to consider going against consultants advice?

[TiredofYorks]

DS1 (2.4) was born by emergency C section.

I am 36 weeks pg with DC2 and have just been to see the consultant. He said because of previous CS I am high risk and need to be in the consultant unit.

I asked if I definitely can't use the Midwife led unit (it is across the corridor from the consultant unit) and he said no, so I asked if that ruled out a water birth (there is one on the Cons unit) and he said yes as I have to be monitored throughout.

I then asked if I would have to be immobile, he said that there is one mobile monitor but if that is in use then yes I will be immobile and will have to stay on the bed.

I asked exactly what the risk is and he said 0.7%.

I know this is a low risk and I do think I'll cope better if I'm left to it (well I think so anyway) and also I really wanted a waterbirth.

So would I be unreasonable if I considered going against the consultants advice and opting to use the Midwife led unit anyway?

Sorry for the long post.

Ok Ruby, I am sure that if I had had my baby at home with no medical monitoring it would have been fine and my body would have somehow intuited the fact that her heart rate had slowed.

And you know, before the days of medical monitoring, and in the developing world, it's definitely much safer to give birth, you're right.

Really.

'Fortunately, uterine ruptures from a prior cesarean with a low-transverse scar is a rare event and occurs in less than 1% of women laboring for a VBAC' from vbac.com

umbilical cord prolapse - less than 1% too

risk of stillbirth - less than 1%

you can still have a uterine rupture without a previous CS. 52% of uterine ruptures were previous csections (in one review - from wikipedia so it is not solely the domain of the vbac.

basically childbirth is pretty risky. i had a birth that had arisk of 1 in 3000 - wasn't expecting that one, let me tell you!

In fact, staying at home as long as possible and staying mobile are too very common snippets of advice given to aspiring v backers. Avoiding the consultant when you are in the hands of very e experienced and capable midwife may be boldly but makes sense.

The second v bac I said to the midwife "please don't let the doctor in". she and her partner were in comet agreement this was fine, the whole thing too fifty mins in hospital as I stayed at home so Lo.g, and afterwards one midwife said to my husband "that's the way to do it". So don't call me an idiot. It's bloody lazy.

Yanbu, there must be a safe compromise somewhere. Being stuck on your back on a monitor is a horrible and completely unnatural way to give birth ime. My ds was delivered by ventouse 30 minutes after I got to hospital (I apparantly wasn't in labour when I phoned the hospital in tears an hour before ) and I'm 100% convinced I'd have been able to deliver him naturally if they had let me get into a better position. You should definitely ask for a second opinion

Agree somewhat with the concerns of girlwithsparklyhair, I am also someone whose baby (first) had sudden deceleration and threatened asphyxia after a long labour, which may not have been spotted if it wasn't for constant monitoring at the time.

I'd also say that while it's fine for the people who feel so strongly about it that they will defy medical advice and dodge consultants rather than be monitored, to go ahead and do so, encouraging other mothers-to-be who are wavering to do so might be just a tad over the line.

loving the sarcy tone girl.

fetal monitoring takes away from the whole point of giving birth. it is like hoovering round a cat trying to give birth. it ain't gonna happen.

i realise your point but in many many births electical fetal monitoring is a hindrance.

i cannot poosibly comment on your particular birth .

Ruby

Could you explain that please???

Are you saying a birth is made unsafe if monitored??

Is this just your personal opinion?? Or is it evidence based??

Have a water birth in the consultant led unit.

"It's not - it is a normal physiological process and you're unlucky if it goes wrong."

See I'm not so sure about that, I thought statistically birth is a fairly risky business even if it is 'natural' (in comparison to other things a woman might do in her life). Side effects of the pill and complications of abortion are much less risky than being pregnant.

I thought this was an interesting article. 1 in 8 women in Sierra Leone die in childbirth, seems awfully high for such a natural process.

WTF is electical fetal monitoring?

Do you mean electrical, or elective?

you do have my sympathy. I'd ask for a second opinion if I were you. why did you have ECS first time?

but remember you want a healthy baby, and that is more important than the @ideal birth@

I didn't say no medical monitoring. So please don't imply I'm being naive

I said that the medical profession treat pregnant women as if they're unwell, something's wrong and they're there to fix it.

Actually they should be more supportive and look to only intervene if absolutely necessary.

sorry electrical

Consultants deal with higher risk births so see more that 'goes wrong'.

A good, experienced midwife, is the expert in supporting a labouring mother who doesn't need intervention for medical reasons.

When I had dd1 in a MLU, the midwife told me afterwards that had I been in the large hospital where she had previously worked, she thought it 99% likely I'd have been pushed into continuous monitoring and even epidural about an hour and half before the time my baby actually arrived.

There were no medical complications. It was 'just' a long hard painful first labour.

That experience convinced me, that where there are no additional risks, a MLU or home are the best environments to give birth. By additional risk, I mean anything 'medical' affecting the baby, but also if the mother is highly anxious or very keen to use pain relief. In those cases, a hospital may be the better option.

"it's so lucky I had continual monitoring because it spotted problem x"

Does it occur to no one that problem x may have been caused by continual monitoring"

It IS always a possibility.

tyler80 1 in 8 die because of poor nutrition, poor hygiene etc. I don't think being pregnant is inherently risky. Otherwise humans would have died out long ago, no??

Ruby How do you know that in many births monitoring is a hindrance?

oh blimey, no i don't have a study but if ina may gaskin can deliver close to 100% natural births including 115 vbacs of which only 2 had to go to hospital for suspected (not actual in turns out) uterine rupture then we are going seriously wrong in taking such an ELECTRICAL medical route. i point you in the direction of the work of michel odent too.

and watch the business of being born - you will see what i mean

i had an emcs for which i am eternally grateful for. i am not stupid. some babies and mothers need help. but many could be prevented with a more natural and instinctive birth process. i could have kissed the surgeon. i will be extremely cautious in any future vbacs etc etc etc

like i said. a cat goes to a dark cupboard to give birth. if you start hoovering round it, things will probably slow down, iof not halt.

appletrees You think that monitoring causes babies to become distressed to the extent that their heart rate drops and they pass meconium?

You are insane!

I think the important issue here is one of informed consent. There's lots of mudslinging and anecdote but very little evidence being quoted. If you've made the effort to find out the risks for yourself and you can base a decision on those risks then great. Nobody should base this sort of decision on another poster's experience and advice. The grey area comes when you're relying on medics to interpret the evidence for you. Then it's down to the individual's confidence in reading a heap of research for themselves, if they have doubts about the validity or impartiality of their consultant's advice.

'Does it occur to no one that problem x may have been caused by continual monitoring"'

Exactly.

very well said thatdamndog!

But surely having an elctrode attached to the baby's scalp is going to have some affect on its 'stress' levels? Not to mention the mother's!

I'm no expert, and can't quote figures, but it seems entirely reasonable that a labouring woman, who has her legs put up in stirrups, and then a foetal scalp monitor inserted and maybe jiggled around a bit to get the position right on the baby's head.... surely her heart rate may increase as a result, which in turn affects blood flow to the baby.. etc?

piss off onedge, who the f* are you?