VBAC vs ELCS experiences

[saltedcaramelanything]

I ended up with an EMCS for DS, 3 yrs ago, after being induced 2wks after due date and then failure to progress. Turned out the umbilical cord was around his neck, stopping him from fully engaging. And he had a (very) large head.

I recovered remarkably well / easily from the EMCS, so my memory of his birth is really - labour was long and difficult, CS was easy.

Now pregnant with my 2nd, I've had the BAC meeting with the midwife and it's very obvious they prefer VBAC. But I'm really struggling on what I want.

Would love some real, good and bad, examples of other peoples experiences with both options?

I had a successful VBAC with ds. It was a very good birth and I have no regrets. (Except when in early labour and walking round the hospital grounds trying to speed things up when I had a very long rant between contractions at Dh about how I could have had an ELCS and had an epidural before I even took my coat off…)

The thing that convinced me to try the VBAC was the reason the birth went wrong with Dd was to do with her positioning rather than my body. (She was back to back, turned wrongly and got stuck.)

Thanks @Mumoftwoinprimary that's a good point.

I am slightly terrified that DC2 will have just as big a head as DS1 - and / or even bigger than his 9lbs - which also makes me feel like an ELCS is less scary

I loved my VBAC. Hated my CS. I know I'm in the minority on MN but I was left traumatised after my CS and three years on I still don't fully know if it was an EMCS that got recorded wrong or an ELCS that got carried out wrong. My VBAC baby had a big head which meant labour went very slowly but we got her out with an episiotomy. I'm usually quite active so recovery from VBAC was better as I was up and about faster than with my CS. I still have itching and sudden pains from my CS scar. 4 months post-VBAC I can't even see where the episiotomy was and my only issue is I'm still rehabilitating my pelvic floor.

I had an EMCS after a failed induction for being overdue. The induction failed because I failed to dilate beyond 2cm after 48 hours of attempts including 9 hours on the drip.

Second time round, I wavered a lot as I was terrified of another section but equally terrified of a VBAC. The hospital were quick to point out the risks of a section and the benefits of a straightforward VBAC but glossed over how likely it was that mine would be straightforward.

I chose an ELCS. This was for a number of reasons but:

• I liked the greater predictability.


• Online research suggested my odds of a straightforward VBAC were low in view of reason for previous CS, age, size of baby, etc.


• I didn’t fancy damage to my perineum when I already had a CS scar.


• I would have wanted a very low-key water birth which didn’t seem compatible with either my or the hospital’s risk appetite in relation to monitoring and I was concerned that their promises of wireless monitoring might well not deliver.


• The scenario I was most keen to avoid was an instrumental VBAC or EMCS. The only clear way to avoid these seemed to be to plan an ELCS.

I also had a straightforward recovery first time round. I found recovery from a planned ELCS harder - I think because the induction felt so rough that surgery was a means to an end whereas with planned surgery, you walk in feeling OK and then they cut you open from a standing start, if that makes sense? I had issues with blood pressure during and after the op too. But it was absolutely the right choice for me and I’d choose it again under the same circumstances.

I would definitely encourage you to think what it is about a VBAC that appeals, and ELCS, and which scenarios you’re most keen to avoid. Therein probably lies your answer. It is your choice - don’t let them push you into one or the other. Obviously worth listening to the medical perspective but make sure you’re getting risks of both birth methods and not just risks of one and benefits of the other, if you see what I mean?

Also, I know a lot of women are put off by the recovery time and restrictions of a section. My experience is that you should be very careful about lifting and must avoid lifting anything heavier than the baby for the first few weeks at least. But I was doing the school run after a couple of weeks without issues. I think it’s easier to recover well from a good section than a botched vaginal birth, personally.

Thanks - it's really good to hear more perspectives.

@MacaroniCheeseCat You've pretty much perfectly captured my situation and my concerns about a VBAC.

I do remember after my EMCS feeling like I'd missed out not having a natural birth. But I think that's a weird romantic vision of giving birth? I would want a low key, no instruments VBAC - but the stats seem to suggest that's pretty unlikely.

If you went for an ELCS, was it post-due date?
I guess if I scheduled one, you could always go into labour early naturally?

Hi OP, good question about scheduling. They normally book an ELCS in your 39th week but my doctor was happy to book it anywhere from 39+2 to 40+10. Based on diaries and how dates fell in relation to weekends. I asked to go about a week overdue to see if I went into labour - I was not keen to go past 41 weeks but I did want to see if things would start naturally. They didn’t, so I had the section at 41 weeks exactly. For me, that gave me a bit of closure - it seems for whatever reason my body doesn’t go into labour naturally and I don’t dilate (or not before 42 weeks). So it made me feel better about both sections.

On some level, ridiculous as it is, I felt I’d failed first time round by not having the NCT-approved water birth/home birth. Probably not helped by the fact that most of my group did get the birth experiences they wanted (which is unusual).

I resisted the VBAC pressure the second hand went for ELCS. both sections were relaxed and straightforward and I was up and about quickly.
My friends are about 50/50 in terms of whether they had c sections or vaginal births. I can't think of any of the c sections where there were bad experiences but some of the vaginal births were horribly traumatic.
My consultant let slip that an ELCS is less risky statistically than a VBAC when nobody else was listening - don't think they're supposed to tell you that!

I had a planned c-section last week after 2 vaginal delivery's both big babies and haemorrhaged after both delivered.

He was 10 pounds and I'd never give birth naturally again

@MacaroniCheeseCat Are you me? Honestly your capturing exactly my thoughts.

@Hmum0fthre3 DS1 was 9lbs 4oz with head 99th percentile... the idea of a natural birth with another one of them is scary! Especially as I'm quite petite.

I think I'm most likely going with your approach @MacaroniCheeseCat - schedule ELCS for 41wks. Give my body a chance to get there naturally, but if it doesn't have a set end