36 weeks - unexpected decision - advice please

[Fingerscrossed11]

Hi,

Up until today my placenta was showing low on the ultrasound, and I thought baby was breech/transverse.

Had scan today and placenta is 2.8 away and needs to be 2.5 for natural delivery so that was a surprise. Baby was also head down but not engaged.

I now have the decision to make whether to have csection or vbac (my son now 6 was breech and I had to have a caesarean then)

The doctor and midwife spoke to me about options and it’s this option or the other but there are a lot of ifs and buts and some advice would be great.

I could wait and go into labour naturally but due to me being 40 this year they wouldn’t want me going over due date unless I was adamant.
If I do go into labour naturally more staff will be required as my previous was a section.
There will also be criteria that needs to be filled and if baby not born by certain time from labour starts etc I will need to get an emergency section.

I can at 38 weeks Go and get waters popped if I’m dilated but I thought I’d only be dilated if I was in labour.

I can opt for c section which would be 39 weeks but I could go into natural labour before then.

I had my mind set on a csection however I would prefer the less recovery time with Vbac looking after my 6 year old. Also wouldn’t want to go through labour to be told I hadn’t progressed the way they would like etc and I need an emergency section.

Any advice? X

C section
If you go into labour before hand they will still deliver you by c section

I don't know why anyone has a vaginal delivery

They are so risky

That's a very interesting view from cult kid! Natural labour has risks but so does everything, and is certainly not always more risky than a c section. Do you want a vbac?

Vbac is all lovely when it works, but you have a few different risk factors there and emergency c sections can be very stressful. I'd go for elective.

@Coffeeandcrumpet

Sorry I realise it sounded shitty of me

I didn't mean to be rude or scare monger

I had two sections
First one was crap
Second was amazing

I just wanted a home birth so bad with my first baby

I was adamant: and now I have so many mum friends
All of them have been really injured/ stressed or abused during their vaginal with the exception of honestly .. 3 out of say 25

C section. From what you say, you might have to have one anyway, and that way you can plan for when it will be (easier for childcare), and you have a six year old - they don't need lifting or carrying like a toddler might do. I understand that the relative risks of C sections take into account the emergency ones, not those planned from the beginning?

Yeah c section, fuck that who wants sum torches in their vagina...I mean fine some people prefer a natural delivery but god knows why. Purely anecdotal but almost everyone I know who had vaginal births in the last 10-15 years still have it at least had all kinds of issues, those with sections not at all but do what you want and not what you think you should want

Sum torches??? Stitches

On the fence here.

I really wanted to try natural delivery after having got so far with the first and was all set for vbac2c under consultant before placenta praevia stopped that with dc2.

Your reason for c section the first time does not mean you could not progress and have a natural delivery with dc2. Vbac risks after 1cs are low. With vbac you would have team ready to c section if you didn't progress, they don't let you go as long before going for c section and it is more like a planned c section if you do need one (I failed vbac as 2nd DC got stuck on the way out like the first one did). I didn't regret trying.

Recovery after 2nd c section (failed vbac) I found easier as they didn't let me go as long so I had less damage internally from trying to push without results, also no forceps attempt. It was fine with a nearly 3 year old and baby managing at home after the birth so don't let that stop you from choosing c section if you want that, your older DC is 6 and needs less lifting.

Make the decision that is right for you based on how you feel.

VBAC would be my choice.
Remember you don’t need to make the decision now. Don’t rush it xx

I've had 3 homebirths, but in your situation I'd say c section. Your placenta is still low, until now you'd planned for a section, VBAC is more risky than a regular vaginal delivery, and recovery from a scheduled elective c section is quicker than an EMCS (which you may end up having anyway).

I was running around after a 4 year old following my second section. Was home the day after the section in my own bed. Day 3 was a bit hard - felt like my insides had been punched but manageable with pain killers.

Grey TS: I was wondering how things must have changed since I had kids and they used torches up your vagina😂😂😂😂

I had an emergency CS first time and VBAC second time. Would VBAC all over again aswel.
If your keen for a VBAC I would booked a CS for 40weeks if you want to be delivered by then for maternal age, and if you labour naturally before then fab. As long as labour is progressing normally they won’t just bail out and do a CS without good reason.
I was induced for my VBAC and wasn’t easy but happy I did it

Did the dr give you their advice on what they think is the safest option? If so, I’d go with that. I’ve had two vbacs after an emergency csection with my first & they were so much better, but I would do whatever they say is safest. All the best.

I'd go with a c-section too. Much less worry involved even if the recovery is longer

Vbac if you want another child.

Vbac here.
I have had two and am hoping to have a 3rd.

Only you can decide - and there’s no hurry, take a few days at least.
Now that your placenta is clear it’s really the VBAC rupture risk (1/200) to consider, as well as the chances of success (about 70% as a rule of thumb but might be more or less depending on individual factors - ask the docs if they haven’t told you what they think).
As a PP said - if you want to VBAC then it would make more sense to consider waiting for natural labour until 40 weeks. 38 weeks seems early to induce esp since section wouldn’t be until 39. Risks with induction are higher than spontaneous labour as well.
If I were you I would choose between either 1) booked CS at 39 weeks with a plan for emCS if you labour before that; or 2) booked CS at 40 weeks, with a plan for some stretch and sweeps and VBAC if you labour prior to that. You can also ask for a CS at any time in labour if you decide you just don’t want to VBAC after all - but bear in mind that it can take an hour or two to organise (if everything else is fine of course).
Personally I don’t think I would have a VBAC induction.
In terms of needing extra staff for VBAC - I’m not sure that’s true? You still need one on one care for labour, you’ll need to be on the CTG monitor, and have an IV line in. There’s a lower threshold for CS because of possible complications but you shouldn’t really feel like you’re on the clock.
Some of the benefits of VBAC may not apply to you - not sure if you’re planning more kids but a lot of the benefits relate to future pregnancy. And another thing to consider is that at age 40 you have a little bit more risk of tearing from vaginal delivery than say age 25.
Would it be easier for you to just stick with what you’d been expecting all along, and have a CS??
Good luck deciding.

My natural labour and delivery was far less complex than my first ELCS which was for a breach baby. I then had a 2nd ELCS as I didn't want to risk rupture. In short if I'd laboured naturally I would of ruptured, of course this won't be recorded anywhere. I have wondered if the chance of rupture is higher than quoted but

*is disguised a bit by women like myself who have gone straight for ELCS.