Is this a strong case for elective caesarian?(48 Posts)
Dh and I are currently ttc.
On having dd four years ago I went through the following:
One failing kidney
Although I did not go into established labour, the experience was very traumatic, one I really do not want to repeat. I realised how at risk I actually was.
I am happy at the prospect of becoming a mother for the second time but am anxious that the consultants will try and talk me out of having a caesarian.
Can you recommend any websites that I can research? I will need to be prepared to fight my case with the consultants.
I asked for an elcs and was prepared for a fight. Download the NICE guidelines, previously any woman had the right to ask for a section if she'd had one before but they were changed recently that any woman can ask.
If you are refused you have the right to ask for a different consultant. That said, I went armed with vbac rates, trial of labour studies and the risks of elcs.
I didn't need any, discussing my previous birth reduced me to tears and I had my section agreed without question. It was good to be prepared but so long as your informed you should get it agreed. Do not go in saying it makes for better childcare arrangements for dc1!
Thanks for the advice.
I intend to gather as much information as I can.
I believe I have a case - just need to convince the consultants!
At what stage do you speak to your consultant? I really do not want to wait until the end of my pregnancy.
Bumblebee- I was very stressed about it (not sleeping well etc) so my uber lovely midwife got me booked in asap- it'll be 9 days since I spoke to her that she managed to get me in. As I said, my midwife is very empathetic so I feel I've been lucky. The best of luck to you too.
hopefullly your mw will be sympathetic (mine was) and understand the need for you to see a consultant sooner rather than later in your pregnancy.
If not, you will need to push for her to put you forward for a consultant meeting (in theory you can just ring the hospital and ask yourself, but it's not the 'norm') - if she tries to put you off or tells you you can't see one until week 35 or whatever, that's not true. I had my cs granted around 20 weeks, I think. Like I say, I had a great mw but they vary and if you get a dismissive one, you will have to insist you meet a consultant and not take no for an answer.
I am not willing to wait until 35-37 weeks to be granted an ELC. I will ask to see a consultant on my first visit with the mw.
I am going to request my notes from my dd's birth and take them with me when I meet consultant. If need be I will see two/three consultants.
if it helps, I think previous pre-eclampsia and a wonky kidney should mean you get access to consultant care fairly easily.
It might be an idea to stress not just the previous physical problems you had, but how much anxiety you are feeling about being able to get a CS booked in. Just that your physical problems will probably put you on a protocol of watchful waiting to some degree (the wait and see how it goes approach) but you might want to get across that this uncertainty isn't enough for your mental and emotional health.
I do think you are a 'good' candidate for a repeat Cs if you want one - I'm just cautious because there is SOOO much variation between individual hospitals and consultants in terms of attitude and policy for CS. Hopefully things will be straightforward for you. I understand it is very stressful feeling you have little control over something so important.
Thanks for the advice. I will definitely lean on the psychological side of things as I know they can throw "this pregnancy may well be different". If it is then I have no case.
I would not be lying about the anxiety. I delayed having dc2 because of it. There was so much uncertainty around dd's birth.
First they tried to break my waters
Labour did not progress
Tried inducing me
Labour did not progress
Gave me an epidural
Labour did mot progress
Kidney started playing up
Rushed to theatre for emcs
I had a caesarean last time. When discussing birth options I asked if I could request one this time. He said no problem. I don't actually want one, but it was nice to know the option was there. No fighting.
I had my ELCS agreed with the consultant and on my notes at 11+5weeks! Booked in at hospital with consultant following dating scan, and asked when we could discuss it as I was very anxious (on ADs at time) she agreed an ELCS was the best course and its certainly helped me manage my pregnancy better, knowing I will be having one.
I had pregnancy induced hypertension, failed induction and EMCS due to footling breach and mother and baby distress. They were quite happy with my reasons, they obviously went through the motions, asking how I would feel if baby was in position this time (they got it wrong last time) and success rates, but you tell they were saying what they had to! Don't forget a 75% success rate, is a 1in4 failure rate!
I was identical to you and waited 2 years to do it all again currently 30 weeks; first time round developed severe pre- eclamp at 35 weeks, we both nearly died so know how it stays with you.
Pre-eclampsia means you automatically have consultant care, no questions or fight. I personally had to change hospitals as the first consultant (head of obstetrics local hospital) said I had no right to an elec section I should be a vbac.
Unfortunately pta doesn't pre-suppose an elective section amazingly. Thanks to the changes of funding/policy relating to c sections nationally from the tory government late last year. They fine hospitals who breech a certain %age of c sections so they all try to keep them down. They say it's costly and unnecessary. Tell that to the pre-eclamsia ladies who have suffered because of vbac and those ridiculous guidelines.
I changed hospital and saw another consultant at 28 weeks who was so appaulled by my previous care he offered me what-ever I needed; he specialises in high risk pregnancies. I told him (truthfully) I'd actually considered termination when the 1st consultant said at 20 weeks I may have to go through the whole thing again, it was so traumatic.
Long story short I'll be formally booked in for elec section when i get to 34 weeks. NICE guidelines say that if the consultant has explained every other avenue and the woman still wants elec section, they can have it.
If you encounter problems you have to be referred to a consultant who will consent to an elective section. Simple as that. You'll be seen at 20 weeks or before if you ask (mw will refer) You need to be clear right from the start what you want and if you don't get it, be referred on.
Can they really force a VBAC on someone?
I imagine that anyone with a previous c section can choose between a repeat CS or a VBAC. I'm shocked to hear that even women with prior c sections are being forced to beg and plead for a repeat c section. It's appalling.
I am willing to change hospitals in order to be granted an elcs. I will not be forced to have a vbac. I want to have a worry free pregnancy rather than pondering on all the things that went wrong at dd's birth.
this discussion is v interesting, thanks! Am on my first pregnancy and my mw was NOT supportive of my ideas of having an ELCS rather than a vaginal birth. will meet someone at the hospital in Brighton (hope someone who's sympathetic) at the end of the month. in the meantime I'm reading a book on ELCS and going through the NICE booklets. I'd recomend reading the full NICE data, as in the 20-pg doc you can find on the NHS webpage they only mention risks with CS (elective and emergency, btw) and none of the risks with vaginal birth. don't feel like going there and whinge, I just think an ELCS is the best way of giving birth for me - it's make me feel more confident & safe and less stressed about the delivery. that's not too much to ask I'd say....
I had an emcs the first time. When I got pregnant again they asked what did I want to do,try for a vbac or have an elcs.
I didn't even have to see a consultant.
scuzzi, I just wanted to clear up that we are discussing a specific set of circumstances in this thread and the risk factors I've quoted are for VBAC, not prima VB. The risk factors in prima VB are very different (and much lower) to those for a VBAC.
I tried incredibly hard to have a VB with DD, however, mistakes and ill-judgement meant that I ended up with an incredibly traumatic EMCS. My scenario was due to very bad luck and a difficult medical situation. Had anything gone right with my previous pregnancy, I would be joyfully planning a home water birth right now, that is no exaggeration.
I'm not trying to downplay your feelings but I certainly wouldn't have wished my recovery on anyone either, and I think that side is overlooked. It took me more than six weeks to recover physically and I'm still recovering me talking from what was a major operation, the mental scars are nowhere near healed.
Its normal to feel stressed and worried about the birth, certainly I did, and there's no accounting for how you will feel in later pregnancy, I was actually looking forward to my VB by the end. I would suggest you try to enjoy your growing baby and look forward to meeting them, rather than fighting the medical profession at such an early stage.
The women on this thread have all attempted a VB, and due to being that 1/1000 have cone out the other end quite damaged both physically and mentally. I can't speak for all the ladies, but from what i can gather by the responses it would seem that VB would have been the preferable option to all of us. A CS is a stressful, major operation with a potentially long recovery period. I wish to the heavens above my first birth had been a stress-free VB.
I had an EMCS first time, 2nd time was ELCS.
ELCS was a much more positive experience, was very relaxed. And my recovery time was a lot quicker.
Scuzzi, Unless you have tokophobia you won't be allowed an elec section for your first and if you have a normal pregnancy why on earth would you? It's around 10 grand privately- I'd start saving.
AnitaBlake, the women on this thread have not all attempted a VB, sorry - I had a planned and very much wanted CS for my 1st DC.
It was for tokophobia. I enjoyed my CS (apart from one moment, but that was down to horrible mws) and was very very grateful for it, especially when I see what a traumatic and damaging time most (most!) of my contemporaries had VB-ing their first.
I know one person who had a water/hypnobirth, exactly as they wanted - a friend had a quick labour she described as being relatively easy, and seemed happy with it.
The rest are a catalogue of disaster and injury, some with ongoing problems.
I fully support every woman in attempting the birth she wants - but f**k me, am I glad I got my CSection.
Wheresmespecs- isn't that what tokophobia is? Like I pointed out earlier. Unless you have it or a reason to have a c section- good luck and save hard! Tokophobia is a totally different to just wanting a c section and an altered way of looking at child-birth.
I think you'll find that most relatively low-danger births of women who don't have tokophobia were preferable to most ladies than the thought of a c section.
Not sure I understand your post newby, but yes, I did have a cs for tokophobia.
IME women have all sorts of preferences for all sorts of births and best of luck to them.
I'm not sure what 'just wanting' a c section is. there are women (here on mn) who have wanted and in some cases got c sections not because they are phobic about vb but have other reasons for believing it is preferable for them personally, under their indidvidual circumstances. In particular, women who have had a traumatic first birth, or who have physical damage that may get worse with a vb.
I don't think it is fair to dismiss another woman's birth preference as a whim. There are high risk women who choose to have home births or who campaign hard to have the birth they want against medical advice, and it's easy to judge, but I prefer to think that they have their own good reasons, however different they are to mine.
btw it's not true that you have no chance of getting a c section on the nhs unless you have tokophobia or a purely physical reason for needing one.
It varies hugely, but again, you will find women here (well informed women) who have asked for one and got it. Others who haven't - it really varies from place to place.
Dear AnitaBlake & newby2 (and all the others), sorry to hear about your dreadful experiences and I truly hope that you will recover physically andd psychologically as soon as possible. However, it does not seem to me that my comment was out of place. One of the many reasons I'd rather have a CS is because I do not want to risk such traumas.
While VB is surely the best and preferred choice of birth for some women, it is not for all. What I find staggering about the general discussion about birth choice (so not necessary what has been posted here so far) is the request for respect for those women who choose or rather would like to have a VB, and the lack thereof for those who prefer a CS who are often described as phobic and hysteric or with an "altered way of looking at child birth". Surely, women who suffer from tokophobia should be given the option for CS, but this may not be the only reason for preferring a CS (and please don't start going down the too posh to push trail - I personally find it insulting to informed women who prefer going through a CS rather than a VB). To depict women with different views as irrational and not able to control their emotions (fear in this case) has been a strategy used since the dawn of times, but this is another story.
All I am asking is respect for my own informed choice, because this is what I try to give to other women who prefer other forms of delivery, not to be treated as un-natural, and not to be treated as a pain in the neck by doctors/midwife because I am claiming my right to choose.
I absolutely agree with you both scuzzi and wheresmespecs. We should be allowed the informed choice to have whatever we want. Tell that to the new government, not me. If you have had a baby this year, you'll know its a very different place and political atmosphere to last year even so be prepared to have a good argument if you have no medical reason tokophobia being recognised as a medical condition. Guidelines are only guidelines.
Hospitals are fined on their c section rates. Are you in NHS management? I have been. Finances are the bottom line to keeping a hospital open. There should be a priority system which includes every-one.
I'd like to know how you get on scuzzi with confirming a c section. I hope you have what you want Bumble and Scuzzi. Good luck.
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