Marslady, Klaw ,Lulumama

[LadyBuzz]

So sorry to do this but I have been told you are lovely ladies that might be able to give me a litle bit of advice about a birthplan I have written for a possible Vbac/Possible Elcs?

can i be of assistance?

I too am a Doula.

do share with the group!

no need to be sorry, ladybuzz, fire away

oh hi Lulu.

Cake?

Thankyou so much - I will provide the cake
Basically I had my son 2 years ago by emcs after an induction and 2 days of labour, my blood pressure shot up and I failed to progress and DS started to get distressed, we were both fine but I had a wound infection and a UTI from the cathater afterwards.
So I am 37 wks pg with DC2 and up until this morning baby was transverse and it was looking likely that I would have to have another section, I was OK with this I am not adverse to either avenue at this moment. I had got my head around having an elcs. However baby is now head down and the consultant said to me that there was no medical reason why I shouldn't have a VBAC and at the end of the day it was my decision. So now I don't know where I am, I am going to see the CMW tomorrow to discuss my options again and have written a birth plan which I would like a second opinion for:

I would like to be booked in for an elcs on the first possible date after my due date as I went 16 days over with DS and if it is a straight forward elcs then so be it.
If I go into labour naturally before then I would like to try for a VBAC and want the following to happen.
I would like to know exactly when to go to hospital and be confident that I won't be sent away and also what to expect with regards to CFM whilst I am there.
I don't ant any cannulas or cathaters unless absolutely necassery.
I want to know immediately if my blod pressure starts to rise, there is any fetl distress or I am failing to progress in any way.
If there is any suspicion that there may be a need for a CS I would like it to be done straight away nd no waiting to see how things pan out.
I also don't want to be left i labour for too long but I'm not sure how long is reasonable.
I feel that I missed out on DS birth as I cannot remember a thing about it and I really don't want that to happen this time.
Sorry for the massivly long post

Ladybuzz,

I have supported many clients having vbac's and in my esperience in response to your list the following:

I would like to be booked in for an elcs on the first possible date after my due date as I went 16 days over with DS and if it is a straight forward elcs then so be it.

Are you sure you want a VBAC? If your hearts not in it your mind won't be either....

I would like to know exactly when to go to hospital and be confident that I won't be sent away and also what to expect with regards to CFM whilst I am there.

You have to listen to your body, if you go in at 1cm the likelyhood is they WILL send you home, however no one is going to know how far along you are until they do a VE. Could you get a CMW to come out to see you at home and you can decide together when to go in? In regards to CFM, most hospitals want at least a 20min trace

I don't ant any cannulas or cathaters unless absolutely necassery.

For most hospitals this is standard practice as you had a previous c/s, HOWEVER, it is your RIGHT to refuse any 'offer' of there. This will be something to discuss with your MW before if you can, and get her to put it in your notes. also write it on your birthplan

I want to know immediately if my blood pressure starts to rise, there is any fetl distress or I am failing to progress in any way.

They will inform you of this (generally) and you can discuss the options open to you

If there is any suspicion that there may be a need for a CS I would like it to be done straight away nd no waiting to see how things pan out.

'suspicion' is always there, in any birth, no one can tell exactly how things are going o go. If there was any sign of baby getting distressed, thay would of course get you down to theatre asap

I also don't want to be left i labour for too long but I'm not sure how long is reasonable.

This is a tricky one, how long is too long??.....sosme ppl that may be 12hrs, others may 'want out' after 2hrs

I feel that I missed out on DS birth as I cannot remember a thing about it and I really don't want that to happen this time.

Speak to someone at Birth Trauma, I think lulumama does some of the phonecalls from them

take a look at the AIMS website for VBAC info, some great stuff on there. www.aims.org.uk

Also, no one can make any decision apart from YOU. Do what feels best for you.

Good luck.

xx

i have read your post and i have to say i totally concur with everything hertsnessex has said

re a VBAC, your best chance of a succesful VBAC is a spontaneous start to labour, be it at 40 weeks or term + 12 ! as little intervention as possible, being able to labour on your own terms, with as little interference as possible

in terms of going in, wait until your ctx are every 3 -4 mins and lasting around 50 seconds + IMO , unless you start losing blood, have pain that does not go away between ctx or something feels 'wrong'. remember scar rupture is rare, it is increased if your labour is augmented, but it is still rare, but it does happen so havea google of mary cronk and scar rupture as she has done a really good easy to understand piece about it

you have to be committed to a VBAC, as you might well come up against some barriers, but it sounds like, if you are being encouraged to go for it, your hospital will be supportive.

i would book an el c.s for 42 weeks, not before but that is my preference

and do you have a doula?

ladybuzz, which hospital are you at?

I'm asking as our hospital have different "policies2 for vbacs ie

If you labour in water, you will be treated as any other labouring woman.
If you labour on dry land, you will be required to have cfm.

If you asked, you may find a similar outlook.

I agree with everything else that Herts has said.

Can only reiterate, you can refuse any kind of intervention, so long as you are well informed and you know all your choices. It is your labour, birth, and your baby.

True failure to progress as told to me by a mw last week is when NO progress is made, our hosp now has a new policy of 1cm every couple of hours as opposed to 1cm per hour now. All good stuff.

My main thought when i read you post was exactly the same as Herts.

If you are not truly comfortable, confident in a vbac, chances are it may well not be for you. The mind is a powerful tool.

Definately birth trauma would be able to help you lay some ghosts to rest i think

Good luck.

Thanks for the cake, twas lovely.

Thanks Ladies, Its not that I am not committed to having a VBAC, I really would like one its just that if I do end up having a CS it won't be the end of the world for me.
I didn't go into labour last time so am not sure how a 'normal' labour progresses.
I know for fact that I do not want any intervention to speed things up but I am not adverse to the monitoring as I know it will be for my benefit, the same goes for a cannula. The only thing I really do not want is a cathater before any anaesthetic has been given as I ended up with a nasty UTI last time and have had problems with these in the past.
I have no idea if they discussed anything with me last time as I was delirious and lost a good 12 hours I expect they probably did and will again.
Its the length of time to be in labour that is confusing me, I don't want to give up at the first hurdle but I don't want things to drag out too much and wear me out completely, I had heard you shouldn't go too long after a CS but then I am no expert .
I don't have a doula but do have a very good CMW, I am at the cumberland infirmary in Carlisle - don't know if you have any experience with them at all.
Seriously though thankyou for everything, I will go through the links you have recomended and gather some more information.

Best of luck, please let us all know how you get on

xx

LadyBuzz, I'm not a doula but have had 2VBACs. RE duration of labour, my hospital did not have a policy on how long the first stage lasted, but were not keen on letting you push for more than an hour if you had had a previous section. This doesn't mean a c-section necessarily - I had a forceps delivery with dd2 following spontaneous labour.

Should have said best of luck with it all.

Thankyou for the wise words - every little bit helps. I will let you know hertsnessex your advice has really helped me with my birth plan

Ladybuzz, Hello!

I always refer people to this great Birth Plan page which you can pick and choose from.

I also say to think of it as Birth Preferences (in the event of x, y and z) so that you are flexible but still in control and therefore have the best birth for you in the circumstances.

What HeartsinEssex says is true, You have to be committed to your VBAC and ensure that your birth partners know what you want to achieve so that they can best support you.

I was really happy to be at a birth where the mw always discussed options with the mum and pointed out what she wanted to achieve and how things might impact that. She was a great mw! Mum ended up with a repeat CS in the end but it was still an empowering birth.

[waves to all her favourite MN people ]