Guest guest Posted May 25, 2001 Report Share Posted May 25, 2001 I had an emergency c-section after 14 hours labour with my first baby. She was breech and labour wasn't progressing, so whilst classed as an emergency it was fairly leisurely under epidural. My second baby I had in hospital with minimal intervention. I refused continuous fetal monitoring, but did have a canula in my arm at all times " in case " (very inconvenient in the bath). I achieved a normal vaginal delivery with a little bit of gas and air. My third baby was born at home, with no problems and a positive attitude from my midwife. It was a wonderful way to do it, for me at least, I know it would not suit everyone. My fourth baby is due in less than two weeks and I am again planning a home delivery. Having experienced giving birth both by c-section and vaginally, I feel that a big factor is the recovery time. A c-section is a major operation and recovery does take time and cannot be rushed. Personally, I would do a lot to avoid another. But on the other hand, c-sections do have a place when used in " apporpriate circumstances " (whatever that means in each individual case). Good luck in achieving the birth that suits you. Love Feeling fat and ready to pop (but will probably feel the same in 3 weeks time) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2001 Report Share Posted May 25, 2001 i agree and try to use vaginally as musch as i can! Love http://groups.yahoo.com/group/the-soapy-group vbac > > > NCT info sheet in production below is a draft - will let you know when > you > can get the real one > > Belinda > > Vaginal birth after a caesarean (VBAC) > > This leaflet gives information for women who have had their last baby > by > caesarean section and who are pregnant again. Often women in this > situation > would like to have their next baby normally (i.e. a vaginal birth). > The > care of a woman in labour after a previous lower segment caesarean > should > be similar to that of any women in labour. > > A vaginal birth after a caesarean is usually shortened to VBAC - > pronounced > 'vee back'. Some midwives and doctors may also use the terms " trial of > labour " or " trial of scar " . > > Here are some of the questions which women frequently ask about VBAC. > > How safe is VBAC? > There is now quite a lot of good research on the safety of VBAC and it > is > very reassuring. > > The three common concerns women have about VBAC are > · am I more at risk > · is my baby's life more at risk > · am I more likely to lose my uterus > > The evidence shows that the risks of a mother dying (which are very > small > indeed) or losing her uterus are lower with a VBAC than with a repeat > caesarean section. VBAC is safer for the mother than repeat caesarean > because caesarean itself carries extra risks ie more chance of > infection, > injury from the operation, pain after the birth, problems getting > pregnant > again, feeling low and staying in hospital longer. There is also, > especially with repeat caesareans, a greater risk of needing a > hysterectomy > (removal of the uterus), Although very rare, the chances of the mother > dying from a repeat caesarean section are about 4 times higher than > with a > normal vaginal birth (2 per 10,000 as against 0.5 per 10,000). Women > also > suffer more serious illnesses after surgery than after a vaginal > birth. > > Providing your baby is well positioned and there is no particular > medical > reason not to have a vaginal birth VBAC is also as safe for your baby. > > The exception to this is if your previous caesarean was done through a > high, vertical cut in the uterus. If this is the case you will need > more > detailed information to make a decision > > I have had two (or more!) previous caesareans - is it still possible > for me > to go for a VBAC? > Yes, it is. The research on this is encouraging. The likelihood of > women > successfully having a vaginal delivery after more than one previous > caesarean section is about the same as that in women who have had only > one > previous section. > > Why are midwives and doctors worried about women having a vaginal > birth > after a caesarean? > When a woman has had a caesarean section her uterus has a scar on it. > 'The > concern is that the scar may not be as tough as the surrounding > muscle. The > stretching of the muscle during pregnancy or the strong contractions > of > labour could cause the scar to become thin or begin to separate. In > practice this happens in only 0.5-2.0% of women . This is known as > 'scar > dehiscence' and it doesn't usually cause any problem - providing there > is > no bleeding. Doctors' main concern is the extremely rare situation > (0.3% > of VBAC labours) where the scar opens causing bleeding and other > complications. This is called 'uterine rupture' and is a serious risk > to > both mother and baby. If a uterine rupture happens during labour, the > woman > needs to have a caesarean section very quickly. However careful > monitoring > of the baby's heartbeat and watching for significant bleeding or pain > that > lasts between contractions will give early warning of serious > problems. > > Will my midwife and doctor support me in having a VBAC? > They should, but it does vary in different parts of the country and > between > different consultants and midwives. If you want a vaginal birth this > time, > discuss it with those caring for you. Find out whether, in their > opinion, > the reason for having a caesarean section last time is likely to apply > to > you again this time - usually it doesn't. Women who have been thought > to > have a small pelvis have gone on to have a safe and straightforward > vaginal > birth, often with a baby larger than the caesarean-born baby! > > If your midwives and doctors are not supportive, and advise you to > have a > caesarean section without going into labour (an 'elective' section), > you > can do one of three things: > i) ask your midwife or GP to refer you to a different consultant > ii) go along with what your midwives and doctors advise, if you feel > this > is best for you > iii) stay with your current caregivers but decline their advice and > choose > a vaginal birth. They should support your right to make an informed > decision. If you find your carers reluctant to respect your > preferences, > you can get support from the NCT VBAC supporters (contact details > below). > > What are the chances of my having a vaginal delivery this time? > Most women who choose a VBAC do succeed in having a vaginal delivery. > The > rate varies a lot between different studies and different areas, but > everywhere more than half of the women who choose a VBAC go on to have > one, > and several studies record VBAC rates of over 90%. Having a VBAC also > seems to improve your chances of a another vaginal delivery for any > future > baby. > > There are a number of things you can do to maximise your chances of > having > a vaginal birth - these are exactly the same as for any woman giving > birth; > > > · Start labour naturally, avoiding prostaglandins (especially repeat > doses) > · Let the waters break on their own > · Choose to have the baby's heartbeat listened to with a stethoscope > or a > hand-held Sonicaid (a 'doppler') rather than being strapped to an > electronic fetal heart rate monitor > · Avoid having an oxytocin drip to 'speed up' labour > · As long as your labour is progressing don't be tied to strict time > limits > on how long the first or second stage of labour should be > · Keep moving around, changing position, being upright > > If you get one-to-one support from a midwife throughout your labour, > this > will also reduce the chance of your having a caesarean. Another > option is > to have a birth supporter who can also support your partner. This > could be > a female friend or relative who is relaxed about vaginal birth > > What happens during a VBAC labour'? > Although research evidence shows that the care of women in labour > after a > previous caesarean section should be basically the same as for any > woman in > labour, most hospitals do have policies about how such labours are > managed. > These vary from hospital to hospital. Ask for a copy. There may be > little evidence for some of the procedures they require. Do make your > own > views and preferences known and find out in advance how much > flexibility > there is. Keep in mind that you have the right to decide whether you > wish > to accept any treatments or interventions, regardless of hospital > policies. > You may like to make a birth plan to go in your notes, which should be > discussed with your consultant and midwife. > > Can I choose a home birth? > Yes home birth is an option.. If you are considering home birth you > might > like to talk to the NCT VBAC supporters or the NCT home birth > co-ordinator. If you are considering a home birth, discuss with your > midwife how she will monitor you to spot any problems before they > become > serious. Also consider how long it would take for you to be > transferred to > hospital in the event of a problem developing during labour. > Currently > recommended practice for women with a uterine scar is that they need > to be > in a setting where the baby can be delivered within 30 minutes if an > emergency arises. > > Further information > If you would like more information, a further book list or caesarean > birth/VBAC support, please contact one of the NCT volunteer > co-ordinators: > Debbie - tel: 01252 690627 or - tel: 01256 704871 (both after > 4.30pm > evenings and weekends). In addition, your local NCT branch may be able > to > put you in touch with a mother who has had a VBAC call the UK office > on > 0 for details > > The NCT specialist worker on home birth is Horn,: > angela@... One of the personal websites dedicated to > homebirth > is: www.homebirth.org.uk > > For the research evidence on VBAC read chapter 38 in: > Enkin M and others (eds.) (2000) Guide to Effective Care in Pregnancy > and > Childbirth, 3rd edition. Oxford: Oxford University Press. > > Further reading > Crawford K, Walters JC. (1996) Natural Childbirth After Cesarean - a > practical guide. Blackwell Science. (American, and as such 'natural' > tends > to mean 'vaginal', but good with much guidance on how to prepare > yourself > for a VBAC) > > Clement S. The Caesarean Experience (1995) 2nd edition. Pandora. > ( > Clement is a psychologist and deals well with feelings on having a > caesarean as well as other aspects). > > NCT Caesarean Birth - your questions answered £4.00 from NCT Maternity > Sales: HYPERLINK " http://www.nctms.co.uk " www.nctms.co.uk tel: > 0141 > 636 0600. > > UK VBAC organisation See > http://www.hants.gov.uk/cousin/cousinweb/vbac.html > > The National Childbirth Trust is a charity and we would be grateful if > you > would make a donation towards the cost of providing this information. > We > suggest £3.00. Thank you. > > Add NCT address enquiry and bf line number and fax no and charity no > and > purpose statement and all 3 websites > > > > *** NCT enquiry line - 0 *** > > Live chat http://www.yahoogroups.com/chat/nct-coffee > > Have you found out about all the other groups for the NCT online? > > Quote Link to comment Share on other sites More sharing options...
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