Feel I'm being forced into VBAC - Help !

[DefNotYummyMummy]

Does anyone have any advice ?

In August 2006 I had an emergency caesarean with my first child. My waters broke naturally at 39+4 days, and they gave me a drip to try to speed things along as the baby wasn't doing so well. I had an epidural. With each contraction the heart rate was dropping. The drip didn't work and I only got to 3cm after 10 hours and so then they decided on a caesarean. Unfortunately I had a panic attack as I could feel them cutting into me when preparing for the caesarean and it is only after the fact I realise I had a poorly administered epidural. I could still feel contractions on one half of my body, but not having had one before I just thought this was how an epidural should feel and I never voiced my pain. Anyway, I ended up having a panic attack and had a general anaesthetic for the operation.

Luckily the baby was fine and I was out of hospital after 2 days (they needed the bed, but I couldn't wait to escape to be honest).

I am pregnant again and at my 20 week scan I saw the consultant. Well after a chat about my previous birth and no real other discussion (she gave me a leaflet), and just said that there is no reason why I can't try VBAC and walked out. So now that is written on my notes : 'try for vbac if all ok'.

Since then I have done a lot of research myself on government statistics and studies and I would prefer to have an elective caesarean. I want to try to have an epidural again as my pain threshold is low. This may slow down labour. I am terrified of having to go through an emergency operation again, and would prefer to have a controlled experience, especially as I am not planning to have any more children. An epidural (I read) can increase the likelihood of instruments which can put extra pressure on your scar, and I certainly wouldn't want any drug to try to speed along labour due to the risk of scar rupture (however small). Last time I had pregnancy induced hypertension which had to be controlled with drugs from 36 weeks, and they have been keeping an eye on me with growth scans. Last week my growth scan (32 weeks) was fine and I started talking about the birth with a doctor (not my consultant) and she just said 'you'll be fine, don't worry'. In my notes she just put 'wants an epidural'. I have another growth scan at 36 weeks.

So now I feel I need to be more forcefull to actually request what I want. I haven't written a birthplan yet in my notes. Maybe that would concentrate the mind. I don't feel I have had a proper discussion about what I want for this birth. It's my body, my baby ! I'm a person who doesn't like confrontation, but I am losing sleep over this.

Anyway, I was wondering if I have the right to ask for an elective caesarean and to ask to see the consultant again as I feel bullied into having a VBAC as it is convenient for them. (I know someone in the NHS who said they are trying to get their statistics down regarding elective caesareans).

Sorry this is long.

Louise xx

Having experienced the joys of an emergency cs I can fully understand your fears.

My understanding was that you had every right to ask for an elective cs if you were in your situation. Even if you start labour naturally you can ask for a cs any point. Or at least that was the experience of one of my friends who was in the same position.

Perhaps you just need to make your voice heard!

Thanks DefNotYummyMummy - I hope you manage to sort yours out too. I'm at St James' in Leeds and so far I've had positive experiences in hospitals in this area, so I'm really hoping it will go smoothly. I'm just cross that we should have to fight for anything, as you rightly say, we shouldn't have the added stress.

I don't understand why you weren't offered an elective cs. I had a cs first time round, and although I wanted a vbac (and had one) it was made clear it was my decision and it would have been equally valid and understandable for me to want an elective cs!

Is there no guidance on this provided by the RCOG? I know that obs are under quite a bit of pressure to decrease the cs they carry out, so it may be that unless you really object strenuously you go into the category of "wanting" (ie being prepared to try) a vbac?

If I am giving my ob the benefit of the doubt, maybe she thought 'why on earth would she want to go through that again ? Obviously she would want to try for a natural birth ?!'

I will check my literature from the the RCOG to see if there is any guidance on the matter. I know that it does say there must be a discussion and an agreement with the patient for what is best.

But there wasn't ever any discussion or even the direct question 'what do you want to do ?' And anyway, at 20 weeks, who knows. I was just finishing morning sickness and wasn't really thinking about the birth which is also maybe why I wasn't so energetic about asking questions and forcing a discussion.

It's up to me now to re-visit and go through all the literature that I have read and meet with her to discuss it properly.

And so once again I keep on changing my mind, and today I feel like trying for vbac ! I wish I could make up my mind and just go for it.

Aaaarrrggghhhh. I'm such an idiot.