VBAC after elective caesarian - any advice?

[AllieM]

I am 39.5 weeks pregnant with my first baby. Due to a long-standing back problem and a damaged disc in my lower back (L5 disc), and following the advice of two orthopaedic surgeons, I have the option of giving birth by C-section and am booked for it on Thursday morning (19th May). I am not necessarily keen to do this but initially thought it best to take care of my back and thought a C-section wouldn't be so bad this time round, and that I had a good chance of successfully giving birth vaginally next time round if I strengthen my back sufficiently in between babies.

However the statistics of successfully delivering vaginally after an elective C are apparently only 30/40% in my favour. The obstetrician and the midwives all seem to be of the opinion that whilst it's not impossible to give birth vaginally after an elective C, it's very unlikely I'd succeed. This is because my body will not have experienced any kind of labour first time round and will therefore be under a lot of pressure second time round as it'll be like a first birth, and there's a risk that the scar could rupture and the baby could become distressed.

I don't want to damage my back; but I don't want to condemn myself to C-sections from now on whenever I have children, as I really want to experience vaginal birth. I'm not saying C-sections are always bad at all, it's just from my POV I'd like to try it naturally. If I don't, I may never know if I could.

Has anyone else experienced birth with disc problems in their back, and also has anyone experienced VBAC after a first-time elective C?

Many thanks, and sorry for the long essay!

allie, it's not "condemning" yourself to a c/s if that's what you choose: you would simply be making a risk assessment on the advice given to you by professionals. personally i can't see the reason for having your first baby by c/s and then a vbac..if you feel that strongly then why not deliver vaginally first time round? it's up to you though, once you're armed with all the facts. good luck

Hi Allie
Success rates of VBAC vary from hospital to hospital. "They" say you have a higher chance of achieving a VBAC if you had an elective than if you had an emergency section.... not sure I agree from my own professional experience (I am a birth doula).
Risks of uterine rupture are very low... nothing to do whether you did or not experience labour last time.

Have you considered a doula for this? We work a lot with women who want VBAC (half my "clients" want a VBAC and achieve it too).
If you want more info on what doulas can do to support VBAC, feel free to asks...

Sorry just realised this is your first
I would try to start labour naturally and aim for a section in labour if you feel it is not going well...
Also you could aim for an epidural and deliver on your back without putting on any extra strain on your back.
Can I just say that labour isn't hard on the back.... but I am not sure I understand how bad your back is.

Hi AllieM

i had a c section with DS as he was breech. DD was VBAC last week! I was induced and although carefully monitered had no problems at all - only took 5 1/4 hours.

I am so pleased that I stuck to my guns as registrar was pushing for c-section.

Yes there are added risks but you have to weigh up what you want to do.

Good Luck

Hi i agree with the others.I am a Maternity care assistant, and am going to train as a doula, I supported a mother who gave birth naturally,she had spinabifida. she had a lot if back pain in her normal day to day life and although she did experience some back pain during labour is was because the baby's position was back to back. This can be very uncomfortable on the back no matter what state your backs in. so I really think it is well worth considering trying labour to see how you get on, you may find you have a good experience.

Oh, try it vaginally, try it! I had an elective cs with dd (coming feet first). Then I had placenta praevia with ds (chances of this are doubled after you've had a cs). And when they did the cs to get him out, they said the scar from the first time had split open and they could see the placenta through it, and would I please not have any more...

Just my experience, loads of people will tell you of their fabulous vbacs!

Nice guidelines on cs / vbac

I had a VBAC after an emergency c-section and I am pleased I did. I was absolutely terrified of the possibility of uterine rupture but all was fine that way. Despite having a nasty forceps delivery and episiotomy which is still bleeding 7 weeks later (have posted on another thread about that!) , I am actually still pleased to have avoided a c-section as it was really important to me to experience the vaginal birth. You will never know if you don't try!!

Hi
I had a VBAC but after an emergency section with my first. There is a link here which may be of use vbac

Hope that works, not tried a link before!

You have obviously had loads of discussion about this (ortho surgeons advice etc) but from your post it sounds like you are doubting your decision. Go with your gut reaction (!)
IME recovery from vaginal birth is far quicker and easier than from Csection - the fact that you have "no" stomach muscles could mean extra strain on your back after the birth.

Good luck with whatever you decide and wishing you a lovely healthy baby (in the end that is what matters).

AllieM I have had a sore back for 7yrs.In my first pregnancy I had an Emergency c-section as it was a long labour baby distressed etc then 4yrs later I had a vaginal birth, which In my opinion was much better but what I would say to you would be if you did have a trial of labour first time round, keep moving about as much as possible and try and avoid any pressure on your back, and if you decide to deliver try to go on all fours to keep your back from further damage. As I had a previous emergen c-section I was confined to a bed to be monitored with the vaginal birth and because of the 5hours laying on the same position on my back I damaged my back further, I am now in more severe pain than I was before the vaginal birth. But If I had been allowed to move about I would have avoided damaging my back further.