If you are planning and ELCS, how did you decide what to do if you go into labour beforehand?

[LoopyLoopsBettyBoops]

ELCS booked for 11 days time. Head engaged, feeling quite imminent. Consultant suggested thinking about what to do if I go into labour beforehand.

It's not something I've considered, and I don't know where to start!

[LoopyLoopsBettyBoops]

I had an EMCS last time, as DTD1 was stillborn and DTD2 (well, both of them clearly) only 32 weeks. I've chosen the ELCS because I'm petrified (of both options) but can be sedated for the CS. Also the risks seem to be more for the baby with VBAC, whereas they seem to be more for the mum with a ELCS.

Basically, I'm a big wuss.

The consultant was very keen for me to try for a VBAC if it comes early, but I can't get my head around it. I just don't know how to decide something like this.

[PeppaPigandGeorge]

Think about it, and write down your reasons so the consultant can see you've thought about it. Also discuss it at ante-natal apps so they can record it.

I "went into labour" at 35 weeks, plan was an ELCS at full term. The registrar spent the best part of a day trying to persuade me to read a leaflet about VBAC and telling me I needed to make an informed decision as CS at term is a different decision to earlier CS. I knew I wanted a CS as I had looked into this issue but I was in no fit state to convey this at the hospital - I was delerious and vomiting and could only manage to say "please do a CS now... or get me some morphine". As it turns out, I had an abruption and they did a crash CS just in time to save me and the baby. Had I had a record of my informed decision in the event of early labour, they would have done the CS earlier and saved an awful lot of pain.

[nunnie]

I wanted a ELCS, as I had an EMCS with DS 8 motnhs ago as he was brow and distressed. I have had a natural birth with DD 4 years ago but I had a failed 3rd stage so ended up in theatre for that.
After a discussion with Consultant it seemed that a VBAC was the better option for me, in terms of worry due to early labour. My problem is with both mine I went into spontaneous labour 39+1 with DD and 36+3 with DS and I progressed with both from stage 1 to 2, in a very very short time, with DS i arrived pushing, if I arrived this way again and all was looking ok, then they would not preform a CS anyway, so with my history and the fact they will only do an elective at 39 weeks here, I decided to go for a VBAC then I can worry about something else instead.
I am currently only 25 weeks and have a scan at 34 weeks because my placenta was close to cervix at 20 weeks, and there is a possibility of previa and accreta so the decision might be taken off me once again, so not usre how it works in this case, as if my placenta stays where it is I believe it can be quite dangerous to labour but I'm sure I will find out more then, and trying to avoid Googling and pooping.

[Stangirl]

I had an ELCS with DD at 39 weeks and am planning another ELCS for DC2 at 39weeks. I am currently 34 weeks. I have confirmed with both MWs and Ob that if I go into early labour I will be taken straight to theatre for c-section. I have no medical reason for a c-s - I just want one. I am at Kings which seem quite pro-cs and they have been very reassuring about moving me straight to c-s if I start labour.

[LoopyLoopsBettyBoops]

Been in early labour for nearly 48 hours now. :( No sign of a doctor, let alone any way of requesting my CS. What should I do? Do I need to be in full blown labour before they talk to me about it? 37+4.

[PeppaPigandGeorge]

Are you at hospital? If not, don't be fobbed off with any "not until the contractions are X apart". Just go in. Otherwise they will try to get you to wait it out as a VBAC. Fine if that's what you want, but if not get into hospital. Whether or not you get to see the doctor immediately, tell the MW you DO want a CS (if you do, which you seem to) and you have made an informed choice taking into account all of the risks of CS at less than full term. Make sure they note this down; my big problem was trying to convince them I had made my mind up. Ask when the consultant / registrar / whoever will be able to see you. If you get nowhere, make a formal complaint via PALS.

[LoopyLoopsBettyBoops]

Thank you.
I'm at home now. The problem is I just don't know what I want. I feel totally railroaded into this VBAC, but now after so long I'm not sure what I want. I know that I can't do this much longer. :(

[PrincessScrumpy]

I have cs written on my notes very clearly and have been told I'll get one even if I go into labour early. I pointed out to the consultant that dd1 came in 2hours 5 minutes and he laughed and said "Well in that case it will be a bit more of a rushed emergency, but we'll make sure you get one, don't worry."

My only concern is mws refusing to call the consultant as I'm not in full labour which is what I was told 20 mins before dd was in my arms. Really don't want an argument at that stage.

[LoopyLoopsBettyBoops]

That's what is going on here. Not full labour, so no options.

[PeppaPigandGeorge]

How early is early labour? What have you had?

I have to say, I'd be inclined to go to hospital, as you might get seen by a doctor sooner. I'd just turn up as if you ring they'll tell you to wait (you can always apologise and plead ignorance once you're there).

[LoopyLoopsBettyBoops]

I've been in twice yesterday, they just sent me home. I was only 1cm dilated. Contractions since Monday night. Pissed off now. :(

[PeppaPigandGeorge]

If you want a CS it shouldn't matter how dilated you are. I'd go back and maybe tell a few white lies about how far apart the contractions are?? Also, you could say your mum / dad / whoever dropped you off as an emergency and you can't go home so will have to wait. If the hospital MWs won't let you see a doctor, be firm and insist you need to see one as you want a CS. Write in your notes that you have considered the impliations of early labour and CS and still want one. You could always complain via PALS if they won't let you see a doctor.

[LoopyLoopsBettyBoops]

I'm getting more contractions now. I'm planning to go in when they're a bit stronger/closer then refusing to leave.

[nunnie]

That's sounds like a good plan Loopy. Sorry they are making this so difficult for you.
I was told when discussing mine, that if I went into labour or even just thought something was happening to go straight there. I really don't understand why protocols vary so much from hospital to hospital.

Hope you get them to listen soon.

[5inthebed]

You poor thing, doesn't sound like they have been helpful.

I had a very traumatic labour with DS1 which ended in an EMCS. I had bad PTSD and PND, so when I was pregnant with DS2 I dfinitely wanted an ELCS. There was no ifs or buts about it.

However, when I was pregnant with DS3, I wanted a VBAC, but because of previous trama I was not allowed.

Personally, I woul ask for a c section. Good luck.

[harrygracejessica]

I was booked in foe ELCS with DS1 for 39+1 and had it, was having ELCS with twins but got to 33 weeks so kept in labour for steroids and had them at 33+2 (one was breech), booked in for 37+6 with twins and got to 36+5 so 2 what they class as emergency ones. I was told if your dute a section ahnd things agre happening goi straight in so its not a full emergency.

[jjgirl]

for my ELCS at 36 weeks i was lucky i made it, but only just. plan was carry a phone at all times, dont go anwhere remote or away from people. first sign of a contraction call the ambulance imediately. procede to hospital immediately any bleeding occurs.

oh i had PP grade IV by the way and it was considered a huge risk of bleeding.