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SPD: Is ELCS advised?

(10 Posts)
Yarnswift Mon 30-Apr-18 15:53:24

Second baby. Had elcs for the first due to placenta and vasa previa. Have had spd very badly both times - currently 23 weeks and in considerable pain with greatly reduced mobility.
I will of course see the same Osteo who helped a bit last time (state physio was zero use...) bit I’m a bit worried about being forced into VBAC and mybpelvos being damaged further.

Full disclosure: I’m not in the Uk, I’m in an EU country with no right of request for elcs, massively high birth injury rates and an obsession with all things natural.

So: is there any clinical evidence I can bring to the table that an elcs is in my interests with severe spd? It took over two years after the last birth to get any treatment for it and it’s inpacted my life hugely. I want to recover from this birth as well as possible so I can regain my pre kids fitness. Right now I’m headed to disability territory and that’s quite frightening

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Spudlet Mon 30-Apr-18 15:58:15

Didn't want to read and run... I think the advice in the UK is that you can have a vaginal delivery but that you should test how far apart your knees can go without it being painful, measure it with a bit of string, and make sure that the midwife, dr and your birth partner all know that it's that far and no further. I had pretty severe SPD and in my case, was able to labour and deliver in a kneeling position without hurting my pelvis. But it's about what works for you.

I hope you get the support you need and the outcome you want, and that your poor pelvis feels better soon. SPD is an utter bitch of a thing. flowers

Yarnswift Mon 30-Apr-18 16:00:25

Cheers. There is no way on earth I can kneel, which is the issue. My mobility is seriously compromised.

If I was mobile, younger and generally less decrepit I’d be up for VBAC. However I’m extremely worried about being channeled into it against my will and ending up with an instrumental delivery that damages my pelvis more than it already is.

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Spudlet Mon 30-Apr-18 16:16:27

I don't blame you for being worried in the least. Have you been in touch with these guys?

They're UK-based but they should still be able to advise, I should think. That page isn't particularly informative but I would think it would be worth emailing or calling them.

eddiegetlost Tue 01-May-18 15:09:07

Would they be more accepting if you focused on needing a 2nd section by not accepting the increased risk of a ruptured uterus involved in a VBAC rather than on the SPD? Depends on the gap between your babies as I know this risk diminishes with time but it's established in research I think?

Yarnswift Tue 01-May-18 15:17:11

Alas no. Prior c section is no excuse here. Everyone is channelled towards VB. I had a placenta previa that was 12mm from the OS last time. C section refused until they found the vasa previa as well.
It’s quite crazy - vb over everything

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GrainneWail Tue 01-May-18 16:52:00

I hate to be a bearer of bad news, but my second section exacerbated my spd hugely and I was significantly more debilitated after delivery than before. And still am 6 years later. Obviously this is rare, but make sure you get good advice on what will be best for you as I would be very hesitant to suggest a section will the be cure to your ills.

Yarnswift Tue 01-May-18 18:41:48

I’m sorry to hear that grainne

Do you know why? Was a reason for the worsening ever offered to you? I suppose reducing the integrity of the core could do it.

I have had some really good treatment with an osteopath (which I’ll be honest I didn’t believe in before I saw her.) she was very un-woo and hands on and realigned my pelvis. This was about a year after the first birth and it resulted in probably an 80-% improvement that stayed. I think with better ongoing treatment I’d have improved more but life got in the way a bit and now I’m pregnant again.

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GrainneWail Tue 01-May-18 23:21:57

Unfortunately no one will tell me why I walked out of hospital on crutches and was on them for 6+ weeks afterwards. I think it was cutting through the abdominal muscles for a second time that destroyed the limited strength that was there. I fully admit I should have been stronger before getting pregnant, but thems the breaks I guess. Other than keeping my core as strong as possible now (which I find hard when I'm in pain, which is not always I should say) the menopause may be my best hope for relief!!

Anyway, I really hope I haven't scared you, but I worry when women read or are told that sections are the cure for many ills when sometimes they aren't. With good advice, and it sounds like you've good experience with your osteo, you'll be in a better position to get the best outcome for you.

Yarnswift Wed 02-May-18 07:08:15

Ah if you had something go wrong and they need to actually cut muscles then maybe that was it? A normal C doesn’t actually cut any abdominal muscles (they only do incisions in the skin, membranes and uterus.) the rest just kind of gets shoved out of the way. They do cut the connecting fascia sometimes - I wonder if this has knitted back badly for you?

Do you have a diastasis (separation of abs) If so you could have a good case for surgical repair. Also the ‘restore your core’ program is good for DR.

So sorry you’re still suffering - postnatal care has a lot of catching up to do imho sad I genuinely don’t think men would be expected to put up with it.

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