Anyone able to answer some questions about VBAC, induction, back to back and birth plan?

[Alicetheinvisible]

Sorry, not asking much am i?

I am planning a VBAC this time (emcs last time) due in 5weeks.

I didn't write a birth plan last time as i was fairly open to the whole thing (first time) and had no idea how i would feel. I had a long labour with a oxytocin/syntocinon drip to help things along a bit which made DD's heartrate drop each time they tried to up the dose. This ended in an emcs.

I saw a consultant quite early on in this pg to talk over the vbac vs elcs. We decided that i was a good candidate for a vbac, but have booked a cs for 10days over to avoid induction. I can't remember if he told me i couldn't be induced, or whether he asked if i would rather be induced or have a cs. I really don't want to be induced.

My questions are;

1)Even without being induced, can they still give me oxytocin etc to help things along? Can i refuse this? Or write on my birth plan i want it properly discussed before use?

2)My baby seems to be back to back atm. Will this mean an immediate cs? I don't want a long labour resulting in a cs when i would have needed one anyway because of baby's positioning iyswim?

3)How can i write this on my birthplan without coming across as a pain?

I think that is it......

Many thanks

Hi Alice

I can only tell you about my experience with attempted vbac, I gather that it varies from place to place and of course with what happens on the day.

1. DS was v badly positioned and back to back before labour even started. I did everything possible to turn him around the right way (look at spinningbabies.com) But he was extremely stubborn and wouldnt budge.

I went into labour naturally but didnot dilate quickly, so Drs gave me a v slow syntocinon drip to get things moving a bit, ultimately it didnt work and I had a repeat C/s.

Not the ideal vbac experience that Id set my heart on, however interestingly enough it was very similar to what happened with my first child. I never got to the pushing stage with with either

Of course you can refuse anything you like! But Im pretty sure that they would not let you linger in unproductive labour for very long!

No harm in writing down in a birth plan what you want in all cases, ie should it go to emsec.

Good luck! I totally know how you are feeling I hope you get your Vbac!

Thank you Sunchild. That sounds very much how my first labour went, and although i didn't find it traumatic, i feel it is silly for me to attempt spontaneously going into labour only for the same thing to happen.

Obviously i have a toddler at home this time, so going for an elcs would mean i could have her care sorted before i go in iyswim? But i don't like the idea of having a cs just 'because' you know?

But if baby is back to back, is it worth attempting a vbac?

Baby can turn right up until the very last minute so Im told! It just wasnt happening/ wasnt going to happen with me, i tried very hard, but was out of my control. Im SO glad I tried though, because it was v v important to me to try ( I was v sad that it all went wrong first time around). I still wonder now if I have something wrong with my pelvis. But short of a CT scan no one could have told me that until I went into labour.

I think You still have a really good chance of a vbac if you decide that what you really want.

This group is GREAT for Vbac advice (you need to apply to join! Lots of lovely women who are very empowering, and encouraging!

health.groups.yahoo.com/group/ukvbachbac/

I am currently pregnant with #3 and have decided to have an elective this time around, because I honestly dont think I could cope with "trying" to do it myself again, and of course it does make things easier with planning etc. I dont "Want" at C/s though. I hate the recovery and how much it hurts

Good luck to you, whatever you decide You CAN do it and there is no reason why it wont happen for you, (its just there is no crystal ball to predict it)

Thank you so much for your help, will have a look at that site

Hi Alice, I am in a similar position to you, although due in October and have a meeting with a consultant midwife next week.

DS was also back to back, and although this didn't help matters, ultimately he was brow presenting and this resulted in a emcs. Everything I have read suggests that there is no reason why you could not have a VBAC back-to-back birth, particularly as it is your second baby and you went through a labour process up to a point. Also, there is nothing to say that the baby is going to stay back to back. My friend was due at the weekend and last week she was in loads of pain as the baby had turned back to back. However, she spent a lot of time on all fours, and he/she has turned again. DS only turned back to back on the day. My friend was told that it is first labours that are more of a problem with back to back babies.

But I know what you mean, and I might feel the same if this baby turns back to back in the run up to the birth. I would rather have another c-section than another traumatic labour resulting in a c-section anyway. I think...part of me wants to at least give it a go regardless of the outcome, to at least be part of the process, iyswim.

Ultimately I would say yes, it would be worth trying a VBAC with a back to back baby, but perhaps you can have another chat with an experienced midwife or consultant beforehand? Good luck

I forgot to add, that don't worry about appearing to be a "pain" on your birth plan - this is really important stuff. I also don't want to be induced, and was told this would not be a problem. My midwife also said that it could be put in writing that I would rather have a c-section that have forceps used (although obviously this might not be possible), so I they should be pretty open to your wishes.

See this is a problem.......My MW. She is very nice, but i don't really have a lot of confidence in her.

No, I don't have a lot of confidence in mine, because she has never had a patient/client (what are we called???) who has had a c-section before! But it's unlikely she'll be delivering the baby, and there are midwives with lots more experience, so just ask to see a consultant one.

I know 4 people who had my MW. One thought she was great, one was rushed to Hospital with severe pre-eclampsia and had to be induced at 34wks after the MW refused to see her, and the other two had undiagnosed breech babies, one was seen by her whilst in labour and she still got the position wrong

Also, saw her last at 24wks and i told her i was having BH and she said that was a good thing. Then tried contacting her a few times because of prem labour and missing bloods but no reply.

Doesn't fill me with great confidence tbh...

1)Even without being induced, can they still give me oxytocin etc to help things along? Can i refuse this? Or write on my birth plan i want it properly discussed before use?

They tend to try to avoid oxytocin in VBAC as it cn put extra pressure on the scar but they will offer this if your labour is slow and they think it will help.

2)My baby seems to be back to back atm. Will this mean an immediate cs? I don't want a long labour resulting in a cs when i would have needed one anyway because of baby's positioning iyswim?

Back to back is not always a problem. In my opinion it is a combination of babies size, pelvis size and shape and mobility of the mother. If your babny is big, your pelvis a narrower shape and you are not mobile in labour or have an epidural then this is when problems can occur.
Many women can deliver a back to back baby without problems, even if they dont rotate in labour (and many do rotate to a better position in labour)
I have supported (as a Doula) a few VBAC's now of women that had a CS due to problems with their first baby being back to back.
Twice the second baby was back to back again, but using techniques like rebozo, inversion, pelvic lift, lunge (Spinning babies)etc they did have successful VBAC's.
Have you considered a Doula to support you?
Selina

Thanks very much Selina That is very helpful.

Would seeing a chiropractor help shift the baby? I have heard it mentioned.

I had considered a Doula at various points of the pg, but a bit unsure of the details/what it entails etc.

No worries Hun,
Yes, I definetely recommend seeing a chiropractor, esopecially if you have had problems with babies position before or you have any kind of fall or old pelvic injury.
Doulas all do work quite differently.
I'm a member of Doula UK www.doula.org.uk/
They have a search facility for you to find local Doulas.
THey have a mentoring system and REcognition procvess and Code of conduct etc
All Doulas work differently, its best to meet a few until you find one thats right.
Most visit you at least 3 times in pregnancy to discuss your last birth and plans for this one (some like me, like to do more visits)
They work WITH your partner to support you as a team, men can worry they feel excluded, but I think most (if not all) Dad's I've worked with have been glad I was there.
Your Doula is on call for you 24 hours a day so when you can go into labour you can phone straight away and they can spend time at home with you in early labour, help with pain relief like massage and positions to help baby turn. REasurrance etc
They go to hospital with you to help you stay relaxed and mobile too, and wont leave till your baby is born and you are all comfortable.
They will also visit you after the birth to talk through how everything went, help with any problems, feeding etc
Please do feel free to ask ny other questions.
Selina
PS A new film of Doula ion action here doulafilm.com/

Thanks, will speak to DH about it later