Will I be expected to have a VBAC as previous elective CS was due to breech baby?

[Pinkjenny]

I struggled a bit to think of a clear title for this thread, but I had an elective cs with dd at 38 weeks, as she was breech, and had been from 27 weeks. ECV was discussed, but not an option due to her position.

No one discussed vaginal birth with me at the time, and to be honest, I think I would have opted to have a CS anyway. I am now pg with dc2, albeit only 5+2 (so getting way ahead of myself here!) and am wondering about VBAC.

Lots of the threads in the archives are about VBAC after EMCS, as opposed to Elective, and people wondering whether the same complications will arise again. Now I'm assuming that dd being breech was just bad luck (please God, no more clicky hipped babies ), so will I be expected to go for a VBAC?

I am totally undecided at the moment, but it seems ridiculous to have surgery unnecessarily.

Does anyone have any experiences?

I had an emcs with ds1 but was still encouraged to think about a vbac with ds2.

I think it very much depends on your consultant but they should outline the pros and cons of both.

Am sure you'd have no problem in trying for a vbac provided baby not breech again or any other factors pop up like going very overdue.

yes, I had elective cesar with DD1 as she was breech. Two years later with DD2 (not breech), I had a vaginal birth. It was fine

Huw - was it assumed you would have a VBAC, or were the options laid out for you?

Pinkjenny I'm 30weeks and had an emcs last time after being induced. My friend who is due a few weeks after me had an elective last time due to placenta praevia.

We are both with the same trust and have been told it is entirely up to us whether to have a VBAC, or elect a CS. They said the risks/benefits of both. They also said that you can change your mind at any point if you want.

I was really pleased with that, having the choice and not feeling pushed one way or the other. I'm not sure if it differs between trusts though...

I had a very easy experience with my elective cs, and I have to admit, it is tempting, although clearly I would not be guaranteed the same this time round.

It's all so confusing.

I found my emcs a doddle and recovery very easy.

It's so hard to know what to do.

In the end I booked a CS for 41 weeks, and see if comes naturally first.

All well and good until I realised about a week ago that i might actually have to give birth which I somehow hadn't actually realised before .

At the moment, talking to people and on here, I reckon that it's about 50/50 good birth/bad birth, whether natural or CS, and that which you get is down to luck.

So I'm going to stick with my plan and see what happens.

This probably doens't help you though! It is so hard to know what to do - I wish I had a crystal ball...

pink I had a cs for dd1 who was breech

I was allowed either option the second time - they said as I'd had a previous cs I could have another but a vbac was fine too.

In the end dd2 was breech as well so I had two cses

It is a very hard decision, I dithered throughout until my mind was made up for me but you don't have to decide until the very last minute when your gut will probably tell you what to do so entertain either option as long as possible. If you want more than two dcs, however, I'd say consider the vbac as it's not great for your body to have repeated cses and if you have two, my obs told me a third would be compulsory. Good luck.

That is a very good point, jujumaman. I had never thought of repeated sections.

you can choose. and having had previous c.s then you can certainly request one and if baby 2 is breech or in another odd position, you will have a planned c.s offered to you as a matter of course

it is ultimately your decision as to how you deliver.

the VBAC clinic should be starting on thursday mornings in the near future. ask your MW for more information

you can book a c.s or induction (2 doses prostin maximum and no synto ) for term + 10 or something as best chance of VBAC starts with spontaenous labour . i imagine if you have never experienced any labour/contractions etc it is a real leap into the unknown

i know a good doula

I had an elective section with dd1 who was breech.

Dd2 was also breech right up until I went into labour at 34 weeks, when they discovered she was actually head down. My consultant then said 'right, normal delivery then'

I sat there open mouthed and apparently said something like 'but i don't know how to' and was told it would be fine.

As it happened though not long after they changed their minds due to dd2 becoming distressed and me not having dilated at all.

PJ, it was discussed in as much as I shouldn't assume another cesar but they would monitor my scar.

Lulu. You are absolutely right about the 'leap into the unknown'. I think a lot of my decision (at the moment, being so early into my pg) is to do with me not wanting to leave dd for any amount of time. Although my recovery was swift and easy, I did not like staying in hospital for two nights at all, and would wish to get back to dd and dh asap (I say this now!).

It's all great food for thought. Very interesting, Huw.

Nervous - at 'I don't know how to' - that's how I'd feel too!

you need to do your reading and research, and i would always say on balance, in the absence of a further need for c.s, go for a VB. hospital are v v encouraging of VBAC , hence the clinic and you will get lots of support.

there are risks and benefits to both, and i always think it is important to consider , if this is your last baby, and you will regret not trying VBAC, and experiencing labour, if that will be an emotional sticking point, or if you would be perfecly happy with another c.s

you don;t need to decide until much later on. see how the pregnancy goes and if this little one is head up or down.

Okay, here are some facts about caesareans that you need to think about when trying to decide between VBAC and CS:

Caesarean sections are major abdominal surgery, and like all surgery, carry the risks of complications. These can include dense adhesions, excessive scar tissue growth
that connects the uterus to surrounding tissues and organs. Adhesions can increase
the risks of longer operation times and injury to adjacent organs. The risk of
hysterectomy, or the surgical removal of the uterus, also rises. Undergoing
repeated cesareans make it more likely a woman will experience placenta accreta,
in which the placenta grows into the middle layer of the uterus, possibly causing
haemorrhages and requiring a hysterectomy.
A woman who has repeat caesareans can also be more likely to experience
thromboembolisms (blood clots that break loose and block blood vessels), or
excessive blood loss. And while uterine rupture remains a concern after one or more cesareans, the risk of uterine rupture is
small, and it decreases further with each additional VBAC.

Was wondering when the line "C-sections are major abdominal surgery . . ." was going to be rolled out. I think the OP probably already knows that.

I'm sure she does know that yes, but as she says "it seems ridiculous to have surgery unecessarily". It's ALWAYS worth rolling out IMO.

The fact is that in the UK both vaginal and CS delivery carry very small risks. CS is not a dangerous procedure in this country. To balance the post, the mortality risk to the baby is slightly higher with a vbac than with another CS. vbacqueen your post was rather unbalanced and not terribly helpful.

Personally that side of things has had/will have no bearing on my choice.

Lulu interesting about induction - my PCT said they do not induce if you have had a previous section full stop. That was key for me as it was an induction I had last time and that's what I wanted to avoid this time. I wonder if that is something else that varies between health authorities.

Sorry you found my post unhelpful - however it's something that I wish had been spelled out to me before I was talked into having "routine" caesareans.

Lulu I'm surprised that your PCT will induce a VBAC - is that general protocol or specific to one consultant/hospital?

I guessed you felt strongly from your posting name vbacqueen! I'm sorry that you didn't feel that you were given the opportunity to make an informed choice.

I just think that what the OP (and I) need is a balanced view so we can weigh up the pros and cons.

It is a tough decision to make and of course it's difficult to predict what choice will be best - until after the event. Both ways can go very well and both can go very wrong...

i had a vbac after a cs for breech presentation. Best thing I've done - i was totally buzzing for weeks afterwards (despite the stiches) unlike with the cs where i was in more pain and feeling totally removed from the whole birthing experience.

It is a totally personal choice but i am so glad i got the chance to experience natural birth. My consultant assumed that I would opt for a repeat cs but was happy for me to try a vbac

sorry for using the word totally 3 times in 1 post . am sitting here being distracted by ds and so my thoughts are rather disjointed

I had an 'elective' cs with DD1 (I say 'elective' as I had 24 hours notice after it was undaignosed until I was 42 weeks...but that's a whole other thread!) I had an ECV but it was not expected to work because of her position, and didn't (but was bloody painful)

When I saw consultants this time round it was almost assumed I would want a CS but I it was left up to me. They did seem a bit surprised that I wanted a VBAC and trotted out risks of uterine rupture etc but were happy to aupport me once I explained that I understood the risks of each. When I saw them at 36 weeks it was made clear to me that shoudl I change my mind and want a CS at any point from then on I could have one.
I ended up with a VBAC with DD2, and had late scans to reassure me she was the right way up.

Hi - I had a VBAC two years after having an elective C-section due to my DD being breech.

My DS was in the correct position and I wanted to experience a VB although I was told at the time that I had to go into labour naturally (as they would not induce me as they said it may lead to a stronger labour and greater risk of scar rupture). I was 3 days away from the C-section when I finally went into labour and thankfully avoided another c-section (with a little help from some forceps).

There was no problem with my C-section scar, although it had been very sore during the pregnancy.

I was really glad to have the experience - couldn't walk properly for about 3 weeks (due to the stitches) but as I still get pain from my C-section scar the VB was easier to recover from.

Good luck whatever you decide

i am only really familiar with the one hospital i doula at... the willingness to induce varies a bit from consult. to consult.

very amenable to accomodating the wishes of the mother though and encouraging VBAC

You shouldn't be 'expected' to do either. I tried for VBAC, but it didn't happen. But at every point (antenatally and during labour) I was supported in the decisions that I had made by the midwives and hospital doctors. It's up to you, don't feel pressured into any decision you aren't comfortable with.