Earliest you can have an ELCS?

[Sparklies]

This is DC3 - DC1 arrived spontaneously (and quickly!) at 36w6d. I had preterm labour with DC2 at 34 weeks which stopped, but I ended up having her at 35w5d as I had an infection via EMCS.

My babies (so far) are always BIG - 95th percentile when born. They come out screaming with maximum apgars, and come home with me, despite the theoretical prematurity. I honestly don't think my body is supposed to bake them for 40 weeks - there is a reason I have not made it to term yet.

This time out I require an ELCS as I have a permanent stitch in so the only exit is through the sunroof. I could labour for eternity and all I'd get would be a ruptured uterus (which means if I went into labour pre ELCS it could be.. interesting) This is compounded by the fact I am prone to precipitous labours. Plus we need to schedule out childcare and haven't got any emergency form of childcare. So I really, really don't want an emergency situation.

Ideally, so long as everything checks out of course, I'd like an ELCS scheduled for 37 weeks or a few days after - full term, but I would actually possibly stand a chance of reaching it. 38 weeks I'm pretty sure I won't and never mind 39 weeks.

As you can probably guess, my consultant won't schedule an ELCS before 38 weeks despite all these mitigating circumstances. However I don't like my consultant much and I am planning on going somewhere else anyway.

To compound it all I have seriously bad SPD (to the extent even my osteopath doesn't have a clue how to fix it) and have done since 16 weeks - I can't walk more than a few yards (and I'm in pain for that) and I have two young DCs I have fulltime care of. So the sooner the better for that reason too although it's the least of my concerns really. My main one is the sudden labour/uterine rupture fear which my current consultant won't even listen to me over.

Has anyone managed to get a baby via ELCS any earlier than 38 weeks? Was it with a consultant in a south east London hospital by any chance and if so who? Or.. can anyone recommend a consultant at a hospital that actually, you know, LISTENS to their patient? Probably asking a bit much with that one though..

I'm in the north and i had to push to have my baby at 38+5 and had to sign consent to say i was aware i was increasing the risk of my baby needing to go to scbu after delivery due to immature lungs

38+1 & consultant first looked at 37+5 & said to tell paeds it was 38

That was brought forward due to my SPD

I am interested to know this. I am pregnant again after having EMCS 16 weeks ago .

My DD came after only 2.5 hours and was 6 days early. My DS 4 weeks early, I arrived fully dilated and was pushing 5 minutes after arriving at hospital, he was later delivered by EMCS due to being brow and getting stuck, but had the potential to come in the car.

I know I have increased my risk of rupture due to stupidly getting caught too soon, but I am worried if I psych myself for a ELCS then I start to labour I could rupture before I even get there.

Someone told me it is 39 weeks here so will have to wear tights and cross my legs for the final 4 weeks I think.

Sorry this doesn't answer your question at all does it

I had one at 37 weeks (S.London). I had a history of a very bad labour and emergency section. They did not want to risk me going into labour at all.

Ugh.. so it does sound like consultants really, really don't want to do prior to 38 weeks.

Much as I despise the US system of elective inductions because it's sunny that day or whatever, and practically nobody ever reaching their due date as a result, I'd probably have much better luck over there as I know of plenty of US women who've managed to get them scheduled for 37 weeks. Often they have amnios for lung maturity too, something I am pretty sure only happens very rarely over here and almost certainly not in my circumstances.

Now kicking myself as they wanted to move my due date forward by 4 days at my 12 week scan and I said no.. because it landed me in a world of trouble last time (long story) when they moved it back. Those extra 4 days could have been priceless at the end!

Glad to know I'm not the only one wanting a slightly earlier ELCS.. it seems even with good medical reasons, unless any labour at all is completely a no-no (as opposed to potentially risky) they just don't want to know.

Another reason for avoiding 38 weeks - it's Wills and Kate's wedding that week and everyone will be on holiday/gridlock in London. Which will mean even fewer resources on the nightmare postnatal ward

Sparklies - my bet is you get scheduled not a day before 38 weeks, then if you go into labour earlier you'll get an EMCS.

Nunnie - wow you have got your work cut out for you!! Best of luck.

Nunnie...did you actually have a period and are you breast feeding? If you don't mind me being nosy!

My hospital doesn't do it before 39+0, so that's what I've got mine scheduled for.

Consultant discussed with me option to try VBAC should I go into labour earlier than that (daughter was EMCS at 38+4), but agreed with me in the end to do EMCS if that happens

I think I will be kept very busy.

Don't mind you asking at all bamboostalks. I did have one period, second one never came.

BlackSwan - yep, that's what they've told me they will do. I pointed out my precipitous labours (one constant huge excruciating contraction - can't even make a phone call let alone walk, gotta be good for a sealed up cervix with previous c-section scar) all preterm with very healthy babies and he just shrugged and said I'd have to make sure I made it to the hospital quickly then. Which is highly practical when trying to sort childcare for two children.. or if it happens during the day when DH is at work over an hour away.. (no-one else we can ask in a hurry to help) what do I do then? Ugh. Think I will be teaching DC1 (4) how to ring 999!

Okay, so maybe I'm catastrophising a bit but the scenario isn't impossible with a bit of bad luck!!

nunnie - good luck! I'm impressed you could face doing anything of that nature in the first year, let alone the first few months

Good luck Sparklies - if you're in an emergency situation just take the kids with you!! Poor thing, I don't think you're catastrophising - but with some luck it won't turn out as you fear. Keeping fingers crossed for you.

Hehe, well, I couldn't really leave them behind!! I did ask last time what would happen and they said sometimes midwives will look after them on a ward until someone else can get there which reassured me a little. It's not ideal though.

I still remember the time I had to take them with me in the ambulance when I had anaphylactic shock after two back to back courses of penicillin (totally out the blue) - it wasn't quite an emergency-emergency but I was plastered in hives and could feel my throat closing over. It took an hour for DH to reach me at the hospital, during which time I was hooked up to an IV and desperately trying to stop DCs from running off and/or screaming the place down!! Hopefully with an emergency labour situation I wouldn't be left like that though, but then again, they would take me to my local deathtrap hospital knowing my luck so it wouldn't surprise me

Last time it all worked out beautifully and we had a LOT of luck on our side.. not so sure we will be that lucky this time!

Thanks btw!!

It was Christmas, wouldn't be having this conversation if it hadn't been

Going my my consultant appointment yesterday!!

Brief history - DS at 39+1 due to severe SPD (ELCS). 15 months later twins which they said they would deliver at 37 weeks but I got to 33 weeks so c-sec again. This time im pregant with twins again and they want me to get to 38 weeks even though I had the last ones early and they dont book in now until 38 weeks instead of 37 weeks because they have had 37 weekers with breathing probs and 7 days extra makes alot of difference.

SO fair enough but they wont even give me steroids just incase they come early again it wll all have to be dealt with in an emergency instead.

Wow two sets of twins!

Don't know about ELCS but have same history of early deliveries with good birth weights. DS1 born naturally at 35+5 with 6.5 hour labour, weighing 6lbs 9oz, DS2 born naturally at 36+6 with 2.5 hour labour weighing 7lbs 7oz. With DS3, they finally diagnosed Obstetric Cholestasis last week. This is a liver condition related to pregnancy which causes itching in 3rd trimester, and also tends to cause premature deliveries. At last they started taking me seriously, and (surprise, surprise), DS3 appeared in the early hours of this Sunday morning at 35+3, again with a natural delivery and a 5.5 hour labour, weighing a whopping 8lbs 6oz! Basically what I'm saying is that it might be worth getting tested for OC - my itching was really mild and I only mentioned it very much in passing, and had no other symptoms. If they have a reason for you to be having these early and good weight babies, they might take your need for earlier delivery more seriously? [Apologies for long post...]

harrygracejessica - Wow at two sets of twins too!! Yes - I was only given steroids at 34 weeks when I had proper preterm labour (which stalled) - they wouldn't otherwise. And this was with a rescue stitch and I wasn't expected to make 28 weeks.. so in a way I'm glad I didn't get the steroids that early. Part of the problem is that the benefits only last a week and they don't work so well if they're given again. Funny old thing. Maybe that is why?

Jellyelly - Thank you for that, very interesting! I can't say I have noticed itching but then I haven't been looking out for it. I always assumed my babies came early because my cervix is rubbish, but that doesn't explain the big at all. I will ask next time I see someone in a few weeks.

Today I had my consultant appointment and it's been scheduled for 38w2d (the day before the Royal Wedding, and under a few miles from it too - nightmare!) which is probably the best I could hope for. I guess it'll be a case of wait and see what happens! My consultant reassured me the risk of uterine rupture was low so long as I got there reasonably quickly, but if I was in agony I'd have to go to my local hospital. Not that I'd have a choice or want to argue with that I suspect!!

Yes indeed wow 2 sets of twins lol

Sparklies - thats interesting they only last a week ,if she had spoke to me about that then maybe I would have understood!

I was given steroids at 27 weeks with my first as they thought I was going to go into premature labour (I didn't), they never once mentioned that the effects only last a week.

That sounds like I am saying you're wrong, I wasn't saying that sorry.

Just looked it up as I was curious as to why you don't get a second course if you don't go into labour within the week. Apparently the risks start to outweigh the benefits rather than them not working. More information here:

www.babycenter.com/404_should-i-take-steroids-during-preterm-labor_5437.bc

Yes, it's a bit off they never mentioned that to either of you. I think my consultant did when I reached 24 weeks and said it was basically up to me - I'd only get one shot at it (excuse the pun!) but he didn't recommend it. He didn't say why however. Doctors often seem to forget we're a) human and b) not stupid and would appreciate being informed on why a particular thing is or isn't being done! Saves a lot of unfinished mental business later.

nunnie I am in the same position, I am 11 weeks pg and they will be giving me a c-section at 38 weeks, i was hardly given a choice! :)

Hey. Had mine in Lewisham at 37 weeks. Placenta previa. There are two consultants that are really good. Ann Billet and Ruth Cochrane. Hope you can sort this out. I know what it is like to be scared to end up in an emergency situation.