Midwife Consultant bully!

[libertysilk]

Expecting my third child, and, as I'm 45, am monitored quite a lot. I have 3 weeks to go. I've had a complication free pregnancy. Scans and tests all normal and within expected parameters.
Due to my age, I've been refused the option of giving birth in my local birth centre as its not attached to a maternity ward. I challenged this, and was booked an appointment with a midwife consultant.
She wants me to be induced at 38 weeks, due to statistics of women my age having problems. She keeps saying I'll haemorrhage or have a still born. In a meeting on Wednesday she took my hand in hers, and placed it on her stomach. Said she wants the best for me and wished me well.
My midwife has ok'd me for a home birth, and disagrees with the consultant.
I feel I'm being scare mongered, and bullied.
I'm part of a group run by a midwife and doula with 38 years experience between them. They support me along with my midwife, and say I am healthy and fit and perfectly able to have baby at home. They've said the midwife consultant is behaving professionally and is bullying me, and I should report her.
I'm in two minds.
I'm not naive, and will not put my baby at risk, but, this is putting huge stress on my pregnancy, including confusing and upsetting the father too.
AIBU to be upset?

I had a lovely home birth with 2nd baby and wanted one for 3rd baby. I'm not very big and have big babies (10lb plus) and I was strongly advised to have a hospital birth. My DH was keen for me to have a hospital birth as although I enjoyed the home birth I did come close to an emergency transfer to hospital when baby got stuck.

Baby number 3 was a very emergency c section. It was all alarms going and when doctor arrived they just grabbed the bed and ran, no time to say goodbye to husband who was just left standing there, no time for epidural. She had inhaled meconium and was distressed, I was very relieved I was in a safe place with all the medical staff and equipment.

I understand how you feel, you probably have a good chance of things going well but you can't guarantee it.

Good luck with the decision.

couldnt
As I said, having a section would not have altered the outcome for the better.

You could op, stay at home for as long as possible, or plan for a home birth with the proviso that you will go into hospital at some point in labour.

Lots of experts here who agree with providing informed choice, after which the OP can make said informed choice?

In the original OP, the midwife consultant spoke of there being statistically higher risks for a 45 year old mother. How was this broken down - was the OPs risk profile being assessed or was the medic talking about the average 45 year old?
In providing informed choice, did the medic state the statistics for a women of the OPs weight, blood pressure, GTT status, previous births/pregnancies - or just talk about the average 45 year old compared to the average x year old.
Was there a specific discussion on the risks for someone with your medical profile birthing at home, at the MLU or hospital.
Was there a specific discussion about the risks at 38, 40, 42 weeks for someone like you?

Hopefully many more things were discussed too - it's not informed choice if all you're told is that you should do x or your baby will die. No course of action is risk free but a relaxed calm mum who feels that she has some control, will have a better birth experience.

Good luck!

Why is no one discussing an elective c-section? I had my 2 at 37 and 39. The first was 40 hours of labor followed by an emergency cs and the second was a VBAC followed by a postpartum haemorrhage. My baby almost died the first time and I almost died the second time. It took me years to recover physically from the two labor/deliveries and even longer than that to recover emotionally from the trauma. Our bodies were designed to have babies at 13, not 39 and if I had it to do all over again I would have an elective cs with both. I would have been physically and mentally in much better shape and at least with my first, he would have been physically in better shape.

Hmm. I had a section and it left me with PTSD.
The after effects were long ranging.

@Headofthehive55
think it depends on your attitude to risk. Certainly with one of mine I was prepared to have a stillbirth to avoid a c section. Each to their own I think.

No this is what you said. You implied you'd rather have a stillbirth than a caesarean section.
Attitude to risk and all that crap, has absolutely no place or logic when discussing something as devastating as the loss of a baby.
If you know better than medical experts, then good for you.
You either have a stillbirth or you don't. Until you do, you will never understand how utterly shite your reasoning is.

@Headofthehive55
I've just seen your other post.
My twins were also just below the viability age and a caesarean actually would've given them a better chance as it's often the trauma of labour that causes them to die.
It also depends on how long the steroid injections have to work on the lungs.
So your probability of risk/reasoning isn't the same as mine.
That's why informed choice and professional advice for each individual is paramount.

And informed reasoning depends on the medical professional you speak to.
that was not the opinion of our neonatal unit.

Congratulations OP. I hope everything goes smoothly.

What an ugly attitude headofthehive

I can’t believe the head of your NICU made that comment; as far as I am aware the trauma of labour is more damaging for extreme premies than the effects of a c-section.

OP, only you can make this decision. Anecdotal stories of difficult hospital births or easy home births are meaningless to your personal decision.

It might be a good idea to speak to another medical professional within your hospital team. Do your research and make a decision based on your assessment of the risk involved.

Even though your pregnancy is progressing well at this point, it’s the final few weeks that have the real bearing on the functioning of the placenta.

Hmm. I had a section and it left me with PTSD.
The after effects were long ranging.

Hmm, I had a vaginal birth and it left me with PTSD and long ranging after effects. Physical and mental. My section, in contrast, was a hugely positive experience.

But then neither of these anecdotes are, in themselves, helpful to anyone else. Because women get PTSD following vaginal births and sections.

Anyways OP, good luck. Sounds like you've worked out a solution that will suit you with the hospital MLU choice. Fingers crossed all is straightforward and baby is born there! I am thinking cervix ripening thoughts.

penggwn
Thank you.
I believe that everyone has the right to body autonomy, and to make decisions regarding care as they see fit.
That includes a woman's right to choose whether she continues with the pregnancy or not.
If a woman wanted a section or home birth then I would fight for her to get it.

There is risk in hospitals, not just intrinsically from the procedure but often from unintentional consequences. So I don't think we should look at that as a risk free option.

I'm interested to know why people, who have been quite unkind I think would have preferred me to have a section for what was at the time an unviable baby. Ironically I was probably more at risk, due to the heavy bleeding I was sustaining, by not having a section.

IT is fairly normal for consultants to have very different opinions.

headoffive I think the phrasing of your first post might be the reason you are getting flack.

You did not make it clear that the pregnancy was not viable, and I thought that you meant you would not have a c.section under any circumstances, even if it would have improved the outcome, as you did not want to limit your ability to have future vbacs.

Your later posts make it clear that the pregnancy was not viable, so in these circumstances refusing a c section is a very understandable decision.

^^ what bellende said

Headofthehive, you would have received very different responses if you had said in your earlier post that you were talking about a non viable baby, rather than a full-term healthy baby, which the OP is discussing. Two entirely different scenarios. Your first post came across as flippant.

I think that, in light of your subsequent post, of course you absolutely did the right thing. You weren't simply avoiding a c-section to the detriment of a viable healthy baby. You were avoiding a major operation as it was highly unlikely you would get a good outcome. That's completely understandable.

I agree with bellende.

But it's reasonable to deter intervention such asa c section to protect the chance of having a healthy baby - and mother at a future point.
It's one of the reasons staff try to persuade women to have VBAcs, or not have elective sections in the first place, if it can ve avoided.
The issue of risk, I am arguing, and others have certainly done similar (WHO in particular) should be looked at within the context of your childbirth career not just in isolation.

C sections load risk onto future children.

What are the risks Head? Have you any statistics?

It’s true. If you have a lscs you increase your risk of uterine rupture, placenta accreta, placenta percreta in future pregnancies.

So if a 45 yo having her first baby requested a lscs I think most consultants would say yes, fine. Whereas if a 20 yo having her first baby requested a lscs they’d be more likely to try and talk her into having a vaginal birth.

Personally knowing three people who've had stillborn babies, I'd just follow any advice to get babies out as safely as possible