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.

Igglybuff 1 in 8 isn't going to kill off the human race, but still fairly risky in the grand scheme of things.

Yes of course I do. Staying immobile could slow labour which causes distress and so on. I am far from insane.. it is a commonly held view. You haven't taken much interest in birth have you?

You seriously think that continual monitoring can cause damage to a baby?

thebody "having a baby isnt just all about the birth, its about the rest of their lives."

So true.

To everyone egging on the OP to escape the consultant at all costs: I can't understand what the agenda is when encouraging other women to rebel against convention and disregard medical advice. Why do you care? What do you gain?

appletrees it's total codswallop to say that problems in labour detected by CFM are caused by CFM. That just makes you sound crazy.

TiredOfYorks definitely talk to the senior midwife/wives and see what their take is on it before you decide. I started my first birth in a midwife-led unit and when it started to become a risky birth, they marched me across the corridor to the hospital unit. It isn't either CLU/or MLU, that compromise is clearly a practical option for you if you need it, and I hope you don't.

I don't know about monitoring causing problems with babies but there is the chance that monitoring can lead to unnecessary interventions. For example the monitor picking up mum's heart rate leading to them thinking the baby is in distress. I don't know any stats to back it up but I've heard it mentioned.

I also agree with ruby - I read Ina May's book which convinced me the medical profession have it the wrong way around. I mean can it be right that 33% of labours end up being a CS (in my hospital anyway). I'm sorry but that is ridiculous.

Can someone answer my question? I genuinely want to know?

It seems to me that a labouring woman who is made to lie flat with legs in stirrups (which may in itself cause extra sudden pain if she's been up and mobile) who then has an elctrode inserted and jiggled about to get it correctly positioned on the baby's scalp... surely there is a chance that that procedure will cause stress to the mother and/or baby?

Tyler the 1 in 8 stat cannot be used to demonstrate that pregnancy and labour is inherently risky. Have a look and find me some stats for a woman having a baby in a clean safe environment. If it's 1 in 8 I'll eat my computer.

autodidact, unfortunately a water birth in the CLU was also a no no as they can't use the monitor.

violet, of course it will. It's about weighing up the risks vs the benefits. Just because we can do something doesn't always mean we should do it, monitoring just gathers information and it's what we do with it that's important etc etc

violet I think inserting electrodes can result in infections to the baby. And having a wire screwed into your head cant be pleasant surely?!

Well those were my thoughts precisely!

There may well be situations where monitoring is the better option, but I found it strange that some people were claiming that was is a very invasive procedure can't possibly every cause distress.

It should be taken into account that you have had one cs and the medical prof are cautious.

I don't blame them, they are there to minimise risk (obs payouts due to mistakes are some of the biggest in NHS).

As someone said earlier you ultimately have to assess the risk that you are prepared to take responsibility for. I do agree that preparing a person for birth well and low key monitoring for most women result in the most vaginal deliveries (considered by most to be desirable). I had no internal exams with no2 for this reason in a regular general hospital. I said I think I want to push and the midwife said OK push. (I'm putting this in to show I'm very sympathetic to the Ina/Shelia K model of childbirth). However your consultant has given you their advice with your notes and previous birth history in front of them, I would be taking the advice. I don't think I could live with the consequences of falling in the 0.7% sorry.

OnEdge when you are in that room, listening to the sound of your baby's heartbeat, the adrenaline is pumping. you may not be breathing calmly and deeply, which affects the baby's blood supply. they do have a certain capacity to withstand a certain amount of hypoxia, but this will not last forever, so decisions have to be made regarding the safety of the baby. as the adrenaline is pumping, so the production of oxytocin, responsible for the process of contractions and epulsion of the baby, is being inhibited and labour slows etc etc

there are absolute indications for caesareans, and the doctors are really skilled at finding these out. but if the intermittent monitoring is going well, surely the woman should be left to do what she needs to to encourage labour to be quick and efficient.

i don't know, this is as i understand it.

Violethill I didn't have the clip on ds' head but I was in stirrups with the belt on and I found it much more painful in that position. The belt hurt, I was really distressed and felt totally degraded. I'm still really angry about it and certain that I could have delivered ds naturally if it hadn't have been for being stuck on that monitor.

Ruby that sounds right as midwives are not supposed to recommend "purple pushing" as doing this means mum holding her breath and not breathing deeply which reduces oxygen to the baby.

I really thought women had moved on from the nodding dog attitude to childbirth. It is very sad.

See, the thing with consultants is that they only ever see the worst case scenario's. They don't see normal, run of the mill textbook pregnancies. That's what makes them prone to being scapel happy.

I would definately question what you've been told.

I had am EMCS in 2004, then had a VBAC in 2008. I had to fight tooth and nail to get that as i was told that i couldn't have one - because i had a csec, i had to have another one. Bollocks to that. They 'let' me have a trial of labour and dd was born vaginally with just gas and air. Then when pregnant with DS3 i was told i had to have a csec as the risks of uterine rupture were greater this time. That's very wrong - the risks go down the more vbac's you have. I had DS3 naturally in January. And anymore i do go onto have will be birthed naturally too.

You need to do some research and then make a decision that you are happy with.

igglybuff - just a point on the length of pushing my SiL recently gave birth after a nice smooth pregnancy and labour, she was pushing for somewhere in the region of 3/4 hours! this was at a low risk Midwife led unit.... the time limits they have in hospitals are there for reasons to the mother as well as the baby - as a result of her extended pushing - my SiL had to have a permanent catheter for over a month as was unable to wee at all - she was also hospitalised a week after the birth for about 5 days as her bladder was pretty much ready to explode.... my dn is now nearly 10 weeks old and she still needs to self catheterise after going to the loo as unable to fully empty still!

think I read something by someone (sorry!) further up about the minimal risk of scar rupture... you are right, the risk is minimal - however IF the scar starts to rupture, there are a matter of minutes avaiable to the medical professionals around to get baby out and you seen to before both mother and baby would die! My sister was borderline about to rupture with her 3rd and its not pretty at all when it does happen!

this articulates the issues with CFM pretty well

Ruby "when you are in that room, listening to the sound of your baby's heartbeat, the adrenaline is pumping. you may not be breathing calmly and deeply, which affects the baby's blood supply."

But some people might be more anxious thinking about what could be happening that they don't know about, without monitoring?

CFM doesn't automatically make everyone stressed and slow the labour down like you are making out.

It's not EITHER blissful peaceful natural intervention-free birth OR hideous floodlight-lit medical trauma. Good grief, some people here make the hospital delivery unit sound like a horror film. Drama queens.

There is middle ground!

Theochris, this 0.7% risk being quoted - that's the risk of uterine rupture. In a well-managed and monitored labour this complication should be identified and dealt with in minutes. It isn't the risk of foetal death - which, incidentally, is comparable in VBACs and first labours.

The stats don't exist for women having a baby in a clean safe environment, because these situations don't exist where medical intervention is also excluded.

Even looking at homebirths isn't accurate because those who transfer to hospital are recorded as hospital births so the safety aspect there is rather self selecting.

Maternal mortality has plummeted over the last century because of medical intervention, but to read some views (not talking about you personally), you'd think the opposite was true.

Whilst the 1 death in 8 is no way representative of the UK, I don't think it's unfair to assume that rates of required intervention are going to be similar. The WHO suggests that 10% is a reasonable expected caesarean rate. I think it's important that women are aware that intervention is going to be required fairly often (and i count 1 in 10 as fairly often) so that they can make their own decisions and to try and save them from feelings of failure if they don't have the 100% natural birth they've planned and been told is possible.

mummy sorry to hear about your SIL. My point is that having limits means that they can be strictly adhered to without any recourse to common sense derived from experience. So many midwives and consultants do not have the experience of being with a woman from start to finish so have lost any knowledge of what to do if things aren't progressing. So you could be pushing for 1 hour and have trouble but nothing happens unless its been two hours. I'm sure two hours was decided upon based on some statistical analysis but that gets in the way of experience.

Feel sorry for the OP that the thread has been hijacked by militants.

however IF the scar starts to rupture, there are a matter of minutes avaiable to the medical professionals around to get baby out and you seen to before both mother and baby would die!

f* me, that is awful isn't it!

i read someting by a woman who had it and it was hideous. it made me cry!