Advised not to go for VBAC and am devastated

[Kaito16]

Hi all,

My first post on Mumsnet - hope I’m doing it right.

I had DS 2.5 years ago and am due with my second child in 3 months.

With first DS my waters broke and 18 hours later I was only 4cm and not progressing further so I was given the induction drip which successfully got me to 10cm fully dilated within a few hours and ready to push. I pushed for about 1.5 hours but to no avail. Baby was not coming out/stuck. I was rushed to theatre not knowing whether they would do an instrumental or c-section. Once we got there and they assessed me they decided an urgent c-section was required.

My little boy came healthily and we were pleased but I struggled emotionally to come to terms with having a c-section as I had my heart set on a vaginal birth and is something that as a woman I feel is important for me to experience.

So I met with the obstetrician who delivered my son today to discuss the birthing plan/options for my #2 due in 3 months. To my huge disappointment and devastation, he was extremely strongly encouraging me to opt for a planned c-section. He felt that a VBAC may not be successful for me because the reason for my first c-section was not a one-off occurrence (such a fetal distress) or a slow progressing labour. I still needed a c-section after getting to full dilation and pushing for a while, possibly suggesting that the shape of my pelvis was not allowing the baby to pass through effectively. Something he thinks may be likely to happen again (although no one knows until you get to that point).

He acknowledged that we would not know until I tried but if I tried a VBAC and then induction or emergency c-section occurred then this could have serious risks for myself and my baby.

I am so torn between my personal desire for a VBAC so I feel fulfilled as a women but now can’t help but think whether I would be selfish to go for this when I know full well what the risks would be. I would not be able to forgive myself if something went wrong with a VBAC and I knew it was because I went against medical advice because of my personal desire to deliver vaginally.

All I read all over the internet is how much you should push for a VBAC if you want it and don’t let anyone else tell you otherwise. Does this mean I should go against the advice of a well trusted and hugely experienced doctor?

I read constantly of women saying a VBAC was empowering for them and helped heal their trauma and guilt from their first c-sections. This is what I desperately wanted for myself but I just cannot see logically see I can go against the advice of a doctor with over 30 years experience who I trust and value his opinion, and instead take the risks of a VBAC as he explained them.

I feel like I have no options left and that this and God-willing any future children I have will all have to be by c-section. I don’t know how I will come to terms with this. :(

I had to have an emcs as after 12 hours on induction drip, I was only dilated 2cm.
I was just relieved that dd was safely delivered. I actually found the whole experience quite peaceful and calm after having been induced.
I am fully expecting to be told that I will have a planned section with the next one (currently pregnant again) and that is fine by me. I don't care how my babies arrive as long as they arrive safely.
I think we're fed a lot of bullshit about vaginal births being the only way/ having a birth experience/ being a real mother.

Firstly, I'm sorry you didn't get the birth you wanted. Although I suspect our expectations of what a good birth is are different, it is scary and horrid when things start to feel out of control.

My experience is that DC1 was an EMCS after 5 days of failed induction - frankly the delivery was amazing after the nightmare of the induction.

Unlike you, my consultant pushed for a VBAC with DC2. After DC1s birth, when no one could explain why a VB didn't work, there was no way I was up for a VBAC and fought (successfully) for a CS. That delivery was awesome too. Not only that, the surgeon told me after DC2 was out safely, that my decision saved their life because the cord was wrapped three times around the neck. Not something which had been picked up beforehand.

I don't feel any less of a woman for mot pushing a baby through my vagina. I feel strong and empowered because, eventually, I had the choice of my delivery and I haven't for a second regretted choosing CS. If we have a third I will choose a CS again with no qualms or feelings of womanly failure.

Given your obviously strong feelings I think you would benefit from a second opinion. I also think you would benefit from some counselling about why you feel so strongly that a VB is such an essential and empowering part of your womanly experience that you are willing to go against medical advice to experience that (and also to prepare yourself in case you do try a VBAC and it doesn't live up to your expectations)

Dinosauratemydaffodils
What a lovely story. Thank you for sharing and congratulations!

I had an emergency cs under general anaesthetic with my first; was encouraged to go for Vbac with second and ended up with a second cs. I believe that this attributed to my pnd with my second baby (got to hospital fully dilated, baby got stuck, section under spinal which got converted to general anaesthetic as they couldn't get DD out (she was fine) - I was black & blue both physically & mentally.

I had an elective section with number 3 - I was sceptical as to how different it could be but I found it to be a healing, empowering process. No drama, no worries - just happy, healthy baby & mum.

I really wanted a vaginal birth with 1 & 2 - I coped with labour fine & needed no pain relief but the little buggers we're not for emerging. Don't beat yourself up - ask for a second opinion, and a third & fourth if you want, then make your choice. I know a few friends who had successful VBacs & friends who had cs after vaginal deliveries. As long as you are both ok on the other side, it doesn't really matter how the baby gets here x

I completely understand how you feel OP. I really wanted to experience natural childbirth, but the birth of DC1 was very medicalised due to baby being small for dates and ended in EMCS due to fetal distress. The surgeon performing the section apparently said that the baby had been in a bad position and I probably wouldn't have been able to push her out anyway.

My second pregnancy was a chance to do it right. I was gung-ho for VBAC and consultant was on board as fetal distress was the reason for my EMCS. I had a natural labour with light pain relief and until we got to pushing things were going well. But I couldn't push the baby out. The midwife felt around and described the baby being in the same bad position that the surgeon had described with my first. They put a 1 hour time limit on pushing for a VBAC before intervention, and as I was really struggling to get anywhere my VBAC ended in spinal/episiotomy/forceps.

So perhaps like you I have some oddity in my pelvis or similiar that means my babies will always be misaligned in a particular way. I'm not going for a 3rd so wont find out! But I will say that even though my VBAC ended in intervention it was a much better experience than my induction and EMCS, as until the end my body was naturally getting on with labour, and yes I found that to be an empowering thing.

Interestingly though, it was still "unfulfilling." Because I had the spinal, I could not feel my baby come down the birth canal and I could not feel him being born. So while I pleased with the experience, I was surprised to find how important feeling him leave my body seemed to be to me.

Anyway, I never used one, but I know there are a lot of birth choices groups out there, who probably discuss VBAC all the time if you want IRL support.

Seriously there is nothing wonderful about a vaginal birth. If anything I feel like less of a human due to all the damage, near death experience and bad memories. I'd choose a c section every time in future. Sorry you're not getting the birth you hoped for but please don't beat yourself up about it due to something that's a bit of a myth about people feeling fulfilled, etc.

I had two C Sections as advised by my obstetricians. I don't think I have missed out on anything- I have two beautiful and healthy children and I am here with them. That's the most important thing.

Well, since this thread is now apparently about whether you can find vaginal birth empowering I'm going to go against the grain. I did find delivering my baby vaginally empowering, although I haven't had a CS so I can't compare it to that.

Since knowledgeable people on this thread have said OP would be eligible for a VBAC where they work and the issue is a matter of opinion on which consultants differ, and since OP feels strongly, I would seek a 2nd opinion. I don't care for the lecturing of women if they dare to question birth recommendations and/or weight their own experience as a factor. These are complex and difficult decisions and clinicians frequently disagree.

Would it be enough for you to labour and then haves c birth after a set length of labour? That would mean the baby gets all the benefits of experiencing labour.

Could the issue be a Bandl's ring?

Would you consider chatting through options on the AIMs helpline?

https://www.aims.org.uk

I had an emcs with dd after a labour very similar to yours OP. The reason for my emcs was that DD had got herself stuck halfway between being back to back and the right way round, so she was effectively trying to come out facing sideways.

However, I was told that I was a good candidate for a VBAC with DS because I had got to full dilation and had gone into labour spontaneously, and it was DD's position that caused it. I think you really need to discuss your notes with someone else and find out exactly what the reason for your baby getting stuck was. As others have said, if it was pelvis shape or something similar, then an elective cs would make sense. but if it was a malpositioned baby, then maybe you should push for a VBAC. Could you ask for another appointment with the consultant or the head of midwives?

Like you, I felt that my second pregnancy was the chance to right the wrongs of my first delivery. I felt all the guilt and trauma you have described. However, DS was having none of it and was an unstable but mostly transverse lie. I had a week on the ante-natal ward and then a CS because it was too dangerous to let me go into labour.

But in the end, the birth did alleviate a lot of the things I felt about DD's birth, even though it wasn't a VBAC. I made peace with the fact that my body clearly isn't good at getting babies out. I've had two labours that, without modern medicine, I (and my children) probably wouldn't have survived. All the negative emotions I felt after my first birth simply went away and I was much more able to concentrate on the positives.

So, by all means, speak to your consultant again and get more information about the possibilities of a VBAC but, if it isn't possible, then don't assume the feelings you will have will stay the same.

I was in a similar situation: days of being in hospital ultimately leading to an emergency c section. Second time around was planning a home vbac, but it was not to be and had a second c section.

I have to say that whilst i’d hoped for the home water birth vbac, and had candles/whale music at the ready, I didn’t see it as defining me as a woman. Both children are healthy, and in their teens - how they came into the world is really not something that crosses my mind or relevant to our lives. Good luck x

Ah, I feel for you. I have had 2 vaginal deliveries with various interventions and a c section.

The c section has left me with the least lasting damage. I do not feel more or less fulfilled by any of the births when I compare them.

In fact, I can also tell you that no one else gave even the tiniest of monkeys how my babies had arrived.

I was all 'I have survived a c section / I have delivered this baby out of my wanny' and literally NO ONE cared. I only wish the c section had been planned and tbh if I'd known what it was like, I would have had one before. I was overdue with all 3, went through horrible inductions, endless interventions and actually having a planned calm c section would have been really nice.

I don't know if any of that is helpful, but I can understand how you are feeling. I had similar issues around breastfeeding for ages and it really gets to you.

I wish you a happy and safe birth experience, whatever it may be.

I remember one woman, on hearing i'd ended up with an emcs, saying "oh no....do you feel cheated?". I laughed at the time but I can see now it's all part of why women fall for this natural birthing = a must have/best/empowering way to have a baby.

Fwiw I was all set for vbac with dc2 but we got to 38 weeks and everything was identical to dc1 (size/presentation/no sign of child wanting to come out every/etc) that I just knew we'd be heading down the same road. So I chose an elcs which was an amazing experience.

Also, the further you get from their birth, the less anyone cares how they got here.

I had a successful home birth VBAC that was PLANNED! I had to fight a bit for it thought. My advice is to read up on the risks and fully inform yourself of them (they are pretty tiny) and ask to speak to the head of midwifery. That's what I did. She got my notes out and went through my previous births and explained and discussed the risks with me. In my favour was me having my first child at home (again planned) so we knew my body "knew" how to birth a baby, and my second which was the emergency section, being an undiagnosed breech. So that was the only reason for my section. There was no failure to progress. You will be in hospital for your labour so you are minutes away from theatre if anything does happen and your risks are not much more than someone who hasn't had a section. Arm yourself with facts and take to the head of midwifery. I can't remember her actual title. They HAVE to support the birth you want and normally they are pretty pro VBAC as better outcomes all round. Obviously medical need may change but you should be given the chance to labour and see how you go. The threshold for intervention will be lower this time round anyway. Go for it! I can't advise you strongly enough on reading up about how labour works and how your body gives birth. The NCT might be good for info and support along with a doula. Relaxed, calm, confidence in your body to do what it is designed to do and knowledge. This is the power you need.
P.s. the dr thought I was batshit and told me I was risking my life and that of my baby but armed with the facts and the knowledge of having given birth at home before I knew the risks were very small for a home birth.

As a currently pregnant previous c section Mummy I feel for you but I honestly don't understand some women's overwhelming need for a "natural" birth above everything.

If I had been born hundreds of years ago me and/or my daughter wouldn't have survived childbirth.

I'd rather me and my child be alive than be dead and have a "real birthing experience" sorry if this offends but it's the truth.

Medical interventions aren't always pleasant (my section left me with birth trauma) but honestly people, listen to your drs advice they aren't doing it for their own personal convenience or pleasure, it's for you and your baby's health!!!!!!

Do you know what was healing and empowerring after my EMCS? My ELCS with my second child.

I know exactly where you're coming from OP. I genuinely went through some sort of grief/minir depression thing first time as I felt (wrongly) that I'd let my DS down, my body didn't do it's job etc etc. I couldn't talk about it without crying - not big racking sobs or anything, I'd be calm but the tears would just start rolling, it was very odd.

At first I was adamant I wanted a VBAC to put everything right, but after a lot of research & soul searching and infinite lists, I decided that the damage done by a second 'failed' labour, would be far greater for me than going for an ELCS, where I was in some sort of control. I also didn't want an instrumental birth which, I am lead to believe, is more likely as they don't let you push too long in a scar.

My ELCS was calm and beautiful and healed all my hurts from the first birth. I wasn't exhausted, I could plan for DS1 and I was home in 24h with an undamaged foof and a much neater scar! Happy happy days.

But good luck with whatever you decide, I just wanted you to know that an ELCS can be very positive too.

Can I also add I got to full dilation too and was told the shape of my pelvis wouldn't allow baby to pass naturally - which again shows that hundreds of years ago me and or baby wouldn't have survived!

Go for the section! It doesn't take away from your experience of being a woman or a mother!

I do understand how you feel, but for God's sake listen to medical advice.

I was given the choice of VBAC or second c-section, had a VBAC and ended up with some damage (slight but permanent). Given the choice again, I would opt for the second c-section. This is just a bit of background and not too relevant to your situation.

HOWEVER... My close friend was advised very strongly by the NHS to go for a second c-section but insisted on a VBAC instead (for the same reasons you give). The baby was born fine, but the physical damage to my friend has been appalling. She has suffered years of failed patching-up operations and eventually had a hysterectomy in her 30s.

Obviously this may not happen to you. But please consider that not everybody is designed for vaginal birth (look how many mothers die in childbirth in poorer countries) and the NHS does not recommend expensive procedures without a strong reason.

Sections are often suggested through fear of being sued should something go wrong but sections carry much greater risk to mother and baby than a natural birth.

I had a VB after 2 sections, 1st emcs (big head, malpositioning poss caused by ARM without my consent), second planned section at 41 weeks (hated it).

I was lucky - VB was great BUT "fulfilled as a woman"? No. Really not. Fuck that shit. More sticks for women to beat themselves with.

If it is what you want, though, at least get a second opinion. Have a chat with the supervisor of midwives/consultant midwife . Read the NICE guidelines, be informed. Then decide.

sections carry much greater risk to mother and baby than a natural birth
No they do not.

Look at elective CS statistics and not emergency CS statistics.

I had a ventouse delivery and a crash section with my second. I would not push anything out of my vagina again. A vaginal delivery is overrated (am sure lots of people have positive births) and doesn’t make you more of a woman or a mother. Look into it but don’t put yours or your babies health at risk. You’ll have an apron and a ruined fanjo whereas at least with a section your fanjo might have some hope.

Baby’s

I get how you feel and you are totally justified in feeling that way. However, look at it a different way, be empowered by the fact that you will be in control this time-you will know the date in advance, you will know what is going to happen, you know you and your baby will be as safe as can be and you will be in charge of things like what you're wearing, the music, the mood, whether you hold your baby first etc etc. Having a c section does not mean you won't be in control. Make the decision that is best for you and your baby, that is what a woman has to do. You are no less than anyone else.

I felt exactly the same as you after 'failing to progress' in my first labour after waters had broken. Had c-section abroad and it was a terrifying experience. Six years later and back in the UK, went to NCT classes and still uhming and ahing over whether to go for vbac. A couple, medical consultants, were also on the course although really for the BF aspect and new friends thing, as she'd already got her section booked for first baby. Choice rather than medical indications.

That made my mind up for me really. I've since met, and become friends with, two GPs. C sections for all their three - no real reason other than preference, at least for #2 and 3.

I spent a while wondering about the 'what ifs' but as time fades I have little regret about never experiencing the wonders of natural vaginal birth.