I really really REALLY don't want a c-section

[SaffronSands]

More of an AIB unrealistic as opposed to AIB unreasonable.

I'm pregnant with my first. Pregnancy hasn't gone the way I wanted it to (of course we all want it to go smoothly, so far it has been far less than smooth and very, very scary).

I am desperate to have a natural birth. Absolutely do not want a section (unless of course I have to for the safety of the baby). I hear that things such as epidural and the type of hospital you birth in can make a difference. I can't give birth in midwife led unit sadly but still have time to choose a different hospital.

Both times I've had a local I've been quite sick afterwards. The idea of surgery of course is not one I enjoy, as I have quite a fear of it and had a bad experience with a complicated appendectomy when I was younger.

So whilst I know that a section may be necessary for safety reasons, is there anything I can do to to reduce my chances of needing one?

Never done this before or felt so out of control in my life.

Also I should've read your post properly op sorry.You may not actually need one and you were asking how to avoid it. Obviously I didn't answer your question .

When I was pregnant I came at it from the opposite angle I desperately wanted a Caesarean for medical reasons so I did quite a lot of research. From what I gathered you have a higher chance of interventions such as forceps, ventouse and emergency section if you have an epidural, and if you are induced, or if you labour on your back. The lowest chance of interventions is when you are having a spontaneous active labour but of course it can still happen. What I would suggest you do is read up thoroughly on the risks and benefits of all the different types of interventions and decide what risks you are happy to take on. For example I was adamant that I did not want forceps because of the risk of injury to myself and the baby. Once in labour your birth plan may well change and it would be a good idea to be fully informed of your rights and what you would like to happen in certain circumstances so that as far as possible the staff can follow your wishes. I would also suggest that you have somebody with you that you can trust advocate on your behalf who is not afraid to stand up to the medical staff if necessary. If you are being advised to have a Cesarean then you should strongly consider why that is and if the medical staff might have a point.. I ended up with an emergency section under general anaesthetic and I wouldn't wish my experience on anyone. You might find it a struggle to get the staff to discuss all of your options with you clearly and without bias towards one or the other so that is why you should do your own research.

I'd never had any surgery before my pregnancy and was adamant I would have a natural birth.

After 24 hours in labour, yes I cried when they said I needed a CS, but the midwife was very reassuring and all went well.

I then had a planned CS with DD2 and it was amazingly easy.

I honestly would not worry, try to think about the baby being in your arms rather than how it's going to get there. Also millions of women have had CSections! They are a very safe way to deliver a baby.

Jaffa "All the natural birth stuff left me with was a deep sense of failure"-

Sadly, reading MN, I think that's very common.

I went into labour just wanting DS and me to emerge alive, healthy and with only one of us with tears (of both varieties!) , but I feel I was strongly guided by my antenatal class to go Natural All The Way as It's Best For Baby.

In retrospect, I wish I'd considered a planned section; but then, I know it wouldn't've changed my relationship with either DS; my love for neither was a tsunami of love. It took a few days to come, like it does for many (despite their natural births!). It's just like many things, you aren't allowed to admit it as it makes you a bad mummy.

No it doesn't.

Two c sections here . Two beautiful DC

Means to an end; so as long as they’re here safely and I say that as an anxious person.

Good luck

One thing I would add is don't listen to any horror stories. I was really frightened about giving birth I'd heard such horrendous things about it. I remember saying afterwards that it was so much better than I expected.

Yes that's so true.
I have been researching calming techniques a lot more and trying to find some music that keeps me calm - I really can't think of much else to do, it's basically in the hands of the professionals.

OP there is a thread in the ask me anything section from gynae

• www.mumsnet.com/Talk/AMA/3303150-I-m-a-consultant-gynaecologist-AMA

What she says about sections is interesting. In general at a population level they are safer for the baby, but more risky for the mother than a vaginal delivery.

Anyway no-one knows how your body will react going into labour and your consultant will calculate the risks to you based on your medical history.

I'm sure, statistically speaking, which hospital you give birth at could make a difference, but there is no way to show that for definite. It could be that there is a culture at a particular hospital of moving towards c-section more quickly, and a more 'wait and see' culture at another. Or, alternatively, it could be that the demographic served by that hospital - for whatever reason - is more or less resistant to birth interventions as a whole.

I think staying at home as long as possible does make a difference, though. I went to 6/7cm dilated at home over three days and was still 12 hours off giving birth when I was admitted. If I had gone in 12 hours earlier, I believe I would have been offered/recommended a section, because they have targets for these things.

I was also desperate not to have a c-section. My pregnancies were ok but short - only made it 32 weeks the first time, 36-37 weeks the other two times. The first time the hospital was very keen to do a c-section because the baby was premature but I insisted I didn't want one, and in the end I had him normally and it was fine. It's important to heed advice, but also remember that you have rights as a patient, and the decision is not always a black-and-white one. The agreement I had with the hospital the first time was that the moment there was any danger they would do an emergency c-section, and I signed all the forms before labour had got too far progressed so that we wouldn't lose time if things went awry. They didn't - baby was born after about 8 hours, no epidural or pain relief of any kind, it was actually very straightforward and better for both of us than a c-section would have been. I would try and keep positive - you never know what will happen in the end, and it's good to be aware that there are situations where a c-section would be the right thing, but also you are allowed to state your preference and aim for a natural birth and you don't have to be defensive about it.
Good luck! I hope it all goes well whatever happens.

No op there’s nothing you can do. It’s the one time when really your body is in control and your brain isn’t.

It’s more about the babies position so if the head is down and the baby is anterior there’s a better chance of a vagina birth but if baby back to back it’s tougher to deliver.

With me dc1 was back to back so needed forceps( should have had s c section really)
Dc2 favtsdtic had worse period pains

Dc3/4 typical vagina births long but ok.

Dc5/6 twins so c section.

Honestly go with the flow. It really matterers very little how your baby comes it’s the relationship you have and trust in the birthing team that matters.

Midwife led units are no different to general hospitals really it’s all about your trust in the staff.

Yes having an epidural, they type of hospital etc can affect your labour for a multitude of reasons.
However birth is very unpredictable situation and there is no point pinning all your hopes one type of birth.

I recommend you read the positive birth book, and maybe attend a Hypnobirthing course.... but find one that isn't purely about natural birth... there are some out there! So do your research.

There are things you can do but ultimately you need to understand and come to terms with whatever outcome. The last thing you want is to feel a failure because you had a c section! Trust me, I've been there!

X

Oh and if you are attending NCT classes do remember perspective! Not everyone opens their vagina and gives both joyfully or indeed breastfeeds until school days

Don’t get caught up in this bollocks too much

I think maybe you would do well speaking to a doula? Perhaps one to attend the labour with you? They can fight your corner for you and try to steer back to the birth plan you wanted while possible. Obviously with the best will in the world some labours will go in directions you didn’t foresee and you need to be open to all eventualities but I don’t think going in with a stated aim of a natural birth is unrealistic.

I wonder if there is a correlation between some of the factors you mentioned and more complex/difficult labours that are more likely to lead to a C-section. This may make some people see them as risk factors for a C-section when actually both things are caused by another factor e.g. A pregnancy complication.

I hope you're able to get some reassurance from your midwife.

In your position i’d look into hypnobirthing, classes if you can afford it but CDs if not - not because it will make vaginal birth more likely, but because the techniques can be used regardless of how the birth progresses and may help you be calmer throughout.

OP,

@MyOtherProfile makes a really good point. The things you mentioned affect the c-section RATE of a hospital, not how likely you are to have a c-section. For example, on paper, some hospitals have a lower rate of c-sections. But this is probably for very specific reasons; like MyotherProfile says, the hospital she mentions does more c-sections but that’s because they’re a teaching hospital. Your chance of getting a c-section isn’t less on a midwife led unit - you are probably sent to a midwife-led unit IF the chance of you needing a c-section is less already, iyswim. If you have a complicated case, you will probably be kept out of a midwife-led unit.

Don’t be afraid of a hospital that has a high c-section rate on paper. This just means, usually, that they handle more emergency cases and may be the exact people you’d want if you end up needing a section.

As many posters have said, some recovered faster from a section than a natural birth. Some overcame the specific things about a section that were causing them anxiety. I would definitely recommend talking to either your midwife or even a mental health professional about the specific things about a c-section that concern you (as one person has already said, you were concerned about local anesthetic and they don’t use local anesthetic for c-sections, but either a spinal block or general anesthetic) and how to handle each of them before you go in for your birthing experience so you’re prepared for whatever comes along.

Good luck and I know anxiety can be so, so awful, so have some and I hope it all turns out how you want!

I don’t think there is anything you can do to reduce the chances. I did NCT and set my heart on a water birth with minimal pain relief for my first. Had complications during labour and an emergency section. It was 100% the best decision, my baby was presenting wrongly, had the cord round her three times (we didn’t know that then), there was meconium and her heart rate was indicating signs of distress. All the whale music, active movement during labour, candles, aeromathetapy and hypnobirthing techniques in the world wouldn’t have changed that, it was always going to be an EMCS for me. I think the best advice is to research all the options so you can go with the flow at the time. Keeping an open mind is essential I think.

@bluetears - my understanding is you can request a c section and as per the nice guidelines, if your consultant doesn’t agree, they should refer you to a one that does. Have you demanded this?

Op I’m pregnant second time and desperately want a c section because the risks of elective seem to be much preferable me than a repeat of my horrible first birth and injuries. Everyone I know who’s had a c section has recovered just fine, wish I could say the same about vaginal births.

I felt exactly the same as you OP during my pregnancy. I was DESPERATE to avoid a section and I spent a fortune on hypnobirthing lessons, spent weeks bouncing on my exercise ball, drank gallons of raspberry leaf tea, stayed at home for longer than I could manage because I was convinced from my NCT classes that the longer I stayed at home the more likely I would be to birth 'naturally'. I arrived at hospital after my waters broke looking forward to getting into a lovely birthing pool to be rushed immediately to the delivery suite and hooked up to a monitor and induction hormone drip because DS had pooed and my waters were full of meconium. I was gutted and felt like i had failed (stupidly) - but after 24 hours he was in danger so I was rushed to theatre. I couldn't have cared less I just wanted him safe and I recovered fully within a week.

You might have the exact birth that you want, but you might not. And as long as your baby arrives safely and you're safe it really doesn't matter. If I have another I'll be electing for a section if they'll let me. And I would have never ever ever envisaged myself saying that a year ago. Good luck for the rest of your pregnancy x

Speak to your midwife openly about your anxiety. I didn't. I was lucky - first labour my midwife on the labour ward was lovely, listened to my concerns about heavy bleeding, was so reassuring when I had to go to theatre for suturing with a severe tear (even explained to the surgeon why I kept my hands over my eyes the whole time), she was just amazing and completely understood my anxieties and was very calm and reassuring and put me completely at ease.

My second labour was pretty much the same, but the midwife was awful...made out I was a complete fruit loop, was nasty too me when I expressed concern about the level of bleeding post birth (something along the lines of "god help you when you hit the menopause if you can't cope with this level of bleeding!"), dismissive of my concerns that I felt ill and put it down to me being too anxious (I actually had a massive internal infection which was causing heavy bleeding and flu like symptoms), and requested the mental health team assess me on the ward before I was allowed home (they were lovely and weren't concerned at all). I wish for my second birth that my notes had reflected that I do suffer from anxiety, but nothing extreme and that it's manageable, but noted my specific fears, then perhaps the awful midwife I encountered may have been more understanding (then again maybe it wasn't in her nature, who knows!)

My pregnancies were 'normal', my labours were protracted but 'normal (14 hours and 18 hours); but, 20 years later , I pee when I sneeze.

I've only ever had c sections. I pee when I sneeze. Pregnancy itself can be enough to ruin your pelvic floor.

I started off with home birth and ended up with c- section, first child. It was a positive experience! I strongly recommend getting resolved to not getting attached to a particular way the labour will go. That’s what I think helped me have the most positive experience within my personal context. The care helped as well. I did if, then planning rather than a birth plan. When it came to it, we had an undiagnosed breech discovered at 9cm dilation. I was already in hospital by that point due to meconium. For me, I really really didn’t want an instrumented delivery. I felt that was more likely to lead to injury for me an baby as we were both tiring. My sister, who’s a surgeon though not obstetrics said if they offer a c-section, take it. C-section was great, I have a massive grin on my face in post birth photos and that has a lot to do with an epidural after I got to 9cm on a tens machine ;)

SaffronSands - I’ve given birth both ways and had my VBAC 3 weeks ago so the memory is very very fresh.

So ‘regular birth’ is fucking painful (or mine was). I begged for the epidural and I’m someone with a fairly high pain threshold but as my labour was so quick (within 3 hours start to finish) I was too far gone by the time I wanted it. It hurt like a bitch. I called the midwife every curse word under the sun. But I did get to have a regular dinner and stand and walk out of the delivery suite which was nice!

Csection - the birth was the easy bit! Spinal anesthesia, no problems breastfeeding however the recovery was so long! I felt way more delicate and had to watch what I was doing for much longer than my VBAC looking back at it.

You are not being unreasonable. I am personally only going to be having planned c sections because that is MY preference and it is OK for you to have yours too.