VBAC or Planned C Section?

[averagemum1]

I need to choose whether to have a VBAC or planned C Section and I'm really struggling to make a decision, it's making me an emotional wreck.

First birth will be 15 months prior to this one due. It was traumatic to say the least. After a 24 hour intense labour, following an induction it was decided to go for emergency c section. I was however at this point 10cm dilated and pushing so incredibly frustrating but bad timing. During the c section I lost half my blood from uterus contracting during surgery. Also my epidural hadn't worked and I was in absolute agony during the surgery (why they didn't knock me out I'll never know). And then I managed to get Sepsis.

The recovery was tough and I just don't want to do that again. I felt like I wasn't there for my newborn during the first few weeks and let my daughter down. Husband is an absolute super hero so no issues there. Support network is questionable at best.

Of course there's the risk of rupturing during VBAC, and if I end up having another emergency c section then what if I bleed again, what if the epidural/ spinal block doesn't work, what if I contract sepsis again.

Just need some other opinions! Help!

I recommend The Positive Birth Book, if you haven't already read it. It's great at helping you to feel empowered about your birth options, while keeping it rooted in science.
I went for VBAC but ultimately ended up with a very similar birth to my first, c-sec after labour slowed, baby was back to back.
Second recovery was harder and I had an infection. But I think you'd have to be incredibly unlucky to get sepsis again!!!
I was desperate to rewrite what had been a difficult first labour with a positive VBAC, but in the end it came down to the best way to get the baby out in that moment.
Occasionally I wish I'd just booked a c-sec but I know I'd always wonder whether I could have done the VBAC, so had to try!!

What you went through sounds horrendous.

I suppose you should go with whatever approach your consultant thinks is safest for you and for your baby. Ask them what they'd do in your position.

I think if I'd been through what you have I'd be inclined to go for a elective section.

@averagemum1 I also had sepsis after induction and emergency c section, I'm currently 32 weeks and am going for a planned c section this time, I didn't realise how much the birth affected me until I fell pregnant!

I’m in this situation too, pregnant after an emergency c-section for first pregnancy.

I’ve decided on elective c-section, but I only dilated to 3cm after three days of labour the first time round. Since you reached 10cm you will have a better chance of a successful VBAC. Google VBAC calculator and it can calculate your chance of success based on various factors about your previous birth. I only got 60% but you would get higher.

I've had two elective sections and they were a breeze - nothing to be worried about at all. If you're unsure about VBAC and have the option of an elective then I would jump at the chance. Good luck!

Thanks guys, sounds like those in similar situations are going down the elective route.

MrsMortimer- I'll get that book on my kindle, sounds like it might be helpful for me. My first was also back to back. In regards to second birth, I've convinced myself first was so bad surely it can't be any worse! Pregnancy was straightforward and baby was absolutely fine first time round, so it's just me that's high risk now really (for now at least).

DramaAlpaca- consultant and anaesthetist appointment in 2 weeks. My question list is extensive for them! Will see what they think.

Towga- sorry to hear you also had sepsis. It's not much fun when you're trying to be the best mum you can be. You're right, I was adamant I was fine but it would seem as though it affected me a lot more than I thought. Luckily I'm quite good at figuring out my own emotions and feelings but they're still there.

Rosemary35- thanks for that! Really helpful. I got 89% which is promising, although there's a lot of factors obviously not taken into consideration.

Schmalex- I guess it's not so much that I'm worried about the surgery, it's more this weird natural instinct telling me I should try for the VBAC. Also the recovery was so difficult the first time and I just want to be able to actually pick up my baby on my own in the first few days this time. I was in hospital on my own because of Covid so just felt so useless and I think it affected me emotionally. So this time I want to be a better mum. I know that doesn't make me a bad mum, but mum hormones, y'know!

I'm having an elective c section on Tuesday after a similar experience to yours. I didn't get sepsis but got a nasty infection. I found the recovery pretty awful but like a PP said, I didn't realise how much it's affected me until I was pregnant again. Everyone tells me an elective will be so much better than my emergency but sometimes it's hard to think that it can be any different.

While I'm not thrilled with the idea of another c section, I knew I really couldn't put myself through labour again. It's a very personal decision and one only you can make. I would have loved someone to make the decision for me! Good luck with whatever you choose

Just to give the VBAC point of view, I had a traumatic first birth and vbac on the second. It was a wonderful experience from beginning to end, and also helped me heal mentally after the first birth. It definitely helps that you laboured first time, as I did, as I think your body acts as if it's a second time labour if that makes sense. I found the recovery fantastic in comparision with the section and it really helped to be able to move around as I had a toddler at home. If you decide to go for it, what helped me was a lot of rest beforehand so I could go into it well rested. I had accupuncture from 37 weeks and did gentlebirth etc. I also stayed at home until my contractions were strong and regular and used the birthing ball to labour. A good tip I got was, even if the hospital wants to do continuous monitoring, you can still sit on the ball. My baby was born quickly with no issues. It's entirely up to you of course and I wish you the best of luck and a happy birth whatever you decide.

I’m sorry you had such a rough time. I had an EMCS following a failed induction for DC1, which I found traumatic, although it was not as objectively awful as yours sounds - no infection or anything. I was adamant that any future births would be ELCS - but when I got pregnant I felt hugely torn. I had this real need to try for a straight uncomplicated VBAC - but I knew that I would have been really upset to have ended up with another EMCS or an instrumental delivery.

After much agonising, I booked an ELCS at 41 weeks with a view to trying for a VBAC if I went into labour before and everything looked straightforward. I didn’t labour so I had the section. And it was a much, much better experience and absolutely the right decision for me personally. I felt I’d laid some ghosts to rest - it seems I just don’t go into labour naturally - and also retained some control over things.

It would be worth thinking about which scenarios are most/least acceptable to you, eg how would you feel if you ended up with another EMCS? Obviously talk to your consultant about risks and benefits, especially in terms of the age gap, but realistically whether what happened last time is likely to happen again, eg whether the EMCS was for a mum-related reason or a baby-related reason like foetal distress.

I think if you have a consultant who knows your history, they should be able to avoid things going wrong in the same way as before. With an ELCS, they would absolutely have time to make sure you’re completely numb, for instance, and could give you other drugs or knock you out if it started wearing off early. A spinal is more effective than an epidural, I think.

Good luck - it’s not an easy decision.

Just to update. I had my elective c section this morning and it definitely helped me heal from my first birth. I felt calm and in control and it was a fantastic experience. You have to make a personal choice for you and for me this was absolutely the best choice

@webuiltthiscityonrockandwheat aww congratulations 😊 glad it was a nice experience! I’m having one in a couple of months

Thank you everyone. It has been really helpful getting everyone's stories and thoughts!

Congratulations @webuiltthiscityonrockandwheat that's so lovely!

Conveniently one of my clients today was a midwife so of course I took the opportunity to grill her a little off duty. She suggested VBAC given that I've dilated to 10cm during last labour and suspects it will happen a lot quicker and easier the second time round.

Consultant appointment is next week so I'll see how that goes and if the post is still active keep you all updated!

Congratulations @webuiltthiscityonrockandwheat

@averagemum1 good luck with consultant appointment next week, I had mine today, my c section is now booked for the week of the 7th June!

Hello All!

Spoken with the various consultants and the plan is to book in a C Section at 41 weeks giving the baby time to come naturally if she decides to. I also found out the reason I had an EMCS was because my kidneys had stopped working for at least 10 hours which is life threatening.

I have a whole list of clauses! No epidural (this is because the epidural didn't work during my EMCS last time so if we avoid this during labour we can go for a spinal block if we end up needing an EMCS), no induction, and C Section if any minor complications arise such as kidneys, back to back, too much pain or slow progression.

I've just got a hunch this baby is going to come early and quickly. Pregnancy instincts!

Thanks you all for your help though it genuinely was helpful to get opinions and advice!