risks for C risks for VBA2C's

Hi guys,
This is more of a debriefing I really don't think there's much I can change but your opinions are greatly appreciated.
I'm currently pregnant with my 3rd baby, my first was born via emergency C after 24hrs of labour, no progression, didn't dilate past half a cm, had my waters brocken muconium was found, babies heart rate dropped and I went into shock. I later found out that ds was stuck in my pelvis and ALSO had the cord around his neck. It was traumatic, I was so not prepared and to top it off had so much trouble bfing him we just didn't bond well at all. He has also been diagnosed with Aspergus (part of the autism spectrum) recently after 8 years.
Second baby was going to be a VBAC trial of labour anyway as my ob would only let me labour for 5hrs however at 39wks she was still breech! so I ended up with an elective. I must say it was so much better, recovery was quicker, I was awake the whole time, everything was perfect. My ob discussed tubal ligation which I refused he also didn't recommend any more children because of the risks of complications with subsequent C's.
3rd time (6 years later) although it was a surprise I am so excited and happy thank god I didn't have the tubal.
Ok here's the distressing part...
As I've had 2 C's of course I am told by my ob I will need a 3rd, at first I was ok with this even though I knew it was possible to VBA2C's if you can find an ob and a hospital willing to attempt it but I really didn't feel strong enough to fight this issue. I mean what if I did VBA2C and ended up having another traumatic emergency C anyway or what if my baby had to go through the same complications as my first I would never forgive myself if something happened just because I chose to trial labour kwim?
My last ob appointment the usual tubal ligation discussion came up and again I refused not because I want another baby (this most likely is my last) but because I don't want my choice taken away. He then informed me of the risks of subsequent C's- bladder tear, ruptures, hysterectomy, placenta on the scar. Trouble is the risks for VBA2C's is just as bleek!! so dammed if I do dammed if don't?? I'm stressing now because all I hear is the risks. I would like to broach the subject of possible trial labour with him but I really don't want to go in there un prepared but how do you argue with a specialist ob who obviously knows more than me!!?? Don't get me wrong he is a wonderful dr and knowing I would most likely have another C he is the most capable and thorough ob and surgeon, I feel safe knowing he'll perform the op. Anyone got any advise?
sorry it's soo long!

Oh I forgot to ad I could get hit by a bus on my way to the hospital is that concidered a risk to?? lol

The risk of rupture for a VBAC is 0.7%. The risk for VBA2C is 0.9%. Hardly a heavily increased risk! There are more risks going for your third c/s than a vaginal birth, but you will have trouble finding an Ob who will support you, as ridiculous as it all is with 0.2% in it... so I would hire a private midwife and possibly a doula too - you need a team cheering you on and supporting you. Read VBAC books, its not hard work in that once you have info, you have power and confidence so fighting isnt that hard.

But wouldn't I need to convince an ob and the hospital of a trial labour first? this is my problem I can't get my foot in the door. I'm not comfortable with a home birth BUT a monitored trial labour in hospital would be great however I think my chances of that are very slim. I can't understand why an ob is happy to put you through the risks of subsequent c's but not or VBAC's?

A "monitored trial labour" is just going to keep you in the same boat anyway, Tiff. You hold the power, not the obstetrician. If you want a vaginal birth, go and get it elsewhere. You don't need to convince anyone of anything. Become knowledgable, if your Ob is threatened by that - go elsewhere. VBAC's aren't for the faint-hearted at the best of times but a VBA2C will be even harder especially within the private system.

I agree totally with the other posters. Have you considered a homebirth?? I don't think the risk of vba2c is comparable to the risks of an elective c/s without medical reason, and personally I don't think previous c/s is a medical reason to have another one. I just had a vbac, which was a planned homebirth though we ended up transferring to hospital due to a long posterior labour (it was not an emergency transfer).
You are more at risk of ending up with another c/s if you labour in hospital, and by the sounds of it you don't have much chance of a vaginal birth with your ob.
I really dislike the term obs use that a vbac is a trial of labour. It is no different to a woman having a first labour, but we don't call those trial of labour. And I believe becoming informed and knowledgeable about your previous labours and what happened, and knowing everything about vbacs, gives you more chance of a vaginal birth that a woman having her first that doesn't know anything about birth and believes her ob will do the best thing by her. I was like that for my ds's birth and never again will I give responsibility for my baby and my body to someone else without knowing what is going on myself.
Good Luck with whatever you decide.
Bec

Congratulations on your pregnancy!
To be quite honest.. I don't fancy your chances of a vaginal delivery with an obstetrician who says he will "let" you labour, monitored, for a certain length of time. Do you really think that kind of pressure will be conducive to your chances of a spontaneous, physiological birth?
A VBAC is just a birth.. it's really no more risky than any other birth. Your obstetrician should be able to give you stastical information about the likelihood of rupture, which is extremely low, instead of using scaremongering tactics which will only serve to convince you that your body is faulty.
Honestly.. if I were you I would hire a private midwife, and never go back to the obstetrician again. Your best chance of having this baby vaginally is in an environment where you are comfortable, where you have the complete support of your care providers, and where you will be respected as the birthing godess that you are.

Thanks guys I have taken everything you've said onboard and I'll do some more thinking. I have some time and as I've been very happy up till now with my OB (he's been through threatened m/c with me) I do feel I should give him the benifit of the doubt and a second chance. I think it's mostly my fault because I should have bought all this up at the first appt, I feel a little bit stupid for not taking control as it is MY responsability kwim? so I think I'll research and write down all the questions I want to ask and points I want to make and take it from there. thanks again guys I think you gave me some backbone ;)

Good to hear - and even if you choose to stick with him, please consider hiring a private midwife who is as passionate as you are about giving it your best shot. It is hard when you feel like you owe it to your doctor, but honestly, you'll remember the birth forever, he'll soon forget you. At the end of the day, you will labour with the midwives around, who all have their own opinions and comfort levels, so if you bring your own who knows what you want and knows its not risk, then you'll have a much better birth experience. Good luck!

can I jump in here with a question? I'm 18wks pg with my number 3. Had pretty similar expiriences as Tiff. I have been adamant I want a VBAC2. However, Ob I saw yesterday kept going on about risks and that bubs is transverse (reason for my 2nd c/s, first was emerg due to fetal distress after fully dialating and pushing and failed vac). She seemed to think the worst would happen, yet the ob who did my last c/s said everything was in topcondition down there and you'd hardly know I'd had a c/s at all. I fully dialated with Kat and I was pushing well. They told me if I'd had another hr or so I'd have had a normal vaginal delivery, but Kat was too distressed. I am stuck now. I keep thinking what if. We def have number 4 on the cards (not for a few yrs now, but we do want more) and I don't know which would be better. I am also scared of going thru a labour again as last labour was hell. I was induced and synto was on full and I was in agony with a posterior bub, stuck in a bed unable to move due to monitors, unable to use shower or bath and it was just such a hard labour, so idfferent to what I wanted and so terribly painful due to all the above. I'm not so scared of the pain. I'm scared of not being free to move or use the bath or fitball again. Being stuck on a bed made the whole thing harder for me and I was scared for Kat. My support team also let me down a little because they were shocked at the pain levels I was going thru. I know I faught the labour. I am so used to trying to ignore pain and fighting it, I'm scared I'll do that again. I asked trish to be my doula, but I am un sure she can make it yet as she's due only 2 months before I am. I know another c/s would be easier. I'd know when bub is coming and I know I can deal with that pain very well. I'd have no risk of tearing really etc, but I feel like suck a failure for not being able to give birth vaginally and it's something I want very much. But everyone else's doubts are making me doubt and rethink. I am so confused. Even Dh has said he'd rather I have another c/s. He also enjoys telling me "See, I told u u couldn't cope with another yet" because Dr keeps thinking I am developing PE (BP seems to go up briefly then back down). I feel so unsupported and unsure now.
Please feel free to move this if you need to Kelly. I would just like some advice and some support from someone would be really nice. Feeling very emotional and unsupported.

Katkins, I think when you are having a vba2c its worth getting a private midwife for the birth, I have a spreadsheet of NSW midwives. Even if you chat / meet no strings attached to see how supported you will feel with them.

I think its definitely worth finding some support, makes a huge difference to your experience, and even if it does go down the path of c/s, you feel more resolved as you know you had good support and did all you could. That said, having a doula means 50% less c/s - thats a huge rate - so worth looking into. You CAN have a great experience and feel nurtured... just find the right people to surround yourself with right now xx

That's the hard thing right now. Pretty much all my family and friends think that I should have another c/s. Even my Dh. They don't get why I feel so bad about having had c/s's why I want a VB so badly. I guess I'm just feeling so alone right now. *sigh*

Your hubby and/or family could also come to the midwife appt and fire their questions at her :)

my other prob is my hubby won't want to pay for a midwife and even if I save my allowance for the rest of my pgcy, I'd not have enough to cover a midwife. So frustrating. Guess I'll just be quiet now. No-one can solve these problems but me. I'll try having another talk with DH about VBAC as soon as he's in a good mood

Hi Katkins,

Did I read right that you were induced with syntocinon (the drip) during a VBAC labour?

no, that was my first Labour. They can't use syntocin in VBAC's as contractions are brought on too strong too quickly. Sorry. My post wasn't veyr clear. Too emotional etc right now. Sorry

Once he has met with a midwife who he feels comfortable with and is armed with some facts, he might lighten up to it... fear and uncertainty is what drives it, so if he has some clarity, information and facts, then he might feel more comfortable about it, and more willing to part with dollars :)

he might, but my hubby is very controlling and he'll only spend money on his stuff really so I'm not too sure.

Ok Katkins. Guess what? It's your body, your baby. I know this might be confronting for you and your husband, but you alone are giving birth, not your husband. It's not up to him where or with whom that you do it. Stand up for yourself.
Your Ob needs a slap quite frankly. What sort of care provider would make an issue of a baby being transverse at 18 weeks? Please at the very least, ditch that Ob or your birthing experience is already carved in stone.

What a shame you have disabled reputation Sam....!

I do? I have no idea. I just come on and hit post! :)

Katkins-The hospital I went to for my vbac would induce with syntocin. I guess it really depends where you go. My labour was a long posterior labour too, but in the end pushing my daughter into the world was the most amazing thing I have ever done.
It is so hard when you don't feel supported. Everyone says as long as the baby is healthy, which is true to an extent, but I do understand your feelings of wanting a vbac so badly, I did!
I guess the thing with this baby is you hopefully won't need induction, so if you were to go into labour spontaneously the contractions wouldn't be as full on. It sounds like you really need to talk to your hubby about what/why you want certain things from this birth. Me and my dh had huge problems dealing with it, but in the end as he said, it is my body. He would have preferred c/s too to avoid dealing with all the other stuff. Yes it may cost a bit to have a private midwife with you, but if you don't hire one and end up with another c/s will you regret it and be upset?? Those are the sort of questions you need to ask yourself.
My problem was actually going to a hospital in the first place. My dd was a planned homebirth, and we ended up transferring due to a long labour but I felt happy with the decisions because I was in control and making the choices-obviously based on what my midwife said, but I still decided in the end.
So if your dh knows that you could end up with depression or really stressed because the birth is not what you want then maybe he would be more inclined to try and see things from your perspective??

I've asked my friend to be a support person. She will stand up for me and what I want so at least I know someone will. The problem is, she's not so knowledgable on births and c/s and pregnancy etc. But I trust her support so much that I really want her there. I might ask her to check out BB and read up etc so she will be able to help me more. I know I have to have a big D & M with her about what I want etc, so when I next see her (she lives an hr away) I'll see what she say about it all. I don't know anyone who has a lot of knowledge about this stuff in this area so I feel at a loss in that reguard. I'll also try to talk DH about it all and tell him why I feel as I do. Prob is a lot of the time he puts it off and we never really get to talk about it. I guess cause it's not him who has to go thru it.
Having said that, he does love me and he wants what's best for me. But I think he thinks he knows what is best IYKWIM? I love him so very much, but yes, I feel very unsupported and such this pgcy

:hugs: Katkins, I kwym, it makes it so much harder when your care providers tell you and your dh that c/s is the safest way and starts scaring you with the risks, my dh wants the safest for me (I'm sure that's what your hubby wants too) a natural birth after what's happened in the past and your ob's recommendations of c/s only compound his feelings that another c is the best way to go, he probably can't understand why anyone would questions the ob after all he is supposed to know it all about having babies right??
That's how I feel. I went to an ob because he/she is the expert, who delivers babies every day why would I question him? But if I don't he won't hear my needs and I will wonder if I could have changed the outcome.
Finding an ob that supports your needs for a vba2c and everything else you want of course would be fantastic but not always possible, I read an article of a woman that had to cross states to find a hospital and ob that would support her vba2c and of course cost is a huge factor as we still have families to support.
I guess what I'm saying is it's very difficult there are ALOT of factors to consider including our own fears, risks and opposition.

Katkins I do hear you I know exactly what your saying.

Hi Joralyd,

You are feeling what many pregnant women feel. If I may can I just correct you on something? You say that Obs are the experts but that is not actually the case. Midwives are the experts at normal birth. Midwives are trained to handle uncomplicated, normal pregnancy and births, as most are if left alone. Obstetricians are trained in the abnormal. Their forte is when things go wrong. This only happens in a small percentage (10-15%). If you had a cold, would you go to a respiratory specialist? Why then would a healthy pregnant woman go to a specialist? Unfortunately women think that by paying the most money, they will get the best care. This is simply not the case. It is a reflection of our materialistic society, and something that some obstetricians take advantage of.
I hope knowing this will enable you to reconsider the assumptions you have made about obstetricians being the experts and perhaps give you the courage to step away from social conditioning and find a care provider who respects you and will give you the birth experience you deserve.

I did a 3wk training in midwifery when I was doing my RN and I trust midwives above any OB/Dr. I saw them handling the whole thing and the ob came in to catch the bub or often he missed the birth. I am not a fan of OBs. And I know the risks are low. I KNOW I want to do it. I know my body CAN do it. And even the Ob at the hosp backed down a bit when I said I'm a nurse and I KNOW how low the risks actually are and that they can't force me to have a c/s. But the most distressing fact is DH not supporting me very much. He's not totally supportive of me having this bub (the timing wasn't exactly planned and he thinks it's too soon with two toddlers etc. He said yes, then the next day said no, but too late, was pg by then). He's been making me feel like cr*ap by saying I'm not coping and that's why my BP is up. But most of the time it's not, it's seems to only be when one Dr takes it that it's "High". I'm not swelling and I feel fine. Yes my kids stress me, but heck, they stress him too! I'm working nights, looking after the kids during the day, doing ALL the housework barr cooking (and dishwasher broke down :( ) and running around with kids. One has severe knock knees and the other has absence seizures (epilepsy), having to see Dr twice a week for BP monitoring and add to that play group and Dh's temper etc. I think I am doing quite well.
None of my family or friends really know much about births and risks, so I can't turn to them for support really and Dh puts everything off all the time so we never really get to talk about it. *sigh* Any wonder I feel so lost and unsupported?

Katkins,

:hugs: I totally understand how hard it is to be preg with no 3 and have two littlies running around - it is so damn tiring and so hard to get some time to just be.

You should be really proud of yourself for seeking out the information you need to get your VBA2C - it sounds like you are doing all the right things and seeking support for your decision. Many women would just accept whatever the ob told them was right, so be proud of that.

I don't have any answers with regard to your DH, but maybe sitting him down once the kids are in bed one night and explaining how low the risks are and how important a natural birth experience and his support is to you might be a step in the right direction? If he is a numbers kind of guy, perhaps giving him the studies to read maybe? It would be worse to accept an unwanted and unnecessary c/s and then resent him for it.

All the best,
C

Hello im new to this forum. i found out for the first time today as i stumbled accross this forum that it was possible to have a VB after 2 sections!! i am so shocked!! the surgeon who i had to meet with regards to my 2nd section told me i wouldnt be able to do it naturally and iwould have to have a 3rd section. ill outline my history.
im 25 with 2 children,living in the UK..both delivered by c-sections.. my eldest who is 7years old was a emergency sectioned,i passed out twice with suspected pre-eclampsia he was born at 7lb 10oz, my second was a trial vbac..they only alowd me to go 1 week over my due date so they had booked it for a week after the due date when i was 7months pregnant ish.. my 2nd son who is now 2yrs old was born a week later by c-section weighing 10lb 3oz!! i was awake for this section..cant say it was a magical experience i cryed i was that scared. i wish to have a girl hopefully but i am teriffied of having another cection.. when i asked docter about a vbac for my second all i got was "ruptures,dangerous,complications" and "3 cections is all you alowd and u have to have a cection for ur 3rd if u have 2 cections" when i read this post it gave me some hope..and my husband to be.. im not sure if its different for me being in UK to wether they will let me have a vba2c .. anyone know? i dont think its as easy as finding new midwifes or docters etc..we pretty limited

Hi Havania,
WElcome to BB!
You'll find heaps of fantastic support here :)
I had a VBA2C in March this year. It was an amazing experience. Have a look in the Birth stories section in this forum you'll find some vbac and vba2c storys there. (mine is there its titled "Jaidans birth vba2c")
I'd encourage you to read lots of VBA2C stories and spend some time on these websites;
Birthrites - Healing After Caesarean
International Cesarean Awareness Network
There are lots more out there though. There is also some great info in the forums if u have a look back over the past threads.
There is an ICAN chapter in Lichfield UK. I'm not sure if you are close to their but they may be able to point you in the right direction with hospitals, ob's, midwifes etc. Homebirth midwifes are usually alot more supportive of a VBAC depending on how you feel about a homebirth :)

Good luck
Jules :)

Hi folks,
I'm new on here but came across this website while trying to do research on VBA2C's. I have had 2x c/s first one emergency and second one, well it was getting near christmas and the dr asked me to come in for an elective cos he thoughti wouldn't have the baby by myself anyway. he also mentioned about the size of my feet, that i wouldn't be able to birth a baby because they're only size four, (lies, i tell you, all lies!!!!) my poor old gran was size four as was my mother and hey, I'm here?! so basically I wanted to talk to you guys cos i need reassurance that i can do this. I'm afraid that if i don't rupture then the baby will get stuck coming out. And I gave up smoking when i learned i was pregnant and that worries me about the scar. any help/advice would be greatly appriciated. I'm from Ireland so not many people know about VBA2C but they do, do vbac. thaks guys!:think:

Hi notthelast

I'm going for a VBA2C next month, and all I can stress to you is have faith in your body - and have supportive care providers.

The body rarely makes something that can't fit out of it - I've been told that many times by midwives, OB's and by reading books on birthing. From what I've read, usually if that baby isn't "fitting" its the birthing position of the mum that is the problem, not their body structure.

I don't know anything about the smoking and rupture cos I haven't heard or read anything about a higher risk of rupture for a smoker? So I can't help you there.

Get support, have faith in your body - and just see what happens!!!

Hi Arimeh,
Thaks for that. it's so nice to talk to someone else who is trying for the same thing as me. my husband is so behind me it's just me who needs to cop on!!! i'll keep on here over the next few months, be sure to let us know how you get on!:clap:

Hi there,
Goodluck in getting your VBA2C. I had a VBAC after 1 cs and found that the most helpful things were:
1) Doing lots of research into Vbac so that I was aware of the risks, best practice and actual statistics etc. Information is power to you as you don't have to rely on what the Dr tells you (which is not always accurate - as you learnt from your last birth).
2) I had a Doula who I knew would support me and give me accurate information and then allow me to make my own decisions one way or the other. I knew she would also go into to bat for me if needed and do any of the hard work that I couldn't do whilst in labour.
3) Labouring for as long as possible at home.

There is a VBAC booklet through birthrites that I found very helpful - perhaps google it?
I hope this is of some help to you and goodluck!

I've been told the same thing, because I've had two caesareans I'm not allowed to have a VBAC attempt. I guess I'll have to find myself another hospital if I want to try!

Hi Katkins, what about the baby bonus? That's yours to decide what to do with, right?

KK, you have a bunch of forces coming against you. Friends, family, doctors and dh all say you can't have a VBAC. All these other personalities seem to have more voice, more force and more clout than you do - and YOU"RE the one having the baby! If you have been socialised to be passive and let others dominate you, it could be that this journey of having caesareans is actually a gift ... it is painful, I know, and scary, I know ... but maybe your empowerment is really what all this is about?? ... prompting you, guiding you to take a stand, raise your voice and BE the authoritative FINAL SAY in your own life. Not letting others corall you, steer you, influence you, manage you, direct you or presume to know what's good for you. Finding you voice and asserting yourself, listening to your own heart and your own instincts MORE than you listen to the bossy voices around you ... might be part of your journey to the birth of your dreams. Taking ownership of your own body and your own process.

It might start with asking yourself , what do I really want? It's so easy to get put off exploring that deeply by thinking, "oh but he/she wouldn't like that" or "I wouldn't be allowed" or "they won't let me" or "I can't afford it." But set those objections aside before they de-rail your thought process.... and go back ...

"what do I really, really want?"

Huge hugs to you KK.