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Original poster

** continuous fetal monitoring during VBAC please advise**

36 replies

rainbowgirl · 20/11/2006 18:11

.. am 22 weeks pg and had consultants appt today to discuss VBAC - had an emergency c-section last time, 4 years ago, following long labour and face presentation..

i have been advised to have continuous fetal monitoring because it is my consultant's policy..

she was actually a nice doctor (!) and says she can't 'make' me but in her experiences of VBAC it is safest for the baby.. i have read up quite a lot about it but am interested in any experiences of women who have had VBAC and can advise...

one thing i'm confused about is that i thought with continuous EFM you couldn't move. she said, you can move, just not out of the room. she said i could still give birth on all fours if i wanted, just would need the strap around my belly..

any advice / help!!

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lulumama · 20/11/2006 18:16

you can move...the leads are long!! and she sounds like she is quite open to the idea of an acitve birth.excellent! much better for encouraing a vaginal delivery.

i had a VBAC ( as you know!!)...and stayed at home as long as i could, and stayed active until i had the pethidine, at which point i had to get on the bed!!!!!!

EFM does not make any difference to the outcome in many respects..and should not be relied on to pick up any signs of scar rupture..there are many many other signs that should be picked up on too!

you could decline continual monitoring and have periodic monitoring instead.

your doctor sounds great..like you could have a reasonable and informed discussion with her and work out what is best for you and your baby!

HTH!!

morocco · 20/11/2006 18:17

it's great that she seems a really nice doctor - that's a nice feeling to go into labour with.
I didn't have cfm (and lived to tell the tale ) but in the end it didn't feel such a big deal either way. I was only in hospital for about an hour before ds2 was born and was past caring really for most of that. I also just lay on my side once I'd settled down and all plans of giving birth on all fours etc went out of the window. So my only advice is not to get too worked up about it (I'm sure you're not, but I was a bit panicky) cos you may not be that bothered when it comes down to it anyway.

Original poster
rainbowgirl · 20/11/2006 18:21

thank you both!!

i am a bit panicky yes morocco the doctor i saw won't actually BE there and i had such a bad experience in labour with dd i'm a bit paranoid now...

lulumama is there a good site that would flag up the other things to watch out for re scar rupture, so i can check at my next appointment that the midwives will know what they are doing?!

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AitchTwoOh · 20/11/2006 18:21

it's a belt, basically, and it really is on a long lead. i was able to fanny around on a birthing ball while being monitored. you probably wouldn't be able to use baths, though, obviously. perhaps discuss how that might work on your next app, but they wouldn't let me in my hosp and it was all fine, tbh.

Original poster
rainbowgirl · 20/11/2006 18:25

thanks AitchTwoOh.. i had this image that i would not be able to move at all.. maybe it won't be so bad..

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franke · 20/11/2006 18:37

I didn't have cfm during my vbac (in Germany). But I distinctly remember the midwife watching very closely while I was labouring which is a good thing.

Here is a discussion which I found quite useful when I was planning my vbac. It's quite old now but presumably still relevant. I found plenty about cfm when I googled too. hth.

lulumama · 20/11/2006 18:43

possible indications of scar rupture by Mary Cronk

google mary cronk- you will find some great info!

and the RADMID site franke has linked you to is brilliant!

morocco · 20/11/2006 18:51

mmm - sometimes I wonder if it's better to refuse cos then they have to keep a closer eye on you rather than just rely on the machinery to do the job for them (which it won't) and wander off and leave you for ages (I've read too many scare stories)

INK · 20/11/2006 19:02

I personally did'nt like the monitoring throughout labour. I laboured fine at home for a good few hours went into hospital and after a while got a bit lost with all the monitors beeping away.I also tended to look at the monitor for when a contraction was coming rather than as before feel for the build up and get through the contraction. At times midwife would say to only take the gas and air when i was having a contraction which i was doing only the monitor was a little slow in picking it up.
I should point out that first pregnancy emcs this one trial of labour (reason for continuous monitoring).

Original poster
rainbowgirl · 20/11/2006 19:26

thanx ladies. that's a really good point morocco. they would have to keep a closer eye on me then huh? lots of food for thought here... keep it coming much appreciated!

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AitchTwoOh · 20/11/2006 19:46

i had a midwife with me constantly precisely because i was deemed a potentially funky labour, she left the room to go for lunch and someone came to replace her. sounds like you need to ask lots of questions on your next appointment, morocco...

Original poster
rainbowgirl · 24/11/2006 22:25

anyone got any further thoughts on the continual monitoring debate? i have now heard that the leads don't allow you move around in reality because they are too bulky.. does anyone have experience of wearing the leads on their tummy and also moving around during labour i.e. not just laying flat on their backs?

please post!

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Original poster
rainbowgirl · 24/11/2006 22:28

lulumama where you say 'you can move.. the leads are long!' did you have continuous monitoring throughout your VBAC after the emergency c/s?

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AitchTwoOh · 24/11/2006 22:29

helloooo-oooooh? me.

AitchTwoOh · 24/11/2006 22:30

the leads are about twice as thick as on a set of headphones.

Original poster
rainbowgirl · 24/11/2006 22:31

think i blanked your post out because i got really scared again!! did you wear it the whole time? was it truly not a problem?

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Original poster
rainbowgirl · 24/11/2006 22:32

opinions seem to differ SO widely on this and i'm a bit scared because my dp isn't with me right now so may not be at the birth.. i'm scared i'll get pressured into stuff i don't want to do iykwim like lying flat on back etc..

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lulumama · 24/11/2006 22:33

i did Rainbow..that enable me to stand by the bed, move with the contractions....and stay upright..i didn;t move far as not using any pain releif at that point and having huge contractions every 3 minutes, lasting a minute and a half..so just standing up was something!!

plus the midwife had to unhook me every 30 mins for a wee!!

once i was in established labour and had some pethidine..i stayed on the bed and delivered sitting up 3 1/4 hours later..so for me personally , it wasn't an issue...

i had 15 hours of labour before i got to 3 cm..12 hours at home...so being restricted was;t so much of an issue !

lulumama · 24/11/2006 22:35

if your consult is into active birth..then i don;t think it will be a problem for you to request intermittent monitoring !

Original poster
rainbowgirl · 24/11/2006 22:36

lulumama thank you darlin! that is reassuring too. so is it ok to stay at home till you are in proper established labour even if you've had a caesarean before?

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Original poster
rainbowgirl · 24/11/2006 22:36

she's really against it, the intermittent monitoring. i guess it will just be a case of wait and see at the time. if the leads really restrict me i guess i won't wear them the whole time.

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lulumama · 24/11/2006 22:39

SORRY..Your OP said she couldn;t make you have it and she is into moving in labour! sorry., misread that then !

i stayed at home as long as i could because i knew the sooner i went in, the sooner they could faff with me.

the reason it took me so long to get to 3 cm was LO was posterior.when she turned ,that's when i started dilating and she shot out!!

lulumama · 24/11/2006 22:41

it is really important to keep active in early labour and to be able to listen to your body........so i would stay at home for as long as you can bear it........once you are in hospital you are under their protocols ! so you need to have it is really important you establish before birth, the things you do not want! ie being made to lie down!

AitchTwoOh · 24/11/2006 23:05

i was induced, rainbow, and i was monitored. AND because my blood pressure shot up i had to have an epidural which didn't work so they spent a lot of time faffing with that (which was a brilliant distraction) but it never worked properly.
SO i had to give birth lying down in the end, but i was only lying down for the last hour and a half as when i turned over i couldn't feel to push and that's when we discovered that the epidural had worked somewhere.
all of it was fine fine fine, i promise. tbh my dh didn't do much, really, just sat around looking a bit ovewhelmed. it was lovely to have him there but it's the midwife who counts. if i was you i would ask for a serious sit-down with someone from the hospital. tell them that you are worried that DH might not be there, so you really want to know what will happen. ask to see the leads, they will be in the delivery suites anyway so you should see them if you do a tour.
i did all my leaning on the bed, on dh, bouncing on the ball, sitting in some stupid chair that i didn't like. the best thing for me was hula-dancing on the spot, which was no problem at all with the leads. i totally understand that you are nervous, rainbow... can you have a good chat with the doc?

bctmum · 24/11/2006 23:09

I've had vbac and refused continuous monitoring. I assessed the situation, decided and told my doc. I got her to write it on my notes and it was in my birth plan.