VBAC - your pearls of wisdom please.

[redllamayellowllama]

I had DS 14 months ago. He was back-to-back and presenting at a very funny angle. As such, there wasn't enough pressure on my cervix to get to the pushing stage (or this is how I understand it). After much umm-ing and aah-ing and observing, I had an EMCS on Wednesday after having gone into labour on Sunday. It was a horrible ordeal and I was certainly traumatised by it.

I am, however, very happily pregnant again and my mind has straight away gone to the matter of giving birth.

I was told in the day after DS's birth that I would have no problem having a VBAC, but I'm very nervous at the prospect. I feel like I want to give it a go, but am more scared this time round then I was prior to having DS. Having not actually got to the pushing bit, or been in transition, I've got no idea of the pain levels involved in that part and having experienced 1st stage, I don't know how my body would cope with any worse than that.

Can anyone offer me any words of wisdom/experience? It would be much appreciated.

Has anyone git

Please ignore last sentence, badly edited

Hello.I had an EMCS for the same reasons as you,and my labour was about the same length too!My DD is 22 months and I'm 23 weeks pregnant now and going for a Vbac.
Birth is very inpredictable but from what I've gathered is 'probably' the reason I didn't progress well last time was that the baby was in the wrong position,despite me sitting on a bloody big ball for weeks beforehand and staying upright for much of the labour!
So no personal experience but lots of ladies on here have had Vbac's.My local hospital and midwives are also really supportive so that makes a difference.

Good luck and congratulations by the way!

I've had a vbac. Go for it but if you do, be confident that you can do it. I swear it helps.

And move around lots. Don't lie down and let them monitor you all the time. Let them monitor you intermittently. Believe me if your scar ruptures (very very very rare) you'll know about it long before anyone looking at a monitor does.

Make sure that you have confidence in your midwife. If you're not happy with her at any time during labour, ask for someone else. You've got to feel supported.

I used a tens at the first twinge of labour and then gas and air. Both got me through it and I'm a total wendy when it comes to pain.

I felt very confident that I could do it. I told the nervy registrar to buzz off as she was hovering and worrying and p*ssing me off. Dd was born quite quickly. And I've had my ds since too - v2bac.

Good luck.

Thanks mrshoolie - same to you!

WinkyWinkola thank you for the advice, I guess confidence is the main thing in all of this. I was very confident in the lead-up to DS's birth and totally trusted my body to get me through things. Well it bloody didn't! I need to find some way of building that confidence up again.

Tens did nothing for me last time, gas and air made me throw up horribly and the birth pool actually made my contractions worse. Obviously, there's no saying my body will react in the same way to these forms of pain relief this time.

The only thing that did make a difference was the eventual epidural pre-EMCS. My concern about having an epidural is the raised possibility of complications relating to it, leading to another c-section. It would be beyond frustrating to go through labour and end up having another EMCS.

I think I would pretty much echo what Winky said.

First birth was an emerg cs after about 9 hours of established labour and I was 9 cms dilated.

I had a home waterbirth with ds2 and the labour was about 4 hours from start to finish. The second stage was only about 20 mins or 30 mins max and was a lot quicker than everyone (me and mw's) expected it to be as I hadn't got to that stage before.

I mistook transition for scar pain , but it didn't last long, and after the pain of contractions I actually welcomed the pushing bit. It actually felt I was doing something rather than letting pain wash over me.

If you feel you still have unresolved issues surrounding your first birth it would probably be a good idea to talk through your birth notes with a mw.

As Winky mentioned, I really do think you have to have your head in the right place. Believe in yourself and your baby.

I also listened to some hypnobirthing cd's which were for vbac. The first part was about letting go of the feelings surrounding your section. I found them great and it doesn't mean you have to use hypnobirthing techniques during labour.

Good luck

Believe you are going to have a VBAC
But be relaxed as to overall what ends up happening

pregnantpeppa it's nice to hear someone else's fears - your plan of action sounds like a good one. I've heard good things about hypnobirthing, might have a look into those locally. It was nice to do some yoga last time round and might make an early start on it this time.

I have a history of epilepsy, so a home-birth was ruled out last time, I hadn't thought of the possibility of one this time round. I'm not sure that I trust that everything will go smoothly and would rather be near a hospital if that's the case.

Good luck to you too - keep me updated!

ILikeTo that sounds like the kind of birth that I wold very much like to have! Thank you for your advice, there's some stuff I need to act on. I toyed with the idea of a de-brief a few months ago when thinking about ttc. I think now would be a good time to go for it.

Redllama,

If gas and air made you throw up then it may well do again. For some women it really doesn't agree with them.

Did you use the TENS from the very beginning of labour? It doesn't work well if you don't. Having said that, for some women again it doesn't achieve anything for them.

So, you need to investigate some other means of relief. Have you thought about water? Hypnobirthing? Lamaze technique? Do you have a partner who would be willing to help with massage?

An epidural certainly has it's place in giving relief from pain but with it comes the much greater likelihood of needing interventions like forceps, ventouse and C-section.

Also, do you think you have really had a chance to talk about your first birth experience? It sounds like it really upset you and I think it's really important you get some help with that. It can affect people for the rest of their lives. The fact that they weren't in control of decisions or in great pain stays with them. You could contact [http://www.birthtraumaassociation.org.uk/ The Birth Trauma Association]] to help you. Sheila Kitzinger has wise words on giving birth too.

I do know how worrying it can be and darned frightening but arm yourself with knowledge and make decisions from that. You may decide you want an elective section as a result. You may decide to go for a vbac.

Good luck. Let us know how you get on!

its place. Grrrr.

Birth Trauma Association

WinkyWinkola thank you so much for taking the time to write. Yes, I did use TENS from the outset and felt like it provided some relief at the beginning, but once I was in established labour it did nothing.

DH is very supportive and did a lot of massage, which did help massively (I'd forgotten that he had done this until reading your post, actually).

Water will help this time, I'm sure and I'm definitely going to have a look into Hypnobirthing.

Someone has recommended a book of Sheila Kitzinger's to me - Birth Crisis, I think. Will look into that one too.

I'm also beginning to open up to the possibility of a home-birth. My medical history might rule me out, but I can't help but think that my worrying about the journey in and the sanitized environment of the hospital contributed to my trauma, Having said that, had we not been in a hospital, things could have gone very badly for both of us.

Lots to think about. Thank you . May be back to ask some more questions as things progress.

I too am in the same boat - 18mnth old DS was back to back and "looking the wrong way" so I never got past 5cm dilated despite being in labour for 2 days.

I am 18 weeks pregnant with #2 and swing daily (sometimes hourly) from going for VBAC and ECS.

Thing that most puts me off VBAC is my hospital experience last time. I was actually going for a home birth and was at home labouring for most of the 2 days which was lovely - midwife popping in every couple of hours, all very relaxed. Eventually we decided to go to hospital as things clearly weren't progressing and the 6 hours in there before they decided to give me the section were miserable. The section itself was fine and I recovered very well.

So I guess despite quite liking the idea of going for it naturally, I am swayed towards the convenience and (I think) predictability of a section.

On the pain front - well, I don't know about you but despite not really getting very far, the fact that DS was back to back meant I was in A LOT of pain during contractions, especially once they started the drugs to get my contractions going, and because they wouldn't let me get up off the bed because they wanted to monitor me. Of course I don't know how that pain compares with the later labour pains - but I think they have to be pretty bad no?

How pregnant are you?

tallbirduk Your penultimate paragraph describes things perfectly. I have been told that back-to-back means more pain, but with nothing to compare it to, I don't know if my pain threshold is quite low or if that was particularly bad. Same thing with the syntocinon (the upsetting thing about the use of it for me, which I was quite anti, is that it definitely contributed to DS's haemotoma on his forehead, which is still there now )

Would another labour with a baby that wasn't back-to-back hurt as much (of course I appreciate it is going to hurt a hell of a lot even if not back-to-back)?

Could you not try for another home birth if it was the hospital experience which put you off? I'm really beginning to consider the idea.

I'm only 8 weeks, so there is still a long way to go, but this is bothering me this much already, so I feel like I should be exploring it now to be confident in my decision.

So many of us in the same position!
Like Tallbird I was also going for a homebirth so I was at home for two days before going in to hospital.
You may get some resistance from the midwives as having had an EMCS you are considered 'high risk'.However you can choose wherever you have your baby and they have to honour that even if they don't support it.

Hi RedLlama I just wanted to wish you luck in whatever route you choose to go down. I'm going for a VBAC (am 38+2) this time after fairly hideous failed induction, EM CS last time round - DS is now 2.4 so I've had longer to get over it! I went to a hypnotherapist after a mc at the beginning of this year and found it very helpful in letting go of a lot of negative feelings I had about DS's birth. I couldn't even think about it without crying my eyes out and felt that I had let him down.

Madness.

I would be lying if I said I wasn't a bit scared. I have moments where I look at the size of my bump and think about it relative to the size of the exit route and just think "oh F**k how on earth does everyone do this?" But they do and I know that I can as well. Having said that if for any reason things take a turn for the worse and it becomes clear that intervention is required then so be it - I am determined not to beat myself up if things are genuinely outside of my control.

I will however be refusing CFM and my lovely, incredibly supportive midwife is getting my consultant to "sign it off" or whatever they have to do in my hospital notes. If I get any grief then I am planning a nice, smiley "yes I hear you and this is what I will be doing" approach. I'm not planning on an argument.

I would be having a homebirth if I didn't live just a bit too far from the hospital. Anyway, best of luck and I have rambled a bit but I wanted to share it with you that it has taken me quite a while to get my head on the right place for this so I recommend you start early!

I'll be totally honest - I found the crowning and the baby actually coming out by far the worst part of vaginal birth. I'd do the whole of first stage again tomorrow, but found second stage bloody awful!

BUT it doesn't last long, and it's the last bit before your baby is with you. I would definitely say it's worth going for a VBAC and tolerating that for the benefit of a faster recovery time, and not having all the restrictions on lifting/driving etc.

So go into being realistic, it's more painful than a csection, but IME definitely worth it.

i had a VBAC. dd1 born by emergency c-section at 30 weeks - she was delivered because I was seriously unwell so I didn't go into labour at all. I chose a VBAC and think if I could chose again I'd go for a section. I guess I could bear labour (it hurt so much more than I was expecting!) but it was the fact that it ripped my fanjo to bits and I couldn't pee without crying for several weeks after. I know my view of c-section is clouded and rather blurry as I was so unwell I guess the section was the least of my worries, but I have to say I haven't emerged from it all as a particularly pro-VBAC lady! Having said that if we had a third (v v v unlikely!) a part of me would want to try another VBAC just to show myself I could do it better this time!

was induced as overdue, like you, back to back and wouldn't fully dilate. Had edpidural and eventually EMCS. 3 yrs later expecting DC2 and keen to go for VBAC which my doctor felt was acheivable. Went overdue again and was advised to book in for a SC. Went in the morning for surgery and last minute decided to still try for a VBAC (surgeons were amazingly patient considering I was first on the surgical list). Had waters burst, no contraction, had that inducing drug (which I had read wasn't advisable as contractions are stronger and pose higher risk to rupturing). Had epidural again for pain and in case I had to fall back on EMCS. Again back to back and coudn't push out on my own. Eventually delivered son with ventuese in theatre just before they were moving in to operate.

Sorry for the long story but feel it might help to hear differnt scenarios and experiences. One thing, you have to feel confident that you can do this or your heart won't be in it and you'll aways think you'll end up with another SC. I didn't really one delivery was better than the other and I suffered badly with tight stitches which left me in tears and unable to sleep whereas I recovered well after SC. Good luck with whatever you choose!

"..just to show myself I could do it better this time!"

I really hate these kind of thoughts about giving birth - it's being cruel to yourself, as if you'd failed in some way.

It's not true.

It's fantastic to have so many responses on this thread - thank you very much.

wasabipeanut good luck to you too. It sounds like you've got your head sorted and a very supportive midwife. Hope things go fantastically for you. I'm interested that hypnotherapy has worked se well for you. I've found a very local practitioner of Hypnobirthing and feel like it could work for me. I'm just trying to figure out now if I can justify the expense.

winkywinkola, I'm very with you on your point. Following DS's birth, I was furious when looking back on the ante-natal classes I'd been to. 'Natural' childbirth dominated the discussions and a caesarean was viewed as A Very Bad Thing. In hindsight, I can see that I was looking for somewhere to direct my frustrations. But I do think this contributed to my feelings of guilt (that I hadn't given DS a 'proper' birth) and failure.

Pre-pregnancy, I'd got myself to the point of feeling like the way in which the baby arrived wasn't important, so long as they were safe. I see now that this was my way of packing it away to some corner of my mind as it is clearly still very important to me that I deliver DS naturally, but I'm bloody terrified.

I've gone on a bit haven't I? It's very cathartic this.

traceface and scanty thank you for giving me alternative perspectives.

violethill thank you for your honesty; I anticipate agony! Recovery time is important to me as DH can't take a lot of paternity leave and family are few and far-between locally.

Have you thought of using a hypnobirthing CD? It can really really change the way you think about birth and expect it to turn out. It helps you believe that you will have the birth you want.

I know it's not for everyone, and it didn't claim that it would be a pain free birth (and it wasn't!). But I had a VBAC in October, and I really believe that the relaxation and techniques I learned from the CD helped me achieve it.

Also, just to add the CD I used stressed that whatever happened in your birth you would remain calm and in control by learning the techniques.

So even if another cs was inevitable, it would help to make it less stressful for you.

meemar I had thought about the CD's but wasn't sure if they would be as effective. Typical me - going for the most expensive option before even exploring others. I'm your classic consumer.

I shall have a look at them now an amazon - can you recommend any particular one?