vbac for third baby, 2nd one vbac, now told need constant monitoring again, anyone given birth at Southampton or had similar experience?

[Janus]

Just been to Princess Anne hospital in Southampton today, have recently moved to area and 33 weeks pregnant.
Despite my local midwife saying that, as I have 'tested' my scar by having a vbac I could go on their 'natural' labour ward, I was told today at Southampton that I couldn't and would have to go to their one for 'high risk', involving lots of monitoring.
Bloody pissed off, what's the point in having a vbac if I then have to fight all this crap all over again for my third? Apparently, as I have now had, quote, 'lots' of babies I am more at risk of rupturing my uterus and so this is why I need more monitoring than a 'normal' birth. What a crock, does that mean everyone on their third baby has constant monitoring?
I feel so despondent, I hated the constant monitoring with my second birth, strapped up on the bed, etc. I want to move around, even had visions of finally getting a water birth!
They have relented and said I could go under the care of a 'consultant midwife' but I have a strong suspicion that when I get there on the day there may not be one there and I'll be back to constant monitoring.
Anyone had any similar experience?? Sorry, not very likely but feel the need to rant!

I gave birth at the princess anne but not a vbac. I'm presuming they want you to give birth on the labour ward rather than the broadlands birthing unit. The labour ward did have a birthing pool on it when I was there. I started off in broadlands, but got moved down to the labour ward when I needed an epidural. I actually preferred the labour ward. I couldn't get comfortable on broadlands.

One thing about PA at time the labour ward may be full inwhich case you have to go to Broadlands anyway (unless really high risk). I have a friend who is due to give birth in 3 weeks she is classed as a high risk birth and was originally told she couldn't use the birthing pool. She has fought her case though and they have said she can labour in the pool, but they want her to get out to deliver.

You can refuse any intervention if you don't want it. I actually found all the midwives really good at listening to what I wanted when I was in there. What does your own midwife say?

Sorry just reread that you midwife feels you would be ok on the birthing unit. If you want it, fight your consultant for it. Especially if you have the support of a midwife.

I had a CS for my first, a heavily monitored, assisted VBAC for my 2nd.........my 3rd I REFUSED to be monitored, and it was the best of my 3 births.

I had no intervention, no monitoring and only one internal (when I first arrived). Just make sure you stand your ground you don't HAVE to accept anything. As long as you know and understand the risks there's no reason you can't at least try for the labour you want

Oh Janus - I'm in exactly the same position as you!! Not in same part of the country though.

Expecting dc3 after a no complications VBAC with dd and I've got to have constant monitoring too - am seething!!!

My own midwife says I'll just have to put up with it.

Someone suggested not actually booking myself in at the hospital until the very last minute so I could stay upright for as long as possible. But that means labouring in the hospital car park I think

I'm 36 weeks now and I'm running out of options.

I know I can be stroppy and insist, but I don't want "troublemaker" written across my maternity notes.

I'm getting quite upset at the thought of being strapped to the bed, which will no doubt put baby into distress and I'll be at a higher risk of another section than ever

I'm sooooo with you on the ranting - it's ridiculous - grr.

I had a vbac in hosp for 2nd baby and then a very straightforward homebirth with only intermittent monitoring for dc3, but that was with an independent mw. I know 2 people who have had nhs homebirths after a vbac in hosp, they had to fight a bit but they managed. Is that an option for you?

Also, for my vbac in hosp, I got them to strap the monitor on while I was sat on my beloved birth ball close to the machine. It took a bit of time to get the heartbeat trace, but worth it as I was sat up and much happier.

I feel better already!!
Tutu, yes, my local midwife 'suggested' I could use Broadlands but referred me to the consultant today to check. (Actually saw a registrar and then listened to her telling the consultant my history and then came back with consultant's opinion which I could hear anyway, why do they tell you you are seeing the consultant if you are not??) Consultant automatically ruled out Broadlands and said I'd have to use labour ward but very interesting that I may be put there anyway, fingers crossed!! Actually you make me feel much better just saying the midwifes listened to you, I'm sure if me and dp stress our case we can get somewhere closer to what we want. I really hate to be deemed as 'difficult' when actually my main intention is to avoid a cs.
FAQ, I think you are right, I just have to be prepared to be a bit strong for once!!
Bobsmum, I fought all this for my second birth and I stayed at home until contractions were very close together, luckily lived only 10 mins drive to hospital. When I arrived I was 10cms and pushing so the monitoring didn't interfere with early labour, think it did with the pushing stage and I did end up with assisted vbac but still 100 times better than cs for healing. Do you live close to hospital so you can chance this too? I now have to allow an hour (although nearer 40 mins in reality) drive to hospital so can't be quite so cheeky with this one.
Wilbur, I can't face a homebirth. My first was very scary, I had to have ga and it was very touch and go for a while. If we were at home I don't think she'd have made it. This scares me too much to consider a homebirth. I want the security of being somewhere IF anything goes wrong but being able to birth as I want, ie either in water, standing, squatting, anything other than on my back with a big monitor restricting any movement really!! Last time I couldn't even get off the bed as the monitor lead was so short, maybe they've improved since then?!
I think I'm going to trust my instincts and insist that I move around and then be monitored either hand held or for 10 minutes every half hour or something. I'm sure if the midwife is good she will go with my feelings, if she doesn't I'll just have to request a change (I've heard you can do this but not sure if, in reality, I would be brave enough!!). Shall we keep eachother informed Bobsmum? I would love to hear how you go as you are 3 weeks ahead of me. Good luck.

Janus - unfortunately I live an hour and a half away from the hospital, but my parents live about 15 mins away. So worse case scenario is that I labour at their house - probably in my old bedroom (which will just be weird )

I've been told I may be able to sit on a birthing ball in the same way that Wilbur managed, but with the external monitoring it will be tricky - the consultant was suggesting a clip on baby's scalp which would allow slightly more movement - I might even be able to stand at times - woopeee doo

But that means a catheter probably as I don't imagine I can just detatch it if I need the loo and so the intervention mounts up.

Apart from the one c section I am totally low risk - I even had a scan at 30 weeks to check the placenta site was miles away from the scar site and I'm sooooooo normal I'm boring and textbook.

I'm happy to keep moaning on this thread for as long as you'll let me Janus

And I'll let you know how I get on.

The closer I get the more likely I am to either cave in completely or freak out in a strop of the highest proportions !!

They can only 'advise' you on what to do, your body, your baby.

If you are confident of what you want don't ask them, TELL THEM

I do speak from experience, I have had two vba2cs, and both times one hospital first of all refused to even entertain the idea and then said I could have a 'trial of labour' with constant monitoring. Solution was to go to a different hospital(further away) and to have to incredible births

Just in case they tell you that you aren't 'allowed' to go overdue, I went to 42+3

Good luck

oops, should have read two incredible births, not to, sorry.

I had a Doula with me too - and she was able to help express my wishes when I was too busy shouting (I had very short, but extremely intense, extremely close together contractions).

my birth story explains how they tried to persuade me once I was there...sorry it's a bit long and waffly - but quicker than me trying to explain it all aggain.

I gave birth on labour ward back in May and had constant monitoring. Having said that, I did need it and my only regret now is that I didn't ask to move into a better position before I felt that I couldn't physically change postion any more. I happened to be looked after by one of the midwife team leaders who was amazing when it came to keeping me confident and talking me through the delivery just as I asked her to. I know that they are very cautious at PAH when it comes to VBACs but I have a friend who fought against the constant monitoring and had a water birth on labour ward in july time.

The only thing that I would say is that although they do come across as being over-cautious during antenatal appointments, labour ward can give you a fantastic and reasonably relaxed birthing experience. I also think that you should consider why they want you to have constant monitoring. I was dead against it and thought it unnecessary until I was in labour and if I hadn't had it, my DD might not be here now.

"Apparently, as I have now had, quote, 'lots' of babies I am more at risk of rupturing my uterus and so this is why I need more monitoring than a 'normal' birth."

Sorry, very short of time here but this is just not true. Statistically speaking having 'proved' your scar you are at a decreased risk of scar rupture compared with women having their first VBAC. Will try and dig out references later, but as everyone else has said it is your body, your baby and your choice. They can insist that you deliver at the main hospital unit rather than a midwifery-led unit but they absolutely cannot make you have continuous monitoring if you would prefer not to.

I think the beauty of the PAH is that you can choose to go on broadlands which is supposed to be a more relaxed birthing unit, but if anything goes wrong they can wheel you to the lift and take you down 1 floor to the labour ward. It's not like you would need to be transferred in am ambulance.

I really can't praised the midwives at PAH enough (although I had ds there nearly 3 years ago) but I expect a lot of them will still be the same. I found them very supportive. They listened to everything I said and were very happy to explain things to me. I really do think they helped me cope with my labour as it was a very long one and in the end was nothing like I had wanted it to be. However because of the support they gave me and the way they enabled me to make choices I was happy with I have never regretted deviating from my birth plan.

www.ncbi.nlm.nih.gov/pubmed/18238964?dopt=Abstract
Here's a review of research which basically says that a previous sucessful vbac means fab chances of further successful vbacs. Also found that the risk of rupture declines with subsequent vbacs.

I'm currently TTC #2 after DD was born by traumatic crash section under GA so it's something I've been thinking a lot about recently...

One suggestion - if you ask for a homebirth you could then agree to the birthing unit as a 'compromise', they wouldn't have to know you don't actually want the homebirth?

And definately bear in mind that just because they are offering you constant monitoring doesn't mean you are obliged to accept it - from my limited research it seems that your desire to avoid being strapped to the bed like a stranded beetle is emminently sensible for a vbac.

Thanks again for all the replies.
My confusion is, as Daisy says, I have already tested my scar by delivering my second child as a vbac, therefore I do not understand their point that I need constant monitoring not because of the scar but that as I am now in multi births I now need to worry about rupturing my uterus, not my c-section scar. If that is so, why isn't all third time mums continuously monitored?
Also, Tutu, I would love to try Broadlands and, like you say, if any problem be transferred down to the ward that can deal with complications but they won't even let me start on that ward, they say I have to go direct to labour ward and be, more or less, continually monitored.
Swaliswan, did they let you move around at all or were you on the bed all the time? I cannot face this again, I found it unnatural and just not the right position for giving birth and this is what I dread the most. If they let me move around with the strap on, fair enough, I will try and cope although I do think it gets in the way.
I think I am also getting confused what the constant monitoring is for, is it for the scar or the baby? If it is for the scar then I think mine has been tested, if it is for the baby, why would it need constant monitoring rather than the usual monitoring babies have, what is the risk the baby is running because my first birth was a cs? I'm confused!
Thanks so much for all your answers though. I have to say I actually came home and cried about this today but, only a few hours later, I actually feel more positive about it again because of all the advice, many thanks.

Some cynics would suggest that the constant monitoring is to cover the medical staff's backs, and a poor substitute for one to one care?? Good question - I don't really know the answer, be interesting to see if your MW or consultant do though.

I haven't been offered CFM - I've been told "It's Hospital Policy" end of.

Message withdrawn

"Some cynics would suggest that the constant monitoring is to cover the medical staff's backs, and a poor substitute for one to one care??"

Call me a cynic but absofuckinglutely!!!

You do not NEED CFM, it is your right to request intermittant monitoring and only move to CFM IF there is a problem.

I can testify to the research that shows that CFM does NOT improve outcomes for baby but DOES increase risk to mother of instrumental or CS delivery. Apgars of 9 and 9 after they did spinal, episiotemy and forceps cos CTG was bad (read unreliable) Also beware of time constraints. You do NOT need to birth in 8 hours.......

Best places to start:
www.caesarean.org.uk/
www.aims.org.uk/
www.caesarean.org.uk/articles/VBACOnWhoseTerms.html
www.radmid.demon.co.uk/vbac.htm

Debbie Chippington Derrick?s recent Presentation on Natural Birth after
Caesarean:
caesarean.org.uk/presentations/NaturalBirthAfterCaesarean.html

Sorry haven't got time to post more, check out the links and do your own research!

Message withdrawn

Morning. I've been thinking about this thread since reading it yesterday. I too am facing my second vbac in a couple of months so it's all pretty relevant to me too. Bobsmum and Janus, I think as well as reading up on the research cited here, make sure that your birth partner/doula whatever is 100% up to speed on what YOU want and will be your advocate on the day. It is hard enough having to have these conversations anyway let alone when you're in labour. I had a vbac 4 years ago and when they wanted to do something I didn't want (putting in a canula for no good reason springs to mind ) I would say "no (thankyou)" once, then handed over the conversation to my excellent dh and got on with the business of birthing my baby. Have to say only had to do this strangely when the doctor put in an appearance, the midwife was more than accomodating to my wishes on the whole .

I know how boring it is to have to have this stress beforehand, but really they can't MAKE you do anything. Hospital protocols are ALL negotiable and if it comes to it downright ignorable, but sadly, you do need to toughen up for the fight and get people around you who will back you 100%. Listen to Klaw - the woman talks sense Good luck

I had CS for my first baby, a VBAC for my second (no problems) then between my second and third delivery the hospital (labour ward) was downgraded I had to go a further 30 mins away because I was still classes as a high risk. Gave birth - no problems.

I can hear what people are saying about it being your body etc. I nearly lost my first baby, if I had not been hospital or monitored then I dread to think of the consequences.

Bottom line is if you didn't have all the constant monitoring and something happened to you or baby - could you/family bear the consequences.

At the end of the day the hospital are only protecting you, your baby and themselves.

"I need constant monitoring not because of the scar but that as I am now in multi births I now need to worry about rupturing my uterus, not my c-section scar. If that is so, why isn't all third time mums continuously monitored?"

Because it is rubbish! Honestly, get a second opinion. The idea that you need continuous monitoring in case your uterus rupture because you're having a third baby is almost laughable if it wasn't so appallingly wrong!

There is still an argument for continuous monitoring because of your cesarean scar. The risk of rupture is small and even smaller than last time, but they will offer continous monitoring (note the "offer" ) anyway.

if it has not been mentioned www.aims.org.uk is good for this sort of thing, 'am i allowed?' or speak to the supervisor of midwives at the hospital as she can be an advocate for you ..

you cannot be made to labour a certain way

i would recommend detailed birth preferences, with importnat bits in read and be ready to demonstrate an informed position, you might well find that HCPs back down

you can labour on your terms, you might have to be demanding , but you can

being a multip does not autmoatically make the risk of uterine rupture higher, that is scaremongering nonsense