Before we got pregnant with our second baby, I knew I was going to have to make a decision about the way I would give birth. Having had a previous traumatic birth with Alfie, I would have to make the decision of having a VBAC or C-Section (vaginal birth after cesarean for anyone who doesn’t know what that means!)
I was sent an appointment to meet with the midwife from the vbac clinic when I was 16 weeks pregnant. It seems that this was quite early compared to others I know who were having a similar appointment. I was quite pleased though because it is one decision that has been playing on my mind and when I walked in to the appointment, I had no idea what I wanted to do.
The midwife I met was lovely! I realised afterwards that she actual did my antenatal class when I was pregnant with Alfie and I loved her then because she was very pro natural birth and natural pain relief – completely on board with the kind of birth I wanted. First she asked me if I knew what I wanted to do and I told her I really wasn’t sure.
We started off by discussing the notes from my first pregnancy. She noted the size of the baby, and the complications I had during labour including pre-eclampsia, a prolonged labour and then a failure to progress. She then asked if I knew the reason I ended up with a c-section, to which I said no. She explained that it was due to Alfie’s positioning (she used a technical term but I can’t remember what it was!) Apparently he was back to back, which I did know, but his head was flexed backwards rather than tucked under so there was no way he was going to come out of my cervix. If he had managed to travel down further, he would have likely got stuck. Then we discussed his size. For those of you who don’t know, Alfie was born 10lb 3oz. No-one expected him to be that big! The midwife said that whilst she couldn’t say that it was due to his size that he was in the position he was, it’s highly likely that he was unable to move around because there wasn’t much space and he was in such an awkward position. She did however tell me that I dilated to 8cm which surprised me because I thought I only got to 6 or 7, and this was one thing that worried me – if I didn’t dilate properly the first time, I wouldn’t be able to dilate properly this time.
The midwife also confirmed that I did have pre-eclampsia. Throughout my labour I was never told if it had been confirmed and it was referred to as “suspected” pre-eclampsia because the protein in my urine was so high. I was told that my blood pressure didn’t shoot up, but the vbac midwife actually said this wasn’t true – whilst my BP didn’t seem high, it was high for me. I also told her how swollen I was throughout my pregnancy and now when I look back at photos I can really see the difference.
Once we had discussed my previous labour, we then got on to the pros and cons of a vaginal birth vs a caesarean. I won’t list them all here, but there are more cons with a c-section due to it being a major operation – so you have risk of blood loss, bowel and bladder problems, scar tissue problems, plus infection and a longer recovery afterwards. The biggest risk of a vbac is scar rupture – but this is less than 1% so a very minuscule risk. There is also higher risk of needing an emergency c-section due to being on a bit of a time pressure as to how long you can labour for. The pros of vbac are obviously much better – quicker recovery and less invasive. I was also given a sheet to take home with a list of the pros and cons.
We then discussed how I felt about what we had discussed. I said that I felt better knowing the reason why Alfie had had such difficulties coming out, but that also worried me if I was going to have another baby that the same thing would happen. I said I was worried about having another long labour, but was told that the midwives would have to keep a closer eye on the time and I wouldn’t be able to labour for too long as the risks were higher – but that worried me more thinking I was going to be under pressure to labour within a certain time frame. Another thing I was concerned about would be if I would be allowed the birth I wanted – a water birth, without being monitored and minimal intervention. I was told that as I was high risk, a water birth was usually out of the question as they would want to monitor me but that if I was sure that is what I wanted, then she would help me write a care plan and have my wishes put in place.
One big worry I have is that I’ll be strapped to the bed like last time. Knowing now that Alfie was in the wrong position, I think that this is probably why – I wasn’t able to get up and move very much and because I was on the ward and not in a private room, I didn’t really have much space to labour how I wanted to. The midwife told me that I can’t be induced, as this is likely to bring on labour too quickly, but they can break my waters if my contractions have started. I was really against induction again, so I’m relieve to hear it’s not something I’ll need to fight against. I was also told that I would be allowed to go 12 days overdue, which I was also concerned about not being able to do.
After the meeting, I was feeling really positive and that I’d really like to give a vbac a go. I was in a really good place, and felt like I would be able to the natural water birth I wanted so much.
Then I had a meeting with my consultant to discuss if I needed to take aspirin and I think unintentionally he put doubts in my mind about having a vbac. He seemed pleased that this was my choice, but then when he saw how big Alfie was, said that I’d definitely need some growth scans and may have to re-evaluate my decision depending on the size of the baby. He wasn’t forceful or dismissive of my plan for a vbac, but I was already starting to have doubts, and this has pushed even more doubts in to my head about what is the best option. I am not scared about giving birth to a big baby, but given the issues with Alfie’s labour were due to his size, it does worry me that the same thing will happen, and I’ll end up with another emergency c-section.
So, it looks like I’m back to square one. I was quite upset after my appointment with the consultant because I was so confused about what to do, but now I have my sensible head on and have decided that I need to wait a bit longer before making my decision. I have a Glucose Tolerance Test booked in for 28 weeks and I will also have my first growth scan at 28 weeks, followed by another at 32 and 36. I think by 36 weeks I will have a clearer idea of what I want to do. For now, I am going to try and not stress about making the decision. I may well book in a c-section for my due date, but if the baby decides to come naturally before then and everything and everyone is in the right position, then I will let it happen naturally. At the moment I just need to take a step back and stop pressuring myself into making a decision that doesn’t need to be made yet.
Has anyone else been in this situation? What did you decide was the best option for you – vbac or caesarean?
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