VBAC or HBAC

I’m so sorry that the consultant scared you like that, it’s really unfair of them to present the risk in such an unbalanced way. I would really encourage you to listen to some podcast episodes about it. Better Birth podcast has an episode about this, as does the hypnobirthing podcast, also the get ready to birth like a badass podcast. Listen to some positive VBAC and HBAC stories on YouTube or podcasts. You could also seek a second opinion and speak with another consultant who might be a bit more balanced. I would also recommend you look at the stats around VBAC and HBAC, as the consultant said themselves, the risk is still pretty low.

I was told I wouldn’t be allowed a home birth or go into the home from home with a previous c-section by the hospital I am with. So I never even had a chance to even think about it.

They support VBAC 100% but you have to be in the labour ward, where you can be closely monitored. If anything major happens in the hospital they will be there at hand to make sure both you and your baby are ok. If you’d like to attempt a VBAC in hospital they will support you.

If you do it at home your relying on an ambulance, which may not have the availability to get you urgently, traffic and distance all to be taken into consideration.

I think you do need to informed of the risks you will be putting both yourself and your baby under so in my opinion I don’t think she has done anything wrong.

If my baby is in any weird position I am 100% getting a c-section and if not I may attempt a VBAC in the labour ward.

Long story short is I would forget about a home birth and focus more on VBAC at the hospital or a planned c-section. As there would be a far higher survival rate if the worst was to happen, which is what I think she is talking about when she says catastrophic.

I think the way she presented the risks was unbalanced and presented in a way to scaremonger. It was coercive. Not the way a health care professional should present the information for a service user to consider their options.

The homebirth team from the same trust are very supportive of HBAC.

She stated that the outcome in hospital would be similar, baby death was mentioned over and over again during the conversation. Yet the risk is 0.2-0.5 % of rupture, and of those ruptures 6% of that figure catastrophic, so very likely to happen doesn’t fit those figures.

Transfer time is sub 5 minutes and the HB team have said there is the option to drive in so that doesn’t worry me.

The bottom line is I wouldn’t trust the hospital not to intervene unnecessarily in a VBAC, so it’s HBAC or c-section.

Depending on the risks associated with a 2nd c-section, once I have those I’ll balance them out and make a decision based on facts, not fear or one person’s opinion.

thanks will take a look at those podcasts.

I’ve spoken to my midwife who has referred me to a consultant who has a more balanced view so hopefully that’ll be a more positive conversation.

After 12 years of looking after women in labour, i can count on 1 hand the number of genuine uterine ruptures I've seen. It is sometimes suspected if there are concerns about the fetal heart tracing but not often found to be ruptured at section. It's much more common for labour not to progress and section be offered due to that. The vast majority of VBAC ladies we see are cared for only by the midwife in hospital but they are continuously monitored where I work. NICE recommends delivery in hospital but not necessarily continuous monitoring.
There are more and more women choosing to deliver at home but my advice would be to be flexible and listen to advice to transfer into hospital if things aren't going to plan.
Risk of scar rupture is present but it is about 1 in 250. Maybe this consultant has had a bad experience previously and is projecting that on to you. Which is understandable. Bad outcomes in the past can affect us as clinicians but it shouldn't affect the counselling about birth choices. X

It sounds the the home birth team are very good and they will be really experienced midwives. If you have a home birth you’re more likely to have a positive outcome as you’ll be much calmer and in your own environment. Don’t let one consultant scare you.

Hi, do you mind me asking what you decided in the end and how it went? Currently having the same dilemma!