Successful Vaginal Del. After CS First Time?

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Hi I am interested to hear from anyone who had a CS with their first child. I want to know what percentage of mums who have a CS with first baby go onto have a Vag. del. with second. Also would like to hear from mums who planned for a vag. del. with second but ended up having another CS. What happened?

Am trying for second baby. First was crash CS. Wanting to know what my chances are of having a vag del or whether to go for an elective next time and cut out the trauma.

you'll get loads of good links in a minute from some more organised people but just wanted to pop in and say hi, go for it, vbac is cool, but would definitely advise reading up as much as pos first and making your own mind up about the necessity of things like continuous fetal monitoring

i'll bump this for you to make sure that lulu, daisyMoo, klaw et al see it and point you in the right direction.

I've just had my second (by c-section) but there were some women on my ante-natal thread who had successful VBACs after a CS.

I'm obviously not the best person to talk to, but in hindsight I wish that I'd had the courage of my initial conviction and gone for a VBAC...it is definately possible!

My friend had a cs first time and went on to have gorgeous ds2 with vaginal delivery.He is a little star and has been troughing solids at my house todayShe was really worried about childbirth 2nd time round but had a wonderful time.

Search for VBAC, it's a very common term on Mumsnet. My sister-in-law had an emergency c-section with her first and two subsequent vaginal deliveries without complication. On the other hand, there are MN ladies who want to go down the section route again subsequently, and that also seems perfectly reasonable to me, you need to decide what seems best for you. Good luck!

VBAC rates stand at about 75% which is actually the same as for any first time mum achieving a VB.

It appears to be important to plan as natural a birth as possible to achieve a VBAC as many of the interventions that tend to be used are what caused the CS in the first place:

Induction without a valid medical reason
Continuous Foetal monitoring
Labouring on your back
....

Can you tell us about your 'crash' please? What happened in labour that led up to that. Then we have a better chance of giving advice suited to you.

From my experience the mums that 'failed' to achieve their VBAC were mostly those who were let down badly by their mw and/or family/dh. One in particular that I know of then went on to have a spectacular HBA2C with a Doula for extra support.

You will need to do your research, decide what's important to you and be strong!

Maybe I should post my resource file of various VBAC links? Can I see a show of hands?.....

I had a CS first time as DS was breech, so it wasn't an emergency CS, as we knew in advance. Had a successful (and short - 4 hours) VBAC last September with DS2.

In my case though, the fact that DS1 had been breech meant that my chances of a successful vaginal delivery were no worse than any first time mum-to-be. The reason for the CS the first time just wasn't there.

Definitely do your research, and talk to your consultant. My worst fear was a long, difficult labour followed by an emergency section. My consultant reassured me that they would not allow that to happen, and that at the first sign of difficulty, I could choose a section.

The recovery from a vaginal delivery (even with 3rd degree tears) was MUCH quicker and easier than from my section. And with a toddler running round as well, it was invaluable being able to be up and about almost immediately.

Good luck with it all.

you need Lulumama
if you keep this thread bumped she will find you
VBAC is like a siren call to her

bump for you!

I had an emergency CS with my first, then went on to have 3 vaginal deliveries.

Very encouraging.

First one, mmm I've posted my birth story a few times don't want to bore anyone but... Waters broke at 37.5 weeks. Labour was very slow to start. About 60 hours about waters broke I had S&S which got things going a bit. 12 hours later I was in hospital and fully dilated but aided by drip induction. I was very tired and on my back and being monitored all the fucking time it was awfully slow. But to be fair I was so exhausted after 3 days with not a wink of sleep I couldn't stand even though I wanted to. Baby appeared in Brow Pres. was advised to have CS. Refused, believe all would be well in the end. After a furter 90 mins. Taken to theatre, given GA, DD stuck in pelvis took 40 mins plus vontous just to get her out via section. By which time placenta has come away so DD in a bit of a state (that's a medical term BTW). She spent a week in special care, which was the worst bit of all. Really nasty bruises on her head where she'd been stuck inside. Poor darling. I'd been following the Jeyarani Way to a Gentle Birth too!! Was so desperate to have a water birth it couldn't have gone further from plan. Someone suggested the other day that DD may have been in Brow Pres because I was induced but the proceedings were spontaneous. However, I've thought about it and I always had the feeling that I wasn't supposed to go into labour when I did. I think the membranes ruptured by accident because my DD was so wriggly and active the evening before it all happened. I think I wasn't really in labour and it was just the S&S which got things going. Also I was induced by drip in the end. So maybe..... that caused her to take that position. Anyway really would like to get it right next time. But am nervous of the horror.

Best places to start:
www.caesarean.org.uk/
www.aims.org.uk/
www.caesarean.org.uk/articles/VBACOnWhoseTerms.html
www.radmid.demon.co.uk/vbac.htm

Debbie Chippington Derrick?s recent Presentation on Natural Birth after Caesarean: caesarean.org.uk/presentations/NaturalBirthAfterCaesarean.html

If you have trouble coming to terms with your previous CS:
www.plus-size-pregnancy.org/CSANDVBAC/csemotionalrecov.htm
www.birthtraumaassociation.org.uk/
tinyurl.com/5gscd "You should be grateful"
www.sheilakitzinger.com/ArticlesBySheila/BadBirthHaunts.htm

Info about how to obtain your previous Birth notes: www.patients-association.org.uk/onlinewebmanager/downloads/Medicalrecords.pdf

And I've got so much more but I couldn't get it to work properly, I can send you a .doc file if you wish.

Wow so much. Thanks for those links. Will have some reading to do.

However, I am still interested to hear of women's personal experiences here as I find it more useful than stats. E.g. the hospital I gave birth in said that only 9% of babies are delivered by CS. But I'm not sure I believe them. There were so many women on my ward who had had CS. And in my NCT group 50% of us had CS. And as far as I can make out the others were not really necessary they had just gone over their 'time limit'.

I don't really think that I'm traumatised by my birth it just happened the way it happned and I'm ok with that. I am absolutely certain that the CS was the only way to get my baby out alive. So again fine with that. But am anxious that the reason my baby got stuck inside was something to do with me rather than the circumstances and therefore worried that I can't deliver normally.

what Klaw said !

I had a VBAC , was amazing..... makes me want to do it all again..

i would suggest that you look into having a doula too, for that extra facet of support

i would also look at optimal foetal positioning and www.spinningbabies.com which can help re getting baby in a good position for birth

brow presentation is unlikely to recur and is quite rare

malpresentation can be encouraged by PROM , as gives baby less ability to manouvre

go for it

my VBAC changed my life utterly, and i mean that !

www.birthchoiceuk.com stats for all maternity units and hospitals in the UK

brow presentation is very very unlikely to have been caused by you, IFYSWIM

What your hospital might have meant by 9% cesarean rate is that there emergency CS might only be 9% with the rest being elective cesareans.

There's also a vbac yahoo group which you can join and get lots of specific advice and support.

I had ec last time and was like you a wanted a section this time so i knew what to exspect and thought i would feel better with planned. However, have after much thought, decided to attempt a VBAC as long as my consultant continues to agree.
I think the difference is, im more prepared for my difficulties and so is the medical team. My consultant continue to agree with me but feel as im seeing them so often that if there is a change of plan i hopefully would be prepared.
Could you arrange a appointment to discuss your worries? Do you know the chances of you devloping the same problems?

Hope this helps and makes sense

lisa

Just to let you know - my mum had me (first baby) by crash C-section in 1980. In 1982 she had my sister vaginally with no problems at all

My first was breech and two weeks overdue so the docter did a c-section. The others were all born vaginal birth. Vaginal has a lot quicker healing time. If I remember correctly, my ob told be that it depends on which way the cut your uterus for the first baby. Do you have a up and down incision, or side to side. Mine was lower stomach side to side. This matter because the uterus heals better from this type of incision. Also, the reason why you had to have CS the first time.
Anyway, if you have a choice, I would go with the vag.

Lullamama, I know that Brow is rare I've have looked into it since, as I hadn't even heard of it before. My hospital told me that they deliver around 15 babies a day and see around 5 Brow Presentations a year. So that is encouraging. However, a lady I know had her first baby in Brow and was told that it was very rare and would not happen to her again but actually all 3 of her children were Brow Pres. This is what led me to think that it could be the shape of a woman inside which caused the baby to present like that. However, I now feel that it could have been caused by the fact that i spent so much time labouring on my back.

Re: doula, I think its a terrific idea but it's not for me. I'm a very private person. Also my husband would feel pushed out I think and I wouldn't want that as he was awesome throughout my first labour and birth. I have friends who are so pro doula but I would rather not go down that route.

Have been doing some reading of the links and feel more likely to go for a vbac. So thanks everyone for your support and contributions.

Well, personally, 009, my first born was emCS due to PROM, foetal scalp electrode which meant flat on my back, no advice at all about positions, even though I didn't have an epidural, lack of sleep, naievity, poor support, OP baby, augmentation of labour which resulted in me having diamorphine, and brow presentation!

for my VBAC I tried OFP to ensure OP wasn't an issue, refused to lay on my back or have augmentation. I did go wrong in getting on the blasted bed, havign CFM and not having support for me and dp. He tried not to let me have diamorphine again but I was scared and needed support so thought that pain relief was needed. With hindsight if I'd been better prepared, had told dp what I needed from him in the greatest detail, had not got on to that bed and refused CFM, insisting on imtermittant instead I would have had a greater chance of avoiding the forceps with a spinal. As it was I did the pushing, the forceps did not pull so I KNOW that next time I will have a HWBAC!

I know you can have a fabulous VBAC, you just need to plan it!

Does this help?

I had an emergency section with DD 5 years ago. I have recently had another section with DS. I was all ready and prepared for a VBAC after speaking here with lulumama and klaw and doing loads of research.

I went into labour spontaneously and was doing fine during the early stages until I had a show. Unfortunately I began to lose a lot of blood - I went into hospital at 2cm dilated, and a little later my waters broke and there was a lot of meconium staining. I discussed the situation calmly with the consultant and we decided the best course of action was a c-section. I felt happy with the decision as I did not want to put myself or DS at risk.

Just to let you know, the recovery from the c-section this time around has been much quicker than first time around.

Klaw, that is helpful. Except please tell me what is OFP and OP. Sorry if I'm being stupid and missing the obvious. Thing is I planned carefully for first birth. I had a water birth planned and followed a strict regime for my entire pregancy 'the Jeyarani Way' but when everything started to go wrong it all fell apart. After 60 hours the midwife insisted that I have augmentation and being totally shattered not to mention is agony, I acquiessed. I think knowing your rights is one thing but actually being able to stick to them in that situation is another. I am normally a very assertive person but well it's all so new isn't it?

I think the pressure from the moment my waters broke of 'if you're not in active labour within 24 hours - you've had it you're strapped up' was so demeaning and so frightening that it prevented me from sleeping for 2 nights, which led to exhausion which caused all the problems. Plus also the scare mongering. My DD's HR dipped during contractions so they really used that to scare me and insisted on the CFM.

It all seems to add up. And I think I can believe that it is not something wrong with me but the clinical environment. It is no place to be giving birth.

Ginerbear, glad to hear the second CS was a better experience.

Hi. It's many years since I have posted on mumsnet but i have been lurking on and off.

I also had a crash section followed 18 months later by a short labour and normal delivery.

I thought the recovery from the CS was easier but I was more concerned about uterine ruptures and other complications especially since the second was so soon after the first.

It was never considered that the second would be anything other than a vaginal delivery.....not even mentioned in my notes or anything. Nor did I have continuous monitoring or any other special care.

Good luck whatever happens.

Wow Pacific. That's interesting and good news. How long ago did you have your children? Or maybe your NHS trust is just more laid back than others.... So good that you were just 'allowed' to get on with it with the second. Brilliant.

Sorry 009, I am so used to using shorthand I forget not everyone is clued up, my fault, not yours.

OFP = Optimal Foetal Positioning, see www.homebirth.org.uk/ofp.htm. The Heath Care Professionals say it's not proven but anecdotal stories back it up and it sounds logical to me. I'm hoping to get to a workshop at the end of the month to hear Jean tell us all about it!

OP = Occiput Posterior, which means baby's back to mother's back

Brow presentation can also be called head deflexed, I think. Having had this myself I looked into this a bit. It's important not to break waters artificially as then the cushioning surrounding the baby is gone. And so if baby needs to tuck it's head in it will find it very difficult to do so without amniotic fluid, and it cannot rotate to Occiput Anterior very well either, it's not impossible, just unlikely without a lot of effort and time, and we all know you don't get given much time by the Health Care Professionals.

From what you've told us you had quite a classic story leading to CS, which is good because next time you will know what to avoid!

DD's hr dipping during contractions is normal, babies are designed to deal with normal contractions and their hr may well dip. If they remain dipped in between contractions then there should be cause for concern and different postions adopted to try to prevent it reoccuring, as baby could be lying on cord for example.

does this help you understand? Keep asking the questions!