AIBU about "Birth after Caesarean" clinic.

[Caff2]

I had an elective section for my second child after previous traumatic birth. At booking in appointment for current pregnancy, I asked the community midwife about elective section this time, and she said she would refer me to consultant again, and did, to same consultant I had last time, and I got an appointment letter through to see said consultant in September.

Today, I had a letter from the "Birth after Caesarean" team giving me an appointment in August to "discuss options for women considering vaginal births aftersection or planned sections". I was confused as to what this clinic was, as I already have an appointment to see the consultant to discuss this. So I rang up to enquire. The hospital midwife I spoke to was quite cagey about what the appointment was for and said it was to "discuss it". So I said "Well, I already have an appointment to discuss the elective section I want with Mrs X (consultant) in September - won't she go through it all with me again?". At which the midwife said "Well, I'll cancel this appointment then, as it's clear to me that we won't be able to change your mind, so there's no point"!!

AIBU to be a bit upset about this and think that they should be more honest about what this clinic is for, as it is plainly to try and talk people out of having planned sections, and not to discuss "Options for women considering vaginal birth after section OR PLANNED SECTIONS"?

Probably to cover their arses, as with all things medical.

YY, a therapeutic tearing or shredding can definitely lift your spirits.

It's totally to get you to change your mind. Seems there's a real trend nowadays to insist women jump through a few extra hoops if they request an ELCS.

I didn't, thankfully, but if I had, I'm sure I would have smiled and nodded and asked where the consent form was.

They have a duty to make sure that they make women aware of all the options they have.
At the end of the day sections do cost a lot of money and are not without risks. I lost my child shortly after my first c section not caused by the section I must stress and I knew with my third I would def want another section but they still called me in for this talk. They did not press me to change my mind at all, just made me aware of the risks of both so I could make an informed choice.

Well, since the last time, the consultant read my birth notes from DS1 and said words along the lines of "Of course you need to have a section, (you can stop crying now the hysteria is not becoming ), let's look at dates", and my birth experience in 2000 will never change without a time machine, they really couldn't have changed my mind. I'm still not over it despite all the therapy.

So if a letter had come about a clinic to discuss VBAC, I would have politely phoned up and cancelled the appointment. Why they pretend it's to discuss either option, I have no idea.

Attempts to let it go again.

Sorry, I missed your post, Rosduk, so sorry for your loss

I understand why you're annoyed - you feel the MW on the phone should have been more honest about the purpose of the clinic (not that she would specifically say "it's to talk you into a VBAC") because you, and no doubt countless other women, would cancel the appointment

What I don't understand is that you haven't been to the appointment, so how do you know what they were going to discuss and if they were even going to try and push you into a vbac. You are winding yourself up over nothing!
For what it's worth, at my appointment they did talk about options but they also tell you about options medically on the day of your section, things/problems to look out for in a pregnancy after section and how to take care of your scar as it stretches in a second pregnancy.

^ That, seaoflove! Exactly that.

You might wish to discuss the type of anaesthesia, even though you are having a planned section. I think those clinics are excellent. Any chance to discuss things might be worthwhile surely. Not everyone would have a consultant appt set up or be as thought through as yourself. A few years ago it was quite the opposite, pressure to have repeat sections, no discussion. There are lots of people who haven't made their mind up at that stage, or like me have moved areas and protocol and policies change.

When VBACs first came in women weren't aware of the possibility and it's good that midwives help women understand they have an option and a real one.

I know, Rosduk, because of the conversation I had on the phone where if I definitely did not want a VBAC there was no point to my attending the appointment, so she cancelled it.

YANBU I was invited to similar despite suffering from Tokophobia (stated clearly in my notes) so just the thought of different options/prospect of having to discuss it all is extremely upsetting. Luckily the consultant could see I was a 'very determined lady' and therefore it was not worth going...I have no doubt some people would find these clinics helpful but it's the lack of transparency that's the issue

Maybe it was for those still undecided? If you had said you are definitely attempting VBAC perhaps she would have cancelled it too?

I think the person you spoke to is the one at fault here tbh. I think she has phrased herself very badly and, considering you already had an appointment with someone else, agreed to cancel.

I've been to one of these clinics recently and it was to discuss my options, all of them, not just a VBAC. I suspect that because you were so adamant about what you wanted there is little point in discussing all your options and the appointment you already had is far more appropriate but she should have communicated it better.

I read it as being for people to discuss options if they are undecided. so it would be pointless as you had already decided (and were set up to arrange with consultant also)

That's it, MrsMallett.

I agree that VBAC is a great option for many women (not me).
I agree that it's great that clinics to help women considering this are great news.
I also agree with Headofthehive that I would have been interested in discussing things to do with my choice to have another section after previus section - HOWEVER.

That is not what was on offer, as the midwife on the phone eventually made clear. This is a clinic purely to encourage VBAC, and the clinic has won an award for doing just that.

SO, why not call it a clinic to discuss VBAC? As MrsMallett said, it's the lack of transparency which is the issue.

Yes sometimes discussing it is horrid and you just don't want to go through it all again. i couldn't bear the Drs being involved and would only deal with the midwives!

Also, when she looked me up on the system, she could see I had an appointment with the consultant. She said when she cancelled the clinic appointment that I would "still need that one then, as I hadn't changed my mind".

If you google "Birth after Caesarean NGH", you will see that the midwives involved with this clinic won an award for reducing Caesarean births, not for their sterling work in discussing women's options in an unbiased, helpful and informative way.

YANBU. It should be called a "VBAC clinic" if that is what it actually is. It is dishonest of them to call it something else. Unfortunately, I think that many midwives' commitment to maternal choice is only skin-deep.

There is a big difference between reducing unnecessary and unwanted (by the mother) caesarean sections, and simply lowering the rate in general - thus virtually ensuring that women who would rather have accessed a c-section have not been able to. That is not a 'success' if you ask me.

That is exactly how I feel, TheSortingCat. I have no doubt that this clinic is very helpful in discussing VBAC and helping women who would like to consider that option. It is a clinic to encourage VBAC. Why do they not say that is what it is? They are absolutely not interested in talking to women who do not want to attempt a VBAC about their future planned sections, as evidenced by my phone call.

I do understand the need for a clinic to discuss VBAC for women who wish to. I don't understand the lack of transparency until really pushed to say what this clinic is!

If you can bear to, I think you should raise it with the hospital. It is only if women complain about poor care - which this is - that things will improve.

But tonight I think you should put it from your ming and try to enjoy your evening.

Argh! Mind, not ming - I know you are not an expensive vase!

It is to discuss options and when you have firmly made up your mind there are no options to discuss? So no they wouldn't want to talk to you?

When decided to have a elcs, crumblybiscuits, there are still options to discuss about that elcs - as headof the hive said earlier, types of anaesthesia. Or aftercare. All sorts of things someone wanting another section might want to discuss, as the letter in fact implies is part of the function of the clinic. Except these are not relevant in a clinic to encourage VBAC, which is what it transpires this clinic is.

Yabu.

The clinic is not to talk you into a vaginal birth. It is to discuss your medical history, previous births, and your options.

It is also a fast way to access an elective section. A specialist midwife talked me through risks, benefits, and when I told her I still wanted a section, she referred me to the consultant team and a date was set. Then I was out of community midwife care.

It is to make sure you have all available information relevant to you. To make sure you are making a properly informed decision. I was also very reassured the section was best for me and my baby.