VBAC or not to VBAC

[zoeb92]

Hi, I'm looking for some advice, please.

I had my first baby in 2023. He was massive from day one — 99th percentile. My husband is tall and broad, so we always knew he was going to be a big boy.
Everything was relatively fine during my pregnancy, but at 37 weeks I was diagnosed with pregnancy cholestasis — which is intense itching. My bowel movements had turned grey, but I didn’t realise the significance until I saw my GP to ask for something to stop the itching. I was admitted to hospital straight away. Although my baby wasn’t due for another three weeks, they booked me in for a C-section at 37 weeks and 4 days and told me I wouldn’t be going home until he was born.

A few days later, a midwife examined me and said my cervix was favourable, and asked if I’d like to be induced. I agreed. Contractions started that evening after the pessary was inserted — uncomfortable cramps that kept me up all night. I was taken to the labour ward the next morning and examined at 8am. I was 2cm dilated. By 5pm I hadn’t progressed. The consultant gave me two options: have a C-section there and then, or wait another four hours.
I chose to wait. I started progressing, but unfortunately, my baby got into an awkward position and became stuck. So, after all that, I ended up with an emergency C-section anyway.

We then spent another week in hospital, as his blood sugar levels dropped due to the medication I was given during labour when my blood pressure spiked. He also developed jaundice. We finally went home when he was six days old.
This time, I’m 12 weeks pregnant. Obviously it’s too early to know whether things will be similar, but my midwife has already recommended a planned C-section at 39 weeks.

Part of me thinks, “Yes, fine — whatever is best.” A planned, calm delivery with no drama sounds appealing. Just book the appointment and go.
But the other part of me is desperate to be left alone and to let nature take its course. I really want to give birth naturally.

I felt like I failed last time — it really got to me. I became obsessed with breastfeeding because I wanted to do something for him myself. But after weeks of trying, he wasn’t gaining enough weight, so we switched to bottles. He’s now two years old and absolutely thriving.
I just need some well-informed advice. I want to do this myself this time — but not if it means putting my baby at risk.

Thank you in advance. x

Can't tell you what your risks etc are but I sincerely hope whatever you decide to do you feel listened to cared for this time around.
You absolutely did not fail. You're body did not fail. Inductions are associated with increased rates of C-section because your body is being pushed to do something it's not ready to do. You had a medical condition that made it unsafe to stay pregnant and you made the best decision for your circumstances.
Just because it was necessary doesn't mean it was all well and good. It sounds like you had a really hard time. Lots of stress, probably lots of difficult interactions with lots of different strangers, long stay in hospital before and after, jaundice is sometimes mild but can also be incredibly difficult, weight worries! All of that makes it harder to bond, harder to breastfeed, harder to look after yourself and your baby.
You have done so well to come through all of that and get to the other side with a healthy thriving toddler. Congratulations and best wishes for you and your new baby to be x

Posting because I'm in exactly the same boat -failed induction at 37 weeks as there wasn't enough amniotic fluid, 4 days and ended in a emergency c-section, have a thriving 2 year old now, and ALSO 12 weeks pregnant! I feel similarly, a planned C-section feels like the safest route but I do feel like I missed out on letting my body do the natural thing and could I do that now? So keen to see other people's takes!

I’m pretty much in favour of natural birth and was booked for a home delivery with my own dd, but ended with a c section, because she was footling breech. I wasn’t happy at the time that I had it, but I see now it was necessary. I think with a very large baby and other complications a c section is best. That’s what I’d choose, anyway. Although I definitely know it isn’t an easy decision. Best of luck with whatever you decide.

We had a similar dilemma - induction ending in EMCS with the first, then were cleared to attempt VBAC for second but with the caveat that they didn't want the baby to go overdue because of being over 40 and increased risk of stillbirth. We discussed it with the consultant and the compromise was that we booked the elective section, but later than they suggested, at 39+6. So we were still giving the baby a chance to come out by himself (encouraged with a couple of sweeps), but with a deadline. In the end we had the section and it was a totally different experience to the first one. Really relaxed, our choice of playlist in the operating theatre (!), breastfeeding way easier than the first time because not exhausted, booked into the special C-section part of the ward right next to the midwives, toilets and shower, home the next day.

Consultant wanted me to go for another section due to big baby and ‘failure’ to progress beyond 9cm. We agreed to a c section at 39 week if I hadn’t can’t into labour naturally by then. I had vbac at 38+1.

I would always go with a c section, had an elective for my first delivery too. For me personally the risks / cons of a vaginal delivery outweigh the cons of a c section. I know so many women who were induced and had an unplanned c section (emergency c sections are only the ones which are done in under 10min when there’s really risk of imminent loss of life and under general anesthesia, at least that’s what a doc told me, all other may be unplanned but are not technically emergency). I also know many women with severe and traumatic birth stories, hence i decided to go with the c section. And im really happy i did it.

But every Woman needs to decide for herself. I rather choose the “evil” I know than an unknown.

I can't comment on your case as im not medically trained. I had emergency section with 1st and elective with my second. I gave birth in the safest way for my child and me. Leaving it to nature would likely to have killed both of us. I chatted it over for my 2nd with my consultant and knew that it was likely to end in another c section. Elective gave me the control back. We were able to arrange childcare and I wasn't sleep deprived when I met her for the first time.

hi OP. Please please don't feel like you failed. Natural births can be absolute shit shows and not all of us are able to have the calm labour and give birth with a few breaths and a massage of clary sage on the tummy. I used to be quite resentful of those who could but am now really proud of my resilience and what my body has been through to have 2 kids.

I had my first baby by so called "natural" birth - he was 9lb 9oz so not huge huge but I am 5"5 and was very slim at the time ( lol) - It was awful - shoulder dystocia, so he had to be delivered with forceps, placenta wouldn't deliver so had to be extracted manually, then I haemorrhaged etc etc. Took me a long time to bond with him as I was physically such a bad way.

Second baby - I had a C section at 39 weeks due to the complications from birth 1. Honestly so much better, I recovered quicker emotionally and physically from the C Section than the "natural" birth, I bonded with DD2 immediately, whereas with DS1 took a good few weeks.

The C Section was so much better than the "natural" birth, and I really really wish they had given me one first time around as I have never really physically recovered from the forceps and episiotomy. Apart from the scar I have no effects at all from the C Section. plus I bonded so much more quickly with the second one.

Also re: breastfeeding - I know it's recommended that it is better blah blah blah, but the kids are 15 and 18 now - and no one knows/cares and it has probably made absolutely no difference to their outcomes! Really don't beat yourself up about it.

Good luck OP with whatever you decide.

Ps if you're the type of person who wants to get all the information about research etc this podcast might be worth a listen.
https://pca.st/episode/1335d7e9-1d37-4197-9e0f-c10b8a2019c5

I had an emergency c section for pre eclampsia at 38/40 , DD was breech so always going to be a section . 2nd DD i had section booked but wanted a VBAC , bit complicated as had gestational diabetes . I was told i was very favourable for a VBAC due to only needing the c section due to medical conditions and not because i hadn’t progressed . Sweeps worked and i went into natural labour 38+1 2 days ahead of planned c section , i was 5cms and hadn’t even realised i was in labour, In the end because nobody can predict how labour will
progress and the risk of a rushed emergency section we still opted for a non urgent c section it was absolutely lovely . I still think about whether i missed out on having the VBAC but i am certain that I am glad we didn’t have a second emergency section.

I think it’s a personal decision and what they recommend due to your previous birth. I had a planned section first time due to breech and opted for a VBAC for my second just over 3.5 years later and am so glad I did, a really positive experience and so much better recovery. I was up and about straight afterwards. I had sweeps from 37 weeks and worked hard with my midwife to go into spontaneous labour which made a difference (as induction more likely to lead to complications and a section) and I went into labour at 39+2.