Can you have a water birth after an EMCS?

[KylieJennersTopLip]

I had an emergency c section a few years ago at 36+6 with my twins following a failed induction, 21 hour labour and failure to progress.
I'm 15 weeks pregnant now with a singleton and would really like to try for a VBAC. The section was fine last time but I worry more this time about the recovery time with 3 yo twins and a newborn to contend with.
I've always loved the idea of a water birth. Last time I wasn't allowed one because they had to closely monitor both babies during labour.

I asked back at my booking in appt last time and the midwife said it would be down to the consultant whether I'd be able to try for a VBAC or if I'd be booked in for another section.

If I'm 'allowed' to try for a VBAC, is there any chance I'll also be allowed to try a water birth or am I likely to need close monitoring again?
I know there's a lot of other factors that may influence things so this is more of a best case / is there any hope? Or should I get the idea out of my head now

Firstly, you can do whatever you actually want to. There will be people who want to advise you (medically and otherwise) You might want to listen to them. But at the end of the day it is actually up to you. It’s important to know that.

Ultimately you need to consent to anything they want but they could be awkward about enabling the birth you want if they’re pushing for constant monitoring etc. You might have to argue for what you want. I planned a vbac for my second and the compromise would have been that I needed to get out of the pool for monitoring and possibly for the actual birth. In the end I ended up having another emcs before long in labour so I didn’t get as far as a pool.

I know it's ultimately up to me but last time around when I expressed my wishes they made me feel awful. I didn't want to meet with my consultant with an idea of a water birth if there's no way it would ever be an option for me.

I remember one particular consultant last time saying that things with multiple pregnancies don't always go to plan so it's best to book in for a section and if you happen to go into labour before that date to follow advice at the time and I said that actually I really wanted to try for a vaginal birth first and she said 'but don't you want what's best for your baby?'
I put my foot down and in hind sight last time she was probably right

I’m planning a vbac homebirth/waterbirth for my 3rd. Consultant advised me as per guidelines (constant monitoring, in hospital), midwives were happy for me to use MLU or homebirth and I decided on the latter as a preference. Ultimately childbirth carries risks and there isn’t a totally risk free option. You need to decide which risks you’re most comfortable with (ensuring you’re clear on the absolute risk of any scenario will help you).

Firstly, I can’t believe the midwife said it would be ‘down to the consultant’ whether you can vbac??

No, it is down to YOU whether you consent have surgery performed on you or not in the event they RECOMMEND you have a cesearean section.

If you do decide to vbac the I guess a waterbirth may be subject to how much monitoring you want (again, another decision which is down to what you consent and your choice) as the hospital may not have the resources to closely monitor water births.

I just find it shocking nobody is actually giving you a balanced discussion about the risks and benefits so you can make your own informed choice.

Could depend on the reason for the em c/sec in the first place. My first was a preterm em c/sec for an APH, unstable foot down transverse lying baby followed by a very scary life threatening PPH. No reason found at time for APH or PPH.

Consultant led care for second. Had an agreed trial of labour resulting in VBAC but not a waterbirth. Hubby had baby thrown his way and still had to hit and hold the emergency call button thanks to yet another severe PPH...........................at that point I no longer cared about how a baby arrived just that it was done safely.

Lets just say after two really bad PPH's bllod work was done and next son was a carefully planned GA medical c/sec with four seperate teams inc heamotologists and the blood transfussion motorbike runner waiting outside the theatre to get even more blood. Thank you so much VwB's.

Best thing to do is discuss why you needed a em c/sec last time. What are the risk factors of something similar in the next pregnancy and so on so you can make the best informed choice for you and your baby as you get closer to delivery.

There are also a few hospitals that have 'telemetry CTG' which means you can be continuously monitored via CTG by a waterproof and wireless machine. I've only seen it in a couple of hospitals but the ones with it tend to be happier with this kind of compromise with a VBAC in the pool. But you can also decide to go for closer intermittent monitoring (every 5 mins instead of 15 maybe) in the pool? As others have said, it really depends on what you think and feel about the risks to you and your baby.

These guidelines from Royal College of Obs and Gynae might be of interest to you. About VBAC and the actual risk of things like scar rupture or repeat CS. www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf