Anyone have a bad ELCS experience?

[pinkelephants]

And if so how did you feel if you had to have another ELCS in the future?

Ds was born 7 months ago by ELCS on consultants advice as I have had previous pelvic surgery and as he was big. My experience, whilst nothing like as bad as as many peoples experiences of vaginal birth that I have read on here, was not a good or positive experience. Although I did have a great recovery.

The spinal wasn't very effective - it worked low down but not very well at all on one side and not at the top of my stomach. I couldn't feel the cutting but could feel quite a lot after that. It also started to wear off quite quickly and I was able to move my legs for most of it and found it difficult to keep still. They had difficulty delivering ds - took a long time, tried forceps but didn't work so used ventuse. Once he was delivered I haemorrhaged - not very badly but took quite a while to control and needed several drugs one of which they didn't have it theater so was a bit of panic while people rushed in and out getting things. I think what made it upsetting for me is that no-one told me what was happening - so I knew it was taking along time to deliver ds but I didn't know why or if anything was wrong. I had realised from what they were saying to each other that I was bleeding more than was normal but I didn't know how badly and I didn't know what drugs they were giving me or why. (I have since seen my notes so I know understand what happened which has helped loads.) I know I should have questioned what was happening at the time but my response to pain tends to be to go into myself and not speak and I really couldn't manage to ask what was happening. I wasn't able to hold Ds in theater which I find quite upsetting.

Has anyone else had a similar experience. I seem to hear a lot about what a good experience ELCS is. I have been told several times that I am lucky to have had an ELCS especially because Ds was big. I realise that I would probably not have had a good vaginal birth experience either but I don't feel "lucky" to have had a CS and don't think I ever will.

We are not planning another baby at the moment but would like more children at some point. I have recently seen my consultant and I know I will be strongly advised to have a CS in the future. I would definitely question the doctors more in the future and request a second opinion etc but I know there is a good chance I will need a CS if I have another baby and, at the moment, I can't imagine how I would make myself walk into theater again.

Hi, I'm sorry to hear you had a bad time. I hope that time has helped somewhat.

I had DD (now 4) by emcs which at the time I felt was quite traumatic but in hindsight I can see that it wasn't really so bad. I think I was just exhausted from a long difficult labour, and pretty out of it from the gas and air. It wasn't how I expected things to go so I did feel quite shocked for a while afterwards.

I chose to have an elcs with DS (who's 2) he was big too and I didn't want to end up having another difficult labour only to end in another cs. Lots of people said to me that the elcs would be much easier than when I had DD with a quicker recovery time etc. That the whole experience would generally be much calmer. However, I found the whole thing rather bad.

The actual operation was ok, I got to have skin to skin time too which was nice. But I felt very sick through out and similar to you my pain relief wore off completely pretty much as soon as I was taken to recovery. I remember being in absolute agony, and no-one seemed especially worried! I lost more blood than I should have and was very anaemic so I had two transfusions. I had to stay in hospital for three nights which upset DD. I generally felt really quite shit tbh. And I think the recovery took longer than it did with DD too. I had a huge amount of pain for over a week afterwards and I don't think I felt up to leaving the house for at least two weeks.

I am now expecting DC3 and am debating a vbac. I'm still pretty undecided. I do think we've been unlucky, you don't hear of many women having a rough time. Obviously it is major surgery, and isn't going to be a walk in the park, but to be relatively comfortable within a week seems to be the usual norm from I can gather. And for the actual delivery to be calm and somewhat enjoyable too.

If you talk to a consultant/midwife I'm sure they could reassure you that any future deliveries are unlikely to be the same.

Hi, thanks for your reply. Time does help and seeing my note also explained a lot. Its good you got to have skin to skin in theater - I am sad I didn't get that. He was about 2 hours old by the time I was in recovery and able to hold him. To be honest I was in almost no pain afterwards - it was during the surgery that I was struggling, no part of the recovery was anything like as painful as that. I was given extra pain relief in theater though once they realised the spinal hadn't worked very and I think that continued to work afterwards. I have found out when I saw my consultant recently that I was also quite anemic both before and after surgery but my results weren't checked so I was never treated. I also stayed in for 3 nights but it was because ds had respiratory distress and needed iv antibiotics (probably also due to the section.) He is my first though so no other children to worry about. Being away from your DD must have been difficult.

You are right I think we are probably unlucky. The midwife I saw when I went through my notes said she would see me again in any future preganacies to help me write a birth plan so it would hopefully be a better experience i.e. so I would be able to have skin to skin. Also I will be able to see an anesthetist to see if there is any reason why the spinal didn't work or if I was just unlucky.

Good luck with you decision for DC3 and I hope it goes well whatever you decide.

I guess from an inside point of view being a nurse a few points of interest maybe to consider. Blood loss in either a vb or a Lscs is very common. I work in ICU and we care for post 'nasty' delivery women. I had one vb and one emlscs. i lost nearly a liter of blood which is reasonable but not extreme..Sinal/ epidural anaesthesia should mena you dont feel the incision but will feel alot of tugging and pulling and this will be uncomfortable. If anasethesia is too high you risk not breathing and this is a bigger problem! so id argue you shouls have been better advised. I guess while the team where soring out your blood loss it wasnt the ideal time to disscuss it with you, surely better they stop the bleed and unless you have medical knowlege it would have caused more distress than if they hadnt. Many hopsitals will not do skin to skin in ot as it is very cold in there! 2 hours is an unpleasant time but id figure a whole heap better than if they had given you a GA and you had been unaware of anything and not seen your baby for about 4 hours?
Certainly if you have a another bub you should discuss your choices. It is rare that a condition prevents an attempt at a natural delivery. however be very wary of a birth plan as a birth be is lscs or vb is very hard to predict! so you may plan to have skin to skin but it may not be possible.

Thank you chloeb2002 you make some good points. I'm also a nurse although in paediatrics so obviously a very different area. I also lost just under a litre of blood which as you say is reasonable but not too serious. The upsetting bit for me was not the bleeding itself but the fact that I was given no explanation - I didn't know if it was normal, moderate or serious so I was imagining a far worse senario than was actually the case. Also I take your point that it was better that they treated the bleed than discussed it, however I can honestly say that I have never, even in a true emergency, given a patient iv drugs without telling them anything about what I was doing. (I obviously wasn't expecting a long discussion about the best course of treatment, but a simple "we need to give you extra medication to control the bleeding" would have made it a far less frightening experience for me.) They literally didn't say a word. To be honest even if someone doesn't have medical knowledge I don't think that giving someone a very simple description of what you are doing will ever cause more distress than saying nothing at all. (In my experience most people - myself included - tend to imagine the worse.)

You are absoultely right that I was far better off avoiding the GA. A GA was discussed as obviously my being able to move was not making the surgeons job any easier! I am very glad that they didn't give it and would far rather have the experience I had than have missed it altogether. The pain I experienced was more than is normal(although far less that labour I'm sure), I was able to feel the closing of the muscle layers - I'm sure I didn't feel all of the pain, but it was definitely pain I felt not tugging etc. When the anestetist was checking the block was effective I said repeatedly that I was still able to feel the cold sensation (tested with ice) but he told me I was misunderstanding and that I could only feel the touch not the cold. He also only tested down one side and it was the other side where I could still move my leg and still had quite a lot of feeling. (This has been investigated at the hospital and apologised for.) I guess part of the reason that I am upset is that I feel as a nurse I should have known better and stood up for myself more (something I'm usually very good at doing!) However at the time I was anxious and upset and not really in the best position to do that. Also in his defence he did repeatedly offer my morphine during the CS but I refused (to be honest I'm not really sure why - was quite confused by this point, obviously with hindsight I should have had it.)

You are right about the birth plan too - I hadn't made one for that very reason - because there is so much that you can't control. The midwife suggested it as a lot of policies weren't followed in my case(i.e it is their policy to at least allow the mother to hold the baby in theatre even if skin to skin isn't possible,) and she felt that it would help me to at least have my preferences very clearly stated even if they would not always be possible in every situation.

With regard to attempting a vb in the future, that would be my very strong preference. I desperately wanted a vb this time but was very strongly advised against it - consultant felt that the is no way a baby would pass through my pelvis due to the shape of it post the surgery I have had. She feels the position ds was in (very high hence the forceps and ventuse) shows that my pelvis shape does not allow a baby to engage much less pass through.) However she has also said that she would have recommended a CS anyway as she thought he was over 10lb (he was well over) and she believes all 10lb + babies should be delivered by CS. I've not found any evidence she is correct in this and therefore would definitely want a second opinion in the future. I saw her as any emergency on my due date for something else and she recommended the CS and it was done 2 days later so I had no time to research what she had told us. This is another thing I feel guilty for - I didn't fight hard enough to be allowed to try a vb and therefore put my son through the CS which I do not believe was the best for him.

Sorry this turned out to be a very long response! Thank you for your post you made good points that I need to remember.

pinkelephants my first section (emergency) was complicated. I had quite a lot of bleeding (they estimated 2500ml), atonic uterus and had problems with the epidural - my blood pressure was very, very low & I was difficult to stabilise. All the way through the anaesthetist explained exactly what was happening - what drugs he was giving me, what the surgeon was doing, he even turned the monitors around so I could see my BP improving. I don't think it is unreasonable or dangerous for them to remember that their patient is concious & aware of what is going on (I'm a medic).

WRT skin to skin, I didn't have it immediately with my first (though the baby was tucked up with me while I was stabilised before we left theatre) but it was offered with my electives. It isn't a big deal for them to accommodate - you slip your gown off after the spinal, baby is born, cord cut, placed on you, given a hat & you're both covered in towels/blankets. There was no problem keeping warm. After a while they are taken to weigh, trim cord & dress then given straight back. My hospital isn't particularly forward thinking, if they can do it then it really can't be hard

I also had two people (dh & my mum (she's a mw)) with me in theatre for the electives which helped a lot (though I know that's pretty unusual, I have a fantastic consultant).

Phlebas thank you. You have confirmed what I was thinking. I probably sound like something of a drama queen! I am really not trying to suggest that I had the most complicated CS ever! I had a few relatively minor complications that were treated. Yours was obviously far more complex. What made it distressing to me is how I was treated. Like you I really can't see how it could be dangerous for them to explain what was happening and I don't think its unreasonable to expect them to do it.

I don't really know what happened WRT skin to skin. I had discussed it with the midwife in advance and she assured me it was standard practice with electives. For some reason he was wrapped completely and given to dh (we had specifically requested that I hold him first.) Eventually someone did attempt to give him to me (dh was too nervous to try and pass him to me) but by then I was in too much pain to be able to hold him. On the plus side ds had a lovely long cuddle with dh while they were sorting me out. I did get lots of skin to skin in recovery though and I was very lucky with my recovery - was very quick and easy so it wasn't all bad.

I think I am probably over thinking it WRT any future pregnancy, I just found the situation being so out of my control frightening. I think I am also sad because I didn't really get many of the advantages that should go with having an elective rather than emergency. I agreed to the elective because my consultant assured my that an attempt at a vaginal birth would result in an instrumental delivery at best and almost certainly an EMCS. I thought I would avoid the instrumental delivery for ds' sake and that an elective would be calm and I would be able to discuss my preferences and I would understand what was happening. In fact ds ended up with scratches from the forceps, a bruise from the ventuse and respiratory distress probably from being born by CS. Now I realise these aren't major issues but they were upsetting and made me feel that I hadn't done the best for him. I know several people who had an EMCS at the same hospital and all of their CS' were better experiences than mine (but obviously they did have to go through labour first which I didn't.) They have all said that the anaesthetist talked them through the surgery (explained what the surgeon was doing, what meds he was giving them etc) and they were all asked their preferences WRT holding the baby etc and their choices were respected.

I completely understand - being treated like a human being makes such a difference (to shit Sherlock!). I had had a long, un-medicated labour in the mw led unit before being transferred but the section was objectively the most dangerous/traumatic part of my daughter's birth, however I think of it fondly because I was treated with kindness & respect (unlike the labour part where I was treated very badly - clinically & ethically - and am still very angry).

lol should preview no shit Sherlock ;)

I think pink that as nurses we are probably less likely to stick up for ourselves. Probably out of done kind of feeling that we shouldn't rock the boat etc! I recently had a very bad experience during an uss that meant I cried through the whole thing. Even my friend who is a senior clinical nurse sat there just dumb struck! Neither of us did anything at the time , although my obst. Did go and wage hell afterwards. We are about to have dc/3 by elscs as I can't have a vbac because bub is too big to turn and is oblique breech. However on the subject of big babies and vbac, there is a paper out about a blind study of big babies that showed no difference in ability to deliver them naturally. Especially if you don't do growth scans so therefore don't have the prior knowledge.. Although we did discuss that I would have known as the bub would be big as I measure big and a small baby would be a miracle..

Oh just a second thought... I guess phlebas makes a good point about her experience and I feel this is the difference between how the general public and medics are treated/ viewed. I know similarly that when I have my elscs in a couple of weeks the anesthetist ... My collegue who is jumping in on the list to do my spinal , will stay in the ot till I'm done and will explain what he and the o and g team are doing. I've also chosen the day that has the o and g consultant I know best on. And she will do my section. I guess as well it is easier for my 'boss' to say oh your Bp is a bit flat I'm just going to put some of x or y. He knows I wouldn't be freaked out or concerned. However with alot of people they would worry and stress! Adrenaline in theatre isn't a good thing routinely! I am surprised however that you just had no feed back! That is very poor practice! I have no doubt that in medical emergency situations we just wade in and kick on! No explanations as one of our consultants says .. Jfdi... ( just f*king do it) and quite often I think there would or should be more time to say this is x... To do y..i
Am even more surprised that they knew you had medical knowledge and didn't give you any insight!