Preparing for VBAC - or not...

[SouthernLights]

My first baby was born nearly 8 months ago and my DH and I already know we want to have a second. There are many reasons for waiting a reasonable length of time before TTC again, but I was wondering whether there is any reason to wait longer, or possibly try sooner, as I am considering trying for a VBAC. The registrar (or consultant, can't remember which) who delivered my first baby told me I had an 80% chance of a successful VBAC after the surgery, as it had gone very smoothly, and I healed extremely well and quickly with no complications. I have heard that a VBAC is safer if your uterus has at least a year to heal between the delivery and the next conception, but does it make things harder if you wait too long (sorry if that's a stupid question)?

Also, if I try for a VBAC and I'm failing to progress again (the reason for the first section), what are the odds of the midwife being happy with me requesting to go straight to EMCS without going through the agony of syntocinon, as that was the only bit about my first labour that I truly hated?

Any similar experiences or advice would be very welcome.

I am not sure if this will answer your questions but I can share my experience. I had a VBAC after a C-section which was advised as they thought my DD was very large. The induced me 6 times at 39 weeks but it didn't work ( no dilation at all)so I had a CS. As it turned out she was 8lb10. I was determined to have a VBAC. I live in Germnay at the moment and after DD they suggested waiting 1 year. I got pregnant just before DD 1st birthday but I also had a friend who had a EMCS and got pregnant under 1 year. They monitored me very closely during the labour with DS as there is a concern that you will have a rupture of your old scar. In the end DS just wouldn't come out and got stressed and I found myself on the way to theatre after 30 hours of labour about to have another CS. Finally I had one final push in theatre and he came out with ventouse. Even after all the stitches the recovery was so much easier than CS. I don't regret trying the VBAC so I would say go for it. Discuss things with your midwife once you conceive I am sure that your birth plan could include changing to CS if you do not progress again. I hope this helps and I haven't rambled too much.

read this and decide

But i think you should try the VB if you have been givin that 80% chance of a succesful Vaginal delivery.

Did your midwife tell you why you 'failed to progress'? Birth is a natural experience in life and so labor should not be rushed. I hate that term failure to progress, its like saying they want baby out in their time.

Make sure you have a great support system around you during labor. Someone you tell all your wants and needs during labor (tell them before) so they can speak on your behalf.

Chellesgirl - that article is quite informative, thank you for that.

I agree about the term "failure to progress", but I think if medical terminology referred to it as "mother so bleeding knackered after a weekend of contractions and nearly 20 hours in labour she has no strength left to push even if she was fully dilated, which she's not", there'd be no room left on your notes!

I don't believe there was a medical reason that I never got fully dilated (made it up to 9.5cm and then started going backwards...) TBH I could analyse it until the cows come home, it's not going to change what happened. I do believe the main reasons were down to me being a control freak and trying to get it all "right", manage my own pain (even rejecting my hypnosis CD and DH's comforting FFS!) and not inconvenience people. Hopefully I will be able to recognise this and not do it again next time.

Brilliant link, Chellesgirl. Thanks for that.

Don't know if this will help but will offer it anyway.

Had ECS in 2001. Badly sewn so didn't heal.
Op in 2002.
Baby 2 born in 2003. VBAC. Extra monitoring but baby okay. I had a retained placenta.
Baby 3 born in 2005. Very traumatic delivery, nearly no baby/no mum with rupture of scar looking very likely.

I guess what I am trying to say is I had an awful time from start to finish but I do have 3 children who are okay now and are all here. I can't risk anymore but that is life.

Good luck.

Im glad the link was a triumph

No mother, southern can get it 'right'. you have to 'let' things happen during labor. Allow your body to go with the flow and not 'reject' what could actually make labor less painful/easier on you and baby. i know its easy for some people to say as in the end it comes down to your personality and beliefs.

Did you listen to the hypnobirthing cd before labor?

Again, every woman's body will react differntly to a VBAC. you have to think what you really want. the medics say you have a very good chance of delivering successfully. most are quick enough to book you in for your next CS even though No2 isnt even coneived yet!

I have another article that may help you. Let me find it.

watch this

read this

pros & cons

The last one, may seem 'scary' but this issue I would like to raise with this one is that it says about having full monitoring during labor and the physician will be happy to try a vbac. Before I had dd, I said I wouldnt have fetal monitoring as It causes distress to the baby. Its true too. dd was born distressed and the midwife admitted she was wrong in the things she did during my labor and I have it in writing.

If you go for another CS then youll be having constant fetal monitoring anyway! plus all those drugs pumped into you and baby.
If you go for vbac, ask for constant blood pressure monitoring for you, but only intermittent fetal monitoring for baby. Next time I have dc2 there will be no fetal monitoring at all.

There are so many things to consider with your discision. think carefully, talk to dh, midwife, consultant get thier point of view. At the end of the day its YOUR choice.

Hi,

This is an interesting post for me as like Southernlights I had an EMCS in march 08 due to that lovely term 'failure to pregress'.I was in labour of over two days and after 4 hours on the Syntocin I only got to 4cm's.My daughter had turned back to back and then when they took her out she was transverse.When I was pregnant I did yoga and sat on a ball for about 6 months and it did bugger all to get my baby into a good position.My daughter however was never distressed but I knew that if I ever did get fully dilated I'd never be able to push her out as I was so tired.

I'm now 6 weeks pregnant and leaning towards an elective C section.However,I'll probably change my mind lots of times before the baby is due!

Mumcah
x

it is also involuntary. you just can't help it, it just happens. ime obviously.

Ditto. SM&MB. Though i wouldnt know as i was strapped to the bed flat on my back after 5 days of labor. I wish I could have been able to stand up.

can I just say that those links are American - they have a completely different view to VBAC in the States (I run the UK arm of ICAN, an American charity which campaigns for VBAC and caesarean prevention) and a lot of what they say doesn't actually apply in the UK.

VBAC is BANNED in many American states which might give you an idea of how different it is. If you want some info that's a little more in formed when it comes to making a decision try these:

aims views on vbac

homebirth after CS

I'm not saying that the info in the American links is all wrong, just that you have a better chance of achieving VBAC in the UK if you understand the way the system works here and what you can and can't insist on. Read The VBAC Handbook by Churchill & Savage too. Very concise and aimed at the UK system.

Vbacqueen 'what you can and cant insist on'

Umm..vby right all women should be able to 'insist' on what they want and what they feel right for them and thier baby.

Here in the UK the medical system is all wrong. doctors feel it easier and quicker to perform a c-section. It takes time and beds to have a natural birth.

Ignore the v
The first link, has just made me feel like I have the right to sue the hospital where dd was born. Thank you.

And that lady that birthed at home at 34 1/2 weeks! wow! I wish id stayed at home now!

Chellesgirl, am not sure whether you were being sarcastic or not! Am hoping not

Yes the medical system here IS wrong but what I was trying (not very eloquently) to say was that we are luckier here than in the States simply because we CAN insist on certain things. Many consultants would prefer that we DIDN'T take control of our own births and would prefer that we DIDN'T know our rights, but it all comes down to informed consent. No medic is allowed to touch you (in theory) without your informed consent.

Please don't get me wrong, I'm not a doctor hater (I had my VBA3C in an NHS hospital and not at home) but I would never have achieved it if I hadn't researched and planned it. Left to NHS protocols I would have undoubtedly had a 4th section.

I just wish that every woman was given enough information during pregnancy to get the births they deserve.

no im not I was simply quierying why you said that.

Yes I do wish that everywoman would be able to have the info during pregnancy.

What you say about consent? How does this sound to you? my midwife 'never' asked me if she could put on the fetal heart monitor, she just said 'right were putting this on to help listen to babys heart' i said 'noooo I dont want that'(winge sort of no if you get me), She still went ahaead and did it.
IS this without my consent?

I know fetal hear monitoring can distress a baby, I had it on for 6 hrs non stop. Even though at many points through out my labor I asked to have it off. she said 'no'.

bugger, I typed a huge reply earlier and it's not here

In a nutshell, yes that was without your consent. And if you told her that no, you didn't want the monitor on, she should have respected your wishes. The main reason that CFM is associated with foetal distress it because you're encouraged to lie flat on your back for long periods of time. We spend our entire pregnancies being told NOT to do this because it reduces blood flow to the baby.

Time after time I hear of women having caesareans for foetal distress and surprise surprise, it turns out they were immobile for hours previously hooked up to a monitor.

Chellesgirl, have you thought about getting hold of a copy of your notes to find out what their version of events was?

To my mind, putting a labouring woman on a monitor and not encouraging her to be upright and to move around is just inviting foetal distress. I'll never understand why others don't see that too.

Thanks Vbac. I might just do that, do I have to pay for them?

I already started a complaints procedure, and had a reply which was awful and very unwilling of them to admit wrong. ive now left it too long to speak to the head of midwifery as they say Id have to book an appointment within 3 months of the letter.

i was too upset to talk to anyone, as I knew if I spoke to her shed just try and worm her way out of it, and then Id get angry/cry around her and I want to be strong for my dd, so I left it and thought if I forgot about it it would make all the PND/birth trauma go away.(which ever I had) had mixed responses and doctor just ignored it!

do you know what i can do now?

there is not a time limit. they are trying to wriggle out of addressing this

speak to PALS at teh hospital

take it to the chair of teh PCT if you get nowhere, medical records are kept for 21 years i think, so you are not out of time in 3 months

if the hospital are being obstructive, then i would go to the top and speak to someone within the PCT

i have just emailed the NHS Health care obundesman, the new way since feb 2009 for dealing with compliants not dealt with properly. will wait for a reply thanks lulumama for that, I just cant bare seeing her face as the words she wrote in the letter are beyond belief!

Sorry I didn't get back to you sooner Chellesgirl. Still good idea to get hold of a copy of your notes as until you've gone through them you don't really know exactly what happened from their POV. If you ring the hospital and ask for Patient Liaison (PALS) and ask what you need to do to get hold of a copy of your notes, they'll tell you. It does vary from region to region sometimes, but generally it's free to go and have a look at them (you'll need to make an appt and don't get to keep a copy) or you can ask for copies. The maximum they can charge you is £50 but some charge a lot less. You'll need to apply in writing.
Once you have them they can be hard to decipher but you could ask your community midwife to go through them with you, or an independent MW might do it (but will probably charge you for your time). An experienced doula may be medically savvy enough to help too if you know one.
Hope that helps and good luck - the more women who stand up and refuse to put up with poor care the better I say! x

Here in the US it is against protocol to give pitocin during a VBAC so that may be one thing you won't have to worry about.

Thanx vbac. I did read some of my notes while in hosp...as i noticed that they had wrote down that I had 2 doses of the steroid to help baby's lungs...when i never. just 1. took it up with midwife on duty, and she slighly crossed it out and said ' oh they probably wrote it in, because they thought you were going to get it here, never mind'

aaaaaahhhhrrrrggggggg!!!!!!!!

I think Im gonna have to write to PALS but first have to get a new GP as moved house, and so need the PND/birth trauma diagnosing 'properly'. otherwise I dont think il have a leg to stand on!

Good luck - a useful site is www.birthtraumaassociation.org.uk/