Had VBAC and want HomeBirth this time...consultant thinks otherwise.

[Mung]

I have just come home from seeing the consultant for my check up as DC1 was a Emergency CS. DC2 was a VBAC 19 months later and now I am pregnant again. This baby will be born 4.5 years after the CS and I was hoping to have it at home. The midwife was supportive when I saw her, but the consultant said that I am now higher risk than last time as the scar has already been weakened. I presumed that the scar had been tested out and proved good and now I would be low risk again, so I was shocked.

I feel stupid that I thought they would say 'yes, thats fine' and that I hadn't really done any research to fight might corner. Instead I did my usual routine infront of people in the medical profession and just nodded and listened.

Now, I don't know what to do, as I obviously dont want to put the baby at risk and I would be doing that if I were at home and had a uterine scar rupture, but the chances of that are slim.

I know that ultimately its my choice and that the medics are there to advise not dictate, but I do want to feel confident if I go for the home birth and at the moment I don't.

Any advice?

Bumping for you. Interested to hear. I'm hoping to conceive no 2 soon and keen to find out how you persuade consultant to do it your way.

Good luck!

I am attempting a home vbac. I haven't seen a consultant and am not planning to, instead I have gone with Independent midwives who have a lot of experience with home vbacs. I know for a fact they have just helped a women with her second home vbac and that first time round they had to deal with a lot of grief from the consultants but both labours were straightforward. Anyway, if a home vbac is what you want and your midwife is happy and you have a normal pregnancy etc then go for it.

Mung, I found this useful when I went for my second vbac last year. In summary it says that the risk of uterine rupture decreases and the chances of success increases the more vbacs you have. hth and good luck.

The choice is yours - obstetricians cannot force you to any particular course of action, no-one can force you to go into hospital for the birth if you would prefer not to. They should explain any risks and leave the decision to you.

Ask to speak to the head of midwifery and ask for her support in having a planned home VBAC.

Good luck

Thanks for the advice. I know it is ultimately my decision, but I feel I need to find out what has happened in the past if people do have a rupture at home. Surely, the time it takes to assemble a team in theatre is the same as the 10 minutes it takes for me to get to the hospital.

I think I will contact the Head of Midwifery and see what she has to say.

Please talk to Debbie or Gina on this webwww.caesarean.org.uk/site, there are loads of useful links on their site as well.

Had a VBAC2 in 2005 and now am having a home birth for my 4th. This is exactly why I am refusing to see a consultant this time and dealing with midwifes only who are the experts in normal births.

Please remember this is your choice, bloody consultants

I had a vbac at home, however I also had an Ind MW as I really didn't want the inevitable fight with the NHS.

From conversations with my Ind MW, she says you don't all of a sudden keel over with a uterine rupture there are warning signs (raised bp, increased hr, scar pain).

All of these mean closer monitoring is required, therefore (imo) it is safer to have a mw at home with you for the majority of the labour who is monitoring and focusing on you, rather than being strapped to a machine in hospital and left for hours on end with no one checking on you.

Cynical? Me?

Not a VBAC, but I used IMs when I chose a vaginal breech birth for DD (my 1st). As they aren't fettered by the policy of their local PCT they tend to have a lot more experience of the more unusual variations of normal birth than NHS MWs get to see. I did see a registrar, and I regret it as I just got quietly irrate while not really saying anything useful.

If I ever have any more dealings with Obs, I'm going to try and remember to ask for the research that backs up their recommendations.

Its worth calling IMs near you - most are very happy to talk regardless of whether you book them (although they can only discuss generics), will be well up on the current research and will be able to give you an alternative view (they may even know whether the consultant you spoke to is generally pro-VBAC). (If the only thing putting you off IMs is the price its still worth talking - lots are happy to accept payment in kind and/or deal in installment plans).

Fingers crossed you can find the info you're looking for and get a birth you're happy with this time round

had similar situation, ds1 born em c, ds2 born 17 months later vbac, then had hbac 3 years after that. I was very relaxed about the scar rupture risk and didn't intend on having cfm in any case. I didn't get involved in a big discussion with the consultant or mw, listened to why they thought hospital was best, thought about it and decided on hbac. I also got a doula - worth her weight in gold.

hbac went fine, birth was fine, also had pool (which I wouldn't have been allowed in hospital) and was very happy with my decision. have to say though, the labour was longer and more painful at home and I think this was cos I called the mw out early just to make sure they were there and didn't try to wriggle out of it. with ds2 I'd laboured at home for almost all the birth and only went in for the last hour. his birth was much quicker and less painful.

you will no doubt think this is hippy nonsense but as I went into labour, I went upstairs for some quiet time with my unborn baby and to ask her if she was ok with being born at home. if I'd felt doubts then, I would just have gone in and not called out the midwives. you can change your mind even in labour at any time and go in to hospital

Hi Mung,

I had a Home VBAC 15 wks ago at. 15months after ECS. I fully researched and informed myself of all the risks and advantages etc. Spoke to consultant (not happy), spoke to another (signed an agreement for homebirth on my notes - VI to do this). My NHS midwife was very pro homebirth for me. I only live 5/10mins from hospital, so same thoughts about time taken to get crash team prepped. When having a home VBAC they have an ambulance on standby with all your details so they can transfer you IMMEDIATELY with no phaffing!! Had quite a few run-ins with registrars who were v aggressive towards me about my decision but I stood my ground (by completely ignoring them and following what I knew was right for me). At the end of the day if anything felt wrong or was wrong I would have transfered. But it was the most amazing experience, and so lovely to be able to crawl into bed with new baby and be left in peace! My NHS midwives were absolutely amazing, they were such a huge support through labour. It was quite wearing and I felt like I constantly had to fight my corner (which you do), but a relief and I'd say a 'healing' experience for me. It was definatley worth the effort!!

Next time I'll probably have a water birth at home, and save up to hire a doula as sounds like a great resource! Goodluck and do what is best for you, not them x

Thanks for all the support here...I need to have a more serious chat with my midwife who has already said that even if the consultant says no, she will support me. I know she would transfer me if she felt anything was up and I would be happy with that. I hope that she can put my newfound fears to rest for me.