Not "allowed" VBA2C

[SpudtheScarecrow]

Feeling really cross with myself for not being more assertive and just wondering what to do now, if anything.

My history is that I've had 1 emergency CS with DS1 for failure to progress - he was big 9lb13 and not in a good position, probably cos he got stuck trying to turn and had big head and shoulders.

DS2 was an reluctant elective CS at 41 weeks when I was showing no signs of going into labour naturally.

Anyway, I'm pretty resigned to a CS this time round but was hoping if I went into labour naturally sometime before 39 weeks to at least have a trial of labour.

I saw the consultant today at 20 weeks and she just said 'no we couldn't let you do that.' They'd want me to go in and have a CS even if things seemed to be be OK. I was a bit shell-shocked and so didn't argue but now I feel a bit pathetic for not being more assertive. She'd also been talking about possible sterilisation so think I was still reeling from that.

I'm not due to see anyone other than routine midwife appointments so don't really know if I should do anything - I'm not likely to go into labour early so is probably a bit of a non-problem and am happy to have CS at 39 weeks. But if there's any chance of a VBA2C I'd want to give it a go.

Do I wait and see and if I go into labour just refuse a CS then? I figure they can't make me have one. Community midwife was v anxious at the thought of VBA2C so doesn't seem much point in discussing it with her.

Thanks to anyone who's managed to stick with my ramblings this long. I'm really cross with myself for being such a wimp!

You might find this article published recently in the BJOG interesting. This page also has a lot of information and links that you might find useful. This article is also pertinent.

Basically you're completely correct - they can't force you to have a CS against your will, and if they are going to "recommend" (even in the loosest definition of the word) they should explain to you why. My understanding is that this is an area with little good quality research, and that much of the research that has been done is mutually contradictory. Although risks for VBAC, VBA2C, etc, are generally found to be raised, there is little agreement on how much by - but the newer research seems to suggest the increase is much lower than previously thought. As such, it would be very interesting to know what research the consultant is basing her opinion on by telling you that they can't "let" you have a vaginal birth.

If you feel confidant in trying a VBA2C then it would probably be worth asking for another appointment with the consultant. You might also want to talk to AIMS, and also contact the Head of Midwifery at your hospital. They should be able to give you the view of an experienced MW, and may also have inside information on the views of your consultant (eg if she's known to be very conservative they may be able to suggest and alternative).

Oh - and for trying to hold your own when talking to consultants, I find these suggestions from Mary Cronk are invaluable

Good luck, whatever you decide

(As an aside, was there a reason to bring up sterilisation? It seems bizarre and unnecessary unless there was something particularly pertinent, and it doesn't sound like she was particularly tactful anyway (on your behalf).)

In most countries they would do a late scan, just of the scar area, to determine thickness and likeliness of rupture. No idea whether that's the case here as I had DC2 abroad (where that was automatically done as DC1 a section). I think that it would be a useful risk-assessment to take.