to think that I should be allowed another caesarean?

[Cat98]

I am pg with dc2. My birth with ds was horrendous, I mean he was fine which is obviously by far the most important thing but the experience was awful. I was determined to have a natural birth and had a very long labour, contractions every 15 mins for 2 days though I only dilated to 3 cm in this time. Kept going on just g and a and in the pool until I was 9.5 cms when they said it had now been too long and I was whisked away and had the works, epidural, failed forceps and then an emergency caesarean. Overall I was in labour 72 hours, no sleep during this time and I was knackered and delerious. When they were stitching me after the section, I vaguely recall the doc chatting to me and saying 'you have a small pelvis, next time you could go for a natural birth but your chances are reduced'. Fast forward to now, 3 years later, and my mw says the small pelvis thing is really rare, and that it is 'unlikely they will be happy with a repeat c section'! Really? The thought of going through labour again scares me, the first few months of ds's like are just a blur after that birth, so tired and problems breastfeeding. Is she right? What can I say to get an elective section or am I being selfish?

I feel if your that scared then I can't see why your being selfish.
I had mine for medical reasons. If your scared and stressed then it's no good for the baby I'm sure they'd agree.

I would suggest you request an appointment with your obstetrician. The mw has no power to approve a cs afaik. You are likely to find the obs much more agreeable to your request. I'd get it sorted soon, rather than leaving it as something to worry about.

Do you know that doctor's name? If he said that it should be put on your notes.

No you aren't being selfish. I wouldn;t worry yet - mw doesn't know, she's just speculating.

yanbu..

write to the notes department at the maternity unit you had your DS, request to go in and read your notes. if the doctor said you have a small pelvis it will be in your notes. If in your notes use this to get another CS.

I have either a small pelvis or just a stubborn one that doesn't open...final dilation 2cms! Ha ha!

Anyhoo..I've had 3 c/sections. All emergency c/sections....both no's 2 and 3 weren't decided on until I was about 36 weeks along...before that no-one, the GP, the midwife or the hospital would be tied down to an elective c/section...they said it was just in case I went into spontaneous labour and they liked to keep their options open.

Either way pelvis wouldn't play....complications before due date and ended up with c/sections anyway.

How far along are you OP?

First pg for me was awful - undetected breech ending in emergency section.
didn't think I could ever go through that again so had elective CS with number two and then again with number 3. Argue your case.
although i would reiterate that CS are no easy option either. Spinal didn't take with DC2 so felt a huge amount of pain and a spinal headache which was dreadful.

Thanks. I don't know the dr's name but he was one of the ones who performed the c section. It was all a blur by that stage but I know I didn't dream him saying that! Dh was cuddling our son at the time so doesn't know either. I think I will be seeing the obs but not for another couple of months and it is worrying me.

I am 12 weeks. I know cs isn't the easy option, I found the recovery hellish - but I just don't feel I could go through failed labour again plus the recovery. And I think I would be so anxious too.

I had 3 c-sections. First emergency - the other two elective. No way on Gods Green Earth I would have had a natural labour after the first experience. Infact I was told, there was no way they would allow it (which suited me). 99% of consultants would prefer to do a c-section.

Tell your midwife to fuck off. :)

She has no say in it - a MW tried that one on me too, after a horrendous birth and following my GPs recommendation that I had a caesar. She glanced at the reasons and told me she'd "never heard anything so ridiculous".

I was all for going straight back to my GP for a termination. It was only my then DH who stopped me, telling me to ignore her and to wait and see what my consultant said. It was a good thing he did!

I had the same all over again in the last 2 weeks of my pregnancy. A junior doctor told me to "go away and think about" my decision to have a caesar despite it all being in my notes and despite that I'd gone to his clinic expecting to be given a date for the op. This time I called PALS and went ballistic. I had an appointment to see the consultant, who again was sympathetic and apologetic about the high-handed manner of his junior staff and who booked me in for what turned out to be a tranquil, easy, painless section carried out under spinal block. Highly recommended.

So, don't take any notice of the bloody midwife - insist on speaking to your consultant and tell the MW to fuck off.

Midwives don't decide this stuff, consultants do.

Get an appointment with your hospital consultant and ask when(not if) he/she can book you in for a c-section.

I dunno...a few years ago it seemed impossible for me to get a VBAC, and now suddenly it is hard to get a repeat section. Madness. It should be totally led by what you feel happy with in this sort of circumstance.

I believe that NICE guidelines say that a repeat C-section shouldn't be refused, as VBAC has its dangers.

I agree with DogsBestFriend last line...all of it!

It was my consultant that booked me in for elective c/sections on No's 2 and 3 for completion at 38 weeks...I just never made it that far.

I was told after first EMCS that I would most likely be having a CS the 2nd time, in fact they encouraged it and i booked an ELCS in case I didn't go into labour. I didn't....and ELCS really positive, calm experience. Weird that the midwife could have such a different view. I thought they'd rather you had a CS after a EMCS. Supposed to safer re: the CS scar rupturing

YANBU.

As has been said, midwive's can't approve c-sections. Don't talk to her about it, just ask to see your consultant.

I didn't breathe a word to my m/w about wanting a c-s. She saw it on my notes when I was 38 weeks and said "oh, you're having a c-s" and I just fixed her with my steely glare and said "yes, that's right".

It's a m/w's job to support a vaginal birth and although many will be very suppportive of your circumstances it kind of goes against the grain for them to not try to get you to consider a vaginal birth.

I cut mine out altogether, no regrets, FABULOUS ELCS at 39 weeks.

Thanks everyone. You have eased the worries a bit :) I will keep my fingers crossed that my consultant is sympathetic!

Right, you CAN get an elective c-section. They are trying to encourage women to attempt VBAC but you don't HAVE to.

If you get to the point where your consultant (you will have a meeting with a member of his/her team at about 18 weeks or so or you might even get to see him/her where this is discussed) says that they will not be offering you a c-section, that is a good time to say that you have considered the risks and potential benefits of a VBAC and that you are not comfortable with the level of risk and therefore will be requiring a c-section. Then say if they are under no circumstances willing to refer you for an elective section, that you would like them to refer you to another consultant, or even another hospital, that will.

It would help very much if you do some research on the stats surrounding succesful VBAC and unsuccesful, leading to emergency c-section, mortality rates for child and mother for both VBAC and C-section, etc, to demonstrate the fact that you have carefully considered your options and are exercising informed consent and are determined in your choice.

I completely agree with DogsBestFriend. Get a referral to the consultant ASAP - don't let the MW try to block it like mine did - and insist on a section. Most consultants would definitely prefer a c section. Electives are easier on you recovery wise than emergency, as you are not as tired from the labour.

YANBU

I had a long labour followed by EMCS with DC1. No real reason for it. DC 2 & 3 both born by ELCS. This was much calmer and I felt in control.

Totally agree with DogsBestFriend.

I went through the same thing almost to the letter...I waited toll I saw the specialist...I think I asked...and I insisted on a 2nd section.

I KNEW that DD2 was occiput posterior like DD1....I KNEW my pelvis was small and narrow and I KNEW that DD was massive

I got my section and I was right on all counts.

I wasn't rising any danger for DD...getting stuck and all that and you CAN get yours too. God luck and stick to your guns.

It's not a midwives job to support vaginal deliveries, it's a midwives job to support women in making informed decisions - whatever those decisions are.

She's right that the small pelvis thing is very rare and it is her job to make sure you know the facts. It's also her job if you still want a section to refer you to the consultant. So ask for a referral. Some drs don't like repeat section for no other reason but it should be your choice. There is a small risk of scar rupture with a vbac so tell them that you don't want the risk.

By the way, you DON'T need to wait to be referred to a consultant by the Dr or midwife. I just phoned the Obs clinic direct (on advice from MN) and made an appt with a consultant over the phone. It was no problem at all and helped me massively as I had asked the GP to refer me to the consultant and she was being a judgey twat about it all.

You could also put a thread on MN asking if any MNers have had an ELCS at the hospital you're going to and see if they can recommend a consultant who will be sympathetic to you. I did that and WAS given a name by a very kind MNer and the consultant was very agreeable.

It has been my experience that after having had a CS consultants were really quite open to go with a woman's preference, all things being equal.

I was offered good information and support for either way of delivery (my situation was different in that I had already had 1 VB, before my CS, so had a 'tested' pelvis ).

Ignore your midwife.
Speak to your consultant.
Show that you are well informed, understand the risks of operative delivery and be prepared to give coherent reasons for your preference.
Don't feel you need to be defensive about your preference either - some women will be v keen on VBAC, others won't

I really hope, you get the care you want and feel supported in your decision.
Good luck with the rest of your pregnancy.

"It's not a midwives job to support vaginal deliveries, it's a midwives job to support women in making informed decisions - whatever those decisions are."

Don't agree with that in the slightest.