VBAC after 2 c sections, on a small Thai island with some medical facilities- need the MN experience pool!

[duchesse]

My sister lives on a small island in the South China sea. The island has two hospitals and is relatively well provided for medically. She could very easily arrange a C section there, but she would rather have a VBAC.

No doctor either in her island or in a natural birthing centre in Bangkok that she went to, is willing to do a natural delivery after 2 c-sections.

She needs information and ammunition and other people's experiences of birthing in Thailand, VBAC after 2 sections either in the UK or not, and anything else you might think she needs to know.

Timing is crucial as if she chooses to return to the UK to attempt a VBAC, she has to travel within the next 2 weeks.

Might I recommend Dr. Nopadol Saropala at Bumrungrad Hospital(Bangkok) He is a good bloke, trained in England and worked in East London for a long time. Also specialises in VBAC. I was very impressed by him. Look for find a doc page here or call up - they speak excellent English there
www.bumrungrad.com/
I would guess your sister is familiar with Bumrungrad already as it is the No. 1 choice for expats.
Ex pat organisation BAMBI www.bambiweb.org (sorry can't do links) have links to Australian-trained Doulas and can be very very helpful (if a bit too Ex-Patty for some tastes)
Hope this helps

Wow- thank you!

I think it depends on how confident she is (second camilla on research). No doctor me, but if she is in a country with good modern hospitals generally, and can get an expat midwife to attend (who may have worries about her own insurance?) how confident would she be about staying at home as long as possible, or for the whole thing. Stress -- am not doctor just 2xvbac.

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It may be a stretch...
Robin Lim, truly amazing midwife in Indonesia may be able to put you in contact with midwives elsewhere in SE Asia. Her email is on her website:
www.robinlimsupport.org/index.htm
Good luck!

Or try to contact the birth centre itself:
www.bumisehatbali.org/

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She needs either a m/w or ob who is happy and confident in supporting a vba2c (ideally both). Not been funny, but although I'm sure a doula would be great moral support, I'm not sure she'd be much use if the uterus ruptured. So finding a doula wouldn't be top of my list of priorities.

Please don't put the idea of flying into your sister's head. We are not allowed to fly for a reason (but have pregnancy brain and have forgotten most of them), not least cos sitting down not moving is bad for our circulation.

I don't have any advice, apart from i hope she takes medical advice, given that it may not be what she wants.

It's a shame she didn't do the research a few months ago (sorry, didn't mean to lecture).

VBAC in Singapore is a link I've had bookmarked for a while, not sure if it's any help....

Doctors don't "do" natural delivery after 2 sections anyway - a woman gives birth naturally after 2 sections, lets get that straight for the get go!!!

Tell your sis to get that in her mindset first and foremost, SHE is the one giving birth! Her Health Care Providers are only there to help IF it is needed, and not to intervene so much that they cause more trouble!

then she can put this in front of these people that are telling her no and see what they have to say to it! Quote: Landon?s study confirms that uterine rupture is the complication with the greatest risk attributable to trial of labor; however, it also shows the risk for uterine rupture is not significantly increased in women with multiple prior cesarean deliveries compared to a single prior operation.

UR IS a risk but it is tiny and if the medics have no faith that they can deal with it at their hospital then I wouldn't want to be in their hospital anyway!

CAT me if you'd like a whole Word.doc of links worth looking at. Your sister is very lucky to have you looking out for her.

Thanks for the info, all. I have pointed my sister to this thread: hopefully she will find her solution either among your suggestions or via her own research.

I'm bumping every so often to maximise the amount of info we can collect. Please say something if you think you can help!

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Sorry to disagree with Santa re. uterine rupture but UR can be difficult to manage due to bleeding, even in a fantastic modern hospital.

I'm going to contradict other people on this thread, but i really do think that your sister shouldn't go against medical advice.

My friend is a GP and she had her 3rd by C-section (due to placenta previa). She said that she would have had c-section anyway due to risk of UR. She said it was a small risk but not one worth taking.

Sorry to scare you but my sister-in-law started with a VB, then needed to change to a c-section cos her first baby got stuck. LO was too low down in birth canal and she ended up with a tear to her anus. She now had endometriosis (which may not be related to the birth) and hasn't had any more children.

Please don't let your sister end up with any problems cos she has her heart set on a VB.

lovemymum... i can see where you are coming from, but there are risks to each and every birth, some of those risks are unique to a VBAC, but some aren't. medical advice is just that..advice.. not orders, same as this thread is advice and opinion... this woman needs to do her research and make her decision based on what she learns and knows and is advised.

there is a risk of cord prolapse in every birth, but no-one harps on about it, the same way rupture is built up to be the most enormous and insurmountable obstacle

there are pros and cons to VBAC and c.s, and though i am very pro VBAC, the lack of medical help would worry me, and i would take it seriously, but this lady needs to make her own decision. i am sure she understands the risks and benefits, and would not undertake this lightly.

when you know people who have had difficult deliveries, and / or had one yourself, it is difficult to imagine birth actually being normal and straighforward, rather than a medical situation to be managed

She needs to understand why she had C-sections the last two times. There may be medical reasons why it's not advisable.

I agree with you lulu.

It's just that i don't understand women who "have their heart set on a VB" and get upset if they can't for medical reasons. It's just my personal opinion. DH is a Dr and he has seen women who have gone against or ignored medical advice which has resulted in a negative outcome which, in some cases, could have been avoided.

In the end, it is our body that will give birth and our wishes need to be respected. We need to ensure that we are as educated as we can be in order to make an informed decision.

well, i had my heart set on a VBAC, as my first em c.s left me incredibly traumatised and depressed.

if i had been advised to have a c.s again, i would have been devastated because there was so much about the labour and birth i did not have with my first DC that i wanted to experience.

birth is more than one day out of our lives, it can have a massive emotional impact on women , negative and positive, and medical advice might not always give enough credence to that

i had a VBAC, i knew the risks , i knew the possible negatives, but these were massively outweighed by the positives. and it was a very straighforward birth with no complications.

i absolutely agree that educating ourselves is key.. and that will enable us to make the right decision for ourselves.

i hope duchesse's sister has a positive and wonderful birth , however it may happen

only read the OP.

nope, i wouldn't try this.

i'd go for another csection if i were her.

Thanks all for continuing to contribute. My sister is reading the thread and is hoping for her MN membership to be approved soon so she can join in in her own right.

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Hi.

Just wondering how your sister is.

This is my first pregnancy and I had NO idea how charged the c-section - vaginal birth discussion/argument is. It's been a real eye-opener for me.