Advice on delivery plan for ivf baby, preferably vbac

[Catren]

Hello lovely minds of mn.

I'm 16 weeks with dc2 and have just had my obstetrician appointment to discuss birth options. It's very early but I'd like to have a general plan in place with a back up in case it doesn't work out, so thought I'd get some outside advice.

Dc1 was natural conception, i was induced at 40+10, and after the pessaries (days 1 and 2) and drip for 24 hours on day 3 dc1 arrived by emergency c section. I was fully dilated and pushing, but baby was back to back and became distressed, hence c section. No forceps or ventouse, and the surgery was straight forward. Dc1 is now 4yo.

I'm told the risk of still birth and other poor outcomes for overdue ivf babies is 1/2000 so have to make a plan to deliver by 40w. That stat doubles with induction by oxytocin.

I'd prefer a vbac over planned c section for the assumed easier recovery (am i right here?). I think it makes sense to opt for a vbac, but if i don't go into labour by 40w I'll elect for c section.

Does that sound sensible? Am i jumping too easily to c section when induction might actually work this time, given i responded well first time round, but it was due to baby distress that i didn't deliver vaginally? We're not sure whether we'll stop at two dc, so am i not able to have another child if i have a second c section?

Experiences of others with vbac would be greatly appreciated.

Thanks in advance!

Ahhh my lovely paragraphs have disappeared! Sorry!

I think your choices appointment should be helpful here. The midwife can take you through the pros and cons of both vbac and elcs. Your plan sounds sensible to me though! You could also look up some of the stats around vbac vs. elcs - I found it very useful when making my own decision.

Our trust won't offer induction for a vbac situation, but others will. Since you went into labour naturally last time you may not need to think about this anyway.

The recovery differences seem to be entirely personal. For example, my elcs was much easier recovery wise than my emcs following a failed induction, and my friends elcs recovery was much easier than her non-intervention vaginal delivery.

As for stopping at two, I don't believe there is an arbitrary limit. The surgeon who delivered DC1 and 2 said they'd like to deliver DC3 if we decide the have another.

Congratulations on your pregnancy

Thank you duggeehugs for your reply! Love your username 😊

My previous birth was an induction so I am a bit concerned about whether I'll go into spontaneous labour. I'm in Australia (had dc1 in uk though) and they will do induction after c section here, but only on the drip - none of the gentler pessaries/gels are available with vbac. So that's putting me off!

I basically have to make the decision at 36 weeks and let them know, and the midwife has talked me through the options already at booking in and i assume this conversation will continue throughout pregnancy.

Interesting about the difference in recovery between emcs and planned, and that makes sense given i was exhausted after 3 days of various stages of labour and all the drugs/ sleep interruptions it's no wonder my recovery was hard.

Thanks again for your reply, it's crazy how much uncertainty there is and the diverse range of variables and experiences - it makes the choice so difficult!

I had the same experience as you OP, with two days on the pessary, then 15 hours on the drip and then EMCS as my cervix wouldn’t fully open!

For number two, I am already certain I will elect. I know what to expect from the recovery and I would not want the worry of not going in to labour and having a failed induction again.

OP I'd read up on guidelines for vbac. They wouldn't be keen to let you have induction or long labour so wouldn't be repeat of first birth.

I had long labour then CS with DD, currently 38 weeks planning vbac, mainly for ease of recovery with a toddler, health benefits for baby, hope of breastfeeding being less horrific to start.

It's a tough one as CS is more predictable, vb could be either brilliant or awful. I was given the option and didn't have to decide until 36 weeks.

If I'm a lot overdue or need lots of fiddling about with then I'm going to ask for CS. Basically want to avoid being a zombie covered in wires and tubes if poss.

Hello

I started a thread in October asking for thoughts re vbac induction or planned section.

I was doe Halloween with baby after many miscarriages and missed miscarriages and failed IVF. After a long chat with our consultant she was recommending a planned section. This was with the primary goal of getting baby here as safely and calmly as possible.

It was her view that a planned section was the least stressful way to do that and the best choice in my specific position.

I felt I should be trying vbac and was at a loss. I did go with plan and had her early one morning on a non section day in a quiet delivery. The section was absolutely fine. I was so concerned re DD and her being here it did not bother me in the slightest. I did the enhanced recovery and was in the shower within four hours. I recovered physically very well.

Consultant was very clear that planned section was the least stressful and easier recovery option than a failed vbac followed by an emergency section. My understanding is the recovery from an emergency section is entirely different as you also have the exhaustion from the vbac before you even start.

Not sure if this helps but I found it a positive experience. The thread I posted overwhelmingly agreed with consultant and planned route for me.

Sorry, I hadn't clocked that you were induced last time.

For me, the failed induction first time was the driving reason behind having an elcs not a vbac second time. The information I was given by the consultant was that an elcs was a higher risk for me but halved the risk of stillbirth, which absolutely confirmed I'd made the right choice in my circumstances.

The recovery was definitely easier without the exhaustion from the induction. First time I was in for two days afterwards, second time I was out within 24 hours which was quite manageable, even with a toddler to consider at home.