Doubting my ability to manage a VBAC...

[moonstorm]

It's early days (15.5 weeks), but I have a midwife appointment tomorrow and want to discuss the birth with her then (I am under consultant-led care and I think the appointment after is with the consultant, so I want to talk to my midwife first).

Ds1 was premature and deilvered by 'urgent' c-section (due to worry about StrepB infectiopn risk).

I really want to VBAC as I took ages to recover last time and now I have a toddler... plus some of his time in SCBU was due to gunk in his stomach/ lungs that hadn't been squeezed out during the c-section.

I am doubting that I'll manage because:

• the hospital VBAC success rate is only 26%

• I'm under consultant-led care, which often means a more medicalised birth

*My last baby was breech which added to the need for c-section (I thought the risks out-weighed my need for V-birth. jmo)

*I am starting to doubt my own body will be capeable ot 'normal' birth. Probably this is silly, but on top of everything else I just am losing the drive to fight for this.

• I am also worried about constant monitoring throughout the birth as I would like to be upright and mobile as i know this can improve the VBAC success rate.

Can anyone offer any advice or support? It's at York hospital... just in case anyone has anyone has experienced this hospital.

Sorry for the essay!!

Thanks

Hi Moonstorm. Unless your consultant can give you personal evidence-based reasons for not having a vbac, this is something you (and your body, iykwim) can do! Is there also a midwife-led unit at the hospital or a midwife-led unit at another local hospital? Sorry, don't know the area you are! Don't doubt your body. You've just written your birth plan in the bullet points you made. Let the midwife know this. Hope all goes well. x

I don't have any real advice but it looks as though your first birth had quite specific things that would necessitate a c-section. If everything with the pregnancy goes smoothly then there shouldn't be any reason why you could not try VBAC.

I had a section with my first and then was hoping for VBAC but this didn't happen due to polyhydramnious and baby who wasn't engaged and couldn't decide whether to be breech or not. I was under consultant care but I did find that my consultant at least was very open to the idea of VBAC if I wanted to.

It might be worth investigating what that VBAC success rate actually means? Is it that 26% of people who attempt a VBAC actually deliver vaginally or that of the women who have previously had a CS, 26% go on to deliver vaginally with the rest being a mixture of elective and emergency CS. If it's the latter then it may be that the majority of women are opting for an elective CS, and the real 'success' figure may be far higher.

I had an emergency c-section and managed a vbac the second time around. You can be as mobile as you want - remember this is your labour ! The midwives were great, moving at my pace and offering support the whole way. They monitored the baby and I was able to move around if I wanted to. You don't have to make a decision for a while but I know it can be a worry. (I'm crapping myself about DC3).

Every pregnancy is different and this one is likely not to turn out the same as your first. You could do the preparation for a vbac (i.e. relaxation techniques and breathing techniques etc etc - which I would suggest as I did nothing for my vbac and didn't cope very well at the time), and what will be, will be.

My consultant just wanted me to give it a go, and if they needed to intervene, they would. I was so convinced it would turn out like birth number 1 that I did no preparation (as said above). Well, I went into hospital at 12 and baby was born at 4:30pm. No tears (but there were a few sobbing tears !). Even as I pushed the baby out at the I remember thinking gross ! I am going to push a baby out of my vagina. I know it is the most natural thing in the world, but I found it odd.

Anyway, I don't regret having a vbac at all. I could have a shower straight away, wander around and pick up my baby. I went home and we went to the localpub the next day for a drink. It was so liberating after my c-section (for which I recovered well, but it took a while). I think it's worth a go if you can.

Those statistics seem a bit odd at the hospital though. I didn't even think of investigating them at my hospital. I just thought I'd try it out and see what happened.

Good luck.

Forgot to say - I NEVER thought I could manage labour and birth. Now preg with number 3, I do feel it is as normal as having poo (sorry for that analogy !). Your body will take over as even though it doesn't feel like it usually knows what to do. Midwives are great support too.

You can't stop a poo coming out, and if all is well healthy with both of you when the time comes, you wont be able to stop this coming out either !

this baby, that is !

Thank you. Daisy - I never thought about looking at the statistics that way

Def - your post is really helpful - I really like the poo analogy!!!

The unit is a midwife-led unit at the hospital, but that worried me about the consultant thing - if I am on the unit, I'll feel better than if I have to go to a consultant led ward.

You have all helped me clarify what I want to ask the midwife tomorrow. As I said, it's early days, but with the consultant appointments I might not see her again until after 30 weeks.

Thanks again

Hello moonstorm, how did your meeting go? I too would like a meeting with a consultant midwife or someone - I am the first woman my midwife has dealt with who has even had a c-section first time round, so she doesn't have much experience. I want to talk to her about the constant monitoring, and the options if an induction or instrumental birth looks likely. ie. I want to try and be active if I am going to have a VBAC, not lying on a bed; I don't have faith in the process if I have to have an induction; and if forceps look likely I would rather have a c-section. I just want to try and have a positive experience this time, and another emergency c-section after a long labour is not going to be that! I am 15 weeks, so trying not to worry about it too much at the moment, but it's at the back of my mind of course!

I had C-section first time (elective, footling breech). I have gone on to have two VB, my consultant was very supportive. DC2 was very nearly another C-section, we were in the operating theatre with full team, I was on very strong epidural by then, I was asked to give one last push, and she was born. (I felt bad taking up so much staff when I didn't need them.) The third was scarily fast.

I tried for VB because the thought of 6 weeks not driving was just too much! (Not the only reason but a good incentive.)

You can request not to have CFM. The evidence supporting CFM even for a VBAC is very shaky so you might want to do a bit of research on this. (I've had two VBACs, one hospital and one home water birth - both with intermittent monitoring).

Also, have you looked into a doula? It's really worthwhile having someone on your 'team' who is confident in natural birth and VBAC and who will have your needs and wellbeing as her number one priority. Doulas greatly improve success rates in VBACs.

Good luck with it. There doesn't seem to be any big reason you cant have a successful VBAC, really

Hi Moonstorm,
I too am under consultant care at York Hospital, little bit further on than you (now 23 weeks) and have had a couple of meetings with consultants to chat through worries and concerns.

I ended up with a EMCS last time because baby was in wrong position, despite a really calm 9hour labour (just on gas and air) and then 2hours pushing I ended up in theatre and it was all just so so scary. Everyone was very lovely and supportive but I am now, as you think too, convinced that my body wont be able to do it naturally.

Im sure the consultant said that 70% of women go on to have a successful VBAC but that may well be a national stat and not specific to that hospital? but the fig you've got of 26% is really low isnt it? and does make me wonder is it worth going through the worry and stress to find myself in theatre anyway? I would rather have more control this time and do a ELCS.

Its really hard isnt it? Which consultant have you been seeing? I have another appointment at 34 weeks and if it makes you feel any better they have been super supportive and listening to me talk and cry and worry and have said it is our decision at the end of the day, I think they always try and steer you in the direction of a vbac but at the moment I find myself leaning towards a ELCS.
Would love to hear how you go on, especially as we're at the same hospital!
Keep me posted

moonstorm I had an emcs with DD and took 10 months to recover. I'm now 28 weeks with DC2 and definitely heading for a vbac simply because like you I can't imagine trying to look after a toddler and deal with a cs. DD was OP, face presenting and the cord was round her neck 3 times so she was never going to come out despite days of trying. I have quite a few wobbles about vbac and I'm dreading going through labour all over again just to have it end up with a cs but as people have said before vaginal births are normal so I just have to trust my body to do what it needs to. I hope you get a good consultant who can empower you to do this naturally!

Hi

Thanks for your replies.

I feel much better after speaking to the midwife and feel more confident about seing the consultant (I see him/ her in 4 weeks, but needed to get things talked over with teh midwife now).

She did say I could turn down CRM if I wanted (I did forget to ask why it might be necessary for a VBAC - I thought the main risk was of the scar rupturing - albeit very rarely).

She said that if I did go own the CFM route, I wouldn't have to be bed bound, I could sit on a birthing ball, kneel, crouch on the bed/ at the side et. but I wouldn't be able to walk the corridors obviously.

She also said that at York they are very keen for ladies to try to VBAC first before anysort of intervention which really cheered me up.

A bigplus is that I will be on a midwife-led ward, with consultants on standby,rather than a consultant led ward.

I have also found some books that are helping me get over my worry that my body can't cope - the Ina May guide to childbirth and (although I never would have bought it without the recommendation of a friend) the hypnobirthing book 'the Mongan method'. They are full of such positiveness that I feel much better about childbirth and about haviong faith in my body - things may still not work out, but I'll deal with that on the day, not worry about it for the next 5 months.

Overall I feel so much better. Thank you all for being so helpful and positive. x

Kity - I would be interested to hear how you get on at York if you would be interested in sharing.

I hope everyone's pregnancy and birth goes well x

Oh also - I think the low figure was how many people chose to VBAC at the time, not the success rate according to the miwife, which was positive

Hi Moonstorm, thanks for posting again, made me feel better! Id say Im still 50/50 undecided but am going to see the birth councellor at York to try and get over my fears and put me in a positive frame of mind. I go in a couple of weeks so will let you know how I go on, and how helpful it is.
I also read a great book, Stand and Deliver which was what really helped me get in a good place for first birth, talks a lot about "pain for a purpose" and that your body is made to do this. I have looked at it again but cant help the panicky feelings from EMCS creep in.
Im seeing midwife next week too so gonna have a chat about success rates in VBAC and stuff like that so will let you go on.
Is it wrong that part of me wishes the baby would be breech then I dont need to make this decision???
Will defo keep in touch! X

With a VBAC it's easy to fall into thinking that you may not be able to do it, because being under consultant care etc sounds all very medicalised. I found it helpful to look on it as something that 'on paper' looked scary and serious, but in practice, didn't mean the birth had to be out of my control. I didn't like the fact that for my VBAC the safest place was a big regional hospital, I didn't like being classified as 'high risk' but it's a procedure which has to be followed. There is no reason why your body shouldn't cope with giving birth. Try to separate what happened first time round mentally, and tell yourself this is a new pregnancy and a unique experience.

I was fortunate in the I had already had my first, natural birth before my CSection, so I knew third time around that my body had done it before, but I have several friends who had CS with their first but still went on to have VBACs. I was monitored closely with my VBAC, and in some senses the birth was more medicalised than I would have liked - the midwives called the doctors in to check me regularly. However, I still achieved a VBAC with gas and air. And the big benefit of course is that you don't then have to recover from major surgery - I came out of hospital later that day and was carrying my toddler around etc

Good luck.