Struggling to cope with failed VBAC

[BHA90]

Hello, wondering if anyone can help. I'm really struggling to cope with my failed VBAC. My first baby was induced and after 3 days of labour I only dilated 1cm despite having waters broken and going on drip etc. Went to emcs due to risk of infection.

For my second, I researched endlessly and planned for VBAC at birth centre. When labour started, my contractions were instantly unbearable, and after 36 hours of mostly 3 in 10 contractions (no pain relief or interventions), I still had only dilated 3cm and had to have emcs due to distress signs in baby (not moving much on monitor, elevated heart rate, heart rate dips). It was suggested that baby was back to back and the consultant made a flippant comment about my cervix being thick, but no other explanation was given as to why this happened.

I am really heartbroken that it happened, and can't stop feeling like a failure (I had hyperemesis in pregnancy and am worried it was because I didn't move enough and got baby stuck in a bad position). I really want to understand why I wasn't able to labour naturally. Has anyone else had this experience? Is it possible to get answers as to why you don't dilate? And does anyone have any advice on how to move on from this?

Obviously, you’re not a failure. Many women have to have C sections and it’s not a moral failing. Prior to modern medicine you or your baby would have ended up dead in all likelihood. Your baby is here, and I’d just try my best to focus on them. I had an unplanned C section too, and mine was quite traumatic, so I get that it’s hard but overthinking and ruminating is pointless.

You can ask for a birth debrief, although if baby was back to back and your contractions didn’t intensify enough to turn him, that may well have been the answer, and they might not have much else to explain.

Did you go into labour spontaneously?

Please don’t feel like a failure. For now; distract yourself, and I promise that it’ll feel a lot less important in time. The only time this is going to matter is if you’re planning another baby, when they’re likely to suggest that you have a planned section because you’ve had two previous sections. I promise that however important it feels now, and I do get that it really does, it won’t in time. Don’t try and process it now.

I’ve had to have 3 csections due to medical reasons the first was because I didn’t dilate and baby was distressed and then after that I was told I couldn’t have VBAC ever so I had the choice completely taken away. I struggled at first that I would never experience a vaginal birth even once but I have 3 amazing children and for that I’m so grateful.
i do feel like you would benefit from having a birth debrief with your hospital maternity team.
my local hospital offers them so I presume it’s a standard practice. You would need to contact them and request one, then they will meet with you and go through your notes and answer any questions you have. Hope this helps x

@BHA90 .. I hear you. It can be a good idea to have a birth debrief at hospital with a midwife practitioner who is experienced with debriefing difficult births.

You can also contact https://www.birthtraumaassociation.org/. While you many not feel your birth was traumatic, you might be displaying a trauma response and might benefit from trauma informed response which will hear your feelings and help you to process them.

Imagine you are your own best friend, allow yourself the space to have these feelings, to put words on them, to accept them with self compassion and to gently process them, reframing the negative thoughts that this was a failure on your part.

Sending you love and a warm suggle in a blanket.

You are absolutely NOT a failure!! I did everything 'by the book' to get my baby into the optimal position for labour. I am a Midwife and did literally everything I was ever trained to do for an active labour and still didn't get past 3cm, 3 days of labouring and 10 hours on oxytocin drip. At the section they were able to explain to me that DS was in a deflexed OP position ie was NEVER coming out vaginally.

The 'back to back' comment suggests something similar for you. With all the will in the world sometimes our baby's positions just don't correct themselves and there isn't anything we can do about that. Poor positioning of baby's head would mean not enough pressure on your cervix which is why you don't dilate.

In actual fact, if a baby is in that bad of a position and by some miracle you do get to fully dilated you're in for a potentially very dangerous birth involving instruments that may ultimately fail. A c section following failed instruments is more difficult and dangerous. So I like to look at the not dilating part as nature's way of protecting you from a vaginal birth that could have been awful for both of you.

It took me a long time to come to terms with my birth. Most of my colleagues have had amazing intervention free births and I felt like a total failure too. A debrief certainly helps and even counselling once you've been debriefed. It used to terrify me to say this but these are the kinds of labours where Mums and babies used to not make it because there were no interventions. With time, I've been able to reframe it for myself and think wow I am so lucky that we live in a part of the world where we have life saving interventions and both me and baby are safe. I know you're not there yet and it will take time.

Congratulations on your baby. I hope you get the real life support you need. Give yourself grace to feel all you need to feel, time is a healer. But a better understanding of events by talking with a Reflections midwife is a good start.

First baby: crap midwifery care, emergency CS.

Second baby: did everything "right" and still had an emergency CS, DD completely wedged. For whatever reason, I can't give birth.

A birth debrief can be useful, but prepare yourself for not coming away with a definitive answer. And echo other posters - it's not a pass or fail test.

Congratulations on your baby x

I have very similar feelings.

DS was back to back and I never dilated past 6cm and he got distressed so it was an EMCS.

I desperately wanted a VBAC and did lots of research, hypnobirthing course etc.
Ultimately though, DD was another EMCS as I never progressed. I have a lot of anger and sadness around this as I now know that the way I was induced (waters broke even though not progressed at all, no pessary or balloon) was always likely to fail.

I get jealous when I hear of natural births and feel like I failed. I'd have loved to have experienced it, and feel like I've missed out on an essential life experience.

It's such a strong feeling of failure that I'm researching a VBA2C, even though I know it's generally not recommended, and would probably be silly to try. I think some women just have a primal urge to labour naturally and logic goes out the window.

I am sorry you feel like this about it and I do understand it. I had an EMCS with Ds1, he was back to back, I bled bright red blood in labour so was monitored for placental abruption and in the end I failed to progress and I had a baby in distress so they jogged me down to theatre. When they were getting him out the lovely surgeon said his head was wedged at a weird angle and there was no way he was coming out vaginally. I had been in labour for 26 hours.

I chose an ELCS with Ds2 because quite honestly and in no particular order, childcare, not going through all that pain again, I have endometriosis so pregnancy was painful with all the scar tissue and labour was awful because of the pulling with every contraction.

I had two healthy babies. There are many stories on here, out there in the world too about complications from vaginal births, tears, incontinence, stitches reopening back up, infections and just damaged women. My sister has PTSD from her post partum haemorrhage and losing more than half the blood in her body and being too weak to hold her baby. She gave birth before me so I knew what had happened to her.

I am grateful to not have gone through any of that. I did plan a lovely water birth but it went out of the window. I am healthy, my boys are healthy. It feels very raw when it has just happened and I think you need to stop looking at it as a failure. Sometimes life and labour don't go to plan.

Hi

Midwife's perspective here. We do not know why babies get in the position they do and I don't believe there is a huge amount that we can do to influence this so it's absolutely not your fault.
OP babies can be pretty problematic for labour as there isn't a good fit of the head on the cervix hence why yours was thick and not dilating. Sorry the obstetrician didn't explain this. For labour to progress and for the cx to dilate there needs to be a tight seal of the head so the pressure of the contractions open it. When the head is OP there is a larger presenting diameter which makes things difficult. It's all down to whether the head can get through the pelvis - millimetre's count. Sometimes they turn but quite often they don't. There are some positions that are simply not compatible with a vaginal birth. The problem is we don't know this until we give labour a go.
Labour is so unpredictable and our expectations are high but things are out of our control.
Your feelings are v valid - I hope that understanding the mechanics of OP presentation will help a bit.
Congrats on your new baby.

I had my hip x-rayed a year or so after my son's birth. The GP commented that it also showed my symphis pubis was all scar tissue between the 2 sides of my pelvis. This would have meant my pelvis was inflexible and never enough room for my son to fit. It probably happened in a car accident years ago.
If I'm honest, while I was interested to have this explanation, I was still just as disappointed not to have given birth vaginally. It's time that has healed that disappointment. I'm so glad now to have my son, and our birth story, which is our story, with all the hope and pain and disappointment and joy. This is real life.

There are helpful techniques that can help, that don't ask you to get over it and be grateful. Your feelings are valid, but they don't have to continue to have a significant impact on your life.

Please don't feel like a failure. I am so sorry you feel like this. I had 3 sections all that mattered to me was that baby was born safely not how.

Hi OP. Another here with a failed vaginal delivery of the kind @remaininghopeful23 described. I went into labour naturally, contractions were every minute or so from the beginning and within hours I was pushing but it didn't progress. Baby was back to back, wouldn't turn and getting distressed with every contraction so was rushed to theatre to attempt a forceps delivery. Surgeon (I think?) took one look and said absolutely not a chance due to the way the baby was facing, so it was never going to be a vaginal delivery and ended with a C-section. The section was really brutal and I still remember the tugging feeling inside (not pain) and the way the surgeon was leaning over me pulling my son like she was playing tug of war. He was unresponsive when delivered.

I remember when they first mentioned an EMCS and produced the consent forms I was really upset having gone through so much pain and pushing only to not be able to get there. My health visitor told me it was a traumatic birth (although I had nothing to compare it to and, in all honesty, I feel like I blocked it out). Hospital ignored my requests for a debrief and so much time passed I just let it go but I ended up affected by PPA and have had counselling.

It's absolutely not how I imagined my birth would go and my scar has healed horribly after months of infection which I'm struggling to deal with but I'm slowly making my peace and I recognise it's the only way we both made it through safely. Definitely look into a debrief or postnatal counselling. It can be really healing to get all your thoughts out - I actually bumped into another new mum at a baby group who also had a difficult time and just exchanging our stories was really helpful to process.

Please stop over thinking and enjoy your baby. I had an elective csection for my second as my first birth was traumatic.

It's nothing to do with being a failure, it's just nature. Some women just don't progress through labour, some babies are back to back or breech. The mortality related to childbirth in years gone by was huge. 100 years ago, you and your baby would both be dead. Now you get to have a birthing debrief and to ruminate on why things didn't go exactly the way you planned. This is definitely a success for everyone involved!

Do you give this much thought as to why you caught a cold or why you developed an ingrowing toenail? I would doubt it. Honestly, in the nicest possible way, just accept it and move on. Enjoy your baby 😊

I would ask for a debrief for your own peace of mind. But, just remember:

Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section.

You have given birth, you have a wonderful child. How they came into the world won’t make a jot of difference in a few years time. It’s like saying you didn’t get pregnant properly if you didn’t conceive via the missionary position !!

I have given birth twice both times by EMCS.The first one was because my baby had gone into transverse lie after I had gone through hours and hours of labour with the head not engaged and still high in my narrow pelvis.My waters broke and the uterus moulded it self around him and he was got out in time before he and I died which would have happened in the past.
You were not allowed to ask for a planned c section in those days, so I had what was called a ''trial of labour'' with the second and last one.The trial failed when life threatening complications set in again and it was another emergency dash to theatre.I had the tubal tie done as well as no way was anyone going to give me a trial again.
I never in anyway felt a failure, I just was not able to give birth any other way.

You're not a failure OP. It makes me so mad that society has made women feel this.
A birth debrief is a good plan..and some counselling to help you come to terms with it. You might just need to cry and rant to someone for a while.
The fact that you didn't dilate in either birth makes me wonder if it's something genetic about how your body acts during birth, some predisposition to this situation arising. Either way, you've had two extremely difficult labours..you've worked hard and been through the mill. And made the best decision for your babies both times. How is that a failure? You've done brilliantly. I'm just sorry it didn't work out how you wanted. It's a genuine loss and you've got every right to feel upset.
How old is your new baby?

I had an EMCS in very similar circumstances; baby was back to back and wouldn’t/couldn’t move, so my cervix didn’t dilate and after days and days of agony, I was wheeled off to theatre.

With my second, I did end up having a VBAC, and it confirmed to me that it is complete and utter luck whether you give birth vaginally or not. I didn’t do anything different this time, it was sheer luck that this baby was in the right position.

I also had really awful feelings of guilt and failure after having DC1; I did two birth debriefs at hospital which didn’t help much, I requested my birth notes through a subject access request and this did help a little, as it meant I had something concrete to go back to and look back over. I also had EMDR privately, which helped MASSIVELY. If you can afford it, I would highly recommend.

Having a VBAC this time wasn’t the healing experience I thought it would be, and whilst I’m pleased I ultimately did have one, I think I would have felt okay if I’d had another EMCS too, because all of my experiences after DC1 really taught me that birth is often just a woman being lucky or unlucky. You didn’t fail, because there was nothing you could have done differently.

I hope you’re okay, and not beating yourself up too much, as I know I definitely did. Time, being kind to yourself and a little bit of therapy might help! Sending hugs x

I struggled for years with not having managed a VB. I tried for a VBAC and also a VBA2C. I had 4 sections in the end. It took me a long time to make peace with it all but I have now. Give yourself time to process your feelings x

Sorry I haven’t read all the replies, but 20 years ago I was in the same position. I’d had a semi emergency C section for my first and ended up with a C section for my second, despite hoping for a natural delivery. Can’t entirely remember the reasons now….another big baby (he was 10 Ibs, and I am not a big person!) 10 days late, back to back apparently. Anyway, I have two lovely, now adult children, and who cares how they were delivered, as long as they arrived safe and sound.
How your children are are delivered into this world does not matter a jot, just enjoy your lovely children now they are here!

I don't know why you feel like a failure, you had 2 healthy live babies. 100 years ago you would have had days of agony before yours and the baby's death. Nothing wrong with an emcs if it does the job. It's not your fault you couldn't have a straight forward birth. I didn't either. My first baby lived but the next two died, this was the 1980's.
Thank God for modern science.
For centuries women and children died in the hundreds from childbirth.

Hello, thank you for all the kind replies and for sharing your stories and sorry to not reply to them all directly.

I just wanted to clarify that I absolutely do not think of anyone else as a failure when I hear that they've had an emcs (or elective cs). All I think when I read your birth stories is that you're all warriors and it would never cross my mind to think that any of you have failed, it's just a belief I have found difficult to shake about myself.

To answer a couple of questions, I did go into labour spontaneously and laboured for 3 days but never got past 3cm. He's 6 months now and whilst I felt ok at first by blocking it out, I've recently started to dwell on it and have found it hard to cope with.

Thank you to those who offered some possible explanations. I never got any explanation as to why my induction with DD1 didn't work so I've never really had an understanding of what it is that can cause labour to stall or simply not work. It is interesting to hear about what could potentially complicate the dilation process.

In my rational mind I know that I am lucky to have two beautiful children and to live in a country where emcs are readily available to save both me and my babies, but it is hard to let go of a birth that I dreamed of for years, as well as letting go of any possibility of a future natural birth.

I think something that has made it especially difficult is that in preparation for my VBAC I fully immersed myself in the hypnobirthing world. I spent months researching natural and 'free' births, did meditations, manifestations and visualisations, and watched hours of footage of natural births. In that world, you are encouraged to absorb the mantras 'my body was designed to do this/I am built for birth' and yet my reality was the opposite, which has been really difficult to accept.

There have been a lot of great suggestions here, and a lot of interesting perspectives so thank you again. I hope that I can find a way to process this so I can accept the situation I have been dealt with and feel proud of myself for what I went through to bring my babies into the world. And I hope those of you who are still struggling get there too. x

Hi OP, I had a slightly similar birthing experience to you, I had an elective induction and had good contractions for 3 days, pessary and multiple gels, but after all that I was the exact same amount of dilation as when the whole thing started (1cm).

On the third day one of the midwives mentioned that “it might be baby’s position” causing lack of dilation and told me to ask the next midwife for some exercises to do to help turn baby as her shift was finishing (I was like thanks for only mentioning this now!).

They then offered to break my waters at 1cm dilation but I declined and asked for a c section instead as I just felt like, if it was going to be a straightforward labour I would have had at least some dilation. I had a fear of a really complicated labour so just had to guess that perhaps the lack of dilation was a red flag that I shouldn’t ignore.

I was quite disappointed in my care, it was a revolving door of different midwives on shifts and although they were incredibly “patient led” in that they just did exactly what I asked, their was absolutely no coaching or explaining concepts around baby position. Eg my baby seemed to almost be back to back, but slightly off to the right side, but no midwife explained what this actually meant for labour and what the contractions were trying to achieve. If I had known what I know now from reading spinning babies website I may have been more prepared for a longer induction or waited a bit longer before being induced etc.

Because I was in the dark and had to guess, I’m left with more of a “what if” thought process, like what if I was just being a bossy know it all and requested a c section too soon? So at least in your emergency situation you can be confident that c section really was the only option!

The consultant on the day was very supportive of my choice (but I don’t know if that’s because it was the correct choice or because he was just supportive of maternal requests) and the c section itself was actually quite a fun experience. I did shed a few tears when I first saw my scar after bandage removal, but am weirdly now starting to love it at 10 weeks postpartum.

Something else that makes me feel better is that a friend of mine had an induction at the exact same gestation as me and hers progressed properly to a vaginal birth - it makes me feel more confident that my choice for c section was the right one as if I was going to vag birth successfully the induction would have progressed for me like it did for her.

Anyway, solidarity! We are probably both ruminating on different things, you on feeling you failed and me on second guessing my choices around the birth.

As you say, we never think that about friends when we hear they had elective or emergency sections, so why think that about ourselves!

You’re not a failure ❤️.
you delivered your children safely, and 80 years ago the outcomes might have been very different. Natural isn’t always for the best and there’s no right and wrong way. They’re here, they’re alive, you’re alive and that’s what matters the most.

section, vaginal, both come with difficulties that we overcome and you should be proud of yourself!

my first labour was a vaginal delivery. With a 4 day back to back labour, forceps, a tear, haemorrhage and a monster recovery. I originally planned for a nice candlelit water birth on the maternity unit. Bath didn’t even get filled before my blood pressure hit the roof and they carted me off to the ward for an epidural and monitoring.

I’m currently 38 weeks pregnant and booked in for an elective section next week because fuck to going through that shite again, however remote the possibility.

You haven’t failed. Failure would be to insist on a vaginal delivery cos “natural” with a detrimental outcome. You did what you needed to do to get your kids out safely.

Be proud!