Is it possible to have an 'active birth' after first was an emergency c-section?

[Janus]

I've just had my 34 week consultant meeting at my hospital to discuss my labour for 2nd baby. He was very negative, spent first 5 minutes reading off statistics of how many 2nd pregnancies of previous c-section end up with ruptured wounds, how many of those babies then die, how I will need constant monitoring in second labour, how I can absolutely forget about a water birth and won't even be allowed to have a bath as I will have to spend 99% of the labout flat on my back to enable monitoring and I should definitely consider epidural asap (as his wife had epidurals with all 3 of her births????????).
To be honest, it's my idea of a total nightmare. My first labour was extremely active, I dilated to 10cms quite quickly, mostly using the hospital bath, was extremely active, no drugs, etc, and nearly gave birth standing up but my daughter just got stuck and I just couldn't get her out. Her heartbeat then dipped and so we ended up with an emergency c-section. The thought of this labour being almost strapped to a bed has thoroughly depressed me and I honestly don't know how I'm going to cope.
To be honest the care with this whole pregnancy has been crap. I'm 34 weeks and I've had just 3 ante-natal appointments, the hospital very much seems to have the attitude of we will worry about you when you come in during labour, I have no midwife attached to my GP surgery so my hospital is the only point of reference.
To the point (!!!!!!), has anyone else had an emergency c-section and then gone on to have a vaginal birth where they were still in control or active? I understand the need to be monitored but can I insist that I be upright when they do this (thought Mears or Leese could help me here??), even in the bath they do have underwater monitors could they not use this?
Sorry this is so long but I'm so upset and don't know who else to ask as the hospital just seemed to want me out of the doors asap and just kept saying 'let's see how it goes', I want to prepare myself if I can.
Thanks everyone.

[Khara]

www - you are right about continuous fetal monitoring. There is no evidence that it has any merit over intermittant hand-held monitoring with a doppler or sonicaid. However, there is plenty of evidence it leads to unnecessary intervention. (Haven't heard about the babies sleeping but it's interesting - though how they can sleep through all that!)

Pupuce- I think you are right about women assuming that when a medical professional suggests a course of action, that it's the only option. Things went wrong for me during my first labour when, about half an hour after arriving at hospital, the midwife informed me that the consultant wasn't happy with the readings they were getting from the belt monitor, so suggested they attach (harpoon) one of those clips to ds's head. When someone tells you there's something wrong with the readings, of course you panic and let them do what they want - when you don't know any better you do anyway.

Oh dear, this is turning into a birth story again. It always does when I get into a discussion on monitoring. Suffice to say ds1's birth was a classic cycle-of-intervention, ending in a ventouse delivery due to maternal exhaustion (no arguments there) and fetal distress (in which case, why did he have an Apgar of 9 at birth?)

Second time around I decided not to go into hospital - then they couldn't use continuous monitoring - and had a lovely homebirth. Not the choice for everyone, but I do believe that women should be offered choices about their labour and sadly, too often, they aren't.

[cas1968]

Successful VBAC accomplished on 24/02/03

Arrived at hospital at 4cm. Monitored for 30 mins, then allowed my freedom I was offered the Birthing Pool and/or warm bath. Basically, dh and I left to our own devices. Everything slowed down at this stage Contractions had been 5 mins and less, but suddenly "stopped" although second monitoring still detected them. dh and I left to our own devices, although we were not allowed home. Established labour finally arrived at around 2am and I was monitored from here on. Baby Niamh arrived 7.26 am

[kaz33]

Congrulations Cas1968 and great to hear that you had a succesful un constantly monitored VBAC.

Having had a tough birth last time I really want to enjoy this one and you have given me more ammunition to take with me when I go and see the consultant.

Hope you are enjoying the little one. Friend of mine has just had her second - about the same time as you. I held him the other day - forgotten quite how amazing the whole feeling was.

[NQWWW]

Congratulations cas1968 - glad to hear it all went as you wanted.

Kaz33 - I'd be interested to hear how you get on at C&W, as I'll be going there too (I'm only 13 weeks pg so a long way to go and haven't seen a midwife yet, but this question is already pre-occupying me).

Most of the posters on this thread seem to have fully dilated before having to have their c-section. In my case I had been going for about 58 hours and had been induced when we opted for a c-section, as I was still less than 6cm dilated. Does anyone know what the prognosis is for a successful VBAC in a case like that?

[willum]

Cas1968 congratulations and thank you for posting your success it gives the rest of us hope. Hope your both doing well and enjoying each other. Well done!

NQWWW - good question, (I only got to 4cm)and am also worried as to whether this will make it harder to achieve VBAC.

Does any one know if opting for home birth increases the chances?

[Janus]

Cas1968, well done, congratulations on the birth of Niamh. It sounds a very positive story that they let you 'get on with it', rather than lots of intervention, especially as your second stage seemed rather long, was it exhausting?
So pleased for you, take care and enjoy your little bundle!

[bundle]

cas1968, well done & welcome to little Niamh

[SofiaAmes]

nqwww, i don't think it makes a diffrence. In my case I did 40 hours and had only got to 6/7 cm when I had my c-section. I had a very successful VBAC with only 5 1/2 hours of labor including only 20 min of pushing.

[pupuce]

Well done Cas... which hospital did you achieve this wonder in????

As to whether or not you can "achieve " a VBAC if you only dilated X centimeters before you had your ceaserean... I think (but I am not the expert) that it isn't going to matter.
If there is an obvious medical reason why you didn't dilate well... well maybe you can address it... but generally your body is far more efficient the 2nd time around and your uterus does a "better" job.
I certainly wuld not phrase it in terms of making it harder to have a VBAC....

[clucks]

Many congrats cas, and welcome to Niamh.

[mears]

Agree with pupuce that dilatation of cervix in previous labour will not necessarily affect chance of VBAC. In some cases though, if you were 10cm (fully dilated) in previous labour then needed C/S, it makes it a bit more likely that you might need repeat C/S if pelvis/ baby head size is the problem.
What can make a difference is that subsequent labour may be faster if the cervix was well dilated previously than not at all. However that does not affect ability to deliver vaginally. HTH.

[kaz33]

Oh don't say that Mears - I was fully dilated but baby resisted one hours of pushing then ventouse and then forceps. They then gave me a c-section.

After the birth the consultant said that the problem was my pelvis - then one of the midwifes said that the baby was the wrong way round ie: back to spine. The consultant then changed his mind and admitted that this was the problem. This was not picked up by my midwife and only became apparent when they opened me up and lifted DS out.

I never had a proper explanantion from the hospital about what went wrong and was too traumatised by the whole thing ( 30 hours labour - no pain relief and then c-section ) to push the point. They never suggested that I had an x-ray to check my pelvis.

You might be able to help me with a couple of questions that were never answered:

1. Should my midwife have picked up on the fact that the baby was the wrong way round ?
   
2. Would the baby being the wrong way round make such a difference to delivery. Believe me I pushed for England .....
   
   Knowing the answer to those questions would help my closure on the event. I was speaking to my DP about the birth yesterday and realised that there was still an awful lot I did not understand.
   
   Thanks
   Kaz33

[mears]

kaz33 - if it is any consolation my cousin had the same experience as you first time round - failed forceps then C/S. Her baby was lying back to back (OP) with her. Second time round she only made it to hospital with 20 mins to spare and had a normal delivery with no stitches.
It can be done.

To answer your questions...

An X-ray of the pelvis is not helpful. It used to be routine many years ago but did not demonstrate any benefit. It is the relationship of the baby's head to the pelvis going into labour that makes the difference.

Some babies do deliver vaginally in that position but it takes an awful lot longer. This is because it is a wider part of the head that is coming through the pelvis so sometimes it is too large.

As for the midwife missing the position of the baby - that is very easily done. I have done it myself. It can be difficult too feel the soft spots on the baby's head (fontanelles) to work out the position. Also there is often some swelling of the baby's scalp (caput) which makes it even more difficult. I have thought that the baby is the proper way round then it has emerged looking at me HTH.

[SueW]

kaz33, if you think it would help get a copy of the birth notes. I got mine recently as I began to think I was going mad about my daughter's presentation but the notes confirm that she was asynclitic - her head was presenting at a pretty unusual angle. She was also posterior, 9lb 8oz and I only found out on the day I was induced she was posterior.

I do know of someone who had their baby vaginally with their baby similarly presenting but their story of labour is very different to mine - not epidural, no syntocinon drip, etc.

DD is now 6yo and I am no longer bothered about how she got here but look at the whole thing as if it happened to another person - in a way it did. Back then I hadnt half the knowledge I have now. Nor did I have much confidence in my body nor, if I'm honest, much clue as to what babies were like, what it would be like to be a mother and would happily have remianed pregnant for much, much longer as I loved that state o being!

[kaz33]

Thanks Mears and SueW - I do have my notes though of course they do not make much sense to me. I am going to take them along when I see the consultant about VBAC - so that they can decipher them. I might have a look and see what they say about presentation.

[wog]

Hi I had my first baby 7 months ago. I was 10 days overdue and induced I started getting cramp about 4 hours later then had an internal 3 hours later and then waters broke 3 1/2 hours after that. I then reached 9cm 7 1/2 hours they then left me for a further 3 hours to try and reach 10cm but they said my cervix would not go up and had to wisk me in for an emergency c-section - I would therefor like to know if in my next pregnancy if i go over my date will they automatically book me in for an elective section or will they allow me to be induced to try and give birth - I was devastated not to give birth my first time round and would hate not to have a chance again.

[Janus]

wog, I was told that it is OK to go overdue PROVIDED that you subsequently go into labour 'naturally'. They will let me go 10 days overdue(although I suspect I could push for a few more days by being strong and maybe having daily scans to check placenta, etc). After that if I would need to be 'artifically' induced they said they wouldn't allow this and I would have to have another c-section. I assume that this is due to the fact that being artificially induced means you generally have stronger contractions which would put additional, unwanted, pressure on your previous c-section scar. I must admit I've buried my head about this scenario (not wise!!) and assumed I won't go too overdue, try all options such as acupuncture, curry, etc, to bring on natural labour although maybe I should face up to the possibility. Be interested to hear if this is the advice others have been given.

[mieow]

Hi, I had a emergeny c/s with my son at 36 weeks as he was breech and I had gone into labour, dd1 was a 31 weeker and I expected to be rushed through for a c/s but she was born natually after 2 hours. DD2 was a 33 weeker and she was also a natual deliverly. I was not allowed to move with dd1 but with dd2 i was allowed to move about, admittly not walking about but i was able to go into a comfortable position. Can't help much but surely if I was allowed to have 2 preterm babies natually they should let you

[wog]

I just wanted to let you all know that I am not pregnant again enough work with my seven month old baby but I cant get my next delivery out of my head. I think it was because my older sister had an emergency c-section. She was overdue by 10 days just like myself - induced just like myself but the reasons for or sections were dufferent - she started having contractions but would not dilate so she basically did not have a labour at all whereas I was in labour for 18 hours and reached 9cm (they said my cervix would not go up - anybody know why this happens). With her second delivery 3 years later, again she went overdue by 10 days but they said they could not induce her as she had previously had a c-section and automatically booked her in for an elective - this I do not want, I don't know if it is just me but I was so frightened about labour (I used to cry myself to sleep with fear) it was the hardest thing I've ever done (my epidural did not block my back passage through my whole labour) then when I reached 9cm my epidural had worn off and they told me they coould not top it up because I would be pushing in 1 hour then proceeded to leave me 3 hours with only gas & air and when they finally came back and said they would have to section me I was devastated (although I think if they had said that they would have to amputate my leg at that point I would have asked did they need any help)and I remember saying to my husband and my mum (still needed my mum) that I was so proud of myself as I had coped when for 9 months I was scared out of my mind - I said I would never do it again - but the thought now that I might never experience labour again fills me with dread and because it happened that way for my sister I keep thinking it will happen to me - that is why if I go 10 days over again I want to be induced - am I really mad?

[musica]

I'm so amazed at the difference in people's experiences with epidurals - for example, wog, you say, they couldn't top the epidural because you would be pushing within the hour, and yet my epidural was topped up half an hour into pushing, and only 10 mins before ds was born!

[wog]

Childbirth is amazing - epidurals are amazing - my cousin had her baby 3 months before me and said she slept through most of it I did not sleep a wink but I think if the epidural had blocked me completelty I would not have even known my angel was trying to get out also maybe if my epidural had blocked completely my body would not have been so tired and would have allowed me to have a vaginal delivery - but there are so many but's because women give birth without epidurals or any pain relief all the time and although I am desperate for labour again I would still be desperate for the epidural - so I'm not that brave ha ha ha

[pupuce]

Wog - induction are not recommended for past ceasarean. Also induction is generally far more painful... and if you go for an epidural (as you seemed inclined to do) you increase your chances of a second ceasarean...

How long is your menstrual cycle anyway?
Maybe you have a gestation of longer than 40 weeks (average is 41 weeks anyway!)... so if you could get the date right you may not be under so much pressure.
The other point I thought I should make... fear is quitre common in labour but it is actually very unhelpful (so is my comment I know ) as the more adrenalis you make, the more difficult it is to have good contractions - but there are things you can do to feel less fear...
You could take Rescue Remedy a few days before and during labour
You could take Aconite (homeopathy) during labour
You could have a birth partner who could help you deal with the fear
You could try hypnotherapy
Also a good debrief of your past labour might be helpful

... what I am saying is, there are things you can do to address this fear - I hope you find the right thing for you.

Good luck (even though you are not pregnant yet)

[pupuce]

Wog - induction are not recommended for past ceasarean. Also induction is generally far more painful... and if you go for an epidural (as you seemed inclined to do) you increase your chances of a second ceasarean...

How long is your menstrual cycle anyway?
Maybe you have a gestation of longer than 40 weeks (average is 41 weeks anyway!)... so if you could get the date right you may not be under so much pressure.
The other point I thought I should make... fear is quitre common in labour but it is actually very unhelpful (so is my comment I know ) as the more adrenalis you make, the more difficult it is to have good contractions - but there are things you can do to feel less fear...
You could take Rescue Remedy a few days before and during labour
You could take Aconite (homeopathy) during labour
You could have a birth partner who could help you deal with the fear
You could try hypnotherapy
Also a good debrief of your past labour might be helpful

... what I am saying is, there are things you can do to address this fear - I hope you find the right thing for you.

Good luck (even though you are not pregnant yet)

[Janus]

Pupuce, hello again! Where can I get Rescue Remedy from? I've heard good things about this and every time keep meaning to ask where to get some and then forget! You've reminded me again so hope you can help. Thanks.

[musica]

You can get Rescue Remedy at any health food shop, or chemist.