VBAC or CS? Cant decide

[Pinkstuffs]

I’m only 12 weeks pg with DC2 but my consultant is already asking me which I would like for my next delivery. I’ve provisionally booked a CS at 40 weeks but am wondering whether to try for vbac?

My last delivery for CS due to a small baby, obviously if I have another small baby I will likely keep the CS but if not would you try a vbac? Any experiences or thoughts are helpful!

I'm biased as the thought of a VB terrifies me, I had an elective c-section for my first and plan on having the same for any future children I have. I personally prefer the 'known risks' involved in a c-section even though it's a massive procedure vs the unknown of how a VB can go. Obviously a c-section can also come with all sorts of complications too but that's just what I'm comfortable with.

SIL had an emergency c-section for baby 1 and a VBAC for baby 2 and says that was her preferred birth because the healing afterwards was easier than c-section and the VBAC happened to be a very complication free delivery as baby was in a rush to come out!

I had an EMCS for my first and have an ELCS booked at 38 weeks for my second. My first birth experience was traumatic, ended with EMCS and the recovery was really awful. DS managed to get stuck and because labour had progressed to the point of pushing, he had moved down and his delivery was really quite brutal which I'm sure affected my recovery afterwards.

Had a consultant appt for this pregnancy and was torn. After the difficult recovery, part of me is saying I can't go through it again and I want a VBAC but there are so many unknowns and no guarantee it wouldn't end in an EMCS or other birth injuries which I want to avoid. When I had my meeting, the doctor talked me through what happened at the first birth, about my son getting stuck, doctors being unable to get him out then needing resuscitation afterwards. Hearing that was really upsetting and I decided I don't want to put myself or baby in that situation again if it can be avoided, so opted for an ELCS. In my case, I have a risk of premature labour so I'll probably go into labour before my CS date anyway and might not get a choice if birth comes on as quick as last time but it's the plan for now.

There are risks and unknowns in all birth scenarios so I think you just need to go with whatever one you're most comfortable with. If I could guarantee a VBAC would go exactly to plan with no injuries then it's an easy choice but for me, it's about minimising unknowns and making a decision that I think will result in a more calm and controlled environment.

I had an EMCS and then a VBAC, as I had hoped for a quicker recovery. As it turned out, nature had other ideas and there were complications with the VBAC that meant I was in for at least as long, if not longer, than with a CS but I don’t regret it.

I found the Royal College of Obstetricians and Gynaecologists guidelines on birth after previous caesarean section helpful in thinking through risks and benefits although they are now ten years old.

www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/birth-after-previous-caesarean-birth-green-top-guideline-no-45/