Help with case for cs

[BusyBee86]

Hi all, I have an appointment with a consultant in Monday to see if I can have a cs.

When I have birth to my son 2 years ago (natural delivery) I lost a lot of blood and had to have 2 blood transfusions I really do not want that to happen again. The thing is I don't actually know exactly why that happened. Midwife said maybe it was because I had a very long labour (56hrs) and my uterus could have been tired and not contracting properly after.
Also I had an epidural and had a 2nd degree tear. I nearly had to have forceps but managed to get him out in the next push. I really hate the idea or having forceps delivery(which I know you have a higher chance if have an epidural) as I do not want to be any more damaged down there than I already am. I had to stay in hospital for 3 nights and I took months to recover down below. And I still feel sore where I tore.

My friend who had a cs the day after I gave birth left hospital a day earlier than me and she seemed to recover a lot fast than me.

I'm not sure what my chances are of having a cs this time but have my appointment Monday and would really appreciate some help and advice in what to say to the consultant.

Thank you in advance

[BusyBee86]

Anyone?

[facemask]

Just tell him your concerns. I had a nightmare 1st delivery & dd ended up in special care because if it. All was ok, but told consultant my fears when preg with dd2 & he wrote on my notes that I was for cs if it looked like another difficult labour. As it happened that delivery was v quick & straight forward. Im due again next week & consultant this time hasn't been so sympathetic esp as this looks like a big baby. Ive told dh if its not quick ill be looking for a cs.
Sorry its been abit waffly, hope you get what you want!

[Sioda]

They might fob you off about the post partum haemorrhage on the basis that it was caused by a long labour and 2nd labours are usually shorter or they'll intervene earlier this time. The first will be of no comfort to you if you're one of the people who don't have a shorter labour, the second promise may well be ignored once you're in labour, things are going ok or they're too busy to intervene earlier if it's not urgent. Emphasize the problems you've had with the tear and the fact it's still ongoing and how that affects you (continence?/sex life issues?/anything that aggravates it that you need to avoid?/painkiller use?), plus your anxiety about an instrumental delivery or another hemorrhage like that and its impact on your recovery. Play up your anxiety if you need to and if it seems to help. And make sure you can show you understand the risks of CS for you. Can you bring your DP or someone similar to support you?

[GingerJulep]

I hope you get a birth you are happy with.

Are you really sure about a CS though? You'll likely be in for 3 days with one of those and then unable to pick up baby/older child etc for a while so it isn't necessarily the 'easy' option.

Have you had a session to talk through your previous birth?

[Ushy]

Ginger - I am not sure you'll be in for three days with c/s in most hospitals and I was actually a lot fitter a lot sooner after my c/s than a vaginal birth recovery from which was horrendous.

I think what you want after a traumatic birth is as much certainty as possible for your peace of mind. C/s does that.

Good luck

[BusyBee86]

Thank you for your replies. Yes I will make sure I mention the ongoing problems that I have. Also if they say how difficult it will be for me to look after a baby and toddler I will say that it won't be a problem for me as I have plenty of help as living with dh and my parents atm so always someone around.

If they say no they don't think I should have one, is that the last say or do I ask for 2nd opinion? Am I allowed one if I really want one?

[BusyBee86]

Anyone know?

[Sioda]

Yes you can insist on a second opinion/some places seem to offer an appeal within the hospital. Or move hospital to one with a more sympathetic consultant. But ultimately yes they can refuse. Have a read of the NICE guidelines on CS but remember they are just guidelines. The right to informed choice of mode of birth for women doesn't exist yet unless you're rich enough to go private. If Monday doesn't go well don't despair though. Post back here. Also the birth trauma association or the choosing caesarean blog might help you. Remember on Monday to not talk about rights or entitlements though. Gets doctors backs up. Adopt the 'I need your help' position instead.

[BusyBee86]

Ok thank you for the great advice, I will post back tmrw and let you know how I get on.

[BusyBee86]

My appointment went very well, she went over all options with me and said she will not refuse me a csection if I want one. I have an appointment to go over birth options and then a follow up appointment with same consultant. Then if I still decide I want one I can

[Sioda]

That's great to hear Busy!! Delighted you got a good one

[Stangirl]

NICE guidelines are now more supportive of women who choose to have a CS and consultants should pay heed to them.

I asked for an ELCS because I was nervous of childbirth and my consultant just asked if I was sure - I then listed a catalogue of disastrous births my friends had had - and then she just agreed. It was really really easy. 2nd time round she just said - I see you had an ELCS last time so assume you want another - and I agreed.

This wasKings College London.