"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

just to say I always found the consultants more willing to "bend" the "rules" (hospital policy) once they were happy you understood the pros & cons, than registrars who were always srictly by the book.

Nevil ask the consultant if there is anything in your notes about the state of your uterine scar. Very occasionally after a number of c/s you can get thinning round the scar which ups your risk of rupture. They can't "force" you to have a c/s under any circumstances (technically it would be common assault to do it without your agreement) they can just advise you what in their view is the best course of action & the reasons why, the ultimate decision is yours.

definitely take the green top guide with you. as has already been suggested

Hi Betsyboop, Will definately ask about the state of my uterine scar, thanks for that.

Im currently collating all the info that I will take with me tomorrow and will probably see a registrar as I don't think I have ever met with the consultant with any of my previous 3 pregnancies. I really hope I end up have a discussion rather than a confrontation when I discuss VBAC but during all of my antenatal appts the MW's and registrars seemed to assume, once they've seen i've had 3 previous sections, its a full gone conclusion i will be having a fourth section . Will ask for appt with consultant if faced with negativity.

My main argument will be that I feel the risks of a fourth section outweigh those of a VBA3C just need to get pros and cons printed as my pregnancy brain cant handle much these days.

Was feeling quite nervous but armed with all this info im beginning to feel quite empowered, roll on tomorrow .

nevil

Unless there are other underlying medical reasons/conditions then they will probably use the increased risk of rupture after numerous c/s as the reason to go c/s again so also check out this (can't remember if this is in the links list or not)

table half way down has data from a study on risk of rupture after 1, 2 or 3 c/s - as you will see not that different after 3 compared to 1. (and a very small risk in either case)

Hi Betsy[waves back]
Nevil, Good luck! Hopefully it won't be too bad! I shall be going through the same (hopefully, am TTcing) so let us know how it goes!

Warning, this is going to be long.......

Well I had my hospital appt today and they made me cry .

I was seen by a registrar and a junior doctor, the junior doctor was lovely and he was very sympathetic but the registrar was horrible. When I mentioned Vba3c the registrar just looked at me as if i was mad, she asked if i knew the risks i said I did and that i had researched vbacs throughly and that i'd bought evidence with me, she asked to see evidence but didn't take much notice of it. She kept on saying that i wasn't listening to her and tried to imply that i didn't understand how serious the risks were, that the baby could die, i could die, i'd leave my kids without a mother .

She then asked if i was going to have a steralisation after the birth (i was thinking wtf has it got to do with you) i said i hadn't thought about it, if i end up with cs then i may consider it or maybe not, she then said that is why we advise women to have a steralisation after 3 sections & .

Lots more was said but to cut a long story short she said she would have to call consultant into room to see me who would never agree to it, i asked what would happen if he didn't agree she said he would refer me to another consultant and if no consultant would support me i would have to go to another hospital. So saw consultant and to be fair he was polite and respectful but stated that he has never heard of a vba3c , i said i have read many stories of successful vba3c's but he wasn't having any of it and stated he would not support me as he doesn't think it's right. He said he would refer me to the consultant midwife and to wait outside while she was called. I was exhausted at this point (had been there for over 2hrs) and had already made up my mind to change hospitals as i no longer wanted to be under their care.

So the consultant midwife came along and I thought here we go again, she took me into a room and she was sooo lovely. We spoke about my previous births and what my wishes were for this pregnancy and guess what..... she agreed to support me .

It was at this point i burst out crying, i couldn't believe what i was hearing after all the negativity. She basically said if i agreed to transfer to another hospital under same trust where she is based we don't need consultants agreement and she would over see everything. We discussed CFM i said i would be ok with it as long i could stay mobile, active and upright (thanks to whoever mentioned those words of wisdom on this thread)she said no problem that would not be a problem. We discussed other things such as no epidural, no induction, etc and said she would see me in 7 weeks to prepare concise birth plan with all my wishes.

So what started off very very badly actually ended up on a very positive note thanks to this lovely lovely consultant midwife.

A big thank you to everyone on this thread for all links and advice I don't think i would have achieved what i did today without mumsnet. DH is well proud of me, im usually so shy, if anyone reading this wants to go for any type of vbac, believe me if i can do it anyone can.

I'm off to read about natural childbirth for the first time ever .

Nevil well done it sounds like you have done really well today . Keep reading and any questions just post them here and hopefully we can help.

Good for you Nevil, sounds like a harrowing experience, but worth it!

Nevil.
FWIW, I cried to get the ok for my VBA2C it just didn't happen in the end, bloody stubborn baby!

I followed your story VS and even though you didn't get to vba2c you gave it your best shot. All the best with TTC and look forward to comparing notes on our successful vba3c's.

went to hospital this morning after a night of crampy pains. all ok, but did manage to make sure that my vbac appointment next week is with the consultant midwife and mentioned vbac homebirth a couple of times during the convo and no-one actively said 'you're joking' but did get some slightly widened eyes.... watch this space. have the green tops ready and in a little celophane envelope.

Hope you're feeling less crampy this morning fourlittlefeet. Good luck with the appt, will be watching out for an update.

hi - can I join? I'm 37 weeks pregnant with DC2. DS is now 2 and was born by emergency cesarean after a failure to progress following induction. I was really hoping for a vbac this time round but am currently breech. I have been using moxibustion (form of acupuncture) for 8 days and have been told that the hospital won't try and turn the baby using ecv cos of the previous cs and that if baby doesn't turn by 39 weeks I'll be looking at elec cs. Any thoughts? experiences?

monkey have you been on the spinning babies website? Get it turning now!

Hi Nevil, FLF and Monkeydops, glad to see the thread still going as it is so empowering and full of really usefull stuff.
Am 32 weeks tomorrow, but so uncomfortable!!! Not enjoying this at all.
Have been working on my birthplan using what VS posted, so please with it.

mppaw, we must be due within days of each other..I'm due on Jan 16th.

monkeydops - DD2 was breech until 38 weeks. I had been trying everything for a few weeks and was going completely mad. In the end I decided to relax and let it be - I reckon that's when she finally decided to turn.

Eeek. off to convince the GP now, consultant midwife tomorrow.

Hi FLF, I am due 18th Jan...2 days after you....

Good luck with the midwife tomorrow, let us know how you get on.

good to see this in active convos

Good luck to everyone, especially Nevil. I've just had a wonderful VBA2C and although the scar rupture seemed to be the big thing at all my AN appointments, once I was in active labour (got to the hospital at 6cms dilated) no-one paid any attention to monitoring me for signs of potential rupture.

I was given a risk of 5 in 1000 for a VBA2C by the hospital; their view was that the risk doubles for each section you have had. i think this is a bit conservative, but even if it was this high, a risk of 10 in 1000, ie 1% is still pretty low in the grand scheme if things.

I also pushed for intermittent monitoring and they were happy to do this. However I did end up having a scalp clip attached to the baby's head as there was a problem with his heart rate dipping. But, as my waters had already broken and my SPD had rendered me pretty immobile, I felt it wasn't going against my birth plan, which had been for no ARM and to stay upright and mobile, but rather a change in plan due to circumstances.

I think if you are open-minded in your approach to it all and let them know that you are willing to be flexible depending on how the labour progresses and that you are aware of and accept the risks, then they have a duty of care to support you.

One thing I did though was hire a doula. Because she works with the hospital on a regualr basis (and is also on the local maternity services liaison committee) she knew which consultant and at which local hospital would be more amenable. Local knowledge is a good thing to have.

Agree that the registrar's were useless, and stuck to the "hospital policy" line so always speak to the organ grinder and not the monkeys

Oh, and can I also say that my mental health has improved vastly since the birth of DS2 as I have finally put to bed the ghost of my labour with DS1 six and a half years ago, and I feel physically so much better than with my last section (sleep deprivation excepted of course)

phew that was meant to be a quick post...sorry

thanks all - hosp have now agreed to try ecv on thursday despite prev section - we'll see how that goes!

good stuff Monkey and good luck!

Well, my appointment didn't go that well. I ended up in floods of tears and with no results to show for it really! Consultant midwife is going to talk to the labour ward manager to make sure they understand my previous horrible experience there in order to try and improve it. She did say if I insisted on a homebirth they would have to support me, but that it was against guidelines and they wouldn't encourage it. Other than that if I go in, and they'd want me in as soon as labour started, I'd have to have the cannula and have to have CFM, but be encouraged not to stay on the bed, but movement would obviously be restricted by wires. Also they don't support vbac water births. Am now feeling highly stressed about the whole thing.

fourlittlefeet, I'm sorry your appt didn't go so well. Have you asked about telemetric monitoring? This is a machine which does continuous monitroing wirelessly, so does not restrict movement. I was supposed to use one for my scond VBAC, but an induction and epidural put paid to that (not too negative, it was a fabulous birth).

Also, the consultant midewife at my hospital (and the cons, FWIW) did support labouring in water for VBAC, but preferred you out on dry land for the actual pushing (though I had also had PPH, so that was a factor in this too). Would labouring in the pool but getting out for the actual birth be a compromise for you? The telemetric monitors work in water too.

Thanks Poledra. They don't have telemetric machines and she refused intermittent monitoring and any kind of water labour as they couldn't monitor me whilst in there.

Hi FLF, mppaw and monkeydrops and anyone else lurking.

So sorry your appt didn't go to plan FLF, you mentioned a home birth and if you have researched the pros and cons of a HBAC and feel confident enough to go for it why not? I know it's not an easy decision to make escpecially when you're not being supported by your caregivers, the last thing you need is an unsupportive MW during the throws of labour. I really hope things work out for you.

Good luck with ecv monkeydrops lets hope it works for you.

Daisy, congrats on your recent vba2c and on the arrival of your DS2. I read your story and found it very inspiring I just hope i do as well as you (piles and all ). Unfortunately can't afford doula since giving up work to be SAHM (but wouldn't change being a SAHM for the world).

Nevil, keep your ear to the ground for trainee doulas looking for clients for their training portfolio as they often offer their services for free or at a reduced rate. Try looking on the doula UK website. I'm glad my story helped .

fourlittlefeet, they cannot refuse you intermittent monitoring, they can only offer it to you. It's entirely your risk and your choice whether or not to accept it. Same goes for induction. I was scared by all the "poor maternal and infant outcome if not continuously monitored" stuff they spouted, but when you get it into perspective, there is more chance of a cord prolapse in a healthy term pregnancy than there is of scar rupture in a VBAC patient, but they don't bang on about prolapse do they?

I was also told they would want me in sooner rather than later, but my consultant did say that they had no control over when I decided to turn up! As it was I wasn't convinced I was in labour until quite late on, then my waters went just as I was telling the hospital I was on my way and I was 6cms when I got there. Staying at home was definately the best option for me as I was calm and relaxed and in control....and playing scrabble and MNing

I also played the mental health card at my consultant appointment . I have suffered from depression on and off since having PNS after my first labour and CS. It was important for me to achieve the birth that I wanted in a bid to put to bed the ghosts of my first labour. My consultant was very understanding about it.

As it was, although it wasn't the intervention free birth I had hoped for, I remained in control of everything that happened and was consulted and given time to think about what was being proposed, and was never forced into making a decision.

and my depression is much much better for it as well