Help convince me to try a VBAC

[SarahL2]

Went to see the "Birth Afterthoughts" lady at the hospital today to discuss DS's birth and what went wrong.

Basically - I had pre-eclampsia and had to be induced at 40+4. Induction did not work and after 48 hours and (what she described as) massive doses of Syntocin (sp?) I was still not in proper labour. I was not having reliable and regular contractions and was just in masses of almost constant pain. DS's heartrate was flat and in the 180's (as it had been for at least 24 hours previously) and as I had only gotten to 3cms, it was decided to deliver him by EMCS. I lost 600ml of blood during the procedure. DS had an APGAR score of just 6 at 1 minute and needed help breathing. This rose to 9 at 5 minutes but even the lady we were talking to today said we were very, very lucky he was OK. It was also found when they opened me up that DS was back to back - no-one had told me this before...

Apparently, there is no physical reason why I couldn't give birth naturally but I'm scared. Scared that I or we will get ill again. Scared that I will be left too long again with a baby in distress and will not be so lucky this time....

The thought of a planned section, earlier than my due date, to get my baby out before all of this could go wrong again is quite conforting but will I feel like I failed again?

I was also told today that I potentially have quite a low pain threshold which is why I found the whole thing so painful so it is quite likely I will need another epidural - should I just go straight for the total block and get it all over and done with with a speedy c-section?

Do lots of research and then decide which mode of delivery is your preferred choice.

I found this very helpful.

In the end you may decide that a nice calm planned CS is for you anyway .

Having said all that, my VBAC last year was a phantastic experience. I suppose I had the advantage of 1 successful induction before an emergency CS for plancenta praevia, so had "proven" to myself and my consultant that I "could do it".

I had a very supportive consultant and felt v well looked after.

I think the most important thing is that you are happy with your decisions

• and the rest is in the laps of the Gods, isn't it? My main reason for wanting to at least attempt VBAC was the quicker recovery after vaginal delivery as I did not relish the thought of going home to 2 DSs with newborn baby and great big scar!!

Do your research and then do what feels right to you.

Good luck

Hello Sarah. I'm on the due in Dec thread with you too.

I think that you need to get your head around the "failed if I have a section" thing tbh as if you do attempt a VBAC there is still the possibility of a c.section and clearly the alternative is a c.section. I think that somehow you need to come to terms with the idea that a c.section is a perfectly valid means of giving birth before you can decide if you want to try for a VBAC iyswim.

Perhaps you can mentally frame the whole thing in terms of positives for either outcome?

Eg I would like to have a VBAC because of the shorter recovery time. If I have an elective c.section then I will be able to have some control over the date that I have my dc???

FWIW I had a c.sectionlast time and had adamantly wanted anelective all through pregnancy and then got an em.section at 32 weeks taking the control that I wanted away from me somewhat. This time I have vaguely toyed with the idea of a VBAC but have pretty much decided on a section unless I went into labour spontaneously before my section date. I'm not really sure why I've come to this decision really but I certainly wasn't traumatised by my c.section in the way that you seem to have been and nor do I have any sense of failure though I think that's because I didn't really want a vb in the first place.

You need to do your research. There's a book called the VBAC Handbook which I found very helpful.

After my DD was born I was certain I would have an elcs next time, but as time has gone on and I have had some post-section complications, I have changed my mind. For me the key factor is that I probably want more kids and sections apparently increase risks in later pregnancies. Plus I have had some difficulties conceiving and the doctor put that down to having had a section.

You can always refuse induction next time around (and many doctors are wary of using many drugs etc with a VBAC) so if the baby needs to come out they do a section and otherwise they let nature take its course. It doesn't have to be the same as last time. I suspect that a spontaneous labour can be a lot "easier" than an induced one, and I am sure that an elcs (that you've planned and accepted) is a world apart from an emcs.

Re your pain threshold, contractions caused by big doses of syntocin do hurt. So does being stuck immobile because of monitoring (don't know if you were but am assuming). In fact the whole experience sounds agonising. Anyone would be in pain with that lot going on, so don't doubt yourself because of it.

I was indeed stuck on my back for the whole thing MrsHappy. Tthey were keeping an eye on DS's already worrying heartrate. He was also back to back which wouldn't have helped.

Have to say PacificDogwood's phrase "a nice calm planned CS" is sounding very good right now...

Will read through the site suggested though - thankyou very much for suggesting it

That's interesting Riven. I always assumed C-sections would mean longer recovery's. Do you mind me asking why the VBAC was longer?

Have just had a VBAC and am so so happy. Am on my feet, jsut a little bit sore. Able to do stuff, lift up DS1 etc.

Also feel very empowered. Feel so chuffed that I've experienced both types of having a baby, this one was far better than Em c-sec.

All the best, whatever you decide.

I apparently lost 600mls blood during my section and only avoided a transfusion cause I seemed to be coping. Was sent home with iron tablets and an infected wound! No wonder I felt so awful afterwards! No wonder you were in hospital for so long Riven!

The thought of tearing my bits does NOT appeal either!!!

Have a trial labour at least-it releases loads of hormones for you and the baby and is infinitely preferable to a planned section.

Every birth is different

Read Stand a Deliver by Emma Mahony for some amazing positive birth stories

What's a trial labour?

A trial of labour: basically you give it a go.
Personally I always felt that having to go through labour AND then have a CS was the worst of both worlds: labour pains and post op recovery.
Reading your recent posts you come across as if you'd feel more relaxed if you knew you were going to have an elective CS, wouldn't you? It is very importan, I think, that you are confident that whatever you decide is the right decision for you.
To kind of timidly go for a trial of labour IMO would not be a good idea, particularly if you then went on to have an emerg CS afterall.
Planned sections can be positive birth experiences. Just do your research and then go for whatever you feel is best for you (whispers: but I did really enjoy my VBAC ..)

who was the birth afterthoughts lady?

she sounds like she scared the crap out of you!

a blood loss of 600 ml is not catastrophic
apgar of 6 rising to 9 is not catastrophic
back to back is not the end of the world but it is a reason you would not dilate as quickly as expected

it really sounds like she has made you terribly fearful

an induciton at 40 + 4 with an epidural which means you are pretty much immobile is a lot of the time, going to end in a c section

something as simple as a spontaneous start to labour can make all the difference, as can no epidural, being mobile, active and upright

an induction before your cervix is ripe with a back to back baby is going to be a long drawn out procedure

who told you had a low pain threshold??

childbirth is painful. and you were tired and in labour with synto which can make it many times more painful

my vbac was a very painful recovery. Episiotomy, stitched up for an hour and couldnt sit down for three weeks. If I hav a DC3 I will go for a planned c section. Also the experience did nothing for the 'failed' first time feeling. I didnt feel an enormous amount of pride or anything for having done Ds2 the 'natural' way. Just a lot of bloomin pain and agony and no sex for 4 months !

every laour is different too-- don't be put off (necessarily/exclusively) by the pain of the first.

my 1st birth was so painful i thought i was going to die, and needed an epidural as i wan't coping at all.

my second hurt like hell but was copable, and this was without drugs (not a hero, just not given pain meds as no one thought i was labouring till waters broke + they saw the head lol)

2nd birth was a vbac. read as much as you can to make an informed choice, and go with your gut.

Hi Sarah, try to remember they will probably want you to have a CS again as that is what I have been pushed into by my consultant led team although my community MW is more than happy for me to have homeVBAC. She thinks a pool might be nice

I have sent PJ (Due Dec 09) my VBAC book and will ask her to forward it to you or get it back from her and send it on to you.

I don't think they can possibly say you have a low pain threshold. You were scared, had preeclampsia, had a distressed baby, were induced, had a back to back baby and stuck on your back. I would be moaning about the pain in that situation as well.

TBH my opinion might be a little biased as I had a wonderful home birth first time round then a highly medicalised ECS the second time round. This is one reason my MW is happy for a homebirth this time as we know I can do it having done it before. I know you don't have that comfort. For what it's worth my poor recovery from my CS is probably very much linked to the fact it was an emergency. I have heard that electives are a lot more relaxed and less traumatic. You can still have the choice of how you want it to go if you do decide on a CS.

try the cs birth plan link

Hi Sarah - you can email me your address if you like and I'll post it on to you. FWIW, I am still completely undecided.

My email address is [email protected]

Also Sarah it is an achievement to birth your baby whichever way it comes out. You have in no way failed. You dealt with the information you had at the time and ensured a healthy positive outcome for your son.

PJ & Sarah how about you book in for both options and decide nearer the time. Hedge your bets now and see what you feel like nearer your due date.

Hi there, I haven't read thru all the posts but I had a VBAC with DS2 and it was the best thing I ever did. The recovery time was so short and even though I had to have ventouse and a few stitches, the joy of being able to walk around and, most importantly, still pick up and cuddle DS1 was immeasurable. It still gives me a buzz 19mths on knowing that I could do it. The labour was long, and the consultant wanted me to have a ECS but I fought right to the last minute (literally). DS1 was ECS because he was breach - DS2 was not so there was no real reason why he shouldn't have been a natural birth. I looked forward to the birth and had a great time - but whatever you decide, best of luck and hope it all goes well for you.

Birth Afterthoughts is the hospital's service for women who feel they need to talk through what happened at thier last delivery. A midwife goes through your notes and explains why things that happened needed to happen.

I've been thinking about this ever since we left the hospital yesterday and this is the conclusion I've come to so far...

I'm not scared of giving birth - I'm scared of the hospital midwives.

I trusted them completely last time and ended up feeling completely uncared for.

A registrar gave me a stretch and sweep which was one of the most painful bits of the whole labour. It made me scream and back up the bed!
No-one told me I had Strep B until someone came at me with a big needle ready to give me AB's. Apparently it had been on my notes for days.
They induced me and it didn't work - OK not technically thier fault but their care of me once I was in pain was awful.
When I asked for pain relief, I was told I couldn't have any as I was about to go up to the labour ward - this then took 3 hours.
When I asked for pain relief - they acted like I was being a PITA - too busy chatting.
When I asked for help putting my TENS machine on - I was told it was too early!
They sent me for a bath to try a relieve the pain but just pointed down a corridor to the bathroom and left me to it. I had to find the bathroom, run my own bath and try to get in. I felt very alone and scared and was in no state to relax. I was overly worried about getting my wristband wet and ruined.
I was throwing up and wetting myself and no-one even noticed (at 4am - not many people up and about!)
They sent my DH home after I went into labour.
My DS had a flat heart rate for more than 24 hours before anyone showed a chart to a consultant!

Nothing went right until I was sent to surgery - perhaps that's why it fels so safe??

Recovery from my 'normal' labour: 3 weeks
Recover from my elCS: 2 days

Don't assume VB has speedier recovery than CS, especially for a first birth, which yours will be.

Ultimately, you have to do what you're most comfortable with - but FWIW, I've had an ELCS and a VBAC and there's no doubt that I recovered much quicker from the VBAC - even with an episiotomy and stitches!

I was so undecided - right til the very end - and am incredibly pleased that I had DD 'normally' and it was such an empowering experience, but I was in no way convinced whilst pg and tried to persuade the docs to bring the ELCS date forward from 40+12. In the end tho', I went into labour at 39 weeks, and even with CFM I stayed upright for nearly the whole time, meaning it was all pretty quick. I'd also done lot of OFP work before labour to get DD into a 'good' position.

Would you feel better if you had a doula or someone else to help support you if you're worried about MW support? Have you thought about some refresher childbirth classes to help you and DH focus on what you want this time? We found refresher NCT really useful.

Good luck whatever you decide Either way, it's lovely having a new baby!!

I did thrice weekly AquaNatal classes to get Ds into a "good" position, not to mention spending hours on hands and knees and he was still back to back!!

Can't afford a Doula either I'm afraid. I'm a SAHM so we have very little spare cash.

Will probably go to the Antenatal classes again although I didn't find them all that helpful last time. Got most of the information I needed from the "Pregnancy Bible" I bought at the beginning of my pregnancy. Did make some good friends though

I don't want to 'talk you into' a vbac but a few things leapt out of your post and have already been picked up on
I'm surprised the blood loss/apgar score was described so dramatically. I always thought 6 was not so bad and rising to 9 in 5 minutes sounds good.
I'm not at all surprised you were in pain and I'd be very sceptical about the knowledge of anyone who would say you have a low pain threshold just based on you finding being induced excruciatingly painful. loads of women find induction to be waaaay more painful than natural labour. you can't move round, you have a drip with synto giving you overly strong contractions, you are lying on your back - of course it hurts more. am very anyone would suggest you have a low pain threshold based on that!
so I am wondering what on earth your 'debrief' person was doing to make you come out of that meeting feeling so bad about the whole thing!

I had pre-eclampsia/failed induction - got to around 5 cm, drip, excrutiating pain, ds1's heartbeat fluctuating - with ds1 and went on to have a 5 hour easy as anything labour with ds2 and then a hbac with dd. had ventouse with ds2 and the episiotomy was no trouble at all, back on my feet hours after the birth, was great.

anyhow, lots of info at www.vbac.com as well as on here to help you make up your mind.