Need help arming myself please?

[nunnie]

I have a 34 week scan on Monday to check position of placenta if low this will all become academic.
However if the placenta has moved I think I will struggle to get an ELCS. As they have continuously told me I am the ideal candidate for a VBAC, having had a VB prior to my EMCS.
Anyway I was happy for this but over the last few weeks I have become terrified of a rupture to the point that I have literally told myself I will not come out of this alive. I can't sleep and because of this I can't function at all during the day I have a constant headache and feel sick pretty much from morning till night which is preventing me from eating properly which isn't ideal considering my previous history (eating disorder in teens).

My fear I know is irrational and ruptures are rare etc, but that does't take these feelings away and they are only heightened by the fact that my DS is only 10 months old and I haven't psychologically come to terms with what went wrong during my labour with him.

I can't cope anymore with this and I need to be strong for my 4 year old DD and my 10 month old DS.

Is there anything out there that I can print off as I haven't discussed my feelings with my DH and I don't really want to. I just want to say I want and ELCS and hand over information relating to why without my DH actually knowing the content. Don't get me wrong he is perfect and a good listener but I am not ready to open up to him about this and whilst I was awake I wasn't really with it during my sons labour and I know he saw, heard and was involved in the decisions in a big way and I don't want to make him relive that time if I am honest. DS is healthy and well and so am I and I would rather not know what really was going on and I know he probably doesn't want to go over it.

Plus how do I tell him my main concern is dying without really having any reason to think this might happen!

[spudulika]

What sort of information are you looking for? Facts and figures won't really help your case as you yourself have admitted that your fear of scar rupture is 'irrational'.

What you need is chance to discuss whether your fear could be described as a phobia or PTSD, and if so whether it's possible for you to have an ecs to avoid experiencing labour again.

Anyway - wanted to link you to this, which might calm some of your fears about scar rupture:


rupture

From the blog:
"The story looks a little different again when you look at the mortality and morbidity caused by uterine rupture. Guise et al (2004) conducted a systematic review of research relating to VBAC and uterine rupture. They found that uterine rupture resulted in: 0 maternal deaths; 5% perinatal deaths (baby); and 13% hysterectomy. They conclude that: ?Although the literature on uterine rupture is imprecise and inconsistent, existing studies indicate that 370 (213 to 1370) elective caesarean deliveries would need to be performed to prevent one symptomatic uterine rupture.?

So, out of the small number of women who experience uterine rupture, an even smaller proportion will lose their baby or uterus because of it. When the uterus ruptures 94% of babies survive."

Shoulder dystocia, cord prolapse and placental abruption cause more deaths and injuries than scar ruptures and are more common. Were you worried about these things when you had your first? Are you worried about them now?

So much of it is a matter of perspective. But to me it sounds like you need a bit of hand-holding from a kind senior midwife, who'd listen to your fears, maybe help you negotiate what sort of care you need with your consultant.

I wish you luck.

[DaisySteiner]

IIIRC NICE guidelines state that women should be offered the choice of VBAC or repeat section. I'd print that out if you can find it and show them. If they don't agree, contact PALS.

[nunnie]

Thank you, I know it's irrational but it's telling my heart that.
I am not sure I can say it is PTSD or a phobia as I have been through 2 labours so far and haven't had an phobia issues before those.
This is purely because the last was an EMCS and the risk of a uterine rupture, which I believe is increased in my case due to the gap between this pregancy and the EMCS.
The only worry I had with DS was a repeat retained placenta but that became an irrelevant fear. Now I also have this worry with this one due to this also increasing the risk of a rupture and the likelihood it will happen again due to the reason it happened previously.

Anyway sorry this is all waffle and me trying to convince everyone and myself that I do need an ELCS when I am sure rationally I don't.

Hope I start thinking rationally in the next couple of days.

[fruitybread]

nunnie, I'm sorry you are having such a stressful time.

I remember your posts from a while back, after having MROP with your first birth - you were very anxious about the chances of it happening again, I think.

Reading your posts, I think you sound very stressed, but also as if you are not giving yourself permission to feel that way. I apologise if you think this is too personal an observation - but it reads as if you are experiencing very high levels of anxiety, and then beating yourself up about it.

You say you are terrified - can't sleep, so can't function at all during the day - feel sick all day and can't eat properly - have a constant headache - and you say you can't cope.

I don't think you need to worry about categorising those feelings as PTSD or a phobia, right now, but I do think you could recognise that you are experiencing extreme levels of stress. Which must be making life very miserable for you, and not letting you enjoy your pregnancy. And you aren't able to share your anxieties with your partner, which leaves you a bit isolated. I would really consider going to your GP, asap, so you can get some support - they should be able to put you in contact with a perinatal mental health team. If you feel that being granted an ELCS would take a lot of stress out of your situation, then you need to be clear with the consultant what your feelings are - as clear as you are here - write it down if necessary, if you don't want to talk about it too much.

I do think that whatever birth route you go down, some immediate support would be very helpful for you.

[nunnie]

Yes fruitybread that is me, the MROP issues were around being awake and how I had felt during the procedure, I think this was when I 1st started using MN.

Last night was possibly the worst so far, I don't remember sleeping at all just staring at the celing. I really do need to snap out of it now before I make myself really ill.
Think the GP is the only option I have now as this really can't go on.

Thank you for all your advice is been very helpful.

[PrincessScrumpy]

On paper I had a "perfect birth" with dd1 as she came in 2 hours 5 mins, but mw didn't believe I was fully in labour until 25 mins before she was born. The birth left me with 30+ stitches so I went to see a consultant before concieving this time to get him to agree to c-section. At first he didn't take me too seriously (I was fairly emotional) but dh stepped in and spoke calmly, explaining our fears and his support was amazing.

I know you don't want to talk to your dh, but honestly, I think you need support at home and as your dh was there through your other 2 births, he will understand. I would be devastated if dh had some deep feelings that he didn't share with me - but I know every relationship is different. Can you talk to your mum or a friend?

It does seem to depend where you are re VBAC or ELCS - as I'm down for ELCS many mws see my notes and assume I had EMCS with dd1 and are surprised when I correct them, despite me being pg with twins. The twins are now in a position that means I cannot have a VB so I guess my body and babies decided to support my brain!

Do try to relax - what ever happens, you will have a beautiful baby at the end of it all. I would definitely visit your gp. Take care of yourself x