HELP I've asked for another C-Sec over my VBAC but I'm being ignored!

[natalieboston]

Apologies in advance for the long post..

Basically, I had my first child in Dec 2013 & didn't have a 'labour' I was rushed in to hospital via ambulance because Id developed severe pre-eclampsia. As soon as I arrived they broke my waters and set me up on 2 drips (1 to bring on labour & another to control my BP)
I was in agony, not from contractions, but from shock. My whole body was seizing up, I couldnt stop shaking & I was carrying alot of water which I was led in for hrs so my legs/bum had become very sore & rashy!
5hrs after being induced I still hadn't experienced a single contraction, I had only dilated to 2cm & my sons heartbeat dropped so I was rushed in for an Emergency C-Sec (by this time I couldnt wait for it all to be over!)
I barely remember the procedure, and can just about remember holding my baby for the first time. The whole thing was quite traumatic & I can't / don't want to imagine having to go through a similar experience again.

SO, I'm now 31+4 with my 2nd child, I'm under consultant led care & I've told them I want another Caesarean.
They asked me why so heres what I told them:

• I'd hate to end up having another 'emergency' c-sec.
  
• I'm terrified of having a scar rupture.
  
• I've been suffering badly with piles in my current pregnancy & I don't want to make them worse! (TMI sorry!)
  
• I recovered amazingly from my last so, I wouldn't want the chance of having multiple wounds/scars (eg if my scar ruptures & have a huge tear down below!)
  
• Because my baby is measuring VERY tall I'm worried about having a huge baby (my sister had an awful VB with a 12lb 1.5oz!!) So big babies run in my family.
  

She seemed to listen as I was speaking, but as soon as I finished she replied with 'well I can assure you you'll have a quicker recovery with a vaginal birth'. ALL she wrote on my notes from out conversation was that I recovered well from my last birth.

I'm seeing her on a 4weekly basis, but I've just come back from my latest appt with her & she again mentioned I'm carrying an incredibly tall baby and that shes back to back - when I looked at her in panic not really knowing what that means she just said 'Oh don't worry we can still go ahead with a VBAC it'll just be a longer and slightly more painful labour'.
I'm so upset, what if I follow in my sisters shoes and have a 12lber?! Her baby got stuck and had to be dragged out (his collarbone was broke in the process!!)

I honestly thought I could elect for a C-sec especially if I've had one previously, I just feel like she's ignoring me completely and I'm at a dead end, I want to be able to look forward to meeting my little girl, but instead I find myself dreading the whole thing
I'm not a hugely confident person, so as much as I wish I could, I never feel like I can 'argue' or 'demand' when I'm there.

Any advice would be greatly appreciated!!!

[Iwonderif]

Didn't want to read & run. What a horrible situation to be in and it makes me livid to hear that your concerns are not being listened to. You can have another section, you've had one so of course you can have another & I feel your reasons why are clear and concise.

Can I ask why you're under consultant care with this pregnancy? With my dc2 I was not happy with my consultant who I had been placed with so took myself off to the GP expressed my concerns and got put with another. That is an option. Depends on how great your GP is.

Please please fight this. You say you're not confident but you can do this. Your consultant sounds utterly rubbish. Please keep us updated.

[LottieDoubtie]

I'm sorry you are going through this.

Take someone with you to your next appointment, either your partner, or your most persistent friend- it really really shouldn't make a difference but in my experience I'm afraid it does.

Ask outright for a section if the doctor says no then ask to be referred to somebody else- be as icy calm and determined as you (or your friend) can manage.

Good luck!

[kiki22]

Ive asked for a section this time had forceps with ds I have a lot of the same reasons as you for wanting a planned section this time, Ive seen 2 midwifes and both said I seem really sure its what I want I seem to know what's involved (I researched) so it shouldn't be a problem. I think going in saying this is what I want I'm not having a vbac this time please arrange it for me ment they knew from day 1 I'm not fucking about.

Do you have someone that you can take that's a bit more assertive your sister or mum maybe? Sometimes it helps having someone to fight your corner. Get totally clued up on and stats print stuff off, write it all down and just keep saying I want one please arrange it over and over.

[natalieboston]

Thank you so much for your replies! I feel completely drained with the whole thing.

I'm under consultant care this time because of the Pre-Eclampsia in my last pregnancy & I've got Bilateral notching in both uterine arteries - so the chances of having P.E again are quite high

I actually found out I was pregnant when I went to a colposcopy appt - something that Ive had to attend a few times during the pregnancy - my consultant knows all about it & knows they want to do a Biopsy 3months after I have the baby - now I've known people who have taken longer than 3months to recover from a VB - so knowing that I'll be having 'work' done down there is I guess, another reason i'd rather a c-sec!

My next appt with my consultant is 15th March - & luckily my mum WILL be coming with me, so I'm hoping they'll finally listen to me and book me in!! I'm just worried they're going to turn around and tell me I'm too far gone to 'book' in for an elected C-sec, I'll be 35weeks at that point!

Xx

[LottieDoubtie]

You won't be too far along- they routinely make women wait that long to book in - it's aim imo is about reducing the no. of sections not supporting women which is fucking annoying, but if you go in with a firm resolve and refuse to leave without being taken seriously it will be ok in the end. ((hugs))

[dobbythedoggy]

I'm hoping to iminantly try for vbac after elcs for breech dd, but this week expressed to the health visitor I was feeling a bit anxious about it. Her first question was is it your choice to have a vbac. I do want to atleast try, but not be induced, luckly midwife and consultant are supportive either way. But was told she was only a phone call away if I needed any support. Have the feeling she would fight tooth and nail for anyone not being given an elcs if they wanted one. Would calling on your health visiting team be an opption?

[goodnightdarthvader1]

You need to be firm and clear: "I want an elective c-section. I am HAVING an elective c-section. I have listened to your opinions and have made my own decision. Please make sure this is appropriately noted at all stages of my care."

[HRHsherlockssextoy]

Is the consultant not listening?

I had my 2nd baby in Bristol and they tried to convince me to have a vag delivery after c section but no.

Make your request clear. Put it in writing. Change consultants if you have to. Talk to your midwife about this, should be on your side

[natalieboston]

I was checked over in hospital yesterday because I had a bout of High BP again, me & baby are all good & back home! :)

But two midwives who seen to me both agreed with my decision of wanting another C-sec & encouraged me to speak with my consultant again (same hospital so they're both familiar with her) said that she usually waits until around 34 weeks before setting a firm plan up :)
So im feeling much better today & hoping I can finally get things sorted for a cesarean on when I see her at my next appt! (March 15th)

Thank you everyone for your kind words and advice! I'll keep you updated!

[natalieboston]

Okay, I had my consultant appt yesterday and to say im a little stressed is an understatement!

She sat me down, and asked me if I have any questions - so I said to her i'm not happy with a vbac, my emergency csec was very traumatic and I felt completely out of control - so I'd like to go for another csec.
She then explained (& apologised) that we were supposed to go through the childbirth at 25weeks (I'm now 35weeks!!!) She grabbed my notes from my first pregnancy and told me (using lots of scientific words & numbers) why I'm the perfect candidate for a natural birth - and that apparently I shouldn't have had an emergency csec with my last!!!! She TOLD me I was having contractions (which I can promise you I didn't feel a single 1!!) & that those contractions were the reason my little boys heartbeat was dropping.

Once she had decided that I was having a vbac she went on to talk about the chance of having a ruptured csec scar during birth, it's apparently 30% chance for ANY woman, but since I've had prescribed local anaesthetic gel for the last few months because of the soreness I've had in my scar I asked if that meant I was more at risk & if it does rupture - what happens?? Will I end up with stitches down below AND having to have repairs done on my belly?!
She then replied with 'We'll be keeping a close eye on you during labour and won't be 'pushing' you because of the scar' & 'let's not worry about the what ifs & just concentrate on keeping my bp low!'

Another thing she's put down for me to have 'stretch & sweeps' 2x a week from 37 weeks so that my labour is 'gradual'... but didn't elaborate on what this means & just said a slower labour is safer & reduces the risk of scar ruptures.

So, none of my questions were answered & I've had MY child's birth decided for me, I can't even call it a discussion. She just spoke at me.
My birthing partner wasnt with me (my partner) so she has booked us in for another 'chat' so she can speak with him because she said she gives women 2chances to go through the childbirth (which as i said should have been done at 25weeks!!!) So shes booked us in for the 14th April, 4 days before my due date - which seems a bit pointless in my eyes!!

I burst into tears as soon as I left the hospital, again I feel like i have no control over my babys birth & im worried ill end up having another emergency section.

[MythologicalPersonage]

This is awful.

I would contact the PALS team asap. Explain that you have not been listened to and decisions have been noted in your care plan without your consent. Ask to see another consultant.

There is no way that you can wait til 4 days before the due date.

[CityMole]

You need to stand up for yourself. I appreciate how hard it is, but really, you can sit through anther appointment with her and say nothing and find yourself labouring with a vbac before you now it, or you can confront the issue and have it dealt with, and stop all of this worry in its tracks.

You can't wait until 14th April, for obvious reasons. You need to phone the hospital as soon as it opens ion the morning and ask for another appointment either with eth same consultant or with another consultant. Take along your birth partner or a friend who can support you.

Say what goodnightdarthvader1 told you to say upthread.

If you are still met with resistance, you ought to cite the NICE guidance- the
relevant bit is at section 1.2.9 of the document you can access from the following link:

//www.nice.org.uk/guidance/cg132

In short it says that if a woman requests an ELCS when there's no medical requirement for it then the doctor should discuss the risks with her and if anxiety is a factor, offer appropriate support (they may insist that you go for counselling- which actually might be quite worthwhile for you, if they can get you referred soon enough). Ultimately, if a woman still wishes to have a CS having understood the risks then the guidance is that the woman's wishes should be respected.

Note that it is only guidance and not hard black and white law. The doctor may still resist, in which case you should be referred to another doctor.

[CityMole]

sorry, am typing with wrist splints on (bloody carpal tunnel!!) Excuse the multitude of typos!

[RedToothBrush]

I think a crucial point here is to challenge what she wrote on your notes.

If she wrote, you 'recovered well' from your last birth and you are extremely anxious and distressed over the prospect of another traumatic birth you may have physically recovered from your last birth, but you clearly have not mentally. This is as important as your physical health and she has outright lied and been dismissive if you have discussed this with her and this is not reflected in your notes.

Also as far as NICE goes and wanting an ELCS after a CS, your opinion is supposed to be listened to and be strong influence on any decisions about your care (your opinion should be a strong influence in any care you receive as part of the NHS charter to patients, so this is a guideline that can not be ignored like others).

If you struggle in being assertive or challenging authority, I strongly recommend being prepared in writing and taking someone with you, you feel confident in. Another person, can either advocate for you, or merely being there may tilt the 'balance of power' in a patient / doctor situation in your favour.

[RedToothBrush]

BTW the maternal request guidelines posted above are helpful but the guideline relating directly to VBACs is actually more useful in this situation.

[dynevoran]

Don't let them push and bully you. Phone up and demand an appointment with this or another consultant, take someone with you and don't leave until you have your c section booked. this is your body and your baby and your reasons are totally justified and understandable. Please do this.....I don't want you to regret it later.

[pullthecracker]

I just want to reassure you on one of your concerns, you wouldn't have a ruptured uterus and a tear on your perineum, if your scar was to rupture, it would usually be in labour (it is very rare) , and you would have an emergency CS then. You'd never have a situation where you would have a vaginal birth and then go to theatre post natally for a ruptured scar. Hope this helps.

[BeaufortBelle]

Phone the ceo and ask to be transferred to a different consultant. Complain formally and write how you feel in your notes. Ask for an apt with the head of midwifery services.

[Cinnamon2013]

Agree with the PPs about insisting on a chance of consultant and challenging what's been written in your notes.

I'd suggest focusing on the anxiety/birth trauma. They will (rightly) want to reassure you re: uterine rupture as it's a really small risk and with a second birth not now generally considered as significant enough to stop any woman going for a vbac. I got a ELCS after EMCS on these grounds, nothing else, so it is possible.

[Cinnamon2013]

And good luck. Don't give up, trust your instincts. It's way too important to compromise, and you could end up with a lifetime of resentment if you do.

[Simmi1]

I would echo the above. I also wanted another c section but got bullied into a vbac. I also got told I was the perfect candidate for a vbac. Well I suffered a third degree tear! Wish I had fought it harder. I went into labour at 38+4 so query whether they would have done it that early anyway...

[Laquila]

I had an ELCS after EMCS and I've never regretted it. The registrar (consultant was never there!) tried to persuade me to a VBAC but I stuck to my guns and asked for an appt with the Supervisor of Midwives, who was brilliant - I'd suggest you do the same,

[BeaufortBelle]

Just write this in your notes and ask to see someone else:

"I was traumatised after my last birth and continue to be extremely anxious. It would support my anxiety, help me enjoy the remainder of my pregnancy and help me bond with my baby if my wish for an elc is granted. If I am forced to have a vbac and I suffer any adverse consequences relating to my mental or physical health I shall hold the hospital responsible. I have suffers undue worry and anxiety because consultant x has refused to listen to my concerns.

That should do it.

[natalieboston]

Hi everyone!
Just an update - after 3 failed attempts at trying to get an appointment with a different consultant, I met with my usual consultant again last Thursday, we sat down and had an extremely long chat & its helped so much with my anxiety.
I think I had already 'prepared' myself mentally for a VBAC, but just wanted to iron out any last worries.

I was due Monday 18th, so im currently 40+ 2 & little miss is showing no sign of making a rushed appearance, the consultant attempted a membrane sweep but couldn't reach my cervix properly & I've refused another because it made me feel really ill!! Aha.
She has booked me in for a CSEC on the 29th (next friday) so if I don't go into labour naturally beforehand - I have a plan in place that I'm happy with! :)

Thank you all so much for your advise, i'm still sad at how late in my pregnancy Ive been able to come to a 'happy' birth plan, and I really think there needs to be a different system put in place for mums wanting an ELCS - but right now I'm just eager to meet my little one!! xxx

[1001questions]

Appalling that you've been put through this, OP. I would still be making a formal complaint, regardless of the outcome.