Consultant meeting at 34 weeks - can you help me get my thoughts straight?

[tattycoram]

I had a v difficult delivery with DS who was OP and 10'11" - ended up with DS stuck, forceps, third degree tear and some incontinence for about 8 months after the birth.

I have a meeting with the consultant on Tuesday to discuss how to deliver this baby. Growth scans all indicate that it is going to be big (I know they're not 100% reliable).

I've posted here before about how all the hcps I have met have assumed that I want a CS, but I am not sure what I should ask about on Tuesday.

The obs I saw at about 15 weeks said taht any damage would be exacerbated by a further delivery - is there any way they can assess what damage there is? And how much difference would that fact that DS was OP make?

I am normally quite confident in meetings, but am worried that I am quite likely to leave this appointment not very clear on what I want, or what the best thing to do is.

Can anyone help me with what I should be asking?

hellllllooooooo! will read now xx

i do think you should have a section, i definitely would in your position.

Have you:

• seen a colorectal surgeon for advice/tests? yes they can assess the damamge that has been done, but I think predicting is a different kettle of fish iyswim?
• Read the RCOG guidance on 3rd and 4th deg tears?
• Researched the evidence base behind CS/VBs?
• Looked on the Raggedy Bits thread over on health

I agree with what you are saying about everyone assuming you want a CS. I have been in exactly your situation (only continence issues are ongoing)and was heavily pushed into CS, which i ended up declining. That was the right choice for ME, I am in no way saying everyone should make that choice, please don't think that.

I wish you lots of luck in making the right choice for you. Also bear in mind that a lot of people (specially mws) head seems geared totally towards "will you tear again?". Actually issues can crop up post-menopause I understand whether you tear again or no, so actually the decision not to have a CS for subsequent pgs may not have been a good one. Although a colorectal surgeon did tell me that the actual pregnancy did damage as well as the birth (sorry, no refs for that).

I strongly recommend asking for a colorectal referral. Mine had loads of experience in dealing with women with our kind of prob!

Am now pg with DC4 and will def be going for VB again btw.

Sorry, that last post looked like I felt that this was the "right" option. I don't think that; I think it's incredibly individual and you need to weigh up the evidence base for yourself and come to the right decision for you. It's very hard isn't it?

No not at all! Can I ask why you took the decision that you did? Was it because a cs doesn't guarantee freedom from probs post menopause, or because continence issues weren't your first priority?

Hallo HC! Am off work tomorrow, can I call for a chat xx

would love to talk, can i ring you? sorting my life out & don't quite know when i'll be free. xxx

yy of course, will be hanging round in playgrounds all day, so any time fine

Yes of course.

A mix really. The reg I saw was so adamant that a CS was an "of course" that my hackles immediately rose and I thought, well, you're not assessing me individually this seems far more blanket policy.

Equally a CS didn't guarantee no probs post-menopause. It did guarantee a stonking great scar on my abdomen though, plus the possibility of other complications.

I wasn't convinced by the whole "if we CS you then continence is preserved". Well, it was already compromised.

And maybe most importantly of all, I thought giving birth the most magical thing in the world. I wouldn't have missed it for anything. And I can't wait to do it again in February.

Really, lots of luck in coming to your decision that you are happy with.

the glamour . which nursery did you go with?

Littlesilver, that's really useful. I absolutely know what you mean about blanket policy, that has got me riled too. I am fine now and can't believe a second birth would be as hard as the first, but I also have the 'what if' voice at the back of my head. I'll look into all your suggestions

HC The children's centre across the road - DS starts in two weeks, is very excited about it.

It sounds as if you had an incredibly rough time of it. Do talk to the other ladies on the Raggedy Bits thread, a lot of them went for CS and found it absolutely the right decision.

Sorry, one last point, I haven't experienced the baby getting stuck bit and I was only commenting on experience of having a third degree tear. So make the most of the HCPs' guidance!

thanks littlesilver, I really appreciate your advice

I experienced shoulder dystocia with DS1 and had a forceps delivery, all pretty nasty.... When I had DS2 I decided to go for an ELCS and it was the best decision I made, absolutely lovely birth and safer IMO than another risky VB. Of course I always wanted to have a nice natural delivery but in the grand scheme of things there are more important issues to me, I felt lucky that DS1 escaped without any long term injuries and couldn't risk that type of birth happening again.
I am currently TTC#3 and will definitely opt for CS again if that is any help to you.
Good luck, and by the way the growth scans were spot on for DS2! (I know they are not for all though).

how did it go?

Hope your appointment went well; do listen to what your consultant says!