how to get best csec possible

[tonythetyger]

I had an emergency csec with ds 4 years ago after induced labour and failure to progress (am type 1 diabetic so they induced at 39 weeks).

I have finally got pregnant again nearly 2 years after a miscarriage and on my first appointment mentioned that I'd like to have a vbac. Diabetic consultant (who I saw at 5+1) said he saw no reason why I couldn't go to 40 weeks if my control was as good as last time to optimise my chances of labour starting naturally and I was pleased with that.

However, the following week I had an early scan and discovered that I'm having twins!!! Very exciting but not great for the vbac plans.

The mw and obstetrician I saw today and yesterday both said I had no option to have a csec. While I'm not keen on the idea I do want what's safest for babies and me and I know that I tick a lot of the boxes against a successful vbac on the rcog guidelines. Also from a couple of conversations with people who've had csecs recently the experience appears to be that if you don't labour the recovery is much quicker. I don't know if that's generally true or not but mine was not a great one after 21 hours of labour.

What I'd like to do (to stop me having nightmares about being cut open again) is some help with things I can ask for and actually get to make it a more bearable experience. So far my thoughts are:
8 weeks of painkillers (no fainting with pain at 2 weeks because they've sewn up too many internal nerves)
room to myself afterwards
proper post-natal care or release after 1 day if they can't give it.

Any other ideas would be gratefully appreciated.

Congratulations.

Personally I would kick up a stink about getting a private room afterwards, it made the world of difference in recovery from my planned cs. And the hellish post-natal ward did a lot of damage after my EMCS.

Stand your ground with the midwives, buzz whenever you need them and get them to do the nappies, they were clearly pissed off when I asked them to do nappies but I wanted to rest for the first 24 hours. It doesn't matter if they hate you for a couple of days, you get to deal with it when you get home. FWIW I was in tears after my EMCS as the post-natal care was dire and the lovely head midwife told me the care wasn't good enough and I was to buzz as much as I liked. The midwife in the birth de-briefing chat was even more narky about it, she said all the money has been ploughed into ante-natal care so women are left to struggle with new babies and little help. You don't want to know what the gynea team who did my hysterectomy think about post cs care, they are not impressed with it to put it mildy.

TBH you might not need so many painkillers after a planned cs. I was off paracetamol after 10 days. (Compared to a month of them after my EMCS).

I was the stroppiest cow ever after my planned cs as I wasn't going to put myself through what I had put up with after my EMCS. We ate ready meals and lots of domino pizzas for the first month too .

I didn't really do anything for 6 weeks in the end but it paid off, I recovered very well and was at the gym at 12 weeks. I'm not usually a stroppy cow by the way, but someone I grew a very thick skin when recovering from that planned cs.

8 weeks of painkillers (no fainting with pain at 2 weeks because they've sewn up too many internal nerves)

Really??? I'm having a c-sec next wednesday and am now shitting myself!

I have had 3 csec (all for different reasons) and if you are prepared then you cope much better.

Here are my tips

Pack for the csec - nice big knickers, loads of snacks, nice comfy clothes for afterwards, CD of music to listen to in theatre

After csec get some food and drink into you as soon as they will let you. Make sure you have everything to hand - drinks, phone, food, buzzer.

Accept every painkiller going!!!

drink loads

Once in the ward I like to have a bedside cot(easier for breastfeeding) but you may prefer a fancy bed which goes up and down in all directions

Next morning get the catheter and drip removed as soon as possible and get in the shower (with help if needed) - get freshened up so you feel like a person not a patient

Drink and eat lots and take every painkiller going!!

Try and move around but don't over do it.

Accept any help going.

I was happy on the ward because there is a bit of support socially and hated feeling isolated. Open the curtains and get loads of light

Be positive and don't do too much (especially lifting)

My second two csec were very positive and on my third they were happy to let me out after 2 days (It was DS1's 4th birthday!)

Good luck

tallpoppies everyone I know who's had an elective seems to have gone off pain killers after a week. The trouble I had was the hospital gave me a week's supply and a prescription for gp to issue a further week. He refused to give more. I got to 2 days before they ran out and tried to cut down from 8 painkillers a day to 6. I fainted from the pain, spent a day in labour ward with new baby waiting for them to authorise more pain killers and got another 6 week supply. At 5 1/2 weeks exactly I suddenly didn't need them anymore. I don't want to have to go through the day in labour ward thing again particularly with ds and 2 babies!!

Thanks meglet - I must work on inner stroppy cowness.

Loris - I did all of that the last time and recovery was still ghastly. I hated the ward. The first night I was kept up all night by next lady's crying baby, the next night by mine.

Tony,

2xELCS here and off the pain meds within 10 days or so both times but if you do need meds and don't have a prescription you can get Voltarol and cocodamol over the counter which are basically what they give you on discharge anyway.

tony, congratulations on your twin news!!! Very exciting, though I'm sorry that you may not get the VBAC you preferred.

tallpoppies, I'm also shitting myself from the thought of the nerves sewn b/c I'm scheduled for a c the wednesday after you! also, b/c the sonographer wrote a note for my consultant to be careful when cutting so as not to puncture one of my fibroids which is close to the incision area, yikes ! Anyway, good luck with everything, only less than a week to go!!!!!!! :)

I've only heard/read good experiences from ELCS mums, especially those from the past year.

In addition to Lorisparkle's helpful words of wisdom, I have packed a lot of yummy high fiber snacks like dried mangos, etc, for other post-op problems I've read about!

Oh god!
I hope I get a private room, I tried booking one yesterday but they said they would have to see if there is one available next week when I go in.
I live in germany at the moment so can't imagine being on a ward with other women and screaming babies when I can't even talk to them properly. I know enough german to get by but not to have a "normal" conversation iykwim!
I'm also worried about making myself understood if I am in pain or need help.
They ran through the options yesterday of which form of anaesthesia I want. Well, when I say ran through the options - they gave me 4 sheets (in german) of the different options.

So, did you all go for general aneaesthesia, epidural or local? They told me most people go for the local option here! How do they do that? Is it literally just an injection in the area they are going to cut?

I had ELCS with DD2 and was off meds after about a week. I was so worried about it before hand but it was actually fine. I had a spinal block and would have been discharged after 2 days if we hadn't had to wait for ECG for DD.

Never had an EMCS so have no idea if it was better or worse, but two women in my bay had and they were on oramorph and seemed to be in much more pain than I was. Also their first babies so more stress all round.

I have heard that a lot of the pain is also to do with EMCS being more traumatic mentally iykwim, so if you can try and stay calm and positive about things it should in theory help. Easier said than done mind.

EMCS are usually more painful as often the woman has been in labour beforehand so is tired, her muscles are tired, etc. A bit like having a major abdominal operation after you've just run a marathon - it's not the best starting point. If you have a true EMCS i.e. against the clock and in a rush to get the baby out, then it's a lot more brutal as they 'go in' very quickly - lots more tugging, lots less care and caution as it's a race against time. Obviously these EMCS are more rare than EMCS that have a more relaxed time frame i.e. an hour or more.

tallpoppies caeasreans are usually performed under 'local' anaesthesia in the form of an epidural and/or spinal block. This totally numbs the body from mid chest down so you won't feel anything except perhaps a slight tugging sensation. There is no pain. General Anaesthetic is not recommended unless medically indicated i.e. in the case of a true crash emergency where there is no time to site the epidural or spinal, in the case of a pre-existing medical condition that precludes the use of epidural or spinal OR in the case of a spinal or epidural failing (which happened to me). General anaesthetic caesareans are harder to recover from and you also have to factor in not seeing your baby being born, which I found very upsetting. From personal experience, if you can avoid a GA caesarean then I would do.

I had an ELCS 2 weeks ago as DD was breech and I was gutted to be having one. DS was a forceps and 3rd degree tear birth but I still wanted to do it naturally again.

My ELCS was bloody brillant. I think not having to go through labour made a huge difference to how I felt after. I had my GPs bring DS up less than 3 hours after the surgery, I felt great. It was so relaxed and I did get my own room as I have M.E. and I cannot deal with noise and coming and goings and it was amazing! My last stay on the ward was worse than the birth itself.

I have 2 friends who have twins and they both gave birth naturally, there is no reason for you to automatically have a CS just because its twins.

Ask for a second opinion.

You have to pay £85 a night here to request a private room (southmead Bristol) for that price I want 4* hotel and continetal breakfast. Not a plastic wrapped bed and pillow set and some plastic White toast!

I was on a ward after both my ELCS but the ward was specifically for CS (and really horrible VBs gone wrong) people as they needed to be kept a closer eye on that the rest of the births and there was only 6 of us in there so not too noisy and not cramped at all.

I had to pay for my single room even though I also have a chronic health condition.

Painkillers should be available - I left hospital with a prescription for codeine and instructions to buy paracetamol and ibuprofen. A GP refusing to prescribe should have meant calling the hospital back - you do not have to go without painkillers (anyway some codeine is available in otc cocodamol).

Agree with everything lorisparkle said. I had two planned (by me, no medical reasons) sections, both fantastic experiences. My boys now 11 and 9, but I remember it all vividly. With second son, was out of hospital on day 2 and driving within a week. I was acutely aware of negativity of people around me before birth - "you wont be able to lift the baby", "you wont drive for six weeks", "you'll never get rid of stomach overhang (utter rubbish)". My planned sections were perfect birth experiences, would recommend to anyone

I had an emergency c section and a VBAC. Then I found out I was having twins, was never offered a c section. The birth was horrific and ended in combined delivery (c section for the 2nd twin after normal first birth) and massive blood loss leading to further surgery. One twin was lucky to survive after a spell in NICU. For that reason I think a c section is safer for twins. I know some people have great twin births but I didn't and there were a couple of others in my local twinsclub who had the 'best of both' births.

Having a room on your own is essential to be honest. Makes such a difference. I had DH there even when it wasn't visiting times (he stayed overnight) as the staff were too busy to help me feed. They were quite happy to have him in helping and keeping an eye on me (I was in HDU). I agree with take all the pain killers you can. I found salt baths helpful after the initial healing period.
I stayed in 9 days with my crash section, 5 days with emergency one and 2 nights with my elective, the care was rubbish so I insisted on discharge. I got better care and rest at home. Wards are not good when there are 4 babies; invariably at least one is crying at any one time.

Good luck and congrats on the twins, having twins is amazing! (mine are 8 now)

Thanks jellybeans - I need messages like that to reassure me as to why ELCS is the best way forward. At least I'm not having nightmares about being cut open yet. Just about the great care I'll get on post-natal

Have had 2 c-sections, emergency for DS who got stuck after 26 hrs of induced labour, then 2 years later an elective for DD.
Elective so much the better experience, planned for it, so had all i needed. Much less tired as didn't have long labour, was out of hospital within 3 days rather than 5 as before, I knew what to expect, bought super comfy C-section pants from the NCT online shop tho they are a bit they were the business.

Also had organised family to help out with DS afterwards knowing roughly what I'd feel like so was generally a much more positive experience despite also having to look after a 2 y/o and newborn.
All the very best of luck - I'm a twin and I love it

Just had second cs two weeks ago today. First was emergency two years ago following an induction nightmare, just prior to being taken to theatre we thought we had lost DD, so all very traumatic although I was so delighted that she was healthy that I didn't acknowledge how traumatic the labour/induction had been until much later. Consequently I elected for a second cs with DS and I am so, so glad that I did. Every now and then on the lead up to it I would question whether I was doing the right thing and then randomly I would speak with someone who would say something along the lines of 'I wish I had opted for a second one, I decided to not to, ended up having really long labour and then emergency section....' In the end this one was also classed as an emergency section as my waters broke early and there were other problems but it was still a hundred times better than DD's birth as no labour, induction or pain prior to cs. I was also relatively well rested which made a massive difference. DS was delivered at 6pm and less than two hours later DD was able to visit us on the ward. The staff in theatre were lovely, I had music playing that I had chosen and it was just a really calm atmosphere. I have to say that probably my expectations are very low but I also found the support available on the ward really good. Obviously it varied depending on the staff on duty but generally I found that I was offered lots of help, especially initally with things like nappy changes & feeding. I was in a room with 3 others which was fairly awful but this time I was prepared for it and had earplugs and ipod at hand which helped hugely, with other babies crying and their mothers snoring! Would def be worth trying to get your own room though, that would make a massive difference. Anyway just wanted to add this message as I know it helped me when I heard positive section stories and as everyone says the recovery from a planned section is completely different from an emergency. Only a fortnight later for me and things are pretty much back to normal. Congratulations and Goodluck, I hope it all works out as you want it to.

Thanks - positive stories do make a big difference.

I really didn't want a csec but had a emergency one as DS was undiagnosed footling breech (undiagnosed until well into labour).

However, it all worked out fine. 3 days on general ward was horrid, but massive improvement in mine and DS's health once we moved to a private room. I was told that CS ladies normally get one but there were non available when DS was born (all beds on mat ward full actually - middle of September!)

I was up within 24 hours, stopped taking painkillers after 48 hours (because I didn't need too, not because I am anti-drugs), driving after 4 weeks, swimming after 6 and running after 12 weeks.

I think the thing that made a big difference (theory also supported by obstertrician) is that I swam 2 or 3 times a week and did pg pilates once or twice a week. Consultant said quick recovery was down to having well toned stomach muscles. This is also the reason cited for DS's position not being diagnosed though!

I also had a good experince of EMCS, far better thaa bad instrumental delivery

Get them to lower the screen so you can see the baby coming out

Ask for baby to be given to you straightaway, not taken to be weighed etc. You won't be able to hold him/ her but they can be beside you on the bed and it distracts you from the rest of the op

I asked for my dh to be with me when they sited the epidural. Some places put them out routinely, goodness know swhy

My mw put in the catheter after the epidural, so you don't feel it

I went home after 24 hours as they care on the ward was non existent. They wouldnt ive be the baby tp feed, kept saying that bf babies didn't need fed for 24 hours

I can't use volterol so got even better drugs. Dh made a chart and gave me them all on time ( you come home with quite a collection). Take them all

I was very careful about exercise afterwards as my sill burst her stitches and warned me not to be so stupid.I didn't drive for 6 weeks and was careful at the gym. It's knt the scar that's the people, it's the layers underneath

Sorry meant not the scar that's the problem

Bloody autocorrect on the iPad

The only painkillers I need were paracetomol. I also used Biooil on my scar from about a month, which has really helped it become supple and fade.

I also took arnica which helps swelling and bruising

Kristina which better drugs did you get?