Wanting VBAC but might be C/S question

[Macca79]

Ok I will keep it short. For this bub our dream of a HB went out the window when the one available midwife said no (high risk because of previous C-section).
So back with old OB who I love. She is happy to help with a VBAC but said if this bub is as big as last bub she want to do a c section since DS got stuck in my pelvis and could not turn. So my question. Can you insist on trying labour first and then going for an emergency c section if need be?
I hope I make sense words are not my friend right now.

[Arimeh]

Yes you can.

[Oorki Galoorki]

yes you definatly can!
just a couple of qs though, what position where you in during your last labour? did you have an epi in? what did your ob do to try and help move your bub in to a better position(before and during labour)

[Macca79]

I had a 14 hour induced labour with slow dilation before a c section was offered. I also had an epi in.

[paradise lost]

Is he psychic? How will he know if bubs is big until he weighs him/her? Scans are very often inaccurate. Cervixes and pelvises aren't - of the baby fits out then out it comes!

Epidurals are associated with deep transverse arrest irrespective of the size of the baby (when bubs cannot turn to get under the pubic bone) because the pelvic floor, which usually helps bub turn a great deal, has little or no tone when numbed.

For a VBAC i would consider trying hands and knees position with one knee slightly further forward, kneeling while making circles with hips or supported squat while making circles with hips to help baby corkscrew through.

Sorry to say that a normal first labour can be 24+ hours. Given that many women who are induced aren't quite ready to labour (in the run up to labour a whole lot of receptors "switch on" in the uterine and cervical tissues so that the uterus contracts effectively and the cervix dilates effectively in response to oxytocin and other hormones) inductions often take much longer without it meaning anything is wrong. 14 hours sounds like failure to wait.

An epidural would be a bad idea anyway with a VBAC (it helps to be able to feel because in the very rare situation of a rupture women usually will feel continous pain rather than only with contractions and will be able to provide a warning before bubs is affected - with the epi they often don't know until the rupture is complete and the baby is in distress) so you will probably find that however big the baby is, you're unlikely to suffer DTA again.

You won't be induced anyway, as it heightens the rupture risk, so if i were you i'd get a doula, stay at home as long as possible provided you feel ok and aren't in constant pain in the abdomen (you will probably feel a lot of pressure all the time as bubs moves lower, rupture is usually a hot sharp coninuous ache near where the scar is). If you can stay home until you feel pushy so much the better. Decline intervention. Tell them you want to be able to move and decline continuous monitoring unless your waters have gone (don't let them break them) and the foetal monitor can be used. They can use a doppler to check on bubs during and between contractions. Stay upright and mobile. You can totally do it!

Bx