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?

Since OP has already had an section I'm sure she is well aware it is a major operation.

Firstly Ladygok having had a previous c-section is a medical reason in itself due to the risk of the scarring rupturing and secondly, anxiety is a medical condition. So is high blood pressure due to stress, both of which could be caused by someone who is terrified of natural birth being forced into it against their wishes. I have never heard of someone being refused a c-section if they requested it.

That may be because I only know people who have medical reasons for wanting one, or only people who are articulate enough to explain their viewpoint convincingly but i suspect it may be because it isn't in the medical professional's interests to try and subject a woman to an invasive and intimate proceedure against their will. It isn't in anyone's interests, hence why it is rarely if ever refused.

NestaFiesta - my consultant told me before my elective section that should I go into labour beforehand I was to turn up at the front desk with my notes and just keep repeating "I'm having a caesarian, my consultant is Mr.xxxxx" like a broken record as the midwives would very likely try to convince me to try a natural birth first so don't think your experience is unusual.

My CS was great. Wonderful positive experience and super-fast recovery, I was up and about before most of my ante-natal group who did natural birth.

Read the thread properly LadyGok

I don't think a traumatic 'normal' birth is to be taken lightly either Ladygok.

Although they may try to persade you to try for a VBAC, consultants will always approve a 2nd csection if that's what you want.

I had a planned CS after a horrendous time having my first which ended in an emergency CS. They did an xray of my pelvis after it and it confirmed my pelvis was too small to ever give birth vaginally. ( I mentioned to the stupid midwife that I thought I was too small......she just asked, repeatedly, if I'd swallowed an encyclopedia, consultant said they should have realised something was obviously wrong and that I should have had the CS 6 hours previously)

Looking at this thread makes me think that an xray is not routinely done? Wonder why I had one? Glad I did though, meant I didn't have to request a CS the second time, it was a given.

You should be able to find facts and figures to support your case here

electivecesarean.com/index.php?option=com_frontpage&Itemid=476

And she has a blog too.

cesareandebate.blogspot.com/

The Skeptical Ob (American) has also gone over the VBAC V ECS data a few times.

skepticalob.blogspot.com/2011/01/table-of-contents.html

If you can't find the relevant posts trawling through the list of contents just ask in comments under the most recent post on the blog. Somebody will point you to the relevant urls.

I absolutely understand where you are coming from. I have an only child because the though of not having a guaranteed ECS the second time around scared the pregnant out of me. My son is ten and I am 43, so I think we can safely say that is not a "passing phase".

I'm watching this thread with interest, I'm pg with #3 DC1 was emcs long labour fully dilated DD back to back never entered birth canal, DC2 was persuaded to vbac, exactly the same again back to back not descended, another emcs. I was told I must have a "queer shape"
Now at booking in when I explained all this to MW who said " but you fully dilated both times, could be possible " well no thank you! they said that last time!!
Don't get me wrong if they can disprove it with scans nearer due date and this one is waving to come out I would try again, but for now I will be insisting on elcs. What is the point in it being an un-necessary emergency?

Clytaemnestra- I know! it's ridiculous isn't it? It's like they have a VBAC target and they have to try and "convert" CS Mums! When the hospital midwife asked me if I had thought of VBAC I was quite insulted as I had done loads of research and soul searching and come to an informed decision which my consultant was in agreement with. I found it patronising that she implied I hadn't really looked into it.

Ok. I think if you really want a section and it is true that you have a small pelvis ( however they can confirm that) then you should have one. However, recovery from a section is much harder than recovery from a vaginal delivery - at the moment you have nothing to compare it to. I understand that you are traumatised by your first experience so perhaps it would help to 'debrief' with your midwife or consultant and try to explore how you actually feel about the vaginal delivery once you have taken fear out of the equation. I think everyone is afraid of the unknown, vaginal delivery if you have had a cs and a cs if you've had a vaginal delivery. You had a very difficult experience and I really wonder sometimes why women aren't offered counselling! If you decide that cs is for you then great but do make it an informed choice and not one based on fear of the unknown.

Nesta, maybe she just had to check that you'd considered all the options. She doesn't know how much you researched your decision.

Spiritualknot - pelvic x-rays aren't done anymore as the research has shown them to be of no use in predicting a woman's ability to birth vaginally. How long ago did you have one?

Nesta - from the other side I meet a lot of women on the morning of their repeat section who hadn't been told/hadn#t understood that vbac was an option. When told about it they then decide they don't want another section and go home.

I can't ever assume that someone has done lots of research, I need to check.

Poor you, that birth sounds awful.

There are National Institute for clinical Excellence (NICE) guidelines on C-sections that all nhs hospitals are meant to follow. Think (can't remember for sure though) these state that if, after one C-section, the woman wants a 2nd section, that is her choice and should be respected.

The NICE guidanca also had useful stuff on factors making a successful vbac more/less likely and the risks/benefits of vbac vs c-section. I found all this helpful (tried for a vbac but ended up with a 2nd unplanned C-section, which was fine).

With respect to what the doctor said, your GP or midwife should be able to write to the appropriate consultant from your first birth who can check the notes and give an opinion. I did this (on another issue) and received a different opinion than had been expressed by the registrar at the deliery.

Iv'e had 2 C-sections both emergencys after a failed vbac the second time around, im currently pregnant with number 3 and i was told after my first hospital appointment that i HAD to have a c-section which i am fine about.

With regards to you op i would deffinatly push for what you feel would be best for you. This is your life, your birth and a memory that is going to stay with you forever so why not make it somthing that you will remember positivly

I had an emergency section with DC1 and it was so horrendous there was no way I wanted to risk it again. I asked for an elective section with DC2 and my obstetrician agreed immediately and said it was my choice - went through pros and cons of both natural and CS and then we agreed I could have CS.

By the way, recovery from a planned c-section was MUCH easier than with the emergency one. I was up on my feet within no time and it was a lovely relaxed birth and I couldn't have been happier.

If you are worried about having a too small pelvis to give birth naturally, and that is what you have been told by a doctor. Insist very loudly that they investigate this, they must be able to xray or ultrasound and measure it. I know that if you try and attempt a natural breech they do that in some countries to make sure you have the space.

I had two emergency c-sections, both turns out because my pelvis was too small and babies too big. It is not unheard of. And I did regret going through all that pain just to end up cut open again!

If you've had an emergency c-section before you are entitled to have an elective c-section 2nd time round. They will of course try to convince you that a VBAC (vaginal birth after c-section) is better but simply stand your ground.

you had a traumatic experience and because of the small pelvis it is likely to happen again (its not like youre pelvis has grown has it??) My DS was just under 9lbs with the biggest head and when he was born by emergency c-section the doctor commented that there was no way I would have been able to deliver him naturally!!!

My DD was even bigger than my son but I took the route of an ELCS, and thought the docs tried to convince me otherwise I was not having it and I'm glad I stuck to my guns...

I would have been furious if I turned up on the day of my section, mentally prepared and someone had started to try and dissuade me.

It's hardly going to put a person in the right frame of mind if they go ahead, they'r going to start doubting themselves and worrying abot how safe/not safe it is if midwives are recommening that maybe a CS isn't the best option for them, on the day.

I had an emergency CS after 2days of induced labour following my waters breaking early. It was on the day I was due to fully decide whether or not I wanted an ECS or Vb - I was always told I had to consider the choice from day 1 due to other medical problems and as I was under consultant care from the start. I guess this is why my MW was so supportive about it being my choice from the sounds of things on here that's rare.
If we do try for no 2 (health dependent ) I would again be given that choice and think that an ECS would be my preference however I've been warned the nxt one would also probably come as an early surprise so we'll see

"I would have been furious if I turned up on the day of my section, mentally prepared and someone had started to try and dissuade me.

"

Totally agree, so would I.