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kit603 Apr 20th, 2017 03:53 AM

Repeat elective c-section or VBAC?
 
Hi ladies :wave:

Sorry for a really long post, but I'm in two minds about whether to go for a VBAC or repeat c-section and I'm hoping some of you could share your stories or any advice? I'll share the story of my last birth as well.

I'm in the UK and with my DS I was in slow labour for a few days at home with contractions that started about 4/5pm about 30 mins apart and lasting 30 secs and gradually increasing in intensity with less time between them until the early hours of the morning (3/4am) when they'd suddenly stop again having reached about 8-10 mins apart and lasting a minute. This continued for 3/4 days starting a day or so before my due date. My midwife told me they were braxton hicks despite being painful, regular and increasing in intensity :dohh: They didn't go when I changed position, had bath etc either.

At 40+3 I woke up with bad back pain at around 5am, didn't think much of it and we went shopping. We were walking around the shopping centre when I started getting more contractions. We got a few bargains in mamas and papas closing down sale as they were closing our local store that day. The contractions continued and I kept stopping and leaning on railings/walls for support and my poor hubby kept suggesting I time them as seemed to be coming faster and me (in denial) kept saying they'd stop again in a minute :haha: It got to about 2pm and we were having some lunch in the food court and my husband pointed out they were every 15 mins or so, and lasting longer, so we went home after lunch. My MIL popped over and I was telling her that I'd had more braxton hicks but they'd stopped again (as not had one for about an hour) and then as she left I went to the toilet and lost my plug and had a slight show. (6.30pm ish)

The contractions started back up every 15 mins after that and were every 10 mins by about midnight. Phoned hospital about 2.30am and went in just after 3am having contractions about 4-5 mins apart lasting just over a minute. I was 4cm so they admitted me... carried on using my TENS for a while then had gas and air from about 6.30am. At 8.30am I was still only 5cm and they broke my waters and there was meconium in the waters. Then by 10.30 I was still only 5cm and they wanted to give me a drip that they said would make the contractions more effective... I declined for a couple of hours then had it just after 12.30, it didn't go very well and I ended up over contracting and having rapid contractions with little time between and by 3pm requested an epidural. It worked but I did still feel the contractions in the back due to son being back to back.

By 7pm, I was still only 5cm :-( Then consultant came round at 9.30 ish and he wasn't happy that I'd been over contracting on the drip, baby was having decelerations during contractions and I had meconium in waters and was still only 5-6cm when he examined me. So he said I needed to be prepped for an emergency c-section.

I had no issues with the surgery itself - I suffer with anxiety and had full on panic attacks whilst being taken in for surgery as c-section in my eyes was the worst thing ever, but in the end being awake etc didn't bother me at all, the epidural was converted to a spinal without issue and procedure went well. I did lose a fair amount of blood after and felt very light headed, nauseous and tired but put a lot of that down to exhaustion as well. DS was 10lb 8oz and surgeon said he was stuck in the pelvis and he didn't think he'd have been born naturally.

Recovery wasn't too bad - DS ended up getting poorly and was in NICU for 9 days so I stayed in hospital anyway. I also got an infection in my wound but it cleared up with antibiotics. I've had no complications since my c-section or from epidural or anything like that so far. I was disappointed that it took so long to get skin to skin, but my son did end up breastfeeding for 16m so don't feel like that was a barrier to that.

This time, I very much wanted to try for a VBAC - ideally a water birth, but last time I wasn't allowed one as required monitoring so had to stay in bed the whole time :-( I discussed with my midwife and consultant and the plan was to have a growth scan at 36 weeks and then see consultant and make a decision (the plan being if she was huge like DS I'd do planned c-section and if she was smaller then I'd look at VBAC).

I've already had two growth scans as fundal height has been all over the place. At 32+1 she was measuring a week or so ahead and estimated 4lb 6oz, but by 34+1 she was measuring 37+3/4 and estimated 6lb 4oz. Her estimated birth weight is going to be over 10lb at 40 weeks based on this and it's looking like she could be bigger than my son :-(

I see my consultant again in just under 2 weeks for a growth scan and then he needs my final decision but I'm just so torn.

We aren't planning more children so I don't need to worry about future c-sections but this will be my last chance for a VBAC and I think the recovery could be easier (especially with a toddler at home too - he'll be 2 on 6th June and I'm due 29 May) and DH only gets two weeks off work and then I'll be on my own so to speak but I'm concerned that if he got stuck and I'm expecting a bigger baby then I'll put myself through all of that to have a repeat experience. If I've got to have one I'd much rather it was planned... I don't want to go through another long labour to feel like I'd failed by having a c-section at the end of it :blush: I know I shouldn't look at it that way... but..

If I do have a VBAC then I think I'd probably go for an epidural anyway - if I'd not had one with my son I'd have had to have been put under for the c-section and I really really don't want that. I definitely don't want to be induced - the drip I got given last time is the same as they give during inductions and it didn't go well at all.

I think DH is very much hoping I'll go for the c-section - he found watching me go through it all before very traumatic and we didn't find the c-section so bad in the end. He likes knowing exactly what will happen (and roughly when) so we can arrange childcare for our son and be prepared for everything at hospital and know we aren't going to have the same labour experience as before.

I just really can't decide :blush:

pinkpassion Apr 20th, 2017 08:10 AM

I can only share my experience. My first was emcs and the recovery was "ok" not great but not horrible. With my second I was set on a vbac but gelt pressured in tje end for an elcs so that's what I did. Everyone told me a repeat would be so much easier than my emcs and BOY they couldn't have been more WRONG!! Recovery was hell!!! And I'll always regret not at least trying to vbac! I'm going for a vba2c this time and refuse to be swayed!!! (Unless of course baby NEEDS to come by c-section)

teacup Apr 20th, 2017 09:54 AM

I'm in a similar situation to you Kit, I had an emergency c section after 36 hours of contractions but only reaching 5cm dilated. My waters breaking were the first sign of labour, and we went to hospital very excited. After two nights without sleep I was exhausted and asked for the epidural. The anaesthetist tried several times to put the epidural in, but it failed and he punctured my spinal fluid dura (meaning I had no fluid cushioning my brain). So I then had the worst headaches ever, followed by my contractions slowing, so they put me on a hormone drip. When it reached 36 hours they gave me an emergency c section, they did a spinal block to do the surgery which went fine (it's a thinner needle than for epidural). My recovery from the wound was fine, but I still had the headaches from hell two weeks later from the spinal fluid leak.

I think that if I hadn't had the epidural then everything may have gone to plan. The spinal dura puncture is a risk of 1 in 200, and I was that unlucky 1 (so was my sister bizarrely). I feel I would like to try for a natural birth again, but don't want to end up utterly exhausted and with a c section anyway. It's a tough call.

I am terrified now of needles going into my back, so the idea of even having a spinal injection for a c section worries me. I just really don't want to experience those headaches ever again, it was a worse pain than contractions.

If you do decide to try for a VBAC then I wouldn't recommend an epidural, because even if it goes well it is proven to slow down labour progression. If you had to have an emergency c section then they would do a spinal block, so not having an epidural wouldn't matter in that case.

Despite my awful experience, I am leaning towards VBAC at the moment. Xxx

kit603 Apr 21st, 2017 13:52 PM

Thanks for sharing your experiences :-)

I think I'm just worried that if I'd not been able to have #1 naturally and he was 10lb 8oz and #2 is likely to be bigger then I worry that I won't manage to have her naturally either :-(

pinkpassion Apr 21st, 2017 14:14 PM

You never know, there are so many videos on YouTube of successful vbacs with larger babies than first ones!

baileybubs Apr 22nd, 2017 09:23 AM

At first I was struggling with a similar choice as both my children got stuck, first ended in EMCS after failed induction and second I did get a VBAC but due to being stuck my son was delivered by forceps and was also in distress after a very quick labour (he was 2 weeks late so I think I had been in slow labour for a while). This time I am concerned baby will get stuck again and will end up in either EMCS or forceps and for me the recovery from a rushed episiotomy and forceps was worse than for the EMCS! My babies weren't big and so I worry it's my pelvis that causes the problem.
However I think I'm edging towards VBAC again as despite the bad recovery and ds also getting stuck I was still happy I had tried for the VBAC. I have yet to see a consultant and know their thoughts but think that's what I may go for.

If your dd is measuring quite big as your ds was do you think that would indicate not being able to birth naturally? If this baby is measuring big for me that may sway me towards ELCS purely because I was terrified when both my babies were in distress and if I felt there was a good chance of that happening again I might opt for ELCS. Saying that though it is a major surgery and not always as plain sailing as some people think so it's tough. What has the consultant said about possibility of baby being big and possibly getting stuck, if anything?

misspriss Apr 22nd, 2017 09:42 AM

I had a VBAC with my second and I'd highly recommend it.

My first was born prematurely, induced due to severe pre-eclampsia. I never got past 5cm either, but not because he was large. I had fairly textbook recovery, after the pre-eclampsia treatment (I just lost the first 24 hours of my son's life due to the magnesium sulfate and having to stay in bed). I stayed the full 4 days my insurance allowed, or maybe 5, they may have moved it to 5. I had trouble getting around the first few days, coughing, laughing, it was all pain. I stayed on high powered pain medication for a lot longer.

My second was a VBAC at term, induced for hypertension. The labor was tougher, but the birth was smooth sailing and the recovery was nothing compared to the c-section. Night and day.

I was up within 2 hours of the birth, walking to the bathroom. I was moved to another room and I was up moving around taking care of DD. I was dressing DD and trying out babywearing the next day. I stayed 2 nights, just because the 24 hr tests would have to be done at like 10 at night and I might as well stay that night too, otherwise I'd have gone home earlier. They gave me meds, but I really just needed some ibuprofen. I think we went to the grocery story on day 3 or 4, I don't remember which, but really soon.

I would suggest trying for a VBAC if at all possible. Growth scans have a huge margin of error when it comes to size, in later pregnancy, especially. They told me DS was going to be over 4.5lbs, clsoe to 5lbs, he was under 4lbs.

kit603 Apr 22nd, 2017 15:24 PM

Thanks for the advice so far everyone :-)

I was definitely edging towards a VBAC before I had the growth scans. This is likely to be our last baby as DH has never wanted more than 2, so I do feel like it's my last chance and I could regret it if I don't try kind of thing. Plus, DH will only get 2 weeks off work and after that he'll work some early shifts and late nights so I'll need to be prepared for getting our son up by myself (lifting him out of cot, getting him dressed, carrying him downstairs etc) and putting him back to bed (helping him upstairs, lifting into cot again etc) plus 3 meals a day in a booster chair/highchair that he needs lifting into... just keep picturing all the things that would hurt my abdomen after a c-section :blush: Id probably need to find a family member that can take him to nursery too, he'll be going 1 day a week while I'm on maternity leave (mainly to keep his place for when I go back to work) but after a c-section my insurance company said no driving for 6 weeks last time and tbh i didn't feel ready any earlier.

On the other hand.... my son was 10lb 8oz, which is almost exactly what his growth scans and fundal height measurements predicted (within a couple of oz) and my daughter's growth seems very rapid 4lb 6oz at 32 weeks then 6lb 4oz at 34 weeks. Midwife I saw said they'd have a better picture after next growth scan but she's on track to be bigger than my son was.

I know a few people who, like baileybubs, have said recovery from forceps/episiotomy etc was worse than a precious EMCS and given size of my babies if I do have a VBAC then an assisted delivery would be likely.

I've not actually seen a consultant since earlier in pregnancy. Don't see him again till 3rd may at 36 weeks, I've only seen the midwife so it was too early for him to make a recommendation last time - he was happy with my plan to try VBAC if smaller baby and repeat csection if large (although we didn't draw where that line would be) and he had no idea yet of how big baby would be as was before fundal height measurements, growth scan etc.

misspriss Apr 22nd, 2017 15:30 PM

Well, you can always try for a VBAC and get a Csection anyway, you can't really plan a c-section and get a VBAC. Always good to have a contingency c-section plan in case and discuss with your doctor.

kit603 May 14th, 2017 16:09 PM

Thanks everyone for your help :-)

Sorry for not updating! The consultant was very helpful when I met with them - discussed everything at length including my anxiety and how I'm feeling this time, my worries/concerns for both options, my labour and delivery last time in depth and obviously this pregnancy and how baby is measuring etc.

In the end we did make the decision to go for a c-section and I'm currently booked in at 39 weeks on 22nd May x


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