AIBU to think that the way c sections proceed needs to be reviewed?

[newmum953]

Just wondered if anyone had any ideas that would further improve the c-section experience? (For instance, I would really have loved there to be no screen at all but have no idea whether this is done - to lower the chance of infection or if it's so that the parents don't have a reaction to what they see or a combination of both?)

What about the privacy issue Lovethesea? It's been likened to assualt because of the lack of control and ability to get away So sad

Is Op a surgeon or is this research? I am not sure that I agree than standardised care is not possible. I mean I appreciate, but the thing we are all saying is that we all want different things, some things are more important to some peole than others. BUT, unless there is medical reason, or danger, all of these 'requests' could be accomodated. woman 1 says to surgeon pre surgery, 'whatever happens don't lower the screen, I don't wnat to see'. Woman 2 says 'I want to see it all, can you explain what you are doing as you do it, and keep the screen as low as possible'. 'I want skin to skin'. Woman 2 is not so bothered. Most things can be accomodated. Its just a communication issue.

Not usre if newmum has been back actually.

I Agree communication is key.

Excellent replies from worriedsilly. I agree with everything she wrote.

Noodle do you mean 52 hours from the onset of contractions, or 52 hours from when you were in established labour as determined by a midwife? If you were left in established labour for 52 hours, then that would be negligence.
I'm glad it all worked out for you in the end.

My cs was fine. Catheter in during the 30 hr labour anyway after epidural at 20hrs, wouldn't have liked it withougt epidural though! Can't remember seeing anything in the lights but I was panicking, everything was going mega fast, and then I puked everywhere and I was off my face on whatever painkilling drug they had given me so I guess I wasn't much looking at the light.

They held DS above the curtain very briefly as soon as he was delivered then took him to have some oxygen and get dried. My DH went over with him, which I asked him to as I didn't like the thought of my new baby being without me or his daddy.

DH had a good old look in while they were trying to stop the bleeding, and a chat to the surgeon as he was suturing everything back! I think he would have liked to watch the whole thing, but it was too much of a panic to get DS out quickly.

My only complaint was the suture. Not the scar line as its so neat that you can't see it, even though it is much wider than any of my freights who had ELCS (wondered if it was because DS had a big head, or if it was to do with speed?). The suture was a bead type, one continuous suture with a bead at each end, which was awful when they took it out - they cut one end and then pull the other. I was sick after the mw took it out! I would ask for dissolvable sutures next time if it was possible.

Oh and the drain was pretty horrid too but I don't think there is anything you can do about that, it was nasty having it taken out though!

I did really appreciate a private room once I got out of HDU the day after the cs, as I could have privacy and a decent sleep. That would influence my choice of hospital for sure. I think if it is a vb and you will be home that day or the next day it wouldn't be an issue but when you are in for 5 days then that really matters.

M labour and cs were pretty traumatic, but the medical staff were excellent, it's just how things happened and nothing to do with the way I was cared for.

RIZZO, it really was pretty awful. But give me a well managed c-section any day. Sections can be very well managed, and can accomodate varying wishes. I'm not sure what could have been improved. The 52 hours before that are a different story, and I have a loooong list!

I think there should be more information given to pg women - its a vicious circle, no-one wants to scare women by mentioning the possibility of an emergency CS, but if you then go onto have one, the fact you know little about it makes you more scared.

My brilliant midwife knew how scared and out of control I felt, she made sure that DH stayed with DS every step of the weighing, etc, and he sat next to me holding DS till they'd finished with me (took ages though as had a double-sited placenta - my one accomplishment ) If he'd been offered skin-to-skin that would have been good though.

I had an emcs due to cord prolapse, so had my catheter fitted on the ward in full view of everyone, I also had a mw holding the cord back into my uterus. Everyone on the ward was asked to leave, but I realy didn't care who saw what

I had the csection under ga and my son was in nicu when I woke up. From what I remember all the staff were fantastic and their quick actions saved my sons life, I did suffer from PTSD after though

Worried - privacy issues? In theatre, in labour? There's previous little privacy it dignity in labour anyway. And in a cs situation you just need to get the baby out safely and quickly and ensure safe mum. In regular surgery you'd be catheterised whilst under GA and even more open to, what, abuse? No, a CS, EM or EL is a major surgery. We all get a bit caught up in the romance of pregnancy and surgery what's actually going on with things like this and scans which are serious medical investigations not just a chance to get a pretty picture of your baby.

I you had tried to catheterise me without anaesthetic I might have had something to say. During my emcs I remember vividly my mw checking I could feel nothing before doing it. I was pretty out of it ( baby in distress, failed induction, never so much as a contraction, baby in extreme distress, straight to theatre, do not pass go) and didn't really care what was happening as was all I could do to stop shaking and remember to breathe. First thing I did when baby was born was vom and I remember saying to them as they moved me back to the bed and packed me up, you could seriously be doing anything right now. I'm sorry you have a complaint, signs like misplaced transfered angst over things but going as the lady expected.

To the OP, birth is an experience but unfortunately a cs is overall major surgery and must be kept safe and sterile over and above the emotional need for control in the birth situation. I had a good idea what would happen in cs as I made our very reluctant nct teacher tell us. Lucky as two of us had emcs and another two had surgical intervention post birth. No idea what mw or surgeon told us at the time, not a good reporter, way too emotional and strung out. But, it was an overall good experience and I could not thank those in theatre enough.

first section (planned) in singapore i had no, or very low screen. because of the angle i could only see in the lights, but husband saw the whole thing. baby (early but healthy) taken away and put in nursery and not brought to me quick enough but bfeeding was fine and continued for three years even tandeming

second planned section in uk had a screen (i was in labour on day of planned section and opted for the section rather than to continue) and was quick and baby handed over straight away for feeding. she fed for hour and a half. ut of hosp in a day, recovery fantastic but scar not as nice as singapore, but who cares, it was free!

interesting thread.

catheterisation -think you should be given the choice. I hated having it put in in theatre - there were so many people around. there was really no consideration of my feelings - at one point when they were getting ready my entire lower half was completely uncovered - until midwife finally responded and covered me up....

there is a doctor who pioneers the 'natural' section - nikolas kiaprides? He's the specialist at Kings in London. I was offered the screen to be lowered and declined - but I was given no advance warning. Had I been talked through it all in advance I think I might have gone for it.

Held first baby in theatre but not the second - it felt too precarious with the bed tilting. Held second baby on the trolly leaving theatre and that felt much better. skin to skin came soon after with both.

In summary - I think a woman should be made aware of all the choices as early as possible. ds was breech so I could have made my choices known weeks in advance.

IMO the key thing is that every opportunity for the woman to feel omre in control should be taken. It may not be the ideal way to give birth but the mother's experience is so important it has to be improved in every way possible.

Am not liking all these references to real life patients' stories from some of our professionals on this thread. If this woman feels like she has been assaulted by public catheterisation, then discussing her complaint on a public board seems inherently wrong to me.

Blimey people want totally opposing things - So basically there is no predicting what people want We better treble the consultant appointment times

Gladders - why? The complaint is in the public domain (press, but I'm not going to search for it) and this is a fairly known about issue. If we don't discuss these things then how can anyone ever learn?

Confidentiality is 100% maintained here, no? No one even knows what country this complaint may have been recieved in.

Public catherterisation? Interesting thought that, I mean everyone there will have been paid staff with specific tasks I assume. Not the public as such.

It's all very sad.

I have had a few cahteters put in and none of them hurt - is it lack of experience doing it which makes it painful?

worried It's not that I think 5 minutes is a long time for the job they were doing, it's that it is a very long time for a mother who has heard her baby's heart rate drop to less than 50 bpm, then been rushed into surgery, and is desperate to see, with her own eyes, that her baby is OK. I am sure that what they did was fine, the issue I had was that I made a request to see my baby, and it was flatly dismissed with a lie - there is no way any mother on that table could have seen her baby on the resus.
What I am talking about isn't actually standardised care at all, I think what is needed, is for there to be a little bit of flexibility to allow for certain things to happen if the mother wants it. My hospital were great about skin to skin, it is normal for them to do that, once the mother is off the table and back on a trolley (he was also laid on me in a blanket while I was being stitched up), but absolutely steadfast on other requests that could have had some leeway.
I know it's hard with a busy caseload for obs teams to tailor the way they deal with every birth, but sometimes it's just a little thing, that takes no extra effort (like lifting a baby up saying "here he is mum, all healthy") that makes an enormous difference to the patients.
That said however, the approach shown in the video I linked seems like a better "standard" for just a little consideration.

I'm not aware of that myself - I have been popping them in forever and some seem to hurt and some don't. I guess stag ein labour and anatomy and people's own pain perceptions must play huge roles. Nerves certainly do, I should think. Surely.

I have asked for my post to be deleted gladders - I don't want to make anyone think confidentiality isn't 100% the thing. It is, and it's a constant battle when posting on mn to keep a beady eye on it.

The ladies that delivered my baby lifted him out and said " Wow here HE is and what a good weight, well done Mum" - considering ds was a titchy little 32 weeker that made SUCH a difference and gave me a real boost as was feeling really low at that point.

Silverfrog, you norty girl

I think it helped that both surgeons were female and one was 5 months pregnant - very very gentle and stitched me up so well you can't even see the scar! I met the pregnant one at a mother and toddler group the following year and thanked her for doing such a fab job with me :)

I agree FutureNannyOgg.

Worried - you don't need a consultant appointment to ask for your preferences, I never saw a consultant until the crash team turned up in my delivery room. But you do have to consent for every procedure right? So how about "you're going to need a catheter, can I do it now, or would you rather we waited until you are under anaesthetic?" Other things like screens can be asked in theatre, I know I spent ages chatting about all sorts to the anaesthetist and one of the midwives (trying to distract me - we had already talked about birth preferences when they were prepping the theatre for me). It might seem like a bit of a faff around, but it's tiny things that make a woman feel like a cared-for human, rather than another piece of meat on the conveyor belt.

I had an ELSC and had the chance to discuss the details in advance with my surgeon who went on to perform the procedure. It was a very positive experience (sorry other posters but semantically a surgery is most definately an experience since it is experienced by the patient!)and I wouldn't hesitate to have another one.

DH was in the room with me, I think he could see over the screen a bit, but it's not something I wanted to see myself. Despite my love for ER, Grey's Anatomy, etc. I did not want to see my insides! Baby was brought to me very quickly after being checked over and weighed (I was fine with that because I would rather be sure she was breathing and OK), and we had skin to skin. She was placed on my upper chest (I am not flat chested but it was not a problem at all), with a blanket over her, I had one arm around her and DH and MW were on either side and keeping an eye out if I needed help holding her (which I didn't). After the surgery I had to go to the recovery room for 2 hrs where I was closely monitored, which was hospital policy and although not ideal in terms of leaving the baby I was happy to follow medical advice and minimise risks. Meanwhile the baby was checked over thoroughly and we met up in the room after the 2 hours were up. I had no problems bfing.

That is what I do Future. For now!

But our hospital want to have a standardised pathway, and there is a forum asking for ideas to decide on some timings - the catheter and the shave being one of them. I don't like it but this will be enshrined in guideline and protocol. Like everything else.

I had the screen down, although the belly was in the way so could hardly see. It was one of the best experiences of my life.
I asked for no suppository up bum afterwards, which was respected. And asked the anesthesist to do a commentary of everything that was happening step-by-step in medical terms (which I had taken the time to study).
So, do your homework, then you know what you can ask for.
Good luck!