# Asking for a VBAC in U.K



## Chalrhow

Ok i am planning on asking my consultant tomorrow for a VBAC, well it will actually be a VBA3C... What happens if he says no, do i have to accept another section... Obviously if i really needed another c/section then i would have 1, but i have read that its actually safer to have a VBAC than repeat c/sections, also that the risk of rupture is 0.6%... My main reason for wanting a VBAC is recovery time... I have 5 children, this will be number 6... My first 2 deliveries where normal deliveries, just last 3 have been c/section.


----------



## irish_cob

They can't force you to have a repeat section, they can't carry you to the theatre and strap you down so it's always your choice. The risk of rupture is slightly higher with multiple sections but still less than 1% You may actually be surprised that you find no opposition to a vbac attempt, the nhs seem to be pretty vbac positive. 

But remember in the uk it's still you choice and you have the right to make an informed decision and be supported even if it's not the doctor's preference. And remember you don't have to see a consultant if you don't want to, even if the midwife arranges an appointment for you you can decline it. Do your own research, ask the questions you want answering and make your own decisions xx


----------



## Chalrhow

Thanks for your reply... My appointment today was so disappointing, consultant said no, the risk of rupture is far too high and the midwife agreed with him, he also said i should be sterilized :( 

I have been reading loads on VBA3C 

Found this today...

# of previous c/s rupture rate
VBA1C 0.6%
VBA2C 1.8%
VBA3+C 1.2%

Why do they lie to your face, i don't know what i should do now :(


----------



## irish_cob

Erm complain! Speak to the Supervisor of Midwives at the hospital, and explain you've been told you couldn't have a VBAC. Hopefully they will be horrified. No one has the right to tell you "no" about anything to do with your birth and your baby, they are allowed to advise you, explain what they think is the best course of action, but they're not allowed to lie to you or make the decisions for you, the decision is always yours.

You could decide to stay at home in premature labour at 30 weeks with uncontrolled gestational diabetes and a baby with known defects and there's nothing anyone could do about it except advise you why in their opinion you were not making the right choice (not that I'm saying that's a good idea - I'm just trying to give an extreme example)

Even if the risk was 50% or 80% it's still always your choice. And what does the consultant mean "no" anyway? How is s/he going to make you have a c-section? If they try and book you in for one, you smile and say "no thank you". They can't march you into the theatre and cosh you over the head.

And you can always change your mind, if later on you decide that you'd like to go ahead with a section, you can still do that.

I think I would be saying to them that you've done some research, this is what you've found (show them the figures you've found), and currently you are intending to have a VBAC, as long as all remains well with you and the baby, and in the event of any changes to either of your health, you will re-evaluate your decision.

But you don't have to engage with them at all if you don't want to. I'm having fairly few appointments this pregnancy, I've refused a consultant appointment, I refused the GTT, I'm planning a homebirth with one2one midwives, if I need to go to hospital, I'll just turn up on their doorstep and they won't have a clue who I am because I'm not registered with the maternity services/NHS system at all at the moment. I'm not worried about it at all.


----------



## Chalrhow

He has written at the top of my notes 'For elective c/section at 39/52' And underlined it, without me even agreeing... I will find a phone number for the Supervisor of midwifes, im sure ive seen leaflets up at the antenatal clinic... If i thought the risk was too high id never ask... Do you think the supervisor of midwives would be able to tell me the %risk of rupture for my hospital ? I don't want to say ive done research, then when asked where did i research i have to say google :shrug:


----------



## irish_cob

It's not a risk on a hospital basis, it's a risk to all women, even women having their first baby have a risk of uterine rupture, and it's thought to be similar to a woman with 1 previous c-section.

Tell her you looked on PubMed and found a study by Cahill:
https://www.ncbi.nlm.nih.gov/pubmed/20374579

I would be fuming about the fact someone had written elective c-section and signed it when I hadn't elected. I'd be telling them all to get knotted and refusing to go back to the hospital and only accepting MW care, and not the MW who was unsupportive, but then I'm a bolshy old cow.

Have a :hugs:


----------



## irish_cob

And another study - this is a big review, I know it's after 2 sections, not 3, but it's still evidence and data in your favour:

https://www.ncbi.nlm.nih.gov/pubmed/19781046


----------



## Chalrhow

Thank you for the links... I have bookmarked them and i will print them out to take to my next appointment... I don't think i am asking too much... All im asking is they let me try have a normal delivery and he made me feel like im endangering my life and my baby's life... Im really not the type of person who would speak up and complain... I need to start speaking up more and this is something i am really determined to try :) thanks !


----------



## Chalrhow

It actually makes me wonder if the consultant actually know how high risk a VBA3C is for rupture or if he is lying by saying it is too high risk just so he can have an easy job.


----------



## MandaAnda

I'd cross it out! The cheek!
I'd also get in touch with AIMS and read up on the ICAN website.


----------



## Chalrhow

Thanks MandaAnda.... There is a lot of good info on the AIMS site... not had a chance to look at the other one yet but i will :)


----------



## JessPape

Chalrhow said:


> Thanks for your reply... My appointment today was so disappointing, consultant said no, the risk of rupture is far too high and the midwife agreed with him, he also said i should be sterilized :(
> 
> I have been reading loads on VBA3C
> 
> Found this today...
> 
> # of previous c/s rupture rate
> VBA1C 0.6%
> VBA2C 1.8%
> VBA3+C 1.2%
> 
> Why do they lie to your face, i don't know what i should do now :(

The risk is really small as you can see, the risk of it being a life death situation if something was to happen is like 6% for both you and baby.

You could seek another health care provider, OR, keep pushing the section date back (and hope u don't go really over due) excusses like no babysitter, childs got a cold lol, work good.

I have attatched a few facebook grounds I found handy, there are also women from the UK on them...

https://www.facebook.com/groups/vbacfactscommunity/

https://www.facebook.com/groups/183444955077965/


----------



## MandaAnda

Ah, Birth Rights as well.


----------



## Chalrhow

Thanks for everyone's replies... I have an appointment with my midwife today... Do i change to another hospital and have further to travel or stick with the one i am already booked at and just refuse a c/section... Does my consultant have to agree or is he likely to tell me to get a different consultant... Why do i feel like i am being so uncooperative :(


----------



## irish_cob

You don't have to agree to anything. If they book you a c-section date, then just don't turn up! They can't physically come and get you from your house and take you to the hospital and force you into an operating theatre.

Do you feel there are risks with your pregnancy? Do you want to see a consultant throughout the pregnancy or not? You don't have to. I've refused anything and everything lol! I'm only seeing my midwife and only on my terms.


----------



## Chalrhow

My only risks are 3 previous sections... I don't particularly want to see a consultant, especially the one i have, if i had a more understanding and supportive consultant... I just feel like i am being really awkward but i don't want another c/section, especially with 5 children to look after and i don't even know how long OH will get off from work, he is probably going to have to take holidays as he wont get paternity leave, just started new job.


----------



## irish_cob

So maybe don't go? There's nothing a consultant can do or change for you at 20 or 30 weeks pregnant in terms of having had those 3 previous sections. He or she can't look at you and tell you whether your scar will rupture in labour. It either will or it won't (to put it bluntly), so there's not a lot of point going to see someone in advance to be told it might rupture - you know that already!

Can't you just enjoy your pregnancy, see your midwife as often as she wants, and then see how you feel towards the end? There's no harm in going for a trial of labour, and you can set the terms and conditions that work for you. Remember total fatal rupture is extremely uncommon, when reports publish scar rupture stats they usually include very minor separations and partial ruptures which are not life threatening or big emergencies. You can decide where you would feel safest labouring and what monitoring you will or won't accept - there is evidence that regular monitoring by an experienced midwife is far better at spotting potential problems sooner than being hooked up to a machine.

Just remember it is always your choice - you can run away and go and give birth in a field - it is your body - you don't suddenly somehow belong to the medical profession just because you're pregnant :hugs:


----------



## irish_cob

Oh and did you ring the SoM and complain? I think the consultant treated you terribly - how dare he write that you'd elected for a c-section at 39 weeks when you hadn't, and how dare he tell you that you should be sterilised.

Get angry. Don't be a doormat. You are entitled to be treated with respect.


----------



## Chalrhow

You are so right, there is nothing he can do or change... No one can tell me that yes my scar will definitely rupture or that no i will be fine... I don't know about not seeing him again as he will be doing my scans... Have never really stood up for myself, that's why i ended up with 2 further sections, I contacted a local supervising authority midwifery officers and im waiting on a reply :) Thanks


----------



## irish_cob

Why will he be doing your scans? Do you need extra ones? Can't you just go for your routine anomaly scan at 20 weeks with the sonographers?


----------



## Chalrhow

irish_cob said:


> Why will he be doing your scans? Do you need extra ones? Can't you just go for your routine anomaly scan at 20 weeks with the sonographers?

Its him and another Dr that usually do the scans... He done my 12 week scan, i get another at 20 weeks and 1 at 32 weeks.


----------

