My section was done by one of the hospital directors (my OH and Mum were told whilst I was in that he had been on his way to his car when they'd run after him to call him back, Tink was delivered at 7:20pm he had come back and stayed behind just to look after me) and he wrote in my notes (we were naughty-- looked last time I was in) "This lady would seriously benefit from a future elective section" and everything has gone from that. My first appointment it was said "you had an extension so you'll be booked in for a section at 38 weeks". No one has ever discussed it with me (apart from in Liverpool but that was because the benefit to a 24 weeker from a natural birth was greater than the risk of rupture at that stage) it's always been said like it's a given. My consultant has always said the same, but I've not seen her more than just at clinic, I'm not sure if that would be something that would normally be dealt with later, I'm 31 weeks and Thursday will be the equivalent date to when Tink was born.
I think 38 weeks is because of the Heparin, they want to get me off of it without me going into labour first.
I spoke to the ladies at caesarean.org and they said the problem is there are so few women who have this type of scar that it's hard to put a figure on it. It won't extend as high as a classical, it's purpose is to give them a little extra room (I don't think they'd planned on a 4lb 2oz 31 weeker!) so it's not more than a nick. The risk will be higher than normal but not as high as a classical because the vertical scar isn't as big.
Reason for last section was 31 weeker, coming footling, 2cm to delivering feet in an hour and my waters hadn't broken (not got my head around that bit, he said it was a risk ) and they gave me a GA because they didn't know what was wrong with my back with no time to find out (physio said good job they didn't), they didn't have time to mess around and I'd had Heparin in the morning. The reasons for a CS aren't necessarily there this time - apart from the potential risks of rupture - but all the same GA reasons are if it's unexpected and at least my back will be a problem if it's planned. I'll happily deliver with no pain relief so they can monitor the breakthrough pain better rather than go through a GA again.
The only thing I want them to remember or consider about my mental health is that I'm still traumatised from my last birth and just to try and reduce this birth adding to it. Last time none of it was expected and they couldn't have done anything different. I guess it's not often that a crash section is expected. In my antenatal class we were talking about the different types of section, she explained elective and emergency then said the third one is a crash. I put my hand up and said "that's when you suddenly get a room full of doctors and MW's, three doctors explaining at the same time consent forms which you have to sign whilst someone is cleaning your nails, removing your jewellery and putting a line in your hand, two MW's dressing each other and you, one MW explaining to your family what will happen and where they need to go, then within 15 minutes you're under GA and baby is out" (all in one sentence because it's the only way to really convey all that!) She just said "Yes".
Sorry, I do tend to waffle when it comes to Tink's birth, I think it's another symptom of the Birth Trauma.