Vbac/ELCS can't make a decision!!

[Mumcah]

Hi Ladies,this is a decision only I can make but I'm finding it impossible and I change my
decision every day.
I'm 33 weeks pregnant with no2.DD was born has just turned 2 and I had an EMCS for 'failure to progress' as I only reached 4cm's after being at home for 2 days (planned HB!) then 4 hours on the drip at hospital.I was active throughout the birth until the last 4 hours when I had the drip.Apparently DD turned back to back and then was transverse when I had the section.She was 9lb 5oz and luckily never got distressed during the labour but it was obvious I was not progressing so I was happy to have a section.

I would love a 'natural' birth and have done some research.It seems 'most' successful Vbacs are for people who got to 10cm/babies got stuck or electives the first time round.I'm not sure if I am in the most likely catagory and how much was due to DD's position last time rather than my body not being able to do it.(sorry for the ramble).
Anyway...I'm going to King's in London who are very pro Vbac (I can even have a water birth) but they still say it's my decision.

I would love to have an elective section (which I could have in 5 weeks time) but I'm scared about thinking 'what if'?I'm not worried about the recovery of a section as DP is around for the next few months without having to work.

Help!Or any experiences please.

Just to say this baby is big although I'm assured size isn't a problem when having a baby vaginally!

I'm watching with interest as I'm hoping to ttc dc2 soon.

I was told by one mw that as I have a small pelvis ds was more likely to get stuck as he was big- relatively speaking.

Oops

I had emcs for failure to progress - got to 8cm. Ds was in op position too.

I had EMCS with DS1 due to failure to progress - didn't get beyond 6cm dilated and he wasn't descending. I opted for ELCS with DS2 because my gut feeling told me I would have 20 hours in labour followed by another section and I wanted to remember DS2's birth (was too tired by the time DS1 was delivered having not slept at all the night before) Can you leave it until nearer the time to decide? With DS1 they were never convinced I would be able to have a natural birth anyway so booked me in for a section a week after due date if nothing happened but as it happened I went into labour at 40+1. I'd rather have an ELCS than EMCS after a long labour any day! It is a decision only you can make. I have 2 friends who opted for VBAC but both ended up having an emcs after labour didn't progress. But then I have another friend who had an unassisted HB after EMCS and she couldn't have been happier with how the birth went!

OP - i had an emcs with DD because of failure to progress.

I am now 20wks pg with ds and after seeing the consultant have decided to go for a vbac with an elective booked for 10days overdue. The reasons for us choosing a vbac:

We are likely to want more than 2dc
I didn't like the thought of ds being 'removed' when not ready iyswim?
It has been agreed that i won't be allowed to be in labour struggling for as long as i did last time
There was no reason to suggest it couldn't work this time but if any problems arise during labour i would be taken in for a cs
I feel that things are slightly more in my control this way.

I hope this helps at all

I think I read that if you got to 10cm the first time your VBAC may be more likely to fail (as possibly there is something mechanical wrong). That's what happened to me anyway - baby got stuck x 2, I am a dud!

But for me it was the right thing to try because in general your chances of succeeding are good. Most women who try do get their VBAC.

If your baby was malpositioned that may be why you FTP, surely? Perhaps it was just one of those things? Second time around can be v different. Even though for me the outcome was the same, the labour itself was infinitely better second time and so I don't regret trying.

Hi Mumcah,

DS1 was born by EMCS after he got stuck, his head being in the wrong position. He turned out to be 9lbs 5oz, however I did get fully dilated.

When pregnant with DS2 I was faced with the decision of what to do, VBAC or ELCS. The consultant I spoke to regarding my first birth said it was just one of those things and that I shouldn't be put off trying for a VBAC.

In the end I decided to let nature take it's course and had a "sucessful" VBAC. However, I ended up with a ventouse delivery and bad tearing. In hindsight I wish I'd chosen an ELCS, as I was fortunate that I recovered well from the EMCS first time round.

As with any birth there is really no way of telling what will happen. However, I would advise you to go with your gut feeling. If after the research you've done you feel you want an ELCS, don't feel bad about it. Instead put your energy into making it a positive birth experience.

Good luck!

Alice - does having 2 cs mean you can't have any more?
I've had a emcs. Will choose elcs next time. We may want 3dc - would that have to be vbac? That doesn't make sense to me.

I want a VBAC next time just because I want to experience contractions! Am I mad?

I had EMCS with DS1 got to 8cm failed to progress ds1 stuck OP and also 9lb 9 so no shifting him.

Was told ds2 was also a biggie and was determined to have elcs and was booked in for this. Went into labour after lot of faffing back and to to hosp who said I wasn't etc eventually got back to hosp in AGONY and when eventually examined after 1/2 hour on monitor to discover I was 9cm dilated! No pain relief!! Whipped off to delivery frantic that I wasn't going to get my ELCS however they said it could go ahead. They were prepping me for surgery when the mw asked me if I wanted to try naturally as the baby was ready. I said noooooo and she asked why to which I replied I did not want to be damaged down there by a giant baby (was on g&a by this time . She said didn't seem that big so I had a go.

DS2 was born within 1/2 hour naturally no assistance healthy 8lb6 not the giant 11lber I was expecting. I am so grateful to the mw for giving me the confidence and support to try naturally. I felt so in awe of myself for doing it and have never felt such a high.

I did have episiotomy and don't know how many stitches and it did take me longer to recover physically than from my emcs (and to be truthful things down there are never the same again) but I would absolutely do it all again. Am hoping for a dc3 and will def go for VBAC again in fact I think i would be a bit gutted to have to have another section.

I never for one minute when I had EMCS with ds1 felt I had missed out as I was so over the moon to have him but having had the VBAC with DS2 I felt totally different and am so glad I was able to have that experience.

HTH

p.s. mrsflux I'm pretty sure if you have 2sections they won't let you try VBAC on no3 they insist on a 3rd section because the scar would be weakened bigger risks of rupture etc.

The tide's changing QQQ, I am 36 weeks with DC3 and had emcs with DS (fully dilated, brow presentation, whopping head), elective c/s with DD (at 40+2, very petite baby, oh the irony) and have been offered VBA2C with this baby.

I am still undecided. And possibly shall remain so until I do. or don't go into labour. My inclination at present is to give it a whirl in the knowledge that I can decide to have a C/S at any point. I found the elective C/S a lot more traumatic than DS's birth, but know I am in the minority.

OP I would suggest reading Michel Odent's The Caesarian - really helped me.

Thanks for your replies.I'll have a look for that book.
After I had my dd I said 'i'm never doing that again,elective section for me next time'!Time makes you forget.

MrsFlux - the consultant said if i was late 30's and only wanted 2 or 3 then they would recomend elcs, but because i am young and have the possibilty of upwards of 3 dc, then if i can have a vbac it would be what they would advise.

DH and i have not ruled out a big family, and i don't like the idea of having 4 (or more!) cs as i think (as does the consultant) that would do almost irreparable damage to my abdominal muscles.

(please excuse atrocious spelling, have serious pg brain this morning )

My emcs was due to distress during induction. I think I got to 5 cms.

This time I was determined to vbac and avoid induction, so after 3 sweeps, 3 nights of on/off labour and waters breaking I finally gave birth at 16 days over dates. I went in for monitoring after my waters went and discovered DD2 was in distress so I was whisked through to labour ward and prepped for another emcs. At this point it did go through my mind that I had been silly to avoid a cs and may have jeopardised DD.

As it turned out, I was fully dilated and DD was turned with ventouse and born with forceps under a spinal. She had the cord around her neck which probably accounted for the stop-start labour and lack of descent.

It all sounds pretty horrendous but in fact it was amazingly positive compared to my emcs. DD2 was born just before midnight, fed immediately and most of the night. I got my catheter out as soon as I got sensation back in the morning, produced my 3 bed pans required for discharge and was home by the afternoon. I could get up and pick up DD with no pain, the episio was a scratch compared with a cs scar, I could feed lying down without straining my scar, I had so much more energy despite not having slept properly for 4 nights, DH didn't have to do everything and we were all so much more relaxed and happy as a result. I could even pick up my toddler. If a vbac is possible I would wholeheartedly recommend it.

All things being equal I would go for a VBAC every time. There is NOTHING like the experience of a VB. Nothing like a C-birth either of course........

However, I would only attempt a VBAC if I knew I was going to be fully supported and able to get into the birthing zone and be left in peace to deliver the baby. Repeated interuptions, a list of can and can't do's, induction, continuous monitoring, being forced to remain immobile, - well, these are all very likely to lead to an emergency c-birth and in those circumstances I would prefer an elective.

I suppose what I am trying to say, is that if you are able to get an excellent birthing environment and support then your VBAC will be successful and amazing. If you have to compromise on any of that you may as well head for a controlled c-birth.

hth

btw big babies are actually condusive to a quicker, easier labour overall!

Del - "I suppose what I am trying to say, is that if you are able to get an excellent birthing environment and support then your VBAC will be successful and amazing. If you have to compromise on any of that you may as well head for a controlled c-birth."

how can you ensure this?
how do you know what sort of support you will get in hospital without knowing when baby is arriving/ who is working then/ what mood they're in/ etc

'how can you ensure this?'

You can never ensure it, but there are things you can do to improve your chances. Meeting with SOM to explain that you are terrified of an unsupported birth/no access to a pool, whatever. Writing a carefully worded birth plan with bullet points. And of course, hiring a doula to protect you and your birth space.

However, from the OP's description her chosen place does appear to offer a good birthing environment. A Unit that allows waterbirths for VBAC are probably more modern and up to date in their knowledge and understanding of the natural birthing process.

I suppose what I mean is that you can improve your chances. Make your needs clear and if at any point you think 'hmm, not sure I like that' then go for a c-birth.

Mrsflux There is no saying how many children you can have by EL-C-Birth but the more you have, the more unlikely it is you can have another iyswim. There is an increased risk of not being able to conceive too.

Possibly, a planned C-Birth is safer in this regard than an emergency C-Birth. That is why it is important that you ensure things are set up in an optimal way to ensure a good outcome vb wise.

I don't know the details of your story, but 'failure to progress' as a term makes me very angry. Given you had an OP, did you have an immobile epidural?

What is your what if question?

I had an emergency section with dc1 and didn't go into labour. I then had 2VBAC. VBAC all the way for me.

I have reread your OP and get it now.

BTW my neighbour ended up with a section for her first child and was told she had a very small pelvis. The second baby was born vaginally with no problems.

ds1 was an emerg section after failure to progress. He was a planned hb and I got to 8-9cm dilated. I recovered v well from the op but I knew that I wanted to have a natural birth next time around.

ds2 - born at home in a pool after a 4 hour labour and only 20 minutes 2nd stage. Even though I recoverd well after the csection, it didn't even compare to the quicker recovery after my vbac. I also felt a huge ense of achievement and I'm still on a vbac high 19 months later!

OP my hospital has all the usual VBAC 'policies' but I met with the consultant midwife and she was really supportive of my wishes to have intermittent monitoring, access to the pool, no cannula, etc. If you do a search you'll find a comprehensive summary of our discussion. As long as she had seen my notes and explained risks, etc. with me she was happy to go with whatever I wanted to do. She made this clear in a letter to my consultant and a copy was placed in my notes at the hospital as a birth plan, and a copy given to my community midwife too. I didn't even know there was a consultant midwife until I got a bit wobbly about my chances of avoiding another cs/unnecessary intervention at a MW appointment (28 weeks or so?) and my MW got in touch with the CMW, who phoned me, sent me some information to read and met me at 36 weeks instead of the consultant Dr.

del - I had a clear bulleted birth plan. I was in the birth suite so mw led. I had access to the pool- even got in it despite not wanting to in my birth plan. I did all of your suggestions bar hiring a doula, another stranger would have made me worse. Yes I had an immobile epidural but things had already gone quite far in the wrong direction by then.

I still ended up with emcs.

Sometimes it's just not meant to be and in a less medical environment/ country it could have probably ended very badly for me and ds.