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    Default VBA3C anyone had one? Positive or negative welcome

    im just trying to do my research for when we finally/if at all, get pregnant again so I know my options, my OBGYN has said if all my stars align I can have a TOL BUT I have to have a straightforward pregnancy, minimal weight gain, go into labour spontaneously etc so if I hit 40 weeks and no bambino he has to do the section, but if I go through with a vbac I want to be fully informed, I've had 1 natural drug free forces delivery 13 years ago. My last section was 3 years ago, I'm not pregnant yet!

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    Hi! No experience with VBA3C, however I'm going for a VBAC hopefully in the next few weeks. If you haven't already, I encourage you to join the VBAC Australia support group on fb as there should be alot of people on there to provide stories.

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    There is a Facebook page and website called Birth Without Fear. They are always posting birth stories; lots of vbac, breech and not so straight forward births. I'm trying for a Vbac in a few weeks and I found reading lots of vbac birth stories really empowering. It's nice to read about other women who went through what I'm going through, have a positive outcome. Their website also has healthful links and they welcome people asking questions on their Facebook page.

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    If your OB will support you, then good on you! That will go a long way in your desire for a VBA3C. Can I just clarify though, you had a vaginal birth with forceps and then 3 subsequent Caesarean sections? What were the reasons for the caesareans?

    The fact you HAVE laboured before, and successfully had a vaginal birth will go a long way in your success. Things to be mindful of:

    - you WILL require continuous fetal monitoring on a CTG. You can ask for a wireless monitor if they have one to allow you to stay active.

    - you will need to be well established in labour before they will allow you an epidural (if you want one). This is mainly because they will be extremely unlikely to use the syntocinon drip on your scar.

    - if your waters break pre-labour, have a realistic timeline of when you'll pull the pin. ie, if labour doesn't start within 24hrs you'll consent to a caesarean.

    - where do you live and where will you deliver? I can't imagine any small private hospital would be willing to accept your care for a VBA3C. You will likely need referral to your closest tertiary hospital (preferably where your OB has visiting rights). This is so there is 24hr access to theatres/anaesthetists etc in the event of an emergency.

    - be realistic. A labour on any uterine scar carries risks. The more scars you have, the higher the risk. Please understand that their threshold for an emergency caesarean will be quite low. Any sign of trouble with your scar, and they'll pull the pin. It would be far safer to pull the pin and have an emergency Caesarean section than push on with a VBA3C and end up with a uterine rupture and an emergency hysterectomy!

    That's all I can think of at the moment. Good luck!

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    Quote Originally Posted by M'LadyEm View Post
    If your OB will support you, then good on you! That will go a long way in your desire for a VBA3C. Can I just clarify though, you had a vaginal birth with forceps and then 3 subsequent Caesarean sections? What were the reasons for the caesareans?

    The fact you HAVE laboured before, and successfully had a vaginal birth will go a long way in your success. Things to be mindful of:

    - you WILL require continuous fetal monitoring on a CTG. You can ask for a wireless monitor if they have one to allow you to stay active.

    - you will need to be well established in labour before they will allow you an epidural (if you want one). This is mainly because they will be extremely unlikely to use the syntocinon drip on your scar.

    - if your waters break pre-labour, have a realistic timeline of when you'll pull the pin. ie, if labour doesn't start within 24hrs you'll consent to a caesarean.

    - where do you live and where will you deliver? I can't imagine any small private hospital would be willing to accept your care for a VBA3C. You will likely need referral to your closest tertiary hospital (preferably where your OB has visiting rights). This is so there is 24hr access to theatres/anaesthetists etc in the event of an emergency.

    - be realistic. A labour on any uterine scar carries risks. The more scars you have, the higher the risk. Please understand that their threshold for an emergency caesarean will be quite low. Any sign of trouble with your scar, and they'll pull the pin. It would be far safer to pull the pin and have an emergency Caesarean section than push on with a VBA3C and end up with a uterine rupture and an emergency hysterectomy!

    That's all I can think of at the moment. Good luck!
    I live in warrnambool and will deliver at the warrnambool base hospital, I don't know if you would call him "supportive" or not, his words were "it's your body you can do as you please BUT "insert conditions here"
    So in a way he is but only if everything goes very smoothly.

    Reasons for C sections

    1st was baby #2 in 2004 at 36 weeks due to pre eclampsia and failed induction

    2nd elective because I was misinformed and didn't know much about vbac

    & 3rd was told he would be too big to even attempt it, I had GD he was born at 38 weeks weight 9lb 5oz

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    So first caesarean seems reasonable. Second one is quite unfortunate and third one seems reasonable give you'd had 2 previous and having a bigger baby.

    There will be conditions on attempting a VBA3C, I'm not going to lie. You'll be hard pressed to find a single obstetrician who will support you without having a plan in place. This is for your benefit also, so you know what the expectations are. That way you know if a) doesn't happen, then b) will happen etc.

    I'm 100% for women having a VBAC. A VBA2C is ok too in the right circumstances. A VBA3C is not common at all. No one knows how your scar will hold up in labour, and that's the risk you have to be prepared to take. I have cared for a woman attempting a VBA3C (had never laboured before though) and I believe her desire for a vaginal birth outweighed any common sense regarding her intended birth. There was a maternity care plan in place but she was disregarding the decisions she had made with her obstetricians making it a very difficult experience for all of us. In the end she had a Caesarean section, and it was quite lucky she did because the obstetrician said that her lower segment (where they make the incision) was paper thin, and had she actually laboured her uterus would have ruptured and she possibly would have lost her uterus.

    I'm not saying any of this to scare you, I'm basically saying make an informed decision on what happens. Make a plan with your doctor and stick to it. Your doctor not only has to worry about your health, but the health of your baby too.

    Do your research now, then when you do fall pregnant and decide to try for a VBA3C you can present your doctor with what you deem to be reasonable requests. Allow room for negotiation, but don't let yourself be bullied. I know many an obstetrician who wouldn't even discuss the option of a VBAC with their patients nor the associated risks of having multiple uterine scars.

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  9. #7
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    Join the Facebook page VBAC Australia support group
    There have been quite a few ladies who have had a vba3c even vba4c
    What some posters have written are not entirely true. YOU do not HAVE to do anything you don't want to. You have the right over your body and it is your right to do as you wish. There are many many risk associated with multiple sections and most do outweigh the small risk of rupture. You will need the right support but do your research decide what you will or will not consent to and make a plan. Good luck I've have a vbac and it was amazing.

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  11. #8
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    Quote Originally Posted by maco View Post
    Join the Facebook page VBAC Australia support group
    There have been quite a few ladies who have had a vba3c even vba4c
    What some posters have written are not entirely true. YOU do not HAVE to do anything you don't want to. You have the right over your body and it is your right to do as you wish. There are many many risk associated with multiple sections and most do outweigh the small risk of rupture. You will need the right support but do your research decide what you will or will not consent to and make a plan. Good luck I've have a vbac and it was amazing.
    Yes I agree with Maco, join the vbac Australia page, it's fantastic. I'm going for a vbac in a couple of months.

    Also someone posted above about continuous foetal monitoring etc being a requirement. It might be your hospital's policy but it's not law. No OB can make you do anything. Also they can't make you have a csection at 40 weeks, that's ridiculous. As long as you and baby are fine, you can wait as long as you like - provided you understand the risks. YOU make all the decisions, no one will 'let you'.

    Ask your OB for the risks associated with a 4th section compared to a vbac. Or do some research yourself. It might surprise you. Good luck!

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    Default VBA3C anyone had one? Positive or negative welcome

    Quote Originally Posted by Spotdog View Post
    Yes I agree with Maco, join the vbac Australia page, it's fantastic. I'm going for a vbac in a couple of months.

    Also someone posted above about continuous foetal monitoring etc being a requirement. It might be your hospital's policy but it's not law. No OB can make you do anything. Also they can't make you have a csection at 40 weeks, that's ridiculous. As long as you and baby are fine, you can wait as long as you like - provided you understand the risks. YOU make all the decisions, no one will 'let you'.

    Ask your OB for the risks associated with a 4th section compared to a vbac. Or do some research yourself. It might surprise you. Good luck!
    I totally get where you're coming from, but there are a few things I want to explain. No, fetal monitoring is not the law, but it will be a requirement in labour. If you decline continuous fetal monitoring it will be documented in your chart, and if something goes wrong that could have been picked up earlier, then you will have nothing to fall back on. A 15min Doppler check may miss a bradycardia where babies heart rate has been dangerously low for a prolonged period. Of course this can happen in a low risk pregnancy too, but a change in the fetal heart rate is often one of the first signs of a uterine rupture.

    Again, you're right that an obstetrician can't MAKE you do anything. But they will want to provide you with safe care. An obstetrician would be negligent if they didn't try to make the labour and delivery as safe as possible. If you want a VBA3C you need to make some concessions to your care. It is a high risk labour, nothing will change that. This is why I'm saying to research now so informed consent can be obtained by both parties.

    Also the OP never said that she would have to have a caesarean at 40 weeks. It was merely used as an example. There will need to be a cut off point - one that BOTH the op and her obstetrician agree on, and in light of having a sized baby at 38weeks, there's always the chance of another big baby. By all means, have a growth scan at 36 weeks and dependent on the estimated weight you can use this as a guide for decision making.

    It's easy to say that you make all the decisions, but after 3 caesareans the decisions need to be made in conjunction with your health care team. It won't be a successful VBA3C if either side makes independent decisions on how things will go.
    Last edited by M'LadyEm; 28-09-2015 at 12:24.

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    Can I please suggest the VBAC Birth After Caesarean facts - evidence based support page on Facebook to the OP. It is a largely American based group but plenty of Aussies are there and they have australian files for you to look over. I find this page to be of a great support to woman desiring a VBAC. These woman are about arming themselves with medical knowledge for the safest outcome.


 

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