VBAC - Why?

[Salleroo]

Is the recovery from a CS that bad? I had complications last time, spisiotomy and forceps dellivery in the end.

Am pregnant again and meeting with my consultant at the end of the month. I suspect I will have to have a section this time.

I'm just wondering why would you want to have a VBAC? Is it to experience a VB or as above the recovery from a CS is so difficult with a baby etc?

I'd be interested to know as will need to do some serious prep mentally for a VB if it is an option for me and am currently of the opinion that I should just go with the CS, go in on the specified date and have it all over and done with.

Because it would be elective would the healing time be reduced due to less 'damage' etc? I know it's different for everyone but experiences would be appreciated.

Questions, questions...

I have to say I was very, very happy with my 2 vbacs, even though dd (1st vbac) was born with a bit of ventouse help and I did tear. Ds2 was born at home in water with barely a word from the midwifes, and it was the most wonderful experience of my life (and I am not a lentil weaver, particularly, nor do I deny that it still hurt like f*ck and was pretty messy). I just felt like I'd conquered the world and I wouldn't have missed the chance for that for anything.

But, hearts and flowers aside, my experiences are compared with the emergency c-section for ds1 (long labour, stuck baby during pushing, long wait for spinal block to work, infected scar, pnd) so anything after that is going to be a picnic. An elective c-section is going to be less stressful, for sure, but I do think, if you can try and have a bit of natural labour, it does at least send a warning signal to the baby that it's time to be born. That's just my opinion, though, so feel free to ignore.

Good luck with whatever option you choose.

do you want to breastfeed? Because it is harder after an elective CS, as there has been no labour so no oxytocin - harder to bring in the milk.

I much preferred my VBACs to the emergency section with general anaesthetic after 14 hours in labour. But everything is relative - my first VBAC sounds a lot like your birth (episiotomy and forceps delivery, second degree tear and infection) and it seemed marvellous to me. I found my CS very difficult to recover from both emotionally and physically. Would second the suggestion that you have a bit of natural labour first - you could write it into your birth plan about your worries, and agree a strategy upfront with your consultant. When I planned my first VBAC, I said that if any intervention was needed, I wanted to go straight to a section as I couldn't face what had happened last time, and my obs was fine with that.

Also, not being able to drive for a month or 6 weeks after the c-section is a complete pain.

Even with an elective, you are not supposed to drive for 6 weeks, which is really tricky for many people. There would also be a number of weeks when you couldn't pick up your toddler, which unless you have lots of help at home, can also be extra difficult.

Hi Sallero

Just thought I'd let you know my experiences of a c-section (emergency). I have to say it was a wonderful experience. Even though my baby was premature and it was an emergency c-section as I was very poorly (due to pre-eclampsia) and I didn't get to hold or see my baby boy for nearly 2 days after the birth. Even given all this I made a very quick recovery from the c-section and would be very happy to have another one next time round. I certainly don't feel like I've missed out on any thing not having a VB, the most important thing to me was that my baby was delivered safely and that I am now healthy and well.

Yes it does take a little time to get your milk to come in after a c-section (if you haven't gone into labour naturally) but it can be done, it just takes a bit more time and effort than normally.

Everyone's experiences are very different though, but mine was a very positive one and I was about and driving within a few weeks, as I felt fine, my consultant was happy for me to drive and my insurance company had no restrictions.

Good luck

Helen

I had everything go right with first baby - waterbirth with one on one care and no tearing. The pain was still horrendous though and I was over the moon when dd2 had placenta previa and I had to have elective c section. It hurt for a couple of days but after that although it was sore if I moved too quickly it wasn't worth taking paracetamol for. When I had ds1 I jumped at the chance of another c section. Like helenlouisey I also drove after 3 weeks with permission from GP and insurance people. The only down side for me was not being able to pick up dds post op and bf did mess up.

I do understand why someone might want to experience a vaginal birth if they haven't though.

For me, there were lots of reasons to have a VBAC, some practical and some emotional.

I found the recovery from my c-section very tough, and couldn't face the idea of doing that with a toddler to look after. I had complications and was fairly ill for a couple of weeks. Practically, I didn?t want to risk that again.

Emotionally, I found my c-section very upsetting. I had unrealistic expectations of what birth would be like (classic first time mother ? whale music, lavender oil and a bit of breathing was going to get me through). I ended up with every form of pain relief and intervention going. I think if my expectations had been more realistic I wouldn?t have found it as hard afterwards as I did, but I felt let down by my body and those who had been looking after me. Interestingly, I had no problems breastfeeding, which I think made a big difference to my mental state - without that I can see I would have been pretty traumatised by the whole thing immediately - as it was, it wasn't until I got pregnant again that I realised how emotionally fraught it had been.

So, second time round I was much more pragmatic. I decided I would do what was necessary to maximise my chances of a VBAC (which involved a fair amount of fighting my corner with the hospital and a lot of reading and research) but made my peace in advance with the possibility of another c-section. Either route would have been fine, but as it was I had a lovely VBAC with minimal intervention, which was very healing.

I took the view that our bodies are designed to give birth. I have no issue with people choosing to have a c-section, it just wasn?t what I would have chosen and I found it unpleasant, stressful and traumatic. I wouldn?t say my VBAC was pain free, but it felt right and I was entirely relaxed throughout it.

I suspect I?m in a different position to you, though ? I didn?t get to the pushing stage as dd got distressed, hence the c-section. For me, the VBAC was a reaction to the c-section. If I?d had a traumatic natural birth, as it sounds like you had, I would certainly have considered a c-section seriously. The recovery isn?t pleasant, but I know people for whom it was a lot easier than me. And an elective c-section is a very different thing to an emergency one ? you?d be rested, relaxed and prepared, rather than shattered after 24 hours in labour!

Just reading through this and just wanted to say that I had an emergency c-section without going into labour and am still bf 10 months on. You may need to be a bit more determined than average but definitely possible.

noses back to where she was in the thread...

My reason for - I think going for a VBAC with the next baby is that I'm currently 35, I want three children and don't want to leave it too long. You have to wait a year after a c-section to be pregnant and don't want to have to do this again.

I had an em cs and recovery was fine. The worst part was the tiredness I felt, but that was a lot more to do with the preceding 36 hours than the section. I was pain free inside a week and less than two weeks after my DD's birth walked 2 miles, which is more than my SIL could do after her straightforward vaginal delivery.

One downside of cs that is, I think, underplayed is that it can cause damage to your reproductive system. My doctor thinks that my cs was the cause of the fertility problems I have had since. If you are weighing up the pros and cons of a cs, this should be included IMO.

Re the breastfeeding, I have to disagree with what has been said. My doctor told me that it is the removal of the placenta, and not labour, that triggers milk production, and so a cs should not negatively impact on your ability to breastfeed.

I got pregnant 6 months after c section. Not great in terms of family planning but having read up on the risks - they are tiny really. The risk is of rupture so if you get pregnant soon after a section you will be put under more pressure to have another section to avoid contractions that might make you rupture.

I do know people who have got pregnant before a year too. They were fine. I might have the next baby in Spain though and they are not tolerant of it there. DHs cousin was told she'd have to abort!

Milk coming in prompted by removal of placenta so should be no problem after C-section - its a myth. I had EMCS with DD and didn't know you could have difficulties BFing, she self weaned at 23 months and not a drop of formula passed her lips.

Pregnant with no.2 and yesterday got classified as very high risk VBAC as my NHS hospital very reluctant to give elective c-sections, I'm having scans at 36 and 38 weeks and then a decision will be made.

You don't know if what happens last time will happen again, are the complications likely to happen again?

It is a very personal choice. I completely respect people who want to try for a VBAC but it definitely wasn't for me. I personally find the idea of a VBAC absolutely horrifying, but then I had the most terrible and traumatic long labour with DD1 (ending in an emergency section) and I never ever want to even think about doing that again (the midwife brought up VBACs at my appt yesterday and I was surprised to find myself close to tears at the thought of it - I rarely think about DD1's birth and so was shocked to find I was still so affected by it yesterday nearly 4 years on!).

I was also told that the same complications were likely to arise again which was definitely a big influence. Perhaps if someone could have assured me of a straightforward birth I'd have felt differently.

The emergency section was absolutely fine, if a bit of a shock.

With DD2 I had an elective section and it was a totally fantastic experience, relaxed, easy, happy. I was up and showered within 6 hrs of the op and my recovery was great (definitely much quicker than with my EMCS). I had no problem at all coping with my 2 yr old at home. I know I was lucky as some people have bad experiences with sections - but generally I think they are not that bad and you are very unlucky if things go wrong.

I am sure that it is a myth that breastfeeding is difficult after a section. Luckily I had never heard of this when I had DD1 so it never crossed my mind to worry and she was feeding happily as soon as I was out of theatre. Same with DD2.

The driving thing is also a bit of a myth. Most insurance companies are happy for you to drive as soon as you feel comfortable doing an emergency stop. I was happy to drive after a couple of weeks.

I'll be having another elective section in April all being well.

I had el cs for footling breech pres... didn't do too much to muck up bfing. My milk came in after 48 hours of colostrum and I bf for a year until ds gave up himself. Recover was a breeze, on my feet in about 10 hours, walking completely normally within 48 hours, driving after two weeks (though I could have done it before but gp recommended i wait) No pain afterwards, they gave me morphine in the hospital, but I think I could have done without it esp as I think it did contribute to ds being a bit sleepy for a week or so at first - which may have had an adverse effect on bfing at first, he was a very slow feeder for a while - still is actually. Takes him an hour to eat a sandwich!

Next time... hmm can't decide whether to go for vbac... cs means we'll know exactly when it'll happen so easier to plan for someone to take care of ds, I'm happy about the recovery from el cs. The thing about vbac that really scares me is the midwives insisting on lying me on a bed strapped to a monitor for hours. If I'm giving birth then I want to be on my feet, but I have a horrible feeling I'd cave in to their pressure. 'Tis a long way off though, not even pg!!!

I have emergency c section with dd - and even so it was OK and felt like I recovered physically quite quickly. Breastfeeding was v. difficult to start with - milk slow to come in, getting comfortable was hard etc, but that may all have been because she was first baby. Scar healed well but even 7 years later it still feels odd if touched (bit numb) and sometimes itchy.

My reasons for wanting VBAC were that I wanted fastest possible recovery, did not want to have scar opened and have to heal again and wanted best chance of breastfeeding.

Delivery of DS ended in forceps and the next day I felt like I had been run over by a TRAIN (whereas after c-section I felt amazingly good actually - probably all the drugs!) Difference was that 48 hours later I felt great, in spite of stitches and breastfeeding was much easier. DS fed in labour room.

Head fairy - I wasn't strapped down and monitored. I spent most of labour in a huge bath having water pouring over my back by DH and midwife! Later on I opted for an epidural which did mean I ended up on bed - but that was my choice.

i had ds 5 months ago by emcs under GA. i really enjoyed being in labour, you soon forget how sore it is!!!!! I felt i had achieved something by starting on my own. DS was back to back and distressed (like his mummy!!) i had been warned that if it went o section it would be GA cause i had low platlets and high risk of bleeding. To be honest i had a good labour but in the end was glad that DS was going to come out safely. Recovery was slow, lots of swelling and pain. i believe recovery is slower with emcs. I really want VBAC next time, as it's only now that the whole not seeing my baby being born is playing on my mind it's a totally personal thing and i have friends who have had dreadful VB's and have then opted for elective.

thumbwitch - DS1 was born by what was effectively elective CS (it was classed as emergency as it was only planned that day) - my waters had gone but absolutely NOTHING else happened at all - my cervix wasn't even starting to soften or anything.

I successfully BF DS1 for 14 months - no-one told me it would take longer for my milk to come in......and it came in quicker than when I had DS2 (induced VBAC) - DS3 (went into labour naturally) took even longer than DS2 for my milk to come in.

I had no problem bfeeding after an elective section at 38 weeks (despite ds being jaundiced & sleepy as result of haemolytic anaemia), it was much easier than after my long difficult labour and emergency section. The not driving for 6 weeks is a myth too.

Not read the thread, sorry only the op. But just to answer the question in my case.

a. because I was afraid ds1 would resent the baby because I wouldn't be able to pick up and cuddle as before because of the scar

b. because I feared recovery would be less predictable and I might be more reliant on other people than I wanted to be

c. because I wanted to be able to drive straight away

c. because I wanted to get out of hospital as quickly as possible that day or the day after.

Those are my reasons, right or wrong. Good luck with your choice -- just make sure it's yours, and not your midwife's or your hospital's!

Mine were the same as bluesky. I also wanted toexperience what a natural birth was like if at all possible. Recovered fairly easily from c section, though.

I was told I am high risk VBAC - I was told I would not be allowed a "natural" birth - I would have to be continuously monitored and probably advised to have an epidural as likely to be long labour - I did point out that if I couldn't move it would be a long labour.
I would prefer an elective than a very medicalised attempted VBAC that would probably end in c-section.

I'm currently going thru exactly this decision (em C-S first time round after 3 failed induction attempts including attempted ventose delivery)
Pro:

• I think I'd recover quicker from a planned c-section than another emergency one

Cons:

• recovery was not good for me - wasn't discharged for 5 days, so much pain I couldn't lift my baby up for 10 + days so am dreading a repeat with a 2 yr old to look after as well
• My hospital has a policy on continuous monitoring for a VBAC and am worried that the whold being stuck on a bed thing means that the labour wouldn't progress well anyway so I'd end up with a CS anyway
• I want to be at home asao with my new familiy of four!

(btw sucessfully b/f from 1 hr after birth, dd has never had any formula - but you do need supportive night nurses, espcially if you can't lift the baby yourself)