Preparing for a VBAC?

[mitfordsisters]

I don't think there's a current thread for VBACers so starting one. I'm 25 weeks now, and had an appointment with consultant midwife yesterday. Will be giving birth at St Thomases in South London. I think they are going to agree that I can labour without Continuous Foetal Monitoring (CFM) - needs to be okayed by the consultant midwife at the Home-from-Home centre.

I'm feeling really positive about this one - first birth was an induction resulting in emcs - determined to make this one different if I can.

Also using a natal hypnotherapy CD to be as relaxed as possible when the time comes.

Hi, I'm 31 weeks and currently heading for a VBAC (although every so often I wonder if I'm insane!) I've been listening to the hypnotherapy cd about once a week but wonder if it will all go out of the window when labour kicks off. My midwife suggested it as I had a v quick labour last time and I felt I didn't cope well - it was such a relief when they did the spinal and went for a crash section.

It's good to hear you're feeling positive, mitfordsisters, I've got 2 friends who had successful VBACs and say they'd definitely head that way again so fingers crossed we feel the same way!

PS I can't get your link to work SelinaDoula. Is it me or the link? Would be really interested to read it.

I enjoyed the birth stories Selina - thinking about hiring a doula, as my dh is willing but wouldn't necessarily advocate for me, and I know a doula would support me in this way.

Happy - do you think you will feel less overwhelmed this time given you have been through labour before? The hypno definitely feels useful - I must be really suggestible as I relax immeadiately I hear the trigger words. Hope it is working for you in the same way.

I'm trying to come at this birth afresh, without dwelling on the last one, which was so far from what I expected. I was continuously monitored then and found it really inhibiting - had to ask to go to the loo - great palaver to even get off the bed. Felt I was set up to fail.

Fingers-crossed I will not go overdue, and will stay home as long as possible.

why were you induced last time?

*HappySeven) the link seems to work when I try it. Search for Magical birth on google, I think my website is near the top.
mitfordsisters Glad you enjoyed the birth stories. I definetely recommend having a doula (not at all biased lol) no harm in calling a few local ones for a chat and see if any of them feel 'right' to you.
Selina x

I confess I've no experience of VBAC, but I did have a (planned) vaginal breech birth so have had "issues" in planning a birth that conflicted with hospital policy.

Mary Cronk has some very useful stock phrases that can help you keep control of over-enthusiastic HCP's. She also comments that "Allow is not a word to use to a mentally competent adult!"

I found querying the research behind recommendations exposed some big loopholes - IIRC there is NO research that shows CFM improves outcomes for mothers or babies (and the reduced mobility can lead to a slower, harder labour with more interventions). So why is it recommended so commonly for VBACs?

Good luck ladies

ps - I also used the natal hypnotherapy CDs. I don't know if they helped, but I did stay very calm and managed the labour and birth of both DD1 (9lb 12 breech HB) and DD2 (6lb 11 induced at 36 weeks) with just TENS. I'm sure luck and genetics played their part, but I do think the CDs helped a lot with my mental state.

I had a VBAeC 18 months ago. I went into spontaneous labour (again) which slowed down after they gave me anti-hypertensives as they realised I was actually pre-eclamptic (again!). After almost 12 hours of contractions on/off, they started discussing inducing me and/or sending me home. I didn't have continual monitoring, but when they were monitoring they weren't particularly happy with DD2's heart rate (same reason why DD1 was an emCS as well as her being breech), so they were quite happy when my contractions suddenly kick started again ! They took me down to the delivery suite (having shipped me up to the ante-natal ward and kicked DH out!), and within 30 mins I'd had DD2 (along with a not so lovely episiotomy due to them panicking !).

Anyway, the VBAC went fine ! No probs at all with the scar or anything like that. There were 25 months in between deliveries. I DIDN'T have continual monitoring through my labour and only had G&A for the last 30 mins (nothing even offered until I asked for it at the pushing stage !!).

Recovery after the delivery was much easier with the VBAC than the emCS, despite having an episiotomy, PLUS I was discharged within 18 hours of delivery rather than 3-4 days !

Good luck with whatever you decide. xx

P.S. Hope I've not scared you at all, I'm just a wierd one that they don't seem to want to check on properly and don't notice that I'm pre-eclamptic until I go into labour spontaneously (thank goodness or I wouldn't have my 2 DD's).

I'm 35 weeks and going for a VBAC. DS1 was breech but I went into labour before the ElCS so I laboured. I too would like to push for not having CFM as I would like to be as mobile as possible (went on an active birthing course that informed me of the benefits of this). I just don't get why I need CFM just because I had a CS last time - breech is hardly a scary medical problem that I had, just about the delivery method.

Snotty - how hard did you have to push for not having CFM? I too have heard of the benefits of not having it and the problems with having it - I think I would be too fixated on the heartbeat when it naturally goes up and down anyway. I thought of just turning the monitor away but not sure that will get it out of my head as it probably makes a noise?

I'm almost 32 weeks and going for VBAC... meeting with consultant on Monday to go through my notes from my DD's birth and get the lowdown on what they recommend for VBACs at the hospital I'm going to - REALLY don't want CFM this time. Have got the natal hypnotherapy CD and have been going to pregnancy yoga, which I think is helping to chill me out... famous last words!

Im 34 weeks and will go for VBAC. I was told i didnt have to have CFM.
I feel i know better this time around so i will try not to be as influenced as i was with DS (had emcs after problem with epidural + blood pressure at 8cm)
Next week im starting active birth + yoga classes
im a bit scared about everything especially after hearing so many stories about forceps delivery.... but im trying to focus on the positive stories.
Got growth scan at 38 weeks and consulatnat appt the day after...

I'll be checking back this thread for VBAC stories (good or bad!)

Nwmum, I was induced as 2 weeks overdue.

MrsJamin, they would rather you have CFM as severe uterine rupture is a (very rare - I know that 'benign' scar dehiscence happens more frequently) complication with VBACs and they say that the baby's heart rate would indicate if the scar was giving way. Others, like Mary Cronk, think that mums pulse is the best indicator of uterine rupture. But hospitals 'manage the risk with CFM. You will probably get stern warnings about the risk of uterine rupture if you don't have CFM, but it is a very small (if alarming) risk. I am going to live with that risk and go without CFM.

Tangle, thanks for the useful phrases and general encouragment.

Also for the VBAC stories - keep em coming...

Tangle, I think CFM slowed things down for me (though position of babe was a factor too).

And snotty - Im not scared - just terrified!

hi all,

it's great to hear there are others in the same boat. I'm 35 weeks and also aiming for a VBAC. Last time was induced due to pre eclampsia which didn't work and resulted in emCS due to fetal distress.

Have got a lovely midwife who has supported me in wanting to give birth at local birth centre (20 miles from main hospital) but have a consultant meeting on monday to tick the boxes to show that I understand the risks etc...think I may also have to meet the supervisor of midwives...am just going to hold firm and stick to my plans. The protocol at the hospital (as opposed to birth centre) is CFM, regular Vaginal exams, time limits for each stage, routine cannula and definitiely nowhere near the birth pool. Have argued against all this protocol and will hopefully be allowed in the water at the birth centre depending upon the confidence of the midwife that I get on the day!

sorry about the marathon post - i look forward to hearing everyone elses experiences...

I hope I will be less overwhelmed this time, mitfordsisters, but am worried it will be even faster (I was 6cm dilated on arrival at the hospital and had only had contractions for 50 mins). I kind of stopped breathing with every contraction and I'm hoping the hypnotherapy cd will help me to overcome that urge as that couldn't have helped.

I'm not fussed whether I have CFM as last time I lay down on my side and didn't move for the next couple of hours so I guess I'll want to be stationary again. It'll be really good to hear people's stories and support on here especially when I start to panic a little again!

If anyone wants the AIMS book(let) on VBAC I am happy to send it. I have it sitting here, not wanting to chuck it as I paid good money for it and it might help someone (didn't help me in the end but that's a different story).

Anyone who wants it CAT me your address and I'll bung it in the post.

Good luck everyone !

Hi all - just saying hello as I (slightly to my surprise) got the VBAC I wanted 3 days ago, and had many of the same questions and worries as you before it! (DS was EMCS due to bad position which caused me not to dilate properly). So, it IS possible, though also flipping hard work

I was worried about CFM too, in fact I was really dreading it as water and movement helped me lots with DS - but managed to avoid it until the very end due to nobody thinking I was that far along until it was too late! In fact most of the dilating happened while I was being shunted round the hospital, from the waiting room(!) to antenatal ward (as they thought I had ages to go...) and finally to delivery when they realised it was all happening a lot quicker than that! So was upright, mobile and doing lots of walking, with no monitoring and just my TENS machine (and G&A right at the end when we reached delivery), which I suppose is just what the doctor ordered.

I did have CFM for the very last bit, once we got to delivery, but mostly only for the final stages of transition and for the pushing bit, and frankly by then I didn't even notice it as 1) I was still able to move around a reasonable amount (different positions on beanbags on floor or on the bed), 2) I was too knackered by then to want to be much more active, and 3) it was all so intense I could have been monitored by aliens for all I would have cared as long as it got the baby out! In fact for me I found the best position for pushing was in any case half-lying on the bed, strangely for me that worked better than all the "using gravity" positions that I tried, so don't rule anything out.

I think the main advantages of VBAC for me were that lovely DD didn't have any after-effects from the birth, we were out of hospital the next day, and although it definitely DOES still take some time to recover from, I think I am definitely getting over it quicker than the CS and can already lift up DS if I really need to, for instance.

Congrats MyNameIs! Well done!!

Thanks for sharing mynameis!!!

I'm going for a Vbac in may (28 weeks at the mo) and it's great to read 'MyNameIs' birth experience as my EMCS in march 08 was to do with DD's position and therefore I didn't dilate.

Looking for lots of positive stories!

I had a VBAC in October. All went well. I would say avoid the continuous monitoring if at all possible. The midwives were all worried about my daughter's 'slow heartrate' until it dawned on them that they were monitoring my heart instead. I was too relieved, once my daughter was safely born, to question anyone about it, but in retrospect I am angry that they couldn't use their 'vitally important' equipment properly after foisting it on me.

I had a VBAC in Sept after an ECS for footling breech. The consultant agreed surprisingly readily to no EFM but when we got into the delivery suite the junior midwife wasn't prepared to go against hospital policy without asking sister and getting me to sign a waiver and all sorts. In the end we agreed to let them monitor for 20 mins to get a base reading and it all happened so fast that the monitor never got taken off.

As for the active labour - DS2 was lying on a nerve, my legs had gone to jelly and walking around wasn't an option anyway. (Babies don't read birth plans!) The midwife was really good at using the bed to get beneficial positions without standing up though.

I'd definitely say it was a positive experience and staying at home as long as possible helped because it didn't give them time to interfere too much when I got to the hospital!

it's great to hear some really positive VBAC experiences - thanks all for sharing, helps me to feel that it is achievable.

I'll be 36 weeks on wed so it's coming round quickly - but have to go to see consultant this morning just to show that I understand risks etc! FWIW I recommend the AIMS book to anyone wanting to make a stand against continuous monitoring etc...

I'll probably come back fed up from consultant visit as am not for one moment expecting her to agree in any way with my birthplan as it goes against hospital policy in every aspect! Hmmm.

l39 - how bizarre - unnecessary worry for you too.

Blue - thanks for your experience - midwife has said to me also that it possible to vary positions even on bed with CFM - glad it went well.

Hope it went well this morning happy2bme - of course the consultant will be coming at things from a different angle. Have read some of the AIMS material - brilliant.

well here I am with my VBAC story slightly earlier than planned! DS2 was born on Friday morning, at 35+6wks. 5am thought my waters were leaking, 5.30 first contraction & woke DH, pain was every 2 mins, 6am left the house, 6.30 assessed at hospital and was fully dilated. 7-8am pushing and DS2 born naturally at 8am. Got my VBAC - yay! Didn't have any pain relief either.

Halfway through pushing midwives were getting worried about his heartbeat and (so DH told me later) were discussing CS. On hearing this I was so determined to avoid CS I stepped up my pushing and he came out after an epi. His hand was on his face that's why we got into that bit of trouble.

I feel so much more competent to do things now than I did after DS1's arrival, am chuffed that I completed my VBAC and would thoroughly endorse it! I did have CFM but totally ignored the monitor (it was behind me).