VBAC experiences

[Santatizer]

I'm hoping I might be able to draw on the wisdom and experiences of others who have been in a similar position. I'm just under 30 weeks and starting to think about whether to go for VBAC or ELCS. I know that certain things might happen which make one or the other necessary / a straightforward choice over the next 8-10 weeks but, so far, everything has been pretty textbook so I'm hoping it continues this way. For context, I am 41, had a BMI of slightly over 30 at booking in and have one DS14. DS was born by emergency section as he was undiagnosed breech - he had actually been spotted as breech but had turned himself when they checked prior to external cephalic version at about 38 weeks, I think. However, he then turned back again (no idea how as he was big at 9lb 4!) but, although he was wriggly, I hadn't realised he had turned and nobody scanned me again. Midwife checks assumed his head was his bottom . So anyway, I went into labour and had to have my waters broken as they didn't go themselves. They offered me an epidural before they broke the waters (good job as it turned out as it only needed topping up for C section) which I took. They broke my waters and then realised very quickly that baby was breech and I have never seen people move so fast. Looking back, I found the whole thing really traumatic - unsympathetic midwives, high stress, after care not great (left to get dehydrated in recovery room, doctor told midwives off in front of me for this), no skin to skin, labour ward was dire, toilets etc filthy - it was just horrible. Got sent for a shower on labour ward and was as quick as I could be following major surgery and midwife told me off when I got back as DS had been crying for a feed, another midwife told me I would hurt him if I didn't learn to breastfeed him properly, despite milk never coming in but that's a whole other story. I know others will have had far, far more traumatic experiences and this is tame in comparison but the whole experience was generally pretty horrid and I was desperate to leave after being in for three days.

All of this contributes to not really wanting another section, especially an emergency section. I am also worried that I won't recover as well from surgery this time, being older and fatter and don't like the thought of needing significant help whilst things heal and my body recovers from a section.

So, I'm leaning towards a VBAC with epidural for pain management. The information from my consultant and hospital has given some of the risk factors, but I've found info from other NHS hospitals which says that if you are over 40, have never delivered vaginally and have a BMI over 30, your risk of a successful VBAC drops to 40% - making an EMCS more likely than not.

I am really stuck for what to choose and don't know if it makes a difference that my EMCS with DS was because he was breech and not because labour was obstructed.

Can anyone offer any insight / experiences in a similar situation with similar risk factors?

Anyone?

Hi @Santatizer I'm in the same boat as you but not as far along but I am swaying for VBAC because of the recovery of a section as I will have a 16month old.
Firstly your care sounds frankly awful I'm sorry that happened. Isit the same hospital? I am sure you will have a much better experience this time with staff and if you don't speak up or get your partner to. You deserve the best experience possible.
Can you ask to be scanned when you go into labour to check baby is not breach again?

Hi @mrssunshinexxx thanks so much for the reply! I just don't know what to do for the best. Like you, I am leaning towards a VBAC but from all the info I can find, the probability of a successful VBAC is around 57% (bit better than 40%) so a high chance of another EMCS, which RCOG says is associated with the greatest likelihood of adverse outcomes. So on balance it seems like I should go for a planned section
... But I really don't want a section ... What have your midwives advised?

Recovery after VBAC isn't always quicker. I was shocked how I was unable to get around whilst people on the maternity ward that had a c section were walking around the ward, i had pretty bad tears after both my dc's, many stitches followed by infection and a huge blood clot after dd2, recovery was not quick. Dd1's birth was very painful, she was back to back and I stupidly asked for no pain relief in my birth plan, I was young and had no idea how painful it would be. With dd2 I opted for an epidural, birth was very easy but recovery not so easy. Epidural was amazing and I would highly recommend it.

I wanted a VBAC, my first pregnancy went 16 days over due date, so I had to be started off and then had a cord prolapse, got rushed off for EMCS with GA. Had a PPH and needed multiple blood transfusions as well as severe oedema in my legs which lasted weeks.
Left it 10 years as I was so traumatised by my first birth but really wanted a VBAC, consultant agreed I could try but again I needed an EMCS as DS was in fetal distress and needed oxygen and SCBU once delivered.

I so wanted a VBAC but it wasn't to be sadly. If your consultant supports your choice then definitely try if that's what you would like. Good luck op x

Why is the percentage so low? @Santatizer from the stuff I've read it says 3 out of 4 women have a successful VBAC but factors for this are BMi,if your labour starts naturally and I can't remember the other stuff. I'm only early on so haven't had consultant appointments yet hoping to feel a lot clearer once I've had that and hope that they can sway me a little once they've read my birth notes. It's true tho a natural birth doesn't necessarily mean straight forward recovery. Childbirth is fun what does your midwife advise? I think keep in mind your baby was breech so you didn't get the chance to labour naturally and that was out of your hands so try to see this time as the first time ? My epidural didn't work and this is something I'm very anxious about if it has last time I think I would of got some rest and actually managed a natural birth

I opted for vbac after emcs with my first.

Dd had the cord around her neck so that's how we ended up with a cs. Her stats were dropping with each contraction but it doesn't sound as stressful as your experience as they monitored for a while and then made the decision as it was just starting to become dangerous.

I chose vbac for my second as there was no reason to suspect the same problem would happen twice. I laboured through the night but it really just never progressed to the end point so I ended up with a second section but honestly it was a much nicer experience.

The whole experience was better as both dh and I felt better able to advocate for what we wanted and the midwives I had were amazingly supportive. I (or rather we as it was discussed between me, dH and midwife) made the decision to go for cs and it was all very calm - as I had been there all night they scheduled me in before the first planned cs of the morning, fixed my spinal block and got me comfortable etc.. in plenty of time, wheeled me down and the surgeon popped in to say hi and introduce himself, it was all a very chatty friendly affair, so probably more like a planned than emergency.

I am glad I tried as it was a good experience (unlike dd which was overwhelming and scary) and as it turned out ds was wrapped in the cord so tightly that he couldn't move into position hense never getting to the crowning point

I would definitely try for the vbac as you can always change your mind

I had a VBAC with my second and almost died. If I could go back and do it again I would have had an elective C-section with both. I was 37 and 39 when I had my children, so maybe things look different in your early twenties or teens.
My recovery from my VBAC was way longer than with the Emergency CS. I was in severe pain from the tearing and stitches for at least 6 months, I was pretty non functional for several months from the major blood loss, and I had far more long lasting pain, and permanent scarring and discomfort which is still affecting me 18 years later. My Emergency CS (preceded by 40 hours of labor) scar was healed up within a few weeks of delivery and I was fully functional and without any residual discomfort of even a minimal amount by 5 weeks.
Just to reiterate, I would recommend an ELCS for everyone over the age of 30.

I’m 40 and just had a vbac for my second (only 15 months between them). My first was emcs for foetal distress at 6cm. I was induced with pessary after waters went but no spontaneous labour.

I was told that in favour was that I’d laboured in first pregnancy to 6cm. Against me was my age. I had a bmi of 20 and was fit otherwise. They weren’t bothered about age gap.

For me the vbac gave me the chance to deliver the “traditional way”. I also was keen to avoid c section with the 15month old as would potentially be longer recovery for lifting.

I’d say recoveries are different. This time I was fine lifting etc after a few days but I have a second degree tear and little incontinence which I find upsetting. However on the positive side, can drive and lift and escaped hospital after only six hours!

There are pros and cons to both. The outcomes are unpredictable and everyone is so different in how they recover. Overall the safety stats seem quite similar- vbac a little safer for baby but tiny differences.

Given my time again I’d still vbac, even with pelvic floor issues but a lot of that is driven by making childcare easier which sounds less of an issue for you. Good luck whatever you decide and I’d talk to your consultant as well

My first was an EMCS at 9cm due to foetal distress. I found it exhausting as I'd been in labour for about 16 hours I think by the time they delivered her and then obviously major surgery.

I was adamant I wanted a VBAC with my second. 2½ years between my children. They warned me that I must go into hospital as soon as contractions started because of the risk of the scar rupturing but I didn't really want to because I knew this would mean they'd strap me to a bed for monitoring which I didn't feel comfortable with and knew it would stress me out.

I went into labour after a sweep at about 39 weeks. Laboured at home and found that I was 9cm when we got to the hospital. DD2 was born 1 hour and 20 mins later. I had a 2nd degree tear (borderline 3rd) and an episiotomy as she got stuck crowning. Ouch!

She was born at 1.20pm and we were home the same evening. I felt sore for nearly 2 weeks and sitting down was awful but then I suddenly turned a corner and felt fine. Contrasted to the section where I felt awful for 5 or 6 weeks. Also I could lift the baby with no pain immediately after the VBAC and found it easier to get comfortable for breast feeding.

I have had some pelvic floor issues after the VBAC but nothing major and it's my own fault as I was very lax doing them.

I'd definitely recommend a VBAC. It was a much better experience for me.

Oh I was nearly 32 for the EMCS and 34 for the VBAC.

@Homassy thanks for sharing there will be 16m for me between and I have been worried about the length of time being quite short for the scar. Is the chance of rupture higher the sooner you give birth after the section? Like because it hasn't had v long to heal?

It's sad to hear all these births where you have laboured and dilated so well then it ends in section I was in labour for 26 hours then ended in a c section I have never in my life been more tired than the first day of her life

I had an emcs for ds for failure to progress they said I wouldn’t deliver naturally as I wasn’t big enough. So I booked an elective second time but had an unplanned VBAC a few days before.
Everything felt different, labour actually progressed and dd was a pound smaller than ds. It was still a 12 hour active labour with 2 hours pushing but it was unassisted
My bmi is 23 I. Was 36 when I had ds and 39 when I had dd

I had an emergency CS 1st time around as DD's heart rate kept dropping dramatically when I went in for my induction at 41+5.

When I got pregnant with my 2nd I went through all the notes from my 1st birth with the consultant. There was so much about my 1st birth I either didn't know or didn't remember so I found that useful in making my decision. The consultant concluded all the things that caused my 1st birth to go wrong (DD was apparently almost transverse and had cord around her neck) were just bad luck, and unlikely to happen again.

In the end I opted to go for a VBAC if I went into labour spontaneously, but a CS rather than an induction if I went overdue again. VBACs with inductions seem to have quite a low success rate so didn't want to put myself through the whole induction process if I was likely to end up with a CS anyway.

As it happened DS came a few days early and I had a reasonably straight forward VBAC. I will say I hurt just as much in the immediate days after my VBAC but overall recovery was much quicker. And so much easier being able to drive and be out and about with an older child as well.

@BaffledBerluga I'm definitely hoping to have a detailed chat with my consultant re first birth notes