VBAC or 2nd Caesarean......

[Kes]

Hi Anya,

Sorry to hear you've had such a bad time.

For what it's worth I found the elective I had second time to be very healing both emotionally and physically. It was so much better to walk into theatre and talk calmly about what was going on rather than being wheeled in exhausted and half delirious! Kings were great about allowing it to be my choice. I know people who've had great VBACS too, but for me the elective was the right decision.

K

[Tickle1978]

You poor, poor woman Anya - what an awful experience.

First baby was born by a scheduled c-section at 40wk due to being breech, at the time i was all for a natural birth, did Calm birthing course etc but the decision was really made for me. I found it to be a really good experience (although it was in Australia so may be different protocol here this time), caught a taxi to hospital for 7am and had my little boy at 9am, I recovered well, and had no issues.

Mainly due to this experience but also the fact and baby no 2 is due round Christmas, organising child care etc, I have requested an ELCS, however because these are usually done a week before due date it means I will be in hospital over Christmas, so currently opting to go to 40wks and if baby arrives before, then I will cross the VBAC bridge, but still waiting on my Obstetrician appoint so we'll see how it unfolds ...

Go with what you feel comfortable with and you feel is best for you xx

[alieh]

It sounds like you know what you want. If no one would ever find out what kind of birth you had would it make you feel even more strongly in favour of an ELCS? If so, then you should make the choice only for you. I've had 2 great VBAC experiences but that was very much what I wanted and the choice that made me feel least anxious in the run up to the birth. You can only go with your gut instinct.

Sorry you've had such a rough time and I hope this time brings you much calmness and newborn cuddles!

[ClareC]

Anya, sound like you have had a terrible time, so sorry to hear of your bad experiences.

Go with your gut feeling ..... And don't forget, you can change your mind if you want to.

I had ECS with number 1 and an ECS with number 2.

The ECS was an extremely positive experience in which I felt totally at ease and in control. Kings were fantastic and I had a really easy recovery.

Good luck with whatever you decide x

[ClareC]

Well that didn't make any sense ;)

First was Emergency (EC) second Elective (EC)!

[Belle]

I have to say I regret not having an elective second time around. I had hoped to lay some ghosts, get healing wtc, abc I know for many the second birth does that - but it didn't for me. I didn't even have a c section first time so my case to get an elective was up for debate, but I could have pushed for it. You have a cast iron reason for one, and as far as I know Kings support maternal choice on this? I believe NICE guidelines also back you up here.

However there are many who have a v different experience to this so as ever it's very personal and ultimately a case of going with your own instinct. Just thought I'd throw in my experience!

Trying to be balanced: I did appreciate not having the hospital stay/recovery. But I think I could have coped with those if I had planned for them.

[snowboarder]

I kind of had the worst of all worlds with my second after a c section with my first - I also really wanted a 'healing' vbac birth, instead I ended up with 4 days of labour and an emergency c section (not dramatic but classed as such) and a further week stuck in kings with the baby on iv antibiotics. Which was pretty crap, not healing and meant I was away from my 20 month old for nearly 2 weeks. I'd go for an elective for sure if I ever had a third (unlikely!), but it's hard the second time as you only have the one bad experience to base it on.

[AnyaJoeli]

Thanks everyone for your messages I've meant to post several times and left it unfinished! Yes I think my main fear is that instead of the rebirth by vbac experience even if I have a "natural" birth it might end up being as traumatic, and maybe I'm just not meant to be one of those earth mothers who birth in water swiftly with no complications.

The hospital stay with the c-section is one of my concerns, as we were in for 5 days first time round (plus the 3 days and nights of no sleep before I had him), and that was just awful with no sleep and ...just really stressful and awful. But I have friends who've had electives and only been in for one night afterwards so I hope that would be my experience.

I have a double layer of fretting about the recovery as I'm a Pilates teacher and so my career is in my abdominals, so to opt for major abdominal surgery seems slightly bonkers...because of complications with the surgery (an "extra incision" which is apparently not totally uncommon) I really really struggled with my recovery last time, it took months for me to feel strong enough to do any kind of light exercise and I suffered with scar pain for well over a year, and it was a big mountain to climb to get even close to pre-baby abdominal strength, in fact I don't think I finally managed it really. That for me would be the major bonus of a natural birth (not to sound unromantic), not having to start absolutely from scratch finding my strength and being able to practise and teach Pilates again.

But there are unknowns with both sides. My general lack of fath in my body (failing to give birth, three miscarriages) unfortunately might mean my mindset leads to a self-fulfilling prophesy against the "lovely" ideal natural birth. I so spoke to someone yesterday who's had two natural births, one at home, and she was evangelising about what an amazing experience they both are. All I have inside is fear and worry and angst, and when I hear stories like that a deep pervading feeling of envy and of it not applying to me.

Think it's my mental state that possibly needs addressing most!! Alieh it was a really interesting point about if no one knew my birth story what would I do. Because there are no guarantees with any birth, I think I need to go for the option that makes me feel most safe in terms of baby health and my being able to cope.

Argh.

Thanks again everyone for your thoughts and stories. I've been reading "the caesarean experience" which I would really recommend for anyone who's been through a traumatic emcs, it expresses lots of the things I've been feeling.

[Belle]

I completely relate to that feeling of envy. I still get it now! But I feel more philosophical about it now. Everyone's experiences are different, my labours were bloody awful (even the Brierly midwife said my second labour was extremely intense and she understood why I'd felt traumatised). I think it's absolutely fine to give natural birth a go and there's every chance it'll work out - but you have to go into it prepared for it not to, and think about how you'd feel about that? I think I pinned too much on my second birth, I did hypnobirthing, I spoke to people, I did it all - but what I couldn't do was change the birth, and my babies just get stuck for some reason! I think I could have coped with never knowing if I could have done it any easier second time round, but I have found it hard (not really so much now - more at the time) to deal with the way the second birth turned out. If that makes sense! I guess what I'm saying is, weigh up - will it torment you if you don't give it a go? Or will it bother you more if you do, and it doesn't go the way you wanted it to?

re tummy muscles, I have had two natural births and still ended up with diastasis recti which I'm still working to repair (slowly!), nearly 3 years after my last birth. I don't know much about this but is it possible that with an elective c section the risks of surgical complications are lower? (and presumably less time in hospital after?) Really are any of our tummies the same after two babies, I'm not sure!! I do get why that is an issue though, but the trouble is you can't guarantee a VBAC.

Good luck deciding, I really feel for you, and sympathise. You still have time, so be positive: you have options, which can only be a good thing.

[AnyaJoeli]

Being tormented is a good way of putting it. I hate the feeling of envy and despair when news of another fab home birth arrives. Wish I could feel total joy and happiness for someone else's good experience but at the moment I seem to twist everything round to my own experience.

I teach pregnancy Pilates and am all about calm empowering breathing and strength - it's an interesting position now to be in m class with a growing bump and possibly admitting to my first time mums that I might be elcs-ing, and not want to suggest to them that birth can be traumatic, ha ha (I don't discuss my birth experience with my preggy ladies! Would be horribly unfair of me)

Belle in terms of diastasis there is loads you can do, I can pm you f you like? For me it actually (luckily) wasn't a diastasis issue as Maurice was only 5lb 12 so my bump was tiny and abdominals probably didn't separate that much, it was more the "overhang" issue, I remember foolishly looking in the mirror once we got home and trying to draw in my tummy and nothing happening at all, the total lack of lower abdominal integrity really shocked me, having to rebuild the muscles and heal...really shocked by quite how weak I was for months and months and couldn't go back to teaching for weeks after I'd planned to (self employed maternity leave isn't very lucrative!). Having that that - I should stick up for the power of Pilates and say that if I had been dedicated in strengthening myself if may not have been such a long recovery, but my little one wasn't a newborn who slept all the time, he slept about a third of the time newborns are supposed to - little snippets of sleep for 15 minutes here and there when he wasn't crying, and I was simply exhausted and weary for the first year of his life so didn't prioritise my own recovery. Not all c-section mums have that so badly so again possibly with an elective it wouldn't be so bad. And hopefully I'll have a baby who isn't quite so fretful this time round. Hmmm.

With my extra incision (just a further cut into my uterus basically) I also have slightly greater chance of scar rupture (another reason I can't be induced this time). I feel like with attempting natural birth I would be fighting against statistics a bit. Whereas with an elective at least I'd know the territory somewhat.

Anyway. I'm just wibbling on now. It's good to know I'm not alone though, thanks again!

[Sonners]

Have you had a labour debrief? I had one at Kings a few months ago (when my daughter was 14 months so quite long after the event) and I found it really helpful, although not for the reasons I thought I would!

I had an EMCS first time round due to a placental abruption at 37 weeks and it was all very quick. In the waiting room at 1am and baby out by 4am and she was then whipped away whilst they spent another hour trying to work out if I was bleeding from a secondary site.

We're thinking about No. 2 so I wanted to know what happened first time round as there was very little explanation at the time, and I wanted to know whether it was something that was likely to happen again or specific to that pregnancy. I went in 100% sure that if I ever had another baby I would have an ELCS (but I didn't find recovery too bad first time) and I came out only 80% sure I might want an ELCS. I'm not even pregnant so all could change but I would highly, highly recommend asking for a labour debrief if you've not had one. I found it very therapeutic and I hadn't felt it was a difficult birth before I went in. Then again, I'd not really thought about it full stop as we soon had a baby who wouldn't feed to deal with instead which overshadowed it all!

Good luck and ignore anyone who tells you about their amazing birth experience. They are the lucky ones and will never understand the difficulties others face I don't think.

[AnyaJoeli]

I went through my maternity notes with a consulting midwife when I got pregnant the first time after Maurice two years ago, then again recently with a consultant at kings when discussing the elcs/vbac conundrum. Not a cathartic experience sadly, more about reliving the trauma and feeling desperately sad for Maurice that his birth story was such a horrendous one, coupled with shivery relief when realising quite how close we came to losing him. Also learnt a few details about the op such as them having cut further than a normal incision, which again made me quite angry that such important details were never communicated after the event, and caused me much physical pain for a year after the birth - a few fruitless visits to the gp complaining of inordinate scar pain were met with "it's probably just scar tissue", when the post op notes clearly state that the incision was greater than for a normal c-section, so even just that knowledge would've helped my recovery mentally I think, rather than simply feeling like I was physically weakened and my body was failing me.

If anything going through my maternity notes made me very angry with the way a few things were dealt with by various different "characters" in my story, which was compounded by the consultant saying quite off the cuff "oh well that's not our practice any more" about a couple of things. She also expressed surprise (negatively) about the fact that I was on the induction ward for two nights in labour instead of being in a room on my own at some point...and a few other small but important details which I may not have become anxious about reared their heads again in the reliving of it. Spent the whole appointment in tears.

So..I guess in some respects it was useful as a way of realising I never want to have an experience like that ever again.

Maybe a calm controlled elcs is the only way.