Are these normal restriction for a VBAC?

[LissyGlitter]

Had an antenatal class last night. Apparently, as I am a VBAC, I will be strapped to those annoying monitors (so stuck in bed, on my back), hooked up to a drip, internally examined every two hours, not allowed to eat, not allowed a bath or to move about and encouraged to have a full on epidural. Oh, and I have to rush into hospital at the first sign of labour so no waiting for labour.

I obviously don't want to put me or the baby at risk, but I had visions of walking about, eating lightly, spending time in the bath and being left to listen to my body. I was also quite keen to stay at home for as long as I could. I'm quite keen on an epidural (wasn't allowed one last time as I apparently didn't look in enough pain ) but would like to at least try the other methods first.

I had an utter nightmare last time, feeling completely out of control and being told I couldn't be in as much pain as I was (only got gas and air and they seemed to think I would refuse paracetamol because they wanted to put it up my bum!) before they made me walk between two delivery rooms and, from my walk, decided to examine me and found out I was 10cm with a very trapped breech baby. Cue a section that I barely remember as I was in such a state they had to pump me full of morphine just to keep me quiet and still! So I don't have much trust for midwives I'm afraid.

I dunno, if I am going to be full of drugs and led on a bed the entire time, it feels like I might as well have another section, then at least it will be over quick and I won't have to rely on my body doing its stuff in very unnatural circumstances.

What should i do?

Hi Lissy

I dithered and dithered over vbac vs elective (ask lulumama) throughout my second pregnancy after emcs with my first. In the end I had an elective at 41 weeks as I definitely did not want an induction.

My advice would be

1. Meet your consultant (not the house officer, not the registrar). talk through with them how you would like to labour, and be prepared to find an acceptable compromise. My consultant was brilliant. She said that she would support me in not having continuous monitoring and to refuse a canula, if that was what I decided, wrote it on my notes. She went and got a monitor and let me try it on to see how far I could move, and actually it was definitely possible to move around the bed and remain upright. She recommended I consider a doula.
2. Remember that you can unhook the monitor easily at any point to go to the loo, have a bath whatever. You shouldn't need a drip at unless you are on IV antibiotics for another reason. A VBAC doesn't have to be totally medicalised.

A good book to read is the The Caesarean by Michael Odent. And talk to Lulumama. Good luck with whatever you decide.

Sorry I missed the bit about your scar - you definitely need to talk through your previous notes with the consultant. Then you can make an informed choice

i have had two attempts at vbac.
My first attempt ended in an emergency section, was awful.
I was induced (not advisable for vbac) because I went 3 weeks overdue. My contractions were hyped up with hormones, I was given an epidural and no-one listened to my protestations at the fact that the drip was turned up too high, and that ds was hitting my hip bone with considerable force with each contraction, that something was quite wrong. In the end the consultant finally appeared and sent me for an emergency section, I was given a ga. Ds was cut on his head where they had to haul him out with forceps, and spent the days and nights for a month screaming continuously, I believe as a direct result of the birth. He now has unknown physical problems, and severe autism, and I sometimes wonder if it was a result of the birth although I will never know. But I can see that the c-s was absolutely necessary for him.
I then had a vba2c, which was very different. I was again given the same restrictions as you, but chose to not go along with them. I knew that ds3 was in a good position, labour started only 6 days after my due date, he was not a large baby, and I was much more confident. I refused all intervention, removed monitors except for 10 minutes in every hour, forced the midwife to monitor my pulse, went walkabout around the hospital when ever I wanted, etc.
He was born without problems.
Again I am still classed as vbac, and am doing the same thing. I was told to have the same restrictions as you, but I have refused. I am not going to hospital at the first signs of labour, and I will not be continuously monitored. If I did it last time then I can do it again. I will be better able to monitor this baby and speak up as long as I am not numbed by an epidural, or laid out on my back. I will not trust the midwives, nor will I necessarily mistrust every consultant. I may ignore the registrars, especially the ones who pay no attention to what is happening to my labour, and barely meet my eye, and talk in a text book manner.
I wish it wasn't so hard.
You need support to make the right decision for you and your baby. I don't know anything about your particular scar. I wish you all the best, and do not be afraid to make the best decision for you and your baby.
Take care,x

I'm 40 weeks tomorrow and hoping for a VBAC (although resolve is weakening with each passing day that I am still pregnant and uncomfortable). My hospital has two wireless monitors, that are prioritised for VBACers and others who need continuous monitoring. With these monitors you can move around freely, including leaving the room for a walk and using the pool, bath or shower. Maybe your hospital has some like that?
I actually want continuous monitoring, as without it last time I wouldn't have known my DS was in trouble. And I've also been told a canula is advisable, and I really don't have a problem with that. I'd rather have one in than have one put in in an emergancy, it's not like it's going to get in the way or anything.
You can go into hospital when you're ready too, but maybe you will feel that you want to be there when things start to happen anyway? I think it's important that you have things the way you want them, but it's also important to realise that there are reasons for protocols around VBAC, and be prepared to make some sacrifices for a safe delivery. Because, at the end of that day, all any of us really want is a safe delivery!

I was continuously monitored but for my first vbac, yet that method failed to pick up any problems.
It depends on the midwife I think.

You got the info from your class not the m/w or doc?

I've had vbac & have been upright, no pain relief & only monitored for about 10 mins for one vbac as no time! All were very quick births - one I was on my side, one standing up & the other sort of kneeling.

I had a scan at about 36 wks to see the thickness of the wall of the womb & it was fine.

Let your medical team know what you want & it should be agreeable.

Info here about classical scar rupture

www.obgyn.net/displayarticle.asp?page=/pb/articles/uterine_scar_rup

Hello Lissy, sorry to hear you've been given advice thats upset you. Who was hte antenatal class with...the hospital??

Personally i would make an appt. to see your previous consultant as the risks are higher with vertical scars if i recall corrrectly. Have a look at hte NICE guidelines for c/s here. If you speak to your midwife she should be able to arrangeg this...if she is unco-operative ring the hospital ward as i succesfully did!

I had an em c/s with ds1 then attempted a vbac for ds2. I was continuously monitored but was able to move around if i wanted (although i didnt), i defo wasnt examined every 2 hrs...once when i went in and then again 4 hrs later though was fully dilated then.

I didnt go in as soon as it kicked off as i had to wait for DH to get to York from Manchester with contractions 3 mins apart, not the best hr of my life so going in straightaway not necessarily a bad thing!!

TBH i didnt mind about the monitoring as there is a (small) chance of rupture and i would rather know asap if there was a probelm. As it happens ds2 was showing signs of distress, v. high heart rate. Then they burst my waters to hurry things along and there was lots of meconium so i ended up wiht anohter c/s in the end. Ds2 was fine though.

I would speak to the consultant as he will give you hte actual info relating to you, rather than some generic advice in a class.

Lissy, I had a vbac.

The registrar was a royal pita. So antsy, wanting to monitor me the whole time. I told her to buzz off. I wanted to get on with it without being forced to lie down which I knew would lead to interventions.

Please don't let anyone scare you or bully you into something you're not comfortable with. Inform yourself so that nobody can do this to you.

Interesting reading

Good old Mary Cronk - guru midwife!

More midwives

Also, have you considered TENS machine, gas and air or water as a means of helping you with the pain?

Good luck.