Dreading Hospital considering HBAC, am 36 weeks?

[BumblBeee]

Any thoughts?

I have posted about VBAC before so sorry if I am being annoying.

I am trying really hard to be positive about a hospital birth but all the negotiation and randomness of the whole thing is making me miserable.

I really just want to have a peaceful birth with an experienced known midwife.

Am I being overly paranoid and pessimistic?

Would you consider an independent midwife? Is there an MLU at your hospital (although I suspect they wouldn't 'allow' a VBACer to use it).

A doula?

I think your only chance of a HBAC is with an independent midwife. A doula would be a good option.

Is the reason for your first CS likely to be repeated? If not then HB could be an option but you would have to get an independent midwife. Its scar rupture possibility that would put me off HB but also I have a few complicating factors.

I'm seeing consultant tomorrow to finally decide VBAC vs CS I'm nearly 38 weeks. It looked like it was going to be taken out of my hands by baby decided to go head down again last week. What worries me most if I push for intermittent monitoring is the shortage of midwifes and the hospital tends to share one midwife between many labouring women so I don't think I'd get the required care.

You should get a home birth on the nhs if you want to they may not like it but they have to provide it as long as it is fully discussed with you and you know all of the risks. Unfortunatley you may well still not know your midwife as they don't work 24/7.

iwantitnow, do you think you would be safer if you were monitored and then not seen for half an hour? It would make no difference, in fact they would probably be more likely to come in more often, not less if you were being intermittently monitored.

In many hospitals though they can see all the continuous monitor outputs on a screen in their office in Delivery Suite. Someone (when I was in labour it was a doctor) will be watching the traces of however many women are having them.

What happened to you Riven, did you have a rupture?

i think with the right support a HBAC can be great

women often find if they want a less medicalised approach and are refused the MLU, requesting a HB often gets the compromise of the HBAC

your best bet is indeed an indie midwife

and definitely a doula if you are going to hospital

there are risks but if you are fully informed, then you can make the right decision for you

Being fully informed does not cut down the risks. I don't think lulu meant this at all. Being fully informed allows you to make an educated decision, know how and where you wish to labour and what you might want to do in any given situation should it arise. There is good research to suggest that women prepared for labour in this way have more positive outcomes.

I'm sorry for your experience Riven. You have a beautiful dd (when I see your name I always think of her montage and the pic of her all decked out for going out in the rain- I love it!).

that is waht i meant SoH

making an informed decision means you have the pros and cons, risks and benefits, rather than scare stories only , or positive stories only

then you can choose what is best for you and your situation

i can;t read the last message on any thread! this is making it rather annoying !!

ok !

I am sorry to hear of your experience Riven.

If something goes wrong in hospital or at home I will always feel badly about the choice I have made.

I guess this underpins a lot of my anxiety.

I have read that you can have silent scar ruptures that can only be picked up by the monitor before its too late.

mrsgboring - most hospitals don't have a system where they can see all of the traces, when I worked in a unit that did, we still had tragedies due to traces being ignored. They are not being continuously watched, and it is very difficult to know what is going on without being in the room and knowing what is happening to the woman.

Baby heart rate traces are often very difficult to interpret, a normal trace gives you a 99 % chance that the baby is ok, with an abnormal one there is still a good chance the baby is ok which is why they sometimes get 'left' for a while. They are safer if used in conjunction with fetal blood sampling which is a very invasive procedure, but it gives a much better picture of how the baby is doing.

I think that is a better way of putting it than my last post which might have freaked people out if they know they had an abnormal trace for a while

Riven - I just want to say thank you for your posts. I have been considering a homebirth for DC4 (due in 2 months). DCs 2 and 3 were born at home, but DC3 got slightly stuck on the way out and I feel that was a bit of a warning for me.
I've been in two minds up until now about home v hospital. However, your words ''My own thoughts now is that the actual birth, whether CS or vaginal or home or hospital doesn't matter. Its that the baby is ok.'' have convinced me that I'm making the best choice with hospital, and I thank you for helping me to not be wracked with indecision for the next couple of months!

I do not mean to offend here, but I do perhaps think that many mumsnetters are a bit overly pro-homebirth. I've had two HBs and they were great, but I would not have enjoyed them nearly so much if I'd had risk factors involved such as a previous c-section.

bumblebee You say, ''I am trying really hard to be positive about a hospital birth but all the negotiation and randomness of the whole thing is making me miserable'' - why don't you try to take as much of the negotiation and randomness out of it as you can? Ignore the midwives and doctors unless you want to listen to them (!) and just use them to be there so that you and your baby are safe. Birth at home also involves a lot of randomness! Why don't you plan the birth you want to have in hospital and get your birth partner to be realy assertive about it for you? You could also plan to leave within a few hours if everything goes well (that's my plan!)

You also say,''I really just want to have a peaceful birth with an experienced known midwife.'' - you're unlikely to get a known midwife on the NHS - they just send who is on shift, you would have to pay a lot of money to go privately for that.

Like you, I want to have a good and peaceful birth experience, but I do think Riven's words quoted above are the most important thing.

Yes, maxbear, that was alarming the way you put it.

I didn't know that a central point for monitoring traces was actually uncommon, as it was available at my hospital. But my point was that just because someone isn't in the room doesn't necessarily mean they aren't looking.

The fact that someone isn't in the room all the time does seem to me bordering on the disgraceful.

'My own thoughts now is that the actual birth, whether CS or vaginal or home or hospital doesn't matter. Its that the baby is ok.'

I agree Riven, but I think it is important to be able to make the decision with accurate information. Perhaps your DD would have been better off having been born in an open properly staffed hospital with competent, rested on the ball midwives, available doctors etc., but there would have been no guarantee that you would have had this experience if you had chosen a hospital birth.

Some people choose a homebirth to increase the chances of a problem being identified earlier, to follow their body and instincts to get their babies into an optimum position, to have more attentive care, and to ensure they are not being sent from pillar to post before they give birth.

The key is to have the facts and be able to make an informed decision.

I had a pph in hosptial, so I was in the perfect place for treatment. However, it was my midwife tugging on the cord during a natural third stage that 'caused' the pph.

Thanks for all the feedback. I guess we all want good care in the end and the anxiety stems from not knowing how best to achieve this.