Terrified they may 'make' me have VBAC.

[Paula1]

My second child is due 29/12/02, first was born by c-section at 38 weeks due to being breech. I have got an appointment in 2 weeks to talk to the consultant (who is new, so the midwives haven't really got a feeling yet for what she is like about these things). I have decided beyond all doubt that I want a second C-section (I know this won't suit everyone), does anyone have any idea of how likely it is/any good things that I can say to the consultant to ensure that 'I get my own way'?? The things I am scared of are that: I've never been in labour, so my body will treat it as a first, and everything will be really slow, my baby is due just after Christmas, what happens if I go into labour and need an emergency C-section during the Christmas holidays and there are only junior staff there? The thought of an emergency c-section fills me with horror. I also don't think I have got the right attitude of mind to face the hurdle that I believe VBAC would entail. Please don't all condem me, I'm really not 'too posh to push', just don't want to go through all the trying to fail and end up with my worst case scenario (emergency CS). Also, if the Consultant won't agree - what other options do I have, can I change Consultants? (and anyway, would one overrule another?) Go private - and if so where?

Paula1 - be reassured that the consultant will not impose their will on you but will ask you to see another consultant if you cannot agree. Try to relax and enjoy the rest of your pregnancy. Best wishes - mears.

Mears, thanks for such an informative summary of the issues to consider with VBAC. I have a consultant's appointment in September to discuss my options and I will be thinking through the points about ascertaining what the staff involved in my care really think I can achieve.
Paula, I was very sorry to hear about your new consultant's intransigence - letting slip her anxiety about league tables was very silly. If necessary, you should maybe take Aloha's advice about camping it up a bit at your next meeting, but I hope Mears is right and it is simply a case of getting a different consultant to give you the delivery you want.

Paula, like Marina I was sorry to hear how unhelpful your consultant has been - and very disappointed that it is a woman who is so unsympathetic!

Hope all goes well for you and that you can have the CS you want. It just doesn't seem necessary to put you through this aggravation...

Lindy, sorry if you don't want to talk about it, but I am interested to know what condition it was your son had that meant a vaginal birth could have been fatal for you both?

Due in October and feeling morbidly curious, sorry.

Can't speak for Lindy, Enid, but persistent transverse lie, which I had, meant almost certain death for baby and probably also mother before the advent of safe c-sections. There was nothing "wrong" with either of us, medically speaking, but attempting normal delivery would have been pointless.

Paula1, I believe all consultants now offer c-sections for breech births as a new study proved they are unsafe to deliver vaginally (ie more babies die in normal birth than in c-sections while complication rates for mums were no higher with the sections than with vaginal birth) However, this doesn't apply to most other births, so a consultant who offers c-section for breech births won't necessarily offer it for other births. Just thought you might need this info.

Aloha... the baby may not be breech though !

I don't think what Aloha said is strictly true -- what I recall is that CS is about 3x safer for a breech baby, but CS does still carry higher risks for the mother, even if the baby is breech, than if the mother attempted a vaginal delivery.

Yes, I did realise Paula's baby may not be breech, but I was really answering about her friends who had a consultant offering c-s for breech babies - just warning that she might not get a c-s if hers isn't (if that makes sense!). And the study did definitely show no more complications (& maybe fewer) for mums after sections than vaginal births if the babies were breech (presumably because the c-s was planned and breech births are often more traumatic physically for the mother). They were quite clear on the latter point, which I thought was important.
BTW I hate the way newspapers use the world elective as synonymous with 'chosen for social reasons' and therefore 'bad'. Elective just means pre-planned. Like Lindy my ds and I would have died without our c-s. So yes, it was an elective - though I certainly didn't have a choice in the matter!

Hear hear re the use of "elective", aloha, mine was most emphatically not through choice (mine or the consultant's), despite the fact it could be planned ahead.

This may be what Aloha is refering to : www.parentsplace.com/expert/birthguru/articles/0,10335,243386_194632,00.html

Marina, dd was a transverse lie and I had her vaginally. It was awful but I don't think either of us were really at risk of death.

Of course, we must not have been as badly positioned as you and ds, so forgive me if thats the case...still not sure about it all after all this time...

Enid, I think the scale of "transverse" starts with one shoulder presenting (which must have been bad enough but I can see how vaginal delivery could happen), and goes right through to flat out along the bottom of the womb (and therefore at 180% to exit). We were in the latter position, so trying to turn ds before delivery was not even attempted and I was told from week 24 by both midwives and consultant that a c-section was our only safe option. I whinged about this quite a lot to my NCT teacher and it was she who told me to shape up and consider myself lucky there was a safe alternative, etc...

Dd was transverse op, the side of her head was presenting. She was turned internally by high forceps. This is a very old-fashioned procedure and I remember the consultant telling me that most people would perform a c-section in this instance.

It was highly unpleasant for both of us and I think a c-section would have been a much less traumatic birth. unfortunately I am at the opposite end of this thread - terrified of having a c-section so would have done anything to have dd vaginally. My fears have returned with this pregnancy and I now need repeated reassurance from my midwife that I won't be 'made' to have a c-section.

If I had been told that a vaginal birth was impossible, or a life or death situation, then of course I'd just have to have a c-section and shut up about it

Enid - what are the chances of a similar lie this time ? I had a very bad lie myself and my very clever MW sent me to a specialist osteopath who did wonders I have to admit - this was in preparation to my 2nd labour which might not have been any easier otherwise. Presumably my situation was not as bad but we did discover that without this help I was VERY likely to have the same problem again and that meant a very difficult labour as I have a pelvis problem.

BTW I read in a midwifery book (Caroline Flint) that if you are going to have a forceps intervention... count to 100 (at a normal pace !!) the intervention doesn't usually last more than 80 seconds and it allows you to know there will be an end to this pain. Maybe Leese or Mears can comment.

Good on you for sticking to your guns. As Mears has said VBAC is safer for you and better for the baby but this is such an emotional debate I can understand why some women would run scared (I did ask for a cesarean at the end of labour 1.... as I thought he was really stuck! - I didn't get my wish )

At my ante natal class the physio or midwife (can't remember which bit of the class it was in) told us that they'd started a trial - I think it was at that maternity hospital but I'm not sure -which was supposed to be for over 2 years (or something like that) - where they were going to allow mothers to try to deliver breech babies vaginally. The trial had been stopped only 6 months in - she said the results were such that they couldn't ethically continue it.

I'm pretty sure it was the physio who told us - even though she was very much in favour of doing everything "right" to allow for a "natural" birth, she was wanting us to be realistic that some of us in the class (of about 20) would end up having a caesarian for whatever reason - and that some of those reasons were very good ones!

JanZ - I'm sure my desire NOT to have a c-section is completely irrational, nevertheless, it is my wish and I'm sticking to it. I know lots of people who have had one with no ill-effects, its just not what I want from a birth.

Pupuce - there seems to have been no medical reason why dd was in deep transverse arrest. So I can only hope this time things will be better. My acupuncturist (is that the right term???) has said she will help me with a few needles nearer the time to help put the baby in the right position

The only positive thing I can say is that there can be few births worse than high forceps and no drugs - this one has got to be better At least last time we were both healthy (eventually), and I actually enjoyed the first stage (before the transverse lie was detected).

Sorry, didn't mean to hijack this thread.

Enid, although I am much less far along than you, and had a very different sort of traumatic birth, I am right with you about being "at the other end" of this thread. I am hoping very much to attempt VBAC and am really dreading being made to have a c-section again. Good luck and stick to your guns.

Marina, I really hope you manage to have a VBAC and I think its really brave of you to try - most women don't seem to (try I mean).

We'll be reading this thread in a year or so feeling proud or regretful...

Marina - have you changed e-mail address ? I had sent you info on the VBAC book but didn't hear back.... and it's not your style

Enid - I wasn't meaning to imply that you shouldn't be doing everything in your power to avoid a c-section - my posting was more in response to Aloha's one.

In fact I too had a massive fear of a c-section - I desperately didn't want to be one of the stats contributing towards the "increasing rate of c-sections" - and coming from a medical family, was also concerned that some doctors were a bit too quick to go for c-section because they are more comfortable with medical intervention.

I actually ended up having a mid-cavity forceps (the doctor was sympathetic to my birth plan and knew I didn't want a cs) as I was exhausted (starting to SLEEP during contractions!) and the baby wasn't moving down the birth canal. He was facing sideways (I can't remember the term now) which wasn't as bad as your transverse lie - but not conducive to further downwards movement.

I was fortunate in that the pudendal block (a local anaesthetic) "took" - she warned me that it might not, but I took the view that the forceps would be over and done with quickly and I was also determined not to have an epidural (I'd been labouring so long anyway!).

The good news is that she said that next time should be easier - the "birth canal" had been used.

Pupuce, no, but have not been on home PC for some time. Assume it went there and will check. Thanks in advance for info...

Enid - my son had a condition called sagittal synostosis which meant his fontanelles were fused, not soft, so would not 'mould' when pushed through the birth canal (sorry if that is not the correct technical term - assume you know what I mean). It is a condition which affects 1 in approx. 4000 so very rare & could not be detected by normal scans. No one quite knows what causes it. Anyway, it meant that his head was an odd shape (elongated) but this was successfully corrected at 6 months at Great Ormond Street - sounds horrific now, and don't want to worry you -it is very rare (purely a 'cosmetic' thing, does not affect brain development).

Presumably he would therefore have got 'stuck' if I had not had the emergcency CS - they did try ventose but realised the baby was in great distress & it was quicker & safer to do the CS.

Sorry if this scares anyone, but just wanted to put the facts down.

Lindy I too was in position of having to have emergency csections. If it wasn't for them, neither me nor ds and dd would be here. 7 yrs I had placenta praevia grade 2/3 and then my placenta detached at 32 weeks -they did an emergency section.

I did a lot of research into placental abruption and whether it would happen again - I decided to go for it. This time it happened at 29 wks and another emergency csection.

In both cases a csection was essential , and , quite honestly I got over them both very quickly. I swear by arnica tablets to help the healing, I gave them to dh when he had the 'snip' - no, we won't be having any more babies

Just thought I'd add my bit to say that they are not the worst thing in the world!

Lindy, thanks for telling us about your ds. It must have been very frightening for you, glad to hear that there were no long-term health risks.

Just another thing to add to my long list of worries