VBAC- advice please

[Izzywhizzy]

My dd is 11 months old and I'm now 8 weeks pregnant with number two.

DD was born by emergency ceasarean and I was advised to wait for a year before getting pregnant again.

Well, whoops! Contrary to plans, I found out a month ago that I was up the duff again.

I tried very hard to give birth to dd the natural way (30 hours on gas and air before I admitted defeat) and I'd really like to avoid going under the knive again if possible.

At my booking in appointment last week, I asked the nurse if she thought that was going to be possible and she said it was unlikely that they would let me go for a VB, because I hadn't left a big enough gap.

I'm still feeling really disappointed about this. I have my first scan on 11 April, and will ask again then, but does anyone out there have experience of VBAC without a year's gap between pregnancies?

bump

Anyone out there with some advice for me? Anyone????

So you're one month off the gap they recommend? That's not much.

Why did you have a C-section first time? Failure to progress or anything else?

Have you had any problems with your scar from your first c-section? If not, I would take each day as it comes.

If you want a VBAC, don't assume you have to have another C-section. Check out this site, for example. There's lots of other information out there to google if you want to research your options before you make your final decision. Don't make your decision based on one opinion.

More information

I had a VBAC after an emergency C-section although my baby was born two years after my first child. The medical staff were still anxious. I just wanted a VBAC so much and couldn't bear the thought of another C-section.

Go to uk midwiferey website lots of inspiring vbac stories there
try good positioning being active maybe yoga, thisbay may be different to 1st my friend had c/s then normal and then c/s 1st baby 8lb + second just 7 3rd bigger good luck, talk to some independent midwives/doulas.

I'm 3 months off the gap (they recommend a year and it was 9 months when I got cheggers).

I've had no problems with my scar and was up quikly after my op.

I had the emergeny c-section basically because dd's head was too big to fit through my pelvis, so I never dilated further than 5cms.

I really don't want another c-section if I can help it, but am worried that I'm going to get pushed into it.

I would get a second opinion.

I had an emergency section and have had 2 VBACS.

Find lulumama - she knows all about this.

Don't make any assumptions about how your next birth experience will be and certainly don't let anybody else make assumptions for you! You make your own decisions.

TBH I am not sure the gap is that important.

I my case I had a emergency section in March 2001, had it resutured in June 2002, a VBAC in Aug 2003 which was fine (excpet for retained placenta) and another VBAC in June 2005 where my scar nearly ruptured and baby and I weren't looking like we would be okay.

My scar was older when it was a problem iyswim.

izzywhizzy, I'm in a similar situation, except DD is only 9mo old and I'm just seven weeks and I'm hoping for a VBA2C

when I spoke to my GP about it, she seemed confident that they would let me have a trial of labour, but of course she isn't the hospital consultant so who knows.

Antyway, I started a similar thread and got a few really positive responses here. from what I've read, all the tissues etc should be healed properly after three months so getting pregnant again before the year is out shouldn't, in the majority of cases, be a problem.

it is lulumama here ! i would look at this site www.aims.org.uk and www.caesarean.org.uk

you cannot be made to have another c.s if you don;t wish to. the health care professionals can advise you, but it is your decision ultimately. you can certainly make an informed decision to go for a VBAC.

there are certainly two or 3 mumsnetters who VBACd with a years gap or less.

It worries me when you use the words, "let me,".

Nobody can make you do anything you don't want. Obviously you will want to make the decisions you feel are best for you and your baby but please don't let anyone bully you. You have to give your permission. Don't treat doctors like gods.

I'm also pregnant with a gap even less than yours - dd was only 10 months when I got preggie again. I'm over 40 and had a very severe infection in the wound - but have been left to make my own decision on either a C-section or VB. The consultant and midwife all said they'd support a VB....so I assume they all think it's possible....!

Maybe try and get more info if you really want to give a VB a try and try finding someone to support you- i'd second a independent doula/midwife.

Apparently there have been studies that show that the risk of uterine rupture goes up slightly if the gap between pregnancies is less than 6 months, and even then the risk is fairly low. Have a look at this

The risks of Uterine Rupture are slightly higher if you have a small gap but they are still tiny.

On the VBAC board I frequent we have VBACers with second babies when the oldest has been about 18 months... and HWBACs.....

My personal experience was a 12yr gap so can't help you there but let me tell you that it is entirely YOUR choice.

You've been badly misinformed!

Best places to start:
www.caesarean.org.uk/
www.aims.org.uk/
www.caesarean.org.uk/articles/VBACOnWhoseTerms.html
www.radmid.demon.co.uk/vbac.htm

After a cs in similar circs to yours Izzy, I was pg within a year and had a successful vbac. Although I was advised to go for another cs (by daft German doctor, midwife rolling her eyes in the background) I insisted on at least a trial of labour and ended up with a pretty straight forward birth (well, I had an epidural near the end, but no other intervention).

AFAIK the risk of scar rupture in all planned vbacs is less than 1%. What would be useful to find out is if there is any link between age of scar and heightened risk - I've not managed to find this out and don't know if such data is available - I would like to know for myself and my own peace of mind (facing another vbac in May).

You don't have to make any decisions now, but if I were you I'd read up on it so that any discussions you have with hcp are informed. Good luck.

x posts - off to read links re age of scar

Thnak you all so much for your fantastic posts. I'll look at those links and go to my appointment as informed as I can be.

I would be interested to know why I was fine 2 years 4 months after my first section but had trouble 4 years after it.

Could it have been because I wasn't sewn up right but then was done 15 months later or maybe it was just bad luck for me or because there were only 22 months between baby 2 being born and baby 3.

Arghhhh.
As I'm sure you have gathered now, no-one can tell you waht birth you are going to have, that is your decision, unless they are going to section you under the mental health act and then strap you to a bed I don't really see how they can stop you

Uterine rupture is very rare, a newer scar may be less likely to be healed, but it's not like it was only last week, so I'd ignore ths scaremongering and research it yourself tbh.

Also, if you/they are really worried about uterine rupture, personally I'd read up on what it entails. It doesn't mean you will explode never to be able to be sewn up again, in many cases of UR it is identified when it starts to happen and as such you would be taken down to theatre for an em CS and to have yourself sewn up. It's not ideal, but if you're being monitored properly and aware of the risks even the eventuality of UR is to some people preferable to a planned CS.

So my advice is to read up the risks wrt your situation, decide how important it is for you to try VBAC, and weigh up the risks, both of how likely a UR is, and what risks you are willing to take.

I'd also bear in mind that an EL CS has risks too, it's not a failsafe procedure (risks of respiratory problems with baby increase from 2-3% with VBAC to 4-5% with EL CS) so by agreeing to surgery you aren't necessarily stopping any possible outcomes being Not Great iyswim.

Plus if you have a CS this time, it could make it harder if you decide to have another baby to go for a VBAC after. (Though I am having a VBA2C this time round, so it is possible)

I'll leave you with my favourite link Looking at part 6.1 it does say that VBAC after less than 2years since previous CS is less likely to be successful, but that doesn't necessarily mean UR.

If you look at 7.2 is states that findings show an increased risk of 2 or 3x for UR if there is less than 24months between babies, this means 0.5% risk of UR would become 1.5%(ish) risk of UR. If that is a risk you're willing to take then by all means tell the cons what you have found and how you feel about it. It does say that risk of a CS due to unsuccessful VBAC increases from 25% to 32% also, so that's another stat to take into consideration.

Would you prefer to try VBAC and have an EM CS if need be rather than an EL CS or would you prefer to have a planned EL CS? Those are the questions you need to ask yourself.

Then after discussion with your consultant decide if you feel they are supporting you enough in your decision.

Good Luck.

NAB, Unfortunately it was probably just bad luck, the risk of UR goes down after each successful VBAC rather than up, so it seems you were just one of the small percentage second time around.

I like that link VS - I was making notes from it the other day because, despite the fact I've got one succesfful vbac under my belt, I am still seen as a walking scar just waiting to explode , so will have to have the conversation yet again with the cons about going for a trial of labour this time around. It seems rather illogical to me as the risks of other potentially life-threatening factors in any labour are greater than the risk of scar rupture, yet they don't advise all women to have an el cs (I know, I know, but still). And in the reality the risks are tiny, tiny, tiny - fewer than 25 women for every 1,000 (and that's the most unfavourable statistic I can find) trying for a planned vbac will experience scar rupture.

It was that link that got me trying for my VBA2C at some point in the next couple of weeks

I must know the study off by heart now!

I'd print it off and highlight the things that are relevant to you personally.

There was a poster (it may have been vacaloca) who mentioned it to their cons only to be told 'not to trust everything you read on the net'. If it was who I'm thinking of she showed him the study, and is now on course for her HBA2C in the next few weeks. It's a lot harder for them to disagree with something in black and white.

Hopefully once they realise you're clued up and know what you want/are talking about they'll just leave you be.

My cons was a bit for a while rgarding my VBA2C, often mentioning EL CS's but now, with the last few weeks to to go she is positively wonderful about it!

Most of the time they just don't want anything to go wrong, and if they don't tell you the risks and something does then it's them that are in the schtick so try and bear that in mind, fingers crossed once they know you're not going in blind they'll be a lot better about it.