Jump to content

VBAC questions


  • Please log in to reply
13 replies to this topic

#1 Lucygoosey1

Posted 28 January 2013 - 08:54 AM

I had an emergency c-section for my DD2.  

After only an hour of labouring at home,  I went to hospital at 6cm dilated.  Another 2 hours and I hadn't progressed so I think they broke my waters and put me on a drip.  I think I then had an epidural and stalled at around 8cm.  My DD then was distressed so they did a c-section.  She was born only 7hours after I went into labour at home.  She was perfectly healthy at birth with apgars 8 or 9 straight away.
I asked my ob (not the one who was on call during my labour),  and he said the reason for my c-section is my cervix had started to swell and she was too large at 7lb14.

I actually birthed my DD1 vaginally after a 12 hr labour.  I was put on the drip and had an epi.  She was 6lb12.

I am now TTC #3 and a VBAC is very important to me.  I have been analysing the labour of DD2 and have come to my own conclusion that perhaps I should have waited longer at home,  allowed my body to 'warm up' naturally,  rather than being rushed onto the drip,  and perhaps avoided the epi so I could get into better positions for her?
My ob said I could most certainly have a VBAC but he is not confident I could birth an 8lb + baby (I am petite). I also asked him if it was the epi that stalled it and he didn't think so as I was already 8cm and in established labour.

Sorry for the essay,  but what advice could you offer me?  
I was happy with my ob,  but do worry that perhaps the ob on call rushed into a c-section?
Is it safe to labour at home for a while after a c-section?
What should I be asking my ob or insisting on at the hospital?
Should I consider going to a different hospital - this is North West Private in Brisbane?



#2 Melissam12

Posted 28 January 2013 - 09:00 AM

Consider a different care provider ... go with a midwife.  There are some great private midwifery practices in QLD.

#3 Soontobegran

Posted 28 January 2013 - 09:18 AM

OP, you have an Obstetrician you are happy with and he said you can attempt a VBAC then I would say go with that.
It seems he is on your side so I would continue to discuss this every visit you have that this is your intention.
You have successfully delivered vaginally which is something that bodes well for you, remember every pregnancy and labour is different from the other so it is hard to predict the outcome. Your swollen cervix may have been from the position of the baby's head and may not factor into your next labour.
Lots of good luck with your TTC. original.gif

#4 nicknick

Posted 28 January 2013 - 06:45 PM

Do you know I did the same thing with my DD's birth, I wanted to know exactly why I had to have a emergency c/s with my 1st that it almost drove me nuts - and yes you guessed it I never did find the answer why!!  rolleyes.gif Around 20 weeks I let the why's go and it was the best thing I could have done, I had a schedule elective c/s booked which I had agreed with Ob that if I hadn't gone into labour I would have but agreed with him that we would keep the plan open and see how the pregnancy progressed. I actually went into labour the week before and had my DD via Vbac.

As for large babies v's your size don't be too worried, both mine have been over 8lb and I am petite so it can be done. I think my biggest advice would be keep an open mind and make sure you have an Ob/midwife/hospital you are comfortable with -  at the end of the day a healthy mum & bub is the most important thing. Goodluck.

#5 tick

Posted 28 January 2013 - 07:07 PM

So you were 6cm after 3 hours of labour and that wasn't fast enough for them? I'd be at least exploring other options in terms of care providers after that! The big baby clause would worry me too. You won't find out how big the next baby is until after s/he is born afterall.

I have had a caesarean in similar circumstances to yours (much longer labour but same deal with drip at 6cm, epi and 'distress' at 8cm). DD2 was a VBAC, born at home with two private midwives in attendance. I had a backup plan for hospital if either midwife thought it necessary (or if I wanted drugs etc) but it all panned out fairly textbook at home. If I was planning a hospital VBAC I'd definitely bring a private midwife or experienced doula with me to keep it real, so to speak.

#6 fairymagic

Posted 28 January 2013 - 07:17 PM

Tick, it doesn't sound like lack of progress that lead to the C/S. It sounds like an edematous/swollen cervix which as STBG pointed out, could have been caused by the way the baby's head was positioned. It may be that this particular baby was too big too and this can cause a cervix to swell causing an obstructed labour. This will also cause fetal distress.

OP as STBG pointed out, you have an OB who is keen to support your VBAC so go with that. You stayed home last time and got to 6 cm - well done!! The fact that you were in established labour when you had the epidural inserted may not have made any difference to the outcome. Being a petite person, there is a possibility that the baby may have been too big for you - by attempting a VBAC you are giving it another go so that if it was a malpresentation of the baby's head, this time that may not happen.

Discuss this with your OB. Discuss what his plan of action is to help you achieve a successful VBAC. Discuss what he will do if you get to your due date with no signs of labour. Discuss with him how long he will recommend this pregnancy go being a VBAC. Some OBs don't like women going past their due date - others will have a day in mind ie  7 days/5 days etc. Get all the information now so you know what to expect and how this pregnancy will be managed by this particular OB. That way, if you are not happy with his proposed management, you can source another OB whose plan may be different.

Good luck.

#7 naturalgoodness

Posted 28 January 2013 - 07:18 PM

After DS1 and DD1 being natural birthing centre deliveries I was very shocked when DS2 ended up being an emergency c/s when apparently his head was not presenting in the correct position and causing inflammation.

Naturally (for the hospital), it was assumed when pregnant with DD2 that I would want a c/s. I advised early on that I wanted to have a VBAC. They threw everything at me - that I couldn't go over date, that I couldn't be induced, that I would have to have close monitoring etc etc etc. I smiled and nodded each time. All previous 3 births had been 40 + 10 so I had no expectation that I would get a VBAC.

When the time came, 1 day before due date, I laboured naturally at home for as long as I could, when I got to labour ward I was 9cm dialated, my waters broke on their own and within 30 minutes DD2 was born. It was not until they were updating my records later that staff realised I was a VBAC!

As for size, I was a large baby and I am plus sized (big boned too), all of my kids have been under 8 pounds. They cannot tell you the exact size of your baby until after birth!

This time I am taking it as it comes. I firmly believe that my body knows what to do, and given that 3 out of 4 births have been vaginally delivered I know that its possible for me to do it. However, I would never compromise my health or that of the baby to meet my own objectives. If a valid and reasonable explanation is given to me as to why a c/s would be required, I would certainly listen and consider.

I hope that you get what you want this time and you are able to have a successful VBAC original.gif



#8 tick

Posted 28 January 2013 - 07:33 PM

QUOTE (fairymagic @ 28/01/2013, 08:17 PM) <{POST_SNAPBACK}>
Tick, it doesn't sound like lack of progress that lead to the C/S. It sounds like an edematous/swollen cervix which as STBG pointed out, could have been caused by the way the baby's head was positioned. It may be that this particular baby was too big too and this can cause a cervix to swell causing an obstructed labour. This will also cause fetal distress.


No but lack of progress did lead to the drip, which probably lead to the epidural, both of which may have affected the progression to c-section..... And that's why I'd be interested in interviewing other care providers.  No harm in assessing all the options before proceeding!  Speaking of that, it can help to get a copy of your hospital records from the previous births and go over them with an independent midwife or similar, just to get another perspective.

#9 Soontobegran

Posted 28 January 2013 - 07:41 PM

QUOTE (tick @ 28/01/2013, 08:33 PM) <{POST_SNAPBACK}>
No but lack of progress did lead to the drip, which probably lead to the epidural, both of which may have affected the progression to c-section..... And that's why I'd be interested in interviewing other care providers.  No harm in assessing all the options before proceeding!  Speaking of that, it can help to get a copy of your hospital records from the previous births and go over them with an independent midwife or similar, just to get another perspective.



Why can't she discuss this with the trusted and supportive caregiver she has already unsure.gif  It doesn't sound like her Ob has any intention to keep her in the dark.

To be fair you are making quite some assumptions in your post unless you are privvy to more history than the OP has provided us with.

#10 tick

Posted 28 January 2013 - 07:45 PM

QUOTE (soontobegran @ 28/01/2013, 08:41 PM) <{POST_SNAPBACK}>
Why can't she discuss this with the trusted and supportive caregiver she has already unsure.gif  It doesn't sound like her Ob has any intention to keep her in the dark.


She already is discussing wither her trusted care provider!  What on earth is wrong with getting a second opinion though?!

#11 fairymagic

Posted 28 January 2013 - 07:47 PM

I agree it is worth going over things with your OB or an Independent Midwife.

I am often disappointed though when reading stories of births on here how quick people are in assuming that an OB (it is usually an OB) is condemned for making a decision re a birth which may not go the way a woman had wished it to, so the OB must have jumped in/intervened too quickly etc.

In this case, labour was established. The OP did very well staying home till she was 6 cm dilated. She came into hospital where Im assuming that she continued to labour with regular contractions. After a further two hours, there was no progress. (This could be an indication that for whatever reason the baby was not well applied to the cervix or in an optimal position on the cervix to assist with dilatation). Perhaps by then the contractions were becoming more irregular hence the decision was made to start a drip. This is not unusual practice. Two hours with no progress - this indicates inadequate contractions or perhaps an obstructed labour or something else is going on.

The drip was started and soon(?) afterwards, there was fetal distress. Again, this may be because the labour was obstructed ie baby too big or malpositioned. A " side effect" of an obstructed labour is an edematous or swollen cervix. A cervix that is swollen does not usually dilate to 10 cm therefore preventing the baby being born. At 8 cm instead of waiting to see if the swelling got worse, that baby was in distress. Some Drs when there is little progress over a period of time will start a hormone drip - this will often get the labour to "show" where it is headed (hope this makes sense). If the labour is obstructed or there is malpresentation of the head, fetal distress is not uncommon when the hormone drip is started. Hope this makes sense??

Regardless, not all labours go to plan and it is not always the Dr deciding to "pull the plug" on a labouring woman earlier than what they should that leads to a C/S. Contrary to "popular" belief, not all OBs intervene unnecessarily, not all OBs want their women to birth in daylight hours nor do all OBs intervene so that they can go to previously planned "events". I think its a shame that the trust a lot of women have in their OBs is questioned when a labour does not progress to plan.

Sorry to the OP. Slightly off track.  blush.gif

#12 Madnesscraves

Posted 28 January 2013 - 07:53 PM

OP, your OB know what he's doing. If you're not happy with the care he's giving, get a second opinion from another OB.

But STBG seems right in what she's saying. When my DD was born (for different reasons to yours) I spent a good year being angry I had a c/s. it wasn't until recently I realised my OB knew what she was doing. She even was willing to let me try induction before c/s but DD was too weak to do it.

Point being OP, I'd discuss this with a professional, not EB original.gif

#13 Mianta

Posted 28 January 2013 - 08:01 PM

I agree with everything fairy magic said, my midwife mind is imagining that this was probably a asynclitic OP baby, in other words a position that can indeed lead to an obstructed labour.

Unfortunately, once you go into hospital, you are "on the clock", particularly if you have had a vaginal birth before. Not to forget that prolonged first and second stage can come with their own risk factors, which is why they do need to intervene at times. We don't always just start synto or recommend epidurals for the fun of it.

OP, the fact is, this may a completely different labour, particularly if the baby is in an optimal position. There is every chance you can do it again. Your ob sounds supportive and it doesn't sound like your c section was performed to suit the ob's timre restrictions. I would start researching how to get the baby in a good position for birth. The spinning babies website is one I always recommend to  antenatal women with OP babies on board.

Best of luck with it all.

#14 Lucygoosey1

Posted 28 January 2013 - 08:36 PM

Thanks for all the detailed replies.  I don't blame the ob or hospital,  but of course you do wonder if you could have prevented the outcome,  and we'll never know!
I was happy with my ob,  so I will discuss all the above q's.  And look into better positioning etc for the next time around.  I will definitely 'shop' around if he doesn't provide suitable answers.
And I think I should be able to attempt a VBAC,  so we'll see how it goes!






1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users

 

Teaching our son to say no to violence against women

Today, on White Ribbon Day - and every other day - we're teaching our son to say no to violence against women.

Mothers told to breastfeed in 'spacious' toilet

If there is one thing the owners of Tillings Cafe can be certain of, it is that the eatery won't win the award for Britain's best baby-friendly coffee shop any time soon.

Mother gives name to son dumped down drain

A woman who admitted to dumping her newborn baby down a Sydney drain has reportedly been allowed to give him a name.

Taking small steps to reduce stress

Are you feeling used up by life's stress, family problems and a demanding job you can't turn off? Many people are way beyond work-life exhaustion. They are functioning as robots.

Bad news: we're running out of chocolate

The world's biggest chocolate-maker says we're running out of chocolate.

Born at 23 weeks, 'Chopstick Baby' survives first week

A baby who was born at 23 weeks has survived her first week of life outside the womb.

Manic stations: the nesting instinct in pregnancy

It might sound like temporary insanity, but almost obsessive nesting as you near your due date isn’t uncommon – even if you’re not usually a particularly clean person.

How a baby can survive alone for days on end

The baby found abandoned in a Sydney drain may have been alone for up to six days without being fed, leaving many asking how he could have survived.

When it begins to look a lot like Christmas

A child's excitement at Christmas time is a beautiful thing, but one dad ponders whether his toddler daughter is getting into the festive mood a bit too soon.

Hospital lets dads the experience some of the pain of childbirth

A new experience is radically altering men's views of childbirth.

Italian doctors questioned over formula bribes

Italian police have placed 12 doctors under house arrest on suspicion of promoting baby milk formula over breastfeeding.

Heartwarming prank gives single mum the house she was hired to clean

Cara Simmons arrived at work to clean a large and beautiful house in time for a party planned for that evening. It was soon hers.

Those special moments of sibling bonding

Every now and then your child does or says something that is truly memorable.

Why we should stop telling new parents to 'enjoy every moment'

A few weeks ago, some dear friends of mine had their first baby. As the proud dad texted me a picture I had to fight the natural instinct to say “Enjoy every moment!”

Baby monitor footage posted online

Footage of Australian babies and children sleeping in their bedrooms are among the images on a Russian site showing live feeds from thousands of homes and businesses around the world.

Did this new dad really hit on his wife's midwife?

Was there really a man who was actually there by his wife’s side as she laboured and gave birth to his child, all while he was making what he perceived to be meaningful eye contact with a midwife?

Keep calm and ignore the Tantrum Trolls

Tantrum Trolls are a small but growing species of predatory bottom-feeders who delight in picking on parents at their most vulnerable.

It's okay to never 'get over' the death of a loved one

The death of children, siblings, and parents has long term impacts on the rest of our lives.

What Mark Latham needs to know about depression and motherhood

Love has nothing to do with mental illness. But love may drive a mother to do something about it.

'We're just trying to keep our child alive': life with FPIES

We have a beautiful seven-month-old son, and his allergy rules our life.

Transgender dad breastfeeds his babies

A transgender man who breastfed his first baby - despite having his breasts removed as part of his transformation from female to male - has now had a second child.

Couple face $1 million medical bill and bankruptcy after babymoon birth

A Canadian couple were slammed with a million dollar medical bill after their daughter was prematurely during their babymoon.

Cigarettes, junk food dominate supermarket sales growth

One in every five dollars spent at supermarkets goes on cigarettes or junk food, according to industry data.

Teacher under fire for breastfeeding in class

There is no doubt mums have a right to continue breastfeeding after they have returned to work, but one teacher in the US has taken it to the extreme.

Win a family pass to Disney Live!

We have 4 family passes to give away to see Disney Live! presents Three Classic Fairy Tales, touring Australia this December/January.

Download now: Essential Kids Activity Finder app

Got bored kids? Quickly find the best activities for kids wherever you are in Australia with the Essential Kids app.

 
Advertisement
 
Advertisement
 
 
 

What's hot on EB

Join PADDINGTON on the red carpet!

To celebrate the release of PADDINGTON, we are giving five lucky winners the chance to win a family pass to the exclusive Australian Premiere in Sydney on December 7!

The tragedy of losing a favourite teddy bear

We were green and uninitiated, perhaps a little naïve when it came to the favourite toy responsibility.

Video: Baby sniffs beardless dad to make sure it's him

She looks him up and down and then touches his chin, but baby Lindsey still isn't sure this clean-shaven man is her dad.

It's possible to workout while pregnant

Medical experts say intense fitness routines can be done safely during pregnancy - if the mums-to-be follow some guidelines.

What parents really want for their kids

Are our hopes, dreams and expectations for our children what they really need?

'I had a feeling something was seriously wrong'

Before even giving birth, Katie Myers' maternal instincts warned her something was wrong with her baby.

When your pregnancy causes a relationship rift

Some dads-to-be don't miss a beat when their partner is pregnant; others struggle with a range of issues and can become withdrawn, right when their support is needed most.

Couple uses group photo trick to announce pregnancy to loved ones

Katharine and Kris Camilli devised a clever trick to immortalise their family and friends' reactions to their exciting pregnancy news.

Why Tracey Spicer has given up make-up

"After 30 years on television, I had become what I despised: a painted doll who spent an hour a day and close to $200 a week putting on a mask."

Knowing you are one of the lucky ones

I am secure, confident and strong, but the responsibility of protecting my children can almost bring me undone.

Why I am so emotional now I have kids?

There are so many ways in which parenthood changes us as women, but one of the most noticeable, for me, has been the changing state of my emotions.

Baby survives despite sharing womb with 'foreign body'

Baby Maia was conceived against the odds, only to find she was sharing a womb with an ominous "foreign body".

Video: Baby shows dog how to jump - or vice versa

They say dog is man's best friend, but this playful pooch seems to have chosen a jumping baby as her number one buddy.

10 ways to soothe a crying baby

New paernts can get frustrated when their newborn gets fussy and can't settle down. When you're feeling overwhelmed, try some of these simple tips to help soothe your baby.

20 baby names that are becoming more popular every year

The data-lovers at nameberry.com have been at it again – this time, they’ve discovered the names that are continually rising up the ranks, ready to take out some top spots in the next few years.

10 great meals to make for new parents

Ideally, you want to give food that isn’t expensive to make, isn't too difficult to create, and freezes well; stews, bakes, soups and pasta sauces are perfect.

Weird pregnancy products

Some pregnancy products come to market and are just awesome. Others just leave you scratching your head.

Carers admit to force-feeding children

Twin brothers have become dads on the same day ? with their partners giving birth in the same hospital, and even the same birthing pool.

 

How many weeks til Christmas?

On your To-Do list

Get the "Santa" shopping done without the kids in tow.

 
Advertisement
 
 
Essential Baby and Essential Kids is the place to find parenting information and parenting support relating to conception, pregnancy, birth, babies, toddlers, kids, maternity, family budgeting, family travel, nutrition and wellbeing, family entertainment, kids entertainment, tips for the family home, child-friendly recipes and parenting. Try our pregnancy due date calculator to determine your due date, or our ovulation calculator to predict ovulation and your fertile period. Our pregnancy week by week guide shows your baby's stages of development. Access our very active mum's discussion groups in the Essential Baby forums or the Essential Kids forums to talk to mums about conception, pregnancy, birth, babies, toddlers, kids and parenting lifestyle. Essential Baby also offers a baby names database of more than 22,000 baby names, popular baby names, boys' names, girls' names and baby names advice in our baby names forum. Essential Kids features a range of free printable worksheets for kids from preschool years through to primary school years. For the latest baby clothes, maternity clothes, maternity accessories, toddler products, kids toys and kids clothing, breastfeeding and other parenting resources, check out Essential Baby and Essential Kids.