VBAC or ELCS

[Fairyrainbow]

Currently 35 weeks and have meeting with consultant soon to decide on birth options. But after some advice/opinions as still currently undecided. Bit of background Previous birth was csection at 36 weeks due to position of baby had section at 36 weeks due to waters breaking. Everything going ok ish this pregnancy however baby is above 90th percentile. Wouldn't mind trying a vaginal birth but would like baby to be here and be home for xmas due to other child (due 28th) am also concerned that if I opt for a vaginal birth and go into labour around due date size of baby may result in assisted delivery (which I do not want) or csection anyway. Also not keen on going overdue then been induced. Also dr at hospital was pushing towards VBAC and said theres a 60% chance I would have a normal delivery, those odds don't seem that convincing. With csection at least I would have an idea of date and know what to expect. Midwife and dr at a previous appointment around 30weeks someone mentioned big baby trial which would mean induction at around 38 weeks but this hasnt been mentioned again. My other option is do I just book the csection and see if I go into spontaneous labour before then and then ask for natural delivery. Anyway just wondered which delivery people would be swaying more towards as was told to go to appt with a decision. Also is it 39 weeks when they usually perform elective sections? Oh and just to add also been suffering from spd so not sure if a vaginal birth would aggravate this?

I don't have advice for everything specific to you. But I am choosing a vbac with the condition that if intervention such as induction is necessary we will skip and go to c section.

No one has a crystal ball sadly

FWIW I had a planned section after emcs and it was fine.

Friend had a vbac was not fine from her perspective.

Lots of people will have other experiences.

60% isn't great odds I agree.

Don't know about spd sorry

Good luck

I had really bad spd and it didnt affect my vaginal labour. It was bliss afterwards to be able to lie comfy again 😊 cant advise on the rest.

The docs wanted me to try VBAC but in the end my baby grew so had section at 38 weeks. My first was 10lbs 4oz at 37 weeks (scheduled for 38 but my waters broke) second baby 9lbs 14oz and I'm type 1 diabetic and 43 at the time. All those factored in to the decision.
I'd go with your doctors advice but I was nervous of vbac and was happy to have second section. Forgot how painful it was after though!

I had emergency section followed by 2 vbac currently pregnant with my 4th and I'm having a planned section and been sterilised at same time recovery is much quicker with a vbac I was home after 6 hours with my first my second had to stay in overnight but only because they used forceps so he had to be monitored for 24 hours and I was cut from front to back but was still moving round fine

They may not induce you for a VBAC anyway (my consultant won’t).

I’m in a similar position. Baby 1 ended up as emergency c section. Have c section booked in at 39 weeks for this one but still not decided whether to go for a VBAC or not. I was also given 60% chance of VBAC being successful which I agree doesn’t sound great!

I'll ask about the VBAC induction. Sounds like booking the csection may be the way forward, then can always change my mind if I go into labour naturally before then. Have they booked you in at exactly 39 weeks or a few days after as just worried I won't be home in time for xmas if I choose this option

I was encouraged to have a vbac after an emcs with first baby. I was worried that the same difficulties would arise again but they reassured me no two pregnancies or labours are the same. My fears came true as while trying for vbac the same problems occurred and I ended up with another emcs. All very stressful and I wish I had chosen an elective.

I'm in exactly the same position as you op but due two weeks after, so following with interest. There are pros and cons for both which makes it difficult but I'm swaying towards the c-section as I feel the odds for a successful VBAC with no intervention aren't great, I also am expecting a big baby.

Good luck with what ever you decide!!

What's wrong with intervention on a VBAC ? Surely a CSection is the ultimate intervention? I'm also due at Christmas. Previously large baby 98th percentile, overdue induced VBAC with ventouse ( was a big surprise that baby was so large). This one as the moment if it maintains the line on my extra scans chart is due to be 4kg. I don't know I'm term
of percentiles.

Also very torn over whether to ask for Csection or not. Was a long recovery after big baby before, but not sure if they consider this one big so might not get any say on early induction or elective. My next scan is 38 weeks.

I've seen posters saying induction 38 weeks for big baby, but think that's due to gestational diabetes. @Fairyrainbow @clemmy0m how have you found out yours is expected to be big?

Ps not saying anything wrong with Csection, certainly considering it myself.

@chicchicken my first baby was big 4150kg (I'm 5ft1 and petite if that makes a difference) and from the measurements they have done this one is predicted to be bigger around 100th C, I do not have GD. My first baby ended up being an emcs because I failed to progress past 8cm as he got stuck and was in distress. The consultant said there was no way he was coming out naturally after the op. They have encouraged me to try a VBAC this time but I suppose I'm scared that I will end up with the emergency again or intervention (50% odds of it being successful if baby is over 4kg). I've also heard some real horror stories from people who had intervention and they have been left with long term issues which have terrified me and I suppose I know what the c-section recovery is like (although do have a 2year old this time) so it's tough. If I had a crystal ball and could have a nice straightforward VBAC that would be my preference. I'm in the UK and my trust has said they won't induce someone with a previous c-section and because the baby is big they won't let the pregnancy go past 41weelks and if I opt for a c-section it will be booked in at 39.

I had to have extra scans as midwife thought I had polyhydramnios but just turned out to be large baby. @clemmy0m am also only around 5ft so this also makes me question if VBAC would be successful with large baby. @chicchicken would rather not have intervention as friends and family who have ended up with forceps/venthouse/episiotomy have ended up with longer recovery time and ongoing problems whereas I had a relative quick and easy recovery from previous section. Could be swayed by VBAC if they would induce at 38 weeks, am ready for this baby to be here now so ai can feel like myself again. Interesting that they won't induce if you've already had previous csection no one has mentioned this as of yet. It's certainly given me a few more questions to take with me to appointment. Just don't want to feel pressurised into either decision by the consultant or doctors as at the minute they seem very pro VBAC.

@Trying2310 that's what I'm worried about opting for the VBAC and then it not going to plan and ending up with a csection and long recovery when I could just have opted for a planned csection and a calmer experience anyway

@clemmy0m My first was 5kg and whilst I've done it once vaginally, i will not do that again as yes it's a risk on the recovery. So if yours is due to be around that then I would go with the planned C-section personally. Here they are saying if my baby is predicted to be 4.5 kg or under then they won't do anything.

I have a slightly different experience to you but thought I would share my experiences. I had a horrific birth with DS1 (8 lb 12oz) and ended up with a third degree tear after forceps intervention. Recovery was pretty awful and took a good 6 months to feel normal.

3 years later I was pregnant with DS2 and was given the option for elective. I was told there was a 20 percent chance I could tear seriously again and that was a high enough chance for me to opt for the elective. DS was born in February at 39 weeks weighing a whopping 10lb 6oz which surprised everyone. The doctor that delivered him said that it was highly unlikely that I would have been able to deliver him naturally and so I was so glad I went for the elective. It was a lovely calm relaxed experience and a world away from the trauma of my first. Recovery was also much easier although my DH was able to take a month off which helped massively.

If we were ever to have another baby I would opt for an elective section in a heartbeat. Good lunch wit whatever you choose.

Good luck not lunch!!!

@Fairyrainbow booked in at exactly 39 weeks.

@chicchicken you’re not wrong about the ultimate intervention, I just think most people would prefer a planned c section rather than emergency. And I’m pretty sure planned is usually safer (and certainly less stressful!) than emergency.

The way I look at it is across a scale of 1-10 for recovery. Where 1 is straightforward birth with a rapid recovery and 10 is a complicated birth with significant long term damage and a very long (and potentially not complete) recovery (and this is the best “10” outcome, obviously there could be a much worse scenario that I don’t even want to think about).

I do feel like c section lands you somewhere in the middle from a recovery perspective so would I rather shoot for that or take my chances that I could end up at either end of the recovery scale?

I would almost rather have my doctor decide for me but apparently we all want some level of control/choice in these things!

I think maybe the reluctance to induce might be that it’s very quick and more intense than naturally going into labour. I was induced due to being overdue with big baby 1 ( although it was nothing to do with size, I was nearly 42 wks) So maybe that puts more pressure on a C-section scar? I have not had a C-section, just guessing. I am not worried about having one apart from the not being able to drive for six weeks. My DCs pre-school needs driving to and my DH is self employed so any time off is unpaid, so basically he can’t take time off. Christmas is slow time anyway for his business and of course you end up spending lots.

I know I am being monitored, but so far no one really seems to appreciate it’s an anxious time expecting a big baby or having previously had a big baby. But then a friend had a c-section purely due to anxiety about birth, she had to be very confident in what she wanted. No medical issues, no previous babies.

My first was born via emergency section (waters broke, failed to progress, baby distressed). I was quite unwell during my recovery (not as a result of the section but a pre existing infection and pre eclampsia) so it did take a while to get back to full strength.

With DS2 I chatted the options through with the consultant. She also said she wouldn't induce me (induction increases the risk of a uterine rupture).

For me another long labour ending in an emergency section was my worst case scenario. Given my failure to progress last time my odds of that were about 50/50 in a vbac scenario which was too high a risk for me personally. In the end I opted for the elective with agreement that if I spontaneously went into labour prior to the booked date I would attempt a vbac with the proviso that if I didn't progress well they would move quickly to a section.

DS2 was born by elective section and it was a very calm and easy experience. I recovered much more quickly and was driving within 3 weeks. I made sure I had lots of support with DS1 for the first month which really helped. I don't regret my decision!

Good luck whatever you decide!

@Fairyrainbow after my second emcs the surgeon said I would never have delivered naturally. I am small with a small pelvis. I was so upset and angry that I had been pushed by vbac midwife to try for vbac despite my concerns. I went on to have two planned sections and the recovery was a breeze in comparison to the first two. I believe its because I didn't go through a stressful labour first with complications. I was much calmer and knew what to expect. Everyone is different and some people will have amazing vbacs but for me and a few of my friends they didn't work.