To request a c section due to sexual abuse as a teenager.

[patronsaintofglocks]

Hi everyone.

Thank you for reading.

I'm 24 weeks pregnant with my first baby and suffer from some mental health problems relating to previous trauma.

Although I am generally very well and posituve about my life and pregnant I am utterly petrified about giving birth.
I am so so fearful that internal examinations will trigger me into panic attacks and make childbirth almost impossible, as I was brutally sexually abused as a teen by a family member.
I am under a consultant for this pregnancy as I am deemed as high risk due to a previous blood clot.

Would IBU to speak with my midwife honestly and ask if they would consider a csection due to this?

Thank you.

Not in the slightest bit unreasonable.

Giving birth can be difficult enough without the added difficulties you have. Speak candidly to your MW and OBGYN and tell them exactly what you have said here.

It might also help to access some CBT/EMDR if you can. Having a tiny baby constantly touching you can be really triggering for some CSA survivors.

Good luck with everything

I agree with everyone upthread - medical considerations aside (risk of clotting), psychological reasons should be just as valid a reason for an ELCS as physical ones.

Re. the experience of having an ELCS - I had one (medical reasons to do with my baby in my case), and it was an entirely positive experience. The operation itself was fine, any feelings I might have had about surgery were washed away by the emotion of seeing DS for the first time, and I recovered incredibly quickly. They put a catheter in once I had the spinal in place, and to be honest I did not register it happening. Of course a day later it had to come out, which was done by a nurse, but she was very gentle and respectful - she didn't even have to touch my body, just pull gently on the length of tubing. It wasn't exactly a pleasant couple of seconds, but it wasn't painful and I (admittedly without any history of trauma) didn't find it distressing.

Good luck with whatever you decide to do, and in finding medical practioners who support you. And congratulations on your pregnancy.

Be aware you may need to have internal exams even if you have a c section though .. you need to talk it through with your midwife / health visitor .. I was absolutely petrified of giving birth( I presumed everyone was) for no obvious reason . I wish I have spoken up before hand .

Definitely not U, but there will still be a fair bit of looking and touching that area even with a C-section. It's possible you may need internals anyway, and they'll also insert and remove a catheter and check you over after. You can request they not do anything not absolutely medically necessary, but often a lot of it is.

Asking for a C-section is highly unlikely to remove the need for all vaginal examinations and care if that's what you're after, so you do also need to prepare for it. Talk to your midwife about your options.

YANBU at all. Explain to your midwife and I'm sure they will be able to help. Don't underplay how you feel - be clear. They will much prefer an elected c section to panic in the labour room.

I had an elected c section with local anaesthetic. No internal examinations other than during the operation itself, when of course I was completely numb from the anaesthic. Later, as said above, the nurse had to pull out the catheter but she was very gentle (a tug) and I was pretty much unaware.

It felt like magic when my dc was born and it didnt matter to me one bit that I hadn't been able to have a vaginal delivery. I was on my feet the next day though in hospital for five days but that was a blessing too - nothing to do but enjoy my baby.

Good luck and congratulations. You clearly have heaps of self awareness and empathy and I'm sure will be a great mother. Enjoy!

I was raped a lot by my first boyfriend. Internal examinations are different. Also request a woman.
Be honest with your midwife. I can't see why they'd refuse. Don't let the abuse you suffered hold you back.

I had an elective section for exactly the same reason. I couldn't face the idea of examinations, I couldn't face the idea of losing all control if it didn't go to plan and having to have forceps and stitches.
Speak to your midwife and don't take no for an answer, I was referred to a consultant and my c section was just fine. They put the catheter in after the epidural and it was only a small tug to take it out. No one gave me an examination and I was home the next day. Good luck

Just wanted to echo what others have said about internal exams not being compulsory for a vaginal delivery - for my second I wrote in my birth plan that I didn't want them and requested that it not be mentioned unless medically necessary, and the midwives were completely respectful of that. Would you consider hiring a doula to advocate for you and help support your birth choices? Best of luck to you xx

Thank you all so much for your responses!
I am so so grateful.

Can anyone advise me who I should speak to first? My midwife or GP? I see the consultant in July but I'd like to talk about it before then.

Thanks again ❤

Speak to your midwife. She will refer you.

I requested a section because of a previous rape. I thought I could go through with a natural delivery but once I got to about 34 weeks I just panicked about the whole thing.

For me the idea of having internal examinations filled me with so much stress the thought of it gave me a panic attack. I also thought that it would be foolish to attempt a vaginal delivery without a signal examination.

I met with the consultant and she instantly agreed that I could do as I wished. I'm sure the same will be for you. I wrote everything down as a back up as I find it so hard to talk about.

Hi OP

I have no idea why people have given you some odd advice here like " do no harm first " there is a clear lack of understanding about trauma here.

Of course you can ask and should be given a section....without question. You may get unlucky and come across a nasty consultant - but I feel 90% you will be given one no question. you have more than enough reason to ask. You can also request to see another consultant if you are unlucky and the first one says no.

Good luck, I have had both vag delivery which was fine and ELC - the ELC was far far better. The recovery was solid two weeks, no lifting etc....but I was in better shape afterwards than the normal Vag delivery....Good luck op it sounds like the right choice for you.

I told my MW I wanted to ask for one - and she wrote it on my notes for consultant.

I don't know whether it varies from one health authority to another, but in my case it was my midwife who liaised with the hospital. (In fact she carefully picked a sane obstetrician for me because as she put it "some of them are a bit fuddy-duddy.")

BTW maybe your clot would mean you need examinations but not a single person touched me below when I had my section bar catheta which I didnt even notice as I was numb and lying down on operating table.

Very different to the frequent exams before and during labour!

"I have no idea why people have given you some odd advice here like " do no harm first shock" there is a clear lack of understanding about trauma here."

If that was aimed at me then I suggest you reread my post - I have a VERY detailed understanding of trauma, thank you.

I was quoting my gp. I am happy to be proved wrong as I would like to know I have the option when I get there to potentially be accepted for an elective but gp was kindly but firmly certain that without a physical, medical reason, they would not accept a request for an elective.

Preparing the NICE guidelines give maternal request as a valid reason for requesting a CS. Section 1.2.9 covers this: www.nice.org.uk/guidance/cg132/chapter/1-Guidance

It isn't guaranteed that you'll get one, but many women do. Our trust is very pro-VB, which can make the request process take a while, but they will listen eventually. It helps if you can show you've researched the risks yourself. The childbirth forum on this site has quite a few threads on the subject containing good advice on how to approach your midwife with the request. One common theme is that, with maternity matters, GPs tend not to be quite as clued into your local system and you may find your request treated more favourably than you think. Especially as the RCOG is pushing for all pregnant women to be told the risks of VB in the same way they are told the risks of CS.

I hope this works out for you

Preparing, in that case see another gp, they are dime a dozen and a have difficulties views. It's a case of navigating the system to get what you need. It's your body. My gp had no bearing or influence on my pregnancy at all and he would have probably trotted out the same shite. My mw bit her lip when I asked but my consultant she had birth trauma experience and say yes straight away.

I am so sorry, OP. Big hugs. I was raped when I was 18. I didn't tell anyone throughout my pregnancy (planned, age 33, happily married - obviously my DH knows) and when I had to go on for a stretch and sweep at 41 weeks I was so tense they couldn't carry out the procedure and I broke down and told them what had happened to me. They were lovely and made a note on my file and called the delivery suite so they knew I would need some extra TLC and gas and air for any examinations. They asked me if I wanted to book in for an elective section and I said no as I had been brainwashed by NCT to believe my body would cope. This is one of my biggest regrets. They said that when I went into labour if I couldn't cope I could request a C-section at any time, which made me feel happier. I decided to try for a natural birth, with a C-section as a back up. However, I was induced at 42 weeks and had a terrible birth. I didn't cope at all, my body went into shock and the examinations were very difficult. My baby was distressed and I was terrified. I begged them for a C-section but the hospital was so busy they couldn't fit me in, and it was horrific. It ended up being a very long and traumatic birth because we knew the baby was distressed but I was so tired and frightened to push and in so much pain (failed epidural). It ended up with a Ventouse delivery, episiotomy and a 3rd (almost 4th) degree tear, as my body didn't cooperate at all.. it went into absolute shock. Thankfully my son was fine, but I was diagnosed with PTSD following the birth and my body is broken. My pelvic floor muscles tore so my bladder is weak and any kind of physical relationship is still very difficult for me (and my son is now 5!). I have no libido and just associate that area with pain and horror. I really really wish I had accepted their offer of a planned C-section at 41 weeks because so much of the above could have been avoided. I would definitely explain your reasoning and concerns and I am sure they will be sympathetic. An inquiry into my case afterwards stated that I had been failed and I should definitely have been allowed a C-section. Good luck, OP xxx

Yanbu at all.

Please can I emphasise here that Midwives cannot agree to a CS. Only a consultant can authorise this. Do mention it soon as sometimes they will ask for you to see a psychologist to assess your risk. Since you have a clotting issue it will need to be a very well reasoned argument that CS is less risky to you than a natural delivery.

You need to be prepared to listen and state your fears very calmly. Take someone with you and don't necessarily expect an immediate yes.

Doctors ultimately need to be able to answer to a court of law or the GMC as to why they offer surgery and carefully consider the risks. In cases of trauma most women will get their request but only after considered discussion.

I am a midwife and I don't think is unreasonable at all. I am sure your consultant will be happy to facilitate this. Good luck

I know somebody who has gone through the same thing as you, they were allowed to have a c section.
I'm 3 months pp and my recovery has been brilliant, so much easier than my vaginal birth. But please bear in mind, they WILL check you below afterwards and they will need to put a catheter in

What you ask for is completely reasonable, but it helps to have a midwife and more importantly a consultant who is sympathetic and understanding about your request. Trusts are under a lot of pressure to reduce the c-section rate, so an elective c-section at the mother's request (rather than for medical reasons) is the sort of thing they might be trying to target. So do talk to your midwife as soon as you can.

Doctors ultimately need to be able to answer to a court of law or the GMC as to why they offer surgery and carefully consider the risks. In cases of trauma most women will get their request but only after considered discussion

On the flip side if you asked for a section and you ended up like Ali above the doctors would also have to explain why they denied you one

On the plus side - far less risk ( elc) - far more managed risk that there is - in a theatre under managed conditions!

In cases of trauma most women will get their request but only after considered discussion.

^

It depends who you see op. i would say you need ot get into the mindset its your body if you do the research look at the facts - speak to people about their experiences etc..and you decide you want one, who on this earth has the right to stop you - its your body for goodness sake.

I was asked if I would like a quick chat with a senior MW just in case, I didnt have too and I didnt really want too but they went through by birth notes which I did want. The chat I had with senior MW was not considered at all.

It was all about my great first birth and all the physical aspects of it - whereas the consultant listening to me all round - physical and emotional etc.

Yanbu at all
However having a planned section doesn't mean you won't have any internals throughout your pregnancy.. I had to have a few and one actually detected strep b which was potentially life saving.

I had ptsd from my first birth experience and knew I was running out of time to deal with it before dd2 arrived. So my consultant referred me for urgent assessment and counselling. I had 3 intense sessions before the birth and some aftercare and they were pretty amazing. You may want to ask for something similar because the chances of you needing an internal at some stage, c section or not are pretty high.
Good luck and well done you in being so proactive about dealing with it x