I've been very much wanting a VBAC for this birth, but it appears I've been thrown another curve ball.
I am doing shared care between my local public hospital and an awesome private Ob (who delivers at a local private hospital but also happens to be a senior Ob at the public hospital and has a lot to do with the birth centre there) He has told me to remain positive about my VBAC prospects but has also been very honest with the reasons why my chances of success aren't high as some.
Firstly, I've never laboured before (DD was an elective CS due to PIH). And that in itself decreases my chance of successful VBAC.
Secondly, I've recently been diagnosed with GD. I don't need insulin yet but it is certainly possible as I've had a few high fasting readings. The Ob has said that as far as the GD goes they would want me to go into spontaneous labour before 40 weeks and the baby would have to be measuring under 4 kilo's. he explained that the issue with a larger baby and VBAC is if bub grows too big, my uterus will be working even harder than normal with contractions to try and push the baby down and out and this will put extra pressure on the scar tissue and effectively increase my chances or rupture.
And thirdly. I developed high blood pressure in the final weeks of my last pregnancy, and although my BP is fine so far, I'm at a fairly high risk of having it creep up again.
My Ob has been great. He understands why I really want a VBAC and has suggested that if things are going well then I should VBAC at the public hospital where the staff are mor comfortable with VBAC and where there are operating theatres staffed 24/7 in case or emergency.
He has, however said that if I end up needing/wanting an elective caesarean then he can do that for me privately so that I specifically get him and so I have the option of recovering in my own room at the private hospital. Just to add also, that he is VERY into ensuring mums have skin-to-skin and first B/feed not just in recovery but while still in theatre and he said he will make sure this happens for me.
I think I will just wait a little longer and see how my pregnancy progresses before making any decisions but I am interrested to know if there are any other GD mums out there who had to choose either VBAC or ECS, and which way did you go?
Last edited by ~mamaspice~; June 14th, 2010 at 09:24 PM.
Me - insulin requiring GD with DS, DD and this pregnancy. Monitoring for growth (due to other reasons) shows this one on track at 50th centile and the the others were 3.485kg and 3.5kg. DS vaginal breech trial ending in emergency c-section (stuck) at 38w6d, VBAC for DD with spontaneous labour at 39w1d. The main issue is not the insulin level but maintaining a tight control over your levels throughout the pregnancy. I passed a 2hr GTT with DD but my fasting levels are above 6mmol.
I had a similar situation was all ready to have a vbac until diagnosed with gd at 32 weeks. My ob planned for me to have a c sect as I was put on insulin then taken off it due to a reaction. I was resigned to having to give up my vbac dream.
In the end though I went into pre term labour at 35 weeks, I was put onto medication in the hope that I made it too 38 weeks. At 37 weeks my waters started to leak. My ob let me progress through the labour but he had me prepped for a c sect jic. In the end I gave birth by vbac 45 minutes after my waters were fully broken. Dd was on the smaller side at 2.75 kilos and had to be admittted to the scn because I had been on insulin even though I wasn't when she was born, her sugar levels were all fine.
So don't give up hope, fingers crossed you go into labour on your own.
Thanks so much everyone for your positive words everyone. It's definately given me more confidence that not all is lost. Now lets hope buggerlugs here co-operates and comes a little early
Elective CS or VBAC with Gestational Diabetes?
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