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VBAC or C-Section?

on Friday, 31 August 2012.

I wasn't going to write this post yet, after all I am not even half way through my pregnancy and therefore birth is an incredibly long way off.

Yet today I had my sixteen week checkup at the midwife.  The appointment ran smoothly and Mads and I got to hear her baby brother or sisters heartbeat for the first time, which was just incredible.

However at the appointment one of the midwives (my normal midwife was on holiday) explained to me about the consultant visit I will have in a couple of weeks to discuss my birth options.  She turned round to me and said 'They are pretty strict and will be pushing you to have a vaginal birth.'

Now before I begin, I knew that this would happen.  I was under no illusion that they would be pushing me to have a natural birth.  After all it is 'safer' for both Mum and Baby, less recovery time, a shorter stay in hospital and of course cheaper for the cash strapped NHS.  I just didn't realise how soon I would come up against a battle.

I mentioned to the midwife that I wasn't sure what I wanted to do yet.  And this much is true- I have no idea whether I want a elective c-section or to try for a vaginal birth.  I was met with a 'What are your worries about natural birth?'

I have worries about both and I am so confused as to what I want to do.  I have written a couple of times before about my birth with Mads, here and here she was an elective c-section because she was a footling breech and it was the most positive and amazing experience of my life.  Therefore a part of me wants to stick with what I know.  Here are my main concerns.

1.  I know that natural birth is the 'safest' thing for Mum and baby but the fact that remains is that with a VBAC they constantly monitor the fetal heartrate out of the fear that your scar may rupture- rare it may be but I am such a panicker and I fear that something may happen to the baby during labour.

2. My body has never gone into labour, so I have no idea how long my labour could be.  If I had experienced an emergency c-section before after being in labour then at least I may have an idea of what it is like- because my body has literally no experience of it, it could be a long labour with less chance of success because of the scar tissue.

3.  Mads was born a week and a day early and was 9lb.  I therefore can assume that this baby will also be big.  If I am allowed to go to term or overdue then the baby will be huge and therefore it means I 'could' be more likely to have an emergency c-section or run into complications.

4.  I want to breastfeed.  I breastfed Mads for 11 months and want to do the same for her little brother or sister if I can.  I know that breastfeeding is supposed to be harder after a c-section, but it is all I know and I managed it.  If I try for a natural labour and suceed then great, but if I go through labour and end up having an emergency c-section then I am worried that it may put a strain on breastfeeding.

5. Although it will be a 'natural' birth, it won't be natural in the way that once you are in established labour they constantly monitor the baby- therefore no birth pool, no changing of positions, no midwife led birth suite.  Therefore to me it isn't as natural as a first labour would be anyway.

 A c-section is all I know, and I know what to expect with one, part of me wants to stick with what I know.  Above are my reasons for feeling like an elective c-section would be more suitable for me, but below are my reasons for the idea of a VBAC.

1.  The recovery time is a big worry- I want to make the transition period easy for Mads and I worry that if I feel as rough afterwards as I did last time, it will put a strain on things.  I can imagine it is very different with one baby than it is with two.  Once Mr E goes back to work I will be on my own, last time my Mum didn't work but this time she owns her beauty salon, although she can take time off as she doesn't actually do treatments, I can't expect her to take too much time off.  Yet I also know that if you have stitches etc during natural labour it can take some time to recover as well.

2.  If I had a natural birth my hospital allows two birth partners so I could have my Mum there too, this means a lot to me as last time they shut the wards due to a virus meaning my Mum couldn't meet her granddaughter until she was a day old, and that is only because I discharged myself sooner than I was supposed too.  I would love for my Mum to experience that.

3.  The experience of natural labour- Although I don't feel cheated having a c-section, and I wouldn't again, there is still a small part of me that would like to know what it feels like to have a natural birth.  

I am so confused as to what to do.  I think if I had to make a decision right now I would say I wanted an elective c-section, just because I worry so much and I feel like there would be less complications for the baby with a c-section.  However I don't know.  Even down to little things like with a c-section I would get more time in hospital to bond with the new baby on my own before going home.  (Even though last time I hated it and discharged myself after one night.)  I worry a lot because Mads was so big but I don't really even know if this is a problem.

I just know that I am going to go to this consultant appointment and they are going to push for a VBAC but I don't know one person who has had a successful VBAC- they have all had emergency c-sections or elective c-sections, and I just don't want to be pushed into a decision that I don't want.  I also don't want to be treated in a different way because I haven't made the decision that the hospital want me too, I can already tell that may happen.

I know that it is months away, and a lot can happen in that time, but I want to be armed with knowledge and feel confident in standing up for my initial decision at my consultant appointment in two weeks time, whatever that may be.  If you have experience of a VBAC or second time c-section, whatever the decision you made, or the outcome, I would love to hear below.

Thank you.

Comments (24)

  • Sarah

    Sarah

    31 August 2012 at 12:56 |
    I had twins by elective c section - wanted to try for a VBAC with preg. number 2, ended up being induced, labour for over 12 hours, baby stuck and then c section anyway. I would go for a c section given my time again .. if you go into it prepared it is much less traumatic than having one at the last minute, and having now had contractions etc, i can say hand on heart that a c section is much less painful. I felt that I had been robbed of a natural birth, with the twins, but now realise how silly that was, and that i should have just put a date in the diary with preg number 2 and been done with it ! .. oh and they cut out the old scar so you still have only one :)
  • Emma - Munchkins

    Emma - Munchkins

    31 August 2012 at 13:01 |
    Oh this all sounds so soon for them to be worrying you about it. However, with me I have never had a c-section and I didn't particularly want one either. My sister had a c-section twice and she was happy with that. My fear if I had a section was that I don't like the thought of a scar being cut over the top a second time, it gives me shivers just thinking about it. For me the plus side of having a natural birth was that as soon as I had my babies I just sat up and had them on my chest. The recovery time is much less and we stay in the country so if I could't drive for 8 weeks it would have been so annoying for me.

    You need to remember that what ever decision you make will be the right one. Only you know what you feel comfortable with and you should not feel pushed into making a choice that you do not feel comfortable with xxx
  • Emma @mummymummymum

    Emma @mummymummymum

    31 August 2012 at 13:03 |
    Its a tough one. I'm afraid I can't be much help from an experience point of view, but I would say don't let the doctors force you into a decision you are not happy with, and don't be forced into a decision before you are ready either..

    My friend tried to have a VBAC and her scar did rupture ( they are both fine now ) so that is a real concern and one the doctors should take seriously.

    Could you ask the doctors for some stats on how successful VBACs are?

    Good luck lovely. xx
    xxx
  • Mummy and the Beasties

    Mummy and the Beasties

    31 August 2012 at 13:08 |
    This may be an essay...sorry! The decision plagued me from early on too Katie so the fact you are thinking about it now doesn't surprise me. I knew I wanted another section pretty much from the off so I was scared about the resistance I might get. In fact my colleague who was pregnant had a more pushy experience when seeing the consultant about what to do. I hadn't bothered going to mine as they messed up my initial appointment, I didn't want some midwife spouting all about the merits of a VBAC when I knew I didn't want it. But in the end I had to have the appointment and I was pleasantly surprised as the consultant midwife was so laid back and didn't push me for my reasons against it. My midwife throughout told me that they like people to go for VBAC's but she gave me the impression that they would be flexible. I stressed over it a lot in my pregnancy and I shouldn't have, so I urge you not to. You have medical enough reason to want a VBAC is that is what you choose, you are not low risk anymore. All I advise is to take the information given to you and if you still want one then to stick to your guns, a doctor who had had sections herself at work told me to do that. Don't let some of those midwives who are so any sections bully you. It's your baby and your body. As you can see I am rather passionate about this! xx
  • Mummy and the Beasties

    Mummy and the Beasties

    31 August 2012 at 13:10 |
    Oh and they give you a booklet with percentages which were alarming in themselves (to me). Heather is the best to advise you as she was in the exact same position as you :-) x
  • Susan Mann

    Susan Mann

    31 August 2012 at 13:13 |
    I had a bad first birth which was going to be a section but got him out quick with forceps, then second was worse and resulted in an emergency section. This time they are looking towards section for me, as I am high risk with my kidneys. I think you have to do what you feel happy with. Think about what you want and explain this to the doctors. Hugs x
  • Hayley Llewellyn

    Hayley Llewellyn

    31 August 2012 at 13:24 |
    I've never had a C-section as both my births were normal deliveries however the first time was under an epidural and all the drugs second time round just natural with a little G&A. I wanted to experience a natural birth so therefore I pushed for what I wanted. I had to be induced on both of my labours but found both of them to be different experiences. I had to be constantly monitored however I was allowed to move around the bed and change position so you're not completely restricted.

    I do feel though you need to be completely comfortable and relaxed so just go with your gut and how you feel. I'm glad I went the natural way and both my babies were 9lb 2oz and 9lb 12ozs! Bigger the baby the quicker and easier the labour apparently! Also what's your shoe size? Bigger the size the larger your pelvis and easier for birth! I'm a size 9!

    I hope you find some peace on this subject soon.
  • Kylie @kykaree

    Kylie @kykaree

    31 August 2012 at 13:24 |
    Huge hugs to you, but I think you are overthinking this, and also assuming the worst, when it all might be ok.

    The changes in NICE guidelines "should" mean that you can have a frank open discussion with the consultant. No one can make you do anything you don't want to do.

    A lot of my friends have successfully VBACed.

    I had a planned section with Joseph (at 27 weeks but that's another story) and as soon as I had him I had a letter from the hospital saying "next time we would encouraged you to VBAC"

    When I went to see the consultant for my post csection follow up (we had to have one due to Joseph's prematurity) and I mentioned about VBAC she said "don't be ridiculous, you would be having a section done by me".

    Just go to your appointment with an open mind, but I would suggest you acquaint yourself with the NICE guidelines so if the discussion does go a way you are not happy with, you are an informed patient.
  • HELEN

    HELEN

    31 August 2012 at 13:45 |
    I'm sorry I can't offer an advice on this but try not to worry about it & let it ruin the rest of your pregnancy.....have a long think & chat with your family & stick to your guns & don't let anyone push you into something that you're not happy with x
  • Cat (Yellow Days)

    Cat (Yellow Days)

    31 August 2012 at 14:36 |
    I can completely understand. I had a similar dilemma but (as I said in our fb chat) I went for a VBAC in the end. What swung it for me in the end was that we'd quite like to have a third baby and if I'd had a c/s for number 2 I'd always have to have them from now on but if you manage a VBAC you are then back to being a low risk birth and have all the options available to you.

    A colleague at work had recently been able to have a wonderful natural water birth for her third son after a very straight forward VBAC for her second. This really boosted my confidence as you don't often hear much about successful VBACs and it was nice to find an example.

    Both are really safe so the most important thing is that you are comfortable with your choice. I would say it's best to make your decision before your appointment and be really clear with them as if it is obvious you know what you want you probably won't get too much resistance but if they think you're not sure they will try and make your mind up for you.
  • Laura

    Laura

    31 August 2012 at 14:55 |
    My SIL had an elective section with her 1st as she was breech but with her 2nd had a VBAC and was fine (was even on one born every minute!) she had no stitches or epidural so there are good stories out there. just do what you feel is right for you x
  • Michelle

    Michelle

    31 August 2012 at 15:31 |
    Honestly, I can't stand the way health care professionals push their personal beliefs onto you, especially while pregnant because it is freaking STRESSFUL on its own.
    I wanted an epidural immediately, I had it decided already, and every nurse in the building scoffed at me about it. Then I chose not to breastfeed and again I was met with a look of utter disgust. Its YOUR body, your birth, your baby. Don't let them push you into anything you don't want to do ot that gives you doubts.
  • Bex @ The Mummy Adventure

    Bex @ The Mummy Adventure

    31 August 2012 at 16:00 |
    I have never had a C-Sec but thought I would comment anyway. Dylan was nearly 2 weeks early and 8lb 10 but I didn't find labour a bad experience and I wouldn't be scared about a natural labour with a bigger baby. They say they are easier to push as your body has something solid to push against. Also they should keep an eye on size and hopefully not let you go overdue if baby grows too fast again? I was lucky D came naturally early.
    Secondly I had to have contractions and heartbeat monitored throughout as I had excess water and they thought he was bigger than he was so I couldn't move but I still had a great expereince and my labour was 6.5 hours. I know every one is different.
    We found breastfeeding came naturally to us both after the birth and as you have been through it all with Mads I am sure you won't have problems whatever you decide. Ultimately though just make the decision you think is right for you as you are the one who has to go through it all

    xxx
  • Lucy at Dear Beautiful Boy

    Lucy at Dear Beautiful Boy

    31 August 2012 at 16:21 |
    I can't really speak on the merits of VBAC versus c-section, however what I will say is go with your gut. The chances are that you have already made your mind up about what you want to do, you just need to admit it and go with it. As you know I had a natural birth last time but ended up in the hospital rather than the midwife led unit. This time, as a second timer, they were very keen to push the midwife unit saying lots of things like, each birth is different and that are bodies are better at things the second time around. I am so useless at having a back bone sometimes that I let them show me around the new unit, I "oohed" and "ahhed" over the lovely birthing rooms with their pools (despite never ever having wanted a water birth) and told them that I would really consider it. I was crying before I even got to the car. I knew I had baggage from my previous labour, but the midwife led unit scared me and the idea of going to hospital again made me feel safe. I knew right then that I'd already made my mind up. That was at 16 weeks too!
    I think it's really natural to want things to go the same way, because it's familiar, but also because it gave you such a great result last time. So be ready to fight for what you want hun. It's your body and your decision. X
  • Kateq

    Kateq

    31 August 2012 at 17:22 |
    It sounds tough to decide, hopefully the consultant appointment will be able to answer some of your questions, it's never too early to start thinking about decisions as difficult as this! I can't offer any advice I'm afraid as I'm expecting my first, but I had my 16 week appointment yesterday so we we must have similar due dates. Looking forward to following your blog over the next few months as I'm clueless!
  • Helen

    Helen

    31 August 2012 at 19:27 |
    VBAC mama here!

    Ok, first off, I just want to say that I totally understand the 'stick with what you know' thing. Admittedly, I was absolutely determined to get my VBAC but there were many many times when I was so tempted to just ask for another section because the unknown scared me. Worries like yours: my body's never really done labour before (I only got to 4cm), what if she's huge, what if I end up with a traumatic labour, or a massive tear....

    I would always advise having a go. The way I see it, you can change your mind one way but not the other: if you decide during a VBAC that you don't want this and would rather have a section, that is easily arranged; if you decide during a c section you'd rather have tried naturally, well there's no going back.

    Your worries about being strapped to a bed etc were ones that I shared. If my labour hadn't been so speedy I would have birthed in water - they have waterproof, wireless monitors which allow you full access to the pool, I was monitored intermittently and, even when I *was* on the monitor, there was plenty of room for me to stand, sway, I could have wheeled the machine around had I chosen to. At no point, except my first monitoring when I had just arrived, was I lying down. I know 'monitoring' immediately brings to mind 'strapped in a bed' but it really was not my experience at all.

    At the end of the day, go with what you feel like, but if it is fear of the unknown that is holding you back then look into it. I say this to everyone who asks me but forewarned is forearmed - the more you know about what frightens you, the less frightening it becomes. Ok, there is a lot we can never know until it happens, but your body is built to birth babies - just because your daughter was 9lbs, does not mean that you would have been unable to birth her yourself. It is very rare that your body grows a baby that is too big for it to expel.

    As for breastfeeding - first time around I had an emergency c section. My milk took 4 days to come in and we breastfed for almost 14 months. I know milk can take a little longer than usual to arrive after a c section but there's nothing to say that you will have any trouble breastfeeding second time around.

    So much of what you wrote echoed my own worries about a VBAC but I really would read up on positive birth stories, get the facts straight and go in with an open mind. You say you haven't heard of anyone who has had a successful VBAC - I promise you, there are SO many stories out there (my own included). I had a drug-free, intervention-free, pain-free VBAC. I would have gone in the pool had my daughter hung around long enough and at no point was I restricted, I was wandering up and down the corridors and was left to my own devices until the second stage. Had my labour not been so quick, I would have been in the midwife-led unit, they were more than happy with that. My birth was more than just 'ok', it was the most incredible experience of my life. I hesitate to use the word 'empowering' because it's so damn cheesy but I can't think of a better way to describe it - I felt like superwoman and it is an experience that, even 14 months on, I look back on and still can't quite believe I had the strength to do.

    My birth story (Amy) is on my website, please feel free to read, although I warn you, it's a long one!

    Whatever you decide, make sure you are deciding it for the right reasons, and best of luck! x
  • FamilyFourFun

    FamilyFourFun

    31 August 2012 at 20:43 |
    I don't know if my tuppence worth will help or hinder and I'm so sorry you've got such a dilemma on your hands.
    I had 3 'natural' births but all with babies in distress, 2 epidurals, constant monitoring etc but they were still wonderful experiences that we were able to cherish and even laugh a little during.
    My 4th was an emergency C-Section and I would re-live all 3 of the others before I'd ever go through that again it was a living nightmare!

    I have had friends who've had positive VBAC experiences however if your elective was a positive experience that you were happy and comfortable with why put yourself through unnecessary stress.

    Make your decision that you fand your partner feel comfortable with and then ignore anything the various different medical people try to say. They'd really mess you up if you paid too much notice as they all have different advice/opinions. xx
  • helloitsgemma

    helloitsgemma

    31 August 2012 at 21:07 |
    My friend had a c-section due to lack of fluid. No labour. straight to theatre.
    She has just had her second VABC. At home, with her partner, best friend and partner's mother in attendance and two midwives.
    No pain relief took about 4 hours.
    It was a really positive experience for her and the baby.
    Every labour is unique, personally I think it's important you feel absolutely confident in whatever route because I think confidence really matters when going into labour/birth. Thats just my view.
    It's your choice, your body. Push for what suits you. It's early days. Why should you even make a decision, don't make a decision until your ready. You may meet other midwives/consultants etc along the journey of your pregnancy who offer a different view. It may become clearer to you as time goes on.
    Best wishes and good luck.
  • Two of Everything

    Two of Everything

    31 August 2012 at 21:36 |
    I can't really comment on a VBAC, but I can tell you about my experience of a natural birth which had a significant chance of ending up in theatre! I had my twins naturally at 34 weeks. Both twins were head down which was the perfect scenario, but you never know what twin 2 will do once twin 1 was out! I decided early on to have an epidural, so if I did end up needing a section I was ready for it. My labour was loooong (almost a week if you count it from when my waters went) so I was ready for that epidural when I got to 3cm. The birth was the calmest, most wonderful experience. I had no pain but could feel when to push. I was totally relaxed, despite being hooked up to the monitors the whole time and I really, really enjoyed it. My birth story is actually on my to-do list for next week!

    You must make the decision which is right for you - don't let ANYONE railroad you into a decision you aren't 100% happy with, it is entirely your choice.
  • Alpine Mummy

    Alpine Mummy

    01 September 2012 at 14:08 |
    Hello, firstly I agree with everyone above who has said that it's your choice and don't be bullied!

    I wanted to let you know that I am a VBAC success story - we do exist! After a difficult pregancy with my little boy everything went wrong during the birth and I had to have an emergency C-section. It was really awful and quite traumatic (I think even more so for my husband than for me in fact, as he had to watch it all go wrong in front of him).

    My main fear for a VBAC therefore was that I would go through hours and hours of labour again and just end up in the same position as before - having an emergency C-section.

    I was very surprised during my meeting with the VBAC midwife, as she genuinely seemed to want to give me the full story and let me make my own decision - I really didn't feel bullied at all (I had gone in there ready for a fight to get an elective C-section!).

    After weeks of deliberating, I reached a compromise - I would provisionally opt for a VBAC. If I went overdue then I would NOT be induced (I think that was the start of everything going wrong first time round) but would instead have an elective caesarian shortly after my due date. In other words, I would give my body a chance to do it itself, but after the deadline that was it, this baby was coming out! Is that an option that has been offered to you?

    In actual fact, I started gettig contractions the morning before my due date and my daughter arrived 12 hours later - she just popped out, it was so easy compared to the first time!

    I did have some bad second degree tearing, which hurt for two weeks. For those two weeks I was really grumpy that I had not had a section, given that I was in pain anyway. But then after two weeks I really appreciated the natural birth - I was totally back to normal (apart from lack of sleep!). There's no way I could have looked after a new baby and an energetic three year old if I also had a c-section wound to contend with...

    Everyone is different, and I think one of the reasons it was so easy for me second time round was because I got to 9cm first time. You wouldn't have that of course so speak to your VBAC midwife to see what she says about that.

    All I can say is: I was sceptical about having a VBAC in the first place; I was certainly regretting it mid-labour(!); and I slightly regretted it when I found out I had to have sticthes. HOWEVER looking back now I am so so glad I did it - both personally (to feel I got this baby out all by myself!) and physically (C-sections are major operations).

    Good luck, let us all know how it goes!
  • MelkshamMum

    MelkshamMum

    01 September 2012 at 23:11 |
    *waves* Hi, I had a successful VBAC and I sound similar to you. First baby was breech, although we didn't discover that until my waters had broken but I never went into labour and admittedly was gutted to have a c- sec as was not prepared at all for it. I had huge troubles feeding after and felt a complete failure. So, second time I was determined to have a VBAC. The main frustrations were not being able to sit in the bath in early stages of labour in case of probs!?! And it was a loooong labour ultimately ending up with epidural and ventouse. The irony was I ended up in the same theatre as having my c-sec in as they couldn't get my placenta out. Joy! I was chuffed that I had done the VBAC as the midwife in charge almost wanted me to c-sec and kept giving me targets to meet!? I recovered quickly and breast fed - hoorah! BUT it is ultimately how you feel about yourself, your body, your baby. I wish you all the best x x
  • jenny paulin

    jenny paulin

    02 September 2012 at 20:02 |
    i cant comment on a VBAC as I had 2 natural births and both were long labours (46 hours with B and about half that with J), although once I reached active labour both births didnt take that long. But it is an amazing experience and whatever the size of baby our bodies are designed to cope with pushing them out.

    Only you will know how you feel but as someone above mentioned, maybe try for a vaginal birth and see what happens. Afterall, you may end up surprising yourself and being a natural at it and wonder what you worried about. It is scary thinking about it whatever kind of birth you had last time but if baby isn't breeched this time (which you wont know for ages yet anyway) then I say go for it lovely and RELAX and not worry.

    Believe me having two post birth is more to worry about then the birth itself lol xxx
  • Catherine

    Catherine

    03 September 2012 at 21:26 |
    Hello, as everyone has said you really need to go with what you feel is right for you - don't feel pushed into something you aren't happy with.

    I had an emergency C-section with my little boy - I got stuck at 5 cm and in the end it turned out he was back to back and his hand was in the way (he liked to rest it on his head, which is okay most of the time but not in labour!).

    I felt sure with our second baby that I would want a C-section, I didn't want to try again and end up in the same position - but towards the end of my pregnancy I had a change of heart and opted for a VBAC - Addenbrookes offered a class with a midwife which was a great place to ask questions and meet other people in a similar position - the midwife also had her own c-section and VBAC personal experience with her children. This class really helped me relax about it all and see that everyone felt like me, we were all of mixed experiences, some ladies had c-sections for breech and some had emergency c-sections like me.

    I still had a few niggly worries that the same thing would happen, scar rupture etc - but I really wanted to give it a go - I didn't want to kick myself aftwards for not trying, as I knew I would. I did however make a note in my birthplan and made sure it was in my notes, that should I change my mind at any point that I could opt for a C-section - even during labour.

    It was the best decision I could have made for myself and after 8 hours of labour our daughter was born naturally. The midwifes were brilliant, and although I was monitored all the way through, I could move around the bed and sit/stand/rock as much as I wanted. I only had one midwife all the way through and it didn't feel any different to first time round. I cant explain how amazing it felt to actually do it - it was rocky some of the time in labour but all of it was worth it.

    All being send you really must go with what you want and feel comfortable with. If you don't feel ready to make the decision yet, then ask not to - you need to be 100% happy.

    I hope you don't drive yourself crazy thinking about it (I know I did at first!) and that you come to a decision you are happy with and receive the support you need from the hospital.

    Wishing you all the best xx
  • Richmond Mummy

    Richmond Mummy

    22 September 2012 at 19:02 |
    You and I are pondering the same decisions right now I know, try not to drive yourself crazy forcing a decision. Give it time and you'll know the right thing to do when it comes down to it xxx

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