VBAC or planned Caesarean after previous emergency C?

[Uwila]

Okay Spilla, here's the thread for you.

Spilla comment from previous thread:

Hi
Can anyone help?? I am 5 months pregnant with my second baby. I had an C-Section with my first due the placenta preavia. I now have the choice of what kind of birth I would I like for my second - I had a blood transfusion after the first and did not feel well for at least 3 months even though the pain if the cut seemed to dies down after two weeks.

I honestly don't know what to do - whilst I like the idea of knowing when my baby will come and not risking being an emergency case due to rupture of scar etc I feel quite inclined to try and deliver vaginally.

I can't stop thinking about it all - Anyone got any experiences of this sort of thing I would love to talk to you????

Aloha - you don't know how happy you've made me reading your comments. I too just don't 'get' the natural childbirth thing. I had an emergency section with DS1, waters broke, but no contractions and because he was breech they did the section. I'm now 23 weeks and will be on my knees begging for another section - I hate pain, and just don't see the point when you can have a spinal and the baby is out! OK the scar is a bit painful afterwards but as you said better that than your 'bits' being stretched and cut!!! I also don't feel that I missed out in anyway with the emotional feelings and bonding with my DS - it was just a lovely, lovely moment when the surgeon lifted him out!

want to add - personally never feel emotional about the fact that I have not given birth vaginally. I have two dd's whom I love and how they got here really isn't important compared to the fact that they are both here... especially in dd1's case.

What? It seems somewhere along this thread people have come to think that I am considering a VBAC. No way, no how! This thread was started on behalf of Spilla (read first post).

I on the other hand think that modern technology/medicine exist for a reason and that they are a very good thing. No. 2 is due end of May, and I have every intention of convincing the consultant to give me an elective (even if I have to threaten severe bodily injury).

Slice my belly (clean up that acar a bit too if you don't mind. Take the baby out, and wake me up when it's over. I had a general for the first one since they were in a hurry, and I was positively delighted when they offered to knock me out.

Can't resist mentioning that I had 6 months of agonising back pain as a result of a badly placed spinal block. I was barely able to walk for the first 3 months and certainly couldn't leave our then flat without someone to help.

Were you actually told the spinal block caused the back pain? By whom? I have looked at study after study and not one has found any correlation between lasting back pain and epidural or spinal anaesthetic. Back pain is very common after childbirth but not more common in women who have had spinals or epidurals.

Sorry Uwila!

BTW, a spinal is safer than a general and IMO it is LOVELY to see your baby lifted into the world, painlessly and easily.

Yes, sure it was lovely to see my baby lifted into the world. My consultant anaesthetist said "Now, that just didn't go in right" as he was injecting my spine, and the pain (once the general overwhelmingness had worn off) radiated very clearly from exactly the point of the injection. Very unusual region for back pain to emanate from. Obviously one can never be 100% certain, but I am pretty damn sure.

Oh, and I had "normal" back pain after a vaginal delivery, and it was completely different and nowhere near as lasting.

Hi everybody. Just thought I'd stick my nose in. Totally agree that any method of having a baby is successful if you are both there at the end of it. I had the fortune / misfortune of a totally natural birth! Basically the midwives never believed that I was in labour until I said that either it was my lungs coming out under all the pressure, or ds's head - it was the head! Anyway, I had been making requests for drugs for several hours previously and was told that I wasn't yet established so should save them for later. End result was that I was pushing the baby out by the time I convinced them this was in fact the case. Not a single stich, and was in the shower and feeding the bub 30 mins later.

In retrospect, it was a wonderful experience. Still not sure if the midwives genuinly didn't think I was labouring, or if they were just trying to jolly me along. My only major concern beforehand, was the prospect of me having full-blown hysterics when somebody tried to examine me. I get tearful and incredibly uptight after smear tests, so was genuinly concerned that if in severe pain whilst labouring and some woman tried to examine me I would have the screaming abdabs and have to be sedated. But it seems that what I was told was true - its no indignity at the time as you are far too busy. I found it far more shocking when some old battleaxe grabbed my breast and thrust my baby's face on to it. (Why do they call the THE breast? I indignantly told her that it was no such thing. It was MY breast!)

So in retrospect, didn't enjoy the pain - who would. But I coped well, you have respite from it between contractions, and they get increasingly stronger allowing you to get used to them. Think it helped knowing that the pain was for a reason - its not the same as pain from an accident when you know it is a bad thing IYSWIM. Love the fact that I was chipper immediately after the birth, although would have liked a whiff of gas after all the NI I have paid over the years.

Oh, and last time I went for a smear, didn't cry at all. It was the same nurse who had given ds his jab the week before and he howled as soon as she opened the door - was far too busy singing 'Big Rock Candy Mountain' to feel bashful!

We are clearly very different - I would be STEAMING to be lied to by medical professionals, and as for withholding painkillers....I would be sharpening my cleaver to give them a taste of their own medicine. How DARE they??? The sheer arrogance of it makes me want to scream. I'm sorry, and Mears seems a real exception, but reading stuff like this makes me even more certain that I wouldn't trust a midwife further than I could throw one. This is far from the first example of them lying and deceiving women and refusing them the pain-relief they are entitled to. How could I trust them? Childbirth is difficult and dangerous....yet the people who are supposed to look after to you lie to you....words really do fail me on this one.

Before I was fortunate enough to be given a section for medical reasons, I did think I'd have to go through labour etc and I was very concerned with pain relief - was investigating to make sure hospitals had anaesthetists on call 24/7 etc, but always worried that midwives would try to prevent me getting the pain relief I wanted. Nothing I have read since has given me any more confidence that they would lift a finger to help me. I bet they wouldn't treat men like this

AllIwant/Poo

just curious as to why there was the doubt as to whether you were in labour or not - had they not done an internal when they admitted you to labour ward?

Aloha - appreciate your rage on my behalf! To be fair, however, I wouldn't say they lied to me. I was examined at 9am by a mw - my waters had broken and I was contracting but wasn't dilated at all. That was the only time I was examined until they agreed that ds was crowning at 5.40pm that same day. Wouldn't say that they refused me drugs either - I was tentative about asking for them as I thought I was so far off from the birth itself. They gave me some paracetamol, and the 2nd lady I had suggested a go in the bath and if that didn't help then she would sort me out. I agreed to all this, so don't feel I was denied pain relief. It was also in my birthplan that I wanted to do wihout if poss, so they were considering that as well. I don't remember the mw popping in and out, but dh assures me she came in and talked very regularly, so wouldn;t say I was abandoned by any means.

I suppose the only concern I have in retrospect is that I was in the unit for so long without any examination. I accept that I have a high pain threshold so wouldn't have 'looked' like I was so far on, and am sure they try to keep exams of labouring women to a minimum. I feel happy with the care I received. I don't believe that childbirth is inherently dangerous if all is well with mother and baby. At the risk of being a bit flip - you are far more likely to be hit by a bus than delivering a baby in a hospital. Having said all of that, I am sure that my views would be somewhat different if things had not gone so well.

I'm glad you were happy with how it turned out - really I am. But wheras you didn't mind being disbelieved and were happy not to be offered pain relief, I would have felt very differently, and I've read this kind of thing so often that I don't think it was just a one-off. I think their job is to beleive you and give you what you want! I think pain is a bad thing and should be relieved as early and as effectively as the person enduring it wants. If you don't want pain relief, then of course that's fine. But if you do, then it should be right there, just when you want it IMO. Otherwise more and more women will opt for sections, I think.

And 9am to 5.45pm is a hell of a long time!

In general I would be a bit uncomfortable to think that a midwife wold just believe what I said - afterall, they are the health professionals, not me. And again, would be concerned to some small degree about simply being given what I wanted. I agree totally that pain relief should be given if asked for, and it should never be a fight. However, I cannot be the only mum who, with hindsight, was glad to be persuaded by the mw's to hang on a bit longer. The idea of having a section was hideous to me - whilst I agree that the thought of somebody having to give you an episiotomy is awful, personally the idea of somebody cutting open my abdomen, then my uterus and rummaging about in there was far far worse. I was keen to avoid epidural-type relief as was concerned about the cascade of intervention thing - wold've hated to have a catheter.

Um, but they were wrong! Not only that, they dismissed what you said without even checking. Negligent or incompetent at best, surely, and lying at worst?
As i say, I'm really very glad you were happy with the outcome, you sound very satisfied with what happened, but I wouldn't have been and I couldn't trust people who are supposed to be experts in maternal care but couldn't even spot that a woman was about to give birth!

Yes, they were wrong. Can't deny it. I suppose I am just lucky that it all went so well. Off to bed now - will kiss ds twice on the way, for being such a sneaky little blighter!

I suppose there's nothing like having a life-threatening condition (in my case placenta praevia) to remove the rose tinted glasses about pregnancy and childbirth! I do see it as a thoroughly risky thing to undertake and quite unpredictable enough without adding labour to the equation! But still, very, very much worth it, and the healthy baby at the end of whatever method you choose/end up with is the most important thing.

Do you know that, even being the wonderful midwife that I am , I have been caught out both ways. I have admitted women who have looked as though they were going to deliver any minute only for them to have contractions completely stop and them not return for days, to having women who do not look as though much is happening to suddenly wanting to push.

Labour is an amazing process. No amount of vaginal examinations will tell you the actual point of delivery. A woman can have strong contractions and be 2cm when examined only to deliver within the hour. Another can be fully dilated and not deliver for 3 hours.

AllIwantforXmasIsPoo was not treated negligently IMO. Examining women frequently in labour only invites interference in what is essentially a natural process. pain relief is achieved by different positions, using water etc. Drugs are not the be all and end all. Nothing like a lovely waterbirth to demonstrate that

Gas and air was the be all for me.. still hurt but i just didnt give a monkeys!! Was quite upset when i was strapped to bed with monitors etc as had epidural in prep for section.. mind you that was after 48 hours and only geting ot 5cm. I did feel like a failure and the m/wife afterwards was really nasty. But.. on reflection i would deff consider a planned section if it was highly prob it would end up being a section again.

Message withdrawn

Oh bloss, I know what you mean about the overwhelming pain. That was me with my first before they gave me the general. I truly wanted to die - it was beyond anything I could have imagined. And I was devastated afterwards - not so much by the c-section as the memory of the pain. And I could not watch labouring women on tv, even in light hearted adverts without crying "it's not like that!"
And remembering that I don't know how I ever came round to the vbac option for my second. But all I can say is in my case it was different. Very quick and just gas and air. And it was the most wonderful experience of my life.
One thing that made it special was the intimacy of the experience. There was a wonderful midwife hovering in the background but it was mainly just me and my husband. Very different to the bright lights of the operating room and the deluge of staff (but as I must keep pointing out - my c-section was a horrible emergency).
C-sections are fantastic things - without them either my ds or I would not be here today. And I believe you should have the option to opt for one if you have already had one. But there can be other options after c-sections. Just wanted to wave the vbac flag again!
No wish to discredit bloss or anyone's experience

glad you had such a positive experience cupcake

good point about the 'deluge of staff' in the theatre, it is VERY shocking all round isn't it, to go from midwife care to a full on theatre with six or seven people you have never seen before and you know they are going to get very intimate with you.

I know I keep harping on about it but wiht my first em C all the staff in the theatre introduced themselves to me, for the second one of them actually went snip snip with a large pair of tongs in my viewpoint, when I told her I could see them she sniffed and replied they were going to use them on me anyway so I may as well see them.

Nice!