"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

Sorry klaw! didn't see your lovely greeting Sending photies soon as -she's bonny!

Good morning! Thought I should introduce myself as I've just been trawling the thread in preparation for my argument with my consultant this afternoon! I'm 36 weeks with No2. Had emcs 17 months ago when, 28 hrs after my waters broke, at fully dilated, after THREE internals somebody spotted that DD was breech and I was too exhausted to contemplate anything but....

At 20 wk appointment registrar was completely happy to allow me a VBAC but "it will be on the labour ward and you will have CFM". Not if I get my way.

Anybody experienced a consultant reluctant to allow you in the midwife-led unit even though it's JUST ACROSS THE CORRIDOR from the labour ward? My midwife has led me to believe that they've never allowed this yet!

Wish me luck and thank you for all the information on here.

Robino -sorry to hear you're on the merrygoround! best thing to do is go to the appointment,announce to the consultant that you've changed your mind and want a homebirth - then allow them to get you to compromise on the MLU - personally, i'd have avoided seeing a medic at all, it's much easier dealing with the increasingly desperate phone calls from their secretary than having to bribe your way to what you want in person.
BTW have you read 'VBAC- on whose terms'?
link here

robino how did you get on with the consultant?

Well...........
Saw registrar who got one of those "oh no, you're one of those types" looks on her face because as soon as she mentioned CFM I pulled a face and shook my head! Then when I mentioned the midwife-led unit she turned a bit of a funny colour and said she'd better speak to the consultant.

So we then had to talk to both of them. I was very insistant from the start that I did not want CFM, cons was v. insistant that I should have it but did then concede that she couldn't force me. Tried to push me for how long I would accept intermittant monitoring but wouldn't tell me whether she wanted to hear a time, or "til I'm 6cm", or what so I just kept repeating "until a problem is picked up". She finally accepted that I could have intermittant monitoring, so I then pushed the point that if I wasn't having CFM then I should be allowed to at least start labour in the midwife-led unit (which is on the same floor as the labour ward) and she again "strongly advised against" but finally agreed that as long as the midwives on the unit were happy to do so, then she would reluctantly agree to it.

I have it written in my hosp notes, and copied into my handheld notes that whilst the cons is reluctant she will agree to these terms. I am waiting for a call from the head of midwifery to firm it up and ask a few more q's; I am a litte concerned that the consultant will try to "nobble" her first but I'll cross that bridge if required.

There are 2 points I'd like to ask you wise people:

1. She was so "doom and gloom" that I got a bit of the colliwobbles straight after. OH has reassured me that I have done the right thing for us but I just need to hear it from you lot too!

2. there is some confusion over notes from previous birth. I thought I'd reached fully dilated, as did OH but the last mention in my notes before C/S is that I was 8cm. However, I distinctly remember the midwife who discovered DD's breech position saying, after I'd agreed to C/S, "you're going to feel the need to push now, DON'T!" and as I was whisked into theatre and having the spinal administered I def had to fight the urge to push. Is there any way I would have needed to push if I wasn't fully dilated? I'm thinking not...

Thanks so much for help so far. Jamila, I hadn't read VBAC, on whose terms? but found it incredibly useful to give to OH to read, thanks.

you can get a pushing urge early if baby is back to back, it can be useful in that case, but it looks like as soon as she saw the breech, your midwife went straight into their breech protocol - some hospitals are more enlightened than that! many new midwives and OB's are learning the skill to assist with breech, but a few years ago there was a very biased study done which tried to claim that C/S is better for breech, it isn't and the study is now discredited and things are improving slowly, its a shame really that if you'd got that far and there was no sign of cord prolapse or a leg dropping out early, that they rushed you into theatre - sadly I was scuppered before that stage, I only got to 5cm - i think them knowing DS was breech was the problem there

DD wasn't back to back (not as far as I'm aware anyway). To her credit, the midwife did say I could try to deliver normally but she did say I was tired. True - I was absolutely crackered, I'd not slept for 2 nights and it was 28 hrs since my waters had broken. I didn't feel pushed into it, at the time it was the right decision for me. Doesn't stop me from wanting to give VBAC a damn good try this time though!

the good news about your situation robino though is that you fall into the group most likely to have a sucessful VBAc , non recurrent cause,dilation greater than 5cm at section etc
I based my whole planning strategy on that

BAck again because I think I'm going to be fobbed off in a big fashion! Spoke to the midwife from the Midwife Led Unit today who suggested a "compromise" and I'm going to meet her on Mon.

The compromise to my hoped for VBAC in the MLU (which is on the same floor as the labour ward) is to go into a designated room on the labour ward which has the same home from home approach with the exception that it has a hospital bed as opposed to a divan and to be encouraged to have as active a birth as possible. However, I would still, I think, be under consultant care.

I just don't get it. The only reason I had a CS last time was because not one of the 5 midwives I saw in the last 2 wks of pregnancy, nor the first two (who also did internals) I saw during my labour, spotted that DD was breech. It was only when 3rd midwife, due to shift change, did an internal that it was spotted and by that point I was so tired I couldn't face trying a breech delivery despite being fully dilated. Am I being foolish? Why, if things go "normally" do I need consultant intervention? If I asked for a home birth they'd have to give me one, right? without a consultant.

Am nearly 38 weeks and not sure I have the energy to battle this one out, and whilst I've said I'll threaten a homebirth I don't think I really want one. Any suggestions, ideas, general support out there?!

speak to aims, www.aims.org.uk you can insist on a birth in the MLU ,m demonstrating you are making an informed decision on the risks and benefits of doing so.

you got to full dilation last time, there is nothing to indicate you cannot give birth vaginally

robino

Rather than getting hung up on where the room is, the important bit is to have a (good) m/w looking after you & you get the active birth you want & that the drs keep their nose out unless/until their services are needed. This is what I'd be concentrating on for your meeting on Mon.

I say this as we have no separate MLU locally, the delivery suite caters for both ML deliveries & CL deliveries, you just get whichever is the next room free. Even for the CL deliveries you start off with just a m/w unless there is already a known issue requiring drs assistance.

IME having the right m/w is the key, first time round the one I had was awful & I know I'm convinced she contributed to the reasons I ended up with an em c/s (refusing to "allow" me to be upright as it screwed up CTG trace - I didn't know any better then & turning synto drip too high - was only spotted by m/w sister about an hour later - I'd been having 4 or 5 contractions every 10mins all that time, when it's supposed to be 3 - by which time DD was in distress (which she hadn't picked up on the bl*y trace anyway) & em c/s was inevitable )

Robino
I would agree with Betsyboop try not to get hung up on the actual room. On the day you could have agreed the MW led unit and it is full so you end up in the labour unit anyway. I have been talking to my community mw, (who is currently doing materninty cover for the regular mw) she normally works on the delivery unit and she says some times it is better to not to push too much before the event just turn up and get on with it. (I may be in for a big shock in Oct when I try to put this into practice). Looking at your posts you have come a long way so far. Is you birth partner totally supportive of your decisions and au fait with what you want?

Thanks for comments - it's not the room as such, it's that I'll automatically come under consultant care in that room. The consultant I met was so begrudging in her agreement to keep her hands off me that I am a bit worried that when the time comes and I'm in labour I'll have to keep battling for what I want when all I actually want to do is concentrate on giving birth. Does that make sense?

I haven't met the midwife in charge yet, that's on Monday and we're going through a birth plan but I'm getting the feeling that she's a bit of a stooge for the consultant.

With DD1 was booked into a stand alone MLU and was unable to go because of staff shortages but I felt completely confident in their ability to care for me, baby and any issues that would have arisen whilst attempting to give me a natural birth (and believe me, I know things can go wrong - my entire family are a disaster when it comes to natural labour!). This time, because the stand alone unit is a 25 min blue light ride from nearest maternity unit if problems do arise I'm not even pushing for it. I'm going to a different hospital all together but it means that, at the moment, I am less convinced in the midwives' ability, and desire, to help me achieve what I would like.

My birth partner does know and understand my wishes and will fight for them but I'd rather it be understood from the get go so that we can, hopefully, concentrate on a natural labour, a less stressful recovery and an easier start to a family of for with our 17 month old and a newborn. Guess I'll have to wait til Monday and go with gut instinct on midwife!

family of four !

I understand that you want to get everyting agreed before you go into labour so good luck with the mw on monday. You are making informed choices and they should respect that.
I assume you are planning to stay at home for a long as poss before going to the hospital? I think it was port and lemon a few pages back who stayed away as long as she could and by the time she got there she was so close to giving birth that she didn't get much hassle at all.
I had a cs last time because my ds was an unrecognised breech. Althought I hadn't started labour, I just went in for a check at 40 weeks, because of reduced movenments, and they found he was a footling breech and I had no amniotic fluid so he was whipped out post haste. I keep freaking that I won't go into labour cos I have never done it before and I know I won't be induced so I will end up with another cs by default. anyway I've got 15 weeks to go. Goodluck again

Have just started reading this thread and am (naively) astonished! Had c-section five years ago due to face-brow presentation after a very easy first-stage labour. Was planning home-birth and had to transfer to hosp after hour of second-stage labour cos ds refused to budge. Am expecting number 2 in November and was just assuming would try for VBAC. In fact was rather surprised to be referred to consultant since in all other respects pregnancy is straightforward. Have ante-natal appointment at hosp at end July - should I expect a fight to try for VBAC? As far as I can tell there really is no reason why I shouldn't try for VBAC - although like last time would of course take advice once in labour about best thing to do. Are consultants generally very dubious? Any thoughts gratefully received!

Ericam

most seem to be fairly supportive of VBAC (but want it on their terms )

Mine just said "do you want to try for a natural delivery or would you prefer another c/s?" I said "natural delivery" & he wrote "trial of scar" (lovely term - not) on my notes & that was it!

However getting a VBAC on YOUR terms is another story. I would suggest you have a look at some of the links on page 2 of this thread before your appt.

for example

no you don't HAVE to have CFM (but may choose to)

yes you CAN be mobile (even with CFM to some extent)

no you don't HAVE to have a cannula in your hand/arm "just in case"

and if you fight your corner you can even get them to agree m/w led unit, water birth or even a home birth if that's what you want!

The consensus of experience seems to be if you are prepared to be doggedly determined & can demonstrate you understand the risks (or not) of what YOU want to do for YOUR ideal birth versus what's an "ideal" birth from their perspective then generally you can get what you want...eventually!

Good Luck

I should have said links are on the second page of this thread, which is of course page 21 (at the moment) as we are going backwards...

Thanks BetsyBoop that is really helpful. I will make sure that I read some stuff before I go so that I am well-prepared.

Ericam I'm plannig a VBAC for this pregnancy I have had one appointment so far with the consultant. She was very supportive of a vaginal deliver but wittered on about monitoring etc. The hospital is a large teaching hospital which has a target to reduces its cs rate. As it was only at 16 weeks I just smiled and didn't make an issue of the details. I have another appointment in August (32 weeks) where I think we will have a more in depth discussion . For me it is the CFM that I really don't want. I didn't labour at all last time (breech) and so I am worried if I am restricted in my ability for an active birth I will be timed out so to speak, as this will be the 1st time my body has gone through the birth process.

Hi Hedgepig

Have you thought about doing hypnobirthing? I did for my first labour and found it enormously helpful. I was in first stage labour for only 7 hours and was at home - when the midwife arrived she was amazed to find that I was not even sure I was properly in labour but was in fact 9cm dilated. So I would highly reccommend it. Really glad I have now spotted the potential issue re: CFM as this is something that I really don't think will help, and as far as I can tell is simply unnecessary in most cases. I really don't think it should all be as complicated as this! Good luck.

I got my VBAC! With fewer arguments than I expected but it did go rather smoothly anyway. Another story of hope for VBACers, thanks for all your support recently - now the proud owner of a second baby girl!

V brief details: put DD to bed at 6.30, cooking at 7, thought "hmm", at 8 said to OH "might be having contractions but not sure", went to bed at ten, decided at 11 def having contractions and couldn't sleep, at midnight decided I'd better call my mum so she could babysit DD - had bath, cleaned bathroom and did some laundry (!?), mum arrived at 2,at 5 decided that I needed gas and air so off to hospital.

Midwife said "well, you're dealing with this fine - I bet you're not in established labour yet but I'll just examine you (eek!) to check - ooh gosh, you're actually
4cm dilated, we'll give you some codeine (haha) and we'll give it an hour, see how you are, might send you home yet, could be hours". She stepped out the room, my waters broke, I was instantly in agony and an hour later I was fully dilated and ready to push, Hour and a half of pushing/resting/ nearly falling asleep, out "popped" DD. Only G and A, 2nd degree tear but well enough to go home 4hrs after gave birth - very pleased!

Thanks for all your advice/ help over last few weeks and I hope those of you who are planning a VBAC enjoy yours as much as I enjoyed mine!

Just catching up with this thread again as i'm now nearly 268 weeks and the date is looming ever closer.

Robino, it's great that you got the birth you want; sounds like it went well and a nice quick labour is what I'm hoping for too. Am starting to have a few wobbles about it all though, and need some reassurance that things will be fine (the thread the other day about anal bleaching and planned vaginoplasty made me wobble bigtime.....not the bleaching; the possibility that things will be a bit mashed down there for ever more )

is hedgepig still around?; it'll be interesting to hear how you got on with your consultant..you said you were seeing them again in August didn't you?

anyway, I know a few more bods who are hoping for a VBAC so fingers crossed they see this thread in active cinvos again and come on over.

heehee...takes medal for longest gestation ever

I meant nearly 28 weeks!

bumping for you daisy ! 28 weeks already ! wow...

there must be some more VBACers out there..

come in, don;t be shy