Back from patronising birth choices clinic

[Popeye44]

Hello,

I’m due my second DC in 4 weeks, my first birth was a couple of years ago and was hell, both delivery and recovery.

I was adamant that I would be open to a vaginal birth again and that I would try to relax and let nature take its course however in the last couple of weeks after talking to my community midwife who is lovely, has referred me back to the birth choices clinic (today was my second appointment there). Basically I want an ELC under the grounds that I had a large baby at 9lb 6oz back to back long drawn out delivery, episiotomy,failed epidural and vacuum delivery. The episiotomy has never healed properly I find intercourse very painful, even before I had my first it was painful so there is an underlying issue with my vagina anyway which I had to see a consultant for a year after my first child in outpatients.

This is the thing though, after explaining my problems I was completely shut down again today and told that I was putting myself at harm by having an ELC. I understand it is a very serious surgery with obvious risks that I have read about on the RCOG website and also on the NICE website. I am still in my early 20’s and the consultant has basically told me she will not be happy signing the consent form alone as I may want to have ‘5 children’ which I told her I did not. She continued to tell me she would have granted it if this was my second child and I was 40.
So the over exaggerating of the risks today was pointless after stating this.

-She told me all first births are difficult (I understand)
-if I went on to have further children they could be stillborn (I understand the risk but the way she said it was ridiculous)
-I wouldn’t be in pain after my second birth as she could gurantee it, and that I would not have to get another episiotomy if a senior midwife was on shift

Basically throwing around facts guaranteeing I would find the birth a guaranteed success and that I would regret an ELC

I have been referred to see another consultant this Thursday to try and convince me into the natural birth with a detailed birth plan

Sorry for the waffle, has anyone been through anything similar I stood my ground today but I found it so hard to get my point across and came away feeling very stupid

[DuggeeHugs]

you shouldn't have been made to feel like that.

You have existing injuries from your first VB and have decided, on the advice of your midwife, that the risk of a second VB is too high. That's perfectly reasonable.

From the guidance you know that you should now be passed to a second consultant who will agree the CS, not change your mind.

I fought for my ELCS (DC1 was EMCS) and I haven't regretted it for a second. I researched and listed the facts I thought were most relevant, including increased risks to me from a VB (20% chance of anal tearing and incontinence, etc.,) and that stillbirth rates are halved with a CS. As my pregnancy became increasingly difficult the consultant finally agreed. The surgeon told us afterwards that having a CS basically saved DDs life.

It makes me so angry that women can demonstrate they know the risks are higher for them, but lower for baby, and still get treated like idiots incapable of making their own informed choices.

Good luck at your appointment - I hope your CS is booked in. If you're still not getting anywhere try the supervisor of midwives or PALS for support.

I would also be having a strong word with the supervisor of midwives about your consultants 'guarantee'.

[Popeye44]

Thank you so much, it’s ridiculous how stressful it is, her patronising tone the whole way throughout was awful I wanted the ground to swallow me up.

Her only major co cern seemed to be my age, she spoke in words like ‘your next pregnancy will have an increased risk of still birth, I should know I’ve had 30 years experience’

I never told her I wanted more children two are enough thanks!
I’m trying not to feel so deflated, I’m preparing myself for another battle on Thursday, time is ticking in, I’m afraid of going into a natural early labour and being forced into a vaginal birth

[Anatidae]

Stand your ground.

I will be in a similar situation but in a country obsessed with natural birth (and a huge rate of birth injury) and no right to elective request. I’m so worried it’s putting me off ttc again.

It’s your right. Stand your ground. Good luck. Wield those rcog guidelines!!! It is disgraceful that women are treated this way.

[DuggeeHugs]

Popeye risk to your next pregnancy? How about getting you safely through this one first?

The difference in attitudes between consultants did make me smile a little though because both my DCs were CS deliveries. Coincidentally both delivered by the same lovely surgeon (who was not the consultant I needed to convince). Within minutes of DC2s arrival, lovely surgeon told me that if we have a third she'd like to perform the CS delivery of that DC too (which would put me on the wrong side of 40 in pregnancy terms!). So there's obviously some discrepancy between consultants in their assessment of risk.

It seems clear that the problem here is your consultants attitude not your request.

[KadabrasSpoon]

This sounds like my hospital. Does your NHS trust have a natural birth policy?

I had an emcs with my first. All very horrendous and was being treated for Ptsd and they still put me through a lot to try to get me to VBAC. It was so stressful and c section wasn't signed off until very late in the pregnancy (after the gestation I'd had DC1!)

I printed the guidance and research from the RCOG website and highlighted bits that supported my case.
And had to be adamant at every appointment.
Told them I wanted no more kids.
Got my PTSD practitioner to write a report.
Even got a bit pathetic and brought DH with me to appointments
In the end DD had a very rare condition which needed various people there that had to be booked and even then they were still on about VBAC.

Good luck OP. It's crappy but keep going

[Popeye44]

That’s what I’m worried about, they will leave it so long that I won’t have choice and will go into labour naturally @KadabrasSpoon

I will keep you updated for Thursday, what’s the chances of two of them saying no?

[KadabrasSpoon]

Once I'd gone through many meetings with my consultant and finally saw the second one she did say yes. I think they do eventually but be prepared to stand your ground and be pressured. Hope she/he agrees

[OnionShite]

Unfortunately, Birth Choices clinics are far too often aimed solely at persuading you to try for a VBAC. ELCS isn't the 'right' choice, you see. There are dozens of threads about it on here.

Stand your ground. Tell them you want to watch them put on your notes that you have told them you don't want to attempt VBAC and they're refusing you anyway. Refuse to leave without a date being booked in. Contact PALS. These are all tactics that people on here have found helpful.

Incidentally, first births aren't all difficult. Some of us have a harder time subsequently. It's not the norm but hardly uncommon either.

[reallybadidea]

Did you see a consultant obstetrician or a consultant midwife?

[Popeye44]

@OnionShite I had a natural birth the first time

@reallybadidea I saw a registrar the first appointment then the consultant obstetrician who I heard good things about on Thursday I am due to see another consultant obstetrician

[OnionShite]

Yeah I saw popeye. This is your second I believe? But the person you saw basically telling you that your second will be easier, well, not necessarily!

[Popeye44]

@OnionShite yes this is my second, she said I only have one experience against her 30 years of knowledge that ALL subsequent births are far easier, I will not be in any pain after labour and within six hrs I can walk Home in her words

[DioneTheDiabolist]

OP, I am over 40 and soon to give birth and I had to fight so hard last week to get my consultant to agree to an ELCS. It was a nightmare, eventually she relented but it took over an hour.

[Keepkickingbaby]

Just wondering whereabouts are you OP? It seems to vary so much from trust to trust, hospital to hospital and consultant to consultant. I'm in NI and had a emcs after failed induction and long drawn-out labour, getting to 10cm, forceps, the works. They are still very much vbac-focused this time around and I get the feeling NI is different from England in this whole area.
To Anatidae, if you don't mind sharing, what country are you in? I can't think of many countries more obsessed with natural birth than here though I'm not familiar with many countries' attitudes to this. On the contrary, my old hypnobirthing "I was born to do this" pre-baby self seemed to hear of nothing but silly countries where c/s had become almost the norm. I used to be quite sneery probably. Not so much now.

[Popeye44]

@Dione is this your first?

@Keepkicking I’m in N.I too, I think it’s a nightmare and all to do with concentrating on their stats

[DioneTheDiabolist]

No. This is my 2nd and last child. I'm in NI too.

[Ttbb]

Condescending bastards.

[Popeye44]

@Dione I’m definitely up for another fight aren’t I, I tried so hard yesterday to not cry in the appointment so I could get all my points across

@Ttbb exactly, she played on my age

[OnionShite]

@OnionShite yes this is my second, she said I only have one experience against her 30 years of knowledge that ALL subsequent births are far easier, I will not be in any pain after labour and within six hrs I can walk Home in her words

All of them? I must have imagined that Cat 1 EMCS I had second time round after a vaginal delivery for the first, then! I didn't actually try walking home while I was coming round from major surgery and losing shitloads of blood, but I have a horrible feeling it wouldn't have gone well. Maybe if I'd had an Ulster fry that morning it would've been different.

You're unlikely to need me to tell you that she's bullshitting. I would advise kicking up as much of a fuss as possible. Threaten complaints, ask for her GMC registration number, tell her you want to see her write on your notes that you want an ELCS but she's not going to ok it.

[Belleoftheball8]

To be honest my first baby was the worse delivery he was the smallest aswell. I torn and ended up ventose. Second baby was a walk in the park she was 8,6 by far the easiest no tears full of energy just had injection and gas and air for pain relief.

Third baby was back to back ended up induced for days had him in early hours of the morning on the 3rd with an epidural was born naturally although if it has been longer would have been a c section and I was sore for a week he 9pounds 6. My point is all three of my labours were completely different to one another and funny how the girl was by the easiest. Could you look at other methods before going to emc? The epidural was definitely needed for my third delivery.

[Popeye44]

@Onion I don’t understand why they put them into the position to lie and get into bother with it, I hopefully won’t see her again and will hopefully have to just convince this other consultant now

@Belleoftheball I had an epidural in the first labour, my issue is with the pain of internals which I know can be minimised, but mostly the state of my perinium after if a tear or another episiotomy is needed

[DioneTheDiabolist]

They will use anything OP. I'm 44, so she couldn't use my age, although she did talk about future children. I told her there would be no future children. I also have suffered pelvic arthropathy since week 18 and have been practically housebound and immobile for the last 6 wks. This means that I have a high risk of permanent pelvic damage if I open my legs too wide during labour and I can't lie on my back for more than a couple of minutes at a time.

She then suggested I could labour squatting, kneeling or standing. I can do none of these. I can sit and lie on my side. And she had no suggestions for how I could not spread my legs too far apart.

I did not hold back on the tears. I cried when they came. I pointed out that I did not think that an ELCS was an "easy" option, but as I had no easy options and faced a prolonged recovery, having done my research, it was IMO the easiest option for me.

I was quite shocked that I had to fight so hard given my age, the complications I am facing and the risk of EMCS anyway. Write your points down OP, that way you won't forget them. And don't be afraid to show emotion. This is difficult enough and they are making it more difficult for you.

[ComfyPillow]

I cannot believe that in her entire career she hasn’t come across a subsequent birth that was equally or more traumatic than the first.
My first 2 were quick, relatively easy births. My third was a 10lb back to back nightmare who got stuck and needed the works to pull him out resulting in him needing resuscitation. It was horrific.
Stick to your guns. You know what you want and need. It’s bloody barbaric for them to be putting this stress onto heavily pregnant women. Good luck.

[lovechildofLordFarquaad]

My advice would be just make sure you don't get pressured into anything and don't show any glimmer of doubt in your decision and conviction

My Ds was born by CS at 42 + 3. I had failed induction and no contractions at all and requested a CS on advice from my community midwife after 4 days in hospital and no progress. I was confident it was the right decision as DS was over 10lb and she thought he would have got stuck.

When I got pregnant with DD I knew I would want another CS after first experience, and sonographer said she looked large at 37 week scan. Hospital tried to push back all the way and wanted me to have VBAC. I sympathise with you as I felt like I was jumping through hoops and had to go through 4 consultations and lots of lectures about the risks. I read up on the pros and cons and just stuck to my guns. Eventually they agreed but it was frustrating and very late in the process. I am glad I did as it was yet right choice for me and allowed me to be calmer etc I also took someone with me for moral support and assured them that I didn't want more children - though the consultation scoffed and said ' that's what they all say' Try not to take it personally though as it isn't, focus on getting your CS as it's surely your right to choose. Good luck!

[Popeye44]

@Dione I wouldn’t be surprised if we had the same consultant, she was very pro natural birth and trying to get me to write a detailed birth plan with one of the senior midwives in the clinic

@Comfy yeah you can’t predict it at all, no detailed birth plan with fix that