SPD & C-section...please can someone help?

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Hello all

I'm posting this query on behalf of my friend and really hope someone can help.

She is 32 weeks pregnant with DC1 and is having a hard time with our midwives in the area (I'm expecting DC4 but never had any SPD so can't advise ). She has severe SPD and is on crutches, you can plainly see how much pain she is in & she already suffered with hip/pelvis problems since childhood. When she had an internal recently (other issues) she literally could not open her legs properly.

The problem is she is certain she wants a C-Section as she can not face labour with the severity of the SPD on top of it. I have had a good long chat to her about the pros & cons (2 VBs & a CS under my belt, plus worked with CMWs until maternity leave started)& have made sure she knows the risks involved.

The issue is that our hospital (which covers a huge geographical area) does NOT offer epidurals AT ALL !! Its not an MLU (I'm under Cons care) but they do not offer them! Despite discussing her valid fears with the midwife she has been fobbed off non stop and is at the point of breaking down in tears . She is convinced that she will not be allowed a C-Section and feels she has no rights or support. The MW hasnt even referred her to a consultant to discuss it.

I had a long chat to her & just wondered if anyone can offer up any further advice for her. Bless her she is sick with worry. I genuinely think that the reassurance of an ELCS will make all the difference, and I feel that she has very valid reasons for it!

Sorry for the LONNNNNNG post!

Any help MUCH appreciated! x

Blimey what a nightmare for her. No epidurals? Where the hell do you live?

If her midwife won't refer her, can she speak to her GP and see whether they will do a referral?

Is there any way that she could go to another hospital where they have come out of the dark ages? I'm guessing perhaps not if the one you are at covers such a big area.

She needs to push to see the consultant, and if that doesnt' work, get in touch with PALS

I had a ELCS for the same reason with DC2. I had severe SPD and got to a point where getting out of bed every day was a bonus. DH nearly lost his job he had that much time off

She has gor less than 2 months to get this sorted out. There is ways to give birth while suffering SPD, but she has to feel confident that she will cope

I had severe SPD and did have a natural labour, which was heavily managed. However, she should be under consultant care and be discussing this with them, and as soon as possible. The wheels grind very slowly in the NHS!

Wish her luck and stubborness from me!

Hello, ty for the prompt reply

We live in Dumfries and the maternity unit is called Cresswell. I've not lived here long, moved from Lincolnshire where there are several hopsitals within the county so this is VERY strange! I'm hoping for a VBAC but I was still when I read online that they DON'T offer them.

There is another hospital but it is miles away down the M6 and I'm not sure its an option for her regarding transport etc as she doesnt drive.

I'm a little cross that they can almost take away a womans choice to have an epidural, but if thats the policy (which would be the only feasible alternative to a woman in so much agony) then I'm sure they ought not to refuse her a CS, especially if she has done her homework!

I'm sure there is something tucked away in the NICE clinical guidelines which states that women can make an informed choice...just have a feeling its on my work computer !

I felt like marching into the midwife and giving it to her straight (but fear she'll end up looking after my VBAC lol!!!). But on a serious note, shes basically being told that she will have to labour & deliver with just G&A / Dia / Peth. HOW she is meant to labour is more of an issue...she cant even get her tights off without crying in pain.

Imnot & Pantaloons thank you!! Sorry, crossed posts...I was furiously typing!! lol

I was surprised the MW hadnt referred her for Cons Care! I think she needs to feel more empowered. I told her she could get some very valuable advice on here so thank you! x

Just read my prev post and it reads that they dont offer VBAC!! Which of course they DO I meant Epi!

She needs to ring he consultant direcxt and make an appointment - it is not up to her mi=dwife to refuse her an appointment and if I were her I would put in a formal complaint.

I would suggest contacting the supervisor of midwives and arranging an appointment, who would hopefully then refer to a consultant.

Hi I have just had a nosey around their website and found a PDF document which states

It should be noted that an epidural service for labour is not available in
NHS Dumfries and Galloway, however arrangements can be made for
referral to another unit which does provide this service. Please discuss
this with your team midwives at the earliest opportunity.

Seems that your friends midwife is not being very helpful. Your friends treatment makes a mockery of the Dumfries maternity care policy which states

To provide quality of care tailored to the individual needs of the mother,
baby and family within a friendly and caring environment.
We believe that the care you receive before, during and after the birth of
your baby is vital in making the experience as pleasant and rewarding as
possible. To achieve this it is our aim that:
● You feel in control of all aspects of your care.
● You are able to make decisions about your care based on your
individual needs and wishes, having discussed options fully with the
professionals involved.

I would suggest your friend ask her GP for a refferal to see her consultant.

Two years before I had DS2 I had fractured my pelvis and the midwives insisted that I would be fine. They tried to prevent me from seeing a consultant. Eventually at 36 weeks I saw one who reccomended CS! much to my relief.

She definitely needs to see a consultant about this and consider changing hospitals if they really don't offer epis.

I had SPD but it was well controlled (knew I was high risk so started physio at 8 weeks pg!). Ended up with a CS after failed induction and although my SPD issues pretty much went after the birth, I have been left with ongoing SI pain - lying still for the operation and recovering knackered my pelvis more! So do be aware that CS isn't a risk free option when it comes to an unstable pelvis.

She def. needs to see a consultant to discuss her optoins. Try going to the GP for a referral direct and whilst she's there ask for some prescription strenght painkillers to manage to pain she's in now plus a referral to the obstetric physio.

I had severe SPD x3. I was on heavy duty pain killers for the bulk of my pg and crutches and weekly physio. Personally the one thing I didn't want during labour was an epidural as you can't feel your movement range threshold and are quite likely, imo to do more damage to your pelvis by ending up in an uncontrolled position. DC1 I had pethedine early then G&A, gave birth lying on left side. DC2 G&A only again lay on my left side but SPD was so bad I couldn't move or lift my leg so had a HCA holding my right leg up but parallel to left the whole time. DC3 G&A and birthing pool - now that was the best choice of all 3, water took my weight and allowed me to change position with relative ease. Unfortunately I had 3rd stage complicaitons and ended up in theatre with a spinal and the op with my legs in stirrups caused my pelvis more damage than the whole pg did. After my 1st pg I got over the "don't take medications when pg" and made sure I took painkillers when I needed them and always at night so I could get some half decent sleep.

I guess my point to your friend is that if she can get her pain managed now, which my GP did with me, I couldn't even lift my legs to get knickers etc on or get in and out of bed when it was bad, there is no reason why she can't go on and have a low intervention birth. I do remember how when the pain is so overwhelming all you want is for it to end but she does need to carefully consider if an epi or ELCS is her best choice if she has SPD. She's got a lot to discuss with a consultant.

QueenBathsheba thats a really useful piece of info!Thanks! Incidentally I did look into other units but as I said the neearest is a long way away (as daft as it sounds its across the border into England from where we live in Scotland!) and she is worried about getting there - unable to drive etc. I think its strange they can offer c-section/spinal at our hospital but not epidural iyswim??

She has looked heavily into a more natural birth, but the birthing pool is out of order (& has been for a LONG TIME!). If she developed complications she would have to either have EMCS or be transferred to the other hospital miles away.

She has physio and has done for a while, in fact her physio was very shocked to find out that she is not under Consultant care & hasnt even been given the option of ELCS. I think she mentioned writing to the midwife on my friends behalf as its obvious they dont realise the severity of her SPD. It seems apparent that she has had very little support and i'll be showing her these posts and encouraging her to push for a speedy referral to discuss her options.

The sad thing is I know that DGRI are trying to reduce their CS rates at the moment and fear this has as much to do with the blase attitude as anything else! The midwifes mantra is "oh we'll talk about that next time...you have plenty of time!" ummmmm NO she doesnt!!

Thank you all so much for your input! x

Good to hear she's already seeing a physio. Not good that there's no birthing pool option. Hope she manages to get a consultants appt SOON. Good luck to her.

Ty TheNewStig. x