How to request an ELCS after a traumatic birth/stillborn - can anyone advise?

[lucy101]

Hello everyone - I am just about to start reading through the support thread (so much interesting information) but just wanted to see if anyone had any specific experience of my situation, or advice on what to say to the consultant I am meeting next week to discuss it.

I lost a baby early this year very late in pregnancy and under very distressing circumstances so had to be induced with my baby stillborn (which is rather different from a normal induction - they go much harder with the drugs etc.).

I already had a problem with internal examinations due to childhood exams which traumatised me (I had already put in my birthplan that I wouldn't be able to consent to forceps and had problems with internals )

In the event, I had to have about 15 internals with different people over the course of my labour (which was 2 1/2 days) and was extremely upset by them, I found them almost more painful than the contractions as I guess my muscles spasm.

I am sure this meant that I didn't dilate until they finally gave me an epidural (after 2 days)... although there was a horrific 2 hour period in the middle of the night when they couldn't get an anaesthetist to administer it and I was in and out of conciousness because of the pain and my husband was very, very worried.

Although I felt I was very well taken care of in general and the nurse/midwives/doctors etc. were kind to me, I am still reeling from the horror of it all (and of course still grieving).

Happily I fell pregnant again very quickly and am now 18 weeks.. but at my first scan last week and midwife appointment I completely broke down as I don't think that I will be able to: give birth again vaginally without major anxiety, have forceps or too many exams, go overdue etc. (I am particularly worried about going overdue, being induced and it all going wrong).

I am less in fear of having the exams etc. as getting into such a major panic because of them (and my memories of the last baby and birth) while labouring that I won't dilate and will end up in some kind of terrible emergency scenario which puts the baby in danger.

I should add that I suffer from depression and have had some severe episodes in the past so I am also terrified that a bad birth for me will lead to PND and not being able to bond with the baby. My therapist and GP support me wanting to have an ELCS by the way.

This pregnancy was never going to be easy for me, I still cry every day about my lost baby, and I know I can't enjoy things like other pregnant women, and doubt if I will be able to until I have a baby safely in my arms.

Above all else, I absolutely know I wouldn't ever forgive myself if anything happens at birth to this baby after what happened to the last one ( I could go through a vaginal birth if I was having a stillborn as it would just be me who would have to deal with it, I wouldn't be worrying about a baby too).

My anxiety is rising and rising and I just want the consultant to agree that I can have an ELCS (preferably at 38/39 weeks?).

Can I ask if any of you know whether the hospital can insist I try a vaginal birth?

I was also going to try and write the above in a slightly clearer form (sorry it is so long) so that I can give it to the consultant if I get so upset again that I can't communicate it all. Do MN's think this is a good idea?

Any other advice would be gratefully received.... I just don't think I can go through the rest of this pregnancy getting more and more upset/depressed/anxious (which I know I can't completely avoid) without them agreeing to it.

You poor, poor thing. My heart goes out to you. Losing your baby like that (what was his/her name?) is absolutely dreadful and it's not surprising that you are so worried now. Anybody would be.

I'm attaching a link to a recent thread where the OP had similar fears to you, which might help:
www.mumsnet.com/Talk/childbirth/1007551-Make-my-decision-for-me-Please

I hope all goes well for you. Showing the consultant and midwife what you have written here is a good idea, and will help to keep you calm during the consultation. You have every right to the kind of birth you want, and I am sure that no medical professional who listens to your story could possibly deny you an ELCS.

I hope all goes well for you - try not to let your understandable fears get you down. Once you know that you can have an ELCS you will feel much better.

Hi Lucy. so sorry to hear about your loss. My first daughter, Laura, was also stillborn, in 2005 when I was almost 42 weeks. Like you I was induced and had a terrible birth with shoulder dystocia, a major post partum haemorrhage, and third degree tears. My second pregnancy miscarried at 10 weeks. With my third child I was terrified at the prospect of another natural delivery, though my consultant seemed keen for me to try. She did not push it however, when she realised how adamant I was that I could not face a vaginal birth and agreed I could have a section at 38 weeks. As it happened I had placenta praevia and got the section at 37 weeks exactly, more for my own mental state than any dire emergency. I am sure your consultant will understand your fear of giving birth naturally. Have you tried the Sands forum? There are many women on there in a similar position. Good luck

lucy101, I'm very sorry you had such a terrible experience.

While a consultant may want to suggest some different ways of dealing with your anxieties about birth (counselling etc), given you are already 18 weeks pregnant and have had such a traumatic experience, if you are adamant an elective CS is what you want, they won't refuse you.

It sounds like the important thing for you is to get what you want agreed now, so you can reduce your anxiety through the rest of your pregnancy.

In general consultants don't sign off CS's until late in pregnancy, so you will need to be active about getting it agreed earlier. I had an elective CS for my 1st, and had it confirmed at twenty-something weeks. It can be done, but I had a midwife and perinatal psychiatrist 'onside' and recommending I had a C-section at an early stage. If for some reason you get an unsympathetic MW who drags her feet and wants to 'leave it' (and I can't think why you would) then you could go back to your GP and get them to move things along - or contact a consultant yourself. The fact you have a history of depression should help, if that's not putting it too bluntly.

I think you write your thoughts and feelings down very well in your post, so putting them in writing and giving them to your GP/consultant is a good idea.

As an aside, C-sections aren't generally carried out before 39 weeks. I was booked in for mine at 39+1, but my waters broke 10 days early, and they simply performed the C-section as agreed the next day.

My C section was a very positive birth experience btw, and I was relieved and very happy to have it.

Good luck.

Hi Lucy, really sorry to hear about your loss.
I had a difficult delivery with my second child (shoulder dystocia and forceps.)
With my third child the consultant virtually offered me an ELCS on a plate. Although my son was fine the consultant realised that he may well not have been.
My daughter was born by ELCS 7 weeks ago.

My situation pales into insignificance when I read what you have been through. They cannot possibly deny you an ELCS. Stick to your guns and be firm. It may be an idea to take your DH or a friend with you who will argue your case.
Having said this it shouldn't come to this. It will depend on the consultant, but they should be offering a ELCS no problem.

Good luck. Hope it all goes well.

oh you poor sweetheart, they cant deny you an ELCS given all this. best of luck

If you don't get anywhere with the first consultant (unlikely though that is) then you are entitled to get a second opinion from a different consultant - if it comes to this then it's worth asking around (either on here or ask midwives) which consultant is most likely to listen to you and give you what you want)

I had to get a second opinion before I was booked in and I think it swung in my favour when I explained that the fear or giving birth again was taking over my life (not sleeping, taking no pleasure from being pregnant etc etc)

Prior to seeing the second consultant I made an appointment with the senior midwife who went through my previous birth ( i found this incrediably hard and my situation was a lot better than yours) she told me afterwards that it would count in my favour as they could see I was genuine, had tried to help myself and was well informed of the pro's and cons

good luck and let us know how you get on - there is a whole thread on childbirth of people requesting ELCS after traumatic 1st delivery which I found a great support

Hi everyone - I wanted to just thank you for all your kind replies (and for taking the time to read the mammoth post - I didn't realise it was so long until it was up...) and advice, I really needed that boost!

It does make me feel better that you are all saying that under the circumstances they should give me one. In a way to deal with it all and carry on I have had to think it wasn't that bad...

ttalloo the baby does have a name, and this week it was finally engraved on the wall of the church where we had her ashes scattered which was lovely if painful... I don't think I can write it here as if I write/say/read it I get very upset and I want to be able to come back to the post... hopefully as time goes by it will get a little easier... but what has shocked me is that being pregnant again has meant I entered a whole and new phase of grieving.

You are all very kind.

First, have a big hug from me. x

My sister was still born, and because of that my mum had both me and my brother via CS. They also let her choose to have it under GA because she didn't want to be awake in case there was a problem.

I will say (although obviously it is not my personal experience) that she has always been anxious about other people being pregnant, and hated being pregnant herself, because of her first delivery. And she never really got excited about DS arriving until he was here. She got very drunk a while ago and told me what happened with my sister, and did a lot of talking. She said that she hurts every day thinking that she isn't here, but that the pain has got more bearable through the years.

There is a lot of support, on here and in RL for people in your circumstances, and I can't see any consultant with a heart refusing to make a difficult time that bit easier for you. If for some reason they do, request to see a different one. Best of luck.

Hi Lucy

I am in the same position as you. Sorry for what you went through and really hope you have a straightforward birth and healthy child. I was induced in last preg and my daughter passed away after 1 day from infection. I am under high risk care this time and will categorically be telling my obstetrician that i will in no way be induced. I have been told that given my circumstances, they will be more sympathetic to an CS.

I too am struggling emotionally and am really looking to talk to meet up with mothers going through similar. Cant write much as am at work.

Where are you based? I am in C London.

x

Lucy,

Im so sorry for the loss of your daughter.

My daughter was stillborn, at 31+5 weeks, two months ago. I also had a 2 day labour and traumatic birth (crash team and almost crash section but thankfully a wonderful dr dragged him out) with my son a year before this.

I met up with my consultant to discuss my daughters post mortem results last week and he practically offered me a c-section for my next pregnancy.
I was told everything was up to me, i can choose how to give birth and when, from 37 weeks, depending on how well the baby is.

Have you had a meeting with a consultant to discuss your daughter as you should be being watched much much more this pregnancy.

Im not pregnant yet but feel i need to get my birth choices sorted now so i have time to get my head round them.

Please bug you hospital and get a meeting with a consultant asap. You need and deserve answers and soon.

Good luck with your pregnany xx

Thank you all for the responses, so helpful and I feel much more prepared for meeting the consultant. I am a bit slow in replying as I try to avoid getting too upset some days.

Am going to go over and start on the other threads now, so thanks for the pointers too.

Sh77 I am not in London but hope you find someone near you to talk to. Lets keep in touch (will look out for you on the other thread) and I hope you get an ELCS too if you request one.

Take care everyone, so many sad as well as happy stories here.