd was elective section due to being breech and i kind of got rail-roaded into a section for the third although i didn't want one. I am expecting my 4th baby in november and already the hospital are indicating that it is normal procedure for a elective section following 3 previous ones. Does anyone know what my rights are? how safe is a vbac after 3 c-sections? hvae got to pop out now, be back in an hour or so, so dont think im ignoring anyone if you reply, thanks xxxxxx

Snowpatrol, it is well worth checking out the vbac yahoo group There are a number of people on there who have had vaginal births after three or even four cesareans.

You cannot be forced into a repeat cesarean, even after having had 3 previous ones. However, you will have to be extremely determined that this is the route to go down as I have to be honest, the pressure to have a fourth will be huge.

Yell if you've got any specific questions. Daisy (homebirth after 2 previous cesareans)

SnowPatrol, I personally know someone who has had a VBA3C and would be delighted to put you in touch if you would like. Just email me on klaw at macmail dot com !!

Also, check out Natural Birth after Caesarean and note that Debbie has had a VBA3C too! She is another person worth contacting.

See also Dr Mark Landon's Study on Birth's after more than one CS!

OH, what a difficult decision, especially when you read scare stories.
I can only say that hypothetical if I had another one I would go for VBAC, but then I had 2 natural Births and then a C-section....however, I also know that I would be more frightened ...one of the huge reasons why I defiantely don't want anymore Kids.
I really think it depends how important a natural /vaginal Birth would be for the Individual...because, well, things, theoretically, could go wrong either way (me a pessimest...nah)...what I mean is, it has to be a decision teh individual is happy with, only then will any risk be worth taking, iykwim.