36 week consultant visit for VBAC in hospital.

[Beeper]

I am currently 36 weeks (by scan) 37 weeks by dates. I am due for my last consultant visit before I give birth. The hospital is pro VBAC and I just would like to run past you some of the things that I was thinking of for the birth situation.

1. I do not want a moblie epidural as this failed last time, I have been told by the head 'needle' man that I can should have a spinal block should I need a section.

1. I have been told that I will need constant monitering, however I plan to say no to this, or I will allow intermittant moniterings as long as I am allowed to stand.

1. I have read on threads about induction being dangerous when you have had a previous CS could anyone clarify this for me and possibly point me to somewhere I could get more info.

1. I dont want memebrane rupture, or the contraction drug as these failed last time and I did not budge a cm. I got to 8cm on my own and after over 3 hours of the drug I did not move.

Is there anything else that I should say that would give me the greatest chance of a VBAC.

Also do you think it is reasonalbe to ask for a section should it come to having a instrumental birth?

Please give me any advice.

Hello Beeper

I'm no expert but will respond to a couple of points and then I'm sure somebody will be along with more expert advice.

I think most importantly, if you got to 8cm last time with no intervention, your chances of a successful vbac are excellent.

There was a thread recently about monitoring (have a look in the childbirth section). I would discuss this with your cons. as protocols are all negotiable and your best chances of success, as you know, are if you are free to move around. As you know, you don't have to accept monitoring if you don't want it.

I think it is generally accepted that induction is a no no for a previous cs but from the info you've given here, I can't help thinking it's going to be an unlikely scenario anyway.

All I would add is when I had a vbac 4 years ago I was adamant that I didn't want to hear any time limits eg "Well we'll let you labour for x hours before we start to intervene." If there's no medical reason to intervene (i.e. if you and the baby are doing fine) then you should be "allowed" to get on with the business of birthing your baby in peace. Time limits just set women up for failure.

A spinal is very quick to put in for most women and works very effectively, if a woman has and epidural for labour it will not always be good enough to be topped up well enough for a cs. So go for it, you have a better chance of success if you avoid an epidural and if you need a cs in all but the most difficult situation you would be able to have a spinal.

Why would you not want an instrumental delivery? For most women and babies it is still safer than having another section especially at a late stage of labour. Of course you could always specify that if it seems that it would be an easy one to go ahead, but if the baby's head is high or in a difficult position then you would rather have a cs. If a baby's head is low it can be much more dangerous to do a cs as it would have to be pushed back up causing trauma to the baby and more infection risk to you. This does not happen too often so don't let it worry you. hth

Why do you need constant monitoring? Will some one be constantly reading it? Sounds like something that would seriously lessen your chances of VBAC.

My cousin was induced at 38 weeks due waters breaking. She gave birth ok but the uterus ruptured and she then had emergency surgery and was in intensive care for a week, including more surgery. Every medic I have ever told that story to says she was very unlucky.

Re section instead of instrumental birth: probably depends on clinical factors at the time, but I don't see why you shouldn't ask, if that's what you want at that point.

thanks so far ladies

I'm in the same situation, after a c-section 16 months ago. now I'm 38 wks and hoping for a vbac. I too have been told I will be constantly monitored but i hope this can be intermitted so i can move about. I have been told they will use pessary if i need to be induced but no drugs as they are not as strong. Being induced puts more strain on the scar, I'm not sure what other problems this causes.
I will take on board what franke said about the time limits- I think that is a good point!!!
I have also been told to come into hospital 'sooner rather than later' to be monitored!! good luck sorry I haven't been much help!!

I'm in the same situation, after a c-section 16 months ago. now I'm 38 wks and hoping for a vbac. I too have been told I will be constantly monitored but i hope this can be intermitted so i can move about. I have been told they will use pessary if i need to be induced but no drugs as they are not as strong. Being induced puts more strain on the scar, I'm not sure what other problems this causes.
I will take on board what franke said about the time limits- I think that is a good point!!!
I have also been told to come into hospital 'sooner rather than later' to be monitored!! good luck sorry I haven't been much help!!

you can definitely refuse CFM, there have been threads about it on here, DaisyMOO posted some useful stuff about it

yuor best chance of a succesful VBAC is onset of spontanoues labour and no intervention, i.e waters break on their own.. esp. if baby is for eg. OP, then the fluid can help baby turn...

being mobile, and able to listen to your body will be helpful too!

i was offered induction at 41 weeks with prostin when i was pregnant with DD, but went into labour just before 40 weeks, so it was not an issue