VBAC v ELCS - Is it my choice?

[Pinkjenny]

I am currently 19 weeks pg with dc2, and next week I have my consultant appointment to discuss my options.

History: Dd was an ELCS due to breech presentation, and I found the whole experience entirely positive.

So, for my own reasons (none of which are medical, I might add) I think I would like to have another CS. Now, I have it on good authority from a well-known MN doula , that my hospital is Pro-VBAC, and that my consultant is a "VBAC Expert". This has obviously made me a little nervous about the fortcoming conversation. This is coupled with the fact that although I am generally quite a bolshy (not my most attractive quality ) person, I tend to be struck dumb when confronted with medical professionals.

I have a feeling that I will allow the consultant to talk me into a VBAC, and then come out and start panicing about it.

I have a list of questions written down, but I am just wondering, is it really my choice? I assume the consultant has to authorise my request. Any experiences or advice gratefully received.

TIA

I had similar history, DD1 was elective c-section for breech presentation. Wanted c-section for DS but told at cons app that it wasnt an option and there was no medical reason for section so it was VBAC. I wont bore you with the details but it ended in an emergency section for a stuck 10lb2 baby. The third DC was an elective section.

I would say take someone in with you to support you, if you really want a section you may have to justify why you want it but make it v clear what your wishes are. Hope you get what you want.

Thanks for sharing your experiences. I will keep you updated.

Lenin - I have a feeling that is exactly what is going to happen to me.

Mine experience was the opposite of Lenenigrads. Arrived at my consultants appointment and he very much expected me to be agreeing to another CS.

I wanted a VBAC and thats what I got, but I was surprised that the consultant assumed I would go down the CS route again when I had no need to ( not criticising others that choose to )

my experience

I guess the reason for my nerves is the knowledge that the hospital is very much pro-VBAC, as is the consultant, so I very much doubt it will be a straightforward choice. And I am more than happy to discuss the pros and cons, I just don't want to feel like I'm being talked into something, iyswim. The thought of an EMCS under GA terrifies me.

Good luck with your appointment PinkJenny. I guess the thing to remember is that nothing is set in stone and you can always change your mind. But it sounds from what lenin says that it would be easier to get a date agreed and then at least youve got that as an option and if later on you suddenly decide vbac is for you - go for it.

Hey Pinkjenny. I've read the VBAC book you posted me and I too have decided that I want another section. Would you like it back so you can take it to your appointment, show them that you've researched it and still want to do this....?

If there's anything I can do to help - you ahve my e-mail address...

Thanks GoldenSnitch, I was thrown by your name change!

Sorry, went with it for Harry Potter and decided I liked it

PJ.... I'm very much in the same boat as you... in my head I think another cs would be perfect, esp as I'm due Christmas day and it would mean the baby would be born before Christmas and I would be home by Christmas instead of lumbering around at 40+ weeks. That's so selfish I know!

The flip side is that this will probably be our last baby, so barring any accidents, my last chance to know what childbirth is like (f*ing painful is all I know!! ) so I'm totally torn between wanting the familiar experience I know I can handle, versus the fear, pain and lack of control of the alternative.

I don't have my consultant appt until early October, so I'm basically going to go in with an open mind, if they're very pro vbac and say I can't have a cs without a medical reason, then I will start hunting for a doula, I think that's the only way I'll be able to face it.

I'm due on the 27th December. Last baby. Went through 28 hours of labour last time but only got to 3cms. Even discussing what happened reduces me to tears

ELCS all the way...

And I'm due on the 31st December. Is there a trend here?

We all had a very boring end of Feb/beginning of April?

I had an EMCS with DS due to his (freakishly huge ) head getting stuck. The birth expereince for me was not a good one and when I was pregnant with DD I felt very reluctant to try for a VBAC. My experience when pregnant reinforced that with each of the 6 different midwives and 3 registrars seemingly unable to agree on how a labour would go (monitoring, coming straight in at onset or waiting etc etc.) so I plumped for a ELCS without any real medical need for it IYSWIM. I much preferred it, calm, organised, and home within 2 days and feeling fine within a couple of weeks. I know this won't be everyone's experience of CS but it was mine.
One of my midwives did say to me that if I had a second CS then I would never be allowed to have a VBAC so if you have any hankering to have a natural birth it might be harder to argue for it next time round.

My experience has been similar to what you describe re being told different things at each different appointment about how a vbac would be managed. It makes me think it kind of depends very much on who you get looking after you on the day and what they think about coming in early/cfm/moving about/speeding things up etc etc

If you need any reasons to back your choice of an elective you can ask about increased risk of instrumental deliveries for VBAC and associated risks of pelvic organ prolapse and nerve damage. You can also ask why so many consultants choose to have elective sections. I am a successive VBAC but my life is ruined from a forceps delivery. I would give anything to have had another c-section. Be selfish.

RuinedandUpset may have a point - when I had my consultant appointment last week and talked about wanting an elective I was given all the pros of VBAC and the cons of a section...

Then, at the end of the appointment, the consultant admitted that she had chosen a section for her second birth too!!!

So sorry to hear you came out of your VBAC so badly Ruined

Ruined - so sorry to hear what a nightmare your VBAC was. I'm another one in the VBAC vs ELCS camp and I'm really concerned that if I were to go for hte VBAC as is being v much encouraged I would also end up w/ an instrumental delivery. Spoke to a consultant (not one who was treating me) who said he errs on the side of ELCS with mums who've had one ECS because if you haven't had a straightforward delivery first time round chances are you won't the second either... I've also heard a lot of people in the other camp argue the complete opposite that no two births are the same etc. V difficult decision as far as I"m concerned.

Update:

Had my consultant appointment yesterday, and the conversation went like this:

Mr. Consultant: Have you had any thoughts about the birth?
PJ: Yes, I'd like an elective section, the experience was entirely positive last time, and the thought of an emergency section horrifies me.
Mr Consultant: Fine, we'll give you a provisional date today.
PJ:
Mr Consultant: Were you expecting a fight?
PJ: Yes
Mr Consultant: We are trying to encourage more women to go for VBAC, but if you were happy with your ELCS last time, I see no reason to sit here and try and change your mind. 29th December OK?
PJ: Er, yes.

That was it. No muss, no fuss.

Glad to hear it PinkJenny. 29th December sounds a very good date, you could be home on New Year's Eve in time for champagne and fireworks!

SmallScrewCap - that's the plan!