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'm looking at this as im only just preg with Dc2 but I'm certain I want an elcs. I'm in the process of trying to gather the risks of uterine rupture etc etc but website to website gives different stats. Where do I get the most accurate weighty stats? Most of the stuff leans towards how safe VBAC is, and I can see why, but unless I was having a homebirth I'm not attempting it, and I'm not having a VBAC homebirth being 40 mins from hospital.

Does anyone know where to get some proper stats so I can get armed up for this exact battle?

My midwife sighed with relief when i said I wanted a repeat c-section with DS3, as she thought she might have to talk me into considering it and there is a 10 year gap between DS2 and the impending one. I wasn't even given a choice with DS2 as DS1 had been an emergency jobby and they were only 14 months apart so the risk of the stitches rupturing during labour was deemed too great.

Honestly, sod the MW and just ask to see the consultant. If you had such a difficult birth last time, I would assume you will be seen by the consultant at least once, if not technically under consultant care, so it shouldn't be too hard to get to see them. I'm sure you will find the consultant much more accommodating as from what you have written, it sounds like you have double grounds to request one, with both having a previous one so risk of scarring causing a problem and it being a traumatic birth and so wanting more control this time so I'm sure it will be fine.

LeninGrad - absolutely! After all, you wouldnt prepare for an operation on your leg by running 100 times round the hospital car park!

My first son was a whopping 9lb 9oz forceps delivery with 3rd degree tear. I was told at the time if I had another it would be a c-section.

At my 12 week scan with my second, I was told I didn't need a c-section I should do it naturally. By then, I had got myself used the idea of a c-section. I talk it through with my fantastically supportive midwife, how I didn't fancy the idea of tearing again and the implications that might have and she was great, told me she completely understood where I was coming from. She said that when I spoke to the doctor at 36 weeks (I had a 3rd scan because my first was large) I should ask if the doctor could guarantee I wouldn't tear if I had a natural delivery, which of course they can't, and if they couldn't that I wanted a c-section. This I duely did. I sat in the office, had the doctor explain to me that just because my first baby was big and I tore there was no evidence the same would happen again. I said that was fine, but I wanted a c-section. In the end she said fine, just as long I knew that there was no medical reason for the c-section. So I had an elective and it was fantastic. I'd spent the whole pregnancy expecting one, I'd read every web page out there on how to improve the recovery, and within a week post delivery I was in better shape than I was after my first. I know this isn't everyone's experience, but then some deliver without drugs with no complications (more power to them!) so everyone has a different view.

My point is, if you have made your decision (and I think you have!), stand your ground. If the doctor says you can't have one, I was told (by the fab midwife) that I could ask for a second opinion and an independent review, at which they would take on board the views of the community midwives. Yes a c-section is surgery, is more expensive, can have increased recovery time (but not always!), can have complications etc but it's a different beast to a emergency c-section (which I was just minutes away from when I forcep delivered).

Good luck

I was told (by the consultant) that it was my small and deformed pelvis that caused dd's birth to go horribly wrong. Both dd and I nearly died. Stong contractions started at 4am on the Thursday morning. Contractions between 2 and 5 minutes apart from then until Sunday afternoon when I was finally fully dilated. DD was born by crash section on the Monday morning after labouring at full dilation for about 14 hours, her head never entered the birth canal. The consultant wrote on my notes 'Please never let this girl go into labour again'

My consultant then has retired and I will meet the new one on MOnday, I intend to insist on a section. My reasoning is if it is going to be a section I would rather have a planned one than an emergency one for the reasons lenin said. I also don't fancy a repeat of last time as nearly dying isn't particularly pleasant experience.

Speak to a consultant and put forward your case.

Why don't you agree with midwives supporting women in their decisions firmansamantha?

Midwives are supposed to be advocates for the women they care for.

If I'm caring for a woman who wants an elective section when the research supports vbacs then as long as she's aware of the research I'll support her in getting what she wants. Even if deep down I think have the vbac. It's not my decision.

YANBU, I think you should be allowed a section.

And I say this as someone who hasn't been there - had an 3mergency vacuum delivery first time round followed by a walk in the park normal delivery second time round and was terrified of having a section. Get a consultant appointment done and ask, an elective section will be much better for you than another round of chaos.

I'm not going to get into a debate on it on a thread where someone clearly just wants advice and support on getting an ELCS vivalebeaver.

BUt I disagree entirely that m/w's are there purely to support a woman's decision. That might be what it says on your job description but in practice, no, I don't agree with that at all.

So I should just go with a VBAC then fireman even though their is in my personal circumstance an extremely high risk of mother and child dying? Please answer because seriously I would like to know.

You can PM me your answer if you want.

There will be a midwife present if the OP does have a CS, there's always one in the operating theatre.

Midwives do a bit of everything to do with having babies, including the aftercare, I don't see them as someone who simply champions natural birth and opts out of anything else either.

xstitch, what????

I was replying to vivalebeaver, haven't even read your post!

I had an ELCS myself after a traumatic birth, if that points you in the right direction!

Well if you mean your MW didn't support you in your decision you should have complained about her because they are supposed to support you.

Firemansamantha, are you saying that its not your experience that midwives support women in their choices and make informed consent? I wonder if you are being read out of context.

No, I didn't say that either xstitch, do you want to go back and read the thread?

I don't understand then, what do you believe a MW's role to be?

Fireman - I suspect people (including myself till I read you had an elective) are reading your post that you think a midwives job should be to support and promote natural birth first and foremost, but I don't think that's what you meant?

No, I honestly don't believe that midwive's are employed to support women to make informed choices. And I confine that to NHS midwives, by the way.

I think, generally, within the NHS they are used as the first line of defence AGAINST caesarean births.

Look, OP, I'm not going to lie to you, I would and did metaphorically move heaven and earth to avoid a CS both times; BUT I would also do the same moving and grooving etc to get you what you want which is your safe birth and a healthy situation thereafter. So do tell your Ob you want a CS and smile.

Here are the NICE guidelines on Caesarian section:

www.nice.org.uk/nicemedia/pdf/CG013fullguideline.pdf

These are the RCOG (Royal College of Obs and Gyns) guidelines on birth after Caesarian:

www.rcog.org.uk/files/rcog-corp/GTG4511022011.pdf

These are the main documents you need in order to make a well-informed decision. It's worth noting that the preference of the woman is meant to be taken into account in deciding the method of birth, as there isn't clear evidence indicating that either VBAC or repeat Caesarian is safer (overall; obviously individual cases can be different). You are also entitled to a second opinion if you don't agree with your first consultant's decision.

HTH and that you get the birth you want.

I had a similar experience to you and I want an elective CS next time (if there is a next time....) unless someone can promise me the same thing won't happen again. So YANBU.

And I hope you a happy and positive birth experience whatever you decide :)

I had a hospital midwife ask me if I had thought about VBAC whilst I was actually being prepped for my ELCS! She wasn't even my midwife. I told her yes, DS1 was nearly 11lb and I only got to 6cm before labour stopped completely after 26 hours. Hence ELCS this time. (I should have told her it was none of her business, and that it was between me and my consultant)I was so annoyed!

You want a elective section cos of last time it's a major op and not to be taken lightly sorry it isn't. I had a section 14 years ago and there is no way on this green earth I would ask for one it was horrendous. In fact I asked to be sterilised cos of it.

If there is no medical reason your consultant will refuse. Sections carry just as much risk as vaginal by the way.