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Old Jul 26th, 2011, 08:41 AM   31
kdea547
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Quote:
Originally Posted by chuck View Post
Kdea...I sure you've already been pointed there but have to had a look at www.spinngbabies.com

Breech birth is another variation of normal, you should be able to breech birth if you choose to however breech births do have additional risks and that on top of VBAC would be a tough one to choose.

Remember if you go down the CS route you can plan it this time and make it yours...have a google of 'gentle cesarean'
As far as I know, there are no doctors that are practiced or willing to attend a breech birth around here, so it will definitely be a c-section if she doesn't turn. In the meantime, I am doing everything can, including the suggestions from spinningbabies. She's just being stubborn!

But, I will be planning a VBAC for my next child if/when that happens.



 
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Old Jul 26th, 2011, 10:33 AM   32
Celesse
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I'm attempting to get a Consultant version of my HBAC birth plan done before my 20 week appointment. Mostly to tell him, "this is what I'm doing, I'm very sensible when it comes to transfer ... so leave me alone and let me get on with my home birth plans".

Quote:
Birth Plan

Location of birth
My first choice for location of birth is at home. I understand this is not recommended, have researched this at home and do not consider the risk to me and my baby to be significant if my pregnancy and labour continue to be normal and without additional risk.

Repeat C-Section:
• For Placenta Previa.
• If my life or baby’s life is in immediate danger.

Hospital birth at start of labour:
• Before 1 December 2011 (37 weeks by scan date)
• After 8 January 2012 (42 weeks by ovulation date)
• Breech baby (however should this occur I am willing to discuss the pros and cons of VBAC versus Elective C-Section)
• Large baby. Confirmed by scan and discussed after scan with consultant.
• Another condition diagnosed in pregnancy that increases the risk to the baby or myself that I have discussed with the consultant, been given opportunity to research and have agreed a hospital birth is safer.

Social Reasons I may decide to go into hospital on the day:
• I would prefer to be admitted to the Birth Centre instead of the Consultant Led Unit. I understand hospital policy may prevent this.
• Snow, and other weather factors which could greatly increase transfer time.
• Child Care issues, for example labour becoming established in the middle of the night and not wanting to wake Abigail up.
• Because I just want to.

Choices for Care

Should complications arise during pregnancy or labour I will listen to my care givers and make an informed decision.

Due Date
I ovulated on 3 April 2011 (at around 6pm) making the due date for this baby 25 December 2011.
My 12 week scan showed a due date of 22 December 2011.
I will make decisions about my care and the care of the baby based on the scan due date up until 21 December 2011. After this date I will make decisions based on the ovulation due date.

Induction / Augmentation
I will consider a sweep after 41 weeks, however I am undecided about this.

I will be declining induction for post dates. If the baby has not arrived by 8 January 2012 then I will opt for monitoring. If a problem is identified through monitoring I will discuss this with my consultant in order to make an appropriate decision.

Should a medical reason arise where induction or repeat C-Section is considered appropriate I would prefer to be induced and monitored appropriately.

In the event of hospital admission I do not want any type of augmentation if at all possible due to the increased risk of uterine rupture.

Internals

I do not want any internal examinations unless a problem is suspected and would prefer my progress to be monitored by observing changes in my behaviour.

Monitoring


• If I am at home I want the baby to be monitored intermittently at a frequency seen appropriate by the midwife.
• If I choose to go into hospital for reasons stated in the section “Social Reasons I may decide to go into hospital on the day” then I want the baby to be monitored intermittently.
• If I go into hospital for reasons stated in the section “Hospital birth at start of labour” then I will consider monitoring by CTG. However dependant on the circumstances I may request intermittent monitoring to allow me to labour in the bath or shower in early labour.
• If I am transferred into hospital during labour for pain relief (additional gas and air/ pethadine) then I want the baby to be monitored intermittently.
• If I am transferred into hospital for slow progress I will consider a period of monitoring by CTG.
• If I am transferred into hospital for problems arising during labour I want the baby to be monitored by CTG.
• If I have an epidural (for whatever reason) I will accept monitoring by CTG.

Pain Relief


• I plan to get a birth pool for a home labour / delivery.
• If I go into hospital for reasons stated in the section “Hospital birth at start of labour” then I would like to be admitted to the Birth Centre and labour in a birthing pool.
• If I labour on the consultant led ward I would like to use water for pain relief whenever possible.
• In addition to water I would like to use Gas and Air as labour progresses.
• I would like to avoid pethadine.
• In the event of a complicated labour I would opt for an epidural in advance in emergency procedures (ie to avoid crash section, or instrumental with only local)
Have I included everything that the consultant will care about? I will have another birth plan clsoer to the time with details such as whos there, skin to skin, cutting cord, aromatherapy and so on. But wanted to make sure I had everything down for the consultant that they will want to advise me on. Its very medcial for a home-birth birth plan, but thats just cos of who its aimed at!



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Old Jul 26th, 2011, 10:39 AM   33
chuck
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Quote:
Originally Posted by Frankie View Post
Hello thought I would join you all to get some info.

I had a C Sec in Feb 2009 due to breech presentation and a failed ECV. I am hoping for a VBAC this time around.

Has anyone got any idea what the consultants will say or do? I am with them on the 10th August and want to get prepared
Hi Frankie...your MW and OB should go through your last labour and give you a balanced argument for CS or VBAC (I say 'should') and ask you what you would refer.

Some areas push more women towards the VBAC route because it is better for you and baby physically, there are fewer risks to you bot and better recovery time, other areas arent so keen on VBAC.

I was asked by my MW at booking what I wanted and from the off I said HBAC, my OB wsan't happy about it so I didnt bother seeing him again as my pregnancy was uncomplicated.

If I were you I'd do some reading and make list of questions you have and go prepared, if baby was breech theres no reason the next one will be! Trust your body and know that not all babies are naughty!

Quote:
Originally Posted by tannembaum View Post
Thanks
Its not the pain I'm scared of....I was handling my labour just fine even with out g&a last time. For me its the fear if something goes wrong and I don't have an epi fitted then I will most probably have to go under ga for a section.
It's very rare for women to have GA for a EMCS even if it is desperate doors time, especially as a VBAC you would have MW's who should be more attentive to you and have a bit of an early get out clause for the labour meaning they will intervene more quickly this time on account of your additional risk (UR).

Just remember there are truly very few true EMERGENCY CS's..needing a cut to made in minute. The 'call to cut' time is around 30 minutes as memory serves so there is time enough to get a or more likely a spinal - an epi leaves a cannula in the back and take s time to work, whereas a spinal block is a singe shot to the spine that is instant. So you are more likely to have spinal in an emergency if you do not have an epi fitted.

BUT THINK POSITIVE...there are always what ifs...but what if everything goes great? More often than not they do!



 
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Old Jul 26th, 2011, 10:41 AM   34
chuck
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Celesse...reember for the 'large baby' thing make sure it's true cephalic - pelvic disproportion ans have that confirmed by more than 1 sonographer. 'Big baby' is too often a misnomer, they arent actually big as scans are so far off or ys they are are bigger but not to big to get out!



 
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Old Jul 26th, 2011, 10:47 AM   35
Celesse
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Large baby is in as I've read its an increased UR risk as much as anything. I've not specified a weight as unless we are talking 10lb + I'm staying at home. I was massive with DD and midwife was convinced she was a monster size but she was 7lb6oz on scan at 40 weeks and born 8lb 1.5oz at 42 weeks. My midwife maintains that the scan was wrong and LO was massive and started loosing weight before she was born.

And I'm big again, so I'm expecting my midwife to tell me she thinks baby is massive and getting sent for a scan which shows baby is normal size. I want it in the plan before they start with the faff.



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Old Jul 26th, 2011, 10:54 AM   36
tannembaum
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Celesse-That sounds great! I don't know if you need to include anything else as this is my first vbac too
I might have to steal bits of this if you don't mind!
my edd is 25th dec by ovulation and lmp but by the scan it is 22nd dec like yours!! How weird!?



 
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Old Jul 26th, 2011, 10:58 AM   37
chuck
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Quote:
Originally Posted by Celesse View Post
Large baby is in as I've read its an increased UR risk as much as anything. I've not specified a weight as unless we are talking 10lb + I'm staying at home. I was massive with DD and midwife was convinced she was a monster size but she was 7lb6oz on scan at 40 weeks and born 8lb 1.5oz at 42 weeks. My midwife maintains that the scan was wrong and LO was massive and started loosing weight before she was born.

And I'm big again, so I'm expecting my midwife to tell me she thinks baby is massive and getting sent for a scan which shows baby is normal size. I want it in the plan before they start with the faff.
If you come across that info again can you post it here, it's not something I've read, good to have that info if we can.

Mind you I would question that as it's contractions that would cause UR - hence why synto/pit contractions increase risk of UR as they make the uterus contract harder. I didnt think the strength of the contraction would be changed by the baby size - although a larger baby may put a little more pressure on the uterus I guess?

You're right though good to have a contingency plan and have it in your plan for the outset though, it's ridiculous that scans that can be up to 20% out (it even states that in my antenatal notes) are performed once and then relied on for EDD and measurements and then used as argument for induction etc.



 
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Old Jul 26th, 2011, 10:59 AM   38
Celesse
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Steal away!



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Old Jul 26th, 2011, 11:01 AM   39
Celesse
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Quote:
Originally Posted by chuck View Post
Quote:
Originally Posted by Celesse View Post
Large baby is in as I've read its an increased UR risk as much as anything. I've not specified a weight as unless we are talking 10lb + I'm staying at home. I was massive with DD and midwife was convinced she was a monster size but she was 7lb6oz on scan at 40 weeks and born 8lb 1.5oz at 42 weeks. My midwife maintains that the scan was wrong and LO was massive and started loosing weight before she was born.

And I'm big again, so I'm expecting my midwife to tell me she thinks baby is massive and getting sent for a scan which shows baby is normal size. I want it in the plan before they start with the faff.
If you come across that info again can you post it here, it's not something I've read, good to have that info if we can.

Mind you I would question that as it's contractions that would cause UR - hence why synto/pit contractions increase risk of UR as they make the uterus contract harder. I didnt think the strength of the contraction would be changed by the baby size - although a larger baby may put a little more pressure on the uterus I guess?

You're right though good to have a contingency plan and have it in your plan for the outset though, it's ridiculous that scans that can be up to 20% out (it even states that in my antenatal notes) are performed once and then relied on for EDD and measurements and then used as argument for induction etc.
I was looking for the article I read it on the other day and couldn't find it. I really need to start bookmarking things. I'll have another hunt once LO is in bed as I think it also included some other factors that increased likilhood of UR...or decreased risk if you didn't have these factors depending on how you look at it.



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Old Jul 26th, 2011, 11:12 AM   40
tannembaum
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Quote:
Originally Posted by chuck View Post
Quote:
Originally Posted by Frankie View Post
Hello thought I would join you all to get some info.

I had a C Sec in Feb 2009 due to breech presentation and a failed ECV. I am hoping for a VBAC this time around.

Has anyone got any idea what the consultants will say or do? I am with them on the 10th August and want to get prepared
Hi Frankie...your MW and OB should go through your last labour and give you a balanced argument for CS or VBAC (I say 'should') and ask you what you would refer.

Some areas push more women towards the VBAC route because it is better for you and baby physically, there are fewer risks to you bot and better recovery time, other areas arent so keen on VBAC.

I was asked by my MW at booking what I wanted and from the off I said HBAC, my OB wsan't happy about it so I didnt bother seeing him again as my pregnancy was uncomplicated.

If I were you I'd do some reading and make list of questions you have and go prepared, if baby was breech theres no reason the next one will be! Trust your body and know that not all babies are naughty!

Quote:
Originally Posted by tannembaum View Post
Thanks
Its not the pain I'm scared of....I was handling my labour just fine even with out g&a last time. For me its the fear if something goes wrong and I don't have an epi fitted then I will most probably have to go under ga for a section.
It's very rare for women to have GA for a EMCS even if it is desperate doors time, especially as a VBAC you would have MW's who should be more attentive to you and have a bit of an early get out clause for the labour meaning they will intervene more quickly this time on account of your additional risk (UR).

Just remember there are truly very few true EMERGENCY CS's..needing a cut to made in minute. The 'call to cut' time is around 30 minutes as memory serves so there is time enough to get a or more likely a spinal - an epi leaves a cannula in the back and take s time to work, whereas a spinal block is a singe shot to the spine that is instant. So you are more likely to have spinal in an emergency if you do not have an epi fitted.

BUT THINK POSITIVE...there are always what ifs...but what if everything goes great? More often than not they do!
The problem I have is I don't trust my body oh said it was 7mins at a max between them deciding I needed an emcs to the first cut and he said it only took that long as I kept saying i could still feel my legs when they sprayed them with water so they had to top up my epi.

So its quite rare to need a section that is That much of an emergency?
Do you think most emergencys have time for a spinal? If that is the case it will put my mind at ease



 
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