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This is page 1 of 2 (This thread has 19 messages.) First | Previous | Next | Last Go to page

WTF??? Consultant trying to persuade me out of my VBAC as head not engaged at 36 weeks.

(19 Posts)
Have been happily preparing for my HBAC and haven't had any wobbles whatsoever, just happy to go for it and if it doesn't work out then it doesn't work out.
Keeping it simple is my motto, homebirth being the simplest option I can think of/feel for. So I'm with great and very supportive midwife and doula but they wanted me to talk over risks etc with a hospital consultant, also so that my history (CSec with DS 17 months ago as head didn't engage despite 7cm and 2 days home labour) would all be on record if we needed to transfer during labour. Eventually after 10 hours on the drip I dilated to 10cm but head still only 2 or was it 3/5ths engaged.
Had a 36 week scan yesterday and consult Gynae had an external feel around, pulled a face that DD isn't yet engaged, sent me off for scan with nurse, who thought everything seemed normal and when I came back to his office he said he recommended that I think again and have an elective section. I was totally and utterly gobsmacked and still am. He said that according to circumferance of DD's abdominal area on the scan, she weighs about 2800 (6.1lbs grams now and will gain around 150 grams a week making her a 'big baby' (eh?) by the time she's due. DS was 3800 grams (8.3) when born, which isn't exactly enormous but he made the comment that I seem to grow big babies and that this one will be equally difficult to birth and that a section was the answer. WTF??? I'm a 5'6" and have an athletic build and there is no evidence to suggest that DS was too big to fit through my pelvis. (Don't believe the too big for your pelvis excuse anyway except in very very very rare circumstances where pelvic joints are somehow locked - so much pelvic expansion occurs during birth). I hadn't told him about my HBAC plan as it's kind of illegal (as in totally against midwifery protocol) and I had to search high nad low to find someone to support me here in the Netherlands. Just told him I wanted to be at home for first few cm's and then come in to the birthing centre. I wasn't arrogant but was very clear and confident about my intentions and ability to give birth naturally. I know him to be a pro natural birth consultant, he's famous for being the best of a bunch in a country which is very pro natural birth with a midwifery model in firm place with home births being the norm.

I am so amazed at his recommendation that I am now wondering what on earth there is to this? I thought that 2nd babies often didn't engage til the labour itself? Is it so worrying that she had not engaged yet? I'm 36 weeks exactly. I'm doing everything possible for Optimal Foetal Positioning, acupuncture and cranio sacral and reflexology on a daily basis, but I"m not neurotic about it as I simply believe I can and will birth this baby naturally, even if she is big.
Can anyone shed any light on this? I"m in a really weird space since yesterday, part confused, part outraged, partly knowing I should just stay away from the hospital. I went there to be told what the risks are etc re rupture and so on but the vibe I got is that it's THE HOSPITAL that feels risky, with all that can happen when you step out of the body and into the head and data and interventions and paranoia and hierarchy. Feels wrong wrong wrong. I think I need a teensy bit of reassurance that I'm not crazy to stay at home for the duration of the pregnancy and let things happen in their own natural way and rhythm and if a complication comes up, then we can use the medically available resources from a grounded and non-fear based position.
I"m also now slightly obsessed with her head engaging, but I'm trying not to go crazy bouncing around on the ball or over focusing on it, as staying open and relaxed seems more important.
Any experiences or suggestions or advice very much welcome.
Add message | Report | Contact poster By Wed 01-Jul-09 11:42:20
justlookatthatbooty, good luck. I understood your confusion with the consultant's logic so I am glad you feel happy with your decision now and whatever the final outcome is.
...and don't forget that there are some women and babies that owe their lives to medical intervention. Just saying
Add message | Report | Contact poster By Tue 30-Jun-09 21:11:58
Hi everyone who posted..been offline for a few days and just catching up...
Thanks for your posts, really interesting to read through.
A range of attitudes/opinions here and very helpful and interesting first hand stories WhoDidThat I can't quite get my head around your response which seems to be bordering on the angry/agressive at my questions.....hmm You don't have to agree with me and I'm open to debate but please could you leave out the unpleasant tone? Brings bad taste to the thread...

Saw midwives today after a weekend of scratching my head over the meeting with consultant. So we are continuing with the VBAC preparation as baby is in perfect position, head just above pubic bone and in her estimation perfect size. She urged me to spare myself any doubts about a successful natural and easy outcome to a VBAC. She reminded me that Plan D is the CSection and we have plans A, B and C to get through before we even have to consider it. I then came home and read one of her books and remembered why I consider her to be more of an expert in normal birth than the consultant at the hospital.

Found some of the information and questions on the www.Caesarian.org.uk website helpful and interesting...e.g
"So why are mother’s instincts and their inner knowledge ignored and given so little respect? Why does the medical profession take over the birth process again and again, to the proven detriment of mothers and their babies? Perhaps more importantly, why do mothers let them take over?" I do think there are other sides to this and there are scores of women who are due huge respect for in some cases having to fight for their rights to a CSection when they feel that it's the best for them and huge numbers of doctors who do a great job of listening to labouring or pregnant women and helping them to deliver their babies whether naturally or not. That's undoubtedly true.

The outcome of my experience with the consultant has been a very positive one. In a funny way I realise this blip came my way to strengthen my confidence in myself to approach the forthcoming birth experience with enthusiasm and optimism that no matter what kind of birth the baby and I have,from plan A to plan D, I have remained truly grounded in my own instincts and wisdom.

Thanks for sharing....
Add message | Report | Contact poster By Sun 28-Jun-09 23:06:17
it would be interesting to find out what the increased risk of an attempted vbac in case of pelvic disproportion would actually be - that way you could make a genuinely informed decision

(I like Odent's idea of a planned c section happening after natural labour has started - not a vbac but next best if things don't work out as planned maybe?)
I also find the idea of a HBAC scary, but that's based on my experiences.

You could try and write your concerns to your consultant in a letter? And list the questions you need answers to. You don't have to send it, but it might help you work out what you need to understand in order to feel as though you're making an informed choice.

When I was worried about my VBAC, I went to see the midwife in charge of the delivery suite with a list of questions / concerns. She was very kind and supportive, gave me an hour or so of her time, and afterwards I felt much happier about the recommendations they were making.
Add message | Report | Contact poster By Sun 28-Jun-09 08:38:57
Well I think if you wish for a VBAC you should absolutely have one. I find the concept of a HBAC rather scary to be honest but will admit to not knowing that much about them.

I do think that an obstetrician isn't advising you for his own pleasure but based on experience and established medical protocols which are designed to minimise risk. Of course I'm not saying so just believe him, you absolutely have the right to have your own birth plan but within it you need to accept the increased level of risk you and your baby will face.

As long as you are sure that you have done this then you should continue with your well supported birth plan and I wish you luck.
Add message | Report | Contact poster By Sun 28-Jun-09 08:31:28
I agree that your consultant's attitude seems odd. My HCPs are all of the view that since noone can predict how a pelvis might behave in labour I might as well give a VBAC a shot, although of course they might be influenced by NHS policy there! FWIW, my midwife says that a too-small pelvis is extremely rare. She sees a lot of VBACs.

I do understand the emotional side for you. It's not paranoid at all to view hospital with fear if that is what you experienced last time. This does have to be balanced with an assessment of what the risks are in your case, and only your medical carers can help you with that. Can you get a second opinion from another consultant? What does your midwife make of his comments?

I reckon also it might be worth posting on the "support for imminent VBACers" thread - lots of knowledgeable women over there.

I hope it works out for you.
Add message | Report | Contact poster By Sat 27-Jun-09 22:44:56
Edam - my own baby was 8lb 4, and I had a very easy, natural birth - I am therefore fully aware its the norm! But I was told that evolution is happening that fast, in terms of birthweight. Babies at the larger end of the scale are supposedly increasingly common. I was told that, pre-NHS, most people had babies at home and those who really needed CS often died, and as the birth history of your mother is a fair guide to your own, and the single biggest indicator of birth weight is your parents', then it doesn't seem amazing that a woman who has inherited a small pelvis might also have a baby that can't fit through it. (That could all just be hokum designed to reassure me pre-birth, admittedly! Ds was meant to be huge, but my mother had really easy labours so the midwife said it would probably be fine. I'm suspicious, now...)

Agree more discussion with the consultant is a good idea, because obviously you're right - 8lb isn't much over the average. But if he is as pro-natural as described then surely there's a good reason for his recommendation?
Add message | Report | Contact poster By Sat 27-Jun-09 22:31:59
"Can you give me a good reason why I shouldn't believe that I can birth this baby in a healthy and natural way" ....... because your consultant says there is a risk of you not being able to, that's why.

"Can you shed any light as to why the consultant should suggest a section when there is no clear rationale for doing so" .... clearly he thought there was clear rationale - shouldn't you have asked him rather than just coming away upset and worried. Presumably he didn't just suggest it for a laugh, but because he felt it was the right course of action.

I am not an expert on childbirth, which is why I went to the hospital and listened to the advice given to me when pregnant. You are clearly very intelligent and well informed, but you are not an expert either. This consultant is an expert.
I am not sure if my experience is really one you want to hear, as I don't want to frighten you. But it may be important for you to think about this.

I wanted a VBAC with DC2, and had all the same feelings you describe about the hospital. It felt as though they were trying to make it as difficult as possible (not allowed in birthing suite, had to have cannula and monitor - well, no one can force you can they, but they were clear that this was what they would want and recommend).

As it turned out, I had an abruption. Lots of blood lost, run down the corridor to the theatre for emergency c-section under a general.

Luckily, the wonderful staff saved us, and we were both absolutely fine

But...

Yes, lots of women do give birth naturally and safely every day, but I would really strongly advise anyone to treat the opinions of medical staff with great respect. Can you find out more about why he is suggesting an elective section?

I also know that this situation very stressful and worrying. I hope everything works out for the best for you, and you can have the birth you want.
This is page 1 of 2 (This thread has 19 messages.) First | Previous | Next | Last Go to page
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