To expect everything to be considered equally by my midwife and doctors?

[FrostyPopThePenguinLord]

Apologies for the long post, I'm stuck at home bored with too much time on my hands!

I'm having my first official midwife appointment on Friday, I say official because it's been a mission just getting to 9 weeks, I've been under the care of EPAC unit since week 4 due to various bleeds and extreme extreme stomach cramps and huge amounts of vomiting. I've been signed off work till the end of the first trimester as my doctor does not think it's worth the stress to my body as the smells trigger the excessive vomiting and I'm in enough pain without adding more vomiting.

It's my third pregnancy this year, I've had an ectopic and miscarriage so far so as you can imagine I'm a bit on edge.
I've been looking into it for a while and I'm fairly certain I want a C section, for anxiety reasons amongst other things. I've looked it up and apparently I can have one at maternal request, I just have to show I understand the risks etc.

I'm concerned however by a number of things I have seen that make me think I won't be taken seriously, numerous stories of midwives being offended and not referring you or waiting until you have no choice but to give birth vaginally.

The pregnancy pack I got given has a bunch of little leaflets in it on various things, there is nothing about Csection, not even as an emergency but there is a lovely colourful one advocating home birth, as in it's all positive....none of the bad things that can happen are put on there, it just makes it sound like it's the best thing ever (I'm sure for most it is, but I want allllllll the medical attention I can get!)

This worries me as it makes me feel like I'm going to be pressured into having a paddling pool in my front room with someone telling me to imagine my cervix opening like a rose or some bullshit like that.

Each to their own, I do not judge anyone for their choices, but I know very clearly what I want and I am prepared to be educated by midwives as to the benefits and other issues concerning other modes of birth. However I'm very concerned that it will be presented to me very differently than an educational information session, rather natural/home birth propaganda.

Im having enough trouble relaxing in this pregnancy with my various issues without feeling like I can't count on the medical professionals who are supposed to support me.
My husband thinks I'm being crazy and I just need to stand my ground but I can't do 30 weeks of stress, it's going to send me insane.
I'm sure my midwife will be incredible, but I've heard so many horror stories I have to ask.

Does anyone have any advice about having to deal with this?
AIBU to want my very carefully reasoned and researched birth choices taken as seriously as any other maternal choice?
I just don't want to get irritated or anxious and then come across as someone who is not sensible enough to be taken seriously.

Write down some examples of the more "bonkers" thoughts to share. They might think you're a bit worried. First time mum to be. It's clearly not just that.

My husband is incredible, he is utterly bewildered by most of pregnancy and the symptoms, but we have discussed it so he knows the implications concerning care of me and baby and recovery and has my back 100%.
In his words, he doesn't give a shit what happens as long as I'm happy and healthy and he supports whatever I want as I have to go through it physically, he is there for me no matter what.

Fantastic. His support will make such a difference. Through pg, delivery and the early years.

Please do tell the midwife about the anxiety at your booking in appt. I had anxiety and depression during my last pregnancy, I'd had a recent MC and was suffering severe HG. I was so pre-occupied with my awful physical health that I ignored the fact that my mental health was deteriorating. I ended up with very bad PND and on medication and poorly for over a year after the birth. I think if I had reached out for support sooner it might not have escalated to that point. I hope you are able to get some help and support early on in your pregnancy.

In fairness contacting the hospital about their policy on c-sections before TTCing is fairly unusual.

Seems sensible if you know you have an issue. One of the reasons I've not had a second DC is that I have been categorically told on three occasions that I cannot choose to have a cesarian rather than be induced if that were necessary again.

Unfortunately, in my experience, you're right to anticipate resistance from midwives/doctors.

I had an elective cesarean on maternal request and found the best source of balanced information to be the Royal College of Obstetricians and Gynaecologists (RCOG) website. I would highly recommend reading their information sheets on c-sections so you can ask informed questions and ultimately make the decision that's best for you.

I asked the medical staff I saw to go through the risks and benefits of vaginal delivery versus c-section. Unfortunately I was only told the benefits of vaginal delivery and only the risks of c-sections. It meant I didn't trust their opinion as it was totally unbalanced. I knew I was entitled to one as per NICE guidelines so I trusted my instincts and had a wonderful experience. My baby was delivered safely and I recovered well (far quicker than I'd imagined - was back driving 3 weeks PP).

Good luck OP and congratulations on your pregnancy 

It's tough OP.

With my 1st pregnancy I was under Consultant Care due to me having two health conditions. At 20 weeks gestation my Obstetrician spoke about labour and she thought it best that I had a c/s. She did discuss other options with me but felt c/s was the best thing for me and so it was agreed. A few weeks after that I had to see a cardiologist and she didn't beat around the bush when it came to disagreeing with me having a c/s. There were about 4 members of staff in the room and in front of them all she really belittled me, I left my appointment quite upset. She even then wrote a letter to my original Consultant to say she thought me having a c/s was unnecessary. A week before my c/s I had my pre-op with the anaesthetist and he too started being very questioning about why I was having the c/s and being quite patronising. I was glad DH was with me for moral support otherwise I think I would have left that appointment upset too.

Im now pregnant with number two and when I had an appointment a few months ago with the Consultant she made reference to my previous c/s and I said I would be wanting the same this time round. She completely dismissed me and said, "There's no need, I'm pretty sure we'll take such good care of you this time round that you can do it vaginally." I told her that my previous section was nothing to do with me being "taken care of" and was because I had two health conditions and that seeing as I still have these conditions then I will be wanting a c/s this time too. I was quite firm but I was just so pissed off about how she'd spoken to me and totally ignored my wishes.

I've got my pre-op appointment with the anaesthetist in two weeks and I'm expecting to have to defend myself again....

It's really, really crap when you're made to feel that having a c/s is some kind of inconvenience to them or that we are being hysterical/crazy/wimpish for requesting one, even when we have genuine reasons for it.

Make your feelings known to the professionals but be prepared for them to try and talk you out of it. Stand your ground!

I chose to have an ELCS and it was great and my recovery wasn't too bad either, in fact I ditched the pain meds a day or two after I got home as I didn't really need them.

I spoke to my midwife who explained it's not up to her and she will refer me to a consultant. 1st consultant was an absolute bitch who basically told me I shouldn't have got pregnant if I didn't want a VB.

Second consultant said it's not what he'd recommend, but ultimately it's my choice.

I never regretted it a second and it was certainly the best option for me.

Hope you start feeling better soon OP.

I think your feelings of anxiety are at a level that they're affecting you and so support is good. I also think it's completely understandable.

If it helps at all whilst you're waiting for your appointment, here's what happened at mine. I am now 17 weeks, I am classed as a low risk pregnancy. My first, I'm 37. I know that I'm classed as low risk because we did a big questionnaire at the booking in that helps to identify what kind of care I needed. This is where you'd talk about anxiety and strong wishes re birth. Writing some of the thoughts that make you go hmmm might help.

Here is what we discussed re birth options: I had to pick which hospital maternity team I would be under care of (there's two in our city). The midwife explained that I don't have to make any choices right now. She signposted where I might find further information and asked if I'd considered home birth. I was surprised as I thought being first time and older I'd be ruled out. She explained that I was considered low risk, which is why she'd highlighted as an option. If I'd been under consultant led care it prob wouldn't have been flagged to me. Literally all she said was 'have you considered'. No pressure at all, more giving me my options.

You also get a folder. In it there's a timeline of appointments and what each appointment involves. That might be helpful.

Also if it helps, my sister is a surgeon (not obstetrics though!) and she's super relaxed about medical intervention for her. She's always said if she has kids she wants an elective caesarean. She's half joking but I'm pretty sure she'd fight her corner for it. So I get your choice :)

Totally ignoring the CS stuff as I don't k ow much but you said you've been really sick; have you been diagnosed with Hyperemesis or is the sickness linked with the bleeds? Because if it's Hyperemesis then I'm on the thread there and there's a few women who've chosen CS so they might be able to also talk with you about it. And a fair few have had miscarriages this year as well so in the same boat as you.

Sadly though, the hospitals I'm with are both absolute gems and I was asked in my booking appointment if I'd thought about what I'd want for the birth. I said no but I already knew that I'd probably go for a natural birth/epidural as opposed to an ELCS. But then I also know that if there's complications then both hospitals will be fully aware.

Hope you get the birth you want.

Not official hyperemis, just severely severely triggered by smell, the thought of a smell etc, at home safe with no trigger smells not a problem, at work surrounded with them (think raw meat) vomiting every 10 to 30 mins for a 10 hour shift and there is no escape. That's why my doctor signed me off I was heaving so much it was making my already excruciating abdominal cramps worse.

The drill is, I get a abdominal pain flare, I wait to see if it goes away, if it doesn't after 15 mins I take a paracetamol, after 20/30mins if it's not getting better or is getting worse I have codine prescribed, if worse after that I have to go to hospital for anti sickness and diamorphine as we are now in the uncontrollable puking and screaming section of the experience.

But I've only gotten that bad twice and I spent a week in hospital.
No obvious reason for the pain all my organs etc look normal, no digestive issues, bloods look good, baby seems fine.

They acknowledge my anxiety is not helping the pain flares, obviously the more pain I'm in the worse the anxiety gets, vicious cycle really, but I've done all the self help bollocks stuff, meditation playlist, breathing patterns, visualisation...probably doesn't help that I think it's all crap, so no placebo effect for me, but I am trying!
I have soothing ocean sounds playing now but it just makes me want to wee 😂

That does sound quite a lot like how I experienced hyperemesis... I agree with pp about speaking to your midwife about your anxiety, I would ask for referral to the mental health consultant (there will be one, I was technically under one even though I still had midwife led care for the most part). I would also recommend that you see you GP with regards to the anxiety - that is also what I did, and I was put on medication which did help immensely. That's not to say that's the best route for you, but remember that it is a risk vs benefit question and if the benefit will outweigh the cost then it might be best.

Finally for the nausea, be sure to push for medication if you need it and want it - ondansetron is marvellous, it's a newer drug so Drs seem to be more nervous to prescribe it, I was only given it once I was hospitalised. Keep going back to try different combos, for me I took two different kinds and alternated them on a strict schedule so I never had more than a few hours without a dose. Getting on top of any sickness is key.

Hugs xxxxx