Still no descision on VBAC vs ELCS

(9 Posts)
MrsGiraffe12 Tue 10-Jun-14 14:35:30

Basically just that really.

I'm 27+2 with DC 2. Eldest was born at 32 weeks by emergency c section due to PET and HELLP syndrome. My consultant appointment at 20 weeks went well for the most part except they said I "have" to have a VBAC this time. Which I'm unsure of, given that I've never laboured at all and worry massively about rupture etc. my midwives say I should be allowed an ELCS if I want one given my history and that they would be happy to care fore after one.

However, consultant seemed very adement that I had to have a VBAC which at the time I didn't argue against as I didn't want to seem argumentative and difficult

I'm not due to see consultant again till 32 weeks but would like some advice on how to begin to argue for a c section / get them to agree without being to awkward etc.

I know the risks of VBAC vs ELCS but personally feel ELCS will be better for me psychologically and for my family over all.

Thanks x

RedToothBrush Tue 10-Jun-14 14:54:49

Why do you have to have a VBAC?

What medical reason has he given you?

I would never accept being told I 'have' to do something without an adult two way discussion about the reasons why.

If your midwives are suggesting that you have a good case for an ELCS, then I start to question whether he has one and whether he's trying to 'enforce' one on you in someway.

In terms of a VBAC v ELCS NICE guidance states that the views of the woman should be given significant consideration.

If he has not properly explained his view to you and listened to how you feel he's failing on two counts.

You also mention about an ELCS being psychologically better for you. Again NICE do support women wanting an ELCS on psychological grounds, but without knowing the ins and outs of your belief on this, saying thats right for you is difficult to know. Thats something that you can only really explore with the support of those caring for you.

An ELCS ISN'T always the solution for everyone, though I do see it being pushed more and more without consideration for what the root causes of how the woman is feeling and without exploring other alternatives first. (Often alternatives are not being suggested).

Personally, I would not wait until 32weeks to pursue this. I would raise it at my next midwife appointment and see if there was anything that could be done to progress this further sooner.

As for feeling slightly railroaded or being difficult with the consultant. Don't. His job is to do whats in YOUR best interests which includes a need for him to listen to you. I would recommend writing all your concerns, pros/cons, feelings etc down before any appointment with a consultant so you feel more confident in raising them - or even just give the consultant a copy of the list and ask to go through them.

MrsGiraffe12 Tue 10-Jun-14 15:35:00

Thank you. I didn't think I was being difficult for wanting a casarean but kind of felt like if I asked for one I would be viewed as difficult if that makes sense. C section was
Wasn't even mentioned and when I said I'm scared
To vbac all she said was "women given vaginally all the time"

Psychologically, I'm very scared if a vaginal
Birth. I find smear tests painful and also am scared about causing myself damage down below or needing an emergency c section in labour rather than a calm and planned one. THis is my last baby so future pregnancies are obviously not an issue.

I'm seeing my midwife at 28 weeks so can ask again about. Section then x

MulberryPeony Tue 10-Jun-14 18:32:59

I had very severe and sudden onset PE first time around and had to have a section at 32 weeks. Second time around I told my consultant that I would consider VBAC but if there was any sign of PE then I wanted another section.

It's good that your midwives are supportive - I'm sure they'll help to write a letter to PALs or something?

As it happened I did end up having a positive VBAC but I managed to get right to 40 weeks with no PE symptoms!

Did you get the placenta checked for notches at 23 weeks?

MrsGiraffe12 Tue 10-Jun-14 18:41:55

No, not been checked since my 20 week scan but have another one at 32 weeks.
Is that too late to check for notches? And what are notches x

MulberryPeony Tue 10-Jun-14 19:43:38

www.fetal.com/NT%20Screening/10%20Uterine%20Artery%20Meas.html

I was told that 23 weeks was the only time it could be done with certainty . It was evident from that scan that I did have notching so the likelihood of getting PE again was very high. My consultant at the time said she had known of people having the same and still going full term but I didn't believe her! I just wanted to reassure you that just because it happened the first time it doesn't mean it's a certainty that it will happen again.

MulberryPeony Tue 10-Jun-14 19:45:22

Oh, are you on aspirin at all? I was on a low dose from the offset but had it increased due to the notching.

I went to my first antenatal with baby number 2 after having a section with my first child. I was very clear that I wanted a section but the registrar was determined to push me into a VBAC.

I kept repeating that I wasn't going to consider it and wasn't willing to take the risk of a uterine rupture, no matter how small that risk.

The doctor was very adamant that I should have a VBAC.

I went to my GP to discuss it with her and she said that under no circumstances can I be forced to have a VBAC against my wishes.

I had the opportunity to speak to the hospital doctor on the phone and told him that I felt very stressed and anxious as a result of the pressure to have a VBAC and that I was going to refuse it. He said to me at that point that if I wanted a section so much he would guarantee me there and then that I could have one.

If this chance conversation hadn't of happened I was going to write a letter to my consultant and ask for it to be attached to my notes explicitly stating that I do not consent to to a VBAC and the only way I am giving birth is through a section.

You have to be polite and respectful to everyone but also think you have to make your wishes very clear and not worry about appearing difficult.

Hope this helps you, I got lots of help and support through mumsnet on this issue.

I'm 14 weeks now, so the doctor better keep his word!

MrsGiraffe12 Tue 10-Jun-14 20:50:27

Thanks to everyone who replied.

I guess it's partly because I've kind of lost faith in my body's ability to have babies "properly" too if that makes sense. I had DS 8 weeks early and was really ill and couldn't even deliver him naturally, then miscarried my next pregnancy and now I'm just terrified to be honest.

I'm going to speak to my midwife next week and see what she has to say about ELCS in our trust x

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