Refuse C-section at 34weeks and revoke my consent to a sterilisation

[Twigsnroses]

Hi everyone

im currently 30+0 and today my consultant said she would schedule my delivery for 1st March. I’ll be 34+2. I am so scared of having a being unwell when I’ll be poorly too. The consultant repeatedly said baby while be fine, will be in special care 1 or 2 days. But this isn’t always the case obviously.

I have complete placenta previa and placenta accreta with possible bowel interference. So 34 weeks is for my benefit.
50% chance of hysterectomy, bladder repair, catheter in for 2 weeks, stents in urether, a sterilisation in the event that I keep my uterus, haemorrhage.
The section will be under GA due to all the work they need to do. So baby will come out poorly in terms of breathing anyway due to GA.

In the appointment today I didn’t object to the day even though I really would like to go to 35+2 which is just the following week. I did not object to a sterilisation if i was to keep my uterus even my partner would get a vasectomy or would be sure to not fall pregnant again. i even signed a consent form. Now I feel so stupid for just saying yes to these things.

Would it be silly to phone to question these again, revoke my consent for a sterilisation? And explore moving C-section to allow baby to bake more?
The consultant did mention that the entire team availability is also important, but i just feel that the outcome for me is grim and same anyway so I’d rather have her stay in longer.

im also shocked and disappointed at myself that i just nodded to everything. Absolutely everything.

Just a hand hold. My baby was delivered by c section at 33+2 (severe pre-eclampsia). It sounds very early but it's actually pretty "good" from a NICU point of view. My preemie was in an incubator for a couple of days but after that only had to be in the NICU in order to grow a bit, and is absolutely fine now (in fact very tall for his age!). It's horrible when pregnancy doesn't go as planned, but hang in there. NICU nurses are AMAZING and your baby will have all the support they need. Also, NICU babies stay tiny for a few weeks (they are still newborns at their due date!) so you will have loads of time with your lovely newborn.

Hi OP, I had ECS at 34+6. He was delivered fine weighing 5.10 and went straight into special care. He was given steroids for his lungs. He was tubed for 3 days. We had no further complications. Now he is 22 and in the armed forces. It was incredibly scary but I’m sure bedside manner, care, treatment has massively improved over the last 22 years. Ask further questions but remember you are not unique they see this all the time. I wouldn’t agree to a sterilisation at the same time personally. I think you have enough on your plate already. Get baby delivered, yourself back to full health then think about the sterilisation. Good luck.

Don't know much about hospitals in South London but I'm sure you have a good surgeon. I was under Pat O'Brien after transferring from a different hospital and I was really happy with him.
It's very important for it to be planned so that they can have the best team available.
It's very scary.

From what you have written it sounds like you are extremely high risk. The consultant will want to do the section whilst everything is stable. If they wait there’s a chance that something could happen which could result in an emergency operation and that could be much riskier than a planned one.

I totally get you. In real life I am a very confident, opinionated person in real life. I did all the positive birthing stuff about speaking up and advocating. Id done my research and knew what I wanted.

Then I had to come in close to the due date and a man in a white coat just started talking confidently about induction. I didn't want it but I nodded along because we are so conditioned to be good and they know best and if you stray off the path youre risking your baby.

To be clear, this doctor was not trying to steamroller me, he was lovely, just going by the book. I just went silent, it really shocked me and I was so cross at myself.

Luckily I had someone with me who interjected and put things on the right course. I allowed myself to be swept along and it was nothing like the decision youre facing so do not in anyway be upset you didnt speak up in your meeting.

Without a shadow of a doubt call back and discuss it further. You may stick with the decision, tweak it, change it entirely or ask for monitoring to make a more informed decision.

Youve got this.

OP, as a professional who works in maternity care, please just go with the plan that has been put in place. This is going to be a high-risk birth, even when done as a planned procedure with the whole team present. Postponing it just increases the chance of you going into labour or having a bleed which could happen out of hours. Your health and life could be at risk if that happens. I understand your concerns about your baby but the situation is what it is and this is standard management of a major placenta praevia.

I think the big thing is your understanding. At the moment you're not confident that this is the best option. Bring somebody with you the next time- the chances are the plan will stay exactly as it i because theres a reason behind it but you'll understand why it's the best course of action and accept that. If you're worried it's being scheduled early because of the teams availability they'll be able to calm your fears. That's not to facilitate days off and rotas etc. That's to ensure yours and your babies best outcome.

My sister has just experienced this.... they do not deliver babies early unless there is massive risk of fatality for one or both of you. Unfortunately for her she went into labour..... it has been an awful time and she is so lucky to be alive but because it was a spontaneous labour the hospital did their best but it's had massive consequences for my nephew. My brother is so hurt and angry that she decided to go against the consultants advice. It looks like my nephew may have lifelong disabilities now. I'm by no means here to scaremonger you but it's such a sad time for all of our family x

Good luck xx

I think they are absolutely doing what they think is the right thing to do understand the circumstances and while 34 weeks is early, it's not ridiculously early.

The fact he mentioned entire team availability means that are trying to ensure you have every possible resource available to you to ensure the risknis as controlled as possible.

I wouldn't be gambling for the sake of 1 week.

That said, there's a hell of a lot in that consent form and it's probably a lot to digest in one go.

I think you should draw up a list of questions and discuss it more to ensure you get as comfortable with it as you possibly can. Write them down. Have a very calm rational person with you. The more you know when ut comes to any decision.

Very best of luck whatever you decide.

They don’t deliver babies this early unless there is a huge risk to life!

id think vey carefully before trying to go an extra week, the consultant knows what they are doing.

I personally wouldn’t want to chance it because the end result could be bad.

@Twigsnroses bit like a horse has kicked you in the arse but yes worth it!

I had placenta previa and placenta percreta with DC2. I felt really pushed into early CS. It cost money but I paid for an independent midwife to come to all my appointments and monitor my pregnancy. With her advocating for me and monitoring I was able to push the planned CS forward, but also felt more in control of the process. Baby was absolutely fine, I had a partial hysterectomy, bladder had some minor damage which was resolved.

The steroids are a bit stingy but nothing too awful. Coming from someone who has had two high risk pregnancies and premature deliveries they do do everything they can to keep them in every single day extra, even hours, my son was in distress but they anted my steroids to have been in 12 hours so we’re fully scrubbed watching the ctg and the second we got to 12 hours raced to theatre. So I would say they possibly are pushing this to the max, but no harm in asking what would be the risks of leaving it an extra week.

It’s so hard in situations like this when you’re on your own and you shouldn’t feel bad! On the occasions my partner couldn’t come with me (had a few consultant appointments) I ended up briefing my mom with what I needed to ask and taking her so she could prompt me to ask what I needed to as it’s very overwhelming! It’s your body and you have input on what happens to it- as above posters have said definitely ask about pros and cons of waiting a little longer. Hope it all goes well and you get the outcome you want! Pregnancy is scary as it is without all ten additional stress you are experiencing, be kind to yourself. X

Just to raise another point. Even if you were to be admitted for another week so they could monitor you closely if you were to suddenly start bleeding they may not be able to assemble the best team.

I’d say I agree to going with what they suggest but obviously only if that is the best course of action. Unfortunately you do hear stories where one doctor’s opinion will have differed from another though so it’s right to question it and do some research on your own when it’s such a final decision on sterilisation and obviously a massive decision in terms of when the baby is born.

In my experience they do tend to leave the baby in there as late as possible if they physically can though so it does sound like they’re concerned when they’ve moved it forward by as much. Still question it though and get a second opinion if you feel you need one.

In my last csection (second baby luckily) I found out I had a uterine window so baby was extremely close to rupturing my uterus. I think the odds of survival for either of us are pretty poor unless it happens when you’re literally already in hospital.

They told me while I was on the table but thankfully they didn’t ask about sterilisation there and then, I’m not sure what I would have said! I’ve since read so many stories though of people who were offered it/told to do it and went ahead with the sterilisation because of risk of rupture in a future pregnancy. One study I read showed very low/if any risk of a uterine window leading to a rupture in a future pregnancy. So lots of women were understandably very unhappy with their decision and some even tried to have it reversed. I’m not saying at all that this will be the same in your case but I very much just agreed with all the risks the doctor told me in hospital then later read a lot of stuff which contradicts it. They do an amazing job though and with all the different research going on things must change constantly.

Hope everything goes smoothly for you and that baby needs minimal help before being back with you. Good luck with it all and please post an update

I think consent in any medical information needs to be “informed consent” and that there is probably a lot of processing you need to do to get to the right point.

It is worth asking your consultant how far she is willing to go, but delivery at 34 weeks is not something they would undertake lightly so it sounds like you are very high risk.

please do reach out to your medical team to try and get a fuller understanding of the factors at play.

re: sterilisation, I understand why this might be difficult but it sounds like you would be risking your life with a further pregnancy, and that would also be risking your baby’s mother. It’s really not worth it at all, and accidents too happen.

OP. You are very high risk. Im
sure you are aware of the statistics regarding placenta accreta. I think you should do whatever the consultant advises, quite frankly.
Im not sure of this is your first baby or not, but when your gorgeous LO is here, you might change your mind about another baby. I was in a similar position to you and now I have my baby and we are both safe and well I am doing NOTHING to jeopardise our lives together.

My third pregnancy (aged 43) was a complete placenta previa and acreta. I trusted my surgeon who was responsible for assembling the team and the timing, and despite losing loads of blood was up walking later that day (she couldn't believe it when I passed her in the corridor on my way to SCBU). I think her (and the team's) skill were the reason I was able to have a fourth baby aged 47.

OP, it sounds like a horrible position to be in. It sounds like the risks to you are huge. But I would bet your baby and partner would rather baby was born at 34 weeks and you were able to be a mother than a few days extra and no mother.

It all sounds so serious and alot for you to take in, of course you can ask again. But it all sounds like the best plan to save both your lives, it’s not like the majority of posters experience who think a CS and sterilisation are being forces upon you .

Maybe the thoughts to declining the sterilisation is your brains reaction to this overwhelming news and it’s fighting for control/saying this can’t be happening/deflecting

I had partial placenta praevia. Not as dangerous as accredita.

Based on my birth experience I strongly strongly urge you to go with the early c-section. I won’t terrify you with the full story unless you really want. I haemorrhaged and lost 7 pints of blood in about 30 mins. I am so unbelievably lucky that I was in the hospital when it happened. It took 6 hours in surgery to stop the bleeding. I owe mine and my babies lives to those consultants who (thank goodness were free) and acted so quickly.

Thanks everyone.
100% will be sure to have someone with me at next appointments.

i will give things a thought, have questions written down and reach out to my team because like many have said, Im lacking the understanding for the reasons the plan is as it stands and take from there.

I know am high risk and have been lucky to not have any bleeding episodes so far. it’s a strange feeling that I feel so well in myself yet high risk

@SophieinParis i just turned 30 and do have a almost 5yo DD.

I had a GA with mine! And it was recently (ish).

No problems for her (or me) whatsoever. Like you, they wanted to be as sure as possible I wouldnt go into labour beforehand. They will have you and the team ready before they give the anaesthetic, such that they'll get baby out quickly - their exposure to the anaesthetic is likely to be minimal. I would see if you can speak to an anaesthetist about it.

I think what you are feeling is completely natural. You've been overwhelmed with a ton of info, you're nervous, you've got conflicting interests of needing to do what's best for the baby and what's best for you. Now IS the time to have an emotional response. But then what you need to do is channel it into sensible questions. Understand the alternatives, and feel like it's the best outcome for both of you.

It's more than likely you'll end up in the same place, because the medics will be suggesting what's best. But sometimes there's a little leeway and it's vital you have complete confidence and don't feel bamboozled.

All the best.