Has anyone manage to have VBAC Water birth? If so, how did you do it?

[Flavs07]

I am expecting my second child and have been told that I cannot have a water birth as I need to be constantly monitored. For my DS birth everything was progressing well, with the aid of G&A and I managed the pain OK. Got fully dilated but when the midwife checked she saw DS was breach so we got rushed to the theatre for a C-section. Baby was fine, I was fine, but I had a tough time recovering from the operation.

So, since I felt that being in the pool definitely worked for me I had my heart set on having my second (and probably last!) child on water. You can?t imagine my disappointment when the MW told me I could not have a water birth this time!

So I have been trying to figure out a way to have a water birth but short of going privately I can't see how I can do this. Anyone manage to have a VBAC water birth on the NHS?? I am 18 wks and booked at St Marys Paddington.

Forgot to add, DS was born 2.5 years ago, also at St Marys.

I have been told that all of the local hospitals have a 'no VBACers in the water pool' policy, but I have hired a private midwife. She says there is one particular hospital where she has attended her clients as a birthing assistant where she has managed to take the NHS midwife on one side and persuade them to let the VBACer use the pool. I am hoping that this works for me.

Of course it depends on how much value you put on using a pool. The first time round I managed to go to a hospital that had the least-used pool in the country - what is the point in having a pool if you ain't going to use it? I would love to have a home birth, but there is something about being an ancient VBAC living in the sticks miles away from any hospital at all that makes me want to be closer to the facilities of a hospital, while hoping that I don't actually use them. I have not hired the midwife specifically to get me the use of the pool, but because I believe last time certain things went wrong that were missed during the shift changeovers (I experienced 3 of these, and can point to something being missed at 2 of them.) I want continuity of care.

It's not for the midwife to tell you what you may or may not do. The choice is yours - the hospital may have a policy for VBAC which recommends continuous monitoring but nobody can make you accept that.

I supported a woman who wanted a VBAC in water. She was amazing - did lots of research herself and decided that there wasn't very good evidence that continual monitoring made a lot of difference to outcome. She felt strongly that being able to be in the water, she wouldn't need stronger pain relief and therefore if there was a problem with the scar her body would tell her.

She had a big fight on her hands, but she just quietly stuck to her guns and insisted that (a) she would refuse continuous monitoring and that (b) she would therefore be able to use the pool. She used that like a stuck record. Eventually the doctors agreed she could use the pool for 'pain relief' and the hospital used a bank midwife who was experienced in waterbirth and VBAC - the woman had a fantastic waterbirth - the midwife kept the doctors out of the room. I should add that the woman and the midwife agreed that should the baby show any signs of distress, she would get out of the water and then the continuous monitoring may be appropriate - so she wasn't 'I must have a waterbirth at all costs'.

You could try really calling their bluff and saying you are having a homebirth - sometimes women do this because the hospital are then happier to agree to the 'compromise' of a hospital water birth.

Contact AIMS, get in touch with your local NCT branch and antenatal teacher for support. Write to the head of midwifery and tell them (don't ask, tell) that you will be expecting to use the pool for pain relief - keep the letter simple and explain that you won't accept continuous monitoring unless there is a clear, clinical reason for it.

Oh - and there are units in the country who now suggest VBACs get in the pool - can't remember where though !Definately NHS

Really Snowsquonk? Would love to know more about that if you can remember any more info!

(I am hoping for VBAC very very soon, but had pretty much given up on being allowed in the pool...)

I've had VBAC on dry land 2 years ago and am hoping for water VBAC in March in an NHS hospital in Scotland. My consultant is supportive of that .

I agree with other posters it is not up to anybody to tell you how you can or cannot give birth.
Speak to your consultant and the midwifery supervisor. Do your own research.
AFAIK as the reason for your previous CS is not likely to reoccur there is no reason why you cannot go for a VBAC and intermittent monitoring is an option for that.
Personally (I had had a VB before my emCS) I also felt that I knew the difference between contractions and the continous pain that would indicate a uterine rupture.

Get lots of info, be assertive but not aggressive when speaking to people.
Unfortunately a lot of hospital MWs are v bound by hospital policy. Also a lot of people forget that 'policy' and 'guidelines' are just that: guides and not cast in tablets to stone....

The thing is, it's all well and good to tell a hospital or midwife they can't tell you how to give birth, but they hold the keys to the birth pool room and you try getting in that pool if they don't want you to! I asked and asked last time, and while the midwives I had said that there was no reason why I shouldn't be able to use the pool, the hospital just wasn't allowing it to be used that day as they were busy. I would have had to break down the door between contractions and run the taps myself. Although given the length of my labour I suppose it would have been something to pass the time!

I'm going for a Vbac at Kings College London and have been told I can labour in water and/or have a water birth as they can monitor wirelessly.I have also met a couple of people who've had water birth Vbac's there so know it's possible.

But no personal experience...yet!

@ pandora!

The reasons you were kept out sound a bit dodgy...

You need to speak to the consultant midwife at the hospital and also your consultant.

If you make it clear that you will not accept continuous monitoring then really there is little reason why you couldn't try for a waterbirth.

TBH you just need to repeat yourself every time you speak to anyone (calmly stick to your guns). Don't even bother speaking to registrars/SHOs about this since they will not deviate from repeating hospital policy. Your consultant, on the other hand might be more flexible so just sit and wait in the ante-natal clinic until s/he becomes free.

I managed to get my local hospital to agree to me having my VBAC in an MLU and to me getting in the pool. In the event it all got a bit dramatic and I transferred to the labour ward and had a crash section, but am very glad to have done things my way up until it became clear that something more medical was needed. I just felt strongly that if I was going to attempt a VBAC I needed to give it my best shot and that meant as natural a labour as possible.

Good luck - hope you get what you want.

I had a dry land VBAC in hospital with intermittent monitoring - they said no to water but then I wasn't so bothered about it that I wanted to fight.
For my second VBAC, I had a waterbirth at home with underwater monitoring with a waterproof doppler, which was great and really reassuring. Not really convinced by the case for continuous monitoring.

I think a good, observant midwife can spot problems earlier than a monitor can.

Thanks for all the replies, isn?t Mumsnet just the best thing ever?! I am so impressed!!!

I will now do lots of research to back my plan up. Snowsquonk (and MrsHappy), I am with you in the sense I am not a ?water birth at all costs?! I would be the first to jump out of the pool if there was a problem (I did exactly that with DS1!). I just remember coping well in the water versus feeling the intense pain and the sense of helpless while on the hospital bed waiting to be accessed.

Pandora69 - I also would hat having heated arguments with MWs while in labour. I just could not face that! And I couldn?t count on DH to do the fighting for me as he is American and while he supports my choices, he is believes in medical intervention and all that stuff so I know he would go with what the MW tell us. That's why I was considering going private for more control but what if I need an EmCS again? Then the costs could easily triple or quadruple and we would go literally bankrupt! I also don't think I would pull off calling their bluff and saying I would go for a home birth. They would probably see right through me!

PacificDogwood - it would be great to hear how you birth goes. I wish you all the best!
Mumcah - when are you due? It would be great to hear how you get on as well and again all the best to you.

I was planning to labour in water for my second VBAC in 2008, with the full support of the consultant midwife and obstetrician at Rosie Maternity in Cambridge. They have wireless (telemetric) monitors which can be used in water, so would have monitored me that way. I agreed not to actually give birth in the pool, but that was because I had a PPH after my first VBAC, nothing to do with my c-s.

You will notice this was all provisional - as it happened, DD3 had to be induced for medical reasons, so I did not get to use that pool, but that was because the hospital didn't like anyone who was being induced to use the pool. As I ended up with synto and an epidural (and a fantastic birth, BTW), it turned out the best for me in the end.

Good luck, I hope you get the birth you want.

PS Snowsquonk, are you Squonk? haven't seen you around for aaaaages - how you doin'?

Flavs, thanks for the good wishes . Hope your birthplan will be listened to by receptive ears.

There will be a birth announcement on MN when my time as come, natch !

I had one 2 weeks ago! I had an EmCS 18mths ago after getting to fully dilated but my DS was in an awkward position (deflexed OP) and got stuck so they had to push him back up and get him out of the sunroof . Have since been told if they'd had someone more highly trained they might have been able to get him out vaginally but ho hum.

Anyway I saw a fantastic MW at Warwick hospital who is the head of midwifery and runs a VBAC clinic. We discussed all the evidence and pros and cons and I said that I'd still like to try for a waterbirth. She supported me in that and documented the discussion we'd had in my notes - including the possible need to get out and for a cannula if needed. Warwick has wireless monitoring available so I agreed to that as I didn't mind being strapped up as long as I was in the pool if it kept everything low stress. I was ready for a fight for intermittent monitoring if not.

In the end I went into labout at 38+5, used TENS at home and was 8cm when I arrived [delighted emoticon]. I was looked after by a MW who was experienced at waterbirths but hadn't had a VBAC one before - she was very calm and professional. I got straight in the pool with lovely lovely gas and air. I only got out for one examination 2 hours later where I was fully dilated (weed in the pool - it's sterile!). We then waited for me to get the urge to push. This didn't really kick off despite my waters going with a mini push so I gave back the gas. Next contraction I started pushing and my DD was born 39 minutes later.

We then spent half an hour in the pool before I got a bit chilly then sat on the loo, had a gentle push and out came the placenta (didn't use injection). It was all very wonderful and so different to last time - I didn't really believe it was possible until her head was out. I had a fairly large 1st degree tear but it's healing very well without stitches. Seeing her floating up towards me with her big eyes open was the most magical thing I've ever seen.

FWIW I'm not totally against medical intervention if it's needed as am medical myself but I think you really need to push for a natural process and loads of MWs will support that - as will some docs.

Good luck OP - go for what you want - the evidence is fairly scant out there regarding all the medicalisation of VBACs. Let us know how you get on!

Pelvicflooragogo, you had the birth I dream of!! I am so happy for you and happy that there people in the NHS that support women like us, who just want a change to try for something more natural. Thanks so much for sharing your experience. It gave me some hope!!

Glad to hear it Flavs07 - keep the faith!

I have to admit after my section last time I wasn't at all hopeful - had a particularly nasty experience of pain during the procedure so it has really helped to put the trauma to bed. Having said that we were nearly induced as my DD was so small and it made me and my DH remind ourselves to be ready for anything again and not to feel like failures if we didn't have the dream birth we hoped for.