I had my first midwife appointment today and she asked how I felt about this question, and I can’t say I haven’t thought about it a lot, but I am nowhere near reaching a decision!

VBAC (Vaginal Birth After Caesarean) or an Elective C-Section?

During my previous pregnancy I had high hopes of a natural delivery, hopefully including a water birth. Because of my SPD I felt this would be the best route as the water should help support my pelvis and limit at least some of the pain! I was quite open regarding pain relief and figured that as I had no idea how labour felt, or how I would react to that pain that the best approach was to see how it went and make decisions at the time.

Then, Monkey was Breech. After lots of attempts to turn him, ranging from being advised to ‘visualise the baby turning’ which hubby helped with by turning himself around in bed (lol, which was hilarious, and ridiculous, but sadly DIDN’T help!) to having a consultant attempt to forcibly turn him in the womb via an ECV. That was seriously painful and not an experience I’d care to repeat! It obviously comes with some risks too.

So as he refused point blank to turn around it was recommended that we have a C Section. I hate the word elective as it feels like somehow you are choosing that option, for no other reason than you want one. What they mean is ‘planned’ rather than ’emergency’ so I wish they’d just use the word planned! Anyway, digressing, I know it is possible to deliver a breech baby naturally however I did do a lot of research and found evidence to suggest that since C-Sections have become the more popular option in breech cases, that the skill level required to deliver a breech baby naturally isn’t found as commonly in hospitals anymore. While you may be lucky and have a midwife who has delivered breech babies, and knows exactly how best to do it, you may also have a midwife who has never delivered a breech baby before, as they are more commonly born via C-section. This means that the risks of a natural breech birth are now actually higher than the risks of having a C Section. (That is how I interpreted the research and advice I received at the time – I am not a midwife, doctor or scientist and it may not be correct, all I can do is say how we made our decision.)

So we opted for a C-section. Now, it turns out that I have a Bicornuate Uterus (sort of heart shaped rather than round) and Monkey had no chance in turning round, because he was stuck in one side and could not turn. The consultant advised that there is basically a 50/50 chance that any future pregnancy would also be breech, which would mean there isn’t much of a decision to make and we would go for a C-Section again without question.

But the question is, what would I do if the baby is not breech. Would I go down the road I know and have a C-Section regardless? Plan it in and eliminate all doubt? Or do I think back to my original hopes for my previous pregnancy and aim for a natural water birth?

Now, don’t get me wrong, I don’t relish the thought of going under the knife again. I would much rather not have the post surgery recovery time, the agony of life that is post C-Section, when you realise more than ever before how important your stomach muscles are and how debilitating it is when moving them causes you agony! I don’t want to be in hospital for days post birth again, being kept awake by all of the other babies on the ward, in addition to my own, struggling to care for baby in those hours overnight when hubby has to go home and I can barely move. That I am NOT looking forward to should I choose that route.

BUT, and it is a big but, the birth itself was calm and relatively stress free.We knew the day, I went to a wedding the day before, knowing the next day I would have my baby. We checked in and were second on the list so Monkey was born by 10am. there was no pain pre-birth, it all ran very smoothly and was just lovely and calm.

I am a planner so for me the unknown elements of giving birth have always terrified me somewhat. When will it happen? Will I go to hospital too early and be sent home? Will I leave it too late and not get there in time? How bad will the pain be? How will I cope? (I’ve watched one born and I know some women cope better with the pain than others – not criticising, we are all built differently and can’t compare, it’s just hard not knowing how it will be for me.) Will I need an epidural? What if something goes wrong? What if I need an assisted delivery? What if I need an emergency C-Section anyway and still have all the negatives of a C-Section, without the benefits of the calm build up?

Add to this the SPD, I know women with SPD give birth naturally all the time but there are added complications and there are fewer recommended positions, for example being on your knees is recommended far and away above lying on a bed with your legs in stirrups.

Am I just nervous? Is that why I am hesitating? Am I a coward for wanting to go down the ‘known’ route of a planned C-Section? Am I less of a woman if I never go through the experience of a natural birth? Am I missing out? But then should I take the option of a natural birth (which comes with it’s own risks as well after a C-Section, including tearing the uterus scar) purely to avoid these opinions? Should I be swayed by such negative thoughts?

I am not going to rush the decision as I am well and truly divided over which I would prefer. I may end up having very little choice anyway if this baby is breech too, so in some ways I don’t want to get my hopes up for a natural birth. I am being referred to the VBaC Clinic, where they will hopefully be able to give me some further advice and help me to make an informed decision.

have you had any experience of this decision? Which way did you go?