VBACS Post Reply

[claphamama]

Hi, I wonder if somebody can help.
I had an emergency c-section with my first and I am now expecting my second baby. I saw the consultant at around 16 weeks and then the VBACS midwifes yesterday (23 weeks). Nobody can find the notes from previous birth (I gave birth at St Thomas in 2011 and that's where I plan to have baby number 2) so instead of having a look at previous notes they are just adamant a VB is the best option for me. I know I can have an elective section if I want to and I am not worried about that but I find really strange if not worrying that without knowing what went wrong first time around they can judge a VB is the best option for me? And is it really safe to advice for that without looking at my notes? Is it very common for the notes not to be found?
Thank you!

[annamike]

Hi! I had similar experience. First one with an emergency c-section after a long labour. I was advised to try VBAC for my second (after 2 years). Notes were there though (at C&W). That said, I had a chat with my gynecologist in my own country (where VBACs are very rarely reccomended) and he told me that I should have asked for further checks ahead of the delivery. First a scan at around 34 weeks to check how big the baby was and measure the thickness of the scar. Apparently there are some paramethers to look at in order to minimize risks of uterus rupture. I was very clear with midwife. I would not have tried for a VBAC without further checks. At the end everything was fine and VBAC was very smooth. However, I had second one at 37+4 and I would not have tried for a VBAC had he come later than 39w. Baby was already 3.2kg at birth and a VBAC at 3.7-8kg would have been far too dangerous.
Hope it helps

[AbbevilleMummy]

My first delivery notes were also lost which I found very frustrating when I found out and I was pregnant with my 2nd as I had a complicated first birth and they told me that 2nd time around I should do this and that.

However, my consultant with my second child didn't seem bothered by it at all, and even expected that my notes would never be seen again. I guess it must be quite common.

My consultant said that he was happy to go with my recollection of what went wrong and what I was told I should avoid should I get pregnant again.

That said, I was requesting an elective C-section so maybe he felt that prior VB history was not that relevant?

[London Midwives]

Hi ladies,

Please have a look at this link:

http://www.ican-online.org/vbac/home

Scroll down to the chart, it might help you to weigh up risks and benefits of elective surgery or vaginal delivery!

I find it quite alarming that they can't retrieve the notes btw, it is important to know if there was a maternal or fetal dysfunction and whether that could have been prevented to plan towards surgery or not...

[2009Kat]

Yep, they lost mine too. Oh and forgot to make an appointment for me to see the consultant (I had no idea I was supposed to) until 38 weeks.... And lost some test results. I went for the VBAC. Anyway I ended up with EMCS no.2. Lucky me. But second time round it was all easier.

[pigeonpairmum]

The fact the hospital lost your notes is terrible. The fact that the consultant does not appear to be bothered would give me great concern if I were under his care. Having my 2nd child by elective c section (after an emergency c section 1st time round, both at st georges) was definitely right for me and I made that choice clear to them early. It annoys me that so many medics /midwives seem to be so pushy about trying VBAC. It is not as if it saves much money as I understand it (the emergency c section of course does cost a lot more) (don't say moeny doesn't come into it!) and weighing up the risks of planned c section vs VBAC it appears to me far less clear cut than the medical profession would have you think. Yes it is surgery, but it is controlled and planned. Vaginal birth has risks too, which increase dramatically as time in labour without the birth goes on. If a woman has had a dreadful / dangerous previous experience in labour, then she should be supported if she wants an elective - she knows her own body better than anyone else.

[London Midwives]

pigeonpairmum, I 100% agree with you. I genuinely think that people have to make their informed choices as this will make them happy, also retrospectively. Who is happy in the end with another emergency section because they were talked into VBAC? In the end you must be happy and content with your decisions, please don't try to make any obstetric practitioners happy!

[claphamama]

Thanks for all your replies! My problem is that I don't feel my decision will be very informed..I understand there are statistics but there are also individual cases and history. The fact that I am told point blank that VB is the best choice FOR ME without looking at my files/why I had a CS with my first doesn't reassume me at all and makes me lead towards a CS. It's interesting to know that it seems to be a common practise to not being able to find previous notes...but definitely not very reassuring!!

[London Midwives]

It is stated that maternity notes have to be stored for 20-30 years after the birth of the last child by the care provider ( Dep of Health ). This duty applies to all care providers therefore also obviously NHS. I would stay persistent regarding your notes, also challenge the suggestions of mw/docs and ask them for the foundation of their opinion.
If that happened to one of my clients I would get in touch with the supervisor of midwives, this is something that you can do as well, you should find their number on the hospital website.