VBAC or elective csection after emergeny c-section?

[mara456]

Hi all. I had an emergency c-section with my first birth, and currently approaching my second birth and trying to decide between elective c-section and VBAC (vaginal birth after c-section). My hospital does gently push women towards VBAC, and I had thought I would do it.

However I've done a bit of research on VBAC success rates this week. I found out your chance of successful VBAC is much lower if your first c-section was due to failure to progress (rather than e.g. fetal distress), it was a previous failed induction, you never dilated very far (for me it was 3cm), you've never had a vaginal birth before, your baby is on the large side.... all these things apply to me! One article I saw said "Women with a history of failed induction of labour were almost twice as likely to have a failed VBAC."

I did some VBAC calculators and they all put my change of successful VBAC at around 60%. This doesn't sound great to me.

I also read that a "failed" VBAC that turns into an emergency c-section is much more dangerous than just having an elective c-section.

Does anyone have any experience of a previous emergency c-section due to failure to progress/failed induction/didn't dilate much, and then going on to have a successful VBAC?

Another factor when I read about VBACs is that women often had very traumatic experiences with their first c-sections. This doesn't apply to me - I was lucky to have a lovely c-section experience the first time round, even though it was an emergency, and after several days of labouring. So the thought of an elective c-section for this next birth doesn't have negative connotations.

Any thoughts/experiences much appreciated!

I've a an EMCS and an elective. VBAC wasn't something I was willing to entertain.

My mental health took quite the battering after my first birth and it took me several years to get back on track. The ramifications of a failed VBAC and another EMCS were just too great.

My planned section was lovely and my recovery excellent. I would absolutely recommend to anyone in my situation.

Thank you @hauntedvagina I'm feeling a similar way about the idea of a failed VBAC and another emergency c-section.

Glad to hear your planned section was lovely!

I had an emergency csection eventually due to fetal distress, only reached 4cm after induction and so many hours. DC 1 was a big baby 10lb3oz which prev was not detected and this worried me about DC2. I had a good meeting with specialist midwife to talk everything over, she suggested VBac with constant monitoring etc but I couldn’t feel confident as worried next baby would be larger.
Had elective C-sect and DC2 was much smaller 8lb6, so vbac may have worked and second babies are not always larger.

Hi Op I'm the same as you in terms of EMCS after failed induction (only got to 3cm despite loads of time on the drip and hyper contracting) then baby was in distress too so they had to get him out. This was an induction at 42 weeks. I've lost faith that my body can even labour naturally and I'm currently definitely swaying towards an elective because even those stats on successful VBACs don't include all the 'successful' ones that still had to have forceps, episiotomy and all other manner of intervention which could leave you in equal amounts of pain and time in recovery as a section. I know it will be difficult with my DS who I won't be able to pick up for a while but I'm getting my argument together for a section. Like you my hospital will push me towards a VBAC

I had an awful, traumatic but eventually 'natural' birth with my first. I felt very disappointed with myself (stupidly) for not being able to give birth easily, or in the way I wanted.

So when I got pregnant with my second, I had planned the birth to be in the water, hoping to have the delivery I'd wanted before. She was two weeks overdue and I had to be induced. Ultimately, it ended up in a csection that was almost going to involve me being put under general. After that, it was as though any misplaced guilt I'd had re how I delivered disappeared.

I had my third over two years ago now and requested a planned section. It was lovely, calm and the recovery was easier than from the emergency one. I would do the same tomorrow if I had the choice again.
Good luck xx

I had a traumatic emergency c section. It was awful and left me with PTSD.
Second time I opted for a planned c section because I didn't dare risk another emergency c section (if the VBAC failed)
I knew that would have massively triggered me and probably have left me feeling traumatised again.
My planned section was last May and it was amazing. Even in a pandemic.
Yes my husband had to leave after an hour, which was really sad, but the procedure itself was soooooooo different the emergency and the staff were wonderful.
I do not regret my decision at all. I know the recovery is longer but I still don't regret it.
The hospital did try to encourage a VBAC but I stood strong on it.

Elective CS. The recovery should be easier than an emergency too.
Better the devil you know I say .

I had an elective after emergency. It was amazing. Felt like I was packing to go on holiday. Also so great starting off with a newborn without the exhausting labour! Pain was also a lot less than after emergency.

@hauntedvagina

I've a an EMCS and an elective. VBAC wasn't something I was willing to entertain.

My mental health took quite the battering after my first birth and it took me several years to get back on track. The ramifications of a failed VBAC and another EMCS were just too great.

My planned section was lovely and my recovery excellent. I would absolutely recommend to anyone in my situation.

I’m the exact same, my first labour is a big big reason we haven’t had a second yet but I will go with elective second time around.

Mine was failure to progress and I was in a horrific painful labour for over 48 hours. I didn’t realise how awful it was not to have control over my own body for that long.

Elective all the way next time.

I had a failed induction, only reached 4cm, baby distressed leading to EMCS.
I experienced loss and delivered twins naturally after a tmfr at 22 wks. Not sure exactly what dilation I reached but it was at least 5.
I'm expecting again and am leaning towards VBAC purely because I didn't enjoy post C-Section recovery. Looking after a both baby and a toddler will be difficult for me post surgery. I am hoping that despite my last pregnancy ending sadly, my body will have a better idea of what to do and that the consultant will allow me to have VBAC.x

I had an emcs with DD1. General anaesthetic, suspected sepsis, DD in neo natal (briefly) week long hospital stay. Never had a formal diagnosis but plenty of health professionals I saw in the years later said I had signs of PTSD. Was going to stop at the one. 7 years later I had DD2. No way on god's green earth was I even going to entertain a VBAC and made that very clear from the first appointment. My choice was never questioned. The consultant at my appointment with her said yup you can have an elective, not an issue but I have to make you aware of the option of a VBAC and risks of surgery use that info how you like.

I was terrified of an elcs as I didn't know what happened. As with my last one I was under a general. But I'm sooooo glad I went for this option. I had a 'natural' cesarean where the baby births themselves rather than being dragged out and it was a very pleasant experience 🤣 it was calm, chilled, we had music on, the staff were chatting amongst themselves discussing what they were having for tea. Very much a normal day in the office atmosphere. But best of all I could have DH with me (he wasn't allowed in with DD1s birth) and I got to actually see my daughter being born.

In a similar situation. I have asked for an elective section after an emergency section last time for failure to progress/early waters rupture/large baby/back to back. I did get to 8cm I think but 2.5 days after waters broke.
I have an appointment with consultant at 28 weeks to discuss it, I get a 50/50 chance of VBAC success on calculators but in my mind a VBAC that requires forceps/tear/episiotomy is not a success. I have looked at all the RCOG guidance to make my case if need be! So far all the midwives I've seen have been supportive.

@Inthesky42 "I'm currently definitely swaying towards an elective because even those stats on successful VBACs don't include all the 'successful' ones that still had to have forceps, episiotomy and all other manner of intervention which could leave you in equal amounts of pain and time in recovery as a section."

@Christmaspuddingsteaminghot "in my mind a VBAC that requires forceps/tear/episiotomy is not a success"

Both really good points!

Thanks everyone for sharing your stories. It's lovely to hear from so many women who've chosen a planned c-section after an emergency c-section and been really happy with their choice. I do feel that there's a bit of pressure from doctors/midwifes/the hospital policy towards VBAC, even though I might not be a good candidate, so quite nice to hear the other side.

Section every time.