Due in February 2017 - thread #9

[twocatsandatoddler]

New thread - hope everyone finds this! I'll try and post the link in the old thread if it will let us go over 1,000 posts.

Welcome back ever I was also a bit worried as I remember you have a history of anxiety and was hoping you were coping okay. Hope your current spell isn't too bad.

ceecee yes to the sore hips!

bisquick I booked NCT a while back as well-- I live in a nappy valley so you have to book early to get a place. Mine starts in December. My midwife did also tell me about the ones run at my hospital. You should try ring someone.

I am going to start thinking about my birth plan once I have my growth scan at 32 weeks. If the baby is huge I'll have a section. If not, then I'll aim for a vaginal birth. My plan won't be too detailed though. I don't want interventions like forceps (I'd rather have a section instead) and I don't want a water birth (I don't like sitting in water and hence almost never take baths). Beyond that though I'm pretty clueless.

I have my 25 week appointment tomorrow but my GTT is booked in for 28 weeks I think.

Fanella that nursery pic is very sweet.

I just got back from a meet up of mum's expecting babies this winter in my local area. There were 25 of us plus partners. I met a good amount of people I liked and had 3 friends there from yoga and pilates who I caught up with so it was a nice evening. They have them every 6 weeks or so.

Thanks London and Sparkles - we'd decided against NCT classes, but want to sign up for the NHS ones. Meh, each midwife so far has been more uninterested than the last. But will get there early for next appointment and bug the receptionist at least until I get the info I need (esp since she's the nicest person there!).
Anyone else ravenous all the time? 8 suddenly feel like I'm hungry round the clock!!!

Thanks twocats and piano - twocats is kindly sorting me out :)

I am still in denial about a birth plan. My only relatively concrete thoughts are:

• I don't want to be induced
• I'd prefer a water birth
• No forceps please
• If it hurts, I'll go straight to the epidural. Meds like pethidine give me bad reactions.

I had an epidural last time after I said before labour that I really didn't want one. It was amazing to be free of pain! I hated gas & air, but I get on ok with opiates so would use pethidine I think, as as early enough in labour that it would be out of my system before the birth, but I've not ruled out another epidural.

My labour last time wasn't typical as DS was in a bad position so I have no idea if I'll be in less or more pain this time round, or if I'll be able to cope better if I can move around - I was stuck on a bed with continuous monitoring last time, whereas this hospital also want to monitor men because of c-section but has wireless monitoring so I can be on my feet.

Morning all!

Re drugs like pethedine, I think you can request them with an anti-emetic to cut side effects?

Welcome back ever! We missed you!

Is anyone else finding this stage a pain in the arse, literally? I keep getting muscle pain in the side of my bum cheek - not sure what that's about!

I was all smug that my London midwife had said I didn't have to have the GTT as my blood sugar is routinely on the low side. But my new NHS trust makes everyone have it so I have to go next week!

Also, there's a woman opposite me on the train with a baby in a stretchy wrap sling.... which she has tied on very tightly completely over the baby's head and face?! There's no way it can be breathing OK in there, surely?!

I'm going for a water birth again this time. I will also use hypno birthing techniques. I thought it was a load of crap but used them second time around and it massively helped. First baby I had on the bed, she came out sideways (so facing the inside of my thighs) and I used gas and air. Second baby I had no pain relief and had her in the pool (she also came out sideways ) . I'm open about the fact things may not go as planned but I'd rather have pretty much anything to avoid a section x

Fenella I got the boba wrap and for new borns you cover the head like this but make sure nose is clear

I want a water birth in the birth centre but I know this is depending on my placenta moving up and my GTT test.
And everything has to be low risk until the end

ever nope- she has it completely and utterly wrapped up really tightly, no nose out, no face out - more like she was clingfilming leftovers to go in the fridge!!

The thing with saying "no forceps" is, well, you might actually need them. No one wants them but they may be the quickest or most appropriate way to get baby out.

DS was literally an inch from the outside world but just would not budge. A c section would have been completely inappropriate. The Dr barely had to put any effort in to get him out with the forceps.

Whether forceps or a section is the most appropriate method of, erm, extraction, will depend on how far down the birth canal baby is. The Dr will advise which is the safest/quickest method.

I think everyone has preferences - in an ideal world I'd have as little intervention an drugs as possible, but as gumboots says, sometimes these things are just necessary! It's definitely good to have preferences and to be informed about the different methods of pain relief and different procedures, but I may as well have not written a birth plan last time for all the good it did me!

This time my preferences are:

• Get as far as I can with just TENS
• Use the pool if possible (there's only one on my labour ward as I can't go to birthing unit for VBAC)
• Would prefer to be mobile as much as possible even if using continuous monitoring.
• will try gas & air again but not holding out hope of enjoying it this time
• if I need it, use pethidine as next step if early enough in labour, I don't want it too close to baby being born.
• epidural as last resort, mobile epidural if possible as my hospital offers this.
• would prefer a repeat section to induction of labour, unless circumstances are such that induction is actually a better / safer option for me and baby.
• will go to 41 weeks and then book a c-section for some time after 41 weeks if I haven't gone into labour.

Mine is:

• I would like drugs. Preference is Meptid + an anti-emetic or a low dose of pethedine to start. Not keen on an epidural if I can help it as I want to remain mobile as long as possible.
• if forceps/ventouse/c section become necessary I want to proceed with whatever is the safest option for the baby.
• I am horrified by the idea of both tearing and an episiotomy - if either of those things look to be on the cards, MORE DRUGS PLEASE.
• squeamish husband so he won't be cutting the cord
• managed placental delivery
• we would like the vitamin K injection
• bounty reps can fuck right off :)

I feel like I'm going to cry again today. If you remember I had extreme fatigue and was anaemic and I had two weeks off work in the school where I am doing long term supply. Since I got back I feel like people are being off with me - mainly the teachers I work with most. We are redhead sing the Christmas play and they are just talking to each other and totally ignoring me, not telling me about changes or involving me in discussions. They were really friendly before but are now frosty and off. It's the second anniversary of my mums death on Monday and I'm really feeling that as well as feeling really lonely and isolated in general. I have no idea who I will be blue to turn to for support when the baby is here. My mother in law isn't offering any support or saying I can call her. I feel really really gloomy and vulnerable. To top it off ive got appointment with the mental health team today about my past with anxiety and loss. I can't have a low risk birth in the lovely unit at the hospital if I'm under a consultant and I think I will be as I can't hide how I'm feeling incase I need the support. Just feeling really really alone and sad. Sorry to moan on x

Gum I totally get what you mean. I suppose what I mean is that if it looks like the delivery is stalling even early on, rather than continuing to try for a vaginal birth and then potentially needing forceps because things aren't progressing, I'd rather pre-emptively have a section.

I am actually having a private birth so my consultant is open to managing my concerns about this.

STOP READING HERE IF YOU ARE NERVOUS ABOUT THE BIRTH!

My 11lb husband caused untold damage to my MIL-- she didn't have any more kids after him for 10 years she was so traumatized (severe pelvic floor damage, prolapse, etc). I know people who have had large babies and been totally fine but for me, it is 100% not worth the risk. In the end after 3 large boys my poor MIL had to have a hysterectomy after multiple previous operations to deal with the aftermath of everything that went wrong. Not a road I would ever risk going down if it can be avoided.

So while I hope the baby isn't huge and I can have a vaginal birth, I'm really not up for a damaging vaginal delivery. I'm not overly concerned about pain relief (I'll have it if I need it but the pain itself doesn't scare me). I'm much more concerned about my pelvic floor. Given I already have a bad back, even relatively minor damage will have serious consequences for my long term health and mobility as your pelvic floor is one of the major elements of spine stability.

Moving around, pools, monitoring, and pain relief are all much less important to me but I'll look more into what options are available once I know if I'm going down the vaginal route following the growth scan.

SBS I'm surprised speaking to mental health support would mean you couldn't use the birth center. Like you said though, its better not to hide the way you are feeling, even if that means a hospital birth.

It can always be hard to come back into a group after you've been out for a while. Why don't you try to have a one on one casual coffee with the most sympathetic teacher in the group. Sometimes, being cliquey isn't intentional and people don't realise how they are making others feel or how group dynamics are playing out.

So sorry you're still struggling Sparkles. I've been a bit down the last few days after feeling better recently, it's horrible having so little control over your mood.

Definitely get the help you need, even if it means you're consultant led.

The birth is such a small part of the whole pregnancy and new motherhood stage, and you might not even be able to have a low-risk birth in the midwife unit for reasons beyond your control (I couldn't last time because despite being totally low risk up until that point, my waters broke and I hadn't gone into full labour 24 hours later which automatically ruled me out of a birth on the MLU according to their rules). So getting the support you need in pregnancy and afterwards is more important than worrying about where you'll give birth - in my opinion, anyway, others might disagree!

London my friend had three small babies and her pelvic floor was f*cked. She had a hysterectomy last year. I know plenty of ppl who have had big babies and no problems. Even if you have a c section, it will not necessarily protect you from the damage to your pelvic floor that pregnancy itself can cause.

If your labour stalls they will likely suggest augmentation before they go to a c section. I would imagine they even do this at the Portland, as surely it reflects badly on an OB if they have a particularly high cs rate.

A c section is major abdominal surgery. Most people I know have flown through both an emcs and elcs with no issues, but unfortunately I have three friends this year alone who have had very complicated sections (both el and em). The significance of the surgical aspect should not be diminished, and it also makes future labours slightly more risky.

Sorry you're feeling so down Sparkles. Pregnancy hormones are a bitch and it sounds like you've got a lot to deal with anyway. I spent a lot of yesterday bursting into tears for virtually no reason. You definitely have reason so it's great you're getting the support from your midwife. I really can't see how that would affect your birth choices. I don't know how it works everywhere but I was consultant lead last time because of varicose veins and I was still potentially allowed to use the midwife lead unit. I didn't but that's to do with what happened on the day.
London my trust considers that you should be able to give birth to a baby naturally if it's up to 11lbs. I couldn't manage a 10lb one and so I'm opting for a c-section because I don't want to even try to squeeze out another one that big. Your poor mil!
Welcome back Evergreen. We missed you!

Just wanted to say, I'm not anti c section btw! I may consider one if I get to 41 weeks.

Gum I'm aware of the risks of a c-section and while pregnancy itself weakens your pelvic floor, labor is what is responsible for most serious damage rather than pregnancy itself. Also, while a small baby can do damage, its much less likely unless there are specific issues with position, which my consultant and I will also be monitoring as the birth nears.

I'm doing, yoga, pilates, specific pelvic floor exercises and am in physiotherapy to manage my pelvic floor and back in light of my specific risks and issues. I've already developed PDP because of my back issues despite all of this extra work so its something I'm taking very seriously and am pretty informed about.

In a private birth situation, a mother can opt for a c-section simply if she wants one. If I told my OB today that's what I wanted, he would book it in now for my 39th week (I'm at St Thomas not the Portland by the way). Its my personal decision to wait for the growth scan at 32 weeks to see if I want to opt for a vaginal birth vs and elective c-section, not the OB's. I'd like to keep both options open for as long as possible before making a final decision.

If I opt for a vaginal birth and it isn't going well, we will all do what's best for the baby and me, but at no point will the consultant's totally irrelevant concerns regarding their or the hospital's c-section rate play any role in that decision making process. As long as it has not become specifically more dangerous to switch to a c-section, the option to do so will always remain available as the birth progresses.

Friendly every trust and every country for that matter is different. In Milan, they offer a c-sections to anyone who they think is having anything bigger than 8lbs! According to NICE guidelines, all women (NHS or private) should be able to choose what they feel is best once provided with appropriate information and medical advice. However, most (though not all) trusts completely ignore these guidelines.

I was on the NHS up until 20 weeks and was very happy. It was always my plan though to switch in later pregnancy though for the additional scans, monitoring and options that are available to me. My NHS care at St Thomas was faultless though and I miss my midwives, though the midwives in the private wing are equally lovely as is my consultant.

London my pelvic floor is pretty much intact after my c-section. Obviously I have no idea what it would have been like after a vaginal birth and it might have been fine too, so I might just be lucky, but I definitely didn't suffer from the incontinence when exercising that my NCT friends did! I'd still prefer to take my chances on a VBAC rather than another section though as I think the risks are lower for me, but DS was 8lb 9oz so not massive.

I am not even close to thinking about the birth atm, I cant even get started on the nursery for 6 more weeks
And my 25 weeks appointment was pretty pointless. Yes another midwife.
It would be nice to see the same midwife twice.
Well, not the best day

Twocats I want to vaginal birth too. My mom had a very easy 100% natural birth. I just flew out in less than 4 hours (first child) with zero pain relief. I'm hoping I have it that easy!

A little stress incontinence when exercising isn't too much of a worry. I'll only opt for a section when the risks are as follows:

1. If the baby is large and the head circumference is looking on track to be greater than 35.5cm. Bigger than this and your risk of serious pelvic floor trauma (prolapse, urinary incontinence, fecal incontinence etc and for me, weaker spine instability) increases by more than 330%

1. If I start a vaginal delivery and the second stage of labor isn't progressing. A second stage of labor longer than 110 minutes is associated with more than a 200% risk of serious pelvic floor injury. The longer you keep pushing after that, the greater the chance of damage.

1. If the possibility of forceps use comes up. This usually happens with a long second stage of labor anyhow but depending on which study you look at the risk of serious pelvic floor damage is 300%-1,400% higher with the use of forceps. Between 35% and 64% of women who had births involving forceps end up with some form pelvic floor damage depending on the study you look at.

Right now, my birth plan is really just to avoid all 3 of these! I don't really have any other thoughts about the birth yet.

Ever why can't you start your nursery? Sorry you've had a bad day. I'm off to my 25 week appointment now. When I was with the NHS, I never saw the same midwife twice but they were all lovely. I think this is becoming more common now unfortunately.