Brain is fried - VBAC/ ELCS decisions

[zorak]

Urgh my brain is totally fried trying to work out what to do.

I was at a VBAC v ELCS class last night provided by my hospital and it has left me more confused than ever.

A bit of history - with my first I went into labour myself at 40 +3, my labour was relatively fast 6 hours from waters breaking to me being fully dilated. However baby did not descend and after 3 hours of pushing it was clear a C-section was needed. It turned out baby was OP, and 9lb 10 oz.

At my class last night I was told if you were one of the women who spent hours pushing with your last baby with no success then you have a less than 50% success rate Ifor a VBAC. However, being an OP big baby I am not sure how that would affect things.

I am having growth scans this time at 36 weeks and my OB said that if he is big then she'd really advocate an ELCS.

My other thought is I don't really want to go over due - reduces the risks of another large baby and VBAC success rates apparently drop after 40 weeks. So I was thinking of planning for a VBAC and if I go past about 40 +4 scheduling a ELCS.

What do you think? To add to factors we are relocating internationally about 7 ish weeks after baby is due, it shouldn't be a factor but obv I need to be well enough to travel, so in that regard an ELCS at 39 weeks may be better.

Argh!

 

[butterflywolf]

I think you need to go with what your heart/gut is telling you. I didn't have a C-section with my last one, but she was a big baby. 9 lbs 3 oz and 22 inches. She was born one day early. I ended up hemorrhaging real bad nearly a minute after I had her. 2 liters lost. So it is a concern for my doctor as well as I to make sure I do not have another large baby.

So he may suggest an early induction. I personally don't want to do an early induction unless my cervix is 'ripe' and ready. I really don't want to go longer than 39 weeks tbh since I already have a strong gut feeling he will be just as big as his sister if not bigger. At the 20 week scan (which for us was 19w 1d scan) he was averaging almost 2 weeks ahead. His sister measured one week ahead at that time. And he was already 11 oz roughly at that scan.

So I have a lot of concerns myself and plan on addressing them with my doctor on our next visit which is Tuesday. I trust my doctor with my life and trust me that's hard for me to say about anyone. So I would talk with your doctor and see what he says/thinks you should do.

I wish I could help more Good luck with everything.

 

[zorak]

It's so hard isn't it. My last LO was also 22 inches. This time I'm on v low dose metformin for pcos related insulin resistance and my OB did say that it should help a little with baby's size.

 

[butterflywolf]

It is hard. Always have to sit and keep rethinking 'is this for the best'. And hopefully that will help keep the baby a little smaller for you.

 

[Liammommy]

It's whatever you feel comfortable with, really.
With my first I was overdue, was in labour for 4 days. pushed for about 2-3 hours, head wasn't coming down, and ended up with a c section, just like you. He was 9 lbs 1 oz.

With my second I opted for VBAC, but went in with the mind frame that if I ended up with a c section again I would be okay with it - all that mattered was healthy baby & mom. OB told me she thought I wouldn't be able to give birth naturally with another big baby.
They did scans to keep an eye on his weight - they said at few days before I had him "oh he is going to be small - about 6 lbs".
I went into Labour overdue again. Was maybe 7 hours start to finish. I delivered him OP and he weighed 9 lbs 2 oz. So I don't think growth scans are too accurate.

I think with the second or bodies are a little bit more prepared. But do with what your comfortable with. But I'm proof it is possible

Goodluck. Only you know your body best. Go with your gut feeling on what feels right to you

 

[misspriss]

Were you able to move around at all during your last labor? Was the 3 hours of pushing all lying flat on your back?

I had a EMCS with DS, he was preemie though so it was totally different situation. There was no question for me I'm going with a VBAC this time.

 

[zorak]

Yes I was very mobile, pushing in the shower , standing up etc. I had no pain relief at all until it was clear we were headed for a c section after 2 hours of pushing . That's when I finally had an epidural , slept for a bit then tried pushing again for another 90 mins or so. I had a brilliant epidural, could still feel my contractions and was mobile enough to support myself upright leaning over the back of my bed. So really we did everything humanly possible. I wasn't really on my back at all.

 

[zorak]

Also I was really lucky that everything was very calm and neither of us were distressed at all.

 

[bluecathy1978]

I would personally say go for VBAC. You will be monitored closely in labour anyway so the first sign of anything they will be on it straight away. I had an emergency section with my 3rd baby then went on to haVE A vbac 12 months later and another normal delivery after that.
My last baby was also born by c section but just because he decided to flip around while I was being induced and was presenting arm first the little sod!
I will be hoping to have a VBAC this time too but will see what happens. All that matters is a safe outcome for mum and baby x

 

[Hopefulk]

I'm opting for elcs after emcs last time, which is completely not me! My reasons

1. Cs was due to pre-eclampsia and baby in distress
2. My bp is already creeping up (despite aspirin) & protein in my water so looks as though I may have it again
3. They will want to monitor baby and me constantly during labour due to history so I won't be able to have the birthing pool or move around freely
4. Induction is likely so it won't be a natural birth anyway
5. I don't want to set my heart on vbac, go through 11 hours of labour and then have section anyway
6. Seeing friends who've had a 2nd section (elective this time), I have seen that the recovery seems to be much easier (friend playing on floor, bedding and standing with her 2yo 2.5 weeks after op)
7. If I have an elcs, it will be booked when my consultant is around (I love on an island) and she will know the type of section I am hoping for - if I try for vbac and fail, I could get someone else doing it who is either unaware or unsupportive of "natural sections" (I think naming them gentle is a byerr description but never mind!)

Such a personal choice. I think only you know the answer.x

 

[zorak]

Thanks for the input ladies.

I've decided to go for a VBAC and if LO is not here by 40 + 4 either be induced or have an ELCS. I am hoping by then I should be pretty favorable for induction. With my first I was in early labour for weeks and was walking about 4cm dilated with bulging waters. Hopefully it will be the same this time so it should be easier to get things moving.