VBAC or elective section - how did you choose and were you happy with your decision?

[alicet]

I had an emergency c-section when I was 9cm dilated with ds1 after he became distressed. Made a good recovery and have only positive memories of my experience even though it wasn?t the water birth using gas and air I had planned. When it came to deciding how to deliver ds2 due in 5 weeks I have agonised over the pros and cons and had come down to deciding to have an elective section. Mainly when it boiled down to it this was what my gut reaction said and I think this is as good a reason as any. My main concern was that I wouldstruggle to look after ds1 but we had found ways round that by ensuring that either dh or my mum would be with me for the first 6-8 weeks and that they would be able to lift him onto my lap etc so he didn?t have to miss out on mummy time.

Well yesterday I went to a physio appointment as I have been having back pain and sciatica type symptoms and to cut a long story short I shouldn?t be lifting ds1 at the moment anyway ? should be trying to find ways round this. This made perfect sense but I was surprised at how much the thought of this upset me. I know regardless of how I give birth ds1 will have to get used to doing more himself once I have 2 to look after but it got me thinking that if being able to look after ds2 myself is so important to me maybe I have been silly to decide on an elective section.

So really what I would appreciate is to hear from people who had to make the same decision as me ? vbac or elective section ? how they came to the decision they did and do they regret / feel pleased with their final decision. With the greatest respect I don?t need opinions as to what I should or shouldn?t do from all the very well informed people on here. This is about trying to get a feel for other people?s experiences in order to make up my own mind.

Thanks very much for reading through my long post and I look forward to hearing your experiences?

I had Emergency section first time which was fine. Thought long and hard about 2nd and weighed up things like would there be enough staff on the ward to see to me if I went VBAC and ruptured my scar? Only way to gurantee having enough medics with you at birth is to have a c-section.

My elective section in May was perfect. I came home the next day, was able to lift DD1 (16 months) after 2 weeks and I cannot say that from arriving at hospital before the op until now I have ever been in actual pain from the section, slightly sore the first week but that was it.

good luck to you

Thanks everyone for sharing your experiences with me. Its been really helpful.

I haven't been ignoring you all - just decided that I needed a bit of time away from thinking about it to get a bit of perspective as I think one of the problems I was having was thinking about it too much!

I think I have decided that I will go for the elective section that I had decided on after all - we have very good support in place so that the not lifting ds will hopefully not be a huge problem. If I go into labur before the section date I may give it a go for a vbac depending on how things are when I get in....Being a mess of sleep deprived hormones though I reserve the right to change my mind!!!!

Hello Alicet (and nelliel)...are you me??...so far in reading this thread i feel exactly like you. Initially was just going to go for elec c/s, good recovery last time, dont feel robbed of birth, currently obsessed to OCD levels with this decision. But am currently down for a VBAC mainly due to liking the idea of having an even better recovery and the benefit of this to my DS.

Its the idea of an instrument VBAC that concerns me most...im seeing midwife at lunchtime so im going to discuss this with her...i.e can i have the option of labour but c/s instead of instruments if owt went wrong. I know it sounds v. shallow but i feel like ive already got the c/s scar so why add an episiostomy (or worse) to the collection!!

As ive said on te other VBAC thread ive also got SPD and concerns relating to that.

Anyway i guess this is the thread for the 'undecided' so i will post on here afterwards.

hairybabysmum - yep I'm not keen on an instrumental delivery either. I have put in my birth plan that I would choose a section in preference to that. However I think there can be some circumstances where the baby is so low down that it would very very difficult to deliver them by section and then I'm not sure you get the choice. If they were still pretty high up then you can say that but it isn't always clearcut as far as I understand it....

I have my consultant appt tomorrow to decide and unless anything major changes before then I have decided I am going to go for elective section and if I go into labour before then I will take a view when I get into hospital depending on how I feel and what stage I am at.

Alicet, sorry didn't reply to your question. With the first one (emer) I had really quick recovery and totally didn't enter my head not to lift anything. DS was over 9lb. He was just turned 4 when I had the planned CS.
Again, I checked with my Consultant and HV, lifting, feeding, carrying the carseat etc - just like normal. It's different for everyone I suppose, but I have had worse experiences and recovey from a trip to the dentist.
The elective CS was the best decision I have made, it was totally a brilliant occasion. I couldn't have asked for more, and it was so different from the late-at-night emergency experience.

I'm dithering too (but only 10 weeks, so I have plenty more dithering time ahead of me). I think I'm going to talk to some independent midwives about VBAC and my chances before I make a definite decision. And then, of course, I'll change that definite decision several times before the birth...

Thanks MrsBoo - now I have decided to go for a section great to hear such a positive experience!!

Lemonaid - good luck in making your decision too. Its relaly hard I found - I just felt a greater sense of responsibility for making the 'wrong' choice - the first time you just get what you are given and cope with it don't you? But what I ahve come round to realising is that there isn't a wrong choice - go with your gut reaction.

Hi there,

I had an elective section with dd1 because she was breech. 2nd time around (dd1 was 22 months by then) I opted for a vbac as I had never been through labour and felt I'd missed out on something vital .

Anyway, it didn't work out and I ended up having an emergency section anyhow. I don't regret this decision as I felt like I had to try for a natural birth. Recovery was a lot quicker 2nd time round and somehow dd1 seemed to understand I couldn't pick her up. Dh had 4 weeks off work and we did things like move dd1 into a bed instead of me having to lift her out of a cot and got her a low chair to sit on so I didn't have to lift her in and out of a highchair.

I had dd3 earlier this year and because I'd had 2 previous sections I wasn't given the option of vbac so another elective section. It was much better being planned as I knew what date she was going to be born and again my dh could get the time off work to look after me and my older 2. Because they were older (6 and 4) they helped me out a lot and they can always climb onto your lap for the all important cuddles.

Good luck!

well, i feel a bit let down by my discussion witht the m/w. She bawsically said i should have a VBAC as is better for me and the baby but didnt go into anymore depth than that. I asked her about having a c/s instead of instruments if it came to that.

She told me that that wasnt possible and what i should do is go away and write a birth plan as i have a "deep seated fear" of instrument delivery . I did question the point of making a birth plan when i knew i would have little choice (ie no water option, CFM etc). Basically i came away feeling like i was going to burst into tears when i had been looking for some reassurancce from her.

Has occurred to me that maybe me not feeling reassured reflects the fact that maybe my gut feeling is to go for c/s and she just didnt tell me what i wanted to hear??? Im still no nearer feeling resolved about this.

The hospital clinic have booked me in for an appt at 41 weeks to sort a c/s if i go overdue, i asked the m/w if i could bring this forward to 40 wks as i didnt want to gooverdue as i am struggling at teh mo at only 36 weeks. She said she couldnt as the clinic was so busy?? I might ring the hospital clinic and see if i can book an appt to speak to someone there myself....or a c/sec

M/wife did give me the tel no. for the womens physio to talk about the SPD and birth side of things as that is worrying me lots at the mo.

Anyway glad you've made a decision Alicet....im defo erring on the side of c/s after today but will sleep on it i think.

Good points re bed/highchair...i have a trip trap chair for my ds (21 months) and took the bar off it a few weeks ago so he climbs up and down himself, plus he went into a bed 2 weeks ago so dont have to lift over the cot sides and those two things have really helped with how much lifting i have do already.

Canmummy how did you find the recovery 2nd time, with toddler compared to 1st??

I had an elective after an emergency section. My resons were:

2. A big distrust that NHS will be prepared to make the right decisions at the right time if it all goes pear shaped again. If the baby goes into distress, will the midwife notice? Will I be forgotten in the shift change? Will there be an anaesthetist available? Will the cord be wrapped around the baby's neck and no one notice until the baby goes into foetal distress?
3. If I have a section I am guaranteed the undivided attention of a surgeon, an anaesthetist, a midwife and a couple more people whose job titles I don't know.
4. I already have the side effects that come with sections(i.e. itchy scar). So whay add those that come with vaginal birth as well (i.e. things that tear and break).
5. I know what a section is like. I know what to expect in terms of recovery. And I know when the baby will be born and can therefore maximise my whopping 6 weeks of maternity leave.
6. And last but not least... having an elective section is the only guaranteed way to avoid an emergency/crash section.

Oh, and one more thing, they tidied up my scar nicely. It wasn't so great after the crash section. Much better now.

I also recovered from the second section much faster. I needed someone to pick up DD for about the first two weeks, not 6.

How was your recovery last time?

THabks elusis...your points seem to sum up how im feeling also. I made point no. 4 to the midwife today...basically saying ive already had the emergency c/s and associated scar (and matching overhang!) and that i feel that therefore having to deal with the potential of an episiostomey (or worse according to lots of threads on here!) gives me a double whammy. She just looked at me as though i was mad and then talked about my deep seated fear of instrument birth! Not helpful really...surely everyone has an anxiety related to instrument birth, i mean it cant exactly be on anyones birthplan!

On the plus VBAC side i seem to remeber being told i would have one to one midwife due to VBAC and continual monitoring?

Yeah, but you might get the patronising midwife you saw today wh olet's face it wasn't exactly listening to you.

I get very angry when they start talking about my fears and how I might want to talk to someone to feel better about the crash section. It makes me want to shake them good and hard and say "Listen here,missy. It's not about feeling better about it. It's about ensuring that it doesn't happen again." ARGH!!!

If you really want a section, ask for one in writing. If the midwife refuses to refer you to the consultant, go see your GP and ask him/her to refer you.

Carry the Nice guidelines in and let them know you've done your homework. If they start asking you to justify why you want a section turn it around and give them the opportunity to talk you out of it. Changes are they won't come up with anything you don't already know.

VBAC - to me it was important and yes it was one of the happiest moments of my life

Why because I was traumatised by a long, difficult birth and probably a bit of PND. So yes it healed something inside me.

I went for VBAC after a horrible emergency section first time round. Because the first section was so ghastly, I felt I needed to try for a natural birth (had gone into the first one totally birth-planned up, with intention for water, no drugs, etc etc). I felt lots of pressure to have a VBAC from the Kitzinger-style school of thought - and people (like my helpful NCT teacher) kept suggesting I had been bullied into a section by the medical establishment. Tosh in my circumstances - I was in labour for 72 hours before they started to insist on a section.

BAD decision. I failed to progress again, had another 14 hours of massive contractions with no dilation and had another section. This time the c-section was great - and I'm sure not least because it took place first thing on a Monday morning instead of mid afternoon on a Sunday. Fab surgeon, fab anaesthetist, great midwives after the birth, quick easy recovery with no infections (unlike first time round with two infections and heavy bleeding for 3 months). The second section healed my experience of the first section as well as any VBAC could have done.

My second emergency c-section experience was lucky. I could have made this more likely with an elective. I would recommend anyone to have an elective, especially if first time round it was for reasons to do with the mother and not the baby.

Hairybabysmum - def call the hospital clinic yourself (or consultants secretary if you have a named consultant) and get a clinic appointment asap to speak to someone who will go through the pros and cons of a section so that you can make an educated and informed decision on what would be right for you rather than being bullied into one by someone who is clearly pro vbac. nothing wrong with being pro vbac but there is a lot wrong when her views mean she has given you none of the facts and an awful lot of guilt tripping.

Nonsense to say you can't put in your birth plan you would have a section over an instrumental delivery. Like I said before there are some circumstances where this won't be possible (if the baby is very low down into your pelvis) but not all.

Thanks to everyone else who have added their experiences to this thread. They are all very helpful for me and I'm sure a lot of other ladies who are posting here....

My experiences are as follows...........

Number one was section due to medical probs

Number two was vbac attempt thwarted by the medical profession who kept me strapped to bed on monitor and after about 9 hours of this ended up as emergency section. Blamed myself as I didn't stand up for myself

Number 3 was a very quick VBA2C, 1 hour 25mins all three parts of labour culminating in a ventouse delivery due to placental abruption - was too out of it to notice and the joy of walking out of the hospital 12 hours later was immeasurable .

Number 4 was an even quicker VBA2C culminating in delivery of an almost 11lb baby with the help of just g and a . Walked out of hospital 3 hours later. Lots of s !!

In the cases of numbers 3 and 4 the births were both active with intermittent monitoring, in order to achieve this I did have to change gps and hospitals to find people who supported me. It was definitely worth it .

I am always saddened that people have not been able to experience what I and my dh experienced ie a positive birth. I did have to work hard to achieve it but bloody hell it was worth it.

If you have even a slight hankering for a 'natural' delivery, then please, research it properly, there are loads of people out there who can help/advise. The UKHBACVBAC chat room on yahoo has loads of information there for the asking.

This is obviously just my opinion/experience, but I wish more people could open their eyes to the possibility of a positive birthing experience..

Good luck what ever you choose, but for me it was a chance to have a healthy mother as well as a healthy baby - I had pnd after section number 2.

Oh and the number of people who are amazed that the doctors let me have a VBA2C after having 2 sections and let me go 17 days overdue with number 4 - it is NOT a case of the doctors letting me, it is a case of the mother making up her own mind as to what is best for all concerned and informing the medics of what she intends to do. No one can insist that you must be monitored throughout labour - how I wish I had known that during labour for number 2 .

Sorry bit of a long one here, if you got to the end - congratulations

Right, feel better today having slept on it and bent my friends ear last night!!

She hit the nail on the head when she said id gone to m/w wanting to be 'sold' the VBAC as i was wavering and she basically jsut didnt do that.

Im going to ring the hospital today to see if i can get an appt. Am going to ask if i can be booked in for c/s at week 40 and if i go into labour naturally before then, i will give the VBAC a try. Reaslised i cant bear the idea of going overdue as i feel i am struggling a bit physically already due to SPD. Ill also discuss c/s vs instruments witht he hospital. Good tip re consultants secretary too...

Will let you know how i get on but feeling much better today thanks everyone.

OK so I have taken the plunge and booked my section for 2nd Oct when I will be 39 weeks exactly. If I go into labour before then I will take a view when I get into hospital depending on how far on I am and how I feel as to what I will do then.

Feel vrey relieved for having made a decision which tells me this must be the right one for me!

Did you manage to make an appt hairybabysmum?

Hi aliecet...good for you. I have got an appt next thurs with my actual consultant (rather than registrar) so that is good. I thin i have decided that i am going to book a c/s for 40 weeks as i cant bear the thought of going overdue (think this is where a lot of my stress is coming from). If i go into labour before then will see what happens/how i feel like you. Will also see how i feel after discussion with consultant

Mind you today have seen a thread about 4th degree tears which makes me want to cross my legs and book a c/s asap!!

Good on you hairybabysmum. Fingers crossed you get decent support from them in making your decision. Keep us posted!

Yep the thought of 4th degree tears is enough to cross your legs and never open them again!!!!!

cheers alice...does it feel nice to have made a decision after all the umming and aghhing? I feel better about it all now i have a plan of action.

Yes it certainly does! And the fact that I feel pleased means that for me it's the right decision. Thats what it came down to in the end really. Despite all the worries about ds and how he would cope while I wasn't able to do so much with him it still felt like the right decision. He will only be 20 months so won't remember any of it and I have my dh or my mum with me the whole time for at least the first 6 weeks and more if necessary so he won't be neglected!

Its a hard decision I think though - I really felt the responsibility of it being my choice. Had been worried I would blame myself if I had complications and wish I had chosen the other. Which doesn't happen if you just have to get what you're given does it!!! Think I have got over that now though - both options have their pros and cons and having weighed them up this feels right.

I have been lucky though that my mw and consultant have been very supportive no matter what I had chosen. Seems like some people have real difficulty finding that sort of support and are being pushed into something thats not right for them. Which is pretty rubbish.

Good luck to you in getting what you want hon whether thats a section or vbac.

I had an emergency cs with DS - heartbeat dropped and when delivered he had the cord twice round his neck and was very blue. Consultant was happy to agree to elective cs for DD - and it was a lovely experience. DS was just over 2 at the time but I had no problems looking after both of them.

I had a VBAC for DS2, and felt very strongly about my right to have a good try to achieve one. I planned a HB, but ended up with GBS, so had to be induced (waters broke on Sunday night, no contractions by the Thursday, so was induced Friday morning). Ended up with an large episiotomy / tear, which was initially very painful (comparable to a section), but wasn't as bad for as long. At 6 weeks post-birth, I wondered what on earth I had done, but at 12 weeks I felt completely back to normal, and that I had made exactly the right decision.

I think if you go for a VBAC, and decide that you really want one, as opposed to having a go, and seeing what happens (which is still a valid choice), you should go in very informed with a clear birth plan and clued up birthing partner. The VBAC support groups are all great (if a bit extreme in some cases).

Hello alicet and everyone else. I had my appt witht he hospital yesterday. All good, i have booked in a c/s for 40 weeks as i really dont want to go overdue and if it all kicks off before then will try for the VBAC.

Consultant did feel my tummy and say all good down there you might not make it to 40 weeks, plus ds was a week early so we shall see!!