concerns at 34wks - long post!

[cookierock]

I've just had a growth scan and consultant app today as I had pre-eclampsia in my last pregnancy and they have been keeping a close eye on me this time round. I have had regular growth scans which have shown baby to be measuring a week behind but today the head was measuring 4wks behind while stomach and femur were 2wks behind. Last time estimated birth weight was just scraping the 5th centile and now it is below as weight has only increased by 0.6lbs in a fortnight. This is really concerning me although my fluid level is good as is blood flow to baby.
Midwife also found sugar in my urine for the 1st time and said if it happens again they will have to do tests but she didnt say what the tests were for or if this is much of an issue?
Lastly, and thank you for reading this far, I had been geared up to ask my consultant for an elcs but she was on holiday so didnt get the chance. My reasons for this are that my last birth was extremely traumatic, I was rushed to hospital at 37wks with severe pre-eclampsia and told if I had arrived much later ds and I could of died, which obviously terrified me! Then I was just left for 3 days attached to machines and getting progressively worse until one evening they decided to rush me to delivery to be induced. Nobody ever really explained what was going on and I was still so ill when ds was born that i didnt bond with him and developed PND.
I really can't face the stress of that again or cope with leaving ds for a 2wk stint in hospital which is how long i was in last time. I am still suffering from depression and anxiety which was made worse by the loss of a close relative recently. Another reason I wanted an elcs was to ensure ds2 isn't born on their birthday and associated with our grief if that makes sense?
However Im wondering if maybe its a sign that i couldn't see my consultant and Im meant to have a vaginal birth. I had really hoped for a home birth or at least a relaxed birth at a mlu but have been strongly advised against staying at home and told i can't go to the mlu. I really don't want to be induced and bed ridden again so really need some advice. The anxiety of it is driving me crazy!

[ButteryJam]

I'm really sorry I can't offer you much advice but would like to offer you virtual hugs. I'm also 34 weeks and I'm feeling the anxiety creeping up.

Have you tried listening to the hypnobirthing CDs? They might help you relax a little and relieve some of the anxiety.

[lotsofcheese]

Hello Cookie - sorry you're having a stressful time. My story is similar to yours: severe PE at 29 weeks - EMCS & had to leave DS behind in NICU for 95 days - extremely traumatic.

However, I'm wondering if you're under consultant care? I have been since the beginning. I've had a few growth scans & when the growth tailed off, I was sent for dopplers, check of fluid levels, ctg (tracing) & am now on twice weekly BP checks. I've never been more than 2 weeks without seeing a consultant & am now there weekly at 35 weeks plus.

I'm booked for ELCS at 39 weeks as baby is breech & EMCS will happen earlier if PE starts up again. There seems to be a big drive on to stop the increase the CS rate - the only ones who have bought this up to me are registrars - I would only have agreed to a vbac on a consultants advice but thankfully being breech has made that decision for me.

It does sound like you need a consultant appt & to discuss your concerns.

It's a worrying & stressful time. Good luck & fingers crossed for you.

[cookierock]

Thank you for your replies.
Butteryjam I will look out for those cds as anything to reduce the stress and anxiety will be great!
Lotsofcheese, yes I am under consultant care and recently have started having fortnightly appointments and scans. A major problem for me is Im extremely shy and emotional so have trouble getting my feelings across. When I tried to discuss birth options, ie home birth or mlu a few weeks ago I ended up in floods of tears and couldn't even explain to them why i was so upset as i was gasping like an upset child. I just felt so humiliated and didnt stop crying for the rest of the day. That is a major reason I am considering asking for an elcs as it should help take some of the anxiety away. However I just don't think I'll be able to bring it up as i was crying before we even got to the hospital yesterday when dh said 'remember they don't do anything regarding birth plans until 36wks so don't bother mentioning it'.
I feel like a useless emotional wreck, I just wish i could be a strong person and talk about how i feel without having a breakdown!

[lotsofcheese]

Oh, you poor thing! I really feel for you. How far along are you?

Although you might not have articulated yourself about your fears, being so upset & teary will have spoken volumes. If you are too upset to speak, perhaps your DH could say on your behalf?

My understanding is high risk pregnancies should deliver in hospital as opposed to MLU or having a home birth. I certainly wouldn't risk it after severe PE & if your baby is on the smaller side too.

Would you feel up to discussing things with your midwife? Or phoning the consultant's secretary?

Also I've had scans in this pregnancy showing growth was dropping, and got myself in a wee bit of a state, only to find at the next scan that it's fine.

[cookierock]

Im 34+4 atm. Im really hoping her weight gain improves and she is healthy. She may be naturally small as ds was 6lb6oz but then the pre-eclampsia might have affected his growth.
I have a midwife appointment on Thursday to have blood taken so i will try to discuss some of my concerns then. It would be nice if i knew her a bit better though as with seeing the consultant I've only met my midwife twice. Im hoping she will bring birth plans up as they are normally discussed at 36wks and I will be seeing consultant then who never really discusses anything but my previous scan results.

[Bearcrumble]

Sounds like you have IUGR. Did they do dopplers of blood flow in baby's brain?

It often goes hand in hand with PE or PIH but frequently not.

If there's not enough nutrition coming from your placenta it will be diverted mainly to the brain and the femur and abdo measurements will lag behind.

If you do have IUGR you shouls have an Elcs without quibbles from healthcare providers.

[Bearcrumble]

Oh sorry didn't read properly - so head is further behind than femur/abdo. Don't pay any attention to my previous post.

[cookierock]

Im not sure what IGUR is exactly but i have had a doppler which showed blood flow was fine. It is actually the head circumference which is almost 4wks behind with stomach 2wks behind and femur about a week behind.
Going to look up IGUR now.

[LadyMedea]

Why dont you write to your consultant? Then you can explain why you are finding this a struggle and that if they agree you would like an elcs. Then you can discuss it when you see them and it should be easer.

While they quite rightly should be trying to reduce Cs rates you sound like the perfect person to be requesting one.

I don't think it's an unusual request after a first Cs as there are risks with vbac.

[cookierock]

Is it reasonable/acceptable to write to the consultant? I certainly would be able to articulate my feelings clearly then though would worry about being cowardly.
However I think my anxiety leading up to the appointment would be through the roof but then again it has to be better than bottling everything up?! I really drive myself crazy at times, so wish my brain had an off switch!
Do you think its common for people to write to a doctor as they cannot get themselves across in person?

[LadyMedea]

It is certainly common in my experience to write to your doctor. I have a family full of complicated health conditions and the only way to manage your 10min appointment efficiently is to write in advance when you need to.

Make it as concise as you can, use bullets, and be clear about what information you specifically want. Ring up the day before the appointment and check with the secretary that they have it and bring a copy too.

Just think - would you hesitate if it was a private doctor? No? Then don't hesitate with the NHS, we do all pay for it too!