Hello all,

I’m just emerging after a brief break from the forum (was sick and then had guests).  Am almost 18 weeks pregnant now, which is very early days to be thinking about childbirth options, I realise, but it’s a bit more complicated for us because we had our first baby in France and are pretty sure we don’t want to have the second here.  It was a disastrous experience and DH and I are still traumatised by it.  France is about 50 years behind the UK and the US in its thinking about childbirth—doctors here still strongly recommend x-ray pelvimetry to decide beforehand if your pelvis will be “large enough” for a vaginal birth, and many midwives still think your shoe size determines whether you have a C-section or not.  I ended up having a C-section after a long labour, even though there was no emergency, DD was not in distress, and I was 8cm dilated.  Just before I was wheeled into the OT, I was told I’d be able to start pushing soon, then the shift changed and the new team simply refused to let us wait longer.  Etc. etc. etc., anyway, to cut a long story short, giving birth in the UK is a possibility for us this time because DH’s work is based in Cambridge, and his job is willing to rent a flat for us for a few months to have him on site.

Has anyone on this forum given birth in hospital in Cambridge or elsewhere in Cambridgeshire?  Also, I’d love to hear your thoughts on hiring an independent midwife vs. trying to work with the hospital midwives.  I have heard different things about the real chances of a VBAC with hospital midwives; my position (for now at least) is that I’d like to go into labour naturally and to *try* for a VBAC, but that if a C-section were really necessary, I would not be upset as long as we were treated like human beings and involved in the decision (barring a life-threatening emergency).  But some people say that in a hospital, because of the continuous monitoring, not being able to use a birthing pool, etc. due to having had a previous C-section, one is unlikely to have a successful VBAC.  The hospital at which I would probably give birth (unless I choose a home birth) is the Rosie Hospital, and they do have a birthing centre as well, but apparently I wouldn’t be allowed to use that because I had a C-section and am now “high-risk.”

If we did hire an independent midwife, we would then need to decide whether to do a full home birth or whether to labour with the independent midwife and then transfer to hospital for the actual birth.  Most of the independent midwives whose websites I’ve been looking at say that they can attend hospital births, not in a professional capacity but just to advocate for the mother.  I wonder, though, if there is any real point to this option?  Or would the independent midwife be completely powerless, and would I be at the mercy of the hospital system and its protocol anyway?

I know that the decision of where to give birth is a personal one and that nobody else can make that decision for us, but I’m curious to hear your opinions.  Do you think my best chances of having minimum intervention and a successful VBAC would be at home with an independent midwife?  Or should I at least meet with the midwives at the Rosie Hospital, see what they say, and try to get some idea of their philosophy?  It’s just that the doctor I had in France claimed to be fine with our birth plan when we talked about it, and then paid no attention whatsoever to it once I was in labour—so I am a bit wary of talking to hospital staff and then having faith that what they say is what they’ll do.  It’s going to be difficult for me to trust hospital staff again, but maybe that’s not justified in the UK?

hi I am 16 weeks pregnant and I am also in the same dilema as you as I will be hoping to have a vbac after have e-c-section with my twins , the most disheartening thing for me is that I just don’t seem to have many options !!!! would absolutly
love to have a home-birth but this out of the question apparantly and if all goes well i can try for a natural birth in hospital with constant monitoring ! my sister in law has an independant midwife and she is so happy with her care so its worth thinking about
and even if she does go to hospital with you it may be nice to have her there ! I cannot believe they made you have c-section like that absolutly terrible x really hope that you get the birth that is right for you good luck x

I had a home birth in Cambridge about 2 years ago and have a fair bit of information that might help. I can’t post a long post now, so will make time later today (I’ll PM you ) -  but firstly I would thoroughly recommend checking out http://www.birthfriendly.co.uk/ There was a lady on this course with me who had a VBAC after 2 c-Sections.

Be in touch later.

Charlotte

I was going to PM you this as I thought I might end up using names of NHS staff, but I’ve managed to keep them out, so have posted on your thread.

I originally planned a hospital birth at the Rosie, but after spending some time with Sarah Ockwell-Smith from Birth Friendly I began to see that it was going to be unlikely that the Hospital would support me to give birth naturally. As past of the Hypnobirthing course Sarah gave us some statistics about Cambridgeshire hospitals and the various figures for C sections, inductions, forceps and so forth. I was amazed at the figures. The Rosie had a massive % of C-Sections. I’ll see if I can dig out the actual stats, but generally it kind of worked that if a hosp had a low number of induced labours they made up for it in C-Secs, if they had high foreceps they generally had low inductions…blah blah. You get the picture. And overall natural births were under 50% in EVERY Cambridgeshire hospital. So we decided to go with a home birth supported by the local midwifery team. Oh how I wish we’d employed an independent midwife. Basically our birth was absolutely fine, the midwife arrived only 20 mins before he was born, which was a good thing.

The community midwife team didn’t seem to know much about what needed to happed after the birth though. I had a retained placenta (which I believe is a result of the midwife upsetting my ‘happy comfortable birthing mind’) and was finding it difficult to feed, I kept asking for advice but no one really seemed interested until 8 days later when he’d lost about 15% of his body weight. I wasn’t supported to BF, only encouraged to FF. I eventually got referred to the lactation consultant at addenbrokes because I was so insistent that I was going to BF, who confessed this was an all to familiar story and basically, ‘good luck with the BF’ she was very helpful, spending a good 3 hours with us, but said that she’d be unable to see me again as she didn’t have the resources.

To cut a VERY long story short I was not supported by the midwife team at all. They couldn’t understand why I was so keen to BF, ‘really, If you can’t BF, FF is fine!’ My MW said I was the only person she’d met that was as insistant as I was to BF. They just didn’t care. They didn’t even offer me the details of local BFing groups or LLL which I later found through Sarah Ockwell Smith.  Even after all of this I couldn’t do it, I gave up trying to BF at 4 months. When my DS was about 9 months old I found the strength to write a letter of complaint to PALS at Addenbrokes who supported me in my view that the midwives had very little training in BF and they were addressing the situation as a result of my letter. All community MW will be sent on extraBF training. Whether this was true or not I’ll never know.

The local view is that The Rosie is an excellent hospital for births which are high risk or complicated, their survival rate is amongst some of the highest in the world, however, for normal births they don’t have a very good rep. West Suffolk, (Bury St Eds, fairs better. )

Of course I am sure there are lots of people who have been very well supported by Cambridgeshire midwifes and The Rosie. I wasn’t one of them. I don’t want this to become a controversial post, just sharing my personal experiences.

I would thoroughly recommend going on Sarahs course, not necessarily just for the hypnobirthing, but the invaluable knowledge she has. Might even just be worth giving her a call and chatting with her about your options. I’m sure she’d be happy to. She is based in Saffron Walden which is a lovely little market town just south of Cambridge.

I have lots of local information on BF groups, lactation consultants (private and NHS), so if you find yourself over here with no local knowledge feel free to give me a shout. Your also more than welcome to pop in for a cuppa..

I wish you all the best in making your decision and if I can be of any more help, just let me know.

Charlotte

To answer your last question, yes, In my opinion I think your best chance is at home with an IM. Of course I’m no expert though.

I didn’t actually say that in my last post! Sorry.

Charlotte

Thanks so much for your responses, and to you especially, Charlotte, for your long and detailed post.  I would love to meet you for a cuppa when we’re in Cambridge (it probably won’t be until the summer, though)!

One of the factors complicating this decision is that an independent midwife would really be a huge expense for us; I think we might just barely be able to manage it, but we might have to borrow some money from DH’s family, so it’s not a decision to be taken lightly.

Of course the other thing is that I *am* considered high-risk after having had a C-section, so I don’t know what to think.  It’s very hard to evaluate the relative risks.  Is it safe for me to labour without continuous monitoring, since foetal distress is one of the first symptoms of uterine rupture?  But then I’ve been researching online and uterine rupture is actually a tiny risk after a C-section, statistically speaking, a smaller risk, in fact, that shoulder dystocia in mothers who haven’t had C-sections, and those mothers are allowed to give birth at home…

Has anyone on this had a home birth after a C-section?  I know that tons of people do, and when I was looking at independent midwives’ websites they specifically mentioned HBACs, but I’d love to hear about your personal experiences if you are willing to share…

Not my own experience, but a friend of mine had a c-section with her first baby.  Gave birth naturally in hospital with her second (c-section was mentioned as an emergency but not the planned delivery).  Her third child was born at home with an IM.  She lives in London and used the same hospital for the first two births.