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.

Err - girlwithsparklyhair - obstretricians are experts at medicalised childbirth, midwives are experts at non-medicalised childbirth and some obstetricians have very little experience of non-problematic pregnancy and childbirth, ergo they are NOT always best placed as the experts on every single birth or pregnancy...

TiredofYorks - look into every possibility and talk to everyone at the hospital and best of luck.

OP, if you feel very uncomfortable with any of the consultants suggestions, then put it in your birth plan and brief your birth partner e.g. definitely no immobilisation.

Discuss birth in MLU with midwife manager and if the answer is no, then relax, use the consultant led unit and be firm about what you do and don't want. Your confidence will influence the confidence of the doctors and they are more likely to allow the process to be more natural.

I had EmCS with DD1 followed by VBAC with twins using a birth pool which went against all hospital policy but everyone ended up happy with it. However, I did change consultant as the first was very pro CS.

My point is really that if you and your birth partner have confidence in what you want then as long as your requests aren't silly, nobody should object. Good luck.

as far as I am aware ToY the consultant led units are still basically run by midwives anyway but the consultants are on hand if required - where as in the Midwife led ones they aren'tinvolved at all.

I would personally say go with the consultant one but make it clear to the midwives and in your birth plan that you want minimal intervention and are very keen on staying as mobile as possible

I think it was that one sentence that made it for me, that and a really lovely - old fashioned midwife!

oh and I was in labour during the chaos and snow at the start of january so they were all over worked, under staffed blah blah blah - the lot! Good luck ToY in your decision... don't worry about what anyone else says, just go with what feels right for you - if you make your preferences clear in your birth plan they have to follow them as much as poss - for example a simple thing like keeping the lights dim can make for a far more relaxing experience

Hats off peas re twins vbac st home. Marvellous.

V good advice too. If you are more relaxed at the clu just be decisive about what you want.

And don't forget about staying at home and hiding in the toilet when you get to hospital. If you feel like it. You know what I mean. Be confident, and the more research you do, and the more positive stories you hear, the more confident you will be.

I had emcs dd1 due to brow presntation, she was distressed

had dd2 by VBAC and was monitored very closley - but only monitored once I got to hospital, b which time I was 6cm and had dd within 5 hours

I was all preped to go to theatre when I got into hosptial

my consultant asked me what I would liek to do and said he only had 3 brow presentations per year so was happy to go for VBAC

Just wanted to comment on the impressive rationality and empathy in violethill's first reply.

I don't think my views (1 hosp birth followed by 2 home birth then one transfer to hospital birth) add much to what has been said here.

Good Luck!

Mummy I want to put bullet points on my birth plan as I only have a few that I would definitely like to happen ie discovering the sex of baby myself, skin to skin contact and I will definitely add, staying as mobile as possible to the list. And I think if I stick to just the most important ones they are likely not to be missed as they possibly would in a 4 page birth -essay- plan

I'm also going to organise a trip to the CLU to have a look around.

C Sections are not the only indication that things have gone awry - followup gynae, urinary, bowel and women's health appts postnatally indicate that problems giving birth are in fact higher than reported - all involve consultants, and not mws.

The mw who was with me for my first labour - (and in whose eyes probably thought it was a successful birth in that she didn't have to give out any drugs and the baby was revived) - happened to do the pre-op for my 2nd baby, an ELCS, and was surprised to find that my medical notes indicated the 1st labour was now categorised a traumatic delivery with a catalogue of post-natal complications caused by the birth.

zapostrophe that's a unique way of looking at it and makes a lot of sense.

thesecondcoming where do I find the birth announcement?

Oh for goodness sake Iggly, what planet are you on, obstericians are requires to deliver HUNDREDS of babies before completing their training!!!At normal and complicated deliveries!

"And don't forget about staying at home and hiding in the toilet when you get to hospital. If you feel like it. You know what I mean."

Appletrees, you are genuinely mad.

I would also like to say that someone I know went for a VBAC and then after complications which led to her DD being severely disabled, successfully sued the NHS for several million pounds.

The main two reasons she won her case were that:

1. she had not been monitored often enough and so when the hearbeat had gone down it was not noticed quickly enough to do an emergency c-section immediately;

2. she was allowed to go for a VBAC by the hospital when clearly this turned out not to be a safe option.

Apart from wanting to give every woman a safe birth, maybe the NHS is trying to avoid being sued for millions of pounds. Just another way of looking at it.

Yes they turn up at the end. They're not there for the whole labour. See also kitty's post.

What planet am I on?? FFS.

Iggly yes they are there for the whole labour. My Mum is a fully trained obstetrician and she was there for hundreds of births - 'normal' and the scary ones.

Iggly, once they reach consultant status, yes, that is generally the case, they turn up at the end. But on Planet Iggly, how do you think they got their consultant's job?

By attending hundreds, and hundreds, of births!!!

ToY I think you probably have sufficient differing views to consider here.

My advice is to place most weight on the experience of your hospital's staff (both midwives and consultants, and by the way yes it is correct that midwives do manage and oversee the medicalised consultant-supervised births). Also take on board the views and stories of people who have had VBACs.

Personally I would ignore any advice which comes from someone who has not given birth before, they may be basing their views purely on having read Ina May Gaskill's Spiritual Midwifery and think that it is something new that they are the first to discover. They, too, will learn through experience.

As you've already said, baby's safety comes first, followed closely by your comfort and preferences. Hope you come to a good arrangement between the MLU and CLU.

thesecondcoming I'm not considering a home birth, I'm 20 miles from the nearest hospital and even I know that would be madnes.

The consultant said I could have a VBAC in the hospital CLU and I was hoping to have a VBAC in the MLU which is accross the corridor from the CLU.

However, following all of your responses, I have decided not to go against the consultants advice.

I rang the CLU this morning to book a tour and to discuss a bit further the monitoring side, the midwife I spoke to said I did have to be monitored continuously but the leads are long enough for me to be mobile. So I am happy with that. I'm having a tour of the unit next Monday and hope to discuss it in a bit more depth.

I have got a double appt with my MW next Tue but as she's a community mw she will probably not venture into the CLU and so I'm happy that I'll get to speak to someone there also.

I'm also going to do what Mummy suggested and make sure staying mobile is on my birth plan.

Thank you all for your replies.

Filibear sorry I started a post that ended up scaring you. I think the majority of births are fine, and I'm sure yours will be fine also. Good luck.

ToY I'm glad you've come to a decision, and focussing on the birth plan sounds a good idea.

Really hope things go smoothly for you :)

It seems that some people really think that Dr's are infallible. Please consider that they are human and will have learnt what they know by reading books, possibly a long time ago and not all are so great at keeping up to date with recent research. It is perfectly acceptable to do this research yourself and be confident in your decision. We are not stupid, honestly, some dr's think women are too stupid to give birth, but that is just sexism.

Best wishes to the OP.