older mums and elective CS??(7 Posts)
Does anybody know what the view of older mums and elective CS is at Chelsea and Westminster? I'll be 43 when I deliver my third child in Sept. Although I've previously had two OK'ish vbs (7 and 9 years ago), this time I've found myself getting increasingly anxious about the increased risks of placenta failure and stillbirth as a result of being older. Am I just being paranoid or is this a real issue (there seems to be such a lot of discussion around stillbirth and the high levels here in the UK). I am so paranoid about the chances of things ending badly if I'm left to go over my due date that I am increasingly thinking about requesting a elcs on my due date. Is that crazy???
Any thoughts/experiences much appreciated.
Hi, I don't know Chelsea & Westminster, but I was in my late 30s when I had DC1. I was offered induction on due date because I had high blood pressure. Scans had shown DC to be okay and a normal size.
I chose to wait. Scan at 40+2 showed insufficient liquor. Induction scheduled for 40+4. I could have had ELCS, but wanted shorter recovery time. Ended up with EMCS, and even longer recovery time anyway.
You may find that as you have had VBs, the hospital will want to steer you towards induction. However, they should make it clear that ELCS is available. If not, ask them about it!
If you decide to consider induction, ask the hospital what percentage of their inductions end in EMCS.
Having seen the effect of a failing placenta on my baby, I regret not taking the induction on due date. If I had been more aware of the risks, I would have taken the induction on due date. Baby survived and is now a healthy toddler, but was in a poor state when born - very thin (2nd centile) and shorter than expected. Lots of support needed to get weight and length growth on track including twice-weekly HV home visits. DC1 is now a tall (91st centile), slim (25th centile) toddler, but it has been a long hard slog that I put down to getting a bad start.
IMHO you are right to consider ELCS to protect your baby.
I fully understand and had quite a wobbly this week when I say my consultant as I am 40 and its already been identified that my baby isn't growing as quickly as it was (although it is just in normal ranges).
While I don't know about ELCS as there are medical reason they don't want me to go down that route, I would definitely talk your concerns through with your GP/consultant, find out what standard procedure is and then state your case. And don't google anymore (it does your head in!) Smile. Good luck and I hope you find some answers.
Nicci the "Scan at 40+2 showed insufficient liquor" made me wonder what was your baby drinking? I know it should have been 'liquid ' and not 'liquor' but it was kind of cute anyway. Smile ... Glad DC1 is doing well.
I was had my last baby 3m before my 44th birthday. I was induced at 42w. No problems, straightforward delivery and healthy baby. Just to let you know that problems are not inevitable due to age.
Darlingdamsel liquor is another name for amniotic fluid.
Thanks everybody. I'll definitely talk it through with the consultant and midwife. I've also booked in a wellbeing scan for 32wks at the fetal medical centre so hopefully that will be able to reassure me that things are still on track (I do think that its not great that on the NHS you're not scanned again for the whole second half of your pregnancy unless there are obvious issues).
Niccibabe - so that glad that everything worked out well and that DC1 is doing well. Thanks for the advice on question re emcs after induction - probably wouldn't have thought of that otherwise!
Even though i know that there is a strong chance that everything will be OK, I don't think I could cope if something avoidable were to happen. Its been a bit of struggle to get to this point (previous termination for chromosomal problems, problematic scans and amnio in this pregnancy) that I just want to make as sure as possible that nothing goes wrong at the last hurdle.
There is definitely an increasing acceptance amongst Obstetricians that in addition to specific obstetric conditions such mothers are more susceptible to increased risks of placental dysfunction & failure with a small but significant increase in assocated postdates SB rate.
In our unit we typically arrange additional routine Fetal growth scans at 28 & 34wks to monitor for problems and in the absence of other contra-indications give such mothers the choice to consider elective IOL between 39-40wks.
Hope that helps & good luck!
"such mothers are more susceptible to increased risks of placental dysfunction & failure with a small but significant increase in assocated postdates SB rate"
SC - it'd be really helpful if you could put some figures on the increased risk. What percentage of multiparous mothers over 40 experience stillbirth after 40 weeks compared to, say, a multiparous mother of 35?
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