vbac and growth scan advice needed

[muminmiddleeast]

sorry for long post,..

i am 29 weeks and due to have a planned cs,because my ds was HUGE 4.76 kg, also i had colestasis and didn't respond to induction - they did cs as last resort wand realised baby was very big.

My consultant has said if the baby is over 4.4kg then he would prefer a cs. Does anyone have experience of dating scans? i am booked for cs anyway but am toying with idea of vbac

I would like to try and have a vbac because of having surgery again scares me, i have a toddler who is very active and I would like to recover faster... i wanted a normal labour last time but got caught up in the flap over the last minute diagnosis of colestasis.

how hard is it to have a vbac after cs? my scar feels very tight now with the weight of the baby. Am i more likely to be cut? my midwife first time round said that all women would/should be cut so i should just get over it. this terrified me as i wasn;t nervous before.

my dh is totally against my having a vbac as he is scared of any damage down there. (he is a nice guy, just reads to many horror stories about it.)

i will not meet my midwives until the day as here the doctors see you til the day and doctor is in charge during the labour.

Have you had a dating scan recently?

My ds was 4.150kg, I was told at 32wks that if I was to carry to term he'd be 3-3.5kg. I carried to 41+6.

I have had 2 sections so have some experience of the way you are feeling. I was definite I wanted a Vbac, but it wasn't to be, they wouldn't induce me & ds wouldn't come out [grrr!] so I had an "Elective Section" (hyphenated as I didn't actually elect it! )

Sorry I am not much help, I asked this question recently on another Parenting site I use & 90% of the dating/guesstimate of sizes were correct of very close.

Best Wishes, I had a 14mth age gap & wasn't happy about having another Cs but thats the way it went and the fact my ds arrived happy & healthy that was the main thing.

If your scar is tight now at 29wks that makes me wonder, how long is it since your last Cs?

i've just had an elective after an emcs last time. One of the reasons last time was for cs was that the baby was 4kg+ and i'm a very petite 5ft. A number of reasons I went for an elective rather than vbac but in the end it was a great decision for me. My recovery has been very quick this time, I'm nearly back to normal after 10 days except I can't pick DD who is up or run that fast. If my insurance company will allow it I believe I'm fit to drive very soon. To be honest I feel physically so much better than being pregnant with a toddler, I have hired a post natal doula to help round the house as I have little family help.

muminmiddleeast, I've just done a TON of research about sizing scans (not dating ones) and vbac, after my consultant offered me a scan.

There is pretty universal research to show that at best, scans are accurate to within 10% either way. That means if they predict a 4kg baby, it could be anywhere from 3.6-4.4kgs. Up to 4.5kgs, your chance of success at vbac is around 50%, depending of course on the care you get (obviously it goes down if they strap you to a machine and make you lie on the bed). Over 4.5kgs, your chance of vbac success goes down to 38%.

However, sizing scans get more wrong, the larger they think the baby is, if that makes sense. They tend to over-estimate, so the rates of error for large babies are more like 15%.

Plus, I found a study that showed that when a scan predicted a baby to be big, dr's tend to intervene more in vbac - even though (a) the baby often turns out to be not so big after all, and (b) there's little scientific evidence that a big baby causes any extra risk for vbac. So where a scan has predicted a large baby, rates of c/s jump from around 30% to around 50%.

hth

thanks phdlife that is very interesting. i want to avoid lying on beds anyway so i must ask the doc if they support any position esp towards end of labour.

claire2009my baby was 1.4kg at 29 weeks according to the doctor which he says is normal. he said that he expects bg growth 36 weeks onwards and will decide then when to do the cs. i want to wait til 40 weeks anyway. he will scan me again next week-like i say they are mad for scans here.

i had my first c section 2 years ago. this baby feels very heavy and i carry very low- lots of water and a big baby plus just me i guess. it does feel weighing on the scar though, i have to keep taking the weight with my hand iykwim

would love a doula but have already searched for one and there are none in this country, its unheard of as ladies have a cs then a maid! aprt from that, they would not be accepted at the hospital.

phdlife, what are you doing then, will you try a vbac?

yes I'm going for a vbac; am quite stubborn

I thought this one was weighing on my scar, but after a while I decided it was just that my scar was squashed in between humongous bump and pelvis, and the waist of whatever I'm wearing (knickers, shorts) gets squashed in there too. could you be feeling some of that, mumin?

www.bigbaby.org.uk

In particular watch the video on the VBAC page.

Other helpful things:

-Join the Yahoo HBAC/VBAC support list and/or the babycenter VBAC forum

-Hire a doula (there must be one where you are if you really look? or if not a doula a mum who is interested in birth and has great faith in women's abilities - perhaps as antenatal teacher?)

-Go through your notes with a midwife/birth afterthoughts service

PhDLife - can i ask where you were researching to get the statistics on VBAC success based on weight of baby?

I had a section last time due to large baby (4.96kg), and I am pushng for a VBAC now. The one reason docs will "insist" on a section is size of baby, so the more facts I can be armed with, the better.

Thanks

Spacetrain, the reference is here

I can't remember 100%, but fairly sure I came across it looking at the vbac pages on homebirth.org

hth

Thanks a lot

hi, am muminetc... just changed name for a change..

phdlife, am going to talk to doc about vbac, he kind of ignored me last time i have been having pain round my scar but am wearing bigger clothes and sitting down as much as i can.

childrenchildren, i can assure you there isn;t a doula and they are not allowed in the hospital anyway! there are one or two in dubai bu not here. midwives have no contact with you before birth, and refuse to speak to you before anyway, have tried- its the doc who makes the decisions. i have sourced a lady who might be able to help, ie stay at the hospital and stop them taking the baby to the nursery. dh has to look after d1 who is too little to leave.

what is recovery like after stitches? am terrified of tearing, and i have met a woman who has a child who was pulled out, nerves damamged and cannot use its arm at all and nver will. the baby was 4.5kg and wouldn't come out-

I find it fascinating how much each health trust must vary in their policies.

My DS was a whopping 5kg and born by emergency c-section. (due to heart problems, not his size) This time I've not been offered any scans to check the size of the baby and was practically refused my request for a repeat section and positively encouraged to try for a VBAC!

So, in fact the complete opposite to what a lot of mumsnetters seem to experience with their consultants.

I guess I'm lucky in that my trust is very pro-VBAC but it does concern me that they don't seemed to be bothered about another potentially big baby when other trusts clearly think it's a problem.

country lover, when i was in the uk, the consultant and mid wife were both keen that i would prep for another c section and look at the guesstimate of the weight nearer the time. to me it sounds strange they haven;t said anything, esp as there are risks of scar rupture etc (really cheery)

Hi, I had a c-section 11 days ago. During the pregnancy, I had 13 growth scans due to previous IUGR and section. At last growth scan at 38 wks, DS was estimated to be 8lb 11oz and was born at 39+2 weighing 9lb 1oz so guess if they had done a growth scan that day, they probably would have been nearly spot on with the weight. The consultant commented to me during the section that he was glad he had done one as my lower segment of my uterus was very thin. Don't know if this was due to weight of baby, previous section 14 mths ago or both. He thinks there would have been a high chance of it rupturing if I had gone into labour. I was going to try for a VBAC if I had gone into labour before section date but didn't and glad now that I didn't but I still think it's worth trying for. We lost our first baby so I guess we wanted to minimise all risks to the baby as much as possible. Best of luck. Cx