C-sect or VBAC? They wont let me have elective c-sect

[BarbieDoll5]

Hi, I am fairly new to mumsnet but am feeling really down and need some advice.

DS1 was born 8 years ago after being induced due to 2 weeks overdue. 24hrs later still did not dilate past 5cm. SO had emergency c-sect. I was only 17 at the time.

Now 36 weeks with no.2. Spoke to midwifes as I would prefer an elective c-sect. They said fine, they would do it at 38 weeks..and was probabley better as did not dilate before, risk of scar rupture, and low sucess rate of vbac.

THEN saw obstratrician (spelling?) who said because of my age (26) she did NOT think I should have another c-sect. and that if i insisted then she still wont do it until I am 40 weeks...and if I go into labour naturally before 40 weeks then tough unless emergency!!!

Why are the midwifes and obs giving different advice?

Since she said this, I now cannot sleep,keep crying, have flash backs of DS1 trauma and am *&^tting myself about going into labour.

Reason for not wanting VBAC is did not dilate before and am terrified of going through labour and ending up with emergency c-sect anyway. (Also am a bit of a prude and cannot handle the whole dignity thing!) I know that I will not want more kids after this (as was dubious about this one at first.) I thought that if you had one c-sect they prefer you to have another?

Am interested in Mears advice or anyone else having elective c-sect?
dOES anyone know who I should talk to about my fears?
Thanks

[nutcracker]

Hmmm poor you, you'd think they could all sing from the same sheet wouldn't you, instead of messing you about.

I have had 3 sections. First was due to breech baby and she was delivered at 38 weeks.
When i got pregnant with Dd2 they said i could have a normal delivery but she was also breech and so they said i had to have another section. BUT then at 34 weeks i went into labour and she had turned to correct poistion and so they said i could try for a normal delivery if i liked, it was very much my choice though. I decided to try for normal delivery but Dd2 had other ideas and got distressed very early on (cord round neck twice) and so i had an emergency section.
3rd baby was then elective section.

As far as i kjnow, most woman who have had a section first time i then given the option second time around of what they want to do.

[bubble99]

Hi Barbiedoll

I'm sorry to hear you're feeling so I'm sorry I can't give you any advice but just a //[hug]]. I'm curious as to why your age is an issue against CS. I would have imagined that after the experience of your previous labour you would have been an ideal candidate for an elective CS. Mears or someone else who can help will be along soon. Try not to get in a stew about this, easier said than done, I know.

[nutcracker]

Sorry also meant to ad that i don't think your age should have anything to do with it. I had my sections at 19, 21 and 24.

[BarbieDoll5]

Thanks.
I though I would have the choice...the obs. was actually really patronising about my age and even said that she had 2 c-sects but it was different becuse she was much older than me!

hy wait until 40 weeks, if she does do it?

I am just petrified of having to go through labour and will prbabley end up having emergency c-sect - so why cant they just do it in the first place? What if I end up resenting the baby due to a bad birth?

I found DS1 birth very traumatic and vowed not to have any mnore kids, but when accidently happened I decided to go for it, although it took a lot of persuasion from DH.

I am also a complete prude and hate the thought of legs akimbo for all to view! I dont even think I could have DHin the room, as I would never feel sexual again!(thats probabley a good thing to avoid more pregnancys)

I feel so anxious - got next aponitment end of the week to discuss further.

[Eva3]

My advice is get a second opinion or switch hospitals even, if you can. They should be sympathetic to your difficult first time experience and let you opt for a c-section. I know that they try to discourage c-sections whenever they can for good reasons but think you have a very good reason to elect for one. Don't give up - if that is what you really want, you can get it!

[MrsBigD]

BD5... your obs sounds a bit hard line imho. I had an emergency CS with dd and an elective cs with ds 5 months ago. My obs gave me the whole spiel on how it's preferable to go for natural as these are the new guidlines as too many women are opting for c-section even first time round.

What he said about waiting till 40wks is total rubbish! elective cs are usually scheduled for week 38/39 (at least that is what I was told) to avoid the mumtobe to go into labour and avoid risk etc.

However, in my case there was still a 77% chance of ending up with an emergency cs anyhow so I told him I insist on an electiv cs. One of the criteria for elective cs is actually having had previous section!

I'd request a different obs if you can, and talk to your GP/midwife if they are any good.

Hope this helps.

[nutcracker]

If your midwives are supporting your desicion and you are sure it is what you want then I would speak to your ob again explaining all the reasons why etc etc.

Hospitals seem to have varying poilices on when to do sections. I had Dd1 at one hospital at 38 weeks but then another hospital with Ds wanted to wait until 39 weeks.

Good luck

[Marina]

Barbiedoll5, you need to share with the obstetrician your real fear of childbirth and what your fear is based on. Thank goodness your midwives are on side at least.
I think the doctor could be more understanding in the circumstances, especially as she is a woman. I think it is very bad of her to project her experiences on to your situation - what on earth does her age and maternal history have to do with yours?
Having said that, and as a veteran of two elective c-sections myself, I personally found them totally lacking in dignity. The catheter, the being lugged, paralysed from the chest down, onto the operating table, the painkilling suppositories, the drain...I think bringing a baby into the world is an embarrassing experience any which way

[crunchie]

Barbiedoll5 I totally understnad your point about wanting a c-section, but just to say all labours are different and this time you could dilate etc. It is medically 'better' for the baby and mother to have a baby naturally therefore I think that is what the consultant is getting at. Once you have had 2 c-sections you couldn't have a natural birth if you got pg again. Now I know you said you won't have anymore, but perhaps the consultant is suggesting at your age you 'might' possibly change your mind as you have many childbearing years ahead of you.

Also if you do go into labourthis time they will usually give you what I think is known as 'trial of labour' in that it you are not progressing after about 4 hrs they will give you a c-section. It doesn't need to be a running down the coridoor manic thing, and you could have the epidural once you are in labour.

I am not suggesting you don't know your mind, or that you may still choose to have a c-section (I have had 2) but I know that FOR ME I wanted to try labour the 2nd time (1st time was a prem baby and no labour). It didn't happen as she wasn't going to come out, I was not engaged and my waters had leaked, so I chose a c-section on the day.

Good luck with whatever you decide and bear in mind not many babies arrive on their due date (or before) so perhaps she wants to wait until your baby is ready to be born, not a couple of weeks early.

[Eva3]

I would agree with Marina. I have had one c-section and one vaginal birth and am about to have another baby (due today !) I would say it is very important to be properly prepared if you are going to have a vaginal birth, if you panic things are more likely to go wrong. If you "withdraw inside," concentrate on breathing and have support around you, then it can be, should be, so much more rewarding and beautiful than being carved up on an operating table. Having said all that, in the end, it is the baby that matters and the end result if gorgeous which ever route you choose. You need to choose what is right for you. Perhaps some councelling, doing Yoga, talking to a few midwives will get you more psyched up to try for a vaginal birth. If not, fight for what you want.

[Tissy]

To second marina, I thought an elective section (medically necessary)would be more "dignified" than all that pushing and grunting. It wasn't .

[wanda]

Barbiedoll5,
hi I'm newish to mumsnet too and was in the exact same position as you re a second section. The circumstances of my first section were exactly the same too ( i only got to 4cms ). I was told that it was entirely my choice as to what to do second time around. However as the pregnancy progressed I got the benefit of many different opinions as to what I should do and by the end I was confused and really peed off. The bottom line is that unless someone tells you there is a real medical reason not to have a section then you should go with your gut feeling. If you went ahead with a natural delivery who would you be doing it for? The are no prizes for it I can tell you. Discuss your fears with your midwife or consultant and tell them that the conflicting advice is making you confused and miserable. People will tell you that your second deliveray may not necessarily be like the first but they weren't there when you had to face the trauma and the fear that things could so easily have gone tragically wrong. I wasn't prepared to take the chance a second time. Stick with your instinct and Good Luck!

[mears]

BarbieDoll5- I had a huge reply there but it diappeared when I went to answer the phone

You are quite right that your consultant and midwives should be saying the same thing. However, in this case your consultant is saying the right thing as far as delivery at 40 weeks is concerned.Your consultant has not actually said she would not do a C/S from what I have understood from your post. She has said that she would not do it until 40 weeks and I agree with that point of view. If you think about it you were 2 weeks late when you were induced last time. If you had an elective C/S at 38 weeks you have the potential of your baby being born 4 weeks too early. Babies born by elective C/S at 38 weeks are more likely to be admitted to the specail care baby unit with breathing and/or feeding problems.
If you go into labour on your own prior to C/S there is a good chance you will progress in labour own your own. Last time you were being induced and your body was not ready to labour. Starting in labour on your own is a different kettle of fish. You would be closely montitored as a previous C/S and you would not be left for hours.
However, if you decided that elective C/S was definately for you, arrangements would be made for immediate C/S on admission to hospital in labour. It is classified as an emergency just because it is not planned before the onset of labour. I think it is highly unlikely that your consultant would refuse to do an elective C/S for the reasons you have mentioned. Have you discussed those reasons with her? I am posting a link to the website for clinical guidelines (NICE) that has advice regarding C/S. Once you have read it you can go to your consultant and say that you are making an informed decision regarding repeat C/S. Definately explain your reasons for your choice.
guideline

[crunchie]

Mears as usual brilliant advice

[BarbieDoll5]

Thank you (esp. to mears) for the advice.
I would just like to say also , that my hospital have cancelled all antenatal classes (they will be starting new ones with the NCT but not until April)...and this is also another reason that I would not feel prepared for a vbac - as I did not attend antenatal classes with DS1 and did not labour so have no experience of breathing techniques etc.
Have looked into alternative (i.e local nct classes) but at £100 cannot afford it.

Mears- the consultant said that if I were to insist on c-sect but go into labour she could not garentee that I would get an emergency c-sect and hinted that I should be left to labour if all seemed ok.

[bubble99]

Eva3 - "......carved up on an operating table." ??????

[mears]

BD5 - your midwife could give you one-to-one information about techniques in labour. I have to say that I do not think classes are necessarlyi a prerequisite to a good labour - the midwife caring for you will give you guidance on the day. Most women do not actually attend classes at all. There are really good books available in the library that you would find helpful.
I think though that you need to have a full discussion with your consultant. Did you tell her of your fears? Perhaps talking to your midwife would allay them. Would you feel ebtter if you were more prepared? Perhaps once you have read a bit more about labour itself you would feel less apprehensive.
What concerns you most about labour? Feel free to CAT me if you would like a deeper discussion without revealing more.

[Uwila]

Your story sounds like min, except I am due with my second child two years after the emergency C. And my consultants anre a bit more agreeable to the elective.

Regarsing your age, I wonder if the consultants point might have been the time between the two babies (8 years) rather than how old you are now. 8 years is a long time for the uterous to heal, hence the likelihood of rupture is reduced.

However, I am a firm believer that the choice is yours. Can you put your request in writing to the hospital (and possibly copy the trust)? That makes the consultant liable if anything goes wrong (or at least makes her look bad). It might encourage the trust to have a little chat with said consultant.

Alternatively, you could refuse the VBAC even when you show up at the hospital in labour. Tell them you have no intention of cooperating. Show them the letter, have copies of everything, and tell them you want a section and as they have refused it thus far, it's there own fault you are standing there in labour in need of emergency attention.

Okay, my suggestion is perhaps a bit radical. But, no way, no how should you have to give in to their preferences. It's your body, your baby. It certainly doesn't sound like they should be refusing your wishes.

Definitely try another consultant if you can.

[mears]

It wouldn't come to that Uwilla. Further discussion is needed with the consultant. If you cannot agree with the consultant BarbieDoll5, you can certainly switch to another sympathetic one. However, if you go to your next visit armed with information and also discussing your concers fully, I am sure she will consent to do an elective C/S or emergency one in labour if that is what you truly want.

[Uwila]

But, she is 36 weeks pregnant now. If it was me, I'd certainly want answers today. How long will it take to get another consultant appointment? How long to get referred to another one if this one is still not agreeable? If nothing else, I'd write a letter to the consultant(s) asking for an explanation of reasons why it can't be scheduled now. Tell them you are not satisfied with the conversation you had.

I will go to great lengths to get what I want from the NHS. One thing I would not be doing is waiting around for referrals that can take days or even weeks.

[KBear]

I've just skimmed this thread cos I should be getting dinner ready BUT I was severely traumatised after the birth of DD 6 years ago and when I fell pregnant 2.5 half years later I was in a right state! My midwife reassured me that an elective would be the way to go and that I would meet with the consultant at 36 weeks to discuss. I worried about it but stood firm. That was what I wanted and that was what would happen - I was in no doubt. I had to put my case forward so to speak and he did try to talk me out of it but NO WAY I said, was I going to end up traumatised and emotionally scarred as I was before. He saw my point and agreed to it.

Get back on the phone, make another appointment and demand the birth you want. The NHS is for all of us and we should be able to ask for what we want without being bullied. Gimme the phone, I'll speak to him.

Subject close to my heart, can you tell?

Lots of luck BD5!

[KBear]

And can I just add that the elective c-section birth was a calm, tranquil experience, I was not "carved up" - (what an awful turn of phrase to use when trying to help out someone who is obviously scared to death as it is ). The surgeon was wonderful, talking me through the procedure and the theatre staff were equally wonderful, kind and fantastically patient.

[Hulababy]

at "carved up" phrase. My cs (emergency due to non progress after induction - 3 days later) was a superb experience and in no way did I ever fell "carbed up" Horrid phrase

[doobydoo]

Agree with KBear.I had traumatic time some 15 years ago took me 10 years to pluck up courage to have ds.Wanted a caesar.Told no..see how it goes.Ended up with an emergency one.I felt alot like you do now.Stick to your guns.If I have another i shall insist on caesar and will not take no for an answer.GoodLuck.

[KBear]

Hulababy - SNAP - at induction and c-section days later! These girls that have babies in six hours huh - I don't know.......