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Original poster

Is this normal procedure re VBACs and elective sections? Confused!

42 replies

sallycinamon · 29/05/2008 23:35

I went to see my mid-wife today (I'm 32 weeks)for a routine appointment. I told her that I'd made my decision and was going for a VBAC. I presumed that I'd be allowed to go over-due and if I still hadn't had the baby by 10-12 days over they would give me a sweep or two and if that failed I would have a c-section. (I appreciate the fact that I can't be induced - scar rupture etc.) This seemed like a reasonable plan - at least I would be giving myself the chance to go into labour naturally. How wrong I am! It transpires that what actually happens is I get a sweep at 39 weeks and if i still haven't had the baby by my due date I will automatically be booked in for a section around that time. This seems ridiculous. Provided me and the baby are fine why can't I be left to go overdue like a first time mum? What's the rush? I am unlikely to have this baby early - my first was 10 days late - so it seems i have to resign myself to an elective c-section.

I thought they were trying to bring the c-section rate down and VBAC rate up. It doesn't seem like it to me.

Sorry to rant on but I just wondered whether this is standard procedure. Perhaps I have been a bit naive.

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amytheearwaxbanisher · 29/05/2008 23:40

did they give you any medical reason for doing things that way?seems a bit strange

PInkyminkyohnooo · 29/05/2008 23:43

I'm sorry to hear this. It's not what I've been told- only that I would not be induced if I went over the usual T+10. Maybe the MW is mistaken? I'm going for a VBA2C in November, BTW. I hope someone who knows their stuff like Lulumama comes along to talk to you soon.
39 weeks sounds a bit mad to me.

Ellbell · 29/05/2008 23:43

Unless there is a medical reason, that seems very odd. I was told that I'd be allowed to go two weeks overdue with dd2 before they'd do another section. No mention of sweeps at all. (I actually went into labour at 37+5, so it didn't get put to the test, but consultant was happy to agree to it.) Doesn't sound like standard procedure to me, but you need someone like lulumama or Klaw to confirm. I'll bump this up for them...

Poledra · 29/05/2008 23:45

I certainly wan't told this when I tried for VBAC with dd2 - if I made it to 41 weeks, I was to go back to see the consultant and discuss the options at that point. As he said, 'I hope we see you before then' and they did.

Actually, if I'm not mistaken, you can be induced using syntocinon after a c-section - it's just the prostagladin pessaries you can't use.

sandcastles · 29/05/2008 23:48

This is the reason I pulled out of VBAC, even tho I really wanted to try.

They wouldn't let me go overdue. {not that I would want to, tbh]
They wouldn't induce me, only break my waters, then do a c sect if that wasn't succesful.
They would do a section at the first tiniest sign of trouble.
They would do a section if my BP became unstable.

But then I have the threat of Pre Eclampsia over me & am now in Australia, so it could be different.

It was all too unpredictable for us, so we [dh & I] decided that we would prefer a repeat section.

StarlightMcKenzie · 29/05/2008 23:48

This reply has been deleted

Message withdrawn

PInkyminkyohnooo · 29/05/2008 23:50

MY consultant won't induce at all - I don't think drips are considered a good idea for VBAC as it makes things a bit full on (from what I've read so far).
I think allowing to go 14 days over sounds reasonable to me.

PInkyminkyohnooo · 29/05/2008 23:52

Good point Starlight- you can't be made to do anything-certainly not surgery. Maybe just a dud MW?

Poledra · 29/05/2008 23:54

Yes, should have said I personally would not recommend inducing with a drip. Had the drip prior to em-c section, and it was pretty full-on even at that point in my labour.

Poledra · 29/05/2008 23:54

And didn't bloody work either, obviously

Klaw · 29/05/2008 23:54

err..... what is she on? This mw is talking out of her backside.... [puzzled]

You do not need a sweep until at least 41wks if you go that far, preferably 42wks and possibly not even at all. You could opt for Expectant Management instead of CS, and make a decision on mode of birth if baby needs to come out for a very good medical reason. Although induction is not recommended (and is a very bad word in my book) for VBAC you may prefer to try it under very careful observation than go for a guaranteed CS. It is YOUR choice.

My VBAC was 42+1 scan edd or 40+6 lmp date. I did go the sweep route and only the 3rd was able to be performed. Hindsight means that I wouldn't bother with any in a future pg.

There are some fab sites out there for VBAC

www.aims.org.uk/Journal/Vol14No1/VBACWhoseTerms.htm

www.vbac.org.uk/

www.radmid.demon.co.uk/vbac.htm

If I were you I'd ask to speak to the Supervisor of Midwives and ensure that this mw is encouraged to update her skills and knowledge

MarsLady · 29/05/2008 23:56

As Mary Cronk says "It's what YOU allow".

Different hospitals have different policies... but hospital policy is NOT a medical reason. Ask the medical reason and why it's relevent to YOU and YOUR BABY at THIS TIME!

MarsLady · 29/05/2008 23:57

Klaw.. they're showing Orgasmic Birth in Glasgow. You must see it. It is so amazing! Am just home from the London viewing.

Klaw · 30/05/2008 00:04

Oh Marsy, I want to but not sure if I can afford to get there, financially and time wise....

Should really get to SDN meeting in Edinburgh on Sat and then swing over to Glasgow for Birthrites Exhibition launch, but again with the cost of fuel....

Tell me more about it! I suggest at MSLC that we organise a showing but was informed that the title would put a lot of people off.. I mean WTF???? [puzzled]

PInkyminkyohnooo · 30/05/2008 00:11

Sally, I found the little book called thw VBAC Handbook quite useful, I got it from Amazon, have you read it? It's quite good at reminding you of your rights of choice in the face of hospital 'policy'.

lisad123 · 30/05/2008 00:11

sounds odd to me. I was going to be induced at 40weeks with 2nd after 1st was ECS. That was only due to blood disporder and other things. Even then no mention of another section.
I would have a clear plan of what you want, and ask why you need a cs?? Silly MW IMO

PInkyminkyohnooo · 30/05/2008 00:12

Poledra- they tried the drip on me at one point, too. Still only got to 3-4cm!

Ellbell · 30/05/2008 00:13

Sorry, should've said before 'Lulu, Klaw and Marsy'

stuffitllama · 30/05/2008 00:14

Yes Sally, I was told the same thing, so I didn't go to the appointment at which a section date was to be fixed. Had the VBAC five days after due date. I think they like to get organised. But there are ways round it.

jamila169 · 30/05/2008 00:22

I'll give my tried and tested advice shall i?
Don't see a consultant unless you've something wrong with you
tell your midwife that you're not an employee of the hospital therefore hospital policy doesn't apply to you
make a solid birth plan detailing at which stage and under which circumstances you will consider repeat C/s
put together a folder of relevant info from good sources (RCOG,ICAN,VBAC site ) and get very good at spotting bullshit very quickly

PInkyminkyohnooo · 30/05/2008 01:32

I'm going to write that down, jamila

Original poster
sallycinamon · 30/05/2008 07:08

Morning

Thank you so much everyone. From what you all say I get the impression that this isn't unheard of but an quite unusual policy. Will see if i can get hold of that book Pinky.

I think I will put together a firm birth plan as you suggested Jamila. If the baby hasn't come by 12 days after my due date (when they usually induce here) despite possibly having a sweep at 41 ish weeks I'll settle for the elective and suggest they book it in for then.
Does that sound reasonable?
I'm still confused about the syntocin drip and whether they'll do it here for a VBAC but think I would like to avoid that anyway.

One of my reasons for wanting to be left alone to go overdue is that my first baby was 6 pound 2 born 10 days late and with this one I'm currently measuring 28cm when I should be 32cm so if it does have to be born early it could be very small. I'd like to avoid this and give it plenty of time to fatten up inside if all is well with it amd me of course!

Anyway, in 2 weeks I've got a placental siting and growth scan so will hopefully run my birth plan past them then.

OP posts:
cats07 · 30/05/2008 08:56

Hi,

I have had one successful VBAC and am due for my second (fingers crossed) any day now. They have been in different health authorities, but procedure is similar, which is sweep if I want it at 40+7, then induction at 40+12.

I went into labour naturally last time (at 40+9) and really hope I do this time!

I really can't uderstand why they would want to start fiddling around with you so early - it doesn't make any sense. I would be worried that it would just trigger a whole series of interventions.

MarsLady · 30/05/2008 09:50

klaw email fathers to be and see if there are any Edinburgh plans. And what about suggesting it to the Scottish Doulas (though I think they are organising the Glasgow one). It's truly amazing and a shame that people aren't brave enough to go despite the title (which is perfect for the film)

PortAndLemon · 30/05/2008 09:56

Not normal here. All I had booked was an appointment at 40+2 to discuss what to do next (and there had been no suggestion beforehand that they wouldn't let me go 2 weeks over. As it was I had DD at 39+5 so didn't get to find out what they would have done.

You don't have to let them do anything, including sweeping you or cutting holes in your abdomen.