natural birth after caesarean - help

[crazynow]

Can anyone give me advice/help/pros/cons on having a natural birth after a c/s. With my ds I had to have an emergency c/s which took me forever to recover from. I am now 25wks pregnant with baby no.2 and have spoken to 2 consultants, 1 said yes you will have to have c/s and the other said no you can have natural birth. So I asked my midwife and she was to busy to talk (this was in my 24wk appointment which wasn't until I was 25wks as it was a bank holiday and she is only in on mondays and the last time I saw her was at 12wks, yes I didn't see her for 13wks!! it was never like this with my 1st. Sorry). So any way she gave me a leaflet and said that should cover any questions I have.

Can anybody out there give me there views/experiances?

I personally can't offer you any first hand advice but there was a thread on here recently re VBAC by a mumsnetter called Kaz33 (i think). Perhaps you can track that thread down or make an appeal for Kaz direct ?

Hope you find the info you're looking for.

Here's the thread WSM is referring to, Crazynow: Once a c-section, always a c-section - there are other useful threads on the subject if you put "c-section" into the Search Boards box.
I am facing a similar dilemma myself although my first delivery was an unavoidable elective rather than an emergency. It was still not much fun, I must say, and like you I took a long time to get over it.
It's always a nuisance when the midwives are so rushed off their feet they don't have time to chat, isn't it...have you thought of finding an NCT Refresher Course in your area? Mine starts Monday and I am hoping to get a good update on labour, pain relief, VBAC etc from that. I'd recommend these classes because they give you what the health professionals sometimes just can't - time to discuss and reflect with other parents and a qualified course leader. My NCT teacher is fab (we had her first time round) and I would consider her an asset in any delivery suite!

I had a chat with my consultant about it (I had am emergency c/s with ds1) - basically a lot of it is related to the reason for the first c/s, and whether the reason is likely to be repeated. So a c/s because of a breech baby would only require a second c/s if the second baby was breech.

There are a couple of circumstances where once a c/s, then always a c/s, which include a vertical incision having been made first time round. A c/s for foetal distress would by itself require a second c/s (2nd baby may not be distressed). However if there had been failure to progress then the likelihood of a 2nd c/s was higher, but certainly my consultant would be happy for a trial of labour.

In my own case the first c/s was a mixture of foetal distress, failure to progress, and a large OP baby getting stuck (I'm just 5 foot tall - ds1 was 9lbs 3 with 38.5 cm head circumference - ie 99th centile!). On discussion, the consultant thought that if I went for trial of labour, there was still a 40-50% chance of needing a second c/s - ds2's head was only 37cm (91st centile), though the scan was indicating another large baby. As ds1 is 2 and a bit, I opted for an elective as at least I could plan for someone to look after him whilst I was in hospital, and make sure that I have help whilst recovering. I had a very good recovery first time round. This time has been a bit more painful (ds2 is 4 weeks old today!) but still OK.

Oh and not trying to outdo you, but I only saw my midwife at 12 and 28 weeks! I did see a consultant after my 20 week scan though, and again at 36 weeks. Didn't see much of the midwife first time round either - in fact saw her more after the birth than before!

crazynow - you're bound to get loads of views both for and against.

I had emergency c-section with ds1. It also took me months to recover from. With ds2 I really wanted the natural birth I'd wanted for the 1st. I got my wish, but unfortunately I tore badly and that took me even more months to recover from - about 10 or 11, and this time it was 'down there' so sex was a real problem (especially for dh!). Every doc I saw was positive & saying there's no reason I couldn't have a VBAC. For me it was not a good experience.

I'm now expecting no. 3 & am seriously considering an elective c-section. Even if it's as bad as the 1st one, it can't be as bad as the natural, plus I'm really frightened of re-opening all the tear and going through all that pain again.

Of course, you might get your 2nd birth and go through it just fine.

You don't say why you had emergency section 1st time - could this be a relevant factor in the 2nd pregnancy/delivery? I'd push next time for a LONG chat to cover any questions a silly bit of paper obviously hasn't covered. SEnding you my best wishes. Good luck.

For me, I'm thinking pros of elective section - as already had 2 kiddies, will need to arrange help - my family are all a plane ride away, so this will give the opportunity of being organised, rather than a 3am 'phone call - her waters have broken - try & book a flight!

I feel that at least I will be in control of the damage done to my body.

No hideous pain where it hurst most.

I've had 2 surprises, so the calm, organised experience will be welcome this time.

crazynow- it all depend s on why you had your first c-section I had an em-section with dd due to the fact she was facing head down but outwards(sorry dont know the medical term) she then managed to get stuck in the birth canal, ventouse and forceps wouldnt budge her so em-section it was. With ds I was told it was my decision, the consultant thought I had a very narrow unusual shaped pelvis and I have a retroverted uterus so this may have made delivery more difficult.

I opted for elective section and it was much easier, very straightforward, and I was home within 2 days. That was my choice, me and dd were very traumatised after the 1st birth and I couldnt risk this again for my 2nd child.

But as I say it dpends on your circumstances, what the consultant advises you and what you feel happy with.

Midwives agree that elective sections are easier to get over than emergency ones.

DS2 now 7 days old, i had an emergency c-section with ds1, pretty much the same circumstances as fio2 and again given advice by consultant that it was my pelvis.

ds2 baby also op position, but after a long labour managed to deliver naturally. Bit busy now as DS2 requiring attention but will post later. It however was one of the most awe inspiring experiences of my life, so proud and glad that I did it. It was touch and go whether I would make it and don't know if I could have handled another ceaserian after a 30 hour labour.

I totally by luck had a brilliant midwife which made all the difference. If you decide to go for a VBAC then I would strongly recommend that you get help ie: a doula. I didn't thinking second births always quicker, it wasn't in my case. Now I realise how lucky I was to get what I wanted.

Hope that makes sense.

Thanks everyone, it has given me a lot to think about.

The reason for emergancy c/s was a mixture of foetal distress and failure to progress. The 2nd consultant has said that it's my choice, but there's no reason why I can't have a natural delivery.

I will read the thread that Marina showed me and I will contact NCT.

Thanks again everyone.

Crazynow - as everyone says - the reason for your first ceasarean will give some idea (no guarantee) as to whether VBAC or 2nd section is a better option.

If you have no real reason to avoid a section (and there are more reasons to have a 2nd section than the one listed below) you and your baby will be safer having a vaginal birth. As you know a section is a major operation. Of course if you need a section than you need a section. But a vaginal birth remains safer and on the whole you will recover faster (again there are exceptions).

You seem to have laboured once so potentially you should have an easier time but there might be issue about the size or shape of your pelvis which would make it safer to have a second section.

Faliure to progress at what stage?

I had an elective section with DS - he was breech. 2 years later I was induced with DD and that was a natural birth.
great to have eperienced both - but I'd opt for the section with regards to the actual delivery as it was pain free and all very civilised. DD's birth was bloody painful - but recovery was a lot quicker.
personally I would think that it's your choice and go what whichever option makes you feel more "comfortable" - it that's the correct word !!

Rollercoaster - What induction method did they use on you?

Hi pupuce, my waters broke 4am tues am (trickling not gushing - was sent home), my contractions started 10.30pm tues, went into the hospital at 2am weds. They put me on monitor for babys heart, but they weren't sure if the machine was faulty or it was the babys heart keep stopping. I was only 1cm dilated.

7.30am they started to induce me by drip, still only 1cm dilated. Basiclly no change with dilation or babys heart, so at 11.30am emergency c/s.

Nothing has been mentioned about my pelvis, so I asume that it's all right (nice and big).

I would love a natural birth (mad I know!!), but I'm just so mixed up with what is best, it's all just whizzing round in my head!

Sorry about the novel, I just can't help myself!

crazynow - as a midwife I would say that there is no indication for a repeat C/S unless that was your personal choice. If you want to try for a vaginal birth then you should. The research evidence is that mothers who have had a C/S should not automatically have a repeat C/S. In your case, you have to view this as a different pregnancy, baby therefore different labour can be expected. Go for it - if you don't, you will never know. HTH.

I am astounded at "they were not sure if the machine was faulty".... How DARE they not use a hand held monitor or another machine or a pinard for that matter.... that's technology gone mad and YOUR detriment.... sorry I need to rant!

From what I read of your last labour.... it smells of mis-management and not evdience based midwifery !

GO for a VBAC

How many weeks were you ?

Pupuce, I was 40wks pgnt, spot on my due date.

Thanks Mears, I will go for natural birth. I'd said to my midwife when I saw her at 12wks that's what I wanted, but it was the 1st consultant who said that I would have to have a c/s and that's what put the spanner in the works.

Crazynow - I am so glad that I had the natural birth after my first c-section. It is a totally different experience and has totally wiped out the negative experience that I had with the c-section.

Its easy to say with hindsight and no doubt if I had had another c-section I would not be posting in the same way. It is a risk, but it is a new birth. For me it paid off.

Good luck with your VBAC.

crazynow...I would strongly recommend a vbac..i have had 2..and they were SO much better than my 3 sections...Next time i will fight tooth and nail for a vbac and WONT be swayed by the 'lies' spouted at me by obstetricians!