Anxious: ELCS - how hard is it to get one agreed?

[RufousBartleby]

I have a wonderful 8 month old DS, but his birth and the subsequent recovery were quite traumatic. I have suffered with some incontinence and have been having physio for the last 5 months which is helping. I saw the continence specialist yesterday who (without examining me) gave the opinion that most of the damage was probably already done, and if I delivered another baby it most likely wouldn't get much worse. I was completely horrified, and I don't think realised until that point quite how terrified I was about the thought of giving birth again - I would love another baby, but would have to seriously consider whether to have one if I thought I would have to deliver again.

To give a bit of background I had a high forceps delivery and episiotomy in theatre (which I know isn't that unusual) within a couple of days it was infected. The midwife checked after a week and said that it was the worst episiotomy breakdown she'd ever seen and I had a gaping hole (sorry if tmi!) I went back in to hospital and spent two days on a drip not being able to eat while waiting for a spot in surgery. Because I wasn't eating my week old DS had to go home with DH as my milk supply obviously dropped a lot and he was frantic :(

The surgery was successful although some of the surrounding tissue was dead and had to be removed. However I have been left with a lot of scar tissue and have lost quite a bit of sensitivity and also have some continence issues although these are improving.

Basically I'm really scared that because this consultant doesn't think I would suffer much more damage that I would not be eligible for a ELCS.

I'm wondering how hard it is to get one agreed?

Has anyone managed to get an agreement in principle before getting pregnant again?

Has anyone failed to get an ELCS agreed and gone private? (approximately how much is this?)

Would also love to hear from anyone who has had a repair following episiotomy breakdown and how you recoved, as I'm yet to meet anyone else who has had this kind of repair done.

Thanks for reading.

I'm sure you'd get one, you have substantial physiological reasons why it is necessary.

Reading your story and knowing other people's stories who have had elcs, I would say that the vast majority of Cons would propose an ELCS.

because of your history of needing surgical repair and continuing continence problems, i can't see a consultant refusing your request for ELCS, tbh.

Thanks for replying everyone. I think I was just shaken by the consultants lack of sympathy and assumption that I would deliver again.

If you get another consultant like that, don't hesitate to request another.

i have complete sympathy for u and feel the xact same way bit of backround history had a really bad birth, agen high forceps, epiostomy, 2nd degree tear etc and big blood loss which they wanted to give me transfusion. afta a few days i was feeling worse and worse was in terrible pain kept asking midwife if stitches were ok, she kept saying yes another couple of days later my blood loss was smelling really foul (TMI) and i cudnt even sit down or walk upstairs without wanting to cry, ended up not being able to sleep having cold sweats etc, midwife came agen sed she thought from smell i had a womb infection got me antibiotics, 2 days later still getting worse she comes back wonders y antibiotics had not had an effect
does an internal and pulls out a rotting swab, by this point was 10 days afta labour. i cry with relief i had been so ill and in so much pain
then get told my stitches rnt healing properly bcos of it go back to hosp consultant removes my inside stitches (ouch) anyway i now still suffer with scar pain and i also have loss of sensation.

im now 24 weeks with my 2nd and i saw consulatant at 21 weeks told her i didnt want a natural birth and all she had to say was that it wudnt happen agen and that she advises natural birth as it may heal better if my scar tears open during birth and re-heals (hmmm sounds lovely) that she doesnt reccomend a c-section bla bla bla, tells me to come back at 37 weeks and discuss it more then and untill then not to worry bout birth

i feel completely traumatised by the whole experience tho and know i now wud not cope with labour well at all :( i completely understand y u feel this way fingers croseed if we both want c-sections they will let us have them

Oh Jbells reading your post brings it all back...the pain, the smell, not being able to sit/stand/walk...I found it was worse than the labour to be honest. I've heard from people with third degree tears that they have left hospital with antibiotics, and I so wish they would do this when you had an episiotomy.

Really surprised your consultant wasn't sympathetic to your request for a c-section - its not very encouraging is it? I sometimes wonder if they factor in the emotional trauma - I mean, how could you possibly feel relaxed about delivering DC2 after that?

I thinnk you are very brave for deciding to have another and hope you have better luck at 37 weeks :)

thanks :) i know i dont think they factor in the emotional trauma at all, i also always say and sed this to the consultant it is not the labour that worries me everyone knows that labour will be painfull, it was the horrendous time aftawards, i just cant imagine ever going thru that agen, i think certain consultant r just much more pro natural labour than others i know my consultant has had 4 natural deliveries which she took great pride in telling me. i all else fails i will just cry a lot at 37 weeks and if that fails i just wont push lol

Just ask for a second opinion - I have done this (when my episiotomy broke down) and it feels like a hard thing to do, but is perfectly normal and hospitals are used to it. I had an experience something like yours (epi breakdown and repair) and the surgeon who did my repair said that it would be my choice if I had an ELCS or VB for any further DC (I don't have continence issues though, which I would imagine would make it more likely that you would be offered a CS). My GP said that she wouldn't have another VB if she was me and has experience in obstetrics. My physio also says that a CS would be better. In the end the decision will be made by you with the support of an obsetrician, not your continence specialist. It is your decision as you are the one to weigh up the risks involved as there are certainly risks either way.

I am hoping to do the birth afterthoughts thing at my hospital and might ask about getting an agreement to a CS before getting pregnant again. Perhaps a chat with your GP and a referral to an obstetrician might be a way forward.

As for private CS - I think that this might be between £10k & £14k. They aren't offered locally to us, but I am considering one if I have any more DC as I would like lots of help postnatally as I will be having a CS as I have no desire to go through any of what I experienced in the months after DD's birth.

Jbells and breatheslowly, thanks for the replies - I know exactly what you mean, I would hate to go through what I went through after the birth again. I totally agree, Jbells that while you are prepared to be in pain in labour you are not expecting to be in agony afterwards.

Would be really interested to know if you are able to get an agreement before getting pregnant for a CS, breatheslowly - could I ask how your recovery was?

I was granted an ELCS just because I said I didn't want to go through the pain of childbirth. They went through the risks and asked whether I was sure - I said 2 of my friends came close to death giving birth and there was no way I was going to go through that. They granted me it straight away - Kings College London.

Thanks Stangirl - that's really encouraging :)

I have absolutely no doubt based on what you've posted that you will have no difficulty at all getting an elective section on the NHS

get a different more sympathetic obs if needed, you cna ask for a second opinion and a 3rd if necessary, ask your MW which is the most pro c.s obs !

to second Stangirl, I have had 2 ELCS for no medical reason at all. Was hard work and did have to use the 'second opinion' but I got them (even with my first baby). Don't let them fob you off & good luck.