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.

Nellie1, thanks for the info - so far I've only had 2 midwive appointments at UCH and all the others have been with consultants or registrars. On the basis of what you've said I think I will try and get appointment with consultant MW as well - have appt with obestritian week after nxt when will be 36 weeks and am going to write down everything I want to say in advance.

Hmmm - I'm not delighted by the news that they go for epidurals and continuous monitoring as standard but I guess that's probably typical of most hospital approaches to VBACs - like you I'm going to do my utmost to avoid that level of intervention - I'll be so interested to know how you get on....good luck with the preparation.

Just been to see the Consultant Midwife at UCH and had a really good meeting. We didn't have time to do a full birth plan this time, but she is going to do my next antenatal appt and write it up in detail.

Basically, I still can't go to the birthing centre, but she was really positive about what I could achieve on the labour ward. I guess it may depend on an individual's medical history, but she said ...

1. Continuous monitoring not necessary - she will recommend continuous care with 1 midwife throughout who can monitor every 15 mins. If the pool or bath is available for me to use, they also have a monitor that can be used in water!

1. Only a few of the midwives still like to have women give birth lying on a bed ... but to avoid this, we could even take the bed out of the room and replace it with a floor mattress. There are also birthing balls, reclining chairs, birthing stools etc. Very similar to the birthing centre.

1. Rooms are bigger on the labour suite, have dimmer switches on the lights, and en-suite bathrooms ... so can get some privacy and calm.

1. Epidural not necessary - the only benefit to this is to make it easier to have an emergency CS.

1. Main advantage of labour ward is that all the equipment and consultants are on hand to

help if there is a genuine emergency.

1. Stay at home as long as possible, and so long as things are progressing ok, only come in when contractions are at a rate of 3-4 every 10 mins. If you go to hospital too early, they will be loathe to let you go home again if things slow down.

1. If you don't get on with the midwife attending you, ask to speak to the coordinator and have them assign you someone else.

Kaffers, I really recommend you speak to Belinda, I think she could really give you some confidence. I feel so much happier now and pretty much decided on going into hospital after all!

that all sounds v positive - for you

Nellie1 - only just seen your message from Mar 4th!!!! Thanks for the info - that is quite different to my experience at UCH yesterday. Saw my obs consultant and though very nice he said they really would want to do CM!

But he was also positive about being able to be mobile even with CM. Also he advised getting into hospital earlyish and not being at home too long(that didn't please me too much).

However - my blood pressure had shot up yesterday and they are a bit concerned (that happened in my last pregnancy) so that might make my situation a little different to yours. They might advise an ECS if it continues to rise and actually I'm much more resigned to that than I was a few weeks ago if they think it's best.

Also I had a really thorough talk with my DH about my previous birth experience about things he remebered that I hadn't or had blocked out. TBH I was shocked by what he told me. I had not realised that it had been quite such a close thing with my DD as it apparently was - incredible that me and DH had never really talked in detail about it all over the last 3 years but he assumed I knew and my drug addled memories had obviously edited out certain things - anyway that as well has made me a little more resigned to a CS if it's deemed necessary. So I've kind of gone full circle from when I started this thread asking about home VBACs.

But if at all possible I would still like a natural birth and I'm going to make an appt with the UCH consultant midwife today - inspired by your experience.

Hope you're feeling well and let me know how you xget on. K x

update
Nellie1 - I phoned UCH this pm and got a 'phone' appointment with a senior mw - but not the consultant one and not the one you spoke to I don't think. They seemed a bit taken aback that I was calling.

Anyway she was lovely but again gave me very conflicting info to yours

1. continuous monitoring a must
2. absolutely no chance of birthing pool
3. come into hospital earlier rather than later

All I can think is that they are giving me specific advice because of my BP being raised and that your advice is based on your particular medical history.

So there we go - I'm ok with it all I think - I don't think I'm going to get my 'ideal' birth scenario (birthing pool, no interventions etc) but I now just think if the baby is ok and I'm ok I'll be happy.
I hope it turns out for you in the way that you want it.

Kaffers, sorry things aren't going quite how you planned. However, I guess the most important thing is to have talked everything through in advance, so you aren't caught too off guard when you're actually in labour! Good luck with everything, and let us know how it all goes. X

Hi kaffers I am a doula and I supported a lady recently who was aiming for a Vbac, he husband took alot of persuading but she's an educated lady who knows her own mind and looked up everything she could and spoke to every consultant she had to.

Eventually it was agreed that she would be able to use the MLU, (literally across the corridor)and be able to use the pool and to only have intermittent monitoring. She suggested to the cons that she would be inclined to stay at homw longer if her needs, wishes wouldn't be taken into consideration at the hosp. She did mention that if she so desired she could in fact have a hb.

I just wanted to reiterate what riven has said really because if we had stayed at home with her, most definately her baby would have died, and if I'm perfectly honest, it probably would have been touch and go with her too, as she suffered a rupture during labour, which thankfully was spotted within minutes at the mlu and she was delivered by cs minutes later. I was with her and I shudder to think what would have happened if circs had been different as when her waters went at home 2 hours before, everything was completely fine.

I really wouldn't want to scare you but It shook me up. In 3 yrs of being a doula and supporting lots of vbac ladies, all successfully so far, I have never seen this before. It is rare but if it did happen, the consequences are so high. It will change the way I doula now I have to say.

Also can I just say that yes having a doula will be a great support for you, especially as alot of vbac success is down to positive state of mind but A doula should be supporting your informed choices and not necessarily fighting the cons and hc providers for you. She should support you in finding out as much info as you need to make your decisions together with your partner but should not be advising you to do anything, or making suggestions as such. We have a very delicate relationships with some docs and mw's and we work hard to maintain positive roles within what is their areas so we need to remember that we are not medically trained and are there to support families with the decisions that they make for themselves.

I wish you good luck for your birth.

Thanks liahgen66 - that's very interesting and actually kind of confirms how I'm feeling at the moment about becoming more risk averse. I think everyone's situation going into VBAC is so different. If it hadn't been for the BP problems last time and the very scary things I have only recently found out about what a close thing it was for my DD1 I think I'd be more assertive about pushing for my 'ideal' scenario. But I just feel now it's not that straightforward and that my last EMCS was more of a close run thing that I really wanted to accept at the time. ( It is literally only in the last few days of talking things through in great detail with my DH that I have found out things that I never knew about what a state DD was in - he thought I knew and I was just in no state to absorb the information at the time). There was actually a really good article in The Guardian the other day by a woman grieving for the fact that neither of her births had been experiences she wanted but very scary touch and go events - her NCT training had given her certain expectations that just could not be met and it was just incredibly lucky that she could get lifesaving medical care for her and her babies. So whilst it's brilliant for anyone who can acheive their ideal VBAC and I wish them all the luck in the world, I'm resigned to keeping my expectations low this time. If the baby is ok and I am I will be pleased.

Thanks as well Riven,
Also have changed my name from kaffers