I have been hoping to go for a VBAC but seen this BBC story

[MamaMaiasaura]

here and is making me think twice.

Consultant has already said wants me to have extra scans as he feels a VBAC would only be appropriate if baby in good position and not humungous. Consultant also said he doesnt want me in labour for longer than 7 hours (was 48 with ds1).

At the end of day I want what is best for baby. DP would love to have another baby after this little one and am concerned another section will hinder this. So confused.

Midwife (she has now left) was really supportive of VBAC.

Oh good grief, siddeways,I definitely thing you should ask some questions. I'd book an appointment with the consultant and say I wanted the hospital statistics on the number of VBACs who end up in emergency sections. I'd ask how they will know if I do tear. I'd basically go in and say give me all the facts for and against VBAC/planned section.

Then, you may still want a VBAC. Lots of women have successful VBACs and are happy they had them. Other prefer a PCAC (planned ceasarean after caesarean). But, by all means, every expectant mother has a right to have the facts (pros and cons) laid out before her so that she can make an informed decision.

sideways... read what chipmonkey has written lower down this thread. It is horrifying that I (totally not medically trained) was easily able to pick up off the internet information regarding the risks of induction and epidurals and yet hospitals go on offering these things are routine to women who are attempting VBAC. (And then wonder why so many are unsuccessful, FFS.) If you are not getting this information from your hospital then you need to arm yourself with it and take it to them. It could not only make the difference between a successful VBAC and a repeat section, but in an extreme it could save your baby's life.

chipmonkey - so glad it all worked out OK for you in the end.

And despite what I've just written, I don't think that all consultants are rubbish. Mine was excellent - totally supportive, but also informed and, most importantly, prepared to share information with me and treat me like an adult. But I got lucky. Hospital policy was still to monitor all VBAC-ers continuously and they allowed induction and epidural for VBAC-ers.

I am now at the lack of information out there about this. Why are people not better informed about it? (Even my NCT teacher knew nothing, though she was lovely. I passed all my notes and the articles I'd printed off the internet etc. on to her after I'd given birth!)

Oh, and DaisyWhoooo... respect, re. your maths!

Eleusis - thanks for that. I have an appointment booked with the consultant for 34 weeks and will get all my facts and questions ready for then.

Last time I even mentioned I would probably want an epidural and they said yes of course.

Thanks Ellbell

eleusis... first labours are not necessarily awful. My VBAC was a first labour and it was really fine. 2nd stage took longer than everyone thought and I got a bit exhausted towards the end, but till the last 20 mins or so the whole labour was completely manageable (with no pain relief except baths and TENS). I'd do it again tomorrow (only dh won't let me )

Alas no, Fio. Am about to start another thread in a blatant cry for sympathy!

I was induced for my VBAC, and it took 40 hours from the start of the induction until DS2 was born . I had to fight to go on from about 4 hours after the start of the induction. Yes, it was hard, but I did all but the last couple of hours with just gas and air, and it was fine. Towards the end I had an epidural (which didn't take) in preparation for a c/s. I knew the risks of induction & epidural (far more than the MW or doctor I think), but took the chance in order to have a natural birth. It felt about as far from natural as possible in the end (long story, but loads of people in the room, big baby, v.strange position to deliver....), but a year on, I'm very very glad I did it.

Haven't read all the replies sorry, just wanted to let you know my experience if it helps. I was 76hrs in labour with 1st dd and had (emergency!!!) c-section. I wanted to go VBAC with DD2. I was also told I would be constantly monitored and would be given 7hrs to 'do it'. In reality baby was monitored for 15/20 minutes in every hour so that I was still free to move around thereby giving us a fighting chance of a VBAC. I was progressing nicely and things were all ok so my 7hrs was extended and gave birth (with relative ease - apart from little bugger let loose a mahooosive poo at the very last minute!! he he poor midwife). So it is very possible to do and not carved in stone re: timings etc. I think they have guidlines to work by and use their experience. GOOD LUCK with whatever you decide to do. Having both births I can say I def preferred the natural one (esp for recovery period!!!)

Awen, if you decide you want to go ahead with a VBAC the most important thing is geting midwives/consultants that support you, you can ask for someone else to be your consultant/midwife if you feel you are not being properly supported.

As others have said, this report is scaremongering. I had a CS with ym first due to placental abruption, and was unsure if I would be able to have a VABC with my 2nd child, I felt totally pushed into having a csection with DS, and was really uspet about it. I am however pregnant again, and having discussed things with ym midwife and doctor (am still waiting for my consultants appointment) am aiming for a VBA2C with my local midwifes support, she ahs said the hospital I am going to be at are great with VBAC's but if I do not get the support I wsih I should make sure I fight for it.

Heree are another couple of articles you could read, more factual and not so scary!!

The main point about uterine rupture is your personal scar, and if it is a normal cs scar it is apparently less than a one percent chance of rupture.

uterine rupture

more

I don't know many of the mumsnetters so cant advise exactly who to speak to, but I have spoken to vbacqueen and she has all sorts of info on it, so CAT her if you need more.

Wow and thanks for all the informative adivce. Really appreciated. I have been of the opinion that I wanted to try for VBAC because of the benefits for baby and for me. I had said to consultant that i want an active birth and not be strapped to bed with monitors and if they really have to continiuosly monitor that i would like a portable one. Tbh I really like my consultant and he was a lovely guy. HE said he wouldnt want me going for a water birth and didnt recommend home birth.

With ds1 I got to 5cm dilated, 48 hours (spontanous labour at 38 weeks), ds turned back to back, I had high blood pressure, protein in wee, ds was 8lb 12, and gestational diabetes. Did have placenta prevaria in early preg but moved up. After section I had post partum haemorrage and also failure to contract back, needed syntocin and 3 other drugs to get it going (by which point epidural been taken out). Was a horrendous experience and pain unbearable. Am petrified of going through that again. I actually thought i was rupturing as the pain was so bad.

As the time comes closer for thinking about the birth I am started to get a but worried as really dont want a repeat of first experience.

I never realised that after 5cm (as that is were i got to) it will be classed as a first labour. I freakily didnt mind the labour and found the contractions empowering (I think the gas and air helped).

It is really encouraging to see so many positive birth stories of VBAC and also of those who ended up with sections but were ok with subsequent children.

Consultant seems to think I am

Actually, my maths is crap Neonatal mortality from uterine rupture was about 0.05% - still very small though.

subject close to my heart!

Best places to start:
www.caesarean.org.uk/
VBAC: On Whose Terms
www.radmid.demon.co.uk/vbac.htm

Debbie Chippington Derrick?s recent Presentation on Natural Birth after Caesarean

"You should be grateful"

Mary Cronk's scar monitoring procedures

Just say NO to induction:
Induction risks for VBAC
Kent Midwifery Practice on Induction
Radical Midwives page on induction
Bishops score

I can't add anymore links for some reason but the above links are just part of a whole load I have collated into a Word.doc and would happily pass on to anyone who wanted (if you google VITAL LINKS & TIPS you should find it online)

All i can add is that the study seems roughly in line with what is already known (though their rupture figures seem high , must go to the study and read the thing properly)
I was chuckling about the 7 hours - don't they read the NICE guidelines? even they have changed to the 0.5 cm/hour guide which equals 20 hrs to reach 10cm - I'd be a bit concerned if I was dilating any quicker than 1cm an hour after 2 hbacs , which is what they are asking some of you to do who are effectively first timers
As for CFM - if they wait for signs of distress from the baby, there's a very high chance you've already ruptured - Mary Cronk advises that you get your midwife to do a baseline pulse at term and make sure it gets checked regularly and also that you walk your fingers over your scar to detect any early changes in sensation as the very first sign can be a spike in your pulse due to shock (blood and or fluid in your abdomen) or pain in the scar area between contractions.
As i say i've had 2 HBAC's, one was 8 hrs from first twinge to placenta, the other was 17 hours (but mercifully almost painless),intermittent monitoring, only one VE to confirm i was dilating no rush, no pressure - Priceless
Lisa X

When I researched all this a few yrs ago I found that although u are at a higher risk of rupture it is still only small risk and other risks of having a section are higher than a risk of rupture. Most hospitals dont use the term vbac but call it trial of labour as u are monitored and anything they are not happy with they go straight to section. But U have to make the decision u are happy with, I do symphamize though coz it is mindboggling. I wish U well with whatever u choose

Awen - I had an emergency section with ds after 3 days of labour (42 hours - ok pre labour for the first 6 hours - but it sure felt like the real thing!).

Failure to progress and distressed baby - got to 8cm. Ds was only 8lbs8oz though.

Had a VBAC with a back to back dd. But she eventually turned in the middle of labour - minx. Was 3 minutes off another section and was being prepped while the midwives fought my corner and gave me another 1/2 hour to push. Was only in labour from Saturday 6pm ish til dd's birth midday Sunday - so not even 24 hours - way shorter!

I ended up with an epidural towards the very end, but was stuck on the bed due to excrutiating SPD. With hindsight I should have had crutches and laboured upright for as long as possible, but hey...

DD was only 8lbs7oz and came out unassisted But I'm only 5ft - so it's possible!

My friend just had a VBAC on Monday - her first son was 10lb10oz and an emergency section, but no 2 was only 9lbs and a normal delivery.

Awen, I don't know if this is helpful to know or not, but I knew someone who had a vbac with twins (2 years after a c-section), then a further single baby a couple of years later. She had no problems. The twins are 18 now, so a long time ago - maybe the advice has changed since then.

Oh crikey - Just read the whole study and the analysis is totally pants - It looks like they've lumped all vbac's into one category to get their 0.9% figure - that includes inductions, instrumentals, 42wks+, etc etc etc, all of which are shown to have an intrinsically higher risk of rupture even with an unscarred uterus - tut tut tut springs to mind - anyone interested in the full study , get in touch and I'll email it to you
Lisa X

can you email it to me please?

lulumama 21 @ hotmail. com

no gaps

thanks xx

can you email me a copy please Lisa

betsy dot boop at btinternet dot com

Thanks a lot

I had a VBAC after 3 c-sections. 7 hour labour and half hour of pushing. Chances are something else is more likely to go wrong or lead to another c-section than uterine rupture. Its very very very rare (I read every research document while pregnant). Its also rare for the baby to die even if the uterus does rupture.

Needmorecoffee I post on a few different boards and know of a few VBA3Cers. Are you a new one to me? Cos if you are I'd love to know more!

I had my daughter 3 and a half years ago and while pregnant spoke to Debbie Chippington-thingy (cant recall that bit) plus was on ICAN and vbacuk.
I don't usually chip in becaue while my vbac after 3 sections went fine with a normal labour and birth at home, my daughter sugffered hypoxia which could have happenend to anyone and was nothing to do with it being a vbac. Hence me saying its more liely something else would go wrong rather than a UR
There's risks with every birth but c-sections carry the additional risks of any operation.

Well it's nice to meet you! I possibly haven't come across you before then as I only recently joined UKVBACHBAC and UKMidwifery, I also post on a (coughs) rival board where we have another VBA3Cer who posts occassionally now.

I recently supported a VBA3C labour which ended in a rupture and crash section. Baby apparently suffered hypoxia but brain scans were good and I've not heard results of EEG's yet. Mum is not doing too good, labour was going well and it seems that we'd barely arrived at hospital when she was whisked off so the shock has been tremendous. She doesn't want to talk about it and I've had to step back.

How has your daughter's recovery been? Does she have any lasting effects?

Sorry to be so nosey but I'm like a sponge when it comes to my specialist subject!