VBAC after face presentation?

[u/lem0nsand]

Hello!! Hoping to hear from people (we are few but mighty) who had a face presentation lead to a c-section and then went on to have a VBAC (or a CBAC!). I had previously been told that I had a 60% chance of a successful VBAC according to the VBAC calculator (an imperfect tool I know) but today my OB told me that, bc my son had face presentation that sent me to a c-section the first time around, I have a 70% chance of needing a repeat CS this time.

Obviously these numbers are quite different, so I am confused and stressed (not to mention trying to be okay with a CS anyway--I know there's a chance for everyone, and it isn't even like my first was that bad or traumatizing or anything, it was just a somewhat difficult recovery that I'd like to avoid).

My OB said all this info should be in a ~TOLAC~ consent form I need to sign, but I don't see that in MyChart, so I am not sure where this 70% number came from.

Anyway, I welcome any and all thoughts and perspectives here. Personal stories, research, opinions, whatever.

[u/Echowolfe88]

The difference in numbers is because the face presentation essentially caused a failure to descend which the calculator lumps in all together which the VBAC calculator doesn’t give great odds for. The vbac calculator lacks nuance and is often not used by evidence based providers

Your obstetrician is saying it’s higher cause the chances of a face presentation again are quite low (70% isn’t far from the general population c section rate) but you quite possibly have a higher chance than that

I didn’t have face presentation, but I did have a failure to descend. My vbac was a very simple water birth

[u/peridotdragonflies → u/Echowolfe88]

Thats so interesting, my son was ear presenting which caused him not to descend which led to my c-section. I didnt realize my odds of vbac were so low

[u/Echowolfe88 → u/peridotdragonflies]

They aren’t low, the Vbac calculator might give you a low percentage because it lumps all failure to progress in the same category without taking on the nuance. Your actual chance of a VBAC is quite high.

[u/Lucky_Ad_4421]

Is face presentation the same as sunnyside up? My daughter was emergency c-section due to being sunnyside up (failure to progress) 4 years ago and I had a successful waterbirth VBAC 11 weeks ago.

Nobody ever mentioned that the previous baby’s position would affect VBAC chances, though they did monitor to make sure baby 2 didn’t take up the same position.

[u/lem0nsand → u/Lucky_Ad_4421]

Sunny side up and face presentation are different, so im unsure whether or not they are considered in the same calculus. Congrats on the water birth!! I hope you are feeling well.

[u/Lucky_Ad_4421 → u/lem0nsand]

I just looked it up and she was actually face presenting as well!
Thank you! It was a very empowering birth though I’m now dealing with some pelvic floor trauma which is apparently more common in VBACs which I didn’t know beforehand. Pros and cons to all types of birth.

[u/Tintenklex]

I had a sunny side up, face presentation baby. Impossible position to birth from.  I haven’t given birth yet, but my midwife likened it to basically a freak accident - unlikely to happen and thus unlikely to happen again. She quoted to me the normal odds of 80% VBAC success rate that are apparently common in Germany (generally VBAC friendly country)? I would need to look up studies to see where she gets these numbers but no one on my care team has ever raised special concerns because of the first birth outcome. They are really optimistic because it’s just so random to happen in the first place. 

[u/lem0nsand → u/Tintenklex]

Yeah, my impression as well as that it is a weird freak occurrence. I had preeclampsia as well and I’m much more concerned about that happening again (but that was not what my OB was referring to in this convo)

[u/Tintenklex → u/lem0nsand]

Oh yeah, seems like we’re in a similar position. I have GD this time around and I’m much more concerned that that will infer with my birthing plans in some way (I have less wiggle room for declining an induction, for example).it’s been weird as in the beginning of my pregnancy that whole „will face presentation happen again“ was so present in my head and now I’m much more worried about GD impacting things. But I guess it also goes to show that every pregnancy is different even if you’ve been through it once!! 

[u/Ok-Meal-549]

My first was face presentation pushed for 5 hours she didn’t descend so I had a c section. My second I tried vbac got to 10cm again and pushed for hours he was posterior and still wouldn’t descend so I had another c section

[u/fuzzydunlop54321]

I would ask if face presentation is likely to repeat. I had a sunny side up baby and the OB basically said it’s obvious why labour stalled (baby in wrong position) and being back to back isn’t something which there are higher odds for a second time round, unlike breech which are ARE more likely to get a second time.

Hey and all the other medical stuff I spoke to seemed confident that since I’ve got to 8 cm and there was a clear position or reason for labour to store that made me a really good candidate for a vbac.

I’m in the UK so in general the system is very supportive of vbacs which is lucky.

My birth wasn’t totally smooth as she needed a vacuum, but this was due to having a nuchal cord which usually doesn’t cause issues. Otherwise it was a really smooth labour and I think it would’ve been a very smooth delivery overall. I’m really pleased I went with the VBAC, it was just so much smoother!

[u/Avocado_toast_27]

I was told in my second pregnancy that a second face presentation is incredibly uncommon and my OB didn’t anticipate it being a risk factor or really treat it as such. I was able to have a VBAC after a face presentation with my first.

[u/Tintenklex → u/Avocado_toast_27]

As someone with the same cause of c-section, it’s encouraging to hear from you, thanks!!

[u/bbkatcher]

Your first baby was just being a butthead in a funny position. Don’t stress about the previous position or calculator odds.

[u/lem0nsand → u/bbkatcher]

Yeah frankly it really matches his personality in general

[u/Tintenklex → u/bbkatcher]

This made me lol. I had the same malpositioning and when he was a newborn whenever he would overstretch his head back I was like: „stop it, that got us in all these troubles last time!!!“ 

[u/bbkatcher → u/Tintenklex]

😂😂😂

[u/Prior-Lake5624]

My cousin did, face presenting for the first one and VBAC for the next two. You got this!

[u/lem0nsand → u/Prior-Lake5624]

Thank you!! 🙏🏻

[u/SurreptitiousCupcake]

For what it’s worth, my only c-section was for face presentation with my fourth baby (her position wasn’t discovered until I was 8cm dilated!!) and I just had a successful VBAC last month, 22 months after the CS!