Can I really have an honest/ none biased talk with consultant?

[Wiggy29]

I'll try to be brief. I had a difficult vb with ds and am very nervous about 2nd. I'm 20 weeks and booked to see consultant at hospital on Tuesday to discuss creating a very structured birth plan.

Honestly, I'd like an open discussion about what is best for me (at the moment it's looking like guaranteed epidural on arrival at hospital or elcs). Is it very naive of me to think the consultant will discuss this without biased/ trying to push me in a certain direction due to their own views? If I just go in there for an honest discussion, will I be eaten alive or is it a realistic expectation?

I've read lots of threads on here re: elcs and fighting your corner but I'm not 100% sure I want to do this as not 100% sure it's the right path for me. That said, I want to be able to discuss all options and their pros/ cons.

Does anybody else have any experience of this?

[Wiggy29]

Forgot to add, how important do you think it is that DP comes to this? I'm pretty strong minded and don't feel he I need him there (he is very supportive of whatever I decide) and he's concerned about time off work. That said, I'm aware it's a big deal and two pairs of ears are better than one?

[charlienash25]

I would personally have my DP there as you'll want to ask so many questions and you may forget some or even forget some of the answered that are fired back at you.

Imo consultants are non-biased and know that they should follow how the mother really feels.

[Wiggy29]

Charlie - that's good to hear. I've learnt a lot of pros/ cons from threads on here for epidural/ elcs, it's been really helpful. I'll have a word with dp, it's in the afternoon so he shouldn't miss too much.

[Wiggy29]

Charlie - that's good to hear. I've learnt a lot of pros/ cons from threads on here for epidural/ elcs, it's been really helpful. I'll have a word with dp, it's in the afternoon so he shouldn't miss too much.

[SoozleQ]

I think a lot depends on your particular consultant. I would not have been happy having the consultant I had for DD during this pregnancy so asked for another one who I like and who I have stuck with even though her clinics are now run out of a different hospital. If I had encountered difficulties talking to her at a level I was happy with, I would have requested a different consultant.

So, I would go to the consultants appointment with a view to the discussion progressing as you would like it to but if you feel you are being pushed around or into a corner, as I was with DD, then I would seek to change consultants.

[steben]

Not sure if this will help but will add my recent exp here - saw registrar rather than consultant first time at same stage as you. I went alone and to be honest preferred it - I wanted to have a discussion about what was best for me rather than have to worry about DH being there if that makes sense? Also I thought if it went badly he could come to the next one at 36 weeks.
I had a fairly traumatic birth first tone which ended in a EMCS - when I went it she automatically started talking about us all hoping for a "better positioned baby this time round" (DD back to back) I wanted a repeat section and stated this - she spent about 10 mins trying to talk me out of it but I said I wouldn't change my mind and age said fine at the end of the day it is your choice. That was that and at 36 weeks have seen consultant and all booked in no questions asked. Good luck and I hope it goes well - I had a fair amount if anxiety about both appointments but nothing but immense relief when they both went well.

[Iggly]

I saw a consultant after a tricky birth with ds. She was incredibly biased and scared me a bit until I went and read up on the risks. She went on about what she would do in her opinion. Highly unprofessional I thought!

Write down your questions so you don't forget everything. Discuss again with your MW afterwards.

[Startailoforangeandgold]

You have to be very firm and very assertive with consultants. Make sure you get your case in first and ask them very straight questions.

Some of them do assume we are all idiots, if you have done your research and thought what you want their not so bad.

[Startailoforangeandgold]

They are

[SheelaNeGig]

Epidural on arrival is not guaranteed. Even if a consultant writes it in your notes. It will depend entirely on whether an anaesthetist is available and willing to do it and if there is adequate midwifery staff.

[poppy283]

I had a similar experience to Steben, saw a registrar at 36 weeks and had to persuade her to grant me an elcs. Best she would do though was 2 days before my due date, and if I went into labour early I had to attempt a vbac.

That's what happened and I ended up with another emcs, so felt vindicated that I needed a cs, but would have rather just booked one a little earlier iyswim. It felt like we were playing chicken with my due date!

[MikeOxard]

I had an appointment with the consultant anaesthetist, as I had a traumatic birth before when epidural failed and mw didn't listen about it so I ended up having an episiotomy with no pain relief! Consultant was really, really helpful and reassurring. She put things in my notes for me. This time I had another epidural and it was monitored so closely, I was offerred top ups when I needed it, different strengths were considered etc. It was really really good. Have the appointment, it can definately make the difference. Good luck with everything. x

[steben]

Sorry poppy just thought I would clarify for
OP just wanted to say I saw the registrar at 22 weeks then the consultant at 36 who booked me in for Elc one week before due date - sorry to hear that happened to you makes me very mad! I know in my bones I would end up in same situation or a more intrusive instrumental delivery which is why I opted/fought for a section.

[ICompletelyKnowAboutGuineaPigs]

I saw lots of doctors of varying levels when I was pg with DD following a 4th degree tear with DS.

I personally found the registrars to be the most forceful and proposing their opinions as non-negotiable facts. The consultants I saw were generally much more open minded. Once I had made up my mind about an elcs (after being scared into it by registrar) I spoke to a consultant who explained in a very informative way why they didn't think it was necessary and all the things they could do to reassure me (i.e. scar tissue scans etc). In the end I stuck to my guns but in retrospect I wish I had listened to the consultant and had that conversation about 3 months earlier than I did.

Also I would say that having DP there is a great idea if he can manage it. I consider myself to be a well-educated strong-minded individual, but with a few choice phrases ('permanent faecal incontinence' being one of them!) I was rendered to mush!

Definitely going to push to speak to a consultant this time because I found them much more knowledgeable and judgemental. Hope you have a good experience.

[Wiggy29]

Thank you all for your advise. It's a funny one because I'm not sure I have 'questions' as such, more that I have a perception of pros/ cons and I want to talk these through and get a professional opinion.

I'd love to hear you opinions on my thoughts as they stand at the moment, especially those of you who've had epidural/ elcs. This is my understanding so far so please feel free to correct me as I'm still a little

Risk to baby:
ELCS- No more risk of major complications than vb however increased risk of respiratory issues.
VB- DS nearly ended up as emcs as was stuck so risks attached there but overall, seems to be slightly lower risk.

Recovery:
ELCS- from reading these threads, this seems to vary greatly. From what I can gather, most are up and about after a couple of weeks but can take months to get back to 'normal' and for many there are lingering issues such as numbness around scar.
VB- with ds had to be cut pretty severely so was not walking easily for a couple of weeks. Could barely walk upstairs etc and had to pour jugs of water over myself when going for a wee.

My own issues/ fears:
ELCS- though this would be planned, there will always be the element of 'unknown'. Would I still be granted one if I went into labour early? Scared of being one of the few who still struggling months down the line with recovery.
VB- petrified of whole idea of this after last time. Concerned that, as a previous poster pointed out, they can't actually 'guarantee' an epidural. What if I'm one of those who it doesn't work for. As far as I'm aware, epidural increases risk of Ventouse/ forceps and petrified of this after last time.

My main hope is to decide on the path I will take as soon as possible as it's the constant questioning that is driving me crazy. At the moment, I'm swaying towards elcs but have an open mind.

poppy I would be terrified if I were told that, not sure how it would make me feel better to know that I would have to have vb if went into labour early- think I would just stress more as I wouldn't know what I was preparing myself up for.

steben I had wondered that about dp, he has said it's up to me (esp as he's witnessed how stressed I've become about this and was there when ds was born). Maybe I'll tell him to come but keep quiet (ish) unless I feel I need support.

iggley/ startail It's hard to be assertive when I'm genuinely unsure as to which would be best for me, that's why (in an ideal world) I'd just have a talk where they didn't try to push me one way or the other but just presented the facts so I could draw my own conclusion.

Icompletelyknow My mw said the appointment is with a consultant who specialises in women's emotional well being re: labour.

A HUGE THANK YOU for reading this far and all of your advice

[Wiggy29]

Also... if you had an elcs, did you tell people it was you who opted for it? I think my parents etc would be very worried if they knew I was having elcs (even though they saw how traumatised I was after birth of ds) and wonder if it would just be easier to tell them afterwards?

[Iggly]

Ok I ended up with a third degree tear after ds, lost a lot of blood and took a month before I could walk to the end of my (short) road...

So I was worried about doing it again. I read a lot into the risks etc. I was offered an ELCS but said no. I discussed options with my consultant including a home birth (which is when she scared me with talk of shoulder dystocia amongst other things). Her overall message was that the risk of tearing again was marginally higher, risk of blood loss was not increased as wasn't due to poor uterus contraction first time around etc.

I actually ended up having dd at hospital and the birth was a dream. Instead of pushing for two hours, she was out in 20 mins. I did tear again but not as bad and I could walk easily the next day! I felt normal which was odd after ds.

As well as speaking to your consultant, read around, speak to your MW who will have a different view then form your opinion.

[Wiggy29]

Iggly I know this is a real possibility too (at first I was signed up for waterbirth in midwife lead pregnancy) but my fear is that, just as you can have a positive birth experience second time (as you did), it can also be very tough/ worse than the first. I was waking in the night worrying about it and it's only settled since I arranged to see consultant. This many be largely just because I feel positive that I'm not just stewing on my own and actually doing something about it).

I'd be worried that I'd go into it fine (as happened with ds) then, if it went wrong again I would just be completely terrified/ distraught. I think dp would find it difficult to as he said last time there were moments where he thought he would lose us, when ds was born, dp said he couldn't even enjoy it/ register it as I was shaking so violently and bleeding so much he actually though I was dying. Urgh- feel awful just thinking back to it.

[ICompletelyKnowAboutGuineaPigs]

Although my recovery from elcs was very straightforward (I was driving after 2 weeks on the go ahead of the Dr) I do wish I had opted for a vd. The elcs was very painful at first and limited what I could do with DS who was 3 at the time.
It will also impact on the birth of DC3 and anymore children I have afterwards as if DH will agree to this!.

I too had a horrible experience the first time with pain and I had to pour jugs of water just to go to the toilet. I also had specialist physio for over a year to get the muscle control back so I wasn't incontinent (from both ends - sorry tmi). This scared me a lot. BUT the likelihood of this happening again was minimal but I was scared off a vb by a registrar.

I think ultimately the 'best' decision is the one that you feel the most comfortable with, but my advice would be make sure that your fears are based on realistic outcomes and then you will be able to make a more informed decision - it sounds like this is exactly what you're doing anyway.

I did tell people I was having an ELCS because I knew the date and was able to plan what happened with DS etc. I was also told that if I went into labour early I would have the option of labouring naturally if I wanted to but that they would also do a cs if I chose.My friend went into labour at 37 weeks with her elcs booked at 39 weeks. She went to the hospital to get checked over because of some tightenings. Then within 30 mins of examining her she was in theatre!

[Wiggy29]

Icompletely the actual elcs was painful? How/why? How did you feel it compared to vb? My ds is 7 and I'll have help from my lovely mum. Does it mean that you will have to have cs for 3rd? Sorry for all the questions!

Does anybody have any stats on chances of you having intervention first time compared to second? If I knew for sure it was statistically far less likely I may be more inclined to opt for that, whereas at the moment it tends to be people saying 'every birth is different/ I had a great second birth' etc but there is also those who had terrible time first and second time round and wished they'd pushed for elcs. So hard to know what to do.

Believe it or not, I'm normally a very laid back person!

[Iggly]

Yes I was scared second time around until I got talking to the consultant and MW etc. I talked about it a lot to prepare myself and in the end it was so easy I couldn't believe it.

[ICompletelyKnowAboutGuineaPigs]

I completely understand about you being a laid back person - me too - but pregnancy and birth do weird things to people!

The elcs itself wasn't painful - it was very dignified (although they did drop DD 'back in' but that was beause of all my extra fluid - there was a lot ) but the days after were painful because you have a major wound.

The comparisons are strange really ... I felt much more affected emotionally by having a elcs (as if I missed out somehow). Physically the pains were just different and in different places.

I'm going to discuss a vbac this time and see what they say. I do feel better prepared mentally for the discussions with Drs than last time.

One thing I would say is that if you want an epidural your chance of intervention increases dramatically. I have said that if I was seriously thinking of epidural as first choice pain relief I would just go for elcs. But that's just me. Part of me thinks that my induction with DS led to my intervention and subsequent tear. I can't know this for certain of course but I went from nothing to baby in a few hours and I'm just not sure my body was ready for it.

[steben]

My consultant has assured me that should I go into labour early I just need to ring the hospital go in and they will take me into theatre - from programmes like one born I suspect they would try and convince me to give it a go vaginally but I would be very forceful on that case! My recovery from my EMCS was fine - the only issues I had we're the extreme tiredness of labouring for 30+ hours beforehand. I am hoping that the Elc will be a much calmer exp - I will be prepared for it and I have plenty if help on hand for the first 3 weeks where it is my intention to do as little as possible to speed recovery. For me the decision was based on mitigating the risk of ending up in exactly the same position as first time, and possibly in a worst state with a toddler to care for as well. I will be having the section in a couple of weeks all being well so I will pop back and let you know how I get on.

[crosscupcake]

Well, i went ready for battle with my consultant.

I knew that i need a c section this time around and had rehearsed my arguments and everything..

But didnt have to, consultant asked me a few questions and then said
"cupcake, all you want is a live baby at the end of this, so i am not happy to mess around with you, lets book you in for a section at 39 weeks...if you get that far and have done with it".

Stunned i replied "thanks, thanks very much" and slunk out

[Wiggy29]

Bit nervous, going in this afternoon. Thanks again for all your advice and I'll let you know how it goes.