Back in June 2011, just one week before Freddie was born, I wrote a post about the curious subject of “VBAC” – aka “Vaginal Birth After Caesarian. If you didn’t read it back then, you might like to quickly now before I go on, as things have taken an interesting turn this week:
Fatherhood²: “VBAC for good” and other strange things
So, for the uninitiated, the NHS generally recommend that mums who have previously had a Caesarian birth and are pregnant again should TRY to give birth naturally. Despite a lot of stories about the risks of ruptures, tears and muscle damage, the natural method is pushed VERY strongly by most doctors.
Well, studies released this week seem to have opened the debate once more, which I’m very pleased about. You can read the entire story on the BBC website here – “Planned repeat C-sections ‘safer’” – but here’s a quick summary of the story:
Australian researchers found the risk of stillbirth was lower in women who had a planned repeat C-section rather than trying for a natural labour.
Meanwhile, a UK study found the chance of womb rupture was reduced when mothers had an elective repeat section.
But risks are low for both natural birth and Caesareans, say experts.
[…]
The current UK guidelines state that women should be able to choose after discussing the issue with their doctor.
So it looks like the debate might not be quite as cut-and-dry as the natural birth champions would have you think.
I should probably point out for those who don’t follow this blog regularly, Freddie (baby number 2) WAS born “naturally”, and Sara didn’t seem to suffer any medical consequences – though we were quite annoyed that we were never really given the option to choose, and were steered very heavily towards the natural birth.
Apart from the outcome of the research itself, the coverage of the news lead me to another interesting fact – apparently UK “guidelines” state that women SHOULD be able to choose. This is very clearly not what happened to us, and from what I heard after I posted the original story, it wasn’t the experience of other parents either. Just like midwives will always encourage you to breastfeed if possible (another issue very close to our heart – if you’ll excuse the pun) it seems that doctors prefer natural births too.
To be fair to the other side of the argument, there are some clear reasons why doctors especially would prefer natural births – not least of all because it’s a lot less reliant on staff and surgeons than a natural birth, which can often be carried out by a team of midwives alone. But I’m not arguing that any mother should be given the choice, just that women who have previously given birth by c-section should at least be TOLD that it’s an option for them.
I’ll be following the research and it’s follow-up very closely over the next few years, but I’m always very interested to hear about the experience of other parents in the same situation – do let me know in the comments if that’s you!
The differences between UK and US medical practice is sooo shocking. After my first (C-sec baby), I got preggers again almost immediately and was not even remotely given the option of a VBAC. In fact, I was told if I started to feel labor-ish, to immediately report to L&D, just in case. To wit, my second was “due” on my first’s birthday, but because he was getting so big so quickly, they took him at the first opportunity and son #2 was born a week before son #1’s birthday.
However, not shocking is that regardless of whatever the medical trend/opinion of the day is, docs are largely unwilling to let go of their opinion of what is best, though that prevailing procedure may be out of vogue the next year.
When I was expecting my second, after having an emergency Caesarean with the first, I asked if I could try to have a natural delivery. I was told rather dubiously by the midwife that I could try, but that the chances of it being successful were 50-50. No one tried to talk me out of it, but I got the impression that they weren’t really expecting it to work out.
When I went into labour, I was practically forced to have an epidural, as the doctors said that if/when things went wrong, an epidural could be topped up easily so that a Caesarean could be performed quickly; otherwise I’d need to have a general anaesthetic and wouldn’t be conscious for the birth. I did end up having another emergency Caesarean, which certainly wasn’t what I had wanted, but at least I did get to choose initially. After that I was told that if I had any more babies, I would have to have a planned Caesarean.
As you know, that was in the same hospital as Robert and Freddie were born in, so I think the different approaches to VBACs must have a lot to do with the reasons for the first Caesarean – my babies were both just too big!