Elective C-Section or VBAC what would you do?

[lauraloo09]

Hiya just looking to get some advice.

I gave birth to my beautiful baby girl in June 09 by emergency section after 36 hours of labour and only getting to 1 cm dilated, my baby refused to engage and I felt as if my pelvis was going to snap!

I have a feeling I'm pregnant again, just waiting to test as I think I tested too early today. I have been thinking about whether I should i should try a VBAC or go for an elective section this time around (if I am pregnant). I would love a VBAC however I am scared of going into labour and not progressing again and needing yet another emergency section.

I was wondering if people could advise me on any experiences you have had on both options.

Thanks x

Everytime I had a contraction it honestly felt like my pelvis was going to snap, but I thought I was labouring ok but every examination they carried out said I was only 1cm gone. I was on everything, mostly gas and air from 7am until 4pm (32hours into labour) when I was given an epidural after the consultant 'kindly' suggested I needed it, I also received anti-b's as when I got to the hospital my blood work came back as showing group b strep. The baby's position was head down but back to back, which I didn't find out until 7pm! (35hours into labour). I think my baby was in distress which made the consultant worry and carried out the section.

To be honest (I might sound mad) but I hate the thought of never experiencing another contraction if I select an elective section but of course i want to do what's best for my unborn baby (if indeed I am pregnant lol)

Hi Lauraloo,
It might be worth getting hold of your notes and going through them with someone.
Could be a Consultant midwife (best option if your hospital has one) a supervisor of midwives or an independant midwife.
If you were 1cm dilated when you had your section, ou were not in active labour (3-4cms dilated).
This is common in a posterior labour, having a very long pre/early labour with frequent, ainful contractions.
Some people just go straight into active labour and miss out this stage.
It is very difficult to cope with, as a doula I have an interest in trying to help malpositioned babies to move into better positions and help women cope with these long, painful early labours.
There are things you can do to help babies move into better positions for birth, lots of ideas here-
www.spinningbabies.com/
Have you considere a doula?
www.doula.org.uk/
I have supported quite a few women with similar histories and from what you have said, I can see no reason why you souldn't be able to have a straight forward VBAC next time.
Selina

Hi Lauraloo. I had a very similar experience to yours - only got to 3cm dilated, hours of very painful labour, eventually went to c-section as the baby was distressed.

Second time around, like you I really wanted a VBAC. All went reasonably well and I got to 5cm but was knackered by then - about 36 hours in - and asked for an epidural which slowed things right down. Didn't dilate at all for the next six hours, again there were signs that the baby was distressed so I ended up with another emcs. Didn't care by then, just wanted the baby healthy and out!

What I would say is that I also had Group B strep and was severely hampered by the antibiotics and constant monitoring. The hospital had said I could be fairly mobile but the reality was that once the drip went in they wanted me in one place, strapped to a monitor. This really didn't help. It felt as though a c-section was inevitable with all that intervention.

I wish, wish, wish I'd had a doula. Felt there was no one fighting my corner, or encouraging me to do it the way I wanted.

Apparently it is possible to have a VBAC with mobile monitoring and some freedom to move about, but the Group B strep situation doesn't help and the hospital I was in turned out to be quite restrictive.

Hope this isn't too depressing but it was my experience. I really would advise talking to different hospitals and exploring your options as much as possible. Good luck!

You are unlikely to have another emergency section if you plan the point at which you will opt for a section rather than continuing with labour.This was the advice I had from the head of the birth centre and it was really helpful.She suggested that if I got shipped from the BC to the labpour ward then that would be a sign things weren't progressing as well as they might and that I asked for a section at that point.This is just what did happen although the consultant was the one who first said that he thought another section would be safer than progressing and I agreed as I was prepared for that to happen.It was a great experience,no panic,no rush and yet all the lovely labour hormones .I didn't go into labour at all with DD1 so I really wanted to try the second time.I am so glad I did try even though I had another section.Also an in-labour c-section is much better for the baby,read Michele odent's "the ceasarian"

FYI I had a doula,and initally I was in the birth centre,so minimal monitoring,they were really supportive of VBAC.(UCH)

I had an EMCS after 2 days of labour and only getting to 4cm even after 4 hours of Syntocin.
I'm due again in may and going for a Vbac.My DD was in the wrong position (turned back to back and then was transverse) and I am told this is probably why I didn't progress.
I'm crossing my fingers that this time it will be better but who knows?Anyway I wouldn't go for an elective as I would always think what if?
It's a personal decision though.I do wonder if maybe my body just can't do it.

Hi i too had a similar experience.

I went through 36 hours of labour to end in a Emerg c-section.
Unfortunatly i gave birth to my first in germany where they dont provide pethidine or gas and air or break your waters.
I laboured slowly from 3cm-4cm (12hours) and then my waters broke bringing the most unbelievable pains in my back with each contraction. I was fully dilated before they realised DS was back to back so to late for an epidural. He wouldnt enter the birth canal so they couldnt venthouse and was showing signs of distress so i had to have a section under GA.
Its was the most horrendous things i have ever been though and to top it off i then didnt meet my son for 4 hours after the op so felt i lost out.

Im due to have my second by elective c-section on monday.
I was sure i wanted vbac from even before i fell preg again, but as it came nearer the decision piont i had to look at what was more important to me, and the thought of putting myself and my new baby through that again was enought to make the decision.
I want to enjoy having this baby and have a shared experience with my husband.

I think this is what you've got to weigh up, what about the birth is more important to you and that should give you your answer.

Hi - I had an ELCS first time round - DS was back to back, very high (never engaged) and as I was huge and DS measuring big, on the advice on my consultant (who thought I was in for a long hard labour) I had a CS - which I was very happy with at the time (don't flame me!!).

Second time round, went for a VBAC and was the best decision for me. Waters went at 39 weeks, had 24 hours of bearable on/off contractions at home and then (might whisper this bit) was put on a v low level of syntocinon (sp?) and DD arrived 6 hours later by ventouse. I was up and moving for most of the labour - even tho I was having CFM, my MWs kept me on my feet and I only got on the bed after I had a shot of pethidine.

Even with the stitches, the recovery was so much easier after the VBAC, as was BF-ing (my milk took 5 days to come in after my ELCS as I just wasn't ready to give birth) and if we have a third I'll go for a natural birth if I can.

There's no rush for you to decide though - I didn't decide to definitely try for a VBAC until 38 weeks and I had very supportive midwives and doctors all the way through.

Forgot to add - several of my friends have gone straight for the ELCS route after hard first labours - none of them regretted it. As long as you feel in control of the decision making process, I think it's easier to reconcile the final outcome. Good luck!

I'm not flaming you Sparky - pretty much same story with my DC1 - family history big babies - she was over 4kg, back to back, and I had a bleeding problem at around 30 weeks, which is when they decided to carry out a section 10 days before due date. But I'm not flaming the OP either if she wants a VBAC! I had a second section - partly my choice but also (this was on the continent) they did a late scan just to test the scar/thickness etc/likelihood of rupture. I would definitely have that to be on safe side. As Sparky says, I think it helps to have the info and fel involved in the decision.

I got to 2-3 cm in first labour, had been induced, but was immobile for the entire labour, had an epidural, and ended up with em c.s for failure to progress... i had a VBAC with DD, which was totally straightforward and i was a lot more clued up about how to at least try for the birth i wanted.

like selinadoula, i am also a doula, having my VBAC inspired to train to help other women , at the very least, achive a positive and empowered birth ,whether it be elective c.s, VBAC or em. c.s

the most important thing to do is to find out exactly why you had the c.s

was it failure to progress ( awful phrase) was it to do with the position of the baby or were there other issues

a posterior baby is not necessarily a reasonf or c.s, my VBAC was a posterior baby, just had a long latent stage.

get informed and move on from there

make the decision that is right for oyu , based on all the information

bellissima I was more worried about getting flamed for the reasons for my ELCS - especially as DS turned out to be under 8lbs....most of it must have been Double Deckers and cinnamon pastries !