Please talk to me about VBAC - especially if you had a good recovery from ELCS first time

[Bibbidybobbitysplated]

I am going backwards and forwards between VBAC and ELCS and would love to hear experiences (i know everyones different and my experience could be different to anything i read).

If it wasnt for the impact on DS i would have another ELCS no question, i recovered so well thanks to lots of rest but gradually upping my walking daily.

I dont want to go for a VBAC and regret it either.......

I had an EMCS rather ELCS the first time but I had a good recovery from it - no problems at all.

I went for VBAC the second time as I didn't have any problems with dilating etc, just that DC1 ended up in an awkward presentation. The birth itself went ok but the second stage was very long and eventually I needed ventouse. I had a third degree tear and had to go into theatre for a lot of stitches. However, despite all that, I was still recovered and properly out and about a lot quicker than after the c-section. It was helpful to be able to drive more quickly as well with a toddler to take about.

@dippyavocado a 3rd degree or 4th degree tear terrifies me in terms of long term effects. Are you OK now? Its the driving with the toddler and picking him up which is whats making me consider it

I had a VBAC and it was great. I’d got quite a long way with my dd before I had to have an emergency c-section. The delivery was very straightforward and I was relieved to not have to have another section. Whatever happens I’m sure you’ll be great.

The year healed really well and I saw a continence midwife afterwards for a couple of appointments which helped by making sure I did my pelvic floor exercises correctly. It wasn't a pleasant experience I admit but I was stitched up by a very good doctor and it really did heal quickly. I know not everyone has such a good experience. Both my DC were pretty big, over 9lbs, with very solid heads!

tear

Thank you, good to hear positive experiences!

I'm going to frame what I say with the fact that I do think a vaginal birth, in my experience, is easier. I have also had to have an ELCS and was told to try for a VBAC in the pregnancy after. What I wish I'd done is more digging into the rate of rupture. I ultimately opted for another ELCS as I had a gut feeling, upon opening me up the previous scar was so thin they could see my baby, almost certainly it would of ruptured if I'd tried for a VBAC. Now obviously because I had an ELCS this won't be published anyway but I wonder how many other women have had this happen. Therefore all I'd say is when you make your decision just be aware that rates of rupture would be higher if everyone had to have a VBAC. Obviously some people are still comfortable that overall the risk is still low but it's just something I wish I'd been aware of beforehand. Obviously recovery is harder when you're looking after other children but I'v been largely fine from very early on.

@lala3 was it just intuition that made you think your scar tissue was thin? There doesnt seem to be any way of checking the scar is there?

I had an emcs for dc1.
I tried VBAC for dc2, but ended with a uterine rupture, haemorrhage and a crash section under GA.
I was all up for the vbac, but it’s not without risks.

EMCS for DC1 who was breech. Out of hospital less than 48hrs later, recovery was very easy.

VBAC for DC2, hurt like fucking buggery despite all the hypnobirthing bollocks. Epidural and gentle forceps, a couple of stitches. And then it took a month to be fully poo continent again, and my Caesarian was far more euphoric. VBAC was certainly not some amazing fabulous bonding experience that some people make vaginal birth to be.

So it’s six and two threes, to be honest. If I hadn’t been so sucked into the “must have vaginal birth” woo, I would have gone for an ELCS.

I dont feel in any way that i will be depriving myself of something by going for another CS.....its mainly thinking of DC1 and being able to look after him.

If it wasn't for the impact on DC1 it would be another ELCS without a doubt

It was purely a gut feeling. Everything should of been in my favour, previous textbook easy labour, fit and heathy, over 3 years since previous section and no visible scar from the outside. I believe it can be assessed via ultrasound (I did a little digging after the event) but obviously this isn't offered. I really don't mean to scare you but healthcare professionals are all very blasé about the risks of vbac but when it goes wrong it goes very wrong. I took the view that I would take the pain of the operation and all that it involved to ensure baby got here safely.

Elcs first time round, vbac with my second. Ended up with episiotomy that got infected and recovery from that was WAY harder than recovery from a second straightforward elcs would have been. Assuming the second section would have gone as well as the first, but it's all an unknown! I couldn't walk or sit or lie due to the pain of the infection. Or wee. Or poo. It was agony. At least with a section the damage isn't where you have to sit!

That said, I'm pregnant again and thinking I'll go for another vbac and hope for a better outcome... same reason as you, I want to recover quickly for the sake of older kids.

It's a very tricky choice! Good luck though, whichever you go with :)

@lala3 I will ask about the ultrasound posibility at my VBAC meeting, im happy to pay for it if its not offered on the NHS

@gruffalOH that sounds horrid, thats my fear, being in a worse state than after ELCS. Also with an ELCS we can be so organised, childcare is over 3 hours away

@BikeRunSki oh blimey that mustve been awful you poor thing

I think for me it depends what your reasoning for section first time round was.

I'm opting for elected Caesarian in feb, as last time I had 24 hour labour, only got to 5cm and ended up rushed down due to my heart rate. When they performed the section they struggled to get her out and told me my hip opening was too narrow for her to pass through naturally.

I felt really guilty at first though when I made the decision for this time round As I was taking a cop out option, (don't know why as I know a section is most definitely not the easy option! But us mums make ourselves feel guilty for everything don't we??).

But there is no way I could confidently go into labour, i would be paranoid about it ending the same, and I lost too much blood last time too so that would just make me very nervous, when it's likely to end the same if baby number 1 just wasn't going to get out!

If it was because baby was breach first time or something like that then I think I would have opted for Vbac.

Understand about concerns about your other child, but will your partner be taking a couple of weeks off to ease off the pressure initially? Hopefully you will feel a lot more able after those first couple of weeks.

@Bibbidybobbitysplated, well, I was largely unconscious for most of the time. Dd was fine, but I couldn’t stand up straight for 2 months. I think DH was the most traumatised.

How old is your DS? I'm sure we offer a lot of practical advice in terms of looking after older children whilst recovering.

DC1 was breach. He will be 23m when bump arrives......i worry he wont understand why i cant pick him up and play properly.

DP will get a week, maybe 2 if his work allows (due to the work he does its a fair reason not an excuse) but i know after 2 weeks last time i couldnt have picked up the weight DS is at now. I could walk miles but not necessarily chase a toddler who runs off

@BikeRunSki thank you for sharing your experience its helpful. Midwifes seem to have a very rose tinted idea of VBAC

I don't think this is the best way to make a decision OP. There's a huge range of experiences, you need to look at risks and your own circumstances.

My vbac was overall brilliant - the birth bit hurt like hell but recovery was so much better and I felt much more in charge. It depends how it goes though!

@horse4course i dont think there is a best way to make a decision to be honest. There doesnt seem to be a way to work out my personal risk factor

I guess the answer is 'no one knows til it happens'

I had a VBAC after a previous EMCS. It was fine and the consultant said that as my earlier EMCS hadn't been down to 'mechanical failure' that it was ok to proceed, however it did mean that I had to go to the main hospital rather than a birthing unit and that if I had gone overdue I wasn't a suitable candidate for induction.

@Bibbidybobbitysplated I totally understand where you're coming from. Good luck!

EMCS with my first. VBAC - forceps with my second. Numbers dc3 through 8 have all been VBAC with no complications. The forceps wasn't a great experience but I can guarantee that a straight forward vaginal delivery is a much easier recovery than a c section. And VBAC still carries fewer risks than a c section.

Try not to worry too much about dc1 (easier said than done I know), but even if you opt for trying VBAC there's nothing to say that it won't still end up in a section anyway, it's totally out of your hands.

Does dc1 go to nursery? That would help, or perhaps if you have any family to stay with you?

Tough decision, but I'd go with what you would feel most comfortable with in terms of the birth itself. Don't dwell on the afterwards too much, good luck!