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23/05/2013 at 16:07
I have an ELCS booked for 39 weeks, however once it was booked I started waivering and so my friend (who is a midwife at the hospital) has arranged for me to meet with the senior VBAC midwife tomorrow to talk it through.
I don't feel as though I have missed out on giving birth as I laboured to 9cm last time, the key for me is that i do not want a general anaesthetic again. That is the bit of birth that I missed out on.
Initially the idea of a VBAC was just not something I wanted to consider, mainly because last time I found water such a relief that I couldn't imagine labouring without being able to use the pool. Funnily though in this pregnancy being in the bath just does nothing for me whereas last time I spent hours in the bath, so I am now more comfortable with not being in th pool. The other thing is that I am coming to terms with not being able to have an active labour and that having an early epidural might be a way forward, not least because that way I would know the epidural was working should an EMCS be required.
The issues for me now are really around logistics. H works in London, we live in York. He is self employed so if he isn't in work he wont' get paid so there is now way he can take time off to be at home "just in case" I go in to labour. So, if I go for a VBAC then I would just have to call him as soon as I think things were starting and hope that he got there in time. The reality therefore is that I may have to labour on my own. There is no one else I would feel comfortable having with me. Add in to this that the childcare for Zoe is my mum who is 2 hrs away and that throws in another issue, although I do have friends that she could go to until mum got here.
Having a section would negate all those issues but ... H can only have a week off work before going back down to London. So that means that a week after having a section I would be on my own with newborn and Zoe, in the school holidays, unable to drive. Not being able to drive would be a huge issue. It wasn't a problem when I had Zoe as I just got the bus in to town and mooched around the shops, or walked to local baby groups. That isn't feasible with Zoe though, she needs to be entertained herself and there isn't really anything walk / busable.
So which would you go for in those circumstances ?
23/05/2013 at 16:15
In your heart of hearts what do you want to do? Really deep down what is the way you want to go? If its elcs then you will be able to make plans for the time you can't drive could your mum move in for some of the time? Of you want to go for the vbac then could then how long would it take h to get back to you? Would friends rally round and pick z up etc and then you get to hospital?
23/05/2013 at 16:21
CP, I really don't have a gut feeling. I just want to be awake when this baby is born. That's is. I couldn't cope with my mum moving in for more than a couple of days, I find it far too stressful. Also, she looks after my elderly grandmother too so she can't really come for very long. There really is no way of knowing how long it would take H to get home, we have already decided that if anything happens and I do go in to labour he will just get a taxi straight back up from London but times will depend so much on the time of day. Sometimes I've driven that route in 3.5 hrs other times it has taken 6 hrs.
23/05/2013 at 16:32
How do you feel about labouring on your own?
23/05/2013 at 16:37
I think you need to ask yourself why you are now considering VBAC after previously deciding on ECS.
For most people its that they feel they missed out by not experiencing a vaginal birth but you say you don't feel you missed out. That was my main reason for considering VBAC but now I'm pretty much decided on ECS.
Only you can decide what is best for you, but if you're wanting people's opinions I would say in your circumstances I would go for ECS ( but maybe I'm biased because I'm choosing that option myself).
I don't see any reason why you would not be awake for it which sounds like your main concern.
Personally my main concern would be doing it alone as your H is a long way away. I can't imagine going through it by myself I think that must be so scary and also sad as its a special time to share.
As I say that's only my opinion and everyone has different reasons for choosing one way or the other.
I hope you manage to reach a decision x
23/05/2013 at 16:40
Well if it were me, and its not so feel free to ignore, I'd have the elcs, I had a semi emergency with Isaac as I went into labour, I was rough the first day but got home when he was 2 days old, I was tired but felt fine whereas with L who was a cat 1 crash section under ga it took months to feel better. I was driving after 3.5 weeks as my ins company asked if I felt I could safely do an emergency stop which I did.
23/05/2013 at 16:43
In your situation I would go for the ELCS, mainly as it seems from reading your posts on the subject that control of events is important to you. It isn't ideal to have your H going away a week after but at least if you know the date, you can make plans for that time without any unknown factors.
23/05/2013 at 16:45
I'm not too bothered about labouring on my own, last time I didn't want anyone around me and when we were at home (was having a homebirth but had to transfer in to hospital at 8cm due to lack of progression) I actually sent the midwives and H out of the room and just laboured on my own in the dark and quiet.
As for why I am now considering VBAC, well tbh since they booked my ELCS at 22 weeks i have been swaying. I'm scared of a section because although I had a section last time I didn't feel or see anything because I had a general anaesthetic, I am worried about recovery as well. But then with VBAC I'm worried about the logistics of me being in pain and trying to sort out getting everyone to the place they need to be, I can see that realistically the best option is that Zoe is going to have to come to the hospital with me and then be picked up by whoever can get there first. However after the birth, presuming all goes well, recovery should be so much easier. But then again if it goes wrong and i end up with an EMCS ....
Argh ... options, options.
Oh and then there is also the thing that this pregnancy has been really really tough and the thought of having an end date in 8 weeks time is much more appealing than having potentially 11 weeks to go.
23/05/2013 at 16:51
Do you know what my ideal would be, I'd like to go into labour naturally at around 38+6 (am booked for ELCS at 39+2) and then the decision is out of my hands. I have said that if I went in to labour naturally then I would continue along those lines. The consultant did suggest booking an ELCS for say 40+7 so giving myself time to go into labour naturally but then I figure if I'm going to have an ELCS I may as well have the advantage of knowing the date and not having to wait as long !
23/05/2013 at 16:56
Well you know i was in exactly the same position trying to decide between elcs and vbac and wanting to avoid another GA. Our babysitting was also 1.5 hrs away and H worked in London whilst we are in kent. From my own experience (attempted vbac ended up with emcs) i would say the following:
I worried and worried about H's parents getting to us in time to have G. As it turned out i called them once contractions were regular but quite far apart. They were to us by 9am and i didnt go in till 4.30pm so there was no stress in the end. I told H not to go in that morning as i had bern contracting overnight.
You can totally have an active labour. I was on continuous monitoring but the leads were so long i could be anywhere in the room and didnt get on the bed at all except to be examined.
When i got stuck at 6cm for 6 hours i asked for the epidural and it started to look like the vbac just wasnt going to plan. That way as you said i knew the epidural was in and whatever happened i would be awake. It was much calmer doing it that way rather than waiting till the very end and its all more rushed. There was no mucking about this time round. As soon as i asked for it i got it. No midwife trying to talk me out of it like last time.
The thing that made me decide against an elcs was that my consultant said if i got to hospital for the elcs and they couldnt get the epidural to work again there was no option to go home and wait for labour. It would be straight to GA - i would ask your hospital about this scenario. I expect they would say the same.
I had P 4 weeks ago today and am only driving short distances this week. I wont do motorway driving for another 2 weeks. Bear in mind some insurance companies say you have to wait at least 6 weeks or you arent insured.
So weighing it all up i have no regrets at all about my decision. I tried for a vbac, it was never going to happen (back to back baby and a bigger baby than first time) and i got closure over G's horrible birth experience. I had massive issues dealing with what happened so i got closure on that which i needed. Although i ended up with another emcs it was on my terms - H and i discussed our options when labour stalled (hormone drip or emcs) and made a calm informed decision. I got all of the things i asked for on my cs birth plan - imnediate skin to skin, fed her straight away, photos in theatre, H cut cord and it was a very positive experience.
23/05/2013 at 17:12
Actually that's a good point, I will ask tomorrow about if the epidural doesn't take. I don't see how they can go against your wishes though as you have to consent. I had said to H that if the epidural doesn't work I will NOT consent to a GA (obviously I would if it was necessary to get baby out but not for an ELCS) so will get that clarified. What I have found in all this is that when I speak to the consultant they say "you will not be allowed, this will happen, this will not happen" with regards to a VBAC whereas the midwives are more inclined to work with me.
23/05/2013 at 17:21
They couldnt physically force you to have a GA but i get the impression its cost related as the theatre team will be ready to go.
I felt that opting for a vbac gave me more options and more chance of being awake. Have you had an appointment with an anaesthetist so you know why it didnt work?
Just bear in mind at your midwife appointment that they will always favour a vbac as thats their job just in the same way a surgeon would favour an elcs....
If you have an elcs would you always wonder if you could have had a natural birth and have years of what ifs? I knew i would so had to give the vbac a go. But we are all different and you need to do what is best for you. I am also a believer of everything being ok in the end whatever hapens. I had doubts after opting for vbac but i have no regrets at all now even though it didnt go to plan and everything was fine.
Its such a tough decision and i totally feel your pain! X
23/05/2013 at 17:42
What would you do if there wasnt an issue with your H's work location and status? What would you choose if he worked nearby and wasbt self-employed? I'd go with that and work the rest out around it.
23/05/2013 at 18:28
In your situation would induction on set date be an option? Instead of going straight to ELCS? Your H would be able to be there, no question of him getting back in time, you could try for VBAC then go from there?
23/05/2013 at 18:49
Can you ask about what happens if the epidural doesn't take.
I had never even thought of that scenario I just assumed it would work! Surely they can't force you to then have a GA. I can understand the cost as they already have the theatre booked for you, but then its the same as forcing someone to try for a VBAC as it saves cost on surgery and they don't make people do that.
I would explain to your consultant you do not want a GA under any circumstances ( unless obviously its an emergency/ risk to you or baby etc). If it doesn't take can they try you on it another day? Or can you say if it doesn't take you will then leave it and try for a VBAC?
Those are the things I would ask. To be honest I might ask my consultant for myself as its got me worried! It worked fine last time but I assume every time is different.
Have it written in your birth plan too and make sure H is fully aware too so he can put his foot down for you if it came to it.
23/05/2013 at 18:58
It's a tough one.
Is your mum coming to stay with you from 39 weeks an option and having a section booked for, say, 40+7? Depending on your mum's circs of course.
How does your H feel about either option?
I also found the vbac mw so much more encouraging and open to ideas than the consultant.
23/05/2013 at 19:10
What would you do if you went into labour naturally before section date and your H was in London? Do you have a plan for Zoe in these circumstances?
23/05/2013 at 19:53
Nope, mum can't come and stay. We'd kill each other, but also she has a cat and my grandmother to look after at home. She could have Zoe at hers, and has offered, but I am worried about Zoe feeling pushed out by the new baby.
Rusty, yep we have a plan. Panic !!! No, in reality the plan is that he will get in a taxi and sod the cost. He has a regular taxi company that he uses and they have given him a quote for the journey and as he has an account he doesn't need to have the cash on him. If that is what happens then it will be a case of hoping my mum can get over asap and that a friend can look after Zoe until mum is there.
23/05/2013 at 20:16
Good plan. I'd say go for a VBAC then.
23/05/2013 at 20:33
Fingers crossed you find a decision you are happy with. What does your H say? How does he feel about potentially missing you labour etc? Or even give birth? Sounds like you had a real crap time, so lots of vibes for smooth easy labour from me.
My opinion FWIW is.... I know if I'm lucky enough to have a number two, ill have a ELCS so I guess I should favour that option but in your shoes I'd go for the vbac (with epiD) just because of the recovery time. The birth is just one day that you need to find childcare and help for, afterwards for those 6 weeks when you may struggle to drive is a whole other matter and its the recovery that absolutely would persuade me (though I know the school holidays coming up would perhaps reduce the burden).
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