'managed' (induced) labour after previous traumatic birth

[Fredfred]

I posted a similar thread to this a week or so ago, so appologies, but have just seen the consultant so wanted to get some more opinions!

I am 23 weeks pregnant with my second child. DD's birth nearly 2 years ago was a horrendous experience- didn't know I was in labour till quite late cause I just had one continuous pain that got worse and worse, DD was back to back, took nearly 4 hours pushing stage (whole labour lasted 8 hours), had a ventouse delivery, an episiotomy, a PPH and a retained placenta which needed manual removal in theatre.

I had to have 2 blood transfusions and DD was jaundiced and had to go in a UV incubator. They made me give her top-up bottles against my wishes which made BF extremely difficult later. She also had reflux and colic. Had difficulty bonding with her.

I've been been diagnosed with post traumatic stress disorder and consultant said I can have either an elective c-sec or a 'managed' labour where I go into hospital, have an epidural from the start and then an induced labour with a head midwife who is really experienced and will be under consultant care the whole time. He seems to think that a 'managed' labour will be safer and will help me to recover from my previous traumatic delivery. I just don't know what to do and I have to go back in a few weeks to give him my decision.

Has anyone else had a 'managed' labour like this? How did it go?

Haven't had a Managed labour but will he considering elcs if and when we get dc2.

I'm sure you don't have to make up your mind fully so early on. You still have almost half a pregnancy left! Get all the opinions, make a list of pros and cons and then do nothing for a week or more about it.
When you come back to it see which of the pros or cons hit you hardest an prioritise/ remove. This is my logical way of doing things.

Fwiw I will prob be doing a elcs but if baby decided they were gonna arrive ahead of schedule I might see how things go naturally???

Nothing you decide in a birth plan is EVER set in stone!

Don't have any experience of this, but as I am sure you already know, having an induction and an epidural in the way you describe makes you much more likely to need an instrumental delivery or a c-section.
Wouldn't you be better off agreeing that you will go straight to hospital when you go into labour, and that you will get an epidural immediately if you feel you need one.

I did bring this up but Consultant seemed to think that risk of this was far less with a 2nd baby and with extremely experienced midwife there from the start.

I was fully dilated within 1 1/2 hours of realising I was in labour. Hospital is an hour away and I want an epidural as I never want to experience the pain I went through with DD again, especially if I have to have a ventouse again. I know some people can handle it, but clearly not me :( I am terrified that I will get to the hospital too late for an epidural if I go into natural labour as I know 2nd babies are usually born quicker.

I had a traumatic first labour and birth (5 days and forceps in theatre etc etc) and have just won the battle to have an elcs as I just can't face the possibility of a repeat performance, the second consultant was far more understanding than any midwife I have seen and instead of dismissing my fears accepted that some of them were realistic and said there were no guarantees that a second labour/delivery would be easier.
at 32 weeks I am finally starting to enjoy being pregnant as now the decision is made the worry has pretty much gone. Not saying that I won't worry nearer the time about major surgery etc but at least I am not worrying that I will end up as i did before.

the senior midwife I saw to discuss my previous birth was all for a managed labour including induction and so was the first consultant and they both dismissed my fears of forceps being needed again as unlikely, however second consultant didn't agree and thought the chances were I would be so upset and sleep deprived by the time I came to give birth that I would prob need emcs so might as well have elcs

have rambled - sorry, hope it makes sense

Sorry to briefly hijack, but I'd like to know how did you get diagnosed with PTSD? I had a v similar experience to OP & have always wondered if I am/was affected by it or if it was "ordinary" PND or just me being miserable.

elvesgirl I don't know how you get diagnosed, but I do know that I thought I was over my last birth until I got pregnant and then the more people I had to speak to about the last birth the more traumatised I got, it ended up taking over my life to the point where I could think of nothing else until they agreeded to a section.

I have seen other threads where people have been fighting for an elcs on PTSD grounds and they have started with their GP, been referred for councelling etc and got a diagnosis. You could try the thread in childbirth about elective sections after traumatic births

eleves I was actually diagnosed with PTSD by a senior midwife who discussed my first birth with me in a 'birth after thoughts' meeting. Like Hevster I did not realise quite how traumatised I was until I became pregnant again.

Thanks Starlight and Hevster for your experiences. Still don't know what to do. I do know if I ended up having forceps or ventouse I would probably freak out though. I am so scared to make the wrong decision.

Could you opt for a birth plan that minimises your chances of needing forceps or ventouse? So the opposite of what your doctor is saying - try to avoid epidural, active birth, maybe a water birth, MLU or home not hospital, etc, etc.

Doctors always think they know best, partly because they never even see an uncomplicated calm non-hospital birth!

Ooops, just seen you've already decided that an epidural is a must.

Thing is, I had no intention of intervention the first time round. I wanted the whole natural thing and planned for that. I even hired a doula to help me and DH manage and I still ended up with ventouse, PPH and retained placenta. If I had been at a MLU or at home I would've been blue lighted to hospital which would've been even worse. Would never dare to go to a MLC in case that had to happen and as I had a retained placenta last time I am at higher risk of it happening again.

So hard as would prefer to avoid a C-sec if poss, cause I have to look after DD and new baby and DD will only be 2 and won't understand, but I'm terrified of it all happening all over again. :(

Thanks for all your advice though. Much appreciated. x

fred I often find it helps to make a decision and see if I feel better for it - eg decide you are going to have a c-sect and then see if over the next few days you feel better about being pregnant and more relaxed about the birth. If not then assume you have made the wrong decision and reverse it?

Hevster thank you for your advice. I've been trying to do as you said and am feeling more relaxed about the whole thing. I still haven't 100% made up my mind about what I'm going to do, but I am not stressing about it quite so much and still have a few weeks left before I have to go back to see the consultant to tell hime my decision, so will think about it some more. Thank you.

This may not be entirely helpful but I just wanted to provide an alternative perspective.

I was induced @ 36wks with DC1 due to bleeding. I had a failed mobile epidural, Pushing stage was 3hrs and 21mins and I also suffered a large PPH and needed a manual removal of the placenta.

My labour and the delivery were horrific and like starlight I used to look at other woman and wonder how on earth they had survived an experience which made both me and my DH cry when we thought about it.

DC2 was a suprise - although I suspect we would have eventually tried for another DC as we very much wanted a big family, I couldn't have imagined being able to make that decision, such was the horror I felt in relation to DC1's birth.

Anyway I decided I would push for an elective section but for reasons mainly due to to a cross county move very late in pregnancy (5 days before DC2 arrived)this wasn't arranged properly and at 38wks I went into labour.

My labour was longer than the first but it was brilliant. Really really brilliant. I felt in control and (please don't cringe!) empowered. I stayed at home, mostly in the bath, for 15hours until I really felt I couldn't manage and arrived at hospital to be told I was ready to push. DC2 arrived within the hour and we left hospital 6 hours to the minute after he was born.

It was such a contrast to my first experience and whilst I realise your situation (particularly with the fast labour) is different I just wanted to emphasise how your first labour doesn't have to provide a blueprint for a subsequent one.

Can I recommned a website which tells you about optimal fetal positioning. Sounds like your back to back labour was the root of all that went wrong first time. There are ways to prevent this happening again which can make you feel you are really doing something.

www.spinningbabies.com/.

I had a negative first birth but like nancydrewrocked had a really great (unplanned) natural birth second time and like her it was a really empowering and healing process.