Meet the Other Phone. Only the apps you allow.

Meet the Other Phone.
Only the apps you allow.

Buy now

Please or to access all these features

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To request ELCS ...

102 replies

KeepOnKeepingOnAndOnAndOnAndOn · 25/04/2014 19:41

After instrumental birth and haemorrage with dd 1 ( which resulted in anemia and no breast milk)

I was induced at 10 days over and in and out of labour for over 48 hours. I was totally and utterly dejected and very ill by the time dd came.

I have just foun out I am pregnant again :) - I know this time maybe different, but quite frankly I would rather skip at the distress for the ext dc and me , and have a ELCS. I know it will be a longer recovery (can be) but my last born left me with weeks of pain (plus exhaustion )

AIBU to request a. ELCS? Will I have mucho hope?

OP posts:
GobbolinoCat · 28/04/2014 11:16

SystemIDUnknown

Is this really an acceptable state of mind for a person to be in when making a choice about such an invasive medication, with potential for immediate and long-term side-effects? Or should the decision be made by a medical professional? Confused

Are you for real!

I made my decision to have an epidural fully compensmentas, after much reading, research, stats as well as personal experiences, and after chatting to my Community MW and our Birth leader well before I went into labour!

I know what my pain threshold is, I know what I can and cant take and I was right!

The denial of my epidural caused far more invasive treatment for my next delivery albeit a procedure I loved and welcomed over Cb any day.

Most women, prepare and think about pain relief long long before they get anywhere near labour stage!

Maybe you went into labour blind with no research at all, but most women are well informed and match that information with their own knowledge of their own mental strength, emotional strength and physical pain threshold.

KeepOnKeepingOnAndOnAndOnAndOn · 28/04/2014 12:24

Chunderalla- you raise a very interestig point about th lack of epidurals. You are right that we do no hear enough about that.

Goblin- I cannot believe you were denied an epidural. I have heard of this, but assumed it was here say. How awful.
My mother actuall said that giving birth is like having diahrrea - when the body is ready to expel , there is no keepin it in! Horrible anology - but sensible. I guess the epidural mate had lesser impact than I assumed? Who knows ...

ELCS all the way this time!

OP posts:
GobbolinoCat · 28/04/2014 12:47

keep look at past threads on here. It was originally women reporting back on MN that raised the issue.

There are many reasons why a woman cannot access an epidural.

Its not the pain relief choice we are usually led to believe prior to birth.

Acunningruse · 28/04/2014 12:59

I requested an ELCS and got one, I think it helped that I had done my research and was informed about the risks but felt that in my circumstances the risks were minimal compared to the 'unknowns' of a VB. My ELCS was a fantastic experience and I will be requesting one again for DC2.

KeepOnKeepingOnAndOnAndOnAndOn · 28/04/2014 13:06

I will do my reasesrch thanks!

OP posts:
thebodydoestricks · 28/04/2014 13:12

I requested an epidural for every one if my 4 labours and didn't get one for any of them. Requested early too.

I am a nurse, know the system and was still denied.

Makes me mightily pissed off to think about it.

I don't think pain relief is take seriously enough in labour and I think it can be absolutely traumatising.

Good luck op. Keep pushing ( no pun)

RedToothBrush · 28/04/2014 13:45

Access to epidurals is a largely cultural thing.

There are several countries in the world which its is regarded as standard and that not having one is viewed as somewhat primitive.

You would think that if it was the epidurals that were causing the problem, that this would form a very clear and identifiable pattern. The fact it doesn't seem to and there is a lot of conflicting evidence on the matter instead suggests that either there are a hell of a lot of flawed studies or that there is no correlation. Or both.

Is this really an acceptable state of mind for a person to be in when making a choice about such an invasive medication, with potential for immediate and long-term side-effects? Or should the decision be made by a medical professional?

Fortunately the laws of consent in this country, do mean that women are regarded as being capable of making informed decisions of their own and are not deemed incapable of doing so whilst in labour. The implications of suggesting that women are not capable of this are extremely concerning. I also find it ironic that you seem to suggest that women could consent to other drugs whilst in labour though - without considering the side effects of these alternatives. Your thinking is simply in-cohesive and biased, not to mention extremely paternalistic.

As for doctors making decisions about pain relief there is also another problem in that doctors are completely unable to decide the level of pain an individual is feeling as it is very much a personal measurement. People do not feel pain in the same way as the next person, and have varying levels of ability to cope with pain. In all other areas of medicine they are primarily driven by feedback from the patient in their decision making over pain relief; it is a guided decision based on input and communication from the patient that a doctor does not make alone. Nor should they. Ironically if they did, they could give more drugs than are necessary to patients who do not need that level of medication. So why should labour be any different?

As for long term side-effects, you are neglecting the fact that there is plenty of evidence that actively denying access to pain relief on demand can potentially have enormous consequences and is a leading cause of birth related trauma and long term psychological problems. This is an area of care that is only just being explored and unfortunately isn't being given the consideration it desires by a lot of people. Its easy just to trot out crap about "women have been giving birth for thousands of years and coped" - except the evidence is increasingly suggesting that women don't and didn't actually cope - they simply lacked the choice and the ability to express how deeply it affected they. And thank fuck we are now living at a time where those taboos are being broken.

Just because you look back on your birth and think "I didn't care what happened to me, had I had a switch to push, I would have chosen death over continuing with that level of pain for another hour. Which is obviously ridiculous...now." is not true of a lot of other women. They are unable to process the experience and suffer flashback and other post traumatic symptoms.

Equally, comparing denying anti-biotics for viral illnesses is utterly absurd! You are talking about drugs for an illness which will have no effect with an anaesthetic which is recommended as appropriate and fit for that particular purpose. Its a comparison which really does show you are talking out your backside.

Going back to the original subject of ELCS, I do think that making sure epidurals are available would be one way of helping women give birth and not have an ELCS. Yet many are going for the more extreme option of an ELCS because this is not being taken seriously enough. Its sad that they don't have this choice which may be right for them. It may not be, but the fact the default suggestion is surgery is quite strange.

I have to say that over all the real key issue is this lack of understanding about the psychological aspects of birth, with emphasis put far too much on the psychical which is leading to devastating consequences for some women and their subsequent appalling treatment by completely insensitive and ignorant HCPs as well as friends and family.

I think the OP is completely within her rights to ask for an ELCS. Asking for an ELCS does not automatically mean she will eventually decide to have one. My hospital take the attitude of not refusing requests, but instead viewing a request as a need to extra support to find out where the problem really lies. Its about putting the woman back in control and feeling able to make decisions freely and be listened to with respect. The system seems to be beneficial as not all women who request an ELCS ultimately end up having one as a result by their choice and thus find it empowering.

All in all it suggests that being consulted, informing, listening and making decisions together with HCP rather than arbitrary decisions forced on women is extremely important in more than one way. I don't see why there is even a debate on this though...

Chunderella · 29/04/2014 07:20

This reply has been deleted

Message withdrawn at poster's request.

KeepOnKeepingOnAndOnAndOnAndOn · 29/04/2014 09:58

Hmm... I am confused as to what is going on!? Why are y'all do angry Blush
what have I started!?

OP posts:
KeepOnKeepingOnAndOnAndOnAndOn · 29/04/2014 09:59

So*

OP posts:
RedToothBrush · 29/04/2014 10:05

Keep on, I simply believe that women should have choice and options in childbirth. Without judgement. I dislike the claptrap spouted which fails to acknowledge and understand that women should be treated as individuals with different needs. It doesn't help anyone.

KeepOnKeepingOnAndOnAndOnAndOn · 29/04/2014 10:12

I definitely agree there red :)

Thanks.

OP posts:
CloverHeart · 29/04/2014 10:53

...there is plenty of evidence that actively denying access to pain relief on demand can potentially have enormous consequences and is a leading cause of birth related trauma and long term psychological problems.

This is a large part of the reason I am requesting an ELCS, amongst other things (link to my own thread below). I had it in my birth plan and i requested it in plenty of time during my labour but was denied it.

My thread RE: ELCS

Somepercentagenotcool · 29/04/2014 11:10

This is all just hypothetical as I have pretty much come to terms with the idea of not having a third DC, but what do you think the medical profession's opinions would be on an ELCS after 2 long labours with instrumental deliveries? Both my two got stuck in the pretty much the exact same position and had to be hauled out by forceps and ventouse in theatre. I had rather been looking forward to DD's birth as everyone had said that second babies were much easier to deliver and had heard so many positive stories but alas it was not to be. Am not really traumatised, but would never want to go through one of those births again!

I was just wondering if, given that it would be rather likely that a third baby would also get stuck, I would ever be granted an ELCS for a third?

Also, is it still no driving for 6 weeks after an elective section? DD is 7 weeks old now and the thought of only just being able to drive again is a bit strange.

As I said its all moot now anyway as Im not having any more, but cant help but wonder.

The positive section stories on here are absolutely lovely Smile

Somepercentagenotcool · 29/04/2014 11:18

On the epidural thing, I waited 3 hours for an epidural for my second birth and was in agony that whole time (psychological as well as physical - having had a lovely textbook dialation, I was then told that dd got stuck and that things had slowed down considerably and I totally lost my mojo as I knew things were going to go the same way as my first birth and that all my contractions weren't really doing anything.) When the epidural finally came they got a student to administer it and she fucked it up 4 times before the anaesthetist finally got it in first time.

Oh the joys of childbirth!

My mum was majorly pissed off at the time as she had seen those two doctors an hour previous just chatting outside a room, so there had obviously been a miscommunication somewhere, but once DD was born it didnt seem worth pursuing it.

GobbolinoCat · 29/04/2014 11:45
  • but once DD was born it didnt seem worth pursuing it

this is a very revealing sentence. I have spoken to soo so so so so many women who say this, I beg beg beg them to report it to pals, you can choose how much further you want to go with it, if you simply want to say, look this happened, I am too tired and busy to go any further but I want you to know.....

This is why i dont trust any stats on child birth.

I beg them because for me childbirth was like torture and I have never felt so vulnerable or awful and if women keep their experiences, bad experiences hidden things will never ever ever get better.

Please, just call PALS at your hospital ( patient advisory liason), say what happened and thats all.....about ten mins of your time but the hosptial will know...

GobbolinoCat · 29/04/2014 11:48

I was just wondering if, given that it would be rather likely that a third baby would also get stuck, I would ever be granted an ELCS for a third?

There is a physical side here and a mental one.

Would they grant you one on the sole basis of the baby getting stuck> Who knows...maybe there is an internal issue, maybe it was awful luck, I would be focusing on the mental and emotional effects of two births like this....rather than the possibility of it happening again.

Driving is when your ready, straw poles on here think insurance compaines dont care about docs signing you of.f.

RedToothBrush · 29/04/2014 12:10

Somepercentagenotcool Tue 29-Apr-14 11:10:56
This is all just hypothetical as I have pretty much come to terms with the idea of not having a third DC, but what do you think the medical profession's opinions would be on an ELCS after 2 long labours with instrumental deliveries?

Honestly I don't think you would get a consensus opinion on this in the UK. I really think it would depend on where in the country you were, the ethos of the hospital you were at, and which individual staff you came across.

In theory you SHOULD be able to get an ELCS based on the NICE guidelines. In practice you may find it dead easy or exceptionally hard.

Unfortunately, although the guidelines were supposed to bring about consistency of care throughout the NHS because there was a lack of it prior to the update, the reality has to been to create even more disparity. The trouble is that the guidelines have been widely interpreted in different ways across the country, with some places feeling that an obstructive approach is better for their CS figures and to impress on women the seriousness of what they are requesting, whilst others taking a much more sympathetic approach with mental health considerations as much as physical ability given much more priority.

Hypothetically though, you should eventually be able to get an ELCS as the guidelines now make it difficult, for even the most hostile hospitals to ultimately deny you if you were very determined to have one.

I think it makes being in the "not sure/undecided" camp very difficult though, as you will come across a range of opinions within the profession that would treat someone with your history in a wide range of different ways.

Ultimately in this climate, I think the emphasis does end up being placed on the individual concerned - and how much they listen to messages from outside, how they feel themselves and how much they trust the HCPs caring for them because it can all be extremely conflicting.

I don't think there are any right answers here. Just right answers for each woman, which could, again vary widely.

Chunderella · 29/04/2014 14:25

This reply has been deleted

Message withdrawn at poster's request.

TillyTellTale · 29/04/2014 14:45

I completely disagree that being in so much pain you would rather die is normal or something women should simply expect to endure.

If I was in that much pain outside of labour, I'd want effective painkillers. Why should it any different in labour?

As it happens, my one experience of labour never got that painful (but that might have been the codeine tablets), but if it had, I would have asked for an epidural. And have been entitled to do so!

Fleta · 29/04/2014 14:47

I doubt I'll have another but if I do I will have an ELCS for the simple reason that I do not want another labour.

Gen35 · 29/04/2014 15:04

I don't see what's wrong with not wanting to feel anything at all during labour. Suggesting that women aren't given control of their own pain relief for their own good is just atrocious. I'm thankful I had an epidural because the placenta retrieval that was urgently required to be done manually (and several times) post partum would have been excruciating without it. I'll certainly complain if I can't get one this time round.

backwardpossom · 29/04/2014 17:39

Re: driving, I felt completely recovered after two weeks. After three weeks, I phoned insurance company as I felt it was ridiculous that I'd probably have to wait for another three weeks to drive and I live in the middle of nowhere and a bus only goes through the village now and again. So insurance company said we'll cover you as long as doc says it's ok. I phoned the doc, got an appointment the same day (cancellation) which I drove to and she checked my scar which was fine, asked if I felt confident enough to do an emergency stop etc and said she was happy for me to drive.

Somepercentagenotcool · 29/04/2014 19:53

redtoothbrush I agree that it would depend on which hospital you are at as to what you are offered. I think if in reality I ever did have another (I really am not going to!) I would probably just make it very clear on my birth plan that I wanted an epidural as soon as possible (ie once I am in established labour) and go on and on about it during my pregnancy and hope that one was available when the time came!

gobbolinocat you make a good point of complaining in order to help others in the future. In my mind there was no point in complaining as dd arrived safely and is healthy and that is all that really matters, but I guess just getting something logged could help in the future.

One of my friends is not even pregnant yet and she is absolutely adamant that she is having an ELCS if she ever has a baby!

RedToothBrush · 29/04/2014 22:12

Somepercentagenotcool Tue 29-Apr-14 19:53:50
One of my friends is not even pregnant yet and she is absolutely adamant that she is having an ELCS if she ever has a baby!

And why not?
If she thinks thats the right approach and she understands the risks and whats involved properly. Depending on her reasons I don't think its something thats remotely surprising or shocking. I think its good she feels able to express that as I think it would have been taboo to, a few years ago. Its good that its now possible.

Swipe left for the next trending thread