Page 2 | Flexible private consultant at Chelsea & Westminster

EPfds · 2025-05-08T07:24:54+00:00

Hello, I’m pregnant with my third and am trying to find a private consultant at Chelsea and Westminster hospital. I’m considering attempting a VBAC but have some red lines that I would need the delivering consultant to respect in labour - which are: - no IV/cannula unless it’s an emergency, I don’t want to labour with a painful cannula in my hand and never needed them before but was previously forced to have them. - I’d probably still want an epidural, again, without cannula unless it’s absolutely necessary - Absolutely no instrumental delivery or episiotomy, if things don’t work out on their own I want a c section. I have PTSD from previous births because I was never listened to and already lost a child to an extremely premature birth at 24 weeks, as my entire pregnancy and delivery was horribly mismanaged. Subsequent elective c section was better but I again hated having no agency and feeling coerced into multiple unnecessary things, constant takings of blood for unnecessary tests and so on. If anyone can recommend a consultant who believes in maternal agency during birth and would respect the above, I’d be very grateful.

EarlGreywithLemon · 10/07/2025 14:47

That is true, I could have insisted on a section when we found the baby was back to back. I’m sure they would have done it - though I did go to 10cm very quickly and there was no indication that anything was amiss with her position before that.

And yes, of course you can have a section at any stage - the question is, how risky is it for the baby especially (but also for the mother) vs an instrumental delivery. They were prepared to give me the section, and in fact I was fully prepped for it in theatre in case instrumental delivery failed. But they had to explain the risks, and I made my decision based on that.

Incidentally, I originally only consented to ventouse, which failed. I had said absolutely not to forceps, until the doctor said she was pretty confident she could get her out in just one gentle tug- which she did. I was getting very anxious about the baby by that point, and wanted her out ASAP. I then went on to have a suspected placental abruption, so I’m very glad I did make that choice.

Also - ventouse isn’t particularly great. Two people had to hold me back on the operating table while they were trying to pull her out with the ventouse. And the doctor confirmed my 3B tear had already been caused by the ventouse, before the forceps.

Whiteflowerscreed · 10/07/2025 14:34

EPfds · 10/07/2025 13:49

I think if nobody will give me an epidural without a cannula, then I will attempt to labour without an epidural, and if the pain gets too bad go straight to section. I will not labour with a cannula in my hand under any circumstances. I doubt that I'd manage without an epidural, I don't believe in having severe pain in childbirth. So another section it most likely will be.

Was there anything that helped you get to 9cm pain-wise?

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Yes! A tens machine helped me get to 9cm without epidural. Really helped.

btw are you okay with cannula in hand for c section? Pretty sure I had to have that for all my c sections

Original poster

EPfds · 10/07/2025 14:00

EarlGreywithLemon · 08/05/2025 20:13

I’m so sorry for your loss! Two words of warning from experience. I had an epidural and a spinal and did not have any issues. I then had another spinal with my latest section, my blood pressure tanked and I felt really awful until I was given medication to bring it back up through the (already sited) cannula. If they’d had to try to cannulate me then it would have been horrendous. I felt bad enough waiting for the medication to start to work as it was. That also applies in a proper emergency - you do not want the team to waste precious minutes trying to site a cannula, which can take even longer to do if they can’t find a good vein etc

The second point: I was also determined that I would not consent to an instrumental delivery or episiotomy in my first (vaginal) birth. In the end my daughter’s heart rate went wrong when she was so low down in the birth canal that a section would have been risky for both of us - they would have had to push her back up to do the section. So I consented to forceps. What no one explained to me in advance - and I wish they had - is that in a vaginal birth there are no guarantees that you won’t need an instrumental delivery. The only way to guarantee that is an ELCS - which is what I had for my subsequent two children.

Very best of luck, and hope it all goes smoothly. I had all my children at C&W but it was NHS, so sadly I can’t make a consultant recommendation.

Thanks for sharing. I know that they tell you that there is no way to guarantee not having an instrumental delivery in vaginal birth, but that's simply not true.
Instrumental delivery obviously fails often and then they have to do the section regardless how far along the 2nd stage is. They can therefore skip straight to C section and will have to do so if the mother denies consent for instrumental. It's just that they often don't want to because it's faster to quickly shred the mother with forceps. Forceps are banned in many hospitals in Europe, and their use is extremely rare almost everywhere in the world. The UK has an abnormal and unprofessional obsession with a frequent use of forceps.

There are also other ways to mitigate risks before it gets to that point in delivery - I personally would always skip straight to section if my baby was posterior or otherwise poorly positioned, or if there were early signs of my own exhaustion or fetal distress. Induction, especially if progressing slowly, is another sign that things are just not going optimally. Basically I'd always try to opt for an early pivot to section rather than press ahead with a vaginal delivery in suboptimal circumstances.

OP posts:

Original poster

EPfds · 10/07/2025 13:49

Whiteflowerscreed · 09/05/2025 06:17

OP would you be willing to forgo the epidural?

I attempted vbac (in NHS hospital) and went against guidelines as chose the MLU. I said no to constant monitoring and no to canulation of both or either hands as I found it painful and distracting previously. It was done very tightly.

it meant in labour I was able to feel comfortable and more animal like (on all fours) no pain relief. I got to 9cm before an unlucky event meant a c section but I do believe all my choices of being less ‘medically bothered’ helped me get to 9cm easily

I think if nobody will give me an epidural without a cannula, then I will attempt to labour without an epidural, and if the pain gets too bad go straight to section. I will not labour with a cannula in my hand under any circumstances. I doubt that I'd manage without an epidural, I don't believe in having severe pain in childbirth. So another section it most likely will be.

Was there anything that helped you get to 9cm pain-wise?

OP posts:

Whiteflowerscreed · 09/05/2025 06:17

OP would you be willing to forgo the epidural?

I attempted vbac (in NHS hospital) and went against guidelines as chose the MLU. I said no to constant monitoring and no to canulation of both or either hands as I found it painful and distracting previously. It was done very tightly.

it meant in labour I was able to feel comfortable and more animal like (on all fours) no pain relief. I got to 9cm before an unlucky event meant a c section but I do believe all my choices of being less ‘medically bothered’ helped me get to 9cm easily

countbackfromten · 09/05/2025 00:52

Obstetric anaesthetist here - I don’t know any of my colleagues who would agree to doing an epidural without a cannula in situ, I certainly wouldn’t and it is in our guidelines and those of every hospital I can find that we would not put an epidural without a cannula. The risks of doing so are just too high and there are extremely good reasons why you need a cannula for an epidural as others have explained.

EarlGreywithLemon · 08/05/2025 20:13

I’m so sorry for your loss! Two words of warning from experience. I had an epidural and a spinal and did not have any issues. I then had another spinal with my latest section, my blood pressure tanked and I felt really awful until I was given medication to bring it back up through the (already sited) cannula. If they’d had to try to cannulate me then it would have been horrendous. I felt bad enough waiting for the medication to start to work as it was. That also applies in a proper emergency - you do not want the team to waste precious minutes trying to site a cannula, which can take even longer to do if they can’t find a good vein etc

The second point: I was also determined that I would not consent to an instrumental delivery or episiotomy in my first (vaginal) birth. In the end my daughter’s heart rate went wrong when she was so low down in the birth canal that a section would have been risky for both of us - they would have had to push her back up to do the section. So I consented to forceps. What no one explained to me in advance - and I wish they had - is that in a vaginal birth there are no guarantees that you won’t need an instrumental delivery. The only way to guarantee that is an ELCS - which is what I had for my subsequent two children.

Very best of luck, and hope it all goes smoothly. I had all my children at C&W but it was NHS, so sadly I can’t make a consultant recommendation.

Original poster

EPfds · 08/05/2025 13:25

@Lavenderandlemons thank you. Re previous tests - I know that in the run up to, before and after my ELCS the hospital insisted on literally dozens of blood tests that were entirely unnecessary. They just wanted to charge us for them. They even got a cardiologist consultant in who harassed me for hours after the section to have additional tests to “rule out” that I had a cardiac arrest during the surgery, which was ludicrous, there were zero signs that I had and ofc I did not. Basically, when I was under NHS care nobody tested me for anything ever and so tragedy struck. Once private, every test under the sun was forced onto me to bill me for it.

Regarding the cannulas - yes, sadly I’m aware that they are forced on women on maternity wards, but they should not be a requirement for an epidural. They can obviously be given ad hoc when required rather than in a blanket approach without indication. I never needed an IV for fluids, but was given medication through it without consent in the past and would never agree to a cannula again unless in an emergency.

OP posts:

Greybeardy · 08/05/2025 12:04

From an anaesthetist... you will need to explore anaesthetic consultants as well as obstetricians. There (hopefully) aren't many anaesthetists who would agree to site an epidural without IV access secured (however, they should be able to explain why IV access is part of the package so you can make an informed decision re. whether to proceed).

Lavenderandlemons · 08/05/2025 11:53

I'm so sorry you've been through so much, especially the loss of your child. I don't have personal experience with this hospital so can't give an opinion on consultants, so my reply might not be helpful but didn't want to ignore.
Did you ever access a debrief after your births? Might be something to consider if not. What might seem like unnecessary bloods may have had an explanation behind it, it would be unusual to take blood for no reason. Someone going through all of your notes with you could shed some light.
Did you have a cannula in a very uncomfortable location maybe? As a Midwife I've never met an anaesthetist happy to give an epidural without a cannula. A side effect to epidurals is that your BP can drop quickly so you need IV access and IV fluids ongoing for that reason. That would not be possible for your obstetrician to ok even if you found someone supportive of your other wishes. I hope you get some more helpful responses than mine but just wanted to offer what I could.