In the event that I should have a vbac, I was looking into a couple of ideas for my birth plan, which raised a couple of questions I thought some of you wonderful people may have some ideas on:

Which is preferable if necessary, and why? Ventouse or forceps?

and...

Would you have the jab to bring out the placenta more quickly after birth, or let it come out on its own?

Thanks for any ideas, in particular ones with good, clear explanations. I'm feeling a bit snowed under with questions at the mo.

Oh, and another:

Tear or cut if necessary to get babe out?

Stitches, or no stitches if not absolutely necessary?

Not sure what a vbac is but.. with my first, she was in distress and so i had to be cut. I was told it's much better to be cut than to tear. I had stitches inside and out, but i'd had an epidural so didn't feel them. They didn't take too long to heal, and didn't cause me any problems really, except for one knot which got a bit sore so i cut it off in the bath with a mirror :gag:
I'm pretty sure i've had the jab to release the placenta with all 5. Isn't it supposed to help make sure it comes away in one piece or something?

...............................

I had cut, ventouse and jab for placenta.

Not sure what a vbac is?

<snipped>
VBAC is a Vaginal Birth After Caesarian.

I had to have the jab for the placenta after badly hemoraging with my first two. I wouldnt want to be cut unless there was no other choice and luckily never needed stiches for any of them. I feared needing stitches and cutting more then the birth itself. The others I have no experience off.

VBAC is a Vaginal Birth After Caesarian.

aahhhhhh cheers for that PT. Never had a C section, so had never heard of vbac lol

I thought that there was a school of thought saying to tear is better as everything knits better and less scar tissue, therefore no big loss in sensation. Also that if you don't cut before baby is born there is more chance of keeping everything intact. But you may have that decision taken away from you if you or baby was distressed.

I know that having forceps is linked with having increased trauma to you and baby, and you're likely to end up having an episiotomy anyway. I understand that they choose ventouse first then forceps though, but you probably would be past caring by that point!

Hmmm. Totally brutal! I'll stick to looking after my cats for now!

I think i've got this right they tend to use a ventouse when mums are unable to push ie due to a epidural or maternal exhaustion but the baby is right down in the birth canal. They use the forceps when they need to guide the baby through the pelvis as they have got a little stuck or haven't turned properly.
I had a ventouse and episiotomy with my first and after developed a nasty infection i requested to be left to tear with my 2nd and it was much less painful and healed very nicely. I am pretty sure that for a forceps delivery you need an episiotomy due to the nature of it.
I had the injection the first time and it made me vom the 2nd i had planned not to have it but i started bleeding heavily and had to but have no recollection apart from the sheer relief.

Wow, loads of info there, thanks you lot.

I've been and done a little research of my own, too. It appears that ventouse is preferable to forceps due to less trauma to baby. It's a much gentler process, nor do you necessarily need an episiotomy like you do with forceps.

jab versus no jab for placenta - managed third stage - jab is looking likely as it's a load quicker and a bit less risky...though the chances of feelin ill are higher.

cut v tear: tears seem to heal better than cuts, but sutured tears seem to heal better than those left to heal on their own.

Keep bringing on the experiences and info, it's all hugely interesting and helpful

Next question:

Spinal versus epidural...anyone got any experience/preference?

Can't answer drug questions as I'm strange with anaesthetics. However they gave me a spinal when they stitched my tear and owing to my general weirdness it went upwards as well as down and I was too numb to hold my baby for a while :(

I have Ehlers-Danlos Syndrome so had a big risk of haemorrhage. So I opted for a managed 3rd stage, but haemorrhaged anyway. I was supposed to have an episiotomy too, but as I was delivering during the shift handover the new midwife didn't have a chance to read my consultant's instructions - I was quite pleased about this as I hadn't wanted an episiotomy at all. My tear was only 2nd degree and was stitched back together and healed without issue after all the speculation and worry.

I know I'm a special case so much of the decisions were taken out of my hands about this part of the delivery, and I have nothing to compare it to, but I hope my experience might help a bit.

I had entonox for both my deliveries, tore on both, stitches with the first, natural healing on the second. Was offered ventouse on baby two as he was back to front (and took ages) but persisted and managed a natural delivery though quite painful.

edit: and jab for third stage on both deliveries, (by that time I didn't care and just said get on with it)

I had spinal and found it no problem at all but it lasts a short time, if you HAVE to have intervention then I'd suggest it, all my research led me to that by choice and it was great.
But if you can avoid either, I'm told that's best, an active birth is shortest.

I had spinal and found it no problem at all but it lasts a short time, if you HAVE to have intervention then I'd suggest it, all my research led me to that by choice and it was great.
But if you can avoid either, I'm told that's best, an active birth is shortest.

oops! The spinal v epidural question was actually in relation to a section...I would prefer to avoid either otherwise as I found the Epi agonising last time and tried to leave, LOL.
Your suggestion of the spinal was why I even considered it. Smaller needle, shorter time to wear off...it seems the main issue is the limited time frame, if it wears off they will give you a general (shudder)

when i had my children i got a small tear with my first (well he was 8lb 4oz) but i refused the stitches as ui felt they were unnecessary. It healed well on its own. I was in labour 3 days with my 1st so i had an epidural it was fabulous no pain at all, however he is now nearly 6 and i still get muscle spasms and severe back pain from having it.

With All three of them i had the injection as 2nd time around i tried it naturally but its so difficult without the injection when all you want is your baby the injection lets you take your mind off the fact that theres still more to do

forgot to add i had a natural birth with all three of my children, with my last baby who is now 1 i was stood up all the way threw and i would recommend it to everyone! my first two were very bad experiences with awful staff takin care of me but with my 3rd i stayed home until i was ready to push i walked in the hospital and had the most amazing midwife who saved my daughters life. if i'd of got the midwives i had with first 2 i believe Kasey wouldn't be with me now.
I think gravity just helped me with getting her out as obviusly things fall in the direction gravity takes them, i found it much much easier and was in hospital labouring for 15mins

hi cosy...

I had an induction so had an epidural, however when I got took for my em section I could feel in places I should have felt. (suckers put my cathetar in wrong and I was in agony) I had a sky high temp so they then couldnt give me a spinal so I had to have a general. flip side is I was knocked out didnt have a clue what was going on, bad side is we both missed the birth and its something ill never get back

i would advised speaking with your consultant about your planned vbac, because imho I think its better to have an elective section as you have more choice rather than an em section. I had no choice or say at all in my em section, and if my planned section had gone ahead rather than the consultant deciding to send me home instead I would have got the birth I wanted rather than the car crash of my em section then an infection after 5 weeks then an 11 night stay in hospital......

:)

Oh, and another:

Tear or cut if necessary to get babe out?

Stitches, or no stitches if not absolutely necessary?

I have had both. With my first i was cut. I had to have a compleat reconstruction from inside to out. The stitches were the most painfull thing off all (even more than giving birth). Still after 6 weeks of havin my son i was in pain and couldnt sit down.
With my second i tore, i didnt feel a thing, after it was abit sore but nothing like the stitches.

I had an epidural with my first and it was great, took a lot longer to be able to get up and walk about though. I had spinal with my second (Em CS) and it was super quick to work and I was able to walk about within a few hours (not that the midwives liked this idea)

I was cut the first time round as dd1 was huge but I healed quickly and didn't have any problems at all.

One of the problems I have heard a lot about with ventouse is that it can rip the baby's scalp and it's painful for them, with forceps then can be bruised for a wee while but not as bad afaik
What I would say cosy is if you want a vbac and it's at all possible then go for it don't let the consultant do what is best for him rather than whats best for you a cosycub2.

oops! The spinal v epidural question was actually in relation to a section...I would prefer to avoid either otherwise as I found the Epi agonising last time and tried to leave, LOL.
Your suggestion of the spinal was why I even considered it. Smaller needle, shorter time to wear off...it seems the main issue is the limited time frame, if it wears off they will give you a general (shudder)
Ahhh yes indeed. Well, I would recommend it. It started wearing off when I was in recovery so I was quickly back control of my body.

I don't know about how quick an epidural wears off because 2 hours after the birth I was so fast asleep even baby's cries couldn't stir me and the orderly came in to feed him, though I think she had a soft spot for him so she didn't mind. When I did wake, first thing I did was knock all my tubes out and they had to run round Hallamshire looking for someone who could get another vein so they seemed to prefer me asleep. ;)

Though I do strongly think that your experience depends a lot on whether you get a good anaesthetist and I had two splendid ones, both women with cracking senses of humour. :thumbsup:

I should have mentioned as well, as a result of having a ventouse my babies head was so sore she wouldn't feed, we didn't work this out for a couple of days but the poor thing was in agony when i tried to position her to BF feed once we worked out it was fine i just had to lie down on my side to feed her but they were a horrendous first few days. I don't know if you get this with forceps but apparently its very commen with ventouse.

hey i no exactly how your feeling!!
i had my first in september 2003 she was born by ventouse after i had an epidural as i couldnt push properly, they obviously had to cut me so i had to have stitches but they wernt as bad as everyone made out just a bit sore when i had to go to the loo.
my second and third were born naturally no pain relief or anything, i did tear but their was no need for stitches .
i did have the jab to make the placenta come out quicker and easier it meant i could get out of the labour ward and onto the next ward much quicker.
all in all ive quite enjoyed all my birthing experiences and i am expecting my fourth in november i just hope this goes as well as the others i hope this helps.
xxxx

I was induced with my lo. I had an epidural and ended up with ventouse when he got distressed. I think they will always do ventouse if they can but if the baby isn't far enough down they will use forceps. I was told you won't always have to be cut with ventouse but you will with forceps. So for me I'd rather have ventouse if it means not being cut.

However, as it turns out I had to be cut. I also tore upwards. Both were stitched. The episiotomy healed well although it was very painful to sit down for about 3 weeks. But labial tear went wrong. The stiches fell out and they couldn't restitch as it was infected. It killed. I peed straight into it and it was 6cm long according to my records!! I would definitely go with stitches if they advise as the pain of it being open was awful, I begged them to stitch it again. It did heal ok on its own even though they said it probably wouldn't (said I'd proabably have to go back for correction!)

My little one didn't have many signs of having ventouse. His head was a bit bruised but I gather this happens with forceps. He didn't have cone head either although I gather this is normal if you have ventouse as everyone kept saying they couldn't believe he'd been ventouse.

I had an epidural. Took an age for them to do it, they had to do it twice as the first time they hit something - I felt it, not nice! It was a bliss for a short while, until I realised it wasn't working on one side. So I was in pain on one side and the other was ok.

I tore (they were supposed to be doing an episiotomy but they couldn't get someone or something to do it - have vague recollection of why they didn't do it) and had stitches, which were uncomfortable and every time I sat down I thought they had popped.

I had ventouse and was cut with my first because my baby's heartrate suddenly dropped because he had the cord wrapped round his neck which got tighter as he started to come out so he had to come out quick. I had stitches.
Second time she came out on her own and I pushed when told but tore really badly. Had a line of increasingly senior staff come and look at the damage to assess whether I needed to go into theatre but the consultant did it with a local in the end! They healed fine. To be honest though I just did what they thought best and I was happy with that.

I had a forceps delivery and was cut which they didnt tell me but I couldnt know anyway as I had an epidural. Baby's heart rate had dropped really low so it was either that or a section. I had internal stitches which was a bit uncomfy sitting down and going to the loo but honestly wasnt that bad, was sore for about a week

My biggest fear when pregnant was having to be cut or tearing...... I ended up with a spinal and an emergency c section.

The doctor examined me and said, well if that was painful then you will not cope with forceps. I felt like shoving my hand up his ......... and seeing how well he coped !

Spinal was ok but they had to try 3 times to locate it, 1st time I got pain in my left hip, 2nd time in my right hip. 3rd time lucky as they say.

Erm I guess its a case of personal preferance, but by my experience, I'd go with cut / stitches over tear / no stitches (grazing hurts far far worse!!) forceps over vontouse but thats cos the vontouse came off my daughter, I had the jab purely cos its quicker and got it out quicker, I just wanted to hold the baby without faffing about! I've had both a spinal and epidural, preffered the spinal but as someones said, it doesnt last as long, I was given it as a emergency measure as it was thought I needed a c section but managed with forceps.

I did a lot of research when I was pregnant with DS 1. Although it was 2003, I still think a lot of what I found is valid. Although not for a VBAC but first birth. I found that more women had problems with infections if they refused stitches, they healed a lot faster and generally recovered quicker if they were cut rather than allowed to tear.

Now, me PERSONALLY has a 3rd degree tear, ended up needing 45 stitches in 3 sets of 15 to stitch me back up from inside out BUT I did have to have a ventouse delivery due to survere fetal distress. From those stitches I ended up with a rather nasty infection but once on anti biotics it soon healed. One thing I will say, tea tree oil in the bath works wonders!

2nd and 3rd times I grazed but only slightly and that stings like hell :hihi:

I had the injection with all 3 of them, and had a conscious knowledge of this before hand and I would have it again as the benefits of having it are great.

I had pethadine and zantac (anti sickness) with all 3, but I wish I hadn't as it made all 3 rather sleepy and unwilling to cry. I also had entinox with Seb and by god thats good stuff! I think if I'd been given that first I probably wouldn't have asked for the pethadine. I did ask for an epidural at one point, which in all honesty I NEVER thought I would, the midwife just turned and giggled at me and said "Its too late for that love" And she was right :hihi:

I had a home birth after caesarean in May 06. I would highly recommend you read 'Birth after Caesarean' by Jenny Lesley, available from AIMS http://www.aims.org.uk/pubs3.htm.

If I had to choose between ventous and forceps then I would choose ventous because your less likely to need an episiotomy - I think?...But your less likely to need either if you can avoid having an epidural.

I would definitely choose to let the placenta be born naturally - the less interference with the birthing process the better as far as I'm concerned. There is also a good book about delivering the placenta also available from AIMS.

Not sure about the stitches because I've never needed any apart from when I had a caesarean and then they used staples.

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I had a natural 3rd stage with my lo, which made sense to me after what I had learned in my hypnobirthing classes and what I had read. I fed my baby, and the action of the baby sucking ( or any nipple action for that matter) works to contract the uterus naturally and expel the placenta. As I was happy feeding my baby, I didn't give any thought really to the placenta, my uterus just did its wonderful thing.

As a number of people have mentioned, intervention of any kind before or after the birth of your baby can often increase the risk of complications. If you do want an injection in the 3rd stage, it is worthwhile doing a bit of research first. AIMS is a great website with some fabulous and really helpful books identified.

I had my little boy 16 weeks ago and ended up being cut and having forceps. I hate to say it but the forceps were so painful, I still have flash backs of it, lol. I didnt have any pain relief tho as was fully dilated by time got to hosp, so they wouldnt even let me have gas and air. After pushing for over 2 hours and he wasnt budging they used the forceps. Had some LA when they cut me but still felt it, and everything else, but I was glad to just get him out. And he weighed 9lb 3oz which is big for me im not even 5". Ended up haemorroging after and lost over a litre of blood, which was scary. Harry was pretty bashed up from the forceps, his face was very swollen and he was veyr bruised, for a week or so, and ended up with Jaundice which can be linked to forceps. I was in quite a bit of pain from the stitches etc, and am just about getting back to normal now after 16 weeks.

Awww Katie, sorry to hear you haemorrhaged too. I can't remember how much I lost, probably about the same because they gave me a 1ltr transfusion the next day. Baby alien had jaundice too, but because he was a week early (induction), not because of forceps (but I did get a 2nd degree tear). Did you have a managed 3rd stage, as this can reduce the risk of haemorrhaging? I did and it did no good, but I pretty much knew that was on the cards because I have Ehlers-Danlos Syndrome which increases the risk.

The stitches bothered me less, but the persistant anaemia was a nightmare. It took ages to feel better from that, despite iron tablets for well over 6 months. I hope you continue to recover and feel completely normal again asap.

Harry was a week early so I guess that contributed to the Jaundice, plus due to the amount of blood loss my milk didnt come in until a week after I had him, which I believe contributed to the Jaundice. Yeah I had a managed 3rd stage, I was already on some kinda drip cos once I started pushing my contractions stopped so they hooked me upto that to start them again, I remember having the injection in my leg and dr pushing on my tummy to get placenta out, then when I haemorrged, I had another jab in the other leg, and then they put another drip up of the same stuff in other arm as was still bleeding, the dr was manually compressing my uterus and they were rushing to try and get Harry to feed to try and stop bleeding, they were just about to take me down to theatre when it stopped thank god. Its all a bit patchy tho, I only have vague recollection of things, and have been filled in on missing bits by my mum and husband. My mum is a midwife which prob made it worse, cos she said she could tell by there faces that they were starting to panic. The dr came to see me the next to try and explain what had happened and she said the reasons for it were, because I had been fully dialated for quite a while at home, my uterus had become exhausted so wasnt contracting effectively, also I had a large placenta so more area of blood loss, but she did say that if I have another there is an increased risk of it happening again which scares me.
What is Ehlers-Danlos syndrone?
I was given iron tablets which I had to stop taking as I had an allergic reaction to, when I went for my 6 week check they said my iron levels were fine, although I still feel pretty wiped out so not sure if that is related to blood loss.

What is Ehlers-Danlos syndrone?

It's a connective tissue disorder that affects joints and skin, very similar to hypermobility/double jointedness, but it means that skin and tissues etc are very fragile and tear easily. Because wound healing can be problematic there's an increased risk of haemorrhage. They didn't freak out too much with me - they thought the bleeding might have been because I tore badly and rushed me to theatre to sort that. Then they realised I hadn't torn that badly so it must be a haemorrhage, but I'd already fed Jamie (he was ravenous and I needed no help - he just knew what to do) and had injections so it was beginning to slow by that point. Because they stayed so calm my partner and I didn't freak out at first - my partner did after he called my folks casually mentioning I was in theatre and my Mum pretty much had kittens! But he said afterwards he was a bit worried when they took the bed away and there was blood all over the floor.

If I went through that again (likely, if I choose to have another) I'd most likely refuse the transfusion as it caused more problems than it was worth and didn't make me feel any better. I'd only have one if it was life-or-death, which this really wasn't.

I know when we first talked about it, I asked Dave (hubby) if he was worried and he said just slightly, he said they were just scooping what looked like pints and pints of blood from me into a big bucket, lol and they threw my mum out of the room, not quite sure why that was. Oh well these things happen and the plus was that he got to hold Harry for a good half an hour or so while I was being sorted, which gave him chance to have some time with him, which he poss wouldnt have got if it hadnt happened.

I tore and had stitches - 2nd degree tear which is through muscle apparently (ouch). I asked at my 6 week check up why they didn't give me an episiotomy (cut) and she said there are 2 schools of thought and that tearing isn't necessarily better than cutting and vice versa, can't remember the exact reasons why! My stitches took a while to stop hurting but I think by about 3 weeks they were pretty much healed. Also I didn't feel a thing when I gave birth, there's so much other pain and effort going on!

Crikey, this thread makes for scarey reading!

I had a natural birth from start to finish. I didn't even consider having the jab for the placenta, and even though it took me an hour to pass it, this was because I didn't realise you actually had to put effort in and push! As soon as I gave a good heave it was out, not at all painful. I would rather have had it that way than the possibility of feeling sick/sleepy from the injection.

I did tear but not too badly. The midwife said I could do without stitches but a few in would probably help it heal better, so I had them and everthing healed fine. I was very sore for a while afterwards but I don't know if it would have been any different if I hadn't had the stitches.

I think that it is worth remembering, particularly for those pregnant ladies who haven't yet experienced labour, that these stories are these ladies personal stories, and no one elses. If you plan a positive birth, and think positively about the birth you are more likely to have a positive outcome than if you seek out and listen to lost of negative stories about birth. The mind is so powerful and can influence our feelings, sensations and experiences in everyway. I know that all mothers out there have their own birth story and often like to tell people about it and that is their right, however as a pregnant women it is your right to choose what you listen to.

Some people may feel that they want to know all the ins and outs of what "could" go wrong. I would urge you to think about why this is. In my opinion it may be better to charge yourself and your birthing partner with the confidence to ask about risks and benefits of different things at the time, as well as seeking out where and in what environment you feel most comfortable. I believe knowledge is power, but sometimes I think that we can seek the wrong knowledge. Read up on how your body was made to birth, how your uterus works, the natural expulsion reflex etc. Great books out there include Dr Grantly Dick Read's Childbirth without fear, Ina May Gaskin's a guide to childbirth and HypnoBirthing - The Mongon Method (which I teach too, pm me for details)

I think that's some great advice there. I do find when I have shared my experience in the past it has been taken in a negative way. However, for me, doing my research on my condition and labour meant I knew what to expect and wasn't really phased by it. I actually really enjoyed giving birth, even though it was heavily monitored. I look forward to doing it again one day. It was a wonderful experience, purely because it was an experience. I felt very empowered throughout (aftercare wasn't great, but I know how to deal with that for the future - and most women will be allowed home a lot sooner than me).

I read up on hypnobirthing and used it to some extent, but next time around I intend to do a course and use it fully and go without gas (got halfway through without before). We've only just hit the "Wouldn't it be nice to have another, one day?" stage though, so I doubt it'll be for a while yet!

I've taken on board what I feel is useful and informative, and I've absorbed what I feel is helpful about others experiences, be they positive or negative. For some of it, I have shut my eyes, covered my ears and hummed aloud :hihi:
Hopefully others will do the same and not allow themselves to be scared silly. Now i am just hoping to have the kind of birth experience I want, while preparing myself to stay in control of whatever birth experience I end up with.

Thanks all for your input, keep it coming, and good luck to the others of you reading all this in anticipation :D

I agree that it's good to be positive but I was one of those people who wanted to hear all the worst things that could happen. Until I was about 16 weeks pregnant and people started telling me things I was so clueless. I had no idea there was such thing as an episiotomy or that people had stitches. I didn't know things like that you can blead like a period for weeks after.

Other people's birth stories were scary but at least I felt prepared. I didn't think things were going to go wrong (although I was induced at 42 weeks which I wasn't happy about) but I was prepared for whatever happened. I think it would have been worse for me if I hadn't thought about things which could go wrong as it would have ruined a rosy view of giving birth and I would have felt out of my depth.

For anyone reading this thread and now dreading giving birth I would just say that despite some of the bad experiences people have had it seems like we are all ok now and I bet everyone thinks their bundle/bundles (some people do it again !!!) of joy were worth it :)

with mine I tore with all three, 1st one coause it was 1st! 2nd and 3rd cause they had their hands up by their heads (the buggers!) no stiches and healed very well. Had all 3 at home no pain relief apart from tens machine, my best advice is stay off your back and let gravity help as much as possible, but if they induce take all the pain relief you can get!

Hello everyone! Emtink - you poor girl - my sister had the same thing, but will be relieved to hear you had a better time of it second time around. x i will pass it on to her

I just wanted to add to this thread that, particularly for those expecting their first, the prospect of labour is such a scarey thought. As I said, my sister had a bad time of it with her first - and that was just 6 weeks before I had my first baby so you can imagine how I felt! I spent a lot of time researching as a result to try and avoid the worst case scenario. What I found was:

1. Spend a lot of time in the last weeks on all fours NOT slouched back on the sofa to get baby into best position.

2. Try to stay as active as you can throughout pregnancy - and labour.

3. My research led me to believe that tears are generally preferable to cuts - my sis had a cut and then tore from there and was in surgery 3 hrs after

4. Try to stay drug free as long as poss - even paracetamol. If you can, try to let your body produce its own pain relief. Get your birth partner to focus on getting you to RELAX and breathe during contractions - its the wierdest thing but it really is less painful. Remember the contractions are natural and it's opening you up ready for baby to come down. Contractions don't last forever (1 minute each?)and you will get a break between each one to get a breather - walk to the car/hospital whatever. Staying drug free or as limited as poss will help you feel that baby coming down and your body will take over and gently stretch everything backwards and forwards reducing the likelihood of cut/tearing.

5. Stay active - rock through the contractions whatever it takes to get you through.

I really hope this helps - I was sooo scared I used to cry all the time and have panic attacks before the birth. I just wanted to give some positive input to help you feel calmer. My labour lasted max 6 hours - just got to Jessops at 9cm and had my daughter within an hour of being there in the water pool with some gas and air. Just a graze and 2 stitches. I often think back to the birth and how wonderful it was and how it has empowered me after being so so frightened.

Lots of love - sorry it's a long post.

Rach x

I agree with Rach although I would say that sometimes being too active can tire you out so do rest if you want. I had a lovely home water birth with my second child. I used lots of gas and air and different positions, including sitting on the toilet, to help me deal with contractions. During the pushing stage I used techniques that I read about in a book titled 'Birthing your baby the second stage' available from AIMS - www.aims.org.uk. I had a tiny little scratch and needed no stitches. I too felt empowered by this birth experience and would do it again tomorrow (if I really had to!).

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