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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

to be worried about seeing consultant about elective c section tomorrow?

113 replies

heraldgerald · 12/08/2014 11:13

I'm so nervous I actually feel sick. I had a three day Labour last time as I failed to dilate and spent two days at home labouring because I wasn't 4 cm. I never got to bloody 4 cm even with the syntocin! It was a horrendous experience and I've had trauma treatment on the nhs since as a result. I was shattered afterwards and got very ill with an infection.

I have thought long and hard and I cannot face going through that again.

Anyway. I have been told by my midwife I'll have to 'argue my case strongly' about getting one.

I have no idea how strongly I'll need to argue - I don't want to break down in tears and I'm scared I will.

It's triggering even now issues with body control and fears of invasive procedures like sweeps. Aibu to be so wound up?

OP posts:
BornFreeButinChains · 12/08/2014 14:28

Hearld.

littlepeas · 12/08/2014 14:29

It is possible to be assertive without being difficult. I was clear and firm at my appointment, but polite. I think one of the most important aspects of success at a consultant appointment is to go in knowing and understanding the risks - it shows that you have properly considered the situation and not made a snap decision.

MrsWinnibago · 12/08/2014 14:32

Yes Peas I agree and nowhere in my advice did I suggest OP should be "difficult" I only suggested she stick to her guns and know her rights.

Somehow that was interpreted as being an arse by the GP upthread.

RedToothBrush · 12/08/2014 14:42

If people are difficult, then they virtually always have a reason why they are. Its up to the person treating them to offer support and reassurance to defuse the situation and help them relax, not inflame it and reinforce their defensive feelings and make the whole scenario worse.

They are the professional in the relationship after all. If they don't listen, how can they expect their patient who is potentially afraid or anxious - maybe because of past experiences or expectations, to change their mindset and listen to them in return?

Using their power to resist demands rather than carefully explain things is precisely what shouldn't happen. These are the patients that you should be spending more time with so they fully understand what is happening to them, and why certain decisions are the best course of action.

Trust is essential to good healthcare and the responsibility of building trust lies with the HCP and NOT the patient.

MrsWinnibago · 12/08/2014 14:49

Red that is very eloquently put.

RedToothBrush · 12/08/2014 14:56

Its also worth pointing out this:

I have been told by my midwife I'll have to 'argue my case strongly' about getting one.

So women are being actively set up by some midwives that they will have to have a fight with the consultant to get what they want.

I've seen a LOT of similar posts on the same subject too. If there was greater understanding and more consistency of care for this issue, then I do believe, there the attitude that women might have, would be very different.

heraldgerald · 12/08/2014 14:57

Goodness what insight on this thread! Bornfree, keep making your points they are very welcome. As I say I feel better and less alone for debating this. Redtooth perhaps a book from you about this is in the wings? Very eloquent and compelling comments.

OP posts:
MrsWinnibago · 12/08/2014 14:58

Yes. My Midwife warned me I'd have to push to get an epidural with DD1 and with DD2 a different mw warned me I'd have to push to get a c section.

But they were both correct.

heraldgerald · 12/08/2014 15:02

Mrs w, tjee

OP posts:
heraldgerald · 12/08/2014 15:04

Oops

Mrs w there does seem something systemically wrong with the pitting of patients and hcp s against eachother. Must make it worse, or does it empower women to not accept medical decisions they are unhappy with?

OP posts:
heraldgerald · 12/08/2014 15:04

Oops

Mrs w there does seem something systemically wrong with the pitting of patients and hcp s against eachother. Must make it worse, or does it empower women to not accept medical decisions they are unhappy with?

OP posts:
ICanSeeTheSun · 12/08/2014 15:08

I don't see why in 2014 a women has to fight for the birth they want.

It's clear to me in this case that the op failed to progress and in the end was left having to have treatment for trauma.

schmee · 12/08/2014 15:19

arsey how deeply unprofessional. My experience of HCPs has often suggested that some bring their personal values and judgements to bear on professional situations, but I find it shocking that you are not ashamed to admit this. How vile. You are not doing them a favour if you decide to provide them with the best care possible - it's your job.

Fairylea · 12/08/2014 15:22

Op I had a very traumatic birth with my first dc 11 years ago. 3 day labour, failed epidural, was induction so on drip and very painful.. etc etc. When I had ds 2 years ago I was adamant I would only even consider going through with the (much wanted) pregnancy if I could have an elective section - I was that phobic about it.

I had 3 consultant appointments. 2 times they tried to change my mind. I had to virtually state that I knew how serious an op it was and I would sue them for maternal distress and depression if they refused my request. I then wrote a very strongly worded letter and got a 3rd appointment where they agreed to do it.

It was an amazing and healing experience. The most wonderful birth ever. I recovered much more easily physically than my first birth.

I think you need to go in to any appointments armed with all the facts and let them know you know the risks but it's the right decision for you.

RedToothBrush · 12/08/2014 15:38

Herald, thank you for you kind comments, but to be honest, I'm not saying much that hasn't been already published in various ways by people with a medical background / more experience than me. The issue is more about getting that message to a wider audience, or people who are asking questions like you - which is why MN is such a good format to do that.

With this particular subject, there is an additional problem with media representations and political involvement. It has deeply coloured the debate and doesn't really do women who are in need of support many favours.

MN is one of the few places, that I think women can speak openly about their experiences, and can share with others in a similar situation. There are a LOT of women on here who can emphasis with you (perhaps more so than I can, as like I say, my circumstances are slightly different).

In fairness midwives are in something of a rock and a hard place. As are a lot of consultants. There is political pressure to reduce CS and promote 'normal births'. Promoting normal births, is fine, but only if you address all the other issues surrounding it - such as women feeling in control and being listened to and having their rights fully respected. The reason that maternal requests are increasing is largely down to poor care and these issues being ignored.

The point that what women really need/want is the right care for them, is being completely missed. The emphasis is on the medical procedure and not the women centred care, which is fundamentality flawed.

So against this background midwives informing women, that they may face a fight might be completely correct and it would be irresponsible for them not to properly prepare those in their care about a real possibility of hostility and a need to be assertive.

Equally consultants are being held accountable for the number of CS they perform and this is closely monitored and regarded as a 'bad thing'. Hospitals are still rated (and funded) in part due to their CS rates. And ELCS are easily targets to cut than EMCS... Really the two should be treated separately as they carry extremely different levels of risk (and indeed cost).

CSs are however, not a good thing nor a bad thing. They are a neutral thing; the thing we should focus on is, women who need one get one, and that those who don't need one don't get one. Need is not just about physical issues, its also about mental issues and failure to understand this, is at the heart of the problem.

Women who ask for an ELCS are typically labelled or perceived by the media and politicians as being weak or 'too posh'. The reality is very different. The over whelming majority of maternal requests have mental or physical reasoning behind them - they are generally not made without thought. They tend to be made by women who belong to more vulnerable or at risk women who are often the most deserving of support, rather than condemnation.

Chelsea and Westminister is a prime example of this - they have be forced to 'address' their CS rate as it was one of the highest in the country - without properly understanding why they had this rate in the first place. The assumption has been based on the 'too posh to push' myth, rather than looking at why women are making this request and why they might have good reason to. (Rather ironically, in every other area of healthcare, having a middleclass/affluent background is viewed as the best indicator of good care with empowered patients - yet not so for maternity)

What it comes down to, is a real lack of understanding of the issue, ideological beliefs and myths dominating decision making, instead of looking at evidence and women being the focus of their own care, usually being dismissed as an inconvenience.

BornFreeButinChains · 12/08/2014 15:45

Redtooth perhaps a book from you about this is in the wings? Very eloquent and compelling comments

What an excellent idea!

Idocrazythings · 12/08/2014 15:48

I can't believe in 2014 a woman should have to fight for the birth they want sorry but no one gets the birth they want. You get the birth you get. just like you get the baby you get. I think this way of thinking is such a big problem nowadays because people have such high expectations, yet not all the information they need to understand what it is they are asking for. Sometimes they think they have all the information but often it is flawed.

In the past women died in childbirth. Babies died in childbirth and infancy. It was accepted as the way life is. Nowadays everyone is accountable. There has to be someone to blame. To pay. We all have our statutory rights.

With these rights comes policies and guidelines and limits to the care we can provide. Which then affects birth outcomes.

Perhaps instead of blaming midwives and doctors we need to all start looking at the way we think as a society.

OP. This is not reflected towards you in any way. Just some thoughts from a disappointed midwife. Whose only goal when she goes to work is to give the best care to women and families that she can.

BornFreeButinChains · 12/08/2014 15:58
  • You get the birth you get. just like you get the baby you get. I think this way of thinking is such a big problem nowadays because people have such high expectations, yet not all the information they need to understand what it is they are asking for. Sometimes they think they have all the information but often it is flawed

I agree , these pages are littered with women saying ": I had an awful birth, forceps, 3rd degree tear whats wrong with me, I have failed".

Its these comments I see on a frequent basis and its these comments that upset me. Where do these ideas that you will breath out a baby come from? Or if you have an epidural you are going to get a cascade of intervention, or as long as you can move in labour all will be well?

MrsWinnibago · 12/08/2014 16:01

You don't get the birth you get when you need intervention after a troublesome first birth though. You should get the birth you NEED.

RedToothBrush · 12/08/2014 16:04

Idocrazythings

I actually support that idea that I can't believe in 2014 a woman should have to fight for the birth they want rather than believing its just about women having unrealistic expectations.

The problem often lies with HCP's who use the phrases 'not allowed' or don't properly inform / communicate with the women they are treating as grown adults.

It lies with policies across the country being enormously varied and inconsistent. So one hospital will induce at 40+12 whereas others will induce earlier for example.

Its about how women are constantly told they are being weak if they don't do it 'right' - either by HCPs or by the press or other women.

Its about how women are deliberately denied access to pain relief.

In essence its about how women place their trust in HCPs and then are treated as nothing more than something in a factory production line rather than individuals with a variety of different needs and preferences which are utterly disregarded.

I do not think it is unrealistic to expect this as a basic. Its not actually often about the eventual method of birth - its how they are treated during that process and how they are respected and involved in it.

Its amazing how often the same themes crop up again and again; and how it seems that a 'physically traumatic' birth handled well can often be coped with better by a woman than a 'text book' birth which is handled badly by those caring for her.

bnotts · 12/08/2014 16:11

OP- I had a similar experience after a totally normal pregnancy I was induced over several days. Actually remember very little I think I blocked it out but what I do remember makes me shake and my partner remains really distressed. I was required to see a consultant this time around (currently 29 weeks) and actually she seemed surprised I wanted to try a vaginal birth, she had assumed I would want a caesarian and was all ready to book me in, so you may not have to fight. She has said if I change my mind to let them know and given my previous caesarian I won't be induced again which is my main fear. Wishing you all the best

Viviennemary · 12/08/2014 16:19

I think explaining what a traumatic time you had last time and saying you can hardly sleep at night worrying would be more effective than marching in and demanding your rights. But it's up to you.

littlepeas · 12/08/2014 16:21

I feel that, if it is a choice between a repeat section or a trial of labour, it should absolutely be the choice of the woman concerned. There will be some women who know they want to try for a vbac and others who are certain they want a repeat section. In the case of those who are unsure the hcp should present facts and an educated view based on that woman's circumstances , but it should still be the choice of the woman. My greatest fear when facing this decision myself was that I would be bullied into vbac when my gut feeling was that it was not right for me in that particular pregnancy. Luckily I was supported, but I know of people who felt coerced into vbac and were very unhappy, as I would have been.

MrsMook · 12/08/2014 16:31

You can certainly set up a birth experience to be more positive from the outset. Ds2s birth was a choice between a rock and a hard place as I didn't want another Cs, and I was scared of the experiences I had during Ds1's long and traumatic labour. His labour didn't have to be that traumatic, a caring MW, and better discussions over pain relief would have made a difficult experience easier to process. I had support towards preparing for Ds2s birth, and was able to go into labour ward asserting medically, and mentally appropriate methods. I was terrified of being beached helplessly on my back being monitored- not a great starting point for a Vabc. I had a great MW who helped me get comfy over the birthing ball, and was lovely about having to press the emergency button, and explained it calmly unlike first time round. Despite ending up in theatre with forceps and third degree tear with a strong threat of another EMCS, it was quite a positive birth. Not entirely free of frustration, but not traumatising. The day of that birth was a happy day, and his birthday not left bittersweet by painful memories like his brother's was.

There is little choice about the direction a birth unfolds in, but an empowered mother, a positive starting point and the birth being managed with care makes a world of difference.

I hope you get the right birth for you Op, and without resistance to get there.

ICanSeeTheSun · 12/08/2014 16:52

Everything else medically you need to consent to ( unless you are sectioned under the mental Heath act)

I think if a women wants a c section then they shouldn't have a convince a doctor in allowing it to happen.

A women should have the decision on what she wants to happen.