To just ask for an ELCS?

[NotAWhaleOmeletteInSight]

I'm 7 months pregnant with dc2. Dc1 is 21 months old and my experience of birth was extremely traumatic. I don't want to go into loads of detail but it went very wrong, dc was in danger, it ended in theatre with a room full of people, spinal, forceps etc. Afterwards I'm fairly sure I had undiagnosed pnd, although I didn't know it at the time.

The hospital have apologised for how things went and I'm under the consultant for this pregnancy, because I'm so worried about the birth.

I've been psyching myself up for it and they've promised that I can have an epidural as soon as I arrive if I want (they talked me out of it last time). They've also asked if I want an ELCS.

I know this isn't technically an AIBU but I'd really appreciate your opinions. The more I think about it, the more I don't know if I can face going through labour again, although I know it's unlikely to be like last time.

I'm also worried though about the recovery from a CS whilst looking after a toddler. Dh will have 2 weeks off work, and then my mum will come to stay for a bit (family all live hundreds of miles away). I don't need to drive as we live in the suburbs and everything is walkable.

Just how bad is the recovery from an ELCS? Should I just go for it?

Ah! That explains it. I think I must have misread that bit! Well I think it takes an awful lot if courage to even get pregnant after a difficult birth.

I do accept that cost is a factor.
Cost of theatre time/team.
Possibly longer stay in hospital.

But I do not believe that VB is always be the cheaper option.

A best friend of mine started off in the birth centre.
Ended up on delivery suite, failed ventouse, then forceps, massive episiotomy and extended 3rd degree tear.

She ended up staying in nearly a weak with infection etc. Then had reconstructive surgery further down the line, treatment for PTSD/PND and counselling.

I spent barely 48 hours as an in-patient after my ELCS, they were so bloody stingy with the pain relief that I barely got any on the post natal ward!

I wonder which birth/aftermath cost more to the NHS in total?
I realise that this is just 2 examples but to me it illustrates the absolutely lottery that birth can be.

Having a CS was absolutely the correct decision for me.

I'm a junior doctor and trust me, if we're debating things that bleed the NHS dry of money, it's certainly not women choosing to have an ELCS.

Amen

In the department I worked in two of the biggest wastes of money were DNAs (patients who Did Not Attend) and people doing stupid stuff like removing their plaster casts because they were itchy or bored. A removed cast sounds like nothing much but means x rays are needed, they need to see the consultant again, and then a new cast has go be fitted by the plaster tech.

I'm betting there aren't many DNAs on maternity.

It won't always be a cheaper option, no. However if everybody delivered in that way, costs would increase. The trick of course is picking out those who would benefit from a cs, for whatever reason, and leaving who would not alone.

Thats the difficulty of applying mass statistics to individual cases. It can tell you whether you are more likely to have that particular outcome but it can't tell you whether you actually will or not.

I had a first birth like you and had pnd. It was horrendous actually and I bleed bucket loads afterwards. (Was very scary). Birth 2 and 3 were so easy and had no drama and I just used gas. This showed me that I could have home birthed as it was so easy.
Please do not give up on a natural delivery.

Oh and nothing to do with size of the baby my second was nearly ten pounds and the easiest birth of all. The difference was I had probably the most experienced midwife (for both baby 2 and 3) who helped me deliver. No doctors were needed until the very end to sign forms and say I delivered healthy and alive babies.

Ps: the first midwife who helped me deliver (where the birth was atrocious) she then went on to sell property afterwards. Probably a good thing.

I think an awful lot depends on the position of baby.

princess really? Disappointed modern medicine saved you or your child's life? Yeah right.

There's no shame in a section. The birth is one day of your child's life. If the section will keep you calm and realistically with your history that's likely, then do it. Good luck op.

Lol

Ignorance is bliss on MN

"The primal urge". You're right, ignorance really is bliss (hint: take a look in the mirror).

princess is a troll. Don't encourage him.

Sheba that's prob good advice. I cross posted. I thought said had two births? But is a man?

Princess I'm not bothered about a primal urge thanks. Would rather experience no pain and have a nice birth. I don't personally attach emotional significance to what I see as a gory, painful unpleasant experience.

Modern medicine is fantastic. You don't get a medal for giving birth surrounded by incense and granola.

Wait is princess a guy

NICE reckon ELCS would be the cheapest option if they were universally available. Makes sense if you think about it. You'd always get a small percentage of women going into labour before the section date and some who refused, but if you had perhaps two thirds having ELCS, that would cut out the majority of the most expensive types of birth, EMCS and complex VB. You could plan staffing levels much more easily, saving money and making efficiencies there. And ELCS would get even safer if it was more common. Some of you forced VB enthusiasts should be very careful what you wish for, especially as the birthing population get older, fatter, and more primagravida happy.

NICE reckon ELCS would be the cheapest option if they were universally available. Makes sense if you think about it. You'd always get a small percentage of women going into labour before the section date and some who refused, but if you had perhaps two thirds having ELCS, that would cut out the majority of the most expensive types of birth, EMCS and complex VB. You could plan staffing levels much more easily, saving money and making efficiencies there. And ELCS would get even safer if it was more common. Some of you forced VB enthusiasts should be very careful what you wish for, especially as the birthing population get older, fatter, and more primagravida happy.

I would rather not have had a scar on my uterus, as it had dreadful consequences for my next child.

I'd take the pain anyday to that.

Quite frankly persuading people to have a cs to plan staffing is as bad as denying women who want it to save costs!

Fanny exactly

I don't think she's saying everyone should have a CS she's just saying purely from a cost perspective it's actually cheaper in a lot of cases so the argument VB are cheaper is a bit crap

I quite agree head. Two different sides of the same revolting philosophy. The only way forward is MRCS for anyone who wants it and support to attempt VB for anyone who wants it. But the point is, the cost issue isn't as straightforward as some of you are making out.

It certainly isn't straightforward fanny. In fact there are a lots of models proposed looking at a woman's reproductive career, trying to work out long term costs.

A lot depends on whether there will be subsequent children, the legacy of a cs does impact on future choices and outcomes.

However I do like the WHO strategy of individual patient, individual decision.