Please talk to me about VBACs

[LuckySalem]

I'm due in March and have requested a VBAC.

I'm about to write my birth plan which is basically gonna state DO NOT TOUCH unless you ask! lol but I dont know what I need to be specific about.

My MWs have been pretty pants - they won't "talk" to me about stuff, they've just spouted rules and regulations at me with no specific reasons as to why.

So please share your VBAC stories with me - specifically any where MWs have tried to get you to agree to something, even if they were right

Thanks all

I know, I know I'm nagging but anyone?! lol

I had a VBAC at home 5 months ago (had a fight to get it, but after lots of research managed to persuade consultant!)

I would not allow CFM so they listened in every 15/20 mins with a hand held machine (didn't get in the way of me doing anything), they also checked pulse each time
. I wore a canula (just to keep them happy but was not a problem for me). I did have a sweep to get things 'moving' as I was over and they were 'pushing' me to be induced (big no-no for me, would rather have had a planned section). I didn't progress from 4/5cm's for a v long time so I let them brake my waters (they 1/2 your time limits for a VBAC). I did have a long labour as it was back to back, but had excellent, confident midwives with me and they kept in contact with Head of Midwifery throughout, so managed to get my 'time limits' lengthened. The reasons I opted for homebirth: live 5mins away from hospital, felt I would have more control at home, felt interventions would have been less, you get 1 to 1 with homebirth so felt safer (i actually ahd 3 midwives, 1 student and my husband on my bed with me when I pushed baby out(!)...they were holding me in a vvvv strange position b ut it worked!!). It was amazing!!! I wondered around the house eating and drinking as i wished. Used birthing ball, tenns machine, in and out of the bath, listened to music, laughed, joked, burnt some essential oils etc etc.

Research all you can, I found 2 bks a particularly good help. 'VBAC' by Helen Churchill and Wendy Savage - an absolute must, small handbook with all latest research in. Ina May's 'Spiritual Midwifery'. Also websites such as the homebirth one and ceasarean one vvv good.

Sorry I've probably waffled! It was a truely amazing experience and definately want to do it again one day! If you don't get anywhere with your midwife ask to have a meeting with the Head of Midwifery to go through your birth plan with and she/he will sign it off for you, as long as you're fully informed of any consequences etc.

See no-one is talking about my birth plan either - i'm just getting told of the rules as though that's what's gonna happen.

Thanks Mama, I wanted HB but after my ECS I can't and although I want to push my way through I'm aware that DP would feel more confident at hospital and that as long as I'm left alone and back out of the hospital ASAP it's not the end of the world.

I think you definately have to birth where you will feel more confident, and for many women that would be in hospital. It doesn't matter where you have LO at the end of the day as long as you're both well at the end! To have a good birth experience I do believe it's all in the control you feel you have/had. So a birth plan is a must and take every scenario into consideration i.e have a 'c' section birth plan - just in case
. I for example would have felt ok about having another EMCS IF it was absolutely needed and I had known I had tried everything. Which is why you need to inform yourself of all of the facts...you have loads of time to still do that too

Yeh the probs are that I dont know the specific risks to me, I've never been told. I got told something about a rupture but thats it. I dont know if thats a standard risk or if I pose a higher risk to get that or if there are any other risks that I have that I dont know about.
MWs are just not helpful.

I know I should talk to the head of midwifery but I'm too scared to cause a rucuss in case I have to see the MWs at the birth and they're a pain.

Makesure you get your birth plan signed off by consultant/head of midwifery once that time comes. Then you won't be pushed into things when you get to the hospital. Also makesure DP knows exactly what you want so he can be your voice! I told my DH that under no circumstances was I allowed to ask to go to hospital for an epidural/section, if I did he wasn't to allow me!! (I didn't by the way!) I explained to him that during "transition" I may come out with these things but that it was a good sign that I would nearly be there!

Talk to your Head of Midwifery - they rock! I have had 2 VBACs. For the first one, I pretty much did as I was told, but it was OK because my hospital is very pro-VBAC, and were saying from the first that there was no reason why I couldn't give birth vaginally. Second time round, with the help of a great community mw and the Head of Midwifey, I had a birth plan for monitoring when I went in for 30 minutes, then labour in water, then out to deliver (had PPH with DD2, hence desire for me out of water for delivery). Also, have you heard of telemetric monitoring? It's a wireless system, so you can move about more easily, and can also be used in water (which my cons didn't realise, only the mws seem to know).

None of the mws seemed at all put out that I had talked to the Head; in fact, I think they found it reassuring that their boss had supported all this. In the end, it went down the Swanee as I had to be induced (nothing to do with my VBAC, DD3 was at risk from HDN) but it was still a fantastic birth, as the plan made them see how little intervention I wanted. And DH was much happier with me in hospital rather than at home (35 minutes from hospital, he doesn't drive).

Hope you can get what you want

That's what the HOM is there for! Don't worry about the MW's they'll just be 'covering' themselves. You sound as though you need a 'de-brief' about your last birth. With every VBAC you have a chance of rupture...that is the risk, that's what everyone worries about. Obviously it's a worse case scenario but unfortunately it does happen. The Risk is: (NICE guidelines) 3.5% chance of scar rupturing during labour apparently most of these ruptures (in the 3.5%) are where the scar opens very slightly causing no health risk, serious wound opening is a very rare complication.

Ok so how do I contact the HOM? I would like a debrief on DD's birth. I tried to get the registrar to do it but (without sounding mean) she was foreign so I could barely understand her and it was obvious she wanted me out of there ASAP.

Thanks for you experience too poledra.

What do I need to specify then cos I assume if I go to see HOM I should have a birth plan ready for her/him to sign off?

My VBAC didn't work, but I am so glad to have gone for it.

The parts of my plan that I got:

• stayed at home as long as I could (until I was ready to push in the event as I was expecting a longer labour)
• no epidural in labour
• no augmentation
• no CFM (until hand held monitor used after each contraction in the second stage showed foetal distress. Then I was happy to have CFM)
• being active and mobile (actually I was pretty stationary on all fours when it came to it!)
• eating and drinking when I felt like it
• in the pool when I got to the hospital.
• no internals (although the doctors did do these when things went pear shaped, and also broke my waters which I would not have wanted in different circumstances).

I didn't get the other bits because I had a section under GA in the end, but if things had gone smoothly I'm sure my wishes would have been respected. They included natural third stage if possible, no episiotomy unless necessary (and local anaesthetic if it was necessary), no arbitrary time limits.

I also wrote a c-section plan just in case. We couldn't follow it because I was under GA but the thing that was most important to me was that the baby not be taken away from me and my DH. In the event the IM I had hired to act as doula was able to stay in theatre and took the baby straight out to my DH once the paeds people had checked she was ok. So it went about as well as it could have in the circumstances.

They can tell you what they want you to have, but you do not have to agree to any of it. You should be clear on what you want for which research is key. Also, speaking to the consultant midwife is a good idea - she will be able to tell you what hospital policy is and then you can work out how you want to deviate from it.

Good luck - I hope you get what you want.

Thanks MrsHappy,
Will remember about these then. What you've put is basically what I wanted! lol