please help me to get it together for my constant apt on Weds.

(39 Posts)

Hi, I'm 36 + 3 with baby number 2. I had a horrible birth with my DD -Very long labour, with DD getting progressively more distressed, and ending with episiotomy and ventouse. The Consultant I had was terrifuing, and didn't once tell me before examining me (including when he stuck his finger up my bum). My stitches never healed, and I had an op when Dd was 6mnths old to remove all of the scar tissue, and cuaterise (sp?) the area.

I was assaulted about a year before I fell pregnant and after she was born, I sufferred awful flashbacks, which sort of merged into flashbacks of the birth aswell. I had post natal anxiety and mild depression, because of all of this.

Anyway (thank you if you are still following) I managed to discus all of this with my MW a little while ago, and she has referred me to a consultant to discus C-section, or ?perennial care if i'd rather. I have totally buried my head in the sand about getting this baby out, but have been getting so anxious about Wednesday I really need to get my head together. I'm pretty sure i'd like to plump for a C-section, but am scared they'll make me fight for it, and that i'll fall to pieces at the apt.

I'm not sure why I posted really, but I would really welcome any advice, especially when it comes to requesting c-section.

Sorry this turned out to be so long, and thank you if you managed it all.

itsakindarabbit Sun 24-Feb-13 20:53:45

You poor thing sad

As cynical as it sounds, breaking down andcrying a lot will probably help your casefor elcs.

I think you need to decide beforehand what you want, if at all possible. Then you can be assertive when you go in there. Dont let the consultant make your mind up for you if youaresure youwant anelcs.

Oh dear! Just spotted typo in the title... am on my phone! Dammit! Obviously that should say Consultant!

Sorry, X-posted with you rabbit! Thank you for the advice... I don't think breaking down and crying will be too trickyto manage tbh! God, I do hope he's sympathetic! Is it common for them to try and talk you out of ELCS, do you know?

motherinferior Sun 24-Feb-13 21:03:09

Sweetie, I think showing how distressed you are is your best tactic. Good luck!

itsakindarabbit Sun 24-Feb-13 21:05:53

It really depends on the consultant but it is very common for them to convince you to try naturally. I think if you sre persistent you will get an elcs but you need to know that that is what you want and simply refuse to consider any other option. If you get a consultant who turns you down flat you can askto see a 2nd consultant.

You can also change hospitals if it comes to it and geographically ok for you. You can search c-s rates for your particular hospital and that should give you an idea of how proc cs they are. Of the 4 hospitals in my local area i chose the hospital with the highest elcs rate.

itsakindarabbit Sun 24-Feb-13 21:11:09

Just to say, am in scotland so not sure if the data i got is available for english trusts.

RubyrooUK Sun 24-Feb-13 21:11:35

It wasn't the same situation but after a very traumatic first delivery resulting in surgery, I found the consultant was very understanding and immediately suggested a c-section.

So my experience was that actually the consultant wanted the best thing for me. I went in primed to be very assertive but it wasn't necessary.

I would say just be prepared to explain why you wanted to see the doctor. You had a first delivery that left you needing surgery and associations with a previous attack left you feeling depressed and having flashbacks.

Say that this time you want the hospital to help you avoid such serious issues by having a c-section.

(I have to be honest and say no-one seemed that arsed about the fact that the first birth involved DS getting very distressed, doctors/midwives arguing over me and eventually an emergency situation...but they were very pleased my post-birth surgery had been successful at repairing me and the consultant said it wasn't worth destroying all that good work!)

Teapot13 Sun 24-Feb-13 21:16:06

I'm sorry to hear what has happened to you.

It sounds to me (no expertise whatsoever!) as though you have two good arguments for an ELCS -- a previous traumatic birth requiring surgical repair, and the psychological issues resulting from the assaults. I think the NICE guidelines say that if a woman requests an ELCS because of fear of birth she should be referred for counseling and then if she still wants one she should get it. I think it would probably help if you review these guidelines before you go in -- no personal experience, but many people say they take the request more seriously if the patient has done research and clearly understands the risks on both sides.

Given your dates, I don't know if there's time left for meaningful counseling to take place.

If you received a diagnosis, can the person who treated you (GP or counselor) write a letter?

Would you be interested in perineal care? Personally, after what you have been through, I would just go for the ELCS, but it isn't for everyone. (I have one DC, and had an ELCS, so it's what I know.) It's major surgery and a long recovery. I would be curious about perineal care but I would also be wary of sounding undecided when meeting with the consultant.

Good luck deciding and getting what you want, and with the birth, whichever way it turns out.

Thank You for all of your replies... Ruby, it's nice to know that it's not always a battle.

I have done a bit of research, and to be honest, I think I am more on the side of ELCS, just this tiny voice in my head saying maybe it would be different this time, but I agree, Teapot, I am wary of looking like i'm wavering.

Would anyone who had had an ELCS before mind telling me about the recovery, please?

didireallysaythat Sun 24-Feb-13 21:34:58

I argued for and got an elcs second time around. My first born was 9-9, forceps, 3rd degree and while I knew that every birth is different and there was no reason to think my second would be a whopper, I just wasn't up for it. My community wives respected my opinion so when I saw the consultant who yes said there was no medical reason for an elcs I felt confident enough to fight my corner. Yes I cried. Yes I wrote down my reasons on a list beforehand so I wouldn't forget anything.

And my recovery was a lot faster than with the tear. But that's just me.

Good luck

itsakindarabbit Sun 24-Feb-13 21:39:43

My experience was pretty much identical to didireallysaythats. Recovery was no problem for me, though obviously its very personal. Found forceps recovery much worse

Phineyj Sun 24-Feb-13 21:51:29

OP, can you take someone with you to the appointment? Discuss with them before hand what you want to say in case you can't get it out. It's so frustrating to feel you're not being heard -- can be really helpful to have someone calmly saying what you want said.

Thank You again. I already feel much calmer, having had the opportunity to write it all down here and read your replies.

For those of you who did have to argue your case, what sort of research did you do? I have read up on the risks of each, and on recovery times etc. Anything else you think might help?

Sorry for all the questions, but I really am very grateful :-)

I had a traumatic birth experience with DD1. The usual story cascade of intervention induced, long labour, failure to progress, epidural, full dilation was achieved but after 3 attempts at forceps, she was too big and wedged in, they did an EMCS.
I had PTSD. I was seen as an outpatient by our mental health trust for a year after her birth. I was very lucky that my Community practice nurse was wonderful and she helped my case hugely when it came my choice to have an ELCS with DS2. She wrote a letter on my behalf about how it was deemed medically necessary. I also went to the VBAC clinic and it was deemed that i could try to birth him if I wanted. i agreed to try with the clause that nothing was set in stone at any stage. I had the libery to change my mind at short notice, as do you, remember that when youre talking to them.

Did you have treatment following your experience with anyone that you could get in touch with, who may be able to help? Did you see a counsellor or anyone?

My advice when you see your consultant is that they may surprise you, mine did, he left the choice to me and together we came up with an excellent plan. in my case I wanted to avoid induction at all costs. My consultant said that if ds was overdue by a week then automatic ELCS which is what happened. if I had gone into labour with him, then it was agreed that at any sing of ditress or a labour of longer than 12 hours wasn't showing any progression i was to be given a csec. I wasn't going to be induced, I wasn't going to be left too long, and I was quite insistent that my labour be heavily monitered so at the first sign of any trouble a CS. The plan gave me great peace of mind. I had the best of both worlds. As it was ds was 13lb at birth so it was just as well, my EMCS with DD had been because she was 9.4 and got stuck. Theres no way he was coming out that way. The consultant was aware of this and he was superb.

Recovery is a little easier, but my no means a piece of cake, 4 days in hosp, blood transfusion and then i got bloody norovirus from the ward on the day i got home, they wouldn't let me back in because they had closed the wards. That was no fun with huge weeping wound in your belly i can assure you. But that was bad luck.
On the whole the ELCS was very healing experience in many ways. A big thing for me was the lack of control, I was so out of it by the time they told me they were prepping me for theatre with DD that when i was wheeled in it was an alien induction, all bleeps, and lights and voices and people everywhere. This time i walked in on my own two feet and could look the surgeons in the eye and have a conversation. It was very calm, quite civilised and wholly different from DD's arrival. It actually cured the last of my linger anxiety and i haven't had a flashback since.

I wish you luck OP, stand your ground, YOU have the choice.

Appin Sun 24-Feb-13 22:23:44

I had a forceps and third degree tear with my first baby, and an elective section with my second. I found the consultant was happy to support me with an elective due to the damage caused to my sphincter in my first delivery. I haven't had surgery to repair anything, but now eighteen months after my second baby I'm still seeing a colorectal specialist and a physio to deal with my problems, so in my head it's just as well I had a section the second time.

I think the surgical repair is a great argument in favour of a section. Stress the problems you had post natally, and how these were improved with the surgery, and you wouldn't want to undo any damage. To be honest, I just told my consultant that because of all the problems I would never feel confident pushing, I would be in labour in fear of it all tearing again, and she seemed happy with that

Good luck!

Appin Sun 24-Feb-13 22:27:03

And as regards the elective section, mine was fine. I was nervous, but my DH was by my side the entire time, and it was very calm and orderly. And celebratory, I genuinely felt everyone in the room was delighted to meet my DD. It was just lovely. In fact, nothing makes me broody now, with the exception of elective sections on OBEM!

I agree with fishandlilacs, it was healing. Lying there in a calm and happy context gave me the chance to look round the theatre, to take in and study all the things that had been so terrifying the first time I was in that room (yes, same theatre!) and sort out in my head what had happened.

Crikey fishandlilacs That's quite a weight! Dd was only 7lb, and that was quite enough!

Thanks appin too. It has been really good to hear your experiences. I think I have decided in my own mind that I want the ELCS, so now just have to convey that in my appointment on Weds!

Thanks again everyone!

Just checking back in, although I'm not really sure why. The appoinrment is tomorrow morning, and I am feeling so anxious about it. i'm terrified he will make it difficult and I won't be strong enough to deal with it :-(

RubyrooUK Tue 26-Feb-13 21:33:36

Don't panic.

Explain the circumstances of your first birth. This resulted in surgical repair. All has now healed but you are very concerned that having avoided issues like incontinence etc after such a bad birth, you are not keen to risk this with a second vaginal birth.

The impact of the birth last time left you feeling depressed and low at a time when you were wry vulnerable. Add to this that you suffered flashbacks etc.

You tried a vaginal birth first time round. You are not being unreasonable. But after a birth that lead to repair surgery and depression, you think it's only sensible to try and aim for a better outcome this time.

I think that when you see the facts like that, the consultant should want to help you achieve the best outcome. If the doctor suggests different options to a c-section, listen to them all but if they don't seem possible for you, tell the consultant that the proposed solution doesn't really deal with the problems you feel you're facing.

Good luck!

Thank You Rubyroo. That is really good advice. Your post is really reassuring. I know that I am not being difficult, and am justified in my thinking, but it has really helped to see that when laid out factually it still looks reasonable... I don't know if I am making any sense at all... but Thank You!!

How are you today OP? Good luck, please pop on for an update.

MiaowTheCat Wed 27-Feb-13 12:57:36

I found my appointment (albeit with a midwife) to discuss my concerns to be an utter waste of time - her entire function seemed to be patting you on the head that "there there it'll be different this time" and sending you on your way.

Ushy Wed 27-Feb-13 13:19:28

As others have said, getting upset may be no bad thing BUT I reckon you should go armed with a written explanation of exactly why you want a c/s - the awful impact of the last birth, you have looked at the risks on both sides etc etc and if you can't spit the words out - just hand over the signed letter.

I think otherwise you may get sent of to 'ensure' you have 'full understanding' of the risks (ie. have been exposed to their cost saving propaganda about how good a vaginal birth would be for you) and that can just make things worse for you. Let them know you know what the risks are and that you consider they are less than the psychological trauma of an impending vaginal birth.

Good luck and I do hope Mumsnet will intervene at some point and do a campaign on this because there are SO many women being treated or fearing being treated like this.

Hi everyone,

just popping on for an update. My apt was this morning. I was there for 2hours in total, and feel like i've been knocked over by a truck... it was emotionally draining to say the very least!

The Consultant was horrid. He just kept saying 'My job is to persuade you not to have a -section' and even said 'What happened to you happened. Deal with it' I burst into tears, and felt really helpless. He then went to fetch a midwife who specialises in mental health, who took me for a 1;1 discussion. She was bloody amazing, and listened to my concerns, I was able to articulate to her what I couldn't to him. She really advocated for me, and when I had to go back to the cons. she talked me through it, and was an absolute star... even have me a sympathetic squeeze when I needed one.

Anyway, to cut a long story short, he agreed, and I am booked in for the 20 th March.

It was an awful experience, and i'm glad it's over, and I can now look forward to meeting my lovely baby

Thank you all very much for your support and words of encouragement

Penguins

piprabbit Wed 27-Feb-13 16:20:48

I'm so glad you got the outcome you want, well done for sticking to your guns and talking it through with the MW - but furious that the consultant was so bloody awful. I'm sure he has got an objective to reduce the number of c-sections - but he wasn't listening to you about your needs. I wish I knew why consultants seem to have zero empathy for their patients in so many situations.

I had many internals when I was expecting DC1 - the only one that left me bleeding, in tears and white and shaking from shock was the one the consultant did. The MW ones were all fine.

Hurrah, all of this can be forgetten now, you have the outcome and even though the consultant was awful, you stuck to your guns. Good luck with the c sec I hope you get a speedy recovery. Newborn cuddles soon!

myrubberduck Wed 27-Feb-13 21:20:46

Tell him that if you suffer any ill effects whatsoever following a vaginal delivery you will sue; and that you feel so much better knowing that the risk of that happening will be shared between you both; you physically and him professionally ;)

myrubberduck Wed 27-Feb-13 21:21:33

Sorry ignore last post ; I see you got it smile

Piprabbit, that's horrendous... It makes me so angry that it is the case in this day and age :-(

fishandlilac , the thoughts of newborn cuddles are what's got me through :-)

myrubberduck, How I wish I'd said that! Brilliant!

Thanks again wonderful women of MN. XX

AmandaPayne Wed 27-Feb-13 22:15:26

IBlame - I don't blame you at all if you don't feel up to it. But if you do, consider putting in a written complaint about the way your were spoken to. That is appalling, and the consultant concerns needs someone to say so, very loudly, so that it is noticed and acted upon. I am so cross to think about him doing that to woman after woman.

RubyrooUK Wed 27-Feb-13 22:18:28

Very happy for you Penguins.

I can't understand why on earth a consultant would say to you that it was his job to persuade you not to have a c-section. I was under the impression they were there to oversee your care in whatever manner was needed! I always felt my consultant genuinely had my best interests as a patient at heart.

I'm glad you were able to explain your points clearly to the midwife who was able to advocate for you.

Your c-section is a week after mine, so I look forward to seeing you here soon with me moaning about sleep deprivation.....grin

RubyrooUK Wed 27-Feb-13 22:24:55

And actually I agree with Amanda about your treatment by this consultant.

Don't get me wrong, I think it is fine for doctors to discuss different birthing options with patients. If vaginal births are the default for most people, talking through options of how someone could give birth are fine. But I do not think it is fine to dismiss someone's trauma with "get over it".

As I said before, the doctor I saw was happy to approve a c-section for medical reasons. He told me that if I was keen to have a vaginal birth, they would try to manage it for me to ensure the best outcome. But in his view, a c-section was the best option for me physically. That seems to me a reasonable conversation; not one where a patient's genuine concerns are minimised.

AmandaPayne Wed 27-Feb-13 22:28:39

Exactly (sorry about the typos in the previous post). It is not ok to tell a traumatised woman to 'deal with it'. It is not ok to make a woman beg for appropriate medical treatment. It is not ok for a doctor to act with so little human compassion for a patient. If you feel up to it, a complaint would be investigated and, at the vest least, this consultant would have to sit down and tell a manager just why he thought that this behaviour was ok. Which might even make him think twice before doing it again.

Hi all, so sorry for late reply. I think I needed some time just to process everything.

I agree. You are totally right about the behaviour of the consultant. I said to DH that if I was not relatively well read up, or if I was less articulate I would have just been totally railroaded regardless of what was best for me.

It's tricky, as I live on an island, so very limited choice of consultants, and I also work for the trust. I had thought that I will definitely write in total praise of the amazing midwife, and I had kind of thought I would note the contrast in the treatment I received from the consultant, and maybe suggest further training, particularly in dealing with women who have suffered abuse. Comments like hits can undo a LOT of hard work in coming to terms with something like that.

It seems to me that a lot of these consultants are shielded by how vulnerable we are at the time of seeing them. I think women rarely feel strong enough to complain at times like this, which allows it to continue, so I will definitely register my unease with his lack of professionalism.

I'm rambling now... just thinking out loud I suppose. but thank you for helping me to clarify what I was already thinking. The good news is that, for the first time this pregnancy I am excited about the birth and snuggling my little bundle! Eeeek!

Good luck rubyroo I will be keeping my eye out for your news! xx

GingerJulep Fri 01-Mar-13 14:24:32

I'm pleased that you have the outcome you were looking for.

In fairness to the consultant he was suggesting what was, quite possibly, the best option for your child from a physical view point. When it became clear that you had a mental issue beyond his capabilities he went and got you someone who could understand and empathise with you.

Even coming up with preferences for a birth in your own head, where you have a very clear idea of what mental state you are in, is a difficult balancing act. I'm sure it wasn't fun to go through but your consultant this time around got you both the midwife you felt comfortable with AND the outcome you wanted. That isn't really bad going.

MedicalEd Fri 01-Mar-13 15:02:02

Only just seen this thread OP, am glad you got the outcome you wanted.
But I am so furious with that consultant. It is definitely not his job to convince you not to have a section, it is his job to do what is best for you and your baby. And to just say 'get over it' is heartless, demeaning and very poor practice.
If you have the strength after the birth, I would complain about him.
Good luck with the section and enjoy snuggling your newborn.

I do appreciate what you're saying ginger but did find some of his comments to be rather unprofessional and uneducated at best. I was really hoping top go for a discussion, but just got a 'rape's not so bad' stonewalling, which was tough!

Thanks medicaled I plan to spend this weekend getting all the baby bits together, and buying all the practical stuff... Not long now! Hurrah! x

RubyrooUK Fri 01-Mar-13 17:34:00

Hm, not sure I agree Ginger.

I think the best thing for the majority of people is likely to be a vaginal birth. So I think it is totally right for doctors to present all the options and discuss them with patients. A friend of mine who wanted a c-section decided after discussing it with her consultant that actually she would prefer a vaginal birth, especially once the consultant explained very thoroughly how they would help her though it to avoid complications. It was a good outcome.

But if I had a woman telling me of post-birth surgery, flashbacks relating to assault causes by vaginal injuries, I'd never suggest they "deal with it". My own consultant was incredibly sympathetic when we had a similar conversation. I felt like he was thinking of the best thing for the baby AND me.

Yes, Penguins' doctor got the midwife so it was good that he acknowledged that more needed to be done to help Penguins make her point. Still doesn't mean he should have dismissed a birth that induced post-assault flashbacks saying "deal with it".

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