Do you have a good idea what the worst case scenario is with a
vaginal birth? Is it likely that trouble will announce itself
in advance (i.e., if you are about to do damage, will you know
in time to switch to plan B, or do you only know after the
damage has been done)? If you can't know with relative
certainty that damage is about to happen, can you know that
if all indicators stay within certain limits that damage is
*unlikely*? What are the relevant indicators?

I think this is where the problem lies, worse case scenario would be
something along the lines of needing pelvic stabilisation surgically,
which because of lowish success rates, noone does for at least 2 years
after the birth, the thought of the pain is worse than the thought of
the disability this brings. I suppose I could injure the other hip, it
appears I have the same bone abnormality that side and obviously still
have the same connective tissue issues. So the worst is pretty bad - but
not life threatening, only quality of life threatening. I very much
doubt that the worst could happen with no warning, but somewhere well
onto the scale potentially could and we really have no idea what are the
chances of significant pelvic damage, simply by a normal birth and nor
does it appear that anyone else does either! 1% risk and I'd go for a
normal birth, 50% risk and I'd be planning a section. I suspect the risk
is down at the low end, but 10% would probably still be enough for me to
plan a section.

1) Prioritize a non-emergent c-section (in other words, ideally
decide before labor if you'll need a c-section). If this is
your priority, then you have the least chance of a homebirth
or a vaginal birth. On the other hand, you maximize the chance
that if you do have a c-section, you'll be able to plan it
how you want it, and planned c-sections are slightly less
risky than unplanned c-sections.

That is kind of what we are hoping to do, but it's tricky with
caregivers, we've talked to our midwives and they do seem to understand
where we are coming from and feel that we'd actually have a better
chance of a good c-section if we use the OB group the midwives work with
because of a good working relationship with them, so one thing that
is important to me is a short delay before cutting the cord - it's been
shown to be safe for c-section mums, with much better outcomes for
babies, but it's slow to filter through, the midwife feels I'd have a
better chance of getting something like that by planning to have a
normal birth and a lateish transfer to a particular doctor within the
group. To be honest I haven't actually gone and discussed it with an ob
whilst actually pregnant, but in many ways I don't really want to as I
have a huge fear of a vaginal birth in hospital and also the management
of the run up to that. My midwives have said that in a situation where
it became obvious in 2nd stage that injuries were a significant
possibility, it wouldn't be deemed an emergency, so there would be a
real chance of delivering vaginally before I was fitted in for a section
- which would then kind of defeat the object of switching to birthing in
hospital.

I think my hope is that pregnancy will make it clear to me how my body
is and I'm too early to be really getting those kind of clues. Good news
is, I'm feeling movement. Feeling movement later was an early sign of an
anterior placenta which then baby stayed facing. I felt the first
wiggles on Sunday at 16 weeks, so I'm fairly confident that the placenta
is not at the front.

Cheers
Anne