Birth after CS?

[LetsHaveAnotherOne]

If you've already had a cesarian section - do you "automatically qualify" for another next time you give birth - or are you expected to try VBAC depending on the reason for c-section? (like if baby was breach last time)?

There is no reason not to try VBAC - especially if the reason for the first was baby was breach. That is if you want to.

Only real difference is that most hospitals won't induce you if you go over due.

Actually, my baby was "unstable lie" and because I live so far from the hospital I was kept in for the last 2 weeks (incase my waters went while baby was transverse) and it ended in a c section anyway (I totally refused to be induced, and have the baby turned and waters broken artificially due to previous bad experience of induction - particulary when I factored in the size of the baby, babies head (big baby!) and the fact it was back to back whatever).
I am guessing I may get unstable lie again (had it last 2 pregnancies)...so would probably prefer a c-section again in those circumstances (esp as I would not want to spend 2 weeks in hospital while they try to make me have an induction or hope the baby turns and stays head down of it's own accord - the baby was still somersaulting!).
I just don't know if having had a c-section I'll be offered it again automatically or if they'll want to see how things go and see if I can VBAC.
I know it's wrong to want a cs, I just don't want "holding prisoner" (for the safety of the unborn baby) for 2 weeks and being constantly pressured to have the baby turned and an induction as an alternative".

Hi turkeyboots, what do you mean about not inducing you? So if you are hoping for a VBAC they wont induce they go straight for the section?

lets, my MW gave me the choice at my first appointment.

I guess I should be asking if one has had "Unstable lie" if it's likely to occur again too?

With DS, after a section with DD, hospital told me they didn't induce VBAC due to the higher (but still v low!) risk of various bad things happening. Seems to be a general NHS guideline, although I know some hospitals do use a tiny bit of artificial induction to get labour going and then stop once things are under way.

I had a section for foetal distress and failure to progress with DD1. I wanted a VBAC with DD2 - the hospital said that they would have offered a CS but definitely preferred me to go for VBAC, as there was no reason why it should happen again (and it didn't!). I would have thought that you have an argument for another CS, as unstable lie seems to be a feature of your pregnancies, but you might have to fight a bit to get it.

Re induction - my hospital induced me for DD3. They will not use pessaries, but will use the synto drip. The reasoning behind it is that the synto is removed quickly from your system, so itf something untoward starts happening, they can stop the drip immediately and you quickly clear the rest from your circulation. With pessaries, once they're in, they're in and you can't remove them, as it were. So, induction depends on your hospital and, indeed, on your consultant. They did offer me an epidural before they started the drip (and I gratefully accepted).

The hospital I was at for dd2 (induced) "only" used pessaries.. it was not gentle by any means! Especially the bit where they hooked the waters to get things going quicker (5 members of staff all took turns to try and reach - apparently my cervix is very high and difficult to find - excruciatingly painful)...then the staff all rushed off to help other patients and left us on our own...By the time they came back the monitor was showing 160 with no variation for babies heart rate - the room filled with staff - the buzzer on the wall was pressed for the "flying squad"?! and there was talk of emergency cs - then the gas and air was removed from my hand - and I was instructed to push. DD was born with apgar 2 or 3 "unexpected mec delivery" (mostly unexpected because they had not been keeping an eye on things in this induced labour) - she was suctioned before her body was even born and then had her stomache washed and we had to stay in overnight, with supposedly someone checking baby every hour (except they didn't til 5am - when I asked the nurse that appeared what she was doing with my baby!). I was then discharged from hospital with a prescription for some medication - which luckily I didn't take as I didn't know what it was for (asked my mw at home - she said it was for people that had had cesearians!). She told me it was a good job I hadn't taken it as it was not at all suitable for me being asthmatic and allergic to ibuprofen - and also breastfeeding.

I will not ever agree to another induction.
As an alternative - a cs seems very civilised and organised.

Can they really insist you VBAC?

Anyone been allowed a waterbirth following a cs?

I had agreement from my hospital to labour in water for DD3's birth. They did ask that I got out for the birth, as I had a PPH with DD2 and I agreed to that.

I didn't use the pool as DD3 was induced, but the agreement was there. If this is something you're considering, ask them about telemetric monitors - these are wireless monitors which can be used in water, allowing CFM in water.

Personally I would not want to consider giving birth naturally out of water.

With my 1st child, labour was going well - I had started pushing and they asked me to get out for the birth. I got out - they ended up giving me a forceps delivery. It is my beleif that if I had been left to finish the job in the water the forceps would not have been necessary at all. I think it was being asked to get out of the pool and walk up the corridor to another room that caused the birth to go wrong.

I will only agree happily to VBAC if they let me labour AND birth in the water.

Hark at me - only 4 weeks preg and alread an awkward customer!

Some places will induce, it varies. IMHO they should at all, because it vastly increases the risk of uterine rupture.

I planned a waterbirth for my VBAC, was at home though. Some places do allow VBAC in water, may depend on the monitoring available as they usually ask you to have constant monitoring so in water you would need a fancy monitor. Or you can decline constant monitoring if you prefer.

AFAIK you can't force them to let you use a pool in hospital, but you may be able to negotiate something.

Well, that is good to know! At least it's not totally impossible.

I must admit my fastest recovery was after the waterbirth, so it's very tempting if they'll let me try - and if they have the monitor that works in water.

I was told I "might" be allowed to use the pool for pain relief, but not pushing stage during my planned VBAC (ened up with c-section as DS decided to be 2 weeks late). But women who wanted a water birth had priority over me, so was told it was unlikely I'd get the pool.

Oh. That doesn't sound good. Also, if it's unstable lie for me again, i'd have to wait in the hospital from 38w until natural labour started too. I don't like the thought of that again.
In some ways it'd be a lot simpler if they just scheduled a cs then.

Sorry - re inducing, I meant IMHO they shouldn't at all because of the risk of UR.

moaningminnie, even though the absolute risk of serious complications following uterine rupture is very low? Is it not better to give women the risks and let them decide for themselves?

poledra, as sometime who has planned and attempted an HBAC I certainly, in most cases, agree that informed choice is the way to go

But the risk of UR is doubled or tripled with an augmented labour and risk of mortality for the baby is also increased.

IMHO the risk of UR for a low intervention VBAC is perfectly acceptable. But induction is rarely clinically neccessary - as a VBAC candidate I would plan for watchful waiting if overdue or repeat CS if baby seemed to need to be out - induction is too slow if the baby is unwell and the risk of needing an EMCS as a result of any failed induction is quite high IIRC.

Most places will not induce with prostoglandins at all, some will try careful doses of synto/possibly with ARM. In planning an HBAC I considered the risks/benefits of all of these and personally I would not consent to any induction/speeding up of a VBAC labour.

But then my first CS was a crash section under GA and my plans were aimed solely at minimising the risk of that situation recurring - it may be that someone who very much wants/needs a VBAC would be happy to accept induction and it's risks if the alternative was a guaranteed CS.