VBAC for a big baby?

[Renwein]

Hi ladies,

Was hoping for a bit of advice about whether it's worth attempting a VBAC for a potentially big baby.

I'm currently 36+5 with baby number two. DS was born nearly four years ago and I had a fairly straightforward labour till I got to the second stage. Waters broke at 6 am on the Sunday, was 5cm dilated by the early hours of Monday, had gas and air and pethidine, fully dilated by about 7 am on Monday. Really wanted to stay on all fours but had a slightly Nazi midwife who wanted to monitor during second stage. The monitor kept falling off so she put me on to my back and I didn't really feel in any position to resist. Pushed for two and a half hours then contractions started to disappear. They thought DS might have been in the OP position but never quite got to the bottom of whether he was or not. They tried a ventouse in theatre which didn't work so they did a c-section. DS was 8 pounds 13, delivered the day before his due date. That is quite big for me as I am 5 foot three and normally about eight stone (though obviously not at the moment!). I blame DH, who is 6 foot three...

This time round, I saw a locum who made no sense at all at 32 weeks and saw my proper consultant last week. He is sending me for a scan at 38 weeks and says that he would advise an elective section if it looks as if this is another big baby. He is worried about the shoulders getting stuck even if the head delivers. He asked how I felt about it so I think he would probably be amenable to me insisting on trying a VBAC if I really wanted to.

I'm not sure how I feel about it. I'm not a natural childbirth at all costs sort of girl. Medical advances have saved lives and that's a good thing. And I don't want to be a hero and go through labour just to end up with another c-section. But if there's a reasonable shot at a VBAC, I would like the chance of a shorter time in hospital and a quicker recovery for DS's sake. I also find the thought of just turning up for a c-section and coming out with a baby without any of the transition of being in labour a bit weird.

I can't help thinking I might have had a better shot last time if I had been more upright during the second stage. But the hospital has a constant monitoring policy so I'm going to end up on my back again this time. Plus I've had a group B strep urine infection so I will need to go in relatively early to get my antibiotics which rules out staying at home for as long as possible.

Has anyone had a similar experience? If the scan shows it's likely to be another big baby, should I just throw in the towel and go for the c-section? Or is there a reasonable shot at a VBAC?

All views gratefully received.
Freddie

Well...I don't know if that help but I gave birth to a girl first time round, she was 9 pounds 15, ventouse, forceps etc...second time, another baby girl who was 10 pounds 6...homebirth, natural, everything..I am 5 foot 7. Not sure if they'll give you the c section option unless you are in difficulty...

I had a VBAC in hospital for my dd - they kept saying she was going to be a biggun, and she was - 10pound 2oz.

I really wanted a vbac - i'd had a csec with my boys and wanted to do things properly. On the whole it was ok, apart from the continuos monitoring which meant i coldn't get off the bed at all. She was also back to back, which was fun. I ended up with a 3rd degree tear and over 40 stitches, but it was more then worth it.

I'm hoping for a water homebirth this time.

Sorry, just a quick one as am about to take ds up to bed.

I had a vbac at home in a pool. DS2 was 9lb 11oz (ds1 9lb 3oz), it was quite a fast labour of 4 hours and I just had a graze.

I had an Independant MW as I know I would have faced opposition from the NHS.

Let me know if you have any questions and I'll answer them later on x

Hi Renwein

I've not had a big baby, but my mother who is only 5 foot gave birth to a giant 10lb baby (and quite a solid looking one at that!). I do think from what I have read that being upright is likely to help. If you read whatever the book is called by Ina May Gaskin she talks about women who were diagnosed with having a pelvis too small to deliver a big baby in their first pregnancy but who went onto deliver larger babies vaginally next time around.

Re the monitoring, I was stuck on my back during my first delivery. My DD - all of 7lbs - was also stuck and forceps failed. This time I am refusing monitoring - as I can find little to suggest it is massively better than using a hand held every 15 mins - but if for some reason they feel strongly, the hospital can just supply a midwife to help sort out the monitor as I change position. No power on this earth is going to trap me on that bed again! You could try being a bit bolshy about this stuff and see where that gets you...

hi there
ii went though this stuff a while ago-research i did though sure you will find more or different. ie constant monitoring does seem to invite intervention as you can't move around, why do they do this, is it to cover their asses re any legal problems if things go wrong?
you need to be able to squat or be on all fours to enable your pelvis to open properley which will be up to 30% on the day. the consultant cannot tell until you are in labour, so a pelvimetric is not really any use til then.

suggst you talk to nct, a doula, and think about changing hospitals for one thats a bit more birth friendly!

i had c s which was lucky as baby was 11 llb and i was more concerned about bf- also am ok with intervention as soon as needed and agreed.

growth scans can be out by 10% each way.

sure lots of people will help you more, and good luck!

I had a horrendous time first time with DD as she was a 'facial presentation' and her head got stuck - not that they realised that till after she was delivered by ECS.

With DS 3 years later, they talked about a VBAC and I was up for it, though not massively keen after the trauma of the first time. They kept scanning me and decided he was too big in the end. Massive head and 10lb 14 as it turned out so I was quite glad! Elective CS was fab too, very civilised!

I think how they arrive becomes irrelevant after a few months, you just want them to arrive safely!

I had an em cs with my first as he was too big and got stuck. I was wary of attempting a VBAC as I didn't want to be left, again, for hours, before the drs threw in the towel and did a cs.

I recommend reading the NICE VBAC guidelines - they say that you shouldn't labour for more than six hours, that if you slow down, a cs is a good idea. Armed with that info, I felt much more in control. DH was prepared to demand action if things didn't go to plan - I wasn't going for the 'give it another hour and see what happens' approach again. And I wasn't going to accept induction etc. It was going to be either a pretty straightforward birth or CS.

And as it turned out, the VBAC was successful, very quick. Quite glad I gave it a go, just didn't want the hideous marathon labour before a CS, and I think knowing about the NICE guidelines made me feel less powerless about that happening again.

Thanks very much for all your messages. It's really useful to hear everyone's experiences.

I guess I am just a bit too nervous and risk averse not to go to hospital or to fight too hard against what the midwives and doctors are telling me to do. The problem is everyone seems to have such a firm position and it's v difficult to get an idea of what's actually best. I don't believe the medical profession are actually setting out to make women's lives more difficult - it's just a question of how much risk you're prepared to take. Wonderingwondering - I wondered if you had a link to the NICE guidance. I couldn't find it on the NICE site but am probably being a bit crap.

Did think about whether to go to a different hospital when I found out I was pregnant this time round but, in the end, I wanted to go somewhere which was local and convenient. Like you say, minko, how they arrive becomes irrelevant pretty quickly (or it did for me last time). To be fair, the hospital has improved massively since last time. It's just that, having had a c-section last time, I don't get the benefit of things like the shiny new birthing centre.

I'll keep you posted. Am half hoping baby will put in an early appearance as it would take away the question of whether to book in an elective c-section or not. I would just go for it if I went into labour. But unlikely, I expect. Have had a few episodes of crampy backache over the last few days but it didn't go anywhere and today I have felt fine! DS is keen, asking me if the baby will come in one week and lifting up my top to display my bump to everyone at nursery. He doesn't know what he's in for

There are certainly some positions during labour and second stage that are better than others if a good sized baby is suspected. You can be monitored in them as well, so there would be no reason why you would have to stay on your back....worst position to be in if they think baby is a good size.

Your position can often help baby get into a more optimum position...which is many times why someone ends up with surgery for a "big baby"....it is often more a positioning issue than necessarily a size issue.

No way to know unless you had the chance to try. See what the consultant has to say after you have your scan...it may not be an issue. Maybe you will go a bit before your due date...

Hi Renwein, you might want to have a look here - there's lots of different stories on information on VBACs. FWIW, I had an em c-s for DD1 and VBACs for DDs 2 and 3. My babies were between 8lb 11 and 8lb 15, but I am 5'10".

CFM does not necessarily mean labouring on your back - I had CFM for both my VBACs, but was able to sit on a ball, move round the bed etc. The mws just readjusted the monitors if I knocked them askew. They also took them off to let me go to the loo in privacy! There are now also wireless monitors, which will obviously restrict your movements less. These are fairly new, however, so you'd need to ask your hospital if they have any.

Have you spoken to the consultant mw (or head of mws) in your hospital? Lots of us have found them far more responsive to VBACers' requests than the doctors

Anyway, need to go to bed - HTH.

i have gone for an elective next week, and we wil see what happens, ie am in denial
you are v good reseaching. my doc told me that induction is not advised for vbac as dangerous due to possible rupture of scar. my sil had a vbac and it was fine. can you go and see the mw there and talk it through?

my baby is 10llb now according to scan, my ds1 was 10-11 at 40 weeks.am more concerned about bf easily again. have no wish to labour for hours then have cs.

Hi there, have a look at my site about big babies: www.bigbaby.org.uk

admittedly the VBAC page isn't finished yet but there's a couple of good stories and a lovely video link.

I doula'd at a fab VBAC earlier this year. First baby 8lb 13 (I think!) - got stuck, had C-Section at 7cm with major FTP. 2nd baby 2yrs later was an unplanned homebirth (things moved rapidly!) and the baby was a lovely chunky 9lb 10oz

Don't let size put you off, from your story the size of your firstborn was irrelevant.

Good luck!

Well, went for my scan this morning and baby is measuring bang on average so consultant has cleared me for a VBAC. I think this must be what I wanted as I feel quite relieved not to have been booked in for a c-section. I don't think I would have felt at all comfortable going for a VBAC against the consultant's advice so this is the best result really. Not that I'll necessarily be saying that when the time comes - I distinctly remember saying last time "I'm not doing this again" . Now just have to do what I can to make it work when the time comes.

Just wanted to complete the thread. My little boy was succesfully VBACed on Sunday at 39+3, weighing in at seven pounds nine. It was all very quick - six hours from the first contraction to his birth. I did end up labouring on a bed whilst being monitored and sustained a third degree tear so ended up being stitched up in theatre with a spinal anyway. No regrets though, the recovery is still much better than a c-section and I'm very glad to have had the experience of pushing him out and him being put straight on to my tummy. Thanks very much for all your support and advice.

I just wanted to let eveyone know to be aware of VBAC as I was quite keen to have a vbac but at the last minute and sudden memories of my first labour I decided to have another c section and thank goodness I did as during the operation the scar tissue from the first operation had stuck from my womb to my bladder and the surgeon said that had I had an emergancy section it would have been a "disaster" I felt it important to tell people not to be pushed into a VBAC. I felt my hosp really wanted me to have a vbac but manily for their statistics... I had a big baby the first time 9Lbs 4oz and was advised would have another one. My DSS was born 10 days early and was a healthy 8lbs so thank goodness I did opt for the section.
The recovery from the 2nd section has been far better than the first, I was sore for a day or 2 but after a week I didn't need many pain killers at all. Lots of rest is required but its definitely worth it. The surgeon has advised me not to have another baby and I am just very relieved to have 2 lovely sons and a bladder that is still in strong working order. I wouldn't hesistate to recommend a second c section.