Csection or forceps

(92 Posts)
BusyBee86 Sun 03-Mar-13 20:25:02

What would you prefer to have if you had the choice? Csection or forceps and other intervention?

What was your recovery like if you have had either of these?

MiaowTheCat Tue 05-Mar-13 10:59:39

I think it's more common than people know about (there's still this mentality that if SS get called on you "you must have been up to something to justify it" - see AIBU on a weekly basis for that sometimes!) - when I've spoken openly(ish - hubby's family still don't know, mine only really know because they have some connections making the hospital more likely to behave this time) about it, so many people know someone else it's happened to... I just dismissed it as one of our local hospitals being a bad apple - but it looks like it's more widespread than that.

It's gone indirectly up to the head of midwifery when I spoke with the birth-trauma MW at the partner hospital in the NHS trust over this coming birth and she was horrified by what had gone on - but it's not a fight I'm strong enough to take on really... especially since they've also done stuff like buried the entirety of the referral details in DD's notes to make it harder for me to get at and the like. Taken me most of the last year to just come to terms with it - the feeling of guilt that, in essence you being a bit picky (although with the brutality of them and the damage they can cause I don't think that that's the right mentality to have over forceps) put your child at risk of being taken is an absolutely crippling guilt to live with - I remember vividly having to ring hubby (they waited till the second he'd gone home to call me in for a 90 minute interview) and tell him that MY behaviour had got SS called in on the child we'd fought for 6 years to have - it was horrific. Thankfully he backed me all the way - but it was utterly awful.

I think the taboo around SS generally, plus the fact that people can be utterly intolerant of birth horror stories (if I tell anything of mine it's usually the amusing/farcical stuff like MIL wandering in mid-push... stuff like that) - means a lot of stuff like this gets unreported.

RedToothBrush Bosnia-Herzegovina Tue 05-Mar-13 10:48:19

Miaow, my heart goes out to you. I believe you entirely.

RedToothBrush Bosnia-Herzegovina Tue 05-Mar-13 10:44:37

trustissues, I've tried clicking on the ECHR case you linked to, but it doesn't seem to work. What does that relate to as I'm interested to read. The other guardian link was very interesting. I hadn't realised that there had been a case in the UK where someone had successfully challenged staff over forced consent.

trustissues75 Tue 05-Mar-13 10:41:37

Miaow - I am completely speechless right now. \I seriously just don't know what to say. Have you considered just telling your story to a good law firm specialising in medical negligence? And as for you being a family "known" to the ss for life?! Is that even legal? |I had the ss called out on me for cancelling all my son's medical check ups when the Dr's assistant told me to just put him in day care as a solution to the problem of him obviously screaming near constantly in pain. It's awful, but my case was closed after 6 months and the ss couldn't believe how ridiculous the Dr had been and even gave me help in finding a decent Dr. Its an awful thing to go through - but the fact that you were put through that for a choice you were trying to make for a child that hadn't' been born yet is beyond wrong - the child has no legal rights until they are born.

I believe you, BTW...I believe you wholeheartedly.

MiaowTheCat Tue 05-Mar-13 10:33:58

Trustissues thank you so much for posting that Guardian link... I had the social services thing done to me over the last birth - people still think I'm some kind of liar when I tell them it happened, but I keep finding more and more quiet little voices (because of the stigma, and the fact you just feel like the worst mother in the world for basically putting the child you're giving birth to at risk of being taken off you in order to exert some control over your birth) that are piping up and saying, "Well, I don't talk about it - but they did exactly the same thing to me."

While the investigation was closed with "no case to answer" - I had days of hell on a post-natal ward (also from hell), having phonecalls and interviews to prove my worthiness as a parent for a child that I'd not actually GOT to parent yet - because she was still two floors down in NICU. And it ruined my life - the flag that we're "a family known to SS" remains on all our files permanently, and I live in fear now we're at the crawling/cruising stage of the childhood bumps and scrapes and someone querying them in the light of that warning flag. I have nightmares at least 3-4 times a week of them coming to take her away from me - and the saddest bit is, I'm having to view this birth as something I "take" as silently as possible, consenting to everything they want to do (although I'm writing my wishes down I expect them to be ignored) - for fear of both this new baby, and my beautiful, thriving eldest daughter being removed from us if I say or do ANYTHING that irks them giving them grounds to go running back to social services.

My "crime" - I got scared when they were shouting at me and bullying me to consent to forceps, and I wanted them to note my pain-free gap with my SPD so I didn't end up with permanent damage (they pretended to note it, ignored it completely and wrecked my hips yanking my knees up around my ears - they didn't even go THAT fricken high when I did gymnastics three times a bloody week)... that's literally ALL I did - and why I guess I've fixated a bit on the forceps issue this time around to try to head it off at the pass so to speak.

But people don't believe it's happening - look at me like I'm mad when I mention it (or tell me that they believe me cos it happened to a friend of theirs)... so thank you for the article in a loooong rambling way.

I'm too scared to complain btw - can't rock the boat having seen how relentlessly they'll behave to browbeat women into giving into whatever they want to do. I also firmly believe if they hadn't of had me physically held down and pinned to the bed - the issues requiring forceps wouldn't have occurred anyway - when they got me vertical for a spinal block to do the forceps (the choice I'd been given was spinal+forceps or forceps+hideous pain - nice!) she started moving again and would have delivered of her own accord - but I think it was a mark of pride by then that they got to do what they wanted to me. I've been raped in the past - and it was utterly the same feeling of total violation and powerlessness.

CoteDAzur Tue 05-Mar-13 10:33:24

I'm reading here how incapacitated some people were after their CSs and thinking there must be a difference (in damage control) between ElCS and EmCS.

Mine was elective. I had it in the morning, and by that afternoon, I was made to get up (with help) and walk to the toilet & back. On day 2, it was painful but easily managed with a couple of pills. On day 3 I was fine - picking up baby DS from his cot, sitting down and breastfeeding him, putting him back in his cot, etc. I didn't even need paracetamol from that point on. And I was driving on day 10.

Comparing this to DD's vaginal birth with episiotomy: I was crying with incredible pain every day, unable to get out of bed, unable to sit, unable to walk, unable to breastfeed in any other position than standing up. Real torture level of pain for weeks on end. DD was 3 weeks old when I felt well enough to get up and learn to change her nappy sad

If you are going to have a huge cut with many stitches, it is far more preferable to have it on your tummy where you can see & clean it, where it is not constantly peed & pooed on, and also so you can sit ffs. If given the choice, choose to have your delicate lady bits not mutilated.

MiaowTheCat Tue 05-Mar-13 10:22:02

Considering I've been unable to drive since about late-32 weeks anyway from SPD (I can't move my legs across pedals comfortably it's so bloody bad now) - I'd take 5 days not being allowed to drive in a heartbeat... AM CLIMBING THE WALLS NOW!!!

duchesse Tue 05-Mar-13 09:25:14

This was what I was told re CS:

Driving: You aren't covered by your insurance to drive within 72 hours of a general anaesthetic (which is what I had). So it's actually only illegal to drive within 5 days. I moaned at my GP about 3 weeks (large rural parish) after my CS saying I was going stir-crazy, and he said once you are on the mend, can manage to look right over both shoulders (checking blind spots), can fully depress the brake and other pedals, and can wear the seat belt, there is no earthly reason for not going back to driving, but to check with one's insurer first. I think the 6 weeks no driving thing is an urban myth.

Lifting: I was told no lifting anything heavier than than the baby for a week to ten days. Very luckily my incision healed extremely well so I was pretty much fighting fit again with a month (certainly back to driving).

I think the advice given is actually good advice- it helps you recover faster. There's no sense in doing anything too early that jeopardises your recovery. And certainly no brownie points in being up and about earlier than the next person. I spent DH's fortnight paternity leave in bed with the baby and it was great!

TBH I think I recovered faster from the crash CS with DD3 than I did from the birth of DD2, a beautifully straightforward 4 hour home labour, but I also had 2 other very young children to look after, before the days of paternity leave longer than 2 days, and neither of our mothers was available to help, so I was back to normal duties after 3 days. I ended up with mastitis after 4 weeks which I'd never had before and I put down to exhaustion.

trustissues75 Tue 05-Mar-13 09:00:43

galwaygirl - please don't misunderstand me - I do already have one child and have been on the receiving end of bullying - what you describe sounds more towards Guantanamo Bay tactics (we're you refused food too?) You can't always fight for your rights in the moment and I'm really sorry you were treated in such an appalling fashion - but nothing will change if no-one does anything. Forced consent is not consent - have you thought about reporting the hospital and staff?

I'm not surprised you're terrified - I think I would be - and leaving a woman traumatised by the way she has been treated just so the medical staff can do what they want to do is not acceptable.

prettybird Tue 05-Mar-13 08:56:40

I was desperate not to have a CS, so once I was falling asleep during contractions shock, I agreed to mid-cavity forceps.

I was given a puddendal block which I was warned "might work, might not". Fortunately, in my case it did. I was given a episiotomy but still tore a little bit.

I was stitched up really well, ds was fine (he had a tiny mark on his forehead which soon disappeared) and I was mobile straight away.

galwaygirl Tue 05-Mar-13 08:43:22

trustissues the whole fighting for your rights and saying no is a lot harder to do when you're 56 hours in, surrounded by a team of medical people pushing a form in your face and telling you they need to get the baby out ASAP and you have no option to sign section only. And you are completely worn down after being refused pain relief for 6 hours at one point before finally getting an epidural and spending 2.5 hours pushing.
What would you do in that situation? I was convinced I would be able to maintain my stance, the midwife was telling them I had said no forceps but they just ignored me and wore me down into signing.
I think the fact that a consultant told my friend (from ante-natal group, we are both pregnant again and seeing consultants about possible section) that she would have to have an ELCS to be sure of avoiding them speaks volumes about the reality of what happens when you're a regular joe soap with no medical training to argue back on the same level as them if you know what I mean? And the exhaustion didn't help.

Luckily I'll be delivering DC2 in Sweden where they don't use forceps! But I'm still terrified of a VB because of my first delivery.

Wincher Tue 05-Mar-13 08:23:11

Just to add a more positive story, my DS was delivered by Keillands forceps (trial of forceps before proceeding to C-section) with no problems at all, either for him or for me. My episiotomy was expertly stitched by the consultant and healed with no problems. I had had a very long and difficult labour but recovered fairly quickly. For purely vain reasons, I was quite glad to avoid the C-section 'pouch' of skin - my stomach got back to fairly flat within a year of birth.

I am now pregnant again and am heartened by people saying the second baby should just shoot out this time. Just as long as it's not back to back this time!

trustissues75 Tue 05-Mar-13 08:10:30

Oh shoot...that was supposed to actually have been a post for galwaygirl not herethere - I was going between my reply and reading post and somehow spliced you both together!

trustissues75 Tue 05-Mar-13 08:05:40

Herethere - you absolutely CAN say no!!! Unless you are sectioned under the mental health act they can't just do things to you - you're not a piece of meat! And as for insisting on a trial of forceps first when you were in deep transverse arrest just to keep CS rates down - completely appalling. there's plenty of research out there that is pretty clear that the risk of long term life changing injuries to mother and baby are much higher than in the case where a baby is still high up and is CSed out instead. I can just see them trying to press-gang you - further up thread one woman was threatened with a social services referral - the baby under law has no rights until it is born. Threatening social services to get consent is a blatant disregard for a person's human rights and those members of staff are very lucky the poster didn't take it further.

There is a landmark ECHR case that sets a precedent regarding a woman's rights during pregnancy and birth

sim.law.uu.nl/sim/caselaw/Hof.nsf/1d4d0dd240bfee7ec12568490035df05/30b9a2d7ebbbd8c4c12577f9004aa476?OpenDocument

Hopefully, for anyone who reads this, it may be of some help to them.

Here's the article I lifted that judgement from:

www.guardian.co.uk/lifeandstyle/2012/dec/16/mothers-fighting-against-birth-intervention

Don't be fobbed off Detective, keep pestering for a specialist to see the scar if you are worried. Don't just rely on gp's opinion, I know mine just seemed to think that an open weeping sore was to be expected if you're daft enough to have gone and given birth. It took me weeks of making repeated appointments before she eventually referred me and the consultant immediately booked me for op and couldn't believe I'd been managing with it for so long. Straight away following the op I was totally pain free after months of agony.

The same consultant consented to giving me an elcs if I came to her in future. I would definitely not have dc2 if it hadn't been for that assurance. No way I could have even considered getting pg again otherwise.

TheDetective Mon 04-Mar-13 22:16:41

Years? Fuck. sad

I'm supposed to be back to work in 8 weeks. I keep getting fobbed off about my episiotomy. I've pushed for a second opinion, and have a clinic appt this week. Men wouldn't put up with this shit would they?!

angry

TattyCatty Mon 04-Mar-13 20:23:46

The hell that is a forceps delivery is one of the reasons why my DD is an only child. She was yanked into the world following a long back to back labour, after a Registrar tried and failed to manually rotate her whilst still in the birth canal. I was told that ventouse / forceps were pretty much the only option, as she was so low down and that they would be preferable to baby being pushed back into position to facilitate a C section. I was moved to theatre and the Consultant (who apparently had not delivered a baby in years) first attempted to get her out by Ventouse. After 3 attempts, he declared that he "thought he could get baby out" by means of short forceps.

Yes, DD was delivered safely but she had awful bruising to her head and screamed blue murder every time anybody touched her, particularly when we attempted to get her to latch on. She was prescribed Calpol at a day old "to help her to feed" - you can only imagine how wrong that felt on every level. Thankfully, she recovered well and is now a healthy and happy 7 year old.

I, on the other hand, continued to feel the effects of those hideous instruments for years. I had a 3rd degree extended episiotomy (which is a euphemism for "we cut you, but you tore anyway"), which developed a haematoma, which subsequently became infected. I was in agony for around 4 weeks, with a lower level of discomfort that went on for years. Long story short, I ended up being re-stitched when DD started school.

I'm not brave enough to have any more children, but if I did, I'd be booking my C section from day 1.

TheDetective Mon 04-Mar-13 20:02:47

Herethere I am one of the posters who said about no forceps.

I can assure you that you can say no, you just need to mean it, and be sure of yourself. I'm a midwife, and I damn well made sure I got my birth preferences. I went completely against everything that was in the policies and guidelines, including labouring in a pool (vbac) no continuous ctg, went to 40+20 etc. I was planning a homebirth, but due to reduced movements I decided to have an induction. It wasn't a standard induction either. I pretty much forced the hand of the consultant. Will never get a job there now!

I can assure you, no one will come near me with forceps ever again.

I've had a failed ventouse, complete with episiotomy before my section. I don't part with my babies well. hmm

duchesse Mon 04-Mar-13 18:00:29

I'm under the impression that forceps are used in a CS to avoid making a very much bigger incision to allow surgeon's hand/s plus baby through. Plus the smaller incision simulates the physical benefits of a vaginal birth, squeezing the baby's lungs better and leading to fewer breathing difficulties. However, since the incision is held open by clamps and IS bigger than the birth canal, the forceps are much less potentially damaging, especially since there are no bones in the way and the risks of any awkward position are much lower. So in terms of risk to the baby, the risks for forceps in CS are minimal compared to vaginal ones. They are really used to ease the baby out. DD3 had forceps marks from her rather precipitous CS but they faded within a day and there was never any question of her being damaged by the forceps.

I personally feel that vaginal forceps belong in the 17th century. They may have saved lives in the days before surgery did a better job, but really why risk it now that we have much less dangerous medical birth options?

Trazzletoes Bosnia-Herzegovina Mon 04-Mar-13 17:55:43

Oh herethere I didn't take it as aggressive! Don't worry! I thought I just hadn't explained myself properly. thanks back at ya.

MiaowTheCat Mon 04-Mar-13 17:39:01

Oh I'm under no illusions - if they want to get happy with the salad tongs - they're going to no matter what I say or do... but after the fucking bastards (only way to describe them and their behaviour) did what they did last time - this time if they do that and I've got my wishes in writing... I've got some comeback to say, "Look, is there any wonder I was resisting what you wanted to do to me - I've laid down in black and white here WHY I didn't want to take that course of action" - it's about 80% arse covering in my part (I'm terrified of being tagged as a resistant patient and sent back for another SS investigation if I don't let them do whatever they want) and 20% hope I'll get someone who actually gives a damn about maternal choice.

And I think that using forceps as some kind of threat to motivate women to push harder is utterly unacceptable behaviour in a civilised society - yet it's another example of how some medical bods view them as nothing more than an uncooperative bit of meat in the way of a nice interesting baby.

herethereandeverywhere Mon 04-Mar-13 17:37:07

Sorry Trazzle I've just re-read what I wrote and it comes across as really aggressive thanks . My anger and aggression aren't directed at you at all (or anyone else on this thread!) I was trying to offer a contrast view for anyone who hasn't had a forceps delivery like we both had - I'm afraid my experiences have coloured my views!

My thinking was exactly the same as your before my first delivery. I'd prepared, read Marie Mongan and Juju Sundin, was fit and healthy, no history of birthing problems in my family and I trusted on of the top hospitals in the country.

Trazzletoes Bosnia-Herzegovina Mon 04-Mar-13 16:52:22

herethere sorry, I'm not saying my attitude was right. Just that it was the attitude I had. As I've said I had no idea of the risks associated with the forceps until today. And my DS is 3. And I did 2 childbirth courses!

herethereandeverywhere Mon 04-Mar-13 16:46:38

I wish I could agree with Trazzletoes that Drs knew what they were doing and would do whatever necessary and whatever was best for me and DS to come out of there alive.

There was NO GOOD REASON to risk my daughters and my health with Keillands forceps instead of a CS - other than to keep CS rates down (and IMO so that the consultant could show off his skills to the medical students I had foolishly permitted to watch).

herethereandeverywhere Mon 04-Mar-13 16:41:53

A few things picked up from previous posters:

1. Putting "no forceps" on your notes. As another poster has already stated, you simply won't be allowed this choice in practice. I stated in my birth plan that in the event of needing an instrumental delivery I wanted to choose to go straight to CSection. I was effectively press-ganged into trail of forceps first. I was exhausted, very stressed and in massive pain as I'd let me epidural wear off to improve pushing <hollow laugh>. I was told the consultant thought he'd definitely get her out (he was right - but at what price?) so I reluctantly agreed.
2. References to "pushing really hard/pushing for your life" when threatened with forceps. If your baby is, like mine was, in a position such as deep transverse arrest they are stuck. They will never come out from pushing alone.
3. Requesting an episiotomy over tearing. Can't comment on the pros and cons of this but see upthread what happened to my episiotomy - not fun and not restitched.
4. Asking for an experienced consultant to do the episiotomy and stitching. Yep, that's exactly who did mine. Didn't help one iota.
5. Use of forceps AND csection. There are two distinct types of case where this happens and I think they are getting muddled (forgive me if I've misread this).
i) The first case is where a CS, ELCS or EMCS is being performed and the baby is stuck so can't be got out of the abdominal cavity. I could be wrong, but in this scenario I assumed that the forceps were used through the abdonimal inscision to get a grip on the stuck baby. I'm not sure whether the baby could be manouvered into a more favourable position via the vagina - perhaps someone else could answer this?
ii) The second case (what happened to me) is "trial of forceps" in theatre, where forceps are tried first and if the baby can't be got out that way then they move to CS. I was "lucky" that I didn't end up with the double whammy of forceps damage plus CS recovery but WISH TO GOD I'd fought harder for that csection.

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