Vbac decisions

[Anm4]

Hi i need some advice, i have had two natural births (2010, 6 hour labour) (2011, 50 mins labour) both resulting in postpartum haemorrhage.. not needing transfusion.

In 2012 i had gallbladder surgery
In 2013 i had prolapse surgery (anterior/posterior repairs)

In 2014 we fell pregnant with my daughter and was advised an ELCS, my baby was breech but also because of how quick my labour was previously and not being able to get to the hospital, this was done at 37 +4 weeks, i again bled but heavier and recovery was hard.

Fast forward to 2018, we are now expecting baby #4 in october 2018, i saw my consultant yesterday and she has suggested an induced vbac at 37-38 weeks, or a repeat csection at 39 weeks.

She said the risks are lower in a vbac, and that i will likely bleed heavier in another csection and doesn't want me to have to keep having surgery.

What i'm wondering is, has anyone had any similar experience as I'm grateful she has suggested a natural delivery by induction ( to avoid spontaneous labour) but am worried because of the risks of uterine rupture, but im also worried about the recovery and procedure of a ELCS..

I'm so confused, i see her again at 30 weeks but she said she will book me in for either its our choice.

Thanks x

Is this your last child?

Pressed send too soon...

If this is your last one, or if you want more is relevant because increasing numbers of c sections increases risk to future pregnancies. It’s possible you have some abdominal adhesions from the surgeries too.

But really - what do YOU want? Do you want an induced VBAC, or an elcs?

It’s not enough for her to say ‘the risks are lower with vbac.’ She needs to go through each risk: risk of bleeding, risk of further adhesions, risk of rupture, risk of further prolapse etc. Some will be higher in vbac, some higher in elcs.

Then make a choice - it’s totally up to you and if she’s allowing you to pick each option she won’t have a clinically compelling case to definitely choose either.

So what do you want? That’s really what it comes down to

Hi thanks for your reply, yes this will be our last baby.. the only contraception left to try is the coil which i will opt for and my husband will be opting for a vasectomy at some point.

I personally would of avoided my csection last time if my daughter wasn't breech and gone for an induced labour..

This time however i feel slightly scared that there is a risk of a rupture on my uterus if i choose to vbac, she said my other surgeries wouldn't impact it but stupidly forgot to even ask about the risks of a uterine rupture, apparently they are smaller if you have had previous natural births but i don't know.

I'm going to discuss further with her next time as i wouldn't be afraid to birth naturally just uncertain of how dangerous it can be, with my csection it was straight forward enough apart from my womb retaining blood after and doc having to manually scrape me out (sorry tmi) the recovery being quite hard too.

In regards to prolapsing again both can equally cause this but they think this will happen eventually anyway.

I have read posts about vbac after section with no natural deliveries just haven't come across someone with experience of both, feel a little lost at the moment.

X

I was a bit shocked to even be offered a vbac so it threw me off yesterday. I thought my only option would be another section. x

Why does she want to induce so early? I had an induced VBAC at 39+4 for acute polyhydramnios, but plan had been to induce at 40+4.

Could your DP not have this one? Give you a break?

Hi she has suggested 37-38 weeks to keep the risk of spontaneous labour low as my blood doesn't clot on its own it needs help if i was to bleed out, health risks are there but we are going to see how the pregnancy progresses, last pregnancy went downhill i had clots in my leg and couldn't walk due to spd and babys heartrate was peaking so was signs of distress, theres various things leaning towards an earlier induction including preventing me prolapsing whilst pregnant causing risk to both of us, but hopefully all is well and we can get to 39 weeks with either choice its just waiting and seeing her decision nearer the time, she just said i have got to decide on a vbac or an elcs.. i would love to try a vbac but i am just scared of the unknown i think the risks of rupture frighten me.

@Candyflip sorry what do you mean x