Older women and VBAC

[Malyna]

I'm 41 and when I went to see the doctor he told me that because my first baby was delivered by c-section, and due to my age, that I'd most likely have another c-section if I had a second baby.

Has anyone, of my vintage, successfully had a VBAC?

[KimB]

I am actually older than you and I had a VBAC in April last year. Did your Dr say why you would have to have a c/s?? Was it because of the type of c/s you had last time? I had blood pressure problems and gestational diabetes but I still managed to get my VBAC Don't give up on you getting one either.

[Malyna]

I had an emergency c-section because DS's heartbeat went everytime I had a contraction. They thought it could be cord issues, but when they pulled him out there was nothing they could see that was wrong.

He just said that in older woman the uterus isn't as strong and since I had a c-section the first time, there's a high chance I'd need one the second time around (which I know is not necessarily the case).

[Jennifer13]

I just had a home birth VBAC and I turn 35 next month. Probably not classified as older, but I'm getting there.

Surely there's no issue with trying for a VBAC whatever your age and barring problems during the pg? I'd consider getting a second opinion as that doesn't sound very VBAC supportive.

[Traveller]

There is a school of thought that says older mothers have less effective uterus' and as such are more likely to have a CS. Complete rubbish in my opinion but this may be what he is referring to. So a more relevant question for you to ask might be "have any older mothers had a vaginal birth" and you'll probably find the answer is yes, lots

[AnnaBelle]

Hi Malyna,

I am 40 and had my VBAC Sep 2010 - I was 3 months shy of 40 when DS2 was born.
DS1 born when I was almost 38 and was emergency c-section due to the same thing as you - distress at 6cm heartbeat dropped at each contraction blah blah (was induced as he was 2weeks overdue)
DS2 - one day overdue (my OB would only let me go over a week before doing a c section so phew!!)
Labour was 4.5 hours - arrived at hospital at 10cm and he was born 45 min later no drugs

So it can be done - you have to fight for it - I did but glad I did.
However I can fully appreciate now that DS1 csection was so needed and that each baby/birth is different.
Talk to your OB and agree on the boundaries so to speak and give it a go if that s what your heart tells you to do.
I read Birth Skills and it so helped me - I didnt go OTT with reading about VBAC i sort of just went with it and let nature take
its course. Oh rasbery leaf tea at 30 weeks onwards, acupuncture towards the end of pregnancy and a pregnancy massage the day before i went into labour!!
Good luck PM me anytime.

[Malyna]

AnnaBelle - I did the raspberry leaf tea and it didn't do anything, but then I never got past 1cm dillated even after 7 hours of labour.

Thanks for your replies. I'll keep it in mind if we go for number 2

[KimB]

And poo to older womens uteruses not functioning properly. I had my 4th baby at 38 - naturally, my 5th at 40 - c/s due to pre eclampsia and my 6th at 42 - vbac with GD. If anyone should have a dodgy uterus you'd think it would have been me after having it stretched by so many babies lol. Tell your Dr to check his info. I've never been told anything about having a weak uterus.

[Julie Doula]

I had an emergency c-section because DS's heartbeat went everytime I had a contraction. They thought it could be cord issues, but when they pulled him out there was nothing they could see that was wrong.

He just said that in older woman the uterus isn't as strong and since I had a c-section the first time, there's a high chance I'd need one the second time around (which I know is not necessarily the case).

Can I ask what position you were in when these FH changes occured?

Can he produce literature to support that the uterus is not as strong in older women? Last year I had a baby at home at age 43, and supported another woman having her third at age 42. They tried to tell her she'd need a c/s too - but she ended up giving birth by her front door on the way to the car - and I had the great privilege of catching.

I think he's talking through his hat. If you look at the reasons for the first c/s, it wasn't because your body wasn't functioning well or because your "pelvis was too small" (a furphy handed out to lots of women). Something was going on with the cord - and there's a chance that could have been avoided with positioning, gravity and mobility. Maybe?

So that means that a different model of care and a different way of 'managing' your labour is likely to yield a different outcome.

Age and previous c/s are not strong enough reasons to recommend a healthy mother and baby undergo major abdominal surgery. Perhaps he is more comfortable with surgery than with supporting a woman emotionally and physically through the VBAC journey?

He says there's a high chance you'd 'need' a c/s - I think your chances of labouring and birthing normally are higher (given the right support).

[BellyBelly]

One of my first births was a woman in her 40s, a twin vaginal birth. Great uterus

[Julie Doula]

Yes, Kelly! I think the uterus is an incredibly strong and tenacious bundle of muscle fibres. If an older woman is fit and healthy and all her other muscles are doing nicely, thank you very much - I see no reason why her uterus muscle fibre cells would not also be in great shape. And we know the sorts of things that increase cell health and even reduce aging - like vege juicing, greens, water, anti-oxidants, Omega oils, exercise, all that good healthy stuff!

[Malyna]

Can I ask what position you were in when these FH changes occured?

I was sitting on the fit ball, leaning on the hospital bed, lying in bed, walking to the toilet, lying on my side. Before the C-section, the doctors had me changing positions mid contraction for a few contractions to see if it was a positional thing. And that was no fun at all. It wasn't a positional thing it was a baby thing. He just wasn't ready to be born - well that's my layman's thoughts on the issue.

I think the GYN was just giving me the worst case scenario, to make me really think about having number 2 because at the time we were dreamy eyed.

I struggled a lot after DS was born and I'm not sure I have the strenght to go through it again.

[onthefly]

You were induced, right? Makes distress much more likely.

My son experienced distress during my induction too. You know why it was so bad? Because I was distressed. Actually something very similar happened with my second labour, only this time I was well cared for and supported and when my midwives helped me to calm myself, the heart rate improved.

Anyway, plenty of women birth just fine at this age. I hope all goes well for you

[Malyna]

I was calm during the labour, even with the induction. I remained calm the entire time. But then I'm the type of person who remains calm during mega life crisies but put me in the midlde of a shopping mall during last minute shopping sprees and I usually run out screaming!

I've been meditating for almost 20 years, so it wasn't my heart rate that was an issue. Plus I had every faith in my midwife looking after me. She was brilliant.

I think DS just wasn't ready to come out. My body hadn't secreted that hormone/drug/trigger that puts a woman into labour (or whatever the heck that stuff is called).

Plus why would you move out of home when you have all the mod cons laid on - LOL.

[Julie Doula]

It wasn't a positional thing it was a baby thing. He just wasn't ready to be born - well that's my layman's thoughts on the issue.

I'm sure you're right. Synto does increase the likelihood of distress.

I'm sorry you struggled after the birth. There is hope that you can have a different experience this time - even a VBAC if you wish. Perhaps continuity of care with a midwife you select and employ yourself might be an option? It's expenensive but the personalised care is excellent and some health funds cover the bill partially. They do all your pre-natal care at home, help you de-brief (she could go over your notes with you from the last birth) and prepare emotionally, labour at home, checking on you and baby, and then go with you to the hospital when you are ready. In the hospital she won't have practicing rights, unfortunately (a pitiful state of affairs in this country, unlike NZ and UK), but she will be a strong advocate for you and will continue supporting you emotionally.

All the best Malyna. I hope whatever you decide, your path ahead is sunny.

[BellyBelly]

Just a general side comment: I had a convesration with a midwife from the RWH years ago, she said that in the case of first time mothers who came in for induction, she saw around 50-75% of them wheeled off for a c/s. The reasons for those inductions were often foggy too. Far too many inductions being done resulting in far too many c/s, especially for first time mums who the whole labour process and pain is all new to. Coming to terms with that, plus extra pain from the induction, its no wonder they dont cope... Or their babies. I think one very important thing for all mothers contemplating an induction to realise is that induction doesnt just trigger off labour as if your body would naturally. Its unnatural, intense (they have to make sure the labour happens or they would be in trouble - only option with a failed induction is a c/s) and the hormones do not work the same as they do not cross the blood brain barrier. Its not just that simple. Its a HUGE thing without even factoring in all the risks and side effects.

[Jenqu]

I turned 44 in October of 2011. On September 1, I had given birth to a little boy (9lbs, 11oz) via VBA2C. I was induced at 38 weeks due to pre-eclampsia via a foley catheter in my cervix. He was born 20 hours later- no tears or stitches.

My first baby, eleven years earlier, was an emergency c/section. He was almost 11lbs, posterior and transverse. My second, eight years ago, was an unmedicated VBAC. My third, was a planned c/section because no one around here- I am in Chicago- would take me as a patient. This time I found a midwife at a university hospital. Of course, doctors oversaw my induction, but they turned my care back over to my midwife once they saw I was on the verge of delivering. I had no complications, other than the magnesium sulfate portion of my treatment. I healed so very quickly and feel wonderful.

[Julie Doula]

in the case of first time mothers who came in for induction, she saw around 50-75% of them wheeled off for a c/s. The reasons for those inductions were often foggy too. Far too many inductions being done resulting in far too many c/s, especially for first time mums who the whole labour process and pain is all new to. Coming to terms with that, plus extra pain from the induction, its no wonder they dont cope... Or their babies. I think one very important thing for all mothers contemplating an induction to realise is that induction doesnt just trigger off labour as if your body would naturally. Its unnatural, intense (they have to make sure the labour happens or they would be in trouble - only option with a failed induction is a c/s) and the hormones do not work the same as they do not cross the blood brain barrier. Its not just that simple. Its a HUGE thing without even factoring in all the risks and side effects.

I agree, Kelly. This has been my observation too.

I think that this: Alarm over jump in induced births | smh.com.au

... a state-wide surge in (inductions) may be responsible for a continuing rise in caesarean births.

Among women aged 20 to 34 who had their first baby in 2009, 34 per cent were induced - a record high which represents nearly 3 per cent more women than the previous year.

And for the first time, three hospitals induced more than half of mothers in this category, according to new figures released on the Ministry of Health's website.

Overall, more than a quarter of all deliveries were induced, using techniques that raise the risk of needing a caesarean section because they speed the birth process and make it more difficult.

and this: New Study Shows Normal Labor Takes More Time Than OBs Are Allowing For

have a lot more to do with this:

Mums are not prepared for birth | Herald Sun

than women's "unrealistic expectation" - a classic blame-projection dynamic.