In labour - need urgent advice!

[Ineedadvicee]

Well.. kinda in labour, kinda not!

Waters broke 27 hours ago, arrived at the hospital shortly after they broke but contractions failed to start. The hospital said that if nothing happens in 24 hours (24 hours after works breaking), they will start the oxytocin drip to get things moving. Apparently they can only allow 24 hours as you are more prone to infection once waters have gone.

Problem is… the 24 hours are up but there are no beds on labour ward so they want to take me in for a c section. I’m gutted because I haven’t even been given the chance to try for a vaginal birth… of course I need to follow their advice but it seems so unfair that the reason for the c section is purely down to lack of beds, not because of anything medical?

I don’t know what to do…

Can't believe some of these responses, or how precious OP is being.

The most important things is a healthy, alive baby, not you getting the dream birth you 'want' 🙄

A C section is relatively minor these days, FFS.

It’s not precious to not be pushed into major surgery for no reason other than a lack of beds!

OP is not being precious.
I'm a midwife, and I think this is very poor care.
This really isn't a thwarted 'dream birth' scenario, I've seen a few of those.
Caesareans are life saving and a fantastic tool to get better outcomes in childbearing, but it comes with more negative effects for the mother than vaginal delivery.
Outcomes for both mothers and babies are important, and need to be considered carefully.
What if she has the CS, then she has a uterine rupture next time because of this?
A caesarean because we have no labour ward bed? That's insanity, and I don't think that would happen at my trust. They'd probably put her on IV antibiotics first if there were no delivery beds.
It's not acceptable that they are recommending an option with worse maternal outcomes - they could transfer her to another hospital. Its not convenient for the hospital, but being able to provide a labour bed is a pretty damn basic thing.

Ask to be transferred to another hospital. I would be seriously concerned if they have no delivery suite bed whatsoever - if you had a haemorrhage during delivery, which can happen caesarean or vaginal delivery, where exactly are they going to provide care for this? Typically, if someone has a haemorrhage, you'd keep them on delivery suite for maybe 6, 12, even 24 hours if it was very bad.

So, if she has a caesarean and then haemorhages, where exactly are they going to provide the care for the haemorhage?

Hope you are ok

I think that's a really poor show on their part. That you have to have major surgery because there are no beds. It's madnes s But its difficult to know what choice is best. I suppose its best just to follow the medical advice.

Yes agree - all these stories about "I waited a week and it was fine!" just show this isn't a "just wait a couple hours more" thing necessarily. (And that's the good outcome compared to "I developed sepsis after 36h"!)

I had a very similar birth experience to you. I actually found the drip to be much more "medicalised", sitting for 24 hours in a hospital room attached to a half dozen monitoring devices, unable to sleep, feeling very stressed etc. For the C-section I just lay there on the operating table for an hour and then it was done. The worst part was the tiredness from being up 24h before it!

Hoping OP is well and on her way to meeting baby soon. It doesn't matter how they come out. :)

I’m glad you’re saying this. I also wonder about the consent forms, how can you truly consent if you’re being given no (reasonable) choice?

Utter madness that they don’t have a bed but have the resource for a c section! Hope you’re ok OP.

OP you don’t sound selfish, at all. I had a planned c section for no.2 and was quite happy. But to be forced to have a c section because of a lack of beds is utter lunacy.

I had placenta acretia after my 3rd section. Ended up with an emergency hysterectomy and 3 days in ITU. Lost my entire blood volume and was losing it faster than they could replace it.

They will always find you a bed for life saving emergencies.

All of the usual bleats "but it's major surgery"...All of my friends who had elective sections had fantastic experiences, they were calm, quick and uncomplicated. I would jump at the chance to not be in agony for potentially 24 hours or more or risking forceps, tears et Al.

it's almost like there might be a bit more to the story isn't it, and that none of us on here are in a strong position to judge/advise?

Im not sure what sysgw you're at OP, but many years ago I had my waters break at 34 weeks. Because it was so early, they didn't induce ir deliver, and my daughter was eventually born 5 days after my waters broke.

They manages the risk of infection by giving me antibiotics. Is this something they coykd do in your case?

Completely different ward.

It IS major surgery - defined by the degree of incision, the associated risks and the recovery required. This doesn’t mean it can’t be a good experience and of course if it’s clinically necessary then it’s the best option.

I will continue to “bleat”

I’m joining you in bleating. Blows my mind how people minimise it. As much as the prior poster would like to make it sound like a spa day, I’m here with my post surgical internal bleeding and adhesions to balance those reports.

Which is why I said purely because of the bed situation. Obviously if there is another reason you’d like to think that reason would have been explained to the OP. And in that case it would be a bit odd that she’s bothered making a post about a totally different situation. 🤷‍♀️

and it’s why I posted the NICE guidelines so she can read the national guidelines and decide what’s relevant to her. And also why I haven’t given her actual advice.

C-sections can be life-saving for mother and baby but it is major surgery. C-sections should be used where medically/clinically mandated and/or when the mother requests it. As long as it isn't putting the baby at risk, mothers that don't want to have a caesarian section shouldn't have to have one just because there aren't enough beds in the labour ward. If there are beds available at a hospital within reasonable distance, OP should be allowed to transfer there.

As for 'bleating' "....but it's major surgery', you are being rude and dismissive. It is major surgery but it's played down as it's the only major surgery where the patient is required to immediately be up and about caring for a newborn.

C sections are generally very safe. Yes, there are some elevated small risks associated with sections, but they dramatically lower the risk of urinary and faecal incontinence post birth, for one thing.

Risks with sections tend to be more serious (major blood loss etc) but may in part be due to existing complications leading to the section, not the section itself, and can be measured in 10s per 100 000 events. The risks reduced by sections are not necessarily life threatening (incontinence) but are measured in the 1000s per 100 000 for their occurrence in vaginal briths.

@Ineedadvicee how was your night?

If they have a trolley for taking you to the theatre……that’s a bed. And you don’t need a bed in labour suite - you could ask if there’s a bed in a private/side room on postnatal Ward.

If you don’t want an EBAC, you don’t have to have one unless your baby is in distress/risk of infection increases.
Stand firm and tell them to find you somewhere to labour safely.

Hopefully op is having the baby now, look after yourself op!!

I cannot believe that the solution to not enough beds is to perform major abdominal surgery in an area of the hospital where there are enough beds. This is nuts. Does NICE know that this is their protocol? I hope you’re okay, OP.