Any advice on how to stay strong and be firm during Consultant appointment for ELCS?

[nunnie]

My history is:
1 DD born at 39+1 and delivered naturally in just over 2 hours, taken to theatre for manual removal of placenta which had stuck to the womb lining.

1 DS EMCS at 36+3 arrived at hospital pushing but he was brow and in distress after 3 and half hours of pushing.

DS is only 5 months old and I am 13 weeks pregnant again

Have decided due to it being so close and due to the manual removal with DD (which was by far the most unpleasant procedure I have had), I would prefer a ELCS for this one.

I know there is a risk of me going into early labour due to DS being early, which is a problem considering how quick I labour but that is out of my control.
I am quite weak willed, I went into my Consultant appointment with DS determined I wanted a physiological 3rd stage but due to my nature of being easily convinced I agreed to a managed 3rd stage.

I will have to attend this appointment on my own as DH works away and I don't really want to take a friend or family with me.

I know I sound pathetic, just wondered how other people manage to stick to their guns?

Only you know your body - just remember that.

DH and I had an app before even conceiving as I really didn't think I could go through a birth like dd's again. tbh I think if the mw had been more supportive and listened to me I could have coped better with the 37 stitches, but I was on my own being ignored the whole time with dh not knowing whether to believe me or mw (not his fault it was our first time).

Our consultant wasn't keen but then I cried and dh explained the points clearly and he actually read my noted properly. His attitude changed and he said I would be considered for one. My GP then let me know he'd had a letter confirming I could have one. As it happens I'm pg with twins so would probably have been having a csection anyway but we didn't know that at the time.

My advice is to write out all the reasons and make clear that you know the pros and cons of ELCS. Maybe dh could write a letter for you to give the consultant if you feel he's not on side.

Good luck.

I had no problem with demanding an ELCS for my first time. I just told the consultant that 2 of my friends had nearly died in childbirth and a short selection of other friends' horror stories - and then added that there was no way I was doing it. The cons gave me a leaflet to read and asked again if I was sure. i said "yes" and that was it.

Now I'm pg again and whenever I see a MW/cons/sonographer they ask "why did you have a csection last time?" I just say "because I'm scared of pain and wanted it". That seems fine. I'm booked in for my second csection this Summer.

There was just no way I wanted a natural birth so I never gave an inch. I was willing to pay and go private if necessary.

Good luck.

I think deep down I am probably not really 100% certain hence the reason I will probably be easily persuaded to have VBAC.

I went into my midwife appointment saying I was swaying more towards the ELCS and was told I don't see why you are a perfect candidate for a VBAC. The same midwife then proceeded to tell me she had a ELCS with her 2nd due to needing to have a manual removal of placenta with her first, so I did think she was a bit unreasonable to try and persuade me to do something she as a professional didn't even want to try the word hypocrit sprung to mind to be honest.

I don't think the midwife should have told you you were a perfect candidate for a VBAC, as you will be giving birth following a very recent scar for the first baby.

Have a look at some of the research on this. I had a similar situation but I kept saying to myself that whilst there might be a sticky interview or two with consultants/midwives etc at the end of the day I would only be in contact with them for a few days in my life. The consequence of making the wrong decision would live with me and DH for the rest of our lives.

Have a look at this press release about Norwegian research published from RCOG
www.rcog.org.uk/news/bjog-release-risk-uterine-rupture-after-previous-caesarean-section

"Among the 18 794 mothers, there were 94 uterine ruptures (five ruptures per thousand women). The risk of uterine rupture was 8 times higher after TOL than at repeated elective caesarean section. The highest risk was after induction of labour, especially using prostaglandins, where the risk was up to 12.6 times higher."

Five ruptures in a 1000 doesn't sound much but look at those figures again - that's the average! The half of women who had repeat caesarean only had a fraction of the risk of the women who went for VBAC. So about 82 the 94 terrible outcomes were VBAC women - so one in just over 100. Rupture can cause death and brain damage to the baby - so is 1 in a 100 too high? I suppose it depends on personal choice.

What I do agree about is nunnie's point - there are a lot of health professionals encouraging women to do one thing but doing exactly the opposite themselves.

Thank you Ushy, I peronally have never found the 2 in 200 figure small or insignificant and this is another reason which makes the decision so hard if I am honest, there is just so much to take into account, and after speaking to the midwife who is obviously doing what she is guided to do and try and prevent ladies having a major op, but then to find out she opted for an ELCS because she had, had a manual removal of placenta with her first annoyed me. I had a manual with my first and an ELCS never even entered my head with my 2nd, but now I have had an EMCS I am higher risk and she is advising me to do something which if I am honest she was too scared to do herself.
Hopefully the Consultant or whoever I see will read my history and give me informed input from that and not from guidelines, but I presume that won't happen, but we will see. I am not completely anti VBAC just don't want to make a decision on what others have decided or google, I want to be given the information relevant to my history and make the decision from that, so I want to know the risks attatched to both and the pros and cons of both options.

Write all your points down before you go in. If you want you can print them out for the consultant to have a copy too. Read up on the pros and cons of vbac and elcs, show them clearly you know the risks of both and that on balance you want to have an elcs as you feel those risks are lower for you and your DC3.

I had an elcs after a traumatic forceps emergency birth with DC1. I had incontinence issues too so there was no pressure on me to have a vb once they read the notes in detail. I also sobbed a lot on anyone asking me about my first birth so I think that helped the ones who queried the impact it was all having on me.

My elcs was very calm, positive and enjoyable - and a world away from the awful first birth. It healed a lot of memories.

Go with your gut instinct, be well read, then stand your ground - good luck!