Need help with how to deliver.... Sensitive nature(10 Posts)
Firstly this is really long, so greatly appreciate anyone taking the time to wade through. I did post on the topic a few months back in less detail, so apologies for the repetitive element - but I really want some help! In a nutshell my first pregnancy ended in April last year when I delivered our DD at 20 weeks at home. The pregnancy had involved a lot of scary moments and bleeding throughout. I went to two local A&E units the day I lost her, having contractions (first pregnancy as I wasn't sure at the time what was happening) and was turned away as cervix was closed, only for her to arrive a few short hours later. I am now pregnant again, currently 36 weeks (consultant led although no explanation found for what happened with DD1) and due another DD - almost exactly one year on (lost DD1 on 26/4, DD2 due 25/4, which is also unhelpful).
My main fears relate to the previous pregnancy, although I know so far this pregnancy has been very different. I've been having counselling for the last 6 months relating to the bereavement and the trauma I encountered. However the entire pregnancy has been a very anxious time for me, and I find I am constantly having to fight negative thoughts about the outcome. I basically feel terrified each day that something will go wrong and this baby will not survive. As a result of months of feeling this way, I know feel desperate for an end point, and some element of control over the delivery. I am very keen to reduce and chances of distress or problems occurring during the labour as I feel I am emotionally unable to deal with anything other then a straightforward situation. This in itself is very stressful for me as I understand things cannot be controlled in this fashion. My fear throughout the pregnancy has been that my body will once again inexplicably fail me, and the baby will come to early and not survive, so have spent the last few months willing her to stay put. Now I am reaching full term, and whilst I know she is ok, I want her out as quickly and safely as possible, before something has the opportunity to go wrong. Because of this and because of her expected size (measuring 95th centile) and problems this could result in for an overdue delivery I am keen not to go over due.
I spoke to registrar before about the option of an induction if I reach my due date and don't naturally go into labour before then. I like the idea of this in the sense I won't go overdue, and can have a date booked in and therefore an end date in my mind (which seems important for psychologically surviving these last few weeks). This also helps with the trauma I feel relating to actually labouring, and this will be undertaken exclusively within the hospital. My concerns however are that the induction is more likely to lead to a baby in distress, interventions or a emcs.
My concerns relating to a natural spontaneous labour are as follows:
1. I delivered previous baby at home, alone, with no pain relief - after being sent away from two hospitals with 'stretching pain'. The experience was hugely traumatic and life changing for me. Despite 6 months of specialised counselling I still feel very scared and anxious about going into labour and have a huge fear of not being able to make it to hospital and delivering at home and something going very wrong.
2. I am very scared of going overdue and encountering problems relating to that and/or her size
3. The complete lack of control over the situation is unsettling given the circumstance. I have no idea when I might go into labour or how this might work, I am very keen to avoid any situation where the baby becomes distressed. I appreciate that how a labour will go is basically luck and can't be predicted.
Regardless of the above I know that a natural spontaneous labour has a decent chance of being the best and safest situation for me and the baby, and that I have no reason to believe I won't have a straightforward, easy labour & delivery.
The last alternative as I understand it would be an elcs, which is what I am swaying heavily towards at present. I have read extensively about this and from egg I understand the risks of an elcs to the baby and a spontaneous natural labour are at a very similar level. The obvious downside is the recovery time as I appreciate this is a major operation. The elcs would offer me control in that I would have a specific date to work towards and takes away the concerns of a interventions which which could happen with an induction. I feel it's the safest way and offers the highest odds from this external position that the baby will arrive safely and in a non-traumatic way. I do appreciate that not all operations go smoothly and I could be one of the unlucky ones in that sense. I feel in some senses that I would be failing by having a elcs, and that I should be psychologically strong enough to push through for natural labour.
Right, this is basically the huge rambling circle my brain is doing re birth. I would REALLY appreciate any guidance here as I just feel at a loss as to what to do for the best. My DH is pushing for a natural labour as he wants me to avoid surgery. I understand that if I do decide to push for a elcs I need to be reasonably forceful in my choice, and I just don't feel I have enough conviction one way or another at present. My counsellor thinks I should go for the elcs and has totally validated my feelings but in her absence over the last week I have once again become unsure. Urgh.
I tried to make a midwife appointment to discuss options but they are totally booked up and not very helpful. I have a consultant appointment Wednesday (although may end up being with the registrar when I get to here) and I would really like to have a constructive conversation about it then, but at the moment feel like a total flake.
No wonder you are feeling worried and confused. Given your history I'd have thought the hospital would be taking extra care explaining everything and extra midwife support appointments etc.
At 35 weeks your body's labour, healthcare professionals attitudes/interactions with you, and the baby's chances would be very different to last time around so even if you started to have the first labour signs now then I'm sure things would end really well.
As for the ELCS/natural birth decision. It's really tricky. I can totally see why having a date set for a nice calm planned section might really help you mentally. However, if you are hopjng for more than 2 children then you might be better going for natural birth of possible.
Have you thought about having a doula or advocate with you? I don't know much about them but it might be just the kind of experienced and supportive person you need around. They have seen loads of births and are quite good at giving Drs and midwives what for if concerns aren't being taken seriously. They aren't always just no-intervention hard line hippies I'm sure. Have you tried contacting the NCT for support? They have a great advice line that you don't have to be a member to call
Also, I'm really sorry for your loss. What you are coping with mentally is MASSIVE and you are a million miles away from being a flake
Betty, thanks so much for your reply.
I am getting a lot of appointments and growth scans but I don't really have any kind of ongoing relationship with any of the professionals to talk things over with or to advocate for me if that makes sense. I have a midwife team and the last two midwife appointments have been covering midwifed from the next catchment along due to sickness so no continuity there. As for the consultant, I have regular appointments but the last 4 appointments I have seen a different registrar instead of the actual consultant. I'm reluctant I guess to get into such an emotive and big conversation with them as I feel like they don't know my history and I'll likely not see them again, the appointments all feel quite rushed generally especially as the pregnancy has been physically smooth sailing. I have a midwife appointment on Thursday this week, I was hoping that I could talk it all through with them and they could advocate to consultant for me (especially considering I don't know when I'll next see him not a registrar) but I feel maybe this is a idealistic view and not how it will actually go down! I think I'll try the NCT helpline, as advice is really what I'm after. I want someone experienced I suppose to consider all the factors and decide for me, and for me to be able to have confidence in that decision. However I feel my consultant will likely just push natural labour/induction as if course he doesn't know/care for me on that level personally. So I guess I want the impossible!
Fear I'm making even less sense now!
Hi Bearberry I read your post and had to respond as my heart goes out to you. That must have been very traumatic to go through so well done for keeping going.
It's a completely different scenario I have but some of your concerns are similar to mine in the respect of control. I went through fertility treatment to get pregnant and I spend each day thanking my lucky stars it worked in the end but also being terrified my body is going to let us both down. I would never have got pregnant with out fertility treatment (I was diagnosed borderline infertile) and I lost trust in my body.
I'm now 5 months in and have chosen the ELCS route. It I feel is the right choice for me as the unknowns of VB are creating a lot of anxiety and worry for me. Thankfully I have had a very empathetic NHS consultant who agreed an ELCS or a heavily controlled induced VB with significant management was best. However she said it was my choice. The latter option just terrifies me in case something goes wrong and the relief I felt when ELCS was agreed with a date means I'm now beginning to relax.
I thought I'd try and explain the above because it was only when the decision was made I knew it was right so perhaps you need to really imagine what you feel is best for you. No one knows you better than you so try and not let them decide for you. If you are really erring towards an ELCS now I urge you to speak openly with your consultant on Wednesday perhaps with help from the midwife or your GP in order to discuss. If not try and outline your worries on a letter so you can hand this over if you don't have the energy or words to explain.
It may be you decide that a VB which is more managed is fine for you in the end but do try and make the decision yourself rather than let the decision be made for you.
I hope your consultant is helpful this week x
As soon as I read the second paragraph I thought you need an elective cs. However, it is major abdominal surgery & given that you have delivered before, albeit very early & in horrific circumstances, your body knows what to do. So, the likelihood is you'll deliver normally & maybe even quickly.
If I were you I'd definitely push for a fixed date so you have that end point in sight. If you feel you need an advocate, ask for the contact details of the supervisor of midwives on call the day of your clinic appointment, they are there for this very reason. Good Luck.
So sorry to hear your situation. I had to have a termination at 22 weeks some years ago as we found out our much-wanted baby was not going to survive outside womb. It was heartbreaking. It was my second pregnancy and I was grateful to have had a "successful pregnancy" as a frame of reference.
Nevertheless I was anxious for all of the next pregnancy. Not specifically about labour but about health of baby. I found hypnobirthing very helpful. In the end, I went 2 weeks overdue. One midwife theorised that I was maybe holding on as I was afraid of what might happen at delivery. I now reckon it was the personality of that baby, he's stubborn as hell and dislikes change in any form.
I think it's totally normal that your fear relates to spontaneous labour. I am currently planning to negotiate an ELCS due to tear on last delivery. I think the certainty is very reassuring. I had asked to be induced at 39 weeks but in my hospital they say they'll only induce if I'm favourable so induction is not as certain in my case as I would like. Research will always say the best outcome for you would be spontaneous labour. It might also be quite a healing experience emotionally. I did find my last labour very rewarding compared with my first. I think a doula is an excellent idea if you opt for natural.
IN my negotiations with my hospital, I email the generic midwife email a/c and mark it for the attention of the midwifery manager. That way I get all my thoughts out in a constructive way, they have something in writing that cannot be ignored and I'm not getting myself in knots over a difficult subject with the wrong person who can't help me anyway. I got great results doing this when negotiating my early induction and I'm about to do it again now that I've decided to try for an eLCS.
Also if you email them you can set out ideal scenarios e.g induction at 39 weeks if favourable and if not then c section at 39+1. Just a thought.
Thanks all for replying, I've been thinking hard and definitely going to push for an elcs now. Going to prepare some notes ready for my appointment with consultant tomorrow and hopefully I will come away with a booked elcs or at least a referral regarding it.
Good luck. I agree that you have had a horribly traumatic time and you deserve to have a birth where you feel as safe and as in control as possible and, given what you have said, that seems to be an elcs. I hope you get the response you want.
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