Chances of VBAC? Or straight for elective section?

[Createcomet]

So my first birth was 2020 in lockdown. Water's broke, 30 hours later induced with pessary gel. Gel caused 3 in 10 very painful contractions for 6 solid hours, but cervix still closed and posterior. Epidural went in, induction drip started. 6 hours on that got to 2 cm. Baby's heart rate began to drop, and then I was rushed to theatre.

I'm now pregnant again and need to think about vbac or elective section. I have no idea how to decide. What are my chances of a VBAC? I'm conscious that I don't want another child section or an instrumental birth....But also conscious that I have a 2 Yr old to care for a c section recovery will be hard. Is vbac recovery likely to be easier if I manage it?!

I'm refusing induction so will have to book a section at some point but unsure which gestation to go for.

Anyone have any thoughts/able to share how they made the decision between vbac/elcs?

All I really want is to deliver the baby healthily with less trauma than last time, and for my husband to be able to stay in the hospital with me 🙈

I had a difficult first birth. Lots of damage. Wish they’d given me a section and not torn me apart trying not to!

Had an elective second time round. It was just amazing, the recovery was a breeze. Honestly I can’t understand why anyone would even contemplate a VB if they’ve had a bad experience now.

I don’t know the answer but I’m in an identical situation so I’m hoping you get
some good answers. I can’t imagine section recovery with my 2 year old but don’t want to try VBAC and end up in an emergency section! I’m also refusing induction

I had my DH for two weeks but was fine by myself with a two year old after a planned section. I had to remind myself I shouldn’t do things rather than feel I couldn’t.

I was in same situation. 2020 lockdown baby & then had my second recently. I was told that because I didn't dilate at all last time around that my chances of a successful VBAC were 50/50, they'd support me if I wanted to do it and they wouldn't recommend induction given increased risk of uterine rupture.

If I could have guaranteed a successful VBAC id have done it, but i didn't want to risk getting so far then needing an EMCS anyway so opting for an elective c-section gave me some much needed control. I also had some other risk factors so you'd need to consider your own circumstances and health.

Recovery was physically much easier this time around but emotionally I found it tough not to be able to do everything I normally would for my toddler, but nothing to say that would have been any different with a difficult VBAC.

It's a very personal choice and there's risks either way so it depends what you're personally comfortable with, and whats most important to you.

I had a 5 day induction which ended in a EMCS due to baby getting stuck. 22 months later, after a lot of tears, research and discussions and standing my ground I had a VBAC. My plan which I TOLD my registrar, with pages of research from NMC, NICE etc was that I would have a pessary indcution and then if that failed a section.

He wouldn't listen to me so I complained about him due to his refusal to listen to me, so the Matron of Midwifery got involved. She recommended a Foley Cathetar induction which was amazing, no hormones involved and second was born 2 weeks late, big, VBAC and fast! 4cm to birth was 5 hours.

Do what is right for you, research, talk to midwives - also I stressed so much until my health visitor pointed out no one asks after about the age of 4!

I had a vbac with my second, following an EMCS with my first. If I was to choose again I'd have an elective section. Thought the recovery would be better but although I could drive, I didn't feel my vagina was fully healed until at least a year post partum. I ended up with a forceps delivery though.

What I would say, is it's your body and entirely your decision. I would have refused an induction if it got to that. No one can force you into anything you don't want. I had a consultant appointment to tell them I wanted a section in the event of a potential induction. They kept me waiting for 2 hours and I had to get back to my toddler - when I spoke to my midwife and asked her what they would do if I refused an induction, she replied that they'd have to do a section. So no need for the conversation then! Waste of time.

I've had 2 ELCS, 20 months apart. Recovery both times was really quick and relatively easy. I know it's different for everyone but recovery from a planned section is typically far better than that following an emergency.

Personally, I'd opt for a CS every time.

Thank you, that's really helpful. I'm so on the fence about what to do. I have no idea which is better but I do often find myself leaning toward a CS. I don't want CS to be my only experience of birth, but equally I think if I had a planned it would be soooo different to my emergency in lockdown that I could almost guarantee a good birthing experience. I'd quite like a VBAC, but I'm not massively fussed about pushing a baby out. It doesn't matter to me a great deal and I totally appreciate it does to some women. I just want it here safe and alive. I just don't know what to do, but my worry with a VBAC is that I don't know what the chances of it being straightforward are?! Especially having only got to 2cm before. And I feel like as soon as I do something like accept an epidural, I'm going down a path of intervention that's going to lead to an emergency/instrumental birth.

Such a difficult one.
I think if youd dilated further i would say mayve try the vbac.
Might be wise to think about how many children you woukd like in total aswell. I know they don't let you do vbac after 2 sections so this is your last chance to try that.
They sat a planned section is easier to recover from.
I had a choice of c section second time and I declined, I wish I hadn't.
I don't envy your decision

@Likethestarsabove547 its really tough. I'm sorry you felt like you made the wrong choice, that's really hard. Does that mean you had a difficult vaginal birth?
I only want 2 kids, I'm done after this one. Which makes the decision even worse because I could have a 2nd section quite easily.

I keep thinking "but what if I could have had a really straightforward natural birth and I never even gave it a chance". But equally, I know I've got risks of episiotomy, tears, forceps, emergency section etc. It's just such a hard decision!

@Createcomet so first was an induction which was horrible. 3rd degree tear and pph with a blood transfusion. I let my body heal for a good 8 years before having another baby.
Second time I went into labour naturally, had an epidural which failed. No time to resite as baby was in distress so had ventouse and episiotomy as wasn't time for a c section.
I was the same, going backwards and forwards thinking it could be this perfect vaginal birth that heals the trauma from the first time but it just didn't end up like that.
It's an impossible choice and you're always going to wonder either way.
I can't compare my recovery to a c section but first one was hard, took over a year.
Have you had a consultant appointment to discuss it, what does your midwife think?

Your first birth sounds a lot like mine (waters broke, induced, nothing doing, baby distressed, emcs). I went on to have a successful VBAC with my second (2.5lb lighter) baby, although not without some damage so recovery time no better than my cs.

I do feel for you. I had an emergency section and I’m pregnant with my second. For me I already had my mind up to go for a section again although in my case I think there’s little chance of a smooth VBAC.

There’s an increase likelihood of tears with vbac and also with age and maybe some other factors I’m not aware of. It’s important to research if you haven’t already.

It’s ultimately up to you. Whatever you choose be kind to yourself and don’t torture yourself wondering what ifs.

@DontMakeMeShushYou I'm glad you got a vbac! Your comment is really helpful though, thank you. I think I've been telling myself that recovery from a vbac will be easier. But I need to be realistic that it actually might not be I guess.

Probably a little different to everyone else as I was a lone parent when I had my second section. It was an emcs after a failed vbac I had a newborn and 3 other children under 6 to look after alone. It was fine tbh just got on with it when you have to, so its doable having a 2 year old and newborn if you need another csection. Not having anymore but if I did it would be a elective csection

@Likethestarsabove547 I'm really sorry you've had 2 difficult births, thanks for sharing your experience. It's actually really helpful that you said I will wonder either way, so thank you.

My midwife opinions vary. My main midwife supports whatever I want and isn't pushing me (but I have a 28 week app on Wed and think I will try and have a serious discussion about it) l. Birth choices midwife was very supportive of VBAC but I think would also have let me just book a section. Another midwife I saw seemed quite pro section in that it would be hopefully less traumatic and more controlled and give me a birth experience that is better than last time. And my antenatal physio had an emergency section in 2019 and said if she were lucky enough to be pregnant again she'd have another section 100%, on the basis that the scar and stomach muscle damage is already there, so why risk vaginal damage too (which again, is something I had also considered). One of my friends is requesting c section because she had forceps last time and can't face it again, which make me think a bit.

Don't get me wrong, a vbac would be very very healing if it went well. But I'm really scared about how I'm going to feel if it doesn't go well. Or is it just not even going to matter because I will hopefully have a healthy baby and not have to birth again....Just. Don't. Know. 😭

@CadburyDream that must have been tough! But you are 100% right, you do just get on with it. I remember my mum scaremongering about how much help I'd need if I had a section, and then I had one and she came to visit and was like "oh, you're fine". I was lucky I only had the baby but it was lockdown again 2 weeks after he was born and my husband was at work, so I couldn't have any help anyway.

Yes I see so many posts of people saying they couldn't lift the baby for weeks after a section but I had no choice. Had a 2, 4 and 5 year old as well that needed lifting out of the bath etc midwives didn't care! Never caused any issues thankfully

I would ask your midwife at your next appointment to refer you to speak to the consultant about a c section, might be good to talk it through with them. I'd be inclined to find out what the risks of a vbac are in comparison to a c section. I know you're adding uterine rupture to the cards but I'm sure there's other things too. My 3rd degree tear healed really well and I know they have changed how they try to prevent them since I had dc1 and they did prevent it re tearing with me. My episiotomy though didn't heal well, stitches popped as they were too tight and it's not flush with the rest of my skin atm. Apart from that it is OK though, a little achey sometimes but it's scar tissue.
Funnily enough every doctor I saw pre second birth heard about my first birth and literally said 'so c section this time I take it' and were fairly shocked when I said I hadn't decided yet.
I don't blame you for refusing induction either, I wouldn't have allowed it second time round.
The one thing I didn't want was forceps or ventouse but sadly not to be.
I hope you come to a decision you're happy with and that whatever you choose goes well for you xx