Am I mad to want a VBAC?

[Curlychica]

Now 37weeks and just had conversation with consultant obs. to discuss birth plan. She says my chances of having a natural birth are around 30% so quite low.

This is due to a number of factors.

1. One previous CS, never given birth naturally. Maconium in waters and failure to progress (got to 4-5cm) even after drip and epidural
2. DD weighed 10lbs 1oz
3. Have now developed gestational diabetes (did not have in last pg) so may need drip.
4. Have pretty bad SPD which I am downplaying as I know its just another thing to add to list.

I really want a natural birth but not at all costs. I know I want more children in future and posibly 2-3 more. This may not be poss with number of CS. I also have a toddler to look after and live 3 flights up so a quicker recovery time would help.

What do people think? Am I mad? Should I just count my blessings? I feel they are quite reluctant in some ways to support my wish but will do so. Of course it means more monitoring etc which I understand but at the same time I think this didn't help last time as that's when things slowed down for me. They won't let me go past my date if I don't go into labour myself and will give me a CS. Is this normal practice?

Any thoughts comments appreciated.

I don't know anything about GD but reasons 1, 2 or 4 I don't think would preclude you from a VBAC. I'm in a similar situation to you with reasons 1 and 2 and have a great independent midwife who is very encouraging about my chances of VBAC.

birthwithoutfearblog.com/ is a great resource for empowering stories :)

I think if you are keen for a VBAC you should go for it.

I was induced 2 days early for my first for late onset pre-eclampsia. Failed to progress despite full dose of syntocin drip running and had a C-Section.
With my 2nd I was keen for a VBAC especially having a toddler to run after. I went 10 days overdue when they needed to induce me as my BP suddenly rose. Unfortunately I did not progress again and needed another C-Section.

Where I live you can go 10-14 days overdue prior to induction. Even with a VBAC.
If you need to be induced you can not have the pessary but they can break your waters and get you on the syntocin drip. The syntocin drip can not be on as high a dose either. I had to be monitored throughout the labour but I stayed standing and bouncing on the ball until the epidural went in for the C-Section.

I recovered very quickly the 2nd time round and even though I did not get the natural birth I wanted I am glad I gave it a go.

They did say if I wanted any more children they would suggest a C-Section but I have read on the internet of Mum's having 2 C-Sections before having a VBAC.

Hope you get the delivery you want

Hi there,

Please do not think you are mad wanting a VBAC. Firstly, failure to progress should never be used with a labouring woman as a baby will come when he/she is good and ready not when the consultant decides it is time. I have a very similar history to you. My son was born by caesarean after a failed induction and he was 10lb 3oz. I now know that my body was not ready for the induction and that the c-section was completely unnecessary. I am now planning a VBAC at home in a water pool and I have declined consultant led-care.
I'm waffling but there is a VBAC support group through yahoo that I would highly recommend joining. You will need a yahoo email address. I am part of the Leeds VBAC group so I'm not sure where you're from but if you do a google search I'm sure you will find some info on it. It is amazing and full of very knowledgeable women,doulas and women who work for AIMS who are very informed and can really empower you to make the right choices for you and your baby.
Also, Gestational Diabetes is discussed alot and alot of the research behind it isn't very conclusive as most women have raised sugars when pregnant. That is why I have declined consultant-led care as I would prefer to deal with midwives who are experienced in natural birth whereas consultants only deal with the abnormal.
One last thing. If you are planning on having a hospital VBAC then the chances do decrease for natural birth because you will be on the hospital clock and not your own. This is why it is so important to get informed of your choices now. At the end of the day it is your body, your baby and your decision. No one can tell you how you can deliver your baby.
Good luck I really hope you can join a VBAC support group and get the support you so deserve! If I can help with anything please let me know.

FWIW I had a successful VBAC 2 years and 4 months after a failed induction then an em cs due to failure to progress. I was induced withe synto drip despite cervix being unripe in the extreme! The chances of it succeeding as I now know were slim and the fact that I got to 8cm (where I stayed for about 8 hours before consenting to a cs) was nothing short of a miracle.

However, I have since found out that labouring with a first birth even when that birth concludes surgically increases your chances of a successful VBAC next time round. It wasn't the pointless exercise in pain and misery I thought it was.

However, you have more complicating factors than I did and I'm not sure how these affect the chances of a natural birth.

I managed by VBAC in hospital quite happily - I was left for a couple of hours without CFM or any other intrusion just to see how things progressed in which time I went from 2cm to transition. I then was hastily wheeled to a delivery room where I was hooked up to monitor, canula etc. but by then I didn't care as it was obvious that no force on earth was going to prevent DD making her entrance into this world. She was born after 30 minutes of pushing.

Best of luck whatever you decide.

Thanks to all of you for your words of encouragement. Thanks also for the website resources. I know I am going to give it my best shot - if I didn't I would definitely regret it later.

I know my chances are lowered with having a hospital VBAC but I don't think I would be ok with a home birth either. My plan is to labour as long as possible at home then when I go in I have agreed to continous monitoring of baby for a period. If things seem fine I can prob use the pool for a while. I just want time to see how I get on without interventions happening straight away.

I just know what I'm like - not very assertive and my husband will probably panic - even if I tell him before - he is likely to want to follow consultants advice.

wasabipeanut - that sounds like my ideal VBAC. Here's hoping.

I have had 3 vbacs. My experience was that the medical team for dc2 were very positive about vbac and that although the decision was ultimately mine, they encouraged me to give it a go.

That said, my circumstances with dc1 were very different to yours.

I think that it is absolutely fine to make it your main aim, however try not to set your heart on it. I was absolutely determined to have vbac second time round but it was not to be and I was gutted to say the least. I realise in the end that it doesn't matter as dd and I were both much better off as a result of the cs but it has taken time to come to terms with it. I was so, so avid that a natural birth was what I wanted and if I had my time again I would definately have that as my main aim and plan accordingly but I would also be realistic that my chances are low of achieving a natural birth.

Mum2JRC you can go as far 'overdue' as is necessary - the hospital can't 'let' you only go overdue by up to 10-14 days. If a woman chooses not to be induced at 40+14 that is her choice regardless of what her HCPs advise and NICE guidelines say women should be offered the option of expectant management. This would include women opting for VBAC, where induction is generally not recommended due to the increased risk of uterine rupture.

OP, the Yahoo HBAC/VBAC group might be a good place for you to get more advice, as well as here

I had an emCS first time and planned a hospital VBAC second time. I never got as far as the hospital part of the plan - baby just fell out at home! First and second babies are completely different. What I learnt, though, is that it is possible to at least plan a good hospital VBAC attempt. Good luck.

Have you thought about hiring a doula? I would highly recommend it if you can afford it as a good doula will advocate for you and support your husband so that you can make informed choices without feeling pressured from HCP's. They are proven to reduce the incidence of c-sections, interventions and the length of labour. There is some good info on the doula uk website. :-)

You are not mad and don't put too much stock in the 30% thing, there is no possible way to know your individual chances.

Did you have any treatment for the GD? If so this could reduce your chances of having a large baby. With my second child I was cleared for GD but in retrospect probably had it, he was large at 38 weeks, masses of fluid. Was diagnosed with third child and controlled blood sugars, normal sized bump and baby 1lb lighter.

Every birth is going to be different, position of baby/placenta, loads of variables that can't really be calculated. Give it a go and try not to let them guilt you into going against your instincts, an informed doula would be a great idea. Good luck hope you get the birth you want.

I must say as well, because I had GD I had a Dr from SCBU visit me about 12 hours after the birth. She basically said it's procedure to take your baby to SCBU, and started to wheel him off , I caught the end of the cot and said erm no, he is fine here ta muchly.

She then went into a lecture about how I was endangering my baby and he could have brain damage yadda yadda. His blood sugars were being monitored regularly and weren't any were near any kind of dangerous level, I was even topping him up with formula, which I didn't want to do.

Funnily enough the monitoring was stopped about 24 hours after birth, she was a right biatch, more her manner than anything else, grr.