Can ANYONE tell me/advise me on the 'options' of having a vaginal birth after 3 c-sections??

[QueenofVenus]

I have 3 all by c-section, my first because he got distressed and the 2nd and 3rd because i heard alot of scary stories, and figured it was easier and safer. Im thinking maybe one day about having another, but im curious as to any options i may have (if any) with regards to a natural delivery, any input would be good! TIA x

You have options! You just have to know about it because the medical world seem to, in general, assume you will have another section. I had 3 different doctors laugh at me when I said I wanted a vaginal bith aftre 2 sections!

Apparently, more than 1 section makes little difference to the slightly increased risks but I can't reference this.

Do a bit of research on vbac and know your rights.

Thankyou FMN! i have been doing quite alot of reading online and it all seems to be the same thing: no-one recomends it, its an option but do the risks outway the benefits etc. Id like to think that a natural vaginal delivery would be an option for me, but i guess its likely to be a case of 'time will tell' I'll keep reading and checking!

see here, section 6.2 in particular.

I don't think it's impossible, but you will probably have to "shop around" to find a consultant who will support you.

Hi QueenofVenus.
My history is identical to yours - one emergency CS for foetal distress/failure to progress and then two electives. But then in 2006 I had a VBA3C. Before getting pregnant with my 4th baby I started to do a little research into VBAC (which turned into MASSES of research!) and I came to the conclusion that a VBA3C was statistically safer than a 4th CS. Many women opting for VBAC after multiple sections choose to birth at home, usually with an independent MW, simply because the system makes it so difficult to gain support from the NHS. I'm a little too far from a decent hospital should an emergency have happened so I chose to deliver in hospital. I have to say that I struggled to get the support I wanted and changed consultant 3 times and hospital twice. BUT in actual fact, unless you have a problem pregnancy, it IS possible to have MW led care only, without the need to ever see a consultant. Despite having been told this previously, it didn't sink in until around 36 weeks, at which time I happened to stumble upon a great consultant.
It's a good idea to get hold of a copy of your notes from your previous caeseareans so that you know exactly what type of incisions were made and how you were stitched. It's highly unlikely that you had anything other than a straightforward lower segment horizontal incision, developed precisely so that women could go on to have vaginal births after CS.
As long as you are not induced, the risk of uterine rupture is little different to the risk following just one CS. There IS a risk and you need to be aware of it and weigh that up against the risks of another CS but it's a decision that is entirely up to YOU, not a doctor.
If you want to contact me off list I'm happy to send you some relevant research/stats/general VBAC info.
[email protected]
HTH !

Ooh youwill be lucky. I have had 5 sections and valiantly tried to get a consultant to support a VBAC after 2 sections but was told continuous monitoring, no birth pool etc. As i was unfortuantly in position of unsupportive dh and no friends really to take his place iknew I could only have laboured with touchy feely support of midwife unti/aromatherapy/.birth pool etc all of whihchwere out of bounds to be cos of sections.

I wish you however the best of luck and hope you get the birth you want.......

Is it really important enough to you to risk rupture? With my first child I was very keen on the birth experience. After things went wildly awry I changed my position 180 degrees and had ds2 by planned section.

there are risks in every birth, regardless of how baby arrives. if there are no clinical reasons other than the small risk of rupture,. which is almost the same as the risk of cord prolapse which is a factor for every mother, then i would say, know your rights and go for it. AIMS is a good place to start, and definitely get in touch with VBACqueen

and look at having a doula

at the end of the day, it is your body and your birth and you can ask for the birth you want to go for

you might have to fight to attempt it, but you can go for it

hi there
im currently 29 wks pregnant with a very unexpected baby no.3 (having tried for 7 yrs and being told it would never happen!!)
I have had 2 cs one as my son was breech and one as my daughter had iugr and had stopped growing.
my daughter is now 11 and my son 13 and I thought that after 2 cs my only option was another one.
I then read about vbac online and decided that would be so wonderful and told my consultant that was what i wanted to try for.
she was totally awful about it completely non supportive and basically scared the s**t out of me telling me all the risks - I left in tears and am now in a place where I desperately dont want another cs unless absolutely necessary but have been frightened to death by the risks of a vbac after 2 cs.
has anybody got any experiences or words of wisdom????

Hi moonlily

The same thing happened to me when I was planning my VBA3C - I skipped into my first consultant's appointment expecting him to be all happy for me because I was choosing a VBAC instead of another CS. Ha, how wrong was I? The problem is, consultants deal with problem births - it's the midwives who look after most women, and unless a problem occurs during your pregnancy, you don't actually NEED to see a consultant at all. I just didn't understand this until very late into my pregnancy and by then I had actually found a supportive consultant.
But don't lose heart - there ARE great consultants out there, if you choose to have one. Which part of the country are you in? Someone may know of one near to you that they can receommend. Alternatively you can have a homebirth
Definitely find yourself a doula - I saw you asking about that on another thread but I thought I'd just reply on this one. Go to www.doula.org.uk/ for more info and to find someone local to you.
Another great site for general info on VBAC and risks of repeat CS is ican-online.org
Your risk of rupture is less than 0.5% - you have a greater risk of something like cord prolapse happening so although it's important to be aware of the risk, it's also important to keep it in perspective.
There are many great books that you'd find helpful too, but if you find yourself a doula who understands VBAC, you can bet your bottom dollar she'll have loads of books and info that she'll be prepared to share with you!
Good luck.

hi vbacqueen

thankyou so much for your positive reply, ive been feeling really low about things but knowing other people have had the same thing makes me feel better.
im gonna check out the websites you gave me,
im in Derby Uk so if anyone knows a lovely supportive consultant around here thatd be great! how do I get a new consultant? Ive been under a consultant since I was about 17 as I have pcos and both my first babies were fertility treatment, but the lady im seeing now isnt my usual cons, could I write and request him??
dont think I dare go for a homebirth tho ive always dreamed of one, but ive been frightened enough by the horror stories so would like to be where ive got medical help if needs be!!

Hi queenofVenus and moonlily,

I've just had an amazing natural vaginal birth after 2 c-sections. I don't know how much the risks change with vba3c.

I live in the Netherlands and they were very pro trying for vbac. The reason I had my first 2 children by c-sections is because they were breech. My DD, born a week ago, wasn't breech and was in a good positon to try for vbac. That's why I was encouraged to try and was reassured that I would be monitored through and that they would not take any unecessary risks.

When it came to it, I was much more relaxed than I had thought I would be and the birth went very quickly - without epidural or pain relief. I was at the hospital at 2:30 a.m and at 6:11 she was born! and at 12:30 p.m we were all home.

So, I'm sure you will be able to find somebody who can help you get the vbac. The doctors at the hospital told me that the risk of rupture is very small, and if vbacs don't work it's vastly due to other reasons and not rupture.

Good luck!

Hi Moonlily

I had my first two babies at Burton, so not a million miles from you. Unfortunately most of the women I know who gave birth there ended up with a CS and I've never heard of anyone being supported through a VBAC (I ended up having my 2nd CS there as a result of being fed a load of old bollocks by the consultant - he told me unless I'd delivered in 4 hours of labour I'd automatically have another CS so I opted for an elective. If I'd only known then what I know now..........) I don't know any consultants in Derby but I'll ask around for you.
Ultimately, you can choose whoever you want to be your consultant but whether or not they'll be supportive is another matter. That's why so many women end up having a homebirth and paying an IM for the privilege too - I can see that it would certainly take the stress out of things. How far are you from a hospital? It's very rare for a woman to transfer in under true emergency conditions during labour, but I think you'd have to be mad not to have thought about worst case scenario. I was just a little too far for comfort from a decent hospital so a HB was never an option in my mind.
Also bear in mind that you can choose whichever hospital you like too - you don't have to go to the one suggested by your GP or the one that you've always gone to.
Maybe it would be worth having a chat with an IM and seeing how you feel? And don't forget that you're also entitled to give birth at home with NHS midwives too.
Did you look into getting a doula btw?