Should I push for a CS?

[Rockandrollwithit]

Hi everyone,

I'm currently 23 weeks pregnant with DS2, very excited to meet him. As I'm high risk, my care is consultant led and I've had conflicting advice from midwives about the birth. I'm due to have an appointment with the consultant soon and don't know whether I should push for a CS or not. Here are my issues:

-previous birth was epistiotomy and forceps.

• I had a third degree external tear and internal tearing from my bladder all the way down.
  
• blood loss of 3 litres requiring 3 blood transfusions.
  
• due to the blood loss, I had to have a vaginal pack and was unable to move for the first 24 hours. I found this awful. The blood loss also made me very ill for quite some time after.
  
• I developed PND and also some hallucinations, although never diagnosed with psychosis. I'm sure about the birth had a role to play in this.
  

-physically I recovered well considering what had happened.
No continence issues.

• this one is unrelated to me but my sister had a series of heart attacks following the birth of her DC2 and had to have open heart surgery.
  

She is lucky to be here. I'm terrified this could happen to me, although logically I know it's not related at all.

I'm really worried about the birth and literally feel terrified every time I think about it. I'm not convinced requesting a CS would make it better, or even if I would be allowed one.

If you were me, what would you do?

[ShanghaiDiva]

If I were you I would push for a CS. I am not suggesting CS is an easy option, but I think knowing exactly what will happen and when will make you feel more in control.
It sounds like the birth of your first child was quite traumatic and it's understandable that your are now anxious. I had an emergency section under GA with my first and a planned section with my second - I felt more in control and it was a much more positive experience.
Good luck with your decision.

[Rockandrollwithit]

Thanks Shanghai, I'm not at all thinking CS will be an easy option but perhaps more manageable overall.

[myoriginal3]

without question, c section.

[myoriginal3]

I'm sure doctors were wishing they had sectioned you in the first place. nobody wants that amount of trauma to a patient. Tell them all and say you want one.

[Rockandrollwithit]

See that's what I thought first of all, but at my last midwife appt she was all "every birth is different" and I felt really dismissed.

[GU24Mum]

If you want a c-sec, then let them know and don't sound unsure else they'll try and twist your arm to "try" a "lovely natural birth". On the basis that there is some element of choice, you are allowed to put your view forward and it sounds as though you have very good reasons. To be honest, I suspect they'll try and persuade you but won't force you. I had a conversation with the midwife at my 12 wk scan and even before I'd finished running through my reasons, she'd booked me in for a c-sec (I'd had a previous one). Natural birth when it goes well is great but so is the choice and safety offered by a modern health service. No choice is right for everyone but a good part of it at least should be your decision.

[allegretto]

I went for a csection for far less so I agree!

[Rockandrollwithit]

I don't have a consultant appt until 34 weeks and my next few midwife appts are with the community and not the hospital team - should I be trying to get an appointment sooner?

To be honest, the antenatal care has been rubbish so far. I was referred to the perinatal mental health team at my booking in appt and despite requesting an appt twice in person and again over the phone last week, I've not been able to get one.

[DuggeeHugs]

In your circumstances I'd push for a CS. I'd also request an earlier consultant appointment so you can get the ball rolling. Hopefully you'll get a PMH appointment soon too, as they may be able to help. As said above, if a CS is what you want then be firm with both midwife and consultant. Have a look at the risks of both - there's not much in it, some are slightly higher with CS, some with VB - but I've found that showing I'm aware of this and happy to take those risks has made a difference.

[fanfrickintastic]

Section, definitely!

[McTush]

I've had 2 born at home and am as pro 'nature' birth as the next.

Have a section, don't even consider having a vaginal delivery!

[summerlovinggirl]

I had a 4th degree tear with my DS1 and it was bloody awful. I was told after coming straight out of surgery that I may be incontinent for the rest of my life. Luckily I recovered well and have no lasting problems. When recently pregnant withDS2, I was also consultant led. Although the midwives said I could give birth naturally, the consultant was very different. He talked me through all my options and told me if my DS2 came as quick as the first (1.5 hours from no contractions to him being born!) then I would likely have the same tear which second time round would cause incontinence. Although he wasn't allowed to tell me to c section - he said IF he was allowed to tell me - he'd say c section. We agreed c section was best.
Don't worry what your midwives say, wait for your consultant appointment - and talk honestly about your worries. Make a list to go in with so you don't forget anything. I would recommend c section after what you've been through and If needs be - insist that's what you want.
Good luck. X

[AgainstTheOddsNo2]

Very similar birth to you first time round my midwife and consultant agreed to a cs at 7 weeks! The second signatory to the cs got about 3 lines into the history before saying why are you asking of course she needs a section!

[Rockandrollwithit]

Thanks so much for all of the responses, it's been very helpful. I think I will ring and request an earlier appointment with the consultant.

Not knowing how I will give birth is making me so anxious, hopefully they will be able to accommodate an earlier appointment. I will ignore the previous midwife who told me "it was just a bit of blood loss" 🤔

[Bisquick]

I'd suggest just being firm and clear about why you want a c-section. They'd be ridiculous to refuse. I'm on my second pregnancy following a loss at term (but not a traumatic delivery per se) and the NHS consultant has already said quite explicitly that it would be totally up to me what kind of delivery I would want and when.
(I've been panicking about interacting with midwives though so haven't formally booked in or seen a midwife yet; I have a feeling they might be like your midwives but surely the consultant has final say?)

[AceholeRimmer]

I've had two sections due to fear of birth and got them easily.. all the problems you had are partly why I wanted them. I am so pleased I had them as I recovered quickly with no physical or mental health issues, no trauma to look back on. I think some trusts are realising that a section might be more expensive than a birth initially, but ongoing treatment after difficult births for repairs/PND etc can make it become the costly option.

[DuggeeHugs]

Ace your post has reminded me of this article: www.newscientist.com/article/mg23130813-000-uk-doctors-may-starting-warning-women-of-childbirth-risks/

Being given the risks of birth methods up front should help women make informed choices for themselves, rather than feeling in the dark about which might be better for them

[CowParsleyNettle]

I'm sure you won't need to push for it given your history and your worries. It seems like a very sensible thing to ask for.

[CowParsleyNettle]

(I'm pregnant with DS2 too and I would like to be consultant led for different reasons but like you find my MW quite dismissive of my worries, nurse in maternity who did my bloods said that I would be treated differently because of my previous pregnancy issue, so that was reassuring)

[KeepCalm]

Yes. If all of that can be avoided then yes.

I had similarly horrific time with DC 1. Was determined to try again with DC2. I naively thought my body would know better what it was doing. I was wrong. And that ended up in a failed labour and EMCS. Horrific recovery.

With DC3, again I thought I'd try (I know I am an idiot) but due to a traumatic exhausting event I gave in and agreed to an elective. What a joy. It was relaxed, civilised and the 'easiest' recovery of the three. Exactly when I needed it.

Please do consider both your mental AND physical well being

[AceholeRimmer]

Duggee Good article maybe that's why I had "yeah that's fine" at every stage of my pregnancy when refering to having an elective, I had no struggle at all and not even any comments from midwives. Hope this happens everywhere.. I really believe woman should be presented with both choices at the beginning of pregnancy with pros and cons laid out honestly.

[AceholeRimmer]

women*

[DuggeeHugs]

Ace first time around I was so ignorant going in - I genuinely thought the little information they'd given on induction was sufficient - had they been forced to give me full facts I would never have consented. Ah well, we live and learn! I'm expecting DC2 now and my Trust is very pro-VBAC so I've had to argue for my ELCS with the consultant. The decision's been taken out of both our hands now as it looks like ELCS is the only option due to unforseen complications.

After these two experiences I would love to see women being given accurate information and their views being taken seriously as routine. Your experience sounds amazing and I really hope the positive attitude in your Trust spreads quickly

[CaipirinhasAllRound]

I'm currently 36 weeks and gave a consultant's appt on Tuesday.
I also had an episiotomy and forceps then went to theatre for a manual placenta removal and also lost 3 litres of blood. I recovered we'll though and only needed 1 transfusion.
The consultant asked me at 32 weeks if I was opposed to a vaginal birth this time, which I'm not. I said I'd go with whatever they recommend and but I don't think they'll make a decision until a bit nearer.

[Angelreid14]

Following your first experience I doubt you will have to push toon hard for a CS. GoI'd luck and try not to worry x