Refused an elective section and now dreading VBAC at Mayday Hospital (Croydon). Any good advice about either please?

[Lakota]

Sorry if this is long and a bit rambling but I?m quite upset.
I am 35 weeks with my second child and some time ago was asked by my midwife if I'd thought about ?how I wanted this birth to happen?. DS1 was born 3 years ago by emergency c-section, and it was on the whole a pretty horrible experience. I'd just assumed I'd try to give birth naturally this time, but as she mentioned an elective being possible, DH and I began to think about it, read threads on Mumsnet etc and decided that it could be the right option for us. The section was due to failure to progress (I was 4cm when I came in, and no further on about 12 hours later), and the midwife told me that as the problem was down to my body, rather than the baby, it was quite likely to happen again. I really wanted to avoid another emergency section, but found the physical recovery ok, so thought I had this choice. Apparently not.

Yesterday I saw the consultant, and having kept us waiting for an hour, I got 10 minutes in a tiny room (DS and DH on chairs, me perched on bed, consultant leaning against wall, and two medical students squished in too) to be told that I would be having a VBAC, it was hospital policy. I don't understand why I was sent to see him in the first place if hospital policy is so cut and dried, and I felt he didn?t listen to my concerns at all. He didn?t even examine me until after he?d made his pronouncement, and I get the impression he?s dismissed me as ?too posh to push?. Apparently the only way I?d get a planned section is if I went 2 weeks overdue (I am already a week bigger than dates, so not thrilled at that prospect ? especially as I was 10 days late with DS!).

Maybe I got the wrong end of the stick in the first place, but we?d concentrated so much on the positives of an elective that I now feel completely unprepared for labour. I?m dreading a repeat of my last birth ? 24 hours of contractions at home (so no sleep), then constant monitoring on my back in the delivery suite (I?d expected to be able to move around), drip, at least 10 different midwives, no-one telling us what was going on, horrible internals (my cervix is hard to find apparently ? colleagues were called to help!), two attempts at breaking my waters?etc, then finally culminating in a c-section. I?ll just be gutted if all this happens again, when I could have just got the section over with, without the associated exhaustion of labour. And if labour does progress I feel completely unprepared for it and terrified of the prospect of being cut, or tearing. Also, I understand that continuous monitoring will be a given this time too, given my past history.

Unfortunately my local hospital is Mayday (nicknamed May Die), and is basically at the bottom of the maternity league tables published recently. The after care was pretty dreadful last time, and the night staff are notoriously rude, but I figured I could cope with that, as to be fair, they did a good job of the operation itself. I just have no confidence in them supporting me through labour, and have now read up on all the stats about cleanliness/MRSA etc and freaked myself out more! Mayday does have a new birthing centre, which is apparently very good, but I?m too high risk for that, given the last section ? just not high risk enough for an elective.

Sorry for the epic, I just need some good stories about VBACs please, and if anyone has anything good to say about Mayday then all the better!

[Lakota]

Sorry for ?'s instead of apostrophes - typed out in Word initially.

[workstostaysane]

really sorry to hear about your situation lakota. it sounds really insensitive and i'm not surprised you are upset.
I have a friend who had a VBAC after a particularly difficult 1st birth, but she had wanted to do it from the get go.

not sure what to suggest (although i have a HUGE book list about 'natural' childbirth, if you are interested)

i'm sure there will be others along soon with more helpful advice about how to deal with horrible consultants and hospital policy.
best of luck whatever you decide and let me know if you'd like the book list.

[workstostaysane]

really sorry to hear about your situation lakota. it sounds really insensitive and i'm not surprised you are upset.
I have a friend who had a VBAC after a particularly difficult 1st birth, but she had wanted to do it from the get go.

not sure what to suggest (although i have a HUGE book list about 'natural' childbirth, if you are interested)

i'm sure there will be others along soon with more helpful advice about how to deal with horrible consultants and hospital policy.
best of luck whatever you decide and let me know if you'd like the book list.

[MrsMattie]

Do you definitely want a c-section? If so, push for it. Tell the consultant exactly what you've just told us. Write it down if necessary. You shouldn't be forced into a VBAC. That would be quite wrong.

[Smurfs]

Change consultants - thats what I did after I was told it was hospital policy to offer VBAC's after previous C-section's. I had an elective with pregnancy number 1 so it was highly unlikely I would change my mind be prepared to stick yo your guns for what you want.

[barbamama]

Can you switch to East Surrey maybe? I know a few people who have from Mayday.

[Spidermama]

In all honesty I think you could do yourself the biggest favour in the world by calling the South London Independent Midwives. They live around your way and they specialise in VBAC. I've had four home births with them and I still go to thier parties and meet many of their happy clients who've had VBAC.

I know there's the money issue, but I have never looked back. Those women helped make all my births really great. I'm forever in their debt.

[Lakota]

Thanks for your responses. I am entitled to a second opinion, but apparently it will be more a case of the same opinion being given by a second person, if you see what I mean. This is coming from my GP, whom I made an appointment to see the same day, and who was equally unsympathetic. She also said that my midwife shouldn't have mentioned elective c-sections in the first place. Annoyingly, I can't take this up with my midwife, as reception at the GP's tell me she has now left!

I asked about changing hospitals, and was told I couldn't do that either. Everyone seems to get sent to Mayday, which is probably why it's so busy and understaffed.

I'm not sure I have the strength to fight for this when my midwife has left, consultant says no and GP agrees. So I'm trying hard to be positive about a VBAC, despite being really scared I'll end up with either another emergency section, or one of the less pleasant outcomes of a normal labour. Of course, I know this sounds a bit selfish, and that the most important thing is a healthy baby, but ideally I'd like to be in one piece at the end of it!

Thanks Spidermama for advice about Independent Midwives - was wondering about whether a doula would be helpful, so will look into this option as well - do you pay for one-on-one?

[T2M]

I would highly recommend a doula. She will encourage you and give you the reassurance you need to be able to stay at home as long as possible and remains with you through your entire labour offering continunity of care both a home and in hospital. Would you consider a homebirth at all? Be true to yourself as the place you choose to have your baby must be right to enable you to have the best experience within your own circumstances.

[Taichimum]

Your experience of your first birth ending in c-section mirrors mine at Mayday. I feel really sorry about your situation and understand competely how you must be feeling . I was so traumatised by my experience at Mayday, this time a have switched to Kings and I am trying for a VBAC at home, but I organised this at a very early stage.
However, a few things to help. My friend has just had a Vbac at Mayday. She said her care was fine and she is happy with the outcome.
Secondly, most hospitals now will promote VBAC and discourage or refuse elective 2nd section if there is no physical need for it. However, if you had a psychological assessment you could argue for it on mental grounds. Write down your birth story, ask to see another consultant and see what happens.
Thirdly, whilst it is unlikely that another hospital will give you an elective any more easily than Mayday, you may just be happier trying for a VBAC at a different hospital. It may be a bit late to transfer officially now, but if you just turn up at another hospital when you are in labour, they won't turn you away. Depends where you live and how your labour goes.
Fourthly, you have enough time to prepare for Vbac. Have courage. Just because you only got to 4cms the first time does not mean that would happen this time. I only got to 4 cms too and no one (and I have great midwives) has suggested that would happen again. A lot of it depends on the position of the baby and your psychological state. Fear and anxiety can have a very powerful effect on your ability to labour effectively. In better circumstances you may find your body responds accordingly.

There is a lot of experience and support on here for VBacers, who know a lot more than I do as I have not had mine yet! Have a look on the 'Support for imminent Vbacers thread'. If you post on there you will get some great support.
Wishing you much luck in the coming weeks. If I have a successful VBac in the next few weeks I'll post on here to give you courage.

[ButterflyBessie]

If the night staff are so horrendous then maybe a vbac is just what you need , you can go home much quicker so there is a good chance you won't have to stay in overnight .

I have had two vbacs and left 12 hours later and then 3 hours later, bloody marvellous

[edam]

You can change hospitals if there is another one you can get to. You don't need the GPs permission - although it helps. Sounds as if they are just brushing you off as someone who doesn't fit into their boxes and won't just go along with their administrative convenience. Stuff that for a game of soldiers.

Call up the supervisor of midwives/head of midwifery at East Surrey and explain your predicament - see if she is at all helpful. Or alternatively go to your local PALs - at either hospital - they are the patient liaison service who are there to guide you through the system.

[edam]

Btw, sounds as if your first labour was badly mishandled - I'm willing to bet it wasn't your body that wouldn't progress but the way you were treated that made it so hard. Second labours are 'easier' in that your cervix has never completely closed after the first one and hence quicker. If you get good support second time around it is possible you will have a much better experience of labour if that is what you choose.

If you have the time and energy, I'd ask for a copy of your notes from last time and consider making a complaint. Maybe get this one over with first, though!

[workstostaysane]

i'd also recommend south london independent midwives - they are a great bunch.
also, a doula is really a great help. you can look on doulauk or doula.org

best of luck

[workstostaysane]

i'd also recommend south london independent midwives - they are a great bunch.
also, a doula is really a great help. you can look on doulauk or doula.org

best of luck

[mumofdjandp]

I would def push for the elective section if this is what you both feel is the right thing for you/your family - my hosp wouldnt do one either (had emergency like you with dc1). I was adamant wouldnt have another c section but then as time wore on in the sec preg my hubby and I both decided a section would be best (lots of factors). we put our case across once again to them and we got the section and it was fab and def was the right thing to do! def was worth fighting for! so if you feel it is right dont give up. xx

[Lakota]

Thanks all very much for your kind comments. Whilst I feel that it is my right to push for an elective, I'm worried that concentrating so much on the negatives of my last birth just won't be good for my mental health - if I write down a horror story and spend all my time trying to persuade hospitals etc, and it still gets refused - I'll be in a worse headspace than I was before.

I think I need to think positive about a VBAC, insist on being allowed to move about etc - and will definitely look into a doula/independent midwife who might get my voice heard whilst I'm in labour. ButterflyBessie - you're right that a getting to go home ASAP would be one definite positive!

Taichimum - I will certainly look up that thread when I get a chance. Are you due very soon? I hope it all goes brilliantly for you and will look out for your birth story. Thanks also for a positive Mayday story - they are few and far between!

[ButterflyBessie]

Lakota

You could go the whole hog and have a home birth - not too late

join this group for loads of info and support

As I said earlier I have had two vbacs, best thing I ever did, was home soooo much earlier, could move around soooo much easier and I felt soooo much better .

Don't look upon the refusal as a bad thing, think positive and look on all the advantages, do a search on here for vbac or google it.

One thing, a section is major abdominal surgery, there is more risk to you and your baby if you go down this route, why risk it if you don't have to??

[cinnamontam]

Lakota - so sorry to hear about the appalling way you were treated in CS. I had a CS due to failure to progress (4cm seems to be the magic number doesn't it) and I put it down to the constant monitoring they insisted on doing on me and the LO because my waters has 'supposedly' broken 2 days before. I'm planning on a homebirth VBAC for the next one and will have my fabulous doula Marslady around for that one too.

Don't really have anything incredibly helpful to say just wanted to wish you all the best. I also urge you to talk to a doula or independent midwife as they will be really helpful in supporting you and your DH in making a decision that you will comfortable with. Good luck

[maxbear]

The most likely way that you will have a successful vbac is if you stay at home for as long as you possibly can. I have come accross so many people who get stuck in their first labour and do not in the subsequent labour, there seems to be little rhyme or reason to it sometimes. Write a strong birth plan and definately prime your dp, consider taking a female supporter with you who knows exactly what you want and will stand up for you if she feels you are not being treated right. If there is no one you think will be good at this definately consider hiring a doula. Good luck and make sure you post your birth announcement when it happens.

[Sabire]

Lakota - I live in Croydon and sit on the MSLC at Mayday as a user rep. You can contact me at [email protected]

I'm really sorry you're having such a lot of stress with all this - I'd hope that there would be something you can do about it, maybe talk to the supervisor of midwives about your concerns. She's usually pretty helpful. If you want to contact me I'll pass on her e-mail address to you.

[Mintpurple]

If you have decided that you definately want an el c/s, I would suggest phoning and asking the midwife at the antenatal clinic if you can see a senior registrar or consultant who would be sympathetic to you having a repeat c/s. I would not go back to this original consultant to argue your case if possible, probably just a waste of time. I would also very much doubt that there is a hospital policy stating that prev c/s patients must have a VBAC - ask them to show you the policy, it will never happen.
Take sabire up on her offer and meet with the supervisor of midwives, even if she cant change the consultants mind, she will know which consultant is sympathetic to allowing this, and the patient liason dept is always worth a try for support.

If you decide to stay with Mayday, I would also draft up a letter saying that you will hold the hospital and the consultant responsible and will instigate legal proceedings if anything untowards happens to you or your baby during the VBAC as you disagree with having the VBAC and have requested an el c/s, as you know the risks and have considered them to be unacceptable. If you send a copy to the hospital Chief Executive, the consultant and labour ward manager, it may be enough to make them reconsider.

Finally, you can change hospitals, and your GP has to refer you to somewhere else, you may need to threaten them also, but the threat of a letter of complaint to the GMC regarding their negligent standard of care towards you should see them quickly penning a letter of referal.

Dont just turn up at another hospital, as they are just as likely to send you packing to Mayday again, as our hospital would do if you were not in advanced labour!

Its horrible for you to have to struggle to deal with this type of nonsense at this time in your pregnancy, but good luck, I hope you get what you want.

[Sabire]

Sorry - wanted to add that the birth centre at Mayday is FAB and I know a vbac mum who was offered the use of it last year. Basically this mum wanted to have a homebirth - staff tried to negotiate her out of it by offering her the birth centre as a sort of 'halfway house'. Hmmmmm......... it's a thought isn't it?

[Heated]

Mintpurple has given excellent advice

[mears]

It is a real shame that you have been put in this predicament due to a total lack of communication as I see it.

Your first midwife did you no favours IMO by emphasising elective section without also discussing VBAC fully.

By the sounds of things your initial labour was mismanaged which resulted in a caesarean section.

There are very few reasons why VBAC should not be attempted in a second pregnancy. It would have been so much better if your midwife had encouraged you in this option so that you could have mentally prepared for it.

In my own unit we accept women who have had previous CS into the midwifery unit so that they can be mobile and use the birthing pool if they wish.

I would spend my energy researching how to have an active labour and insist on having the midwifery care philosophy of the birthing centre.

Is there a consultant midwife at Mayday? If so he/she will be able to help you.

You are so right to say that you need to focus positively but you need to have positive peolpe around you. A doula or the independent midwives sound a good idea if you do not have a positive response to the suggestion of mobility in labour.

You have nothing to lose by trying a VBAC