Help! Big decision to make re VBAC

Hi all. First time poster hoping for some advice.
My Story: Currently, I'm 20 wks along with bub no. 2. My daughter is 9yo and was born by emergency C after 30+ hours of labour, 18 of which were after my waters broke. I was about 6-8cm dialated and there was a concern about infection if left to go longer so emergency C was decided. Problem was that the [B]epidural didn't take [/B]very well so it wore off during the C leaving me in unbelievably agonizing pain.
Grace was born 9lb 14oz so she was a whopper, despite me not having diabetes however I was heavily overweight at the time of conception. The recovery from the C was awful and now 9 years later my scar still gives me grief from time to time, reopening slightly and getting infected, admittedly it's a lot less frequent now than in the first few years.
After my last experience I swore if I ever got preg again I would have an elective C under general anestesia (sp) to avoid the whole thing. However now, I am fearful of having another C at all because of the recovery issues I had last time.
My husband is worried about the risk of uterine rupture if I try for a VBAC, especially since I'm still having trouble with the scar site. Also I've read that instead of a 75% success rate for VBAC I would have about 50% chance as my BMI is over 40.My other concern is if I don't progress again (baby could be large again) then I would be in the same boat as last time and am risking a terrifying emergency C. If I have an elective C it could be less traumatic however still risky and long recovery time.
I was 19yo at my last labour and feel my inexperience and lack of knowledge about my body contributed to my lack of progression. I spent lots of the time in bed as I wasn't sure I was aloud to move around at all. I have since then been suport person to my friend and her four labours and feel a lot more confident about childbirth, my body and what it can/can't do. However due to hospital policy of constant monitoring for VBAC trial labour I believe I would be bed bound during labour anyway so that would no doubt slow down progression. I also don't want to try cervical ripeners as I have read they increase the risk of uterine rupture. I really don't know what to do!
So it comes down to this: A) Do I try for VBAC, with a lower chance of success because of my weight and risk another botched C, all for a lesser recovery time and more bonding with my baby (which I felt I missed out on last time). Or B) Do I book in for an elective C which will guarantee less risk of complications than an emergency C but will doom me to no chance of a natural "traditional" labour that I long for so much.
The Statistics: If I try for VBAC, I have 50% chance of successful vaginal birth. I also have 50% chance of emergency C. Part of that second 50% is a 1:250 (or more - the stats are unclear) chance of Uterine Rupture putting both me and bub in serious danger. They also say emergency C is more hazzardous than elective C.
So what to do?????????? Advice either way right now would be very very very welcome. Kate.

Hi Kate,
I can understand your fears, they are all perfectly normal. There are so many stats out there that will have you rest assured that VBAC is so very safe and is safer than repeat c-section.

You have the knowledge that you weren't empowered with when you had your 1st child, these are the things that will make all the difference. Get loads of support and keep doing your research... but most of all believe that you can do this :)

xx

It's a tough decision at the best of times I think. I had fears both ways too. That in itself is natural. My concern for you would be you mentioned that your scar still gives you grief and reopens slightly and gets infected at times. That is what plays on my mind from your story. I think it would be really advisable to have a really good chat with your caregiver so they can look at and assess your scar and also find out the position of the scar on the uterus itself...they aren't necessarily where the external scar is. Also, like Tanya said, research, research, research. There are many varied stories right here and some fantastic knowledge, experiences and support. I would lastly say that be confident and well informed in your final decision no matter which way you decide to go. :hug: and good luck with it all.

:

---

Hi Kate,
I can understand your fears, they are all perfectly normal. There are so many stats out there that will have you rest assured that VBAC is so very safe and is safer than repeat c-section.

---

Thanks so much for your advice. I am reading everything I can on the subject, it's just so hard to dertermine what's right for me, as everyone is just so different and has a different set of circumstances. Thanks again. :hug:

Hi Kate,

:

---

My husband is worried about the risk of uterine rupture if I try for a VBAC

---

- The risk is as low as 0.2% and as high as 0.7%. The risk of CS is much higher.
The fact that you've had trouble with the scar site indicates that it might be a problem in the future too.

I've not heard that VBAC success rates diminish with a high BMI, but they do diminish with obstetric care. The highest chance of success is with a private / independent midwife.

There's no reason why an emergency CS would be traumatic if you're well prepared.

The hospital may have a policy of continuous monitoring, but this doesn't mean it is your policy. You can decide your own "policies" for your birth by way of a birth plan. You also don't have to be bed-bound.

An elective CS does not lower the risk of complications. Your risk of bleeding, needing a transfusion, having an infection, having a blood clot in your legs, lungs or brain are all higher. You will also have more pain, use more medication, have trouble moving around etc.

Have you done a lot of reading about CS? There are some great websites - Birthrites, ICAN, VBAC.com etc.

Good luck with whatever you decide.

Melissa.

You've got some great advice here already! :)

I just wanted to mention that the scar problems you've had, which i assume are on your belly (the scar on the outside) are no reflection on the state of your uterus. If you haven't suffered repeat uterine infections, foul discharge or rpeated and worsening adhesions the chances are that however the outer skin is coping, your uterus is whole, healthy and sound and your risk of uterine rupture during VBAC is far lower than the risks of a repeat section, elective or emergency.

Bx

I too had a horrific first caesarean experience. I felt just about everything! I was crying on the operating table!

I had a successful vbac with my 2nd pregnancy. But the 3rd time around I had to have another c-section due to yet ANOTHER breech baby (reason for first c-section). I was terrified of having another painful experience. I talked it over with the dr and anaesthisiologist beforehand and had a painfree c-section thankfully! Though the recovery is something I will just NEVER get over. I also had breastfeeding problems with both c-section babies. I persisted with a LOT of pain at first.

If you feel confident in your body and have no doubts, I would say GO FOR IT (re:vbac!). Even if it doesn't work out, and you need another c-section, your body and your baby have prepared themselves for birth (that's the way I look at it). Your baby had the chance to decide when he/she would be born!

Thanks everyone for your advice. I have a lot of questions to ask my obstetrician when I see them next and am booked in for an independent anaestetist appointment to discuss what went wrong last time and how to prevent it this time. Thanks again all! Much appreciated! :hug:

Hi Kate,
Wow I thought I had a tough decision and I have had 2 normal C-sections with no complications, now about to attempt a VBA2C and thought I had it rough.:redface:
With all the complications regarding your scar sight I would probably be leaning heavily towards a repeat c and discuss your fears with your Dr. I would request that they open you up over the previous site and see what they can do to repair the damage from last time so you might be able to attempt a VBA2C next birth. PLEASE discuss this with your Dr as it is just a theory I have and I have very little medical training.
What ever your decision research the hell out of it and possible outcomes so you can feel as informed as possible. Also if you are not comfortable about anything get a second opinion. Trust your gut, it is generally right. :hug:

Kate, that's a big decision to make. I've never had to deal with VBAC issues, but with regards to continuous foetal monitoring, I had CFM for my last labour, and I was able to move around still, walk a bit, use the fit ball, go to the toilet, kneel, move around on the bed. I delivered on my hands and knees. My husband and my sister at times had to help hold the bands in the right spot, but it didn't interfere with my desire for an active labour.

I hope that helps with one piece of the jigsaw puzzle!

:

---

Kate, that's a big decision to make. I've never had to deal with VBAC issues, but with regards to continuous foetal monitoring, I had CFM for my last labour, and I was able to move around still, walk a bit, use the fit ball, go to the toilet, kneel, move around on the bed. I delivered on my hands and knees. My husband and my sister at times had to help hold the bands in the right spot, but it didn't interfere with my desire for an active labour. I hope that helps with one piece of the jigsaw puzzle!

---

Thanks for that! I'm glad to hear CFM doesn't mean being bound to bed unable to move at all. Certainly makes me able to put a tick in the PRO side of the list.

:

---

With all the complications regarding your scar sight I would probably be leaning heavily towards a repeat c and discuss your fears with your Dr.

---

Well you'll be pleased to hear that I went and spoke about all this with my GP who was previously in Obstetrics for 20+ years. He's a very strange little man but I'm suprised to say I value his opinion a lot. He said that the outward scar not healing is just because I am large and the "overhang" (for want of a better term! lol) from my previous pregnancy doesn't allow for much air circulation. In other words, the reason for the scar giving my trouble is only a dermal or skin problem and doesn't reflect the state of my uterus. He thinks my uterus should be small and tight, and thoroughly recommended pushing for a VBAC. Another tick in the PRO column!

It's a pretty big and scary decision to make isn't it. I wasn't allowed to attempt a VBAC, then I arrived at the hospital on c/s day already 8cms dilated. OB checked me over and said I could attempt a VBAC, he thought I could do it..but i didn't have that belief in myself.

All I can say is read as much as you can. I stopped reading when told no vbac.
Make sure you have good support from your DH and whoever will be involved in your birth.

Are you having a hospital visit to check it out? Don't forget to ask them many questions regarding vbac's and if they have any 'policies' like monitoring...when they hooked me up to the machines, I could feel myself loosing control, and felt like a vbac was way out of my reach....aah just noticed you said the hospital has a monitoring policy... maybe you can stay at home for a bit longer before going in? If that is an option? Maybe ask them if it is ok for you to be mobile, like Toomanytoomany, suggested?

Maybe you could show any info you find supporting VBAC over c/s, to your DH to show him that it is actually a safer option. Get him on board, so he is 100% supportive and believing.

Goodluck with making a decision :)

Nic

:

---

Maybe you could show any info you find supporting VBAC over c/s, to your DH to show him that it is actually a safer option. Get him on board, so he is 100% supportive and believing.

---

You know what Nic, you've hit the nail on the head there. Hubby is so scared what happened last time will happen again he wants to feel like he's in control so I think he really wants me to have a planned C/S. I am busy reading info about both side of the matter but am definitely showing him the PRO VBAC stuff as I will need him 100% committed to it if we decide to try. Thanks for your advice.

:

---

You know what Nic, you've hit the nail on the head there. Hubby is so scared what happened last time will happen again he wants to feel like he's in control so I think he really wants me to have a planned C/S. I am busy reading info about both side of the matter but am definitely showing him the PRO VBAC stuff as I will need him 100% committed to it if we decide to try. Thanks for your advice.

---

My DH was the same. He actually thought i had died, after our DD was born. He had a conversation with my dad the day she was born, and he was soo scared.
We spent years arguing over VBAC vs C/S. He was terrified of me trying a VBAC, so when the option was given to me at the last minute with DS, and DH said he thought I could do it, I found it really hard to believe him...

I think they also find it hard to see us in pain, both physically and emotionally, and a bad past experience with a c/s usually brings both of them out doesn't it!

Hi, just found this thread. I'm at 25 weeks and thinking about a VBAC as well. There are a lot of 'scarey' stories out there that really put you off trying for one.

DH ultimately wants me happy. His reason for an elective c-section is so that i wont be so dissapointed if it ends up being an emergency c-section (which is what happened last time) However I am doing so many things this time to support a vaginal birth that I am much more confident about the whole process (was petrified last time). He sees me happy and confident and so he is happy to support me as much as possible.

I've just listed a bunch of things I am doing, in another thread in the VBAC section, to help me achieve a VBAC. These may not all be nescessary but after lots of research I want to give it a go.

Good luck with your decision, I hope it goes well for you

Hi all,
Now 25 weeks along and just wanted to update everyone on what's been happening. As mentioned in a previous post, I went to see the anesthatist who promptly told me that the feeling I had at my last c-section was probably just "mild discomfort" from the pulling. I tried to explain that the pain relief wore off and I was screaming in agony. He said my notes were inconclusive and although he could see I was admisitered a sedative part way in, the effects of the sedative would have been the reason I was in and out of conciousness, not because I was in immense pain. He thinks because I was vauging in and out, I mistook the the pulling and tugging sensation I was feeling for actual pain! Can you believe it? He said based on my hospital record, there was nothing to say that I have a limited tolerence to pain relief, or that the epidural was mis-inserted (despite them having to do it twice). He said his advice would be to just see what happens next time. If I need an epidural, give it a try and see if it works! I said I was petrified of going under the knife and having it wear off again. He said he doesn't think that's what happened last time so it's not likely to happen again and we went around and around in circles, before he said "I'll make a note of it here on your record, but you'd better tell whoever is on staff on the day too". I was furious and frustrated with this response. Has anyone been treated like this before???!!!! Ughhhh!!!