anyone had natural birth after previous caesarian?

[lukeandbumpsmum]

Had a caesarian with my last child 2 years ago as he was breech and am going to try for natural birth this time. Was told by doctor that I can be in labour for 5/6 hours before they give me caesarian anyway and there is 50/60% chance of giving birth naturally. A bit scared about the whole thing as don't want to go through tough labour and then caesarian anyway, then have to come home and look after a toddler. Has anyone been through this and how did it go?

Thanks xx

Hi, I had an emergency c-section with DS1 after 35 hours of labour, fully dilated, no painrelief ( by choice ) and pushing and DS1 did not come out. Horrible, traumatic experience that really left me scared. After the c-section they discovered that DS1 was back to spine which explained why it was so hard to push him out.

However, DS2 ( now 10 months ) was a natural birth and was one of the most life affirming moments of my life.

I thought that second time round it was likely to be substantially quicker, I got lots of support on mumsnet and the odds I were quoted for VBAC were higher more like 70%. So I went into labour scared but armed with more info.

In practice it was just as tough - look initial stage of about 24 hours, into hospital at about 3cm dilated, contractions for about 4 hours to be told that I had not dilated further. The pain seemed a lot worse as well and didn't cope with it as well as last time. The midwife said that I was probably tense because of previous experience and that was probably inhibiting my dilation. Then had epidural and made it through, great midwife and managed to push him out to find out that yet again he was back to spine. That is apparently much harder to push out than normal delivery.

My circumstances were slightly different in that I was petrified that I would get all the way there and then not be able to get the little blighter out.

There are no guarantees but looking at your message there is no reason that you will not be able to give birth naturally. Also, i was in labour for over 30 hours and there was no suggestion that I needed a c-section second time round. Remember that it is your choice and the only time it will become "necessary" is if the baby is distressed or your scar splits.

If it's any comfort, I have a friend who had a home water birth after 3 previous caesarians. So shouldn't be a problem at all

Hi

Had emergency c-section with ds1. Had to be induced after waters went and then didn't go into labour. After 48 hours, I was put on the drip. Labour was about 17 hours (tens, gas and air, and epidural pain relief). DS1 was stuck and not for coming out. Following 3 failed ventouse attempts had c-section.

With ds2, I was determined to try for a natural birth. Went into labour 4 days after my due date. Slow progress in hospital, same pain relief as first time round. DS2 also got stuck on the way out, so I was prepped for a c-section prior to ventouse as a last option. Thankfully, ds2 put in an appearance at the first attempt with the ventouse.

Ds1 was 23 months when his brother was born. It is tough second time around, but the recovery time is so much quicker with a natural delivery. I found the stitches the worst part, not being able to sit down comfortably for about a week afterwards. It was good to get home 24 hours after the birth, too, and not be stuck in hospital.

I was nervous trying for a natural delivery but really didn't want to have another c-section unless it was absolutely necessary.

HTH

I had an emergency cs with ds in 2001 after being unable to push him out (very similar to kaz33), followed by a vbac with dd in 2003. Vbac was hard work but totally worth it. May I make a few suggestions that I feel really helped me:

I have not ever heard anything about only being allowed 5-6 hours in labour for a vbac (I would ask your midwife about this), only that they might put limits on how long you are allowed to be in second stage, eg pushing. What I did was ask for an appointment with my consultant at the hosp to discuss my birth plan. I wrote a very simple birth plan saying that I wanted to stay upright as much as possible during labour (this IS possible, even with a belt monitor on, don't let them make you lie down if you would prefer to be standing or sitting upright, I used a birth ball until I was fully dilated) and that I was very keen to avoid another c-section and would like to be helped as much as possible to have a vbac. Then, after discussion with the consultant about my ds's birth and why that went pear shaped (his head was not engaged and was very high up, long story), she wrote on my birth plan that she was happy for me to be allowed an hour after I was fully dilated before they officially recorded me as pushing. This was to give time for dd to start the descent naturally. As it happened my 2nd stage was only 20 mins, but it made me feel confident that I would have the time to do it myself. Also, and this is the important thing, the consultant's handwriting on my birth plan gave the m/w's the confidence to let me labour in my own way and not neccessarily follow every hospital policy re vbacs as some of them can be quite unhelpful when you are in labour.

Sorry this is turning into an essay - if you want more info and an idea of what to expect from a hosp vbac, email me if you want to. Above all, believe you can do it, I'm sure you will be fine, and even if you do go into labour and end up with another c-section, at least you know that the bit of labour you did will have had some positive effect.

Sorry to butt in L&Bmum but can i just ask Freckle a question ...

Your friend had a home water birth after 3 sections ?? That is amazing. I have had 3 sections, my last one for no reason other then thet i had already had 2 sections before.
How come she did that, didn't docs and midwives complain (not that i mean they should of) ??
Just very interested.

L&b's mum, I had a trial of labour too, but had unexpected plummeting bp (still don't know why, postural hypotension, possibly) and was rushed in for crash c/s, and as I had v few contractions by then (only waters broken, not actually induced - 42 wks and about to be given a drip when all this happened) hadn't had an epidural so had a general anaesthetic. this is my only regret, that i wasn't conscious for dd2's birth & the ga did make me a bit sick. I was much more scared this time but handled it by planning exactly what I wanted to do if a, b, c happened, so give it lots of thought and please don't be disappointed if you do have another c/s. i had a 2 yr 10 mth old at home and we managed (some help from mum/inlaws when dh away when dd2 3 weeks old) ok.x

If you've never been in labour, then your chances of delivery vaginally this time, are as good as they are for any first-time mother.

They suggest that you restrict the time you are in labour because they are worried your scar might rupture. It is merely a suggestion, they can't force you to have a cs if you feel your labour is progressing ok. Most first labours do take longer than 6 hours. The risk of uterine rupture is so low that you are more likely to experience almost any other complication of labour than a rupture. 50% of scar ruptures occur before labour starts anyway, so you've already accepted 50% of the risk by getting pregnant. And more uterine ruptures occur in women who've never actually had a cs than in those who have - ie you were more at risk of a rupture last time!

If you agree to them restricting the amount of time you are in labour, that does reduce your chances of avoiding a cs. My first child was born by "elective" cs because she was breech too - the next birth is going to be with an independent midwife

Here are some sites with more info:
Effective Care in Pregnancy & Childbirth
Research summaries
More info - you can also email your questions to these people

Same here, emergency c-section first time with no labour at all, 2nd a normal birth induced with syntocynon drip, whole thing took about 10 hours. The only mention of Caesarian was in relation to dd being a bit distressed, but luckily my second stage was very quick (5 minutes!) or we might well have ended up in theatre. Good luck!

She is one very determined lady. Also very well informed and I doubt very much if she'd let something like the medics saying "no" stop her. I also think the fact that she had an independent midwife who was led by what the mother wanted helped enormously.

Well good for her Freckle, have just never heard of it before. Very brave lady too, not sure i could be so brave.

I have emailed my friend and she has given me permission to post her birth story here. I'll copy that at the end of this. It is very long and I don't know if these threads have a limit on posts. However, she also provides the following information too.

There is an AIMS booklet on VBAC which will deal with all these issues which should be out in May. here Another useful ref for her is this which has good articles and links including a link to the yahoo support group for women planning or thinking about vbac.
If she's being quoted 50% then she needs to look at her care providers very carefully as they are probably limiting women's choices and thereby their success rates too. There's a good article on caesarean.org about the policies that some hospitals write for VBAC and how little evidence there is to support them but these policies like continual monitoring and time limits for labour have a huge impact on the probability of VBAC being achieved. She can talk to me (Jenny), Gina or Debbie (VBAC co-ordinators for the NCT) by ringing the enquiry line for our numbers - 0870 444 8707.

Jenny's story:

I went to bed Sunday night, having seduced Raymond on the sofa - his
comment was "You only want me for my sperm" Too right :-)
I spent a restless night, not unusual for me, getting up to the loo
every hour or so and aware that I had reasonably constant period pain
but not daring to hope it was significant after so many previous "is
this it" moments. At half past 6 I decided it was officially morning
and got up to use the loo and perhaps have a bath. I realised as I
went to the loo that I was having a strong twinge/contraction and had
another one on the way back. My first thought was that these could
only be Braxton Hicks as they were too close together to be early
labour contractions. I pottered around the bedroom having more every
5 minutes and told Raymond that I didn't think he should go to work as
this might be it. But I still didn't really believe it even though I
knew the pains were really contractions now.

We got the kids up and started the getting them ready for
school/breakfast/lunch boxes nightmare that is a Monday morning in our
house. I had to keep ducking behind the fridge freezer to breathe
through the pains which were holding at 5 mins apart and needed
concentration to deal with. I decided I didn't want the kids to know
I was in labour as Carys would have refused to go to school and Emma
was starting her SATS that day and I wanted her to be able to
concentrate on those and not on worrying about me. I had a bowl of
cereal in the sitting room while Ray did the lunch boxes and decided
to phone Mary to let her know what was happening. I didn't expect her
to come out to me, I was officially Andrya Prescott's responsibility
now as Mary was due to go to conference on the 1pm train but I did
want her to now. After that I rang Andrya and explained that I was
almost sure this was only early labour but I was concerned that the
contractions were so close together and quite strong. Andrya said she
would liase with Sue and aim to be with me about 10.30.

Mary rang me again about 8am to say she was popping over to see a
client in Brighton before she left and that if we needed her she would
pop in on her way as she would be quicker than Andrea. I was starting
to get concerned that things were hotting up a bit but still couldn't
believe we were looking at a quick labour. My concern was only could
I stand up to 12 hours plus of this!
By the time Raymond left to take the kids to school I was over the
birthing ball and feeling a bit panicky about being on my own for half
an hour so he stopped off at my friend Lesley's house, just round the
corner, and she came to be with me. She's never had children but we
go back a long way and I was just happy to have someone there as I
said ooooooooh over the birthing ball. Ray got back just after nine
o;clock, Lesley left and I got Ray to time how long the ctx were
lasting as they seemed longer. They were lasting a minute and coming
every four to five minutes. I decided to take Mary up on her offer
and Ray rang her - she could hear me saying "oooooooh" which seemed to
be my way of breathing through the contractions and luckily she still
hadn't got past Worthing yet so was happy to divert to us.

Mary arrived at 9.55 and I was so happy to see her. Having sadly
accepted that I was not going to be able have her at the birth, it was
a real treat to see her familiar face. Meanwhile the contractions
carried on inexorably and I discovered that walking about between them
and then holding onto the mantelpiece while Raymond rubbed my back was
the best way of dealing with them.

Andrya and Sue arrived at 10.30. I had met Andrya once before but Sue
was a new face and I felt a bit shy initially. Mary I think sensing
this, offered to cancel her Brighton visit and stay on as long as she
could. Andrya asked me would I like to just carry on as I was or
would I like a VE to assess progress. By this time I was desperate to
know was this really it and was my cervix dilating so we went
upstairs. I was worried about having to lie down for a VE - I
couldn't see how anyone could possibly labour lying down I need to be
up, up, up. I hung on the door aka NCT birth positions poster for a
contraction while Andrya got ready then lunged for the bed at the last
possible minute. Andrya was gentle and quick and gave me the best
news ever - at least 3-4 cm dilated and effacing well. Wow! I had
been dreading her saying "oh only 1 cm" and was delighted that I had
gain in return for the pain.

By ten past eleven I was wondering about getting into the pool - I was
concerned it might be too early and would slow things down. I was
still convinced that I had hours and hours of this to go and asked
Raymond to make arrangements for his mum to pick up the children from
school and take them to her house overnight. I decided to get in the
pool, encouraged by Andrya and Sue who were pottering about getting
their equipment set up. Mary was calculating how late she could leave
it and still catch her train!

The pool was like a welcoming old friend giving you a hug. I had used
it so much during the wait for labour that it was a familiar, safe
place, somewhere I associated with relief from aches and pains. I
half knelt, half floated, arms and elbows on the side. Sue was near
me, asking me if it helped, Raymond was issuing his mum with sleeping
bags for children in the other room. As I aaahed and oohed my way
through a contraction I hoped briefly that my mother in law wasn't too
embaressed.

By half eleven things were starting to really hurt. Mary gave me some
coaching to encourage me to keep breathing through the pain "try to go
saggy with it" I remember her saying.

All these timings are taken from Andrya's excellent record of the
labour, I couldn't have told you what time it was only that it seemed
still very early to be in so much pain. By midday I was at the
thinking I didn't want to give birth any more stage! Bits of me
wondered if I was in transition. Other bits of me just wondered how I
could possibly survive this pain. From all round the room voices of
encouragement came. yes you can do this, you ARE doing this, you are
fantastic, you are strong. Ray was by me head all the time, breathing
with me, soothing me, putting a hand on my back. I got enormous
solace just from his presence and by rubbing my face up and down his
forearm like a cat!

I started to feel an urge to push but it was all mixed up with the
awful. overwhelming last contractions of first stage. I invoked my
Maker a lot to get me through those. I think Mary had left by then
but I could still hear her voice telling me I could do this, mixed
with Andrya and Sue telling me the same thing. The mixture of female
empathy and male strength was just amazing, I never really felt alone
and I felt certainly that both Andrya and Sue knew just how I was
feeling. I was on hands and knees in the pool through all this,
rockig backwards and forwards through each rollercoaster, alternating
outbreaths with moaning but mostly feeling I had control. There were
a couple of really scary contractions where I felt they were winning
and I was losing it, really crying out in panic. The voices soothed
me and I began to find that pushing made the pain better.

I was not altogether sure what I should be pushing where. I did have
a sense of the baby but was actually more aware of a need to poo. I
decided to push the poo out first and then discovered it was helping
me push baby too. At 12:35 Andrya records me saying "Oh Andrya, the
baby moved" and it was a really revelation to feel this solid football
thing actually shifting inside me, getting closer. I can remember
thinking "I'm actually going to do this" and saying "Yes, yes, yes"
with the pushes.

I heard myself begin to bellow and thought "this really does mean not
long now" remembering Gina Lowden saying you only get a few like that
before the baby arrives. Andrya asked me a couple of times did I want
to feel what was happening but by now I had braced myself horizontally
across the pool hands pushing my head away from the side, legs apart
but pushing from the other side. It worked wonderfully I could feel
all my effort paying off and kept bearing down and letting the air
out, grunting and breathing out, swallowing the occasional bit of
water when I forgot to keep my head up!

I started to feel stinging down there. Bl88dy hell, was all I could
think, I've talked about this so much in classes and now its hapening
to ME! Blow, blow, blow Andrya was telling me. I was keen to listen
to her, I desperately didn't want to tear. I blew for England and it
really didn't hurt as much as I had expected it to as his head
emerged. I was aware of Andrya helping the baby a little, she
explained afterwards that his hips were a bit stuck and there was lots
of meconium in the water. I didn't care, it felt like a good thing.
He slithered out and she passed him through my legs to me and I
managed to sit back and take my little boy. He looked a bit green and
pale and wasn't breathing but his cord was pulsing. I just couldn't
believe it. Ray came round to lean over and help keep baby's head out
of the water while I supported his body. I checked he really was a
boy like the scan had said. "Hello,little man" I remember saying
over and over together with "We DID it".

Fergus gradually established his breathing and the cord stopped
pulsing. Andrya showed Raymond what to do and he cut the cord almost
exactly as I felt a contraction and pushed the placenta out into the
pool. The pool was now so murky that Andrya and I had to go fishing
for it! Raymond took Fergus while I got gingerly out of the pool and
sat on a pile of covered cushions and pillows on the floor. He was
born at 12:50, by 13.25 he was on the breast and I had a cheese and
cucumber sandwich and a very welcome cup of tea.

After a while we weighed him, 8lbs 6 and I transferred to the sitting
room. I knew I was intact perineally, it felt great. We sat for
quite a while, talking in wonder about how quick and how powerful it
had all been. Raymond managed to bang out an email which I dictated
to him and we phoned a couple of close family members and friends and
arranged for the children to be brought home to us after school. They
came through the door like little bullets, desperate to see the new
arrival and were completely thrilled by him and by the presents he had
"brought" them.

By 10 o'clock we were all in bed. Fergus having defied all my usual
predictions on baby behaviour and having fed most of the evening.

I've probably left out lots and will need to rewrite this at some
point but it was a fantastic experience, something I will never forget
and I am so glad I did.

Jenny.

I had a section with ds1 who was breach,they let me go into labour normally though but it became iobvious I was not going to deliver him myself,3 years later ds2 was born,normal labour but forceps at the end ,no pressure to have section but were keen on forceps after pushing for approx 45 mins,I could feel he was a bit stuck so felt happy to agree,although I do think part of the problem was that they broke my waters adn this speeded things along before he had time to turn properly.3 years later again Ds3 was born;gas and air only!
With my second there was no pressure to have a section although might have been different if he had been breech and they did say that I would not be allowed to push indefinately,with number 3 I was initially keen for a section,they were not ,but in the end it was a fantastic birth

OMG, am I the only person who thinks the very best thing about having a section for a first baby means you can have one - no questions asked - for any subsequent births?

Been reading these stories and the thought of my emergency section makes me go cold again. I am trying for another baby but had given no thought to the fact that could have VB. What is this about the scar splitting is that common?

Aloha, I know what you mean.
DS1 was emergency section (head circ over 99th centile and I'm 5 foot tall) , and I never progressed beyond 5cm after 36 hours.

When they look at subsequent labours, the issue of how far you progressed does seem to be an issue: I was told I would have a greater of 75% chance of VBAC if I hadn't gone into labour first time, but given how I had got stuck I was closer to 50%. I chose a c/section as I had had a very positive experience first time (second time too as it happens!), and I found a planned c/s easier to contemplate than having to plan labout with a 25-50% chance of another c/s.

I have a friend who tried VBAC after a first c/section - baby born by c/section early as it was failing to thrive. She had a fairly lengthy labour but didn't progress beyond 3cm. Baby in distress so another c/s. On doing the section it became clear that uterus had torn (which was also why she wasn't dilating. No permanent harm done, and all seems fine, though she is fairly down to earth, and unlikely to get worked up about such things. They had put her on a drip to speed things up, so I'm amazed that they hadn't thought about the scar rupturing much sooner. That said it doesn't seem to have been a big deal for her.

i hated the fact that i had a caesarian first time (baby was in distress at 34 weeks) and i was determined to have a normal birth second time. I had been having contractions for four days which kept stopping and starting and ended up in hospital on day three after my waters had broken with contractions every ten minutes that were getting more and more painful but not going anywhere. The next day they stopped again and started up at 20 mins apart, again more and more painful. The only pain relief they would give me was paracetamol as they said i wasnt in proper labour. (they had tried to examine me the night before and couldnt see if i was dilating or not because of the waters leaking apparently) The final icing on the cake for me was when they said the baby was starting to get distressed during contractions and they would start me on a drip and whisk me down to theatre if things got any worse. Like you i didnt want to carry on with labour at the risk of things going pear shaped and i asked (in tears) for another section. It all went well but i often think "did i do the right thing and prevent a difficult situation, or should i have stuck it out?" theres no easy answer. I think i should have looked into all the possibilities before that and maybe asked to be examined again in the morning but i didnt want to look like i was making a fuss when they said i wasnt in labour. If i had that chance again i would certainly do a LOT of research about it but ive been told that after 2 sections, normal birth is not a possibility for me now. Im not trying to scare you by saying all this as i think the majority of these births go absolutely fine without a hitch. The point im trying to make is that even if you do have to have another section, you may be disapointed but youll have your beautiful little baby and you will have done what is best for him/her. ps i know its not the same as having a toddler but im a single mom and ive coped with my two so dont worry xx best of luck with whatever you decide

Sarochka, there are two types of scar rupture. One where it separates a bit, at no danger to mum or baby, labour carries on, and scar heals itself afterwards. Then there's the catastophic major burst-open sort where you need a cs within 30 minutes. Lots of the older research doesn't show the difference, it just says the scar split.

From the International Childbirth Education Association review of research into VBACs: out of 21,000 planned VBACs reported in research trials, there were 46 ruptures of low transverse scars (which is what you probably have but you need to ask or check your notes). Thats 0.22% which is not that high. Of those 46, about 22 were probably only little self-healing splits rather than major bursts. No mothers have died due to scar rupture since 1950 (although several have died due to complications of repeat caesarean). 5 babies have died, 3 of those were in developing countries (and again, more die from caesareans). 12 mothers needed a hysterectomy (10 times as many need them with caesareans).

You're basically more likely to have any other complication of labour (cord prolapse, haemorrhage, foetal distress etc) than a scar rupture. And even if you do have a scar rupture, the outcome is very unlikely to be bad.

75% of womb ruptures happen in women who've not had a cs at all.

Sorry to bombard you with statistics, but I've only just found all this out myself, and I can't believe how much the consultants try to scare us about this. Womb rupture is a possibility but not a major one, and your chances of it don't go up that much after having a cs...

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hiya lukeandbumpsmum
your docs sound like mine to be honest - are you in the uk or abroad? just wondering cos I was abroad and saw an obs all the way through my pregnancy and I think she was a bit too keen on 'control' if you know what I mean.
best thing you can do is find out as much as pos about the whole thing on your own (just like you're doing) and then make your own mind up - don't let docs intimidate you with scary statistics or stories that are not necessarily all that accurate or necessary.
I gave birth vbac a month ago and it was great - I'm so enormously pleased I managed it - a lot less painful than my c section, much faster than I thought for a first birth at 5 hours, couple of pushes and out he popped (OK also very painful but manageable)With an 18 month old to look after, I was up and about the next day and had loads of energy. I had a small episiotomy and ventouse delivery but the stitches healing was nothing at all like the pain I felt from my csection, although I do seem to have felt a lot more pain from that than other people

I know it's hard to decide what to do and I completely understand your fears about ending up with a c section anyway, but check it out, your odds are loads better than 50% (and it's only 75% for first time mothers in lots of hospitals these days anyway)and the 5 hours labour thing is a load of rubbish too (unscientific opinion here)
my doctors wanted me to go in once contractions were every 15 minutes but everything I'd read on the net was about how your odds of a succesful vbac are higher if you stay at home longer than that - you have to decide how you feel about taking that kind of (very small) risk. I went in with 90 minutes to go and contractions every couple of minutes and for me that was a good balance between safety and making sure labour was well and truly established.
I also changed doctors at the last minute (38 weeks) as my obs got less and less supportive. If you can shop around, I'd try and get another doctor or midwife who is more supportive. Alternatively, think about getting a doula or assertive birth partner who can help to support you.
Hope that helps - I'm sending you lots of suppportive vibes whatever you decide.

Thanks so much everyone for your support and stories. From the moment I started reading them I felt better about trying a VBAC, rather than taking the scared approach of booking an elective caesarian. I am going to give it everything I've got, and if I have to have a caesarian anyway at least I tried vaginal birth first. Will let you know how it goes!

Thanks again. xxxx

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I am umming and ahhing on this at the mo, had section with dd (she was in distress and had to come out), but had a fantastic consultation with the doc at my second scan a couple of weeks ago, went through all my notes which were reasuring, and she said she saw no reason why I couldn't go for a natural delivery this time.

BUT part of me wants someone to TELL me what I have to do, so I don't have to make the decision iyswim. I want to be able to say I have 'given birth' but at the same time I am a bit of a wuss and don't know whether I could do it and stand the pain.

has anyone had a natural birth after TWO sections?

Jimjams, if you read my earlier post, you'll see that my friend had a natural (water and home) birth after 3 previous sections. What a star!

Best friend had vaginal birth after Cesarean and she was super chuffed that she managed it and sid it was soo much easier in terms of recovery!!