Want to go through midwife-led unit rather than consultant led - give me some arguments I can use with midwife .... please!

[ejt1764]

I'm 25 weeks now with dc2, and going to see the midwife tomorrow.

I had a c section with ds - think the catch-phrase is 'cascade of intervention' - a horror-story induction lasting 100 hours, and ending with baby getting irretrievable wedged ... failed ventouse = ds out through the sun roof.

I had 2 MCs last year - the second one was horrendous - tale of blood and more blood and bleeding out on operating table (eventually).

Before I had the 2nd mc last year, I was adamant I was going to try for a hbac - to allow me to feel in control etc. etc. However, having discussed with the medical professionals about the risks of pph in my case (was a bit sneaky as I didn't let on why I was asking about risk of bleeding), I've decided that I don't want to take that risk - haemorraghing (sp?) at home was one of the most terrifying things ever to have happened to me.

Now, I'm happy to go to the hospital to try for my vbac - but I don't want to go for the high-tech route - I tried that with ds, and it didn't work - in fact, quite spectacularly.
I don't want an epidural, and will not be agreeing to CEFM as I have severe spd and coccydinia - and I will need to be mobile to have any chance of having a vbac.

Has anybody managed to get themselves into a MLU for a vbac, and what were the arguments you used?

[barbamama]

hi there - no positive stories, just sympathy about the cascade of intervention and conveyor belt. My only success has been getting consultants and midwives to let me have no continuous monitoring and non-medicalized birth this time around after the same sort of disasterous cascade last time. I didn't quite end up with a ceserian tho so don't know specifically what you can argue. One thing that I have realised second time around is that they can't force you to do anything, but equally I am not sure how you can force them to let you in the nice bit. Godd luck.

[ejt1764]

A conveyor belt is a superb way to describe it - I think I will use that phrase with the midwife tomorrow ...

[asur]

I phoned my local mw led unit as they now have a birth pool which I thought would be ideal (increases chance of VBAC) the answer I got was "what's a VBAC?" Good start. Anyway, once I explained, she then said "we only accept women who will have a normal birth!" I'd love to know what a NORMAL birth is!

Seems stupid that a home birth is fine but to be in a place with lots of mw's about isn't... Bizarre rules but HBAC it is!

[ejt1764]

Do you think I should pretend that I intend to go for a hbac, and then 'compromise' to the MLU?

They've already documented my desire to have a hbac at the booking visit ....

[Klaw]

Ejt1764, it has been found on the other board I post on that in order to be 'allowed' to use the MLU you tend to need to say that you intend to HBAC and then they fall over backwards saying that you CAN use the MLU and will allow you to have intermittant monitoring etc...

You shouldn't have to fight for your right to labour how you want to but it seems that it's the only way.

You can contact AIMS for more support. Where are you? I may know of someone with local information....

I would suggest that you seriously consider planning a HBAC, it seems ideal for you! Tell me more about why you are at risk of pph, maybe you're not as much at risk as they make out? maybe we can provide info that can minimise the risk... hope I'm not speaking out of line.

[ejt1764]

Klaw - thank you for your help - I'm covering all the bases at the moment - I'm a member of the ukvbachbac email group - and have asked them the same question...

I think the pretense of hbac is the best route to go ...

Nobody has actually told me that I can't have a hbac because of the rish of pph - however, I had 2 MCs last year - the second of which entailed a lot of bleeding and dashes to hospital under blue lights etc. etc. - I discussed the statistical risk of excessive bleeding as a hypothetical issue - as I wanted the stats - the riskis very small, I know, but having had the horrendous problems with bleeding last year (and having had 2 bleeds during this pg), I am terrified of the thought of having bleeding in my own home - it's happened once, and it was a horrific experience - the smell and sight of the blood is one that will remain with me for a long time!

I am in Penarth - just south of Cardiff - there is an MLU just minutes away from my home, but the one I would settle for is in UHW in Cardiff - in case of any problems, the CLU is just upstairs!
If you know of anybody with more local knowledge, that would be great!

Right, am going to pretend I want a hbac ... hmmm - I am the world's worst liar - this could be interesting!

[DaisyMOO]

It's certainly not guaranteed that threatening to HBAC will persuade them to let you use the MLU - I tried this myself and it really was a no-go. I was told unofficially by a doula in the area that they wouldn't turn me away if I arrived on their doorstep in labour but they wouldn't book me for it. They like to keep their stats looking good to increase their chances of being kept open and don't like to jeopardise them with high-risk women which is a bit but I can understand it. Hoepfully yours will be more accomodating! Your community midwife may not have any real sway over whether or not you can use the MLU so if she says no, I personally wouldn't use up too much energy trying to change her mind and get in touch with the head of midwifery or the midwife in charge of the MLU direct - your CMW should be able to provide you with her/his contact information.

I agree that AIMS may be able to give you some help in getting the MLU to take you and the vbac yahoo group should also be able to give you information and support.

I can understand why you don't want to HBAC. I think home can be a great place to VBAC but the key thing is that you need to feel safe and confident or it can make it more difficult to labour. Whether or not you end up at the MLU (fingers crossed that you do) or the main hospital you could also think about hiring a doula who can help make sure that your wishes around CEFM, epidural etc are respected. Hope it goes well.

[DaisyMOO]

x-posted - I see you've already found the yahoo group!

[j20baby]

no advice but bumping for you x

[ejt1764]

Thanks for your input daisymoo (also waving frantically!) - especially when you have sucha little one to take care off too!

I have already engaged a doula, as my wonderful dh, though incredibly supportive, feels totally unqualified to be bolshy on my behalf - he's neither medically trained, or a woman, so says he just doesn't feel right ...

The doula is going to have to be our protector, in a way!

[alicet]

ejt one way to go might be to see your consultant and discuss with them your wishes. If you can get them to agree that it would be safe for you to go to the MLU esp given that they are just upstairs in case of problems then the mw's might be happier to accept you.

They certainly can't force you to accept any inbtervention even if you have to go to the clu but obviously you will not be in the easiest position to argue your wishes if you are in a lot of pain (so excellent idea to have doula). If everything has been agreed by a consultant in advance then it is harder for them to object. Maybe its worth asking your midwife which of the consultants locally is more in favour of less intervention? Certainl ythe views of consultants do vary a bit so worth checking you're not under someone who is very conservative!

Can't remember why you had your section? The reasons may influence this I guess.

[alicet]

another thing to check which i have recently found out is if your clu has monitoring on telemetry. this means you would still have the monitoring on but rather than being attached to a unit by your bed meaning you can only mobilise as far as the wires will allow, it is cordless and linked to a base on the main ward. So someone is checking it all the time but you can move around and even go up and down the ward.

Our unit has one (just discovered recently!) but apparently its in a cupboard and most people don't knwo it exists which means noone gets it unless you know to ask!!!! How crap is that?

[ejt1764]

Thanks alice for your input - my consultant is very pro-vbac - and has written that I'm to be encouraged to go for vbac on my notes - but when I said that I didn't want to go to CLU, and would prefer mlu if anything, he got quite affronted - his very words were: "it's not a C section factory up on the 1st floor!" ...

I'm not booked to see him again until 36 weeks - if I go ...

[alicet]

A pleasure.

May still be worth checking if there is another who is less conservative - for example my consultant is pro vbac but only with continuous monitoring and strict timings (which I am personally cool with if i decide to go for vbac) but i know one of the others would be happy for intermittent monitoring and to use the birth pool. Thin they can be pro vbac without being pro the other stuff you want if you see what i mean!

[whomovedmychocolate]

Look it's your body and your baby, you have a right to ASK for the birth you want and yes, if they refuse you saying 'I'll have a homebirth then' does give them room to wiggle back to the the midwife unit as a compromise.

Provided your MW unit has prompt access to emergency care, there are few arguments against it.

[ejt1764]

I have been to see the midwife - and it was the one I saw at booking, who is lovely.

Long discussion ensued ... the upshot of it is that I am booked to see the consultant midwife who specialises in 'normality' - Su (midwife I saw this morning) has worked with her with ladies like me before, and the outcome has been good!

She suggested that the MLU would be good for me, as there is a pool there, and with the spd and coccydinia, she feels that labouring in water would be very beneficial for me - which is another tick in the MLU box...

now feeling more positive, and ready to go for it ... I must admit that I was getting myself into a state about the whole giving birth thing, and was considering asking for a C section - which I know in my heart I don't really want!

Has anybody else ever been referred to a consultant midwife?

[barbamama]

I was sent to see the supervisor of midwives when I recently got in a state about not having another medicalized birth - not sure if that is the same thing - she was very helpful and reassuring and switched me to a more pro-normal consultant. Definitely worth speaking to as many people as possible as they do seem more supportive of women like us these days, unlike last time.

[whomovedmychocolate]

Ejt - good to hear your discussions went well. I have seen a consultant midwife and she was very helpful and pro-choice. In my situation it didn't help because I am unable to give birth normally due to an abnormal pelvis (unknown at the time) but very worth having the discussion - you'll come away feeling very empowered.

[ejt1764]

thanks barbamama and whomovedmychocolate - I appreciate you taking the time to let me know of your experiences.

My consultant is already pro-vbac - and has written that I am to be encouraged to go for one!

Here's hoping the consultant midwife can help!