Really want a natural birth after a c/s

[Allusivepond]

Im new to the forum and came across your forum while trying to research VBAC's and how best to achieve one.

My DS is nearly 2 and Im currently 34wks pg with my second bub.

For my first child I ended up with a c/s as my Obs (great as he was) said I was favourable for an inducement. I went ahead with the induction only it failed. I held off a c/s and my Obs again tried to induce twice more over a 2.5wk period. By the time I got to 40wks and 1 day my cervix had not changed a bit and due to taking clexane through my pregnancy, plus bubs was measuring behind quite significantly, after a failed induction that morning he thought the best option was a c/s. Obs said that it was highly likely as my Son was conceived using IVF. He said some IVF pregnancies suffere complications that 'normal' pregnancies dont. So I was not classed as high risk nor was there any risk to the baby.

Knowing what I know now I doubt I would of opted for even the first induction until at least 40wks. I think I just got scared and given what we had been through to conceive our son and then of course the minor complications suffered toward the end I think mentally that interfered with me being able to relax enough to encourage birth if that makes sense.

Now Im sitting here and really wanting a VBAC even though I had a good experience with my C/S I have a little boy that relies on me and the thought of not picking him or being able to be there fully for him while I recover is causing me great angst.

My Obs is quite open to a VBAC but is not open to an induction due to the risk of rupture. He is happy to let me go but because the head didnt engage at all and was still floating above the pelvis he has given me more than one conversation including the one I had today where he basically stated that he feels the writing is on the wall and that there is no way the baby will engage and I really should consider a planned c/s. I have really tried this pregnancy to come to terms with that fact but I cant let it be that way. A growth scan today revealed that the baby is slightly on the smaller side but absolutely no complications.

I guess Im wondering if its possible to be able to birth naturally and if I can how do I prepare mentally to get the demons of 'the writing is on the wall' from the first pregnancy out of my head and put it into a different head space that allows my body to open up and accept what nature meant. Im really struggling to forget the c/s. I keep telling the bubs to head to the light especially when I have very strong B/H. Obs feels is bubs is still not engage by 38wks I really need to consider a c/s. A midwife friend said to take each day and come what may.....I just have no idea how to do that.

Im wondering if my mental mind set is going to once againe prevent me from giving birth naturally as Im put off by my first experience.

Sorry for the long post, I just dont know how else to word it.

I will start drinking raspberry leaf tea and taking the tablets. Im also seeing a chiropractor who specialises in pregnancy and Ive also done a bit of pg yoga.

Any thoughts would be greatly appreciated.

Im really feeling the pressure and not sure how to alleviate it at this point.

Regards
Allusivepond

[HotI]

i am not an expert on vbac, but i have learnt a few things on here and wanted to give your thread a bump so some others can give you better answers!

i wonder what the Ob is basing his prediction on when you are only 34 weeks, plenty of time for baby and you to get ready for birth, maybe deep down he is not really that open to vbac?

plenty of babies don't engage til close to birth, and second babies are often later than 1st babies to engage.

the chiropractor and yoga etc will all be helping to get your body ready. have you thought about writing out your first birth story to see if there are things you are still unsure about or maybe worried about?

take care

[Miss E]

I completely understand where you are coming from. I'm much earlier on in my pregnancy, but I am grappling with the CS vs VBAC decision myself. While I'm not 100% sure which way I want to go, the one thing I know for sure is that I won't consider scheduling a CS before 40 weeks.

I do tend to think that it is premature for your OB to be having these discussions with you now. There is plenty of time for you to go into labour, and most women don't go into labour before 38 weeks. So IMO that is way too early to decide that you're not going to be able to achieve a VBAC. If it was me in your position, I would be telling my OB that I wouldn't be considering booking a CS before 41 weeks, unless there was a medical need to do so. Also, many babies don't actually engage prior to labour. Some only engage in the last couple of hours of labour. So don't read too much in to the lack of engagement, especially at 34 weeks.

[Fleur]

Hi Allusivepond, welcome to BB.

If I'm reading right, your OB in your first pregnancy induced you early? So maybe your body just wasn't ready. That happens all too often... some of us just cook a bit longer.
It's entirely possible that you can have a natural birth... but our bodies don't respond well to being forced, that's all.

He is happy to let me go but because the head didnt engage at all and was still floating above the pelvis he has given me more than one conversation including the one I had today where he basically stated that he feels the writing is on the wall and that there is no way the baby will engage and I really should consider a planned c/s.

It is quite common for babies (especially subsequent babies) not to engage until labour starts. My fourth baby, (VBAC) didn't engage until I had been in labour for about 5 hours, about 10 minutes before she was born.

Like HotI, I'm not sure why he is making these predictions at 34 weeks. I know you say he is VBAC supportive, but I ahve to say those kind of statements don't sound terribly supportive at all. There is no basis for him to be saying that and all it is doing is making you doubt your body, at a time when you should be putting faith & trust in your bodies ability to do what it should.

I don't know at 34 weeks that changing obs is an option, but maybe to help get your head in a better space some hynobirthing classes would be helpful?

[Breeze]

Hi Allusivepond I'm a vbac mum.
I agree with Fleur, it is a little soon for you OB to be making any predictions about your birth. Each pregnancy, birth and baby are completely different. TBH if your ob is suggesting that you plan a c/s now he is not vbac friendly and I would seriously consider a change in careprovider. On the up side to your ob, not wanting to induce you is a good evidence based decision on his part.

Where are you planning on birthing? Do you have a doula?
bbl

[WannabeMum]

Hi Allusivepond - I'm in the same boat, I was on clexane in my first pg, and while the induction worked, my DS went into distress and didn't recover so we were off for an emergency c/s.

I'm with the others though - your Ob shouldn't be saying things like "the writing's on the wall" when you're only 34 weeks! Mine instead has said "if you go into labour naturally, you have as good a chance as any woman of delivering naturally". He's more than happy to let me go to 42 weeks before a planned c/s. He, too, won't augment labour (syntocin drip), but I am more than happy about that, my induction experience was HORRID! Oh, and the increased risk of rupture is a little too much for my liking. But everything else is on the table. It doesn't sounds like your Ob is particularly supportive of a VBAC, but if you go in strong, he may back off and support you through. Getting a doula is a good idea if it's financially an option. I have a friend who is a student middy who's following me through, so she's being an additional support person.

Give yourself all the time in the world, if you want to do yoga or acupuncture, go for it - anything can help! And a natural start to labour means that bubs is in the right position - if it doesn't happen, your decision is made for you, but don't have a c/s before dates! That's my 2c anyway. Good luck - I look forward to seeing how you go.

Oh, and check out the successful VBAC thread - there are lots of links to people's birth stories and they're an AWESOME source of inspiration - I read them every time I have the doubts

[Mumtastic]

I'm very confused by what your ob is saying and to be frank, it sounds like utter bunk.

I've had 2 vbacs:

Vbac 1 - I was induced at 12 days overdue. Yes, you can be induced for a vbac, there is a very slight increase in rupture risk.

Vbac 2 - spontaneous labour at 9 days overdue. Head was still not engaged well into labour, and in fact she only engaged not long before she was born!

I have absolutely NO idea why your ob is saying you will need a c-sec because your baby isn't engaged at 34 weeks of pregnancy and I would be seeking another ob as it sounds like your ob is going to undermine your efforts without evidence-based reasons.

Good luck!

[starangelk]

Hi - congratulations on your pregnancy and welcome to Belly Belly

I too am hoping for a VBAC and I'm currently 39 weeks. My ob won't induce which I'm happy about. He's been quite open to the option of VBAC but after a growth scan measuring big baby I must admit he has been a bit concerned about the engagement (or lack there of!) of the baby. However, he has not pushed a CS at all, just always reminded me that it is an option and potentially we could run out of time somewhere along the way. He has agreed to see me again next week when I am due and I expect that I will be getting the CS talk then. He has absolutely mentioned the CS but also discussed with me regarding labour and VBAC and signed the consent forms etc etc so I'm happy. I think Ob's are just trained to go with what they know and they know CS where as VBAC leaves things to the unknown. There's no certainty. With any job, I know with mine - I also prefer for things to have a plan rather than just waiting and seeing so I can see where they are coming from. BUT that doesn't mean it's correct!

My baby's head isn't engaged but from the feedback I have had on here, I am no longer worried about it. Yes, I would ideally like the baby's head to engage but it seems that heaps of people don't have engagement until during labour or just before birth even. I had an internal and my cervix is softish and doing it's thing so I'm happy things are progressing in the right direction. Maybe I'd feel differently if there had been complications but really, other than some general sickness, this pregnancy has been pretty straight forward and normal.

I am excited about the prospect of a VBAC but if it doesn't happen then that's okay too. I am pulling out all the stops to try and get it to happen though - acupuncture, RLT, DTD, you name it!!

Good luck hun

[zap]

You need to tell your ob that you have no intentions of discussing a c sec until you are past due unless there is a legit medical reason for it. All that pressure to go to surgery pre term is not going to help you go into labour. I have just had my second successful VBAC and my ds did not engage until my waters where broken 9 minutes before he was born. What does your partner think about this? It sounds like you need some moral support and maybe a new ob! Good luck.

[Fleur]

Just wanted to add ...

Being induced does increase not only the risk of a CS, but also the risk of rupture and most Obs will not induce for VBAC (although if the cervix is favourable, AROM may be an option).

With this in mind, and knowing that my babies tend to cook a little longer than 40 weeks, I asked to be allowed 42 weeks and that was no problem with my hospital. At 41 weeks I had a VE and my cervix was so high & tight the registrar could barely find it. I nearly lost all hope then & there of having a VBAC, had some wonderful reassurance form a great doctor and went into labour 3 days later. And then, as I mentioned before, she didn't engage until about 10 minutes before she was born.

So my point is, you might have no signs of labour at all, until right up to that moment. Please don't let that discourage you! Trust your body

Have a read of the VBAC threads, some great stories there.

[Mumtastic]

Hi - sorry just thought i would mention as there's a lot of misinformation about this. Many hospitals induce vbacs - my own does so all the time. The increase in rupture goes from about .04 - .05% to .09 - .10%.

Statistically, there isn't an increase in c-section rate following induction if induction is POST DATES. Induction before the EDD is associated with a marked increase in c-sec rates. (according to a recent study, if you are induced before dates you are MORE LIKELY to end up with a c-sec than a natural birth).

When I was induced with my first vbac, I was not dilated at all the day before and was 'unfavourable'. The morning of the induction, I had dilated to 3-4 cm and contractions started as soon as I had an AROM. Synto was only used at a low strength and was turned off in fact through most of hte labour.

I definitely do not recommend induction btw! I just think that if you feel your choices are betwen induction for post dates nad repeat c-sec, then the evidence is certainly that an induction is the safer choice. Repeat c-sec carry more risks, statistically, than induction.

But it's way too early to be talkingabout all this and the best thing to do is to just let your body do its thing! (EDD is an *estimation* not a deadline. )

[gypsy79]

I have had 2 natural births, so no VBAC experience here, but I just wanted to say that neither of my babies engaged properly before labour started. At all my obs appointments, DS never got past stage 4 (I think it starts at 5 and goes down to 1 (or 0) when they're engaged properly). DD was at stage 3 reasonably early, but stayed there. In fact, the midwife commented when I was in labour (and about 6 cm dilated) that bubs was still quite high. When my waters broke she came straight down and was born within 10 mins.

Moral of the story - don't worry too much about your baby not being engaged!!!

[Allusivepond]

Thanks everyone for your words of support and encouragement. He did say I might get to 37/38wks and be totally over the pg that I want to order a c/s I told him in no uncertain terms that this wouldnt happen. That they earliest I would discuss a c/s as 40wks. Just like my son he really wanted him out before then but I held off until I felt I had exhausted all my avenues of support.

My Hubby is great, he has said whatever is best for baby and me and if I trust what Im doing then thats all that matters. Im the one that has to go through it.

He did say they do induce after a c/s BUT only if the cervix is ripe or showing signs of being ripe. When I was induced with DS my cervix was starting to soften and so he said it was favourable but it was still so high that he couldnt even do a stretch and sweep. I would of had to have had a lot of drugs in order for it to work which had the potential to send the baby into distress and a c/s would of been ordered anyway.

He knows I will wait until 40wks and not one day before. I met a wonderful woman through ABA meetings I used to go to who happens to also be a midwife and she has been explaining things to me and helping me through the jargon and telling me that anything is really possible that the birth is still 6wks away so really nothing is set in stone.

Ive read back but you girls have offered more information than what I was expecting. Its amazing and I thank all of you.

Just wondering if for your #2 bub for those that had a VBAC did bubs engage with #1 or was your uterus favourable. I guess Im looking for an answer to the question that Obs feels that if #1 doesnt engage the odds that #2 will and a successful labour will ensue is slim to none. He did say he is happy to be proven wrong and he has had women who he has said the same thing to and they have gone into labour. Maybe he really has put me under the gun and Im working myself up completely unnecessarily and really until 40wks I have no evidence to suggest either a natural or c/s is needed. Thats not something you can tell until its time.

Perhaps at my next Obs appt I need to be asking, how long he will let me go before intervention....is 42wks a possibility or is 40wks my cut off date. etc those sort of things. Do you think there are any other questions I should be asking him or any other terms I should be laying down.

Regards
Allusivepond

P.S. I wish I had this type of information when I was having my DS I may not be in the position I am now thats for sure. You ladies are amazing.

[Mumtastic]

Hello - I'm sorry you're going through so much angst. I think it's pretty spoton that if you'd had more info earlier you wouldn't be in this position now..... (hindsight, eh!) .. it does seem as if there was no good reason at all to induce the first time.

What your cervix is doing, whether bub is engaged or not.... those things mean nothing in terms of when labour will start. With my third baby, I was engaged at 35 weeks and she was induced 12 days over. My fourth baby never engaged until just before she was born and she was actually my *least* overdue baby.

The state of your cervix is only relevant in terms of *induction* - in terms of how successful an induction is likely to be or how easily the cervix will respond.

In terms of spontaneous labour, it means nothing at all. Your cervix can be unfavourable at a 9am appointment, and you could be back at the hospital at 11pm about to push. "unfavourable' means - unfavourable for induction. It's not a sign that your body has no interest in going into labour naturally. It may well not of course! Some women are 3cm dilated for weeks, some women (like me) are barely 1cm dilated and go into labour the next day.

40 weeks is the *average* length of a pregnancy (or just under!) - it's not an end point, it's not a deadline. If you focus on 40 weeks as the end point then you are probably lessening your chances of a vbac.

You have no reason at all to think that you need an induction. Why not just wait until you go into labour? You don't even have a history of being overdue.... most women do go past the EDD, but most women have had their babies by 1 week past EDD and the vast majority will have had their babies by 42 weeks (over 95%). So really, you have no reason at all to think you'd need an induction?

I think you need to lay down your own terms:

1. There's no increased risk to baby from being overdue until you go past 42 weeks

2. Repeat c-sec carries risks - espeically if you want more babies!

3. This is a new pregnancy and a new baby. What your body did last time, when baby engaged, etc is all irrelevant AND in fact was always irrelevant!

Maybe someone can recommend some good reading material.... I know it's so hard because it's all so important, we don't want to take risks, we like to have plans and feel we have some kind of control but the best coruse of action (in the absence of any specific medical problem) is to wait and let nature take its course...

If a vbac truly is important - and i know when I was making my decisions it wasn't just about what happened in that pregnancy but also in future pregnancies - then the way you are most likely to achieve it is to avoid intervention and wait until your body is ready. Try and put the dates and deadlines out of your head and spend some time with your body and the baby inside you and trust.

I think seeking out support is great - speak to women who've had vbacs and who understand birth and they will help you through. Good luck and best wishes.

[Fleur]

Just wondering if for your #2 bub for those that had a VBAC did bubs engage with #1 or was your uterus favourable. I guess Im looking for an answer to the question that Obs feels that if #1 doesnt engage the odds that #2 will and a successful labour will ensue is slim to none.

If you don't mind me asking, how far along were you when you were induced last time? Because I think that is probably the biggest thing that sticks in my mind. If you were induced early, how on earth does your ob know what your body will do when it is left to it's own devices? You may just have a longer gestational period than 40 weeks, many women do.
And then keep in mind, every baby, every pregnancy, every labour is different. A lot of first babies engage weeks before their due date, but not all. And it is common for second and subsequent babies to engage later.

Keep reminding yourself, this is your second baby. This is a different pregnancy, and a different journey this time around.

Perhaps at my next Obs appt I need to be asking, how long he will let me go before intervention....is 42wks a possibility or is 40wks my cut off date. etc those sort of things. Do you think there are any other questions I should be asking him or any other terms I should be laying down.

Perhaps at your next appt, you can lay it down for him...tell him how far you will go without intervention. Remember, essentially, he is working for you & your baby. He is there to guide & advise you but not to force you to do anything you aren't comfortable with. And that includes induction or scheduled CS.

To the issue of how long Obs are comfortable to let your pregnancy go... it is so individual, to the doctor. When I was pregnant with my fourth baby (she was my VBAC bub) I felt pressured enough as it was to go into labour before 42 weeks. And that was with a hospital who were genuinely happy to see me go that far. But I heard of a friend of a friend in a similar position, who was trundled off for a CS when she didn't go into labour 3 days after her due date. I felt for her, because I was feeling worried as I was that I wouldn't get a shot at a VBAC... that poor girl never got a chance. So, all doctors are different as well. All the more reason for you to decide what you are comfortable with, whether it be the 40 week mark or 42 (or more).

A couple of other things you might want to ask about what restrictions, if any, he will be placing on your labour. A lot of doctors prefer continuous monitoring for VBACs, a canula in the hand, some of them have a time frame they like to see you progress in.
I hope that's not overloading you but things you might want to discuss before your labour.

Wishing you all the best x

ETA - wanted to add - another thing worth considering is the beneficial effects of labour on your baby. Regardless of whether your labour ends in a vaginal birth, it can be very good for your baby to get those labour hormones, and the contractions. Plus you have the bonus of knowing your baby has picked his / her own birthday
Of course it's not always necessarily going to work out like that, and there are times when it might be better to schedule the CS - but it's something else to consider.

[HotI]

Perhaps at my next Obs appt I need to be asking, how long he will let me go before intervention....is 42wks a possibility or is 40wks my cut off date. etc those sort of things. Do you think there are any other questions I should be asking him or any other terms I should be laying down.

You need to think about when you will agree to consider intervention- it's your body and your decision whether to have intervention or not, its not up to the Ob to decide how far he will 'let you go'.

[WannabeMum]

What I said to my Ob - at my first appointment! Was: "I am happy to schedule a c/s at 42 weeks, but will give my body til then to go into labour". If you go into a natural labour you have as good a chance as any woman of delivering naturally. I reckon instead of asking him what HIS cut off is - TELL him what YOUR'S is! It's your baby and your body. Educate yourself then he can't bamboozle you

I agree with the others re other interventions - I've decided no continuous monitoring, labour at home as long as possible, don't care about the IV in (they don't bother me), no epidural, non-pulsatile cord and a natural third stage. I too wish I knew a WHOLE lot more when I had DS.

FWIW to the others, when you're on clexane they're particularly conservative with going post dates (yes, I know it's an EDD for a reason). That's because the risk of a spontaneous labour when anticoagulated is high for both Mum and bub. Yes, they can reverse that with FFP, but you'd be in hospital the whole time and there would be nothing natural about it. My Ob monitored my cervix and stopped the clexane and induced when my cervix was favourable. He's very pro-natural and I feel comfortable that everything was done to facilitate a natural delivery. Induction worked, but DS was distressed with the synt.

[Allusivepond]

I just wanted to update everyone and get some more feedback and support. Sorry I havent logged on for awhile things have been a bit crazy in my neck of the woods of recent. We all know how that feels with little people in our lives.

I had a midwife appt last week or again said that bubs is now measuring even further behind. At first I felt like history repeating itself and then I walked out going pfff who cares. My DS was 7lb 6oz and that was at 40wks 1 day so he came out fine and this one will as well.

On thursday I had an Obs appt and i told him my absolute desire for a VBAC. He said he wasnt against them as long as I was practical about it. I asked what he meant and he said that as long as at 41wks I wasnt sitting there still insisting on a VBAC with a baby whos head was high. He said that was unrealistic.

I said but all my research says that heads in subsequent pg may not engage and he said that is true BUT that as a general rule they engaged in the first pg so therefore the body already has a clue about what its doing. I asked about internals around 39/40wks and he said there was no point if the head was still high as it would already be obvious that there is no change in the cervix as the head hasnt moved to allow it. I said but that doesnt make sense because woman dilate before the head engages so why can it be true for me. He said because of 3 failed inductions, high head and Im already looking at history repeating itself.

I was feeling discouraged but have decided on my Hubbys advice to put what he has said or at least try and put what he has said out of my mind and go back to focusing on the baby and me and my positive affirmations. He said I need to face the reality that some woman just dont go into labour. I said but what about 70yrs ago when I know birth defects and infant mortality was alot higher, but at the end of the day those woman went into labour so at some point you must. He turned around and said I think you will find that in those cases the maternal death rate was higher. Woman just died, they didnt birth at all. But still they went into labour didnt they? Only to not be able to birth their baby caused by complications.

So now Im confused about (and I know it sounds naive or even silly) how this going into labour stuff actually really works.

Ive been having stabbing pains through the ute for a few weeks now and even had a scare that had me at the hospital for monitoring as I didnt know what the pain was only to be told it was probably a UTI and to go home. When I saw the midwife she said it wasnt but had no idea what it was. I also explained these pains to my Obs who said it was more than likely the scar from the c/s and nothing at all to do with the baby.

I guess here are my questions:

Even though the head hasnt engage I can still go into labour?
Even though the head hasnt engaged I can still be opening and thinning (hypnobirthing terms)?
Is there anyway to tell how dilated I am without the Obs doing an internal?

I have been taking raspberry leaf tablets, drinking raspberry leaf tea, walking, rocking on an exercise ball, squatting, pg yoga and Obs keeps saying the head is still high. A midwife friend of mine said to next time ask how high the head is. She said its possible that its high but at the next appt even though its high it might be at 4/5 or something like that which means that progress has been made even if its small.

I just a little discouraged and feeling like my VBAC dream is very slowly drifting away with all my Obs attention focused on a c/s as 'history is repeating itself'.

Regards
Allusivepond