Is it possible to have a Home Birth VBAC?

[kaffers]

Hi everyone,
wondering if anyone has experience of this or advice to give? I am 34 wks with DD2 (DD! is 2.10). With DD1, despite all my plans for a natural birth at midwive led centre I was sent to hospital after waters broke with v. high blood pressure. From arrival at hospital, intervention after intervention followed. I was told I really had to have an epidural for BP and so I had one reluctantly...to cut a v. long story short I felt from there as though everything was taken out of my control and that fear replaced all my natural instincts..I ended up having emergency CS for 'failure to progress' although I had been fully dialated and I was told the head could be seen prior to being told a CS was necessary - TBH I was totally and utterly exhausted by this point after 28 hours labour and felt that there was no other option. But afterwards I was haunted by feelings of failure for months and felt that my whole mothering capabilities were suspect due to my 'inadequacy' at giving birth.

So anyway - this time I really want to try a VBAC, but I'm absolutely terrified - of the same thing happening, of being even more rubbish at it and of all the faffing from doctors, being strapped to machines etc etc I would actually love to try and do the whole thing at home...but part of me fears this would be irresponsible and that I might be causing unnecessary risk to my baby. I'm so worried about the intimidating atmospere of the hospital making everything go pear shaped again.....Apologies for this long post...I'm just trying to get my head round all the issues involved - any comments gratefully received.

to answer your title,yes its possible to have a home vbac, I've had one and it was great.
have you spoken to your midwife about birth options (can you have midwife led unit for example?) yet? they won't encourage a home birth and there are risks - imo they were small risks but you need to make your own decision on that and the relative risks of hospital birth

I'd really recommend a doula if there are any with vacancies near you - having an impartial supporter is a massive confidence boost. you could also choose to stay at home til labour is well established to give you more chance of a normal labour.

you can refuse anything like continous monitoring/drips despite what the hospital might like you to believe. your body has got to 10 cm before so your next labour will hopefully be a nice, quick experience. ds2 was only 5 hours start to finish.

Didn't have a home birth, but did have a very quick, successful VBAC after a very similar first experience to you. I chose to be in hospital as I really was quite poorly the first time and just wanted that reassurance. I wasn't hooked up to machines though and gave birth 3 hrs after arriving at hospital with only gas and air. Good luck and hope you get the birth you want.

Sanfairyann and hmmSleep - thanks so much, it is really reassuring to know that you both had good experiences of VBAC. I think my midwife would be totally anti a HBVBAC as she has already said that I have to be on the labour ward and have no option to even try the midwife led unit at the hospital I'm at. Apparently that's just their policy after an emcs. Also they're already telling me that I'll have to have continuous monitoring which totally did my head in last time. But as you say say Sanfairyann I guess I just have to remember this time that they can't insist even though last time I felt under massive pressure. I'm going to check out if I can maybe get a Doula as well.

I suppose because of the BP issue last time I might be being a bit foolish to try it at home anyway even though it's something I'd love to do. I think I will definitely try and stay at home as long as possible this time though.
HmmmSleep - have you got any tips for making the labour so quick? Did you do anything ifferently than in the first labour or was it just lucky?

walk walk walk once those contractions start (and before)

make sure you put on your birth plan in big letters that you refuse cefm and want intermittant monitoring if that's what you decide and prime your birth partner so they know what your wishes are. I don't understand why some hospitals can't be more flexible on midwife led unitsm- others allow it.

Right Sanfairyann - I'm going to do the walking thing. I remember really wanting to do that last time and the midwife telling me to stay on the bed....and I'm going to prime my DH, i think he was intimidated as me last time. Yes intermittant monitoring is definitely better idea as well - the only thing is whether I can avoid the BP monitor as that was issue last time and cause of all the interventions.....hmmmmmmmm... will do some research. I don't want to take stupid risks but I don't want to feel bulldozed either. Thanks for the top tips. Feel more confident about thinking it all through now.

Strongly recommend joining the yahoo vbac/hbac email list, you will get lots of useful info there.

I planned a HBAC with DS as first labour ended in a crash section and didn't want to be in hospital. As it happened, I chose to transfer and had a CS but it was much better to labour at home.

IMHO, one to one care from a MW, which you would get at home, is likely to be at least as effective as continuous monitoring and various midwives popping in now and then. Plus you are more likely to have a relaxed and active labour at home, which will increase your chances of success.

The main risk is a slightly increased risk of uterine rupture, which is a risk in any labour but increases in VBAC due to the scar - frequent monitoring of your pulse and checking for unusual pain are some ways to monitor for this. Rupture extremely rare unless prostins/synto given.

Best wishes with your plans wherever you decide to have the baby, remember you do not have to attend any consultant appt unless you wish to, you do not need permission to have a homebirth but of course should consider any specific risk factors. And you are not their staff so 'their policies' are just that, guidelines for staff which you are not obliged to obey

Flying Duchesse - do you think they might? I'm really daunted at idea of telling MW that would actually like HB - she was so stern about the MLU. If it wasn't for the BP last time I would be more assertive about the whole think I think. Thanks for your comments - very interesting.

yes it is possible but what intrigues me in your OP is your worry that your whole mothering capabilities you felt were suspect due to your inadequacy at giving birth.
those are strong words and strong feelings that you may need to fully explore with your midwife first.
I just worry that you sound as if you are judging yourself to harshly, a medically assisted birth is a shock but needn't be a disaster.
i have had 2 emergency c-sections and my second was a wonderful, calm, joyful and sucessful experience.
If you don't get a home vbac, will you still have feelings of failure as a mother, will it colour your mothering instincts? now may be the time to also consider how you can best deal with a hospital birth and what would make it a good experience for you with out feeling like you have lost something and not let it hang over those wonderful first few weeks.
simple things could help for me it was booking a cleaner for the first 4 weeks and dam the cost, so that I didn't feel overwhelmed when we got back home.
good luck and remember its not how you give birth that makes you a mother.

Thanks Moaningminniewhinges again - will join that mailing list and thanks for your motivating comments. Lots to think about. I'm new to MN but it is bloody brilliant getting all this advice like this - cheers all.

zanz1bar - you've hit on something there I think, I know my feelings were somewhat irrational and I've questioned many times what the source truly was as - as you say EMCS is a shock but should not rationally be seen as a disaster and also I realise that we're incredibly lucky to have access to medical care that is not available in poorer parts of the world. I guess my ego became tied up (I've always had a strong desire to 'succeed' at school, work, everything) and that's a bit misplaced when it comes to something as unpredicatable as childbirth. I think also I went into a sort of shock afterwards and developed a touch of PND - my confidence about being a mother was not damaged for very long (a couple of months) I don't think and certainly not now (apart from the usual odd difficult day). I suppose starting this thread was a way of trying to confront all those feelings which I'd actually sort of forgotten about before the prospect of the upcoming birth started looming larger.

Flying Duchess - I admire your confidence - I kept thinking all the time - 'of course my BP is high because you keep bloody going on about it and testing me like it's an A level or something'. At the same time, I was too chicken to tell them to bog off.

Ask, ask, ask & keep asking. It does happen & it's entirely possible - sounds like your midwife is just a bit of a stick-in-the-mud, protocol led, grump. Point out to her that you know it can be done (you've the proof on here) & ask to be referred to a specialist homebirth team (most hospitals have one).

Also I just wanted to say to you, that you most definitely are not rubbish at it, & you certainly aren't a failure. You got to 10cms last time & the baby was moving well down in the birth canal despite all those additional fears, anxieties and interventions that were heaped on you - I'd say your body is bloody brilliant at it (if it's allowed to be). You just need someone with you who knows your history, whose professional opinion you trust, & who can be a good advocate for you. A Doula or a great community midwife who is on your side.

It might be worth getting hold of your notes from last time for a read through to see if you can pinpoint exactly why your labour happened that way, & whether you feel you could have done anything to alter the course of events.

Good luck, I say if all is well with you & the baby then go for it!

Thanks missimac.

Oops last message posted prematurely - Missimac - yes MW is a grump and pretty scary and even though the consultants I've seen are really nice, I just don't like the whole hospital environment. I think my use of the word 'failure' as description of my own feelings after last time is a bit difficult in any case because I don't rationally think that is the case - it's just how I felt even though at the same time I though that was ridiculous (if that makes any sense). I certainly wouldn't judge anyone else in that way so I can't really explain why I had those feelings about myself but I did nonetheless. I'm scared of having those feelings again even though I know they're not based on much - afterall we don't see people with illnesses as 'failures' do we? Not if we're sane or empathetic. Sorry - this has turned into self analysis - but even if it's boring for everyone else I feel like it's doing me some good.....(if you've read this far, I'm suprised)

Blimey - I must go to bed but thanks for everyone's comments.

I had a wonderful HVBAC waterbirth. Really recommend a doula and keeping active (walking, up and down stairs, birth ball). It's a lovely way to bring a baby into the world

I had an unplanned homebirth with MW on the phone. After induction 1st time, was dreading going into hospital, would've been much easier if it was planned. But would definitely go for a HB if I had number 3 (highly unlikely though).

Everyone on here will give you the info and courage to stand firm. And like someone said you can always transfer to the hospital if needs be.

Good luck!

Sorry no experience, just wanted to show you this link: VBAC pages at homebirth.org.uk

I know of a lady near me who wanted a home vbac, but was refused. When she went into labour she delayed going to hospital, and ended up giving birth outside her back door (she'd just taken the bins out!)
I think with this, as with a lot of things, it's about fighting your corner. It's also about what YOU feel comfortable with. If you know the risks and feel comfortable doing it, then I say go for it.

The person I know who wanted a home VBAC had an independent midwife (and they're not loaded so it was obviously something she felt very strongly about) and she laboured fro 16 hrs at home and ended up with a hospital assisted (if that's the right word) delivery. She didn't get the HB she wanted but at least she avoided the section. Her MW thinks it's something to do with her back/pelvic shape that makes it difficult for her to deliver.

Please don't feel you have to do it naturally to do it 'right'. missismac has some good advice. As long as you and your baby are healthy.

Kaffers, I am 28 weeks and in a similar position (my 1st was actually planned for home birth but discovered breech at 10 days overdue and had CS without even going into labour).

My current community midwife (slightly inexperienced I think) told me my only option is the labour ward this time, but I could speak to a manager if I was not happy with that. The birth centre at UCH used to take VBACs but recently changed their protocol. I chatted to another midwife at the hospital about it, and he recommended arranging a meeting with the Consultant Midwife to talk through my plans/fears and to discuss the risks and benefits of hospital or HBAC in detail ... I am going to email her today.

The hospital are obliged to send a midwife to you at home if you insist (sadly it will be a case of having to insist). In that case, I was told I would actually get 3 midwives at home throughout the labour and birth!?

Note, midwives and doctors are obliged to obtain informed consent for all clinical procedures, including monitoring, and should not go against your wishes. I guess the important thing is to make sure you are aware of all the risks and implications of any decision, so that you feel confident in sticking with your plan.

I am keen to hear how you get on ... please let us know! And all the best of luck with whichever option you choose.

ps. Sorry for long message! First time posting on a message board!

Yes absolutely!

I haven't had one myself but have been to a beautiful HVBAC as a doula and have another booked soon. There is absolutely no reason why you can't have a homebirth. I second the recommendation of getting a doula and taking her with you to all appointments, I do this with VBAC clients - it is invaluable support. Also strongly recommend the Yahoo HBAC/VBAC support group.

Good luck!

Sarah