"Support for imminent VBACers" thread?

[pendulum]

Hi there,
I am 38 weeks today and planning a VBAC after my el CS for breech.

I haven't spent much time on the ante natal threads because I couldn't keep up with them! But now I am on mat leave and due date is approaching I would love to chat to anyone else hoping for a VBAC in the near future.

Is there anyone else out there, or another thread I can join? (Am just heading to docs to check baby position but will log in again later!)

Thanks
p xx

No?

yes.. ask away !

Oh!! Thank goodness it's you You come highly recomended by Mars!!!
O.K. might be a bit long so bare with me

I had triplets nearly five years ago.Had a wonderful pregnancy,no problems what-so-ever.
I got taken into hospital at 34weeks for a planned c-section. As soon as I got into hospital I sarted to feel bad and was told I would have to have my c-section under G.A. as my platelets had dropped and the epidural might paralyse me,although one of the female Dr's was willing to wait so that I could try for a natuarl birth,but I felt too scared by then after my Consultant had said it was too risky,especially as they were breech.
Came round to be shown pictures of my babies only and they wouldn't take me to see them for two days,so the bonding experience was really hard as I had felt like I had just had an op not given birth.
My blood pressure after the birth went mad and they had to prepare me for theatre in case of a stroke or heart attack,after two weeks my blood pressure went down and I was discharged and hypertension was written on my notes.
What I would like to know(finally!!!)is have I done too much damage to my body to go through pg again? Will I have the same symptoms after the birth? Will i be able to try for a natural birth? What is the likely hood that I would have to have a c-sect under G.A.
There will be a chance of another mulitple birth as I have to have hormone treatment to get pg.
Thank you(if you haven't fallen asleep yet!!)

oh, how lovely, i was going to say mars is good at multiples and VBAC !!

right, re low platelets and the risk of paralysis.. i do not know about this at all, it might be that it is a situation where the risk is too big too take, or it is a teeny tiny risk that gets blown up becasue it could lead to a bad outcome.

re the high BP.. not seeing your babies and having a traumatic time would be partly responsible for increased BP

very and for you that you did not see your babies for 2 days.. even if babies very poorly, you should still have been taken to see them...

it is very disappointing and upsetting to miss out on those first few hours and that should have been acknowledged by the staff.

i don;t know if your body is too damaged, i would think probably not, but you would obviously need checking out.. is the platelet issue likely to recur.. ? is it to do with hormone treatmnet or having a multiple birth?

like all of these situations, it is almost, 'wait and see'. but you can plan for all eventualities.

having had one c.s under GA, you are more prepared if it happens again, and you can write in your birth plan, underlined in red and in big letters that you must see your baby/ babies as soon as you can after you are awake.

if you need a planned c.s under epidural, or spinal, then you can write a lovely birth plan, that includes skin to skin after birth if babies are ok, your choice of music, your own blankets to wrap baby in etc...

or you can go for a natural birth, and again you can do your birth planning in advance, and try to cover all contingencies.

i suppose there would be issues with another multiple pregnancy, and it would depend again in positions of babies as to your odds of a VBAC, but as long as you hvae all the information you need, and you are informed of all reasonable risks, you can ultimately make the decision as to what birth you go for.

AIMS is a good site to help with you getting the birth you want.

whatever happens, you will be more informed this time, you can ask for second or even third opinions, and if you have enough knowledge you can make the best decision for you, and your babies, whether it be an elective or a VBAC or whatever you want to try.

Thank you.

I must say I wish I had known about MN whilst I was pg. I tried to ask my midwife advice and she said sorry i haven't dealt with multiples before?!!! And that there was no point in making a birth plan as it was a c-sect. As it was my first pg i didn't have a clue what was going on,or what sort of control I actually did have. I am wiser (and older!!)now so I feel a bit more confident this time!!

I didn't realise you could actually say I want to see my babies!!!!
I was very lucky that a midwife came on duty one night a week after and was so upset that i hadn't been offered to hold my babies all at the same time and she picked them all up,placed them on me and I cried my eyes out
as it was such a wonderful feeling. I tried to breast feed and managed it for three weeks but because they were prem my milk was not happening properly and all they advised me was to buy a pack of fun sized mars bars to keep my fat intake up?!!!!!!!!

I'm a stubborn cow,so hopefully all this will give me the energy to make sure everything goes right this time!!!! I feel really happy knowing that I can make a birth plan and it is all hopeful.Thank you lulumama.x.

welcome !

it sounds like you had crapola advice and help last time, but hopefully this time, with the power of mumsnet !! you will have a more positive expereince. sometimes, you have to stamp your feet and shout to get what you want, but it is your body, your birth , your babies, and you can do your damndest to get what is right for you x

paranoidmummy - you can find an acupuncturist here - the cost depends upon where you live. I live in south Wales, and my acupuncturist normally charges £50 for the first consultation (which lasted about 2 1/2 hours), then £35 per session afterwards (about 1 - 1 1/2 hours). However, as I had so many treatments (I suffered with hyperemesis during this pg, and at one stage was seeing her 3 times a week! ), she was charging me a flat rate of £20 per week (yes, she deserves sainthood!)
Don't be afraid to ask them for their costs.

TrickortripletEm - am at your previous experience! Good luck with your vbac plans!

Mairwen is beautiful - if a tad zitty! - I am just about to take her to see the HV (who is lovely, and a properly informed one too!!) to get her weighed ...

Good luck vibes to all the vbacers-in-waiting!

TrickortripletEm, just in case you face the option of a further multiple pg I have these links. I though they may inspire you whether or not you have a singleton or multiple birth in future!

Twin VBAC:
www.homebirth.org.uk/vbactwins.htm
www.radmid.demon.co.uk/twinbirth.htm

Thank you Klaw

Thanks for theejt1764 !!!

I thought I had posted on here the other day but guess not. I have my mode of delivery check on Thursday and all is fine for my VBAC. Head is 3/5th engaged with only 3 weeks ot go. I am so excited to see lo and praying for hte natural delivery I have always wanted.

that's great news Flounder

good luck with your VBAC

wish my DC had started to engage....39+3 & head still "free"

Havent read all the latest messages but just wanted to share my VBAC story

DD1 was an emegency cs as she was breeched and in distress. DD2 who was born 11 weeks ago was head down and everythng was fine. Too fine as my labour was so quick it took me by surprise as my waters hadnt even broken so i wasnt too sure! Called the hosp at 3.30am, got there for 4.30 (tried to leave it as late as poss in case it was a false alarm- didnt want to drag everyone out of bed, including my 3 year old!) and dd2 born at 5,20.

I wanted to push as soon as i got there and listening to your body really does help. It was such a positive experience; the hormones that rush through your body afterwards really do make you forget about the pain as i said to myself not long afterwards i could do this all over again. In fact, the suturing (had a second degree tear) was worse and scarier for me than the birthing part. And the feeling of your tummy emtpying as your bb leaves was just weird as well as seeing the placenta for the first time- all of which not possible under aneasthetic during cs. I bonded and fell in love with dd2 straight away and really was on a high- totally different from the first time. took me a few weeks to do so with dd1, not to mention the recovey and pain from cs. But because i was still in effect giving birth physically for the first time, i wasnt sure 'how' to push, with mw telling me i wasnt doing so properly. When she said bb's heart rate was dropping and she might have to get the doctor, i pushed for England and she soon popped out, so maybe that contributed to the tear.

Anway, i later requested to go home early and they let me out that afternoon. I much rather recover at home with family. Pain from stitching and brusing went after about a week or so. i really was chuffed that i managed to successfully have a VBAC- all without any pain relief- not even gas and air as there wasnt any time to get it!!

Sorry for being so long winded. Just wanted to wish everyone who plan for a VBAC good luck and hope it goes well!!

Congratulations Tomliboo

I hope it goes like that for me

Congratulations Tombliboo!!!! Fantastic news!

Let me assure you the VBAC high will stay with you forever!

Quick update

just been to see m/w (39+6 today)

the good news is I'm now 4/5 engaged (felt like baby had moved way down from last week when head was still "free")

the bad news is baby had turned LOP

Off to check out the OFP & spinning babies websites, I can feel some hands & knees watching telly coming on.....

I'm also seeing consultant on Thursday to talk about booking el c/s if I don't go into labour naturally (have decided against induction). I'm sure they will put pressure on me to book it sooner rather than later, but my earliest offer is 9th Nov However I've TOLD baby WE WILL NOT BE NEEDING THAT APPT!

Stay strong Betsy!!! You're going to have a baby soon! LOP isn't so bad, it will just mean extra patience and time to get rotated. Prepare for a slow labour and anything easier will be a bonus!

However, some OFP in the mean time won't go amiss!

Hello all,

Update from latest roller coaster day.

Started well with cons appt at 39+6. Cons has changed, and is now same woman who delivered DS1 who is lovely.

All ok, although she thought baby head high, did sweep and happily surprised cervix thinning. Dislodged show (sorry, TMI).

Agreed date for el CS 13 Nov on basis she thought it would be unnecessary (next few days for labour yippee!) but if absolutely necessary, would examine me on the day and if favourable could do ARM. Absolute no to any other form of induction, which is fine by me frankly.

So skipped off home all very happy, slept for three hours (making up night time sleep loss which is really peeing me off now).

Thinking DH could 'help' promote things IYKWIM .

Then at 6.15 lovely GP called to say the swab they did at false alarm trip to hospital ten days ago has come back positive for thrush. Arse. So no rudies, plus now worried backache for last few days all due to that not early labour.

Sorry, hormonal rant but just want to get things moving!!!!!!(Pg book says irritability a sign of labour - and I would know different from normal how??????)

Also appear to have lost power of composition and grammar.

DS1 is very lovely, but I actually meant consultant is lovely.

Just back from a really frustrating hospital appointment. Nearly 35 weeks pg and was supposed to be seeing the consultant who I still haven't seen this pregnancy. Of course it was an SHO again and I ended up in a rather pointless discussion where I said I didn't want constant monitoring as I felt that being unable to be mobile contributed to my c-section last time. She wouldn't have any of it and was very insistent that I should be monitored constantly AND definitely have a drip in my hand. She ended up saying "Have you ever SEEN a scar rupture? It's not nice". Great. She also told me that whatever I said to her I would have to go through all these arguments with the consultant on duty on the day anyway - at which point I just said there was no point carrying on the discussion with her then. I feel utterly demoralised and dreading having to have these arguments when I'm already in labour. I had imagined that I could discuss it with the consultant and get agreement to intermittent monitoring...no joy. It feels like if I do have a VBAC it will be despite interference. I felt like saying "Well I'll just have a home birth then". Grrrrrr. Sob.

that's sounds good Stripey.

fingers crossed you go into labour SOON

send some labour vibes this way can you? Thanks

Betsy
40wks today & getting impatient!

Has anyone got any links with info/stats re monitoring (benefits of generally and VBAC)? Just might be reassuring as I now have been made to feel reckless.

Kitsilano

that is crap frankly....

I had an almost identical discussion with a registrar at my 36wk appt. (Only difference is that she didn't try & scare me to death with the "have you SEEN a rupture?")

HOWEVER when I stuck to my guns as you did (and I also requested to use the pool during the first stage of labour, at which point she almost fainted ) she went & got the consultant. He went thorugh all the risks again & when he was happy that I understood the risks but still wasn't budging he documented my notes with his agreement to the my proposed plan, that way I don't have to go into it on the day AGAIN.

I would ask for another appt, with the consultant this time - might also be worth speaking to the supervisor of midwives (sometimes called the midwife consultant) at your hospital to see if they can help - I had done this before I saw the consultant & I'm sure it helped as he could see I was determined!

cochrane review on CFM

only thing that has been proven is that it increases the risk of instrumental delivery & c/s - no positive improvement in fetal or maternal outcome proven.

Also checkout NICE guidelines

"Continuous EFM versus intermittent auscultation
Clinical question
Do the following methods of fetal monitoring affect outcomes?
? admission CTG
? intermittent auscultation (Pinard, Doppler)
? intermittent electronic monitoring
? continuous electronic monitoring.
Description of included studies
One systematic review, including 12 trials, was identified.324 The systematic review compared
effectiveness of continuous EFM for fetal assessment during labour with intermittent auscultation
or EFM. Among the 12 trials, only three targeted lowrisk
women in the USA, Ireland and
Australia. The studies were of moderate to good quality.
Review findings
All women (including low- and high-risk pregnancies)
There was evidence that women with continuous EFM were more likely to have CS (RR 1.70
[95% CI 1.32 to 2.20]), CS for abnormal FHR (RR 2.45 [95% CI 1.94 to 3.09]), instrumental vaginal
birth (RR 1.26 [95% CI 1.05 to 1.50]) and need for analgesia (RR 1.09 [95% CI 1.02 to 1.15]),
and less likely to have spontaneous vaginal birth (RR 1.28 [95% CI 1.20 to 1.36]), compared with
those in the intermittent auscultation group, although there was no evidence of a difference in
the use of epidural analgesia (RR 1.00 [95% CI 0.90 to 1.11]).
Although there was no evidence of a difference in perinatal mortality (RR 0.88 [95% CI 0.61
to 1.27]), there was evidence that fewer infants developed neonatal seizures from women with
continuous EFM (RR 0.50 [95% CI 0.31 to 0.80]).
Only women with low-risk pregnancies
There was evidence that women with continuous EFM were more likely to have CS for abnormal
FHR pattern (RR 2.31 [95% CI 1.49 to 3.59]), instrumental vaginal birth (RR 1.29 [95% CI 1.02
to 1.62]) and all instrumental birth (including CS and instrumental vaginal birth; RR 1.35 [95% CI
1.09 to 1.67]), compared with those with intermittent auscultation. There was also evidence that
women with continuous EFM were less likely to have babies with neonatal seizures (RR 0.36
[95% CI 0.16 to 0.81]) and more likely to have babies admitted to neonatal units (RR 1.37
[95% CI 1.01 to 1.87]), compared with those with intermittent auscultation, with no evidence of
difference in perinatal mortality (RR 1.02 [95% CI 0.31 to 3.31]).
155
Doppler ultrasound versus Pinard stethoscope
Description of included studies
One trial conducted in Zimbabwe compared the handheld
Doppler ultrasound and the Pinard
stethoscope, used by the research midwife or attending midwife for monitoring of FHR during
labour.325 The women were a mix of low and high risk. The trial was of a moderate quality.
Review findings
Although women monitored using a handheld
Doppler device had less spontaneous vaginal
birth (RR 0.83 [95% CI 0.76 to 0.91]) and more CS (RR 1.95 [95% CI 1.47 to 2.60]), there was
evidence that women monitored by Doppler were less likely to have babies with admissions
to neonatal units (RR 0.65 [95% CI 0.46 to 0.94]), neonatal seizures (RR 0.06 [95% CI 0.00
to 1.07]), and hypoxic encephalopathy (RR 0.12 [95% CI 0.02 to 0.88]) than those monitored
using a Pinard stethoscope. There was no evidence of differences in perinatal mortality (RR 0.29
[95% CI 0.07 to 1.25]) or low Apgar scores (Apgar score less than 6 at 5 minutes RR 0.37 [95% CI
0.11 to 1.24]).
Evidence statement
There is highlevel
evidence that continuous EFM reduces the rate of neonatal seizures but has
no impact on rates of cerebral palsy. There is highlevel
evidence that continuous EFM increases
the rates of instrumental and caesarean birth.
There is no highlevel
evidence about the value of auscultation of the fetal heart rate when
women are in early labour.
There is moderatelevel
evidence from a single small study in a low income country, of both lowand
highrisk
women, which showed that assessing the fetal heart rate by handheld
Doppler
is more effective than by Pinard stethoscope. In the opinion of the GDG this evidence was not
robust enough to differentiate between the two techniques.
Recommendations on fetal heart assessment and reasons for transfer to continuous
EFM
Intermittent auscultation of the FHR is recommended for lowrisk
women in established labour
in any birth setting.
Initial auscultation of the fetal heart is recommended at first contact in early labour and at each
further assessment undertaken to determine whether labour has become established.
Once a woman is in established labour, intermittent auscultation of the fetal heart after a contraction
should be continued as detailed in Section 7.6.
Intermittent auscultation can be undertaken by either Doppler ultrasound or Pinard
stethoscope.
Changing from intermittent auscultation to continuous EFM in lowrisk
women should be
advised for the following reasons:
? significant meconiumstained
liquor, and this change should also be considered for light
meconiumstained
liquor (see recommendations in Section 12.1)
? abnormal FHR detected by intermittent auscultation (less than 110 beats per minute
[bpm]; greater than 160 bpm; any decelerations after a contraction)
? maternal pyrexia (defined as 38.0 °C once or 37.5 °C on two occasions 2 hours apart)
? fresh bleeding developing in labour
? oxytocin use for augmentation
? the woman?s request."

Thanks BetsyBoop - haven't looked through the detail yet but I will now. I also had put that I wanted to use the birthing pool in early labour on my birth plan but after the above discussion I didn't even dare to mention it. I SO wish I had insisted on seeing the consultant. I had really hoped to get these issues signed off beforehand but she just acted as though it was an impossibility.