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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Can you be refused a ELCS after an EMCS?

18 replies

nunnie · 01/04/2011 20:03

As the heading asks really.
I have finally decided I am 99% sure this is what I want having thought about risks and other factors.

Could they refuse me though?

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whomovedmychocolate · 01/04/2011 20:04

No they can't. They can try and convince you to have a trial of labour but you can refuse. I did incidentally, I had the option of induction or repeat CS and since the induction failed first time round I said 'nope I'll go for the CS please' (and did).

Original poster

nunnie · 01/04/2011 20:07

So it's just a case of remaining firm then? Unless they give a very good argument for a VBAC which I'm not certain they can but I will see.

OP posts:

whomovedmychocolate · 01/04/2011 20:09

Yes absolutely. But they won't be difficult about it - you will be asked at booking what your birth plan is, say 'repeat section' - you will go onto consultant care and book the birth date there and then.

Original poster

nunnie · 01/04/2011 20:17

I've had booking and hadn't really decided as it was all happening a bit quick and I didn't really have time to look at risks and other factors. I am 15 weeks and my EMCS was only 26 weeks ago :$ So my head is mashed, I hadn't really come to terms with my EMCS and aspects of that. I see a Consultant on the 11th. At booking in because I said it wasn't something I had really thought about the midwife was very pushy on the VBAC (even though she told me she had opted for an ELCS with her 2nd due to a long labour with first and a manual removal of placenta, which incidentally I had a manual with my 1st and EMCS with my 2nd so I thought she was a bit of a hypocrit really, but probably doing what the guidelines told her to). So I am in the frame of mind that I will have to fight for this.

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Panzee · 01/04/2011 20:40

I doubt you will need to fight much. The midwife's not in charge. As you've had a section before you'll be automatically on consultant care and just tell them.

Original poster

nunnie · 01/04/2011 20:43

This was the hospital midwife not my community midwife it's all messed up for em because my GP comes under another hospital so my community midwife is based in a different hospital and I won't see her till 28 weeks and that will be my 1st appointment with her, which is a shame as she has been with me for my other 2 and I get on with her.

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Pingpong · 01/04/2011 20:58

IME it is all down to them trying to get better VBAC stats. I was pushed strongly encouraged to have a VBAC. I agreed slightly reluctantly and said I would have a go if I went into labour naturally. However at my 40w appointment I saw a different consultant who was quite negative about the success rate of VBAC when induction was necessary and as they were reluctant to let me go more than 5 days over I was given the choice of induction at 40+5 or ELCS at 40+5. I choose ELCS and even right up to the last hour I was being made to feel I had made the wrong choice. When the surgeon told me that I was only 3/5th engaged and the babies head would have never fitted through my pelvis and weighed 11lb 1oz I was able to smile sweetly at all the staff that had made me feel bad and was able to point out that I had in fact made the correct choice.

WidowWadman · 01/04/2011 22:11

In his own words my consultant didn't try to "twist my arm too much" once he was satisfied that I looked into risks and benefits of both ELCS and VBAC.

As I told him my decision was based on RCOG and NICE guidelines and we had a nice chat about stats and how to read them, he was quite happy to give me an appointment there and then. Otherwise he'd probably would have sent me away with some leaflets to think about it first.

madwomanintheattic · 01/04/2011 22:14

ime it depends on the reason for the emcs. if it was for something that was unlikely to recur in a subsequent pg, they will probably expect you to go for vbac.

post code lottery i think.

i asked for elcs after vbac1 and was turned down. dc3 is now brain damaged and i have a cons letter which says i am not to labour. ho hum.

blueshoes · 01/04/2011 22:52

Just stand firm. Attend whatever briefing sessions they want you to attend to make sure you are fully clued up on the risks. Expect that they will be all over the risks of cs. They will mention something about uterine rupture with VBAC but expect them to completely gloss over the fact that a monitored labour greatly increases the chances of forceps and ventouse and another emcs. It would also never even occur to them to highlight to you the very nasty risks associated with vaginal birth quite outside of VBAC.

Once you have played along with their charade, aim lots of questions at them. Look like you considered everything and have digested it. GOod to quote NICE etc like WW. Then calmly insist on the elcs. And don't back down. Ask to see the consultant. Ask to see another consultant, even change hospitals. You probably won't need to go that far.

I finally got my elcs booked at 36 weeks for 39 weeks. I never felt so happy and relieved. Even the midwife eventually admitted to me she opted for a elcs herself.

I had absolutely no indication that I could not birth naturally. My emcs was due to baby distress, not anything to do with me. The elcs was totally uneventful and did what it said on the tin. Much better than the emcs.

blueshoes · 01/04/2011 22:53

madwoman, sorry to read about your dc3.

Trinaluce · 02/04/2011 00:37

My feeling on this OP is that you'll be having your second birth in the space of a year (if I've done my maths right) and I would have thought they'd be watching you VERY carefully as your EMCS scars won't have healed fully. I would have thought they'd be more than happy to let you have your ELCS just for the safety side!

soppypreggyloon · 02/04/2011 08:04

I saw my consultant on ties - expecting a fight for an elcs. The conversation went like this

"have you decided how you'd like to give birth?"
"yes I'd like a elcs"
"ok we'll book you in"

Was no argument or discussion at all! I was v pleased! :)

japhrimel · 02/04/2011 09:45

nunnie - as someone else has said, I actually doubt a consultant will okay a VBAC so soon after a CS. I was told I had to wait at least a year to get pg again after my CS so that the scar would have properly healed.

You really should be under consultant care already afaik as the chances of issues with the scar are raised with being pg again this quick.

Original poster

nunnie · 03/04/2011 14:50

Thank you everyone. If this one comes on it's due date he/she will be born just under 2 weeks before DS turns 1. If he/she is like DS then and comes 4 weeks early then there will be 11 months between them and they could end up in the same year at school.

My midwife told me the same 1 year before TTC again, but my GP said she was being over cautious and 6 months would be plenty of time for healing. Either way I made a stupid mistake and ended up falling pregnant again 11 weeks post EMCS.

At my booking in with midwife I was told I was the ideal candidate for a VBAC due to having had a VB with my first, even though I had an unsuccessful 3rd stage. However looking into it, I am very concerned with the gap between pregnancies and think that the midwife is wrong in calling me the ideal candidate personally but I am not a professional. This is what makes me think I will have a fight on my hands about getting and ELCS though.

OP posts:

damsels · 03/04/2011 16:46

I had a successful vbac after an emcs only 1 yr and 2 weeks previous.
DS was 2weeks late but I was due on my DD 1st birthday.

It was good birth, (if you can call birth that). i was really keen to have a VB as I found the emcs really deflating.
I was youngish at 23, and I really prepared my self for birth, watched what I ate, did tonnes of yoga & pilates (exersize does not come naturally may I add) 1st DD was 9Lb 3oz and 2nd DS was 8Lb 8oz

With my 3rd child I assumed it would all just happen again, didn't exercise or watch what I ate. 2weeks late as per with all my pregnancies so far, they predicted fairly correctly a whooper and scared me into having an elcs. 3rd DS was 10Lb 3oz So they were pretty right.
Personally didn't enjoy the elcs at all. But that was because I was expecting to have another vbac. Also the spinal block makes me feel really sick, so when they deliver the baby I am dry retching into a little grey tray. Exactly the same with my first cs. Also I am a control freak and hate being so helpless with cs.

Now 36 weeks with 4th hoping for vbac.

Sorry for waffling about my experiences. But to let you know it is possible to have a vbac so close to a cs.

I'd be more concerned about the retained placenta.

Hold your ground if you want a elcs.

damsels · 03/04/2011 16:51

This is a wonderful film and if I end up needing a cs again this is what I will ask for.

positivebirthchoices.blogspot.com/2011/03/caesarean-natural-way.html

Also just to add my vbac choice is totally textbook birth or a cs nothing inbetween.

I will write two birth plans a vbac & a cs one. Really want to avoid the DREADFUL radio song that was playing at my elcs

Original poster

nunnie · 04/04/2011 11:40

Thank you damsel, I will be going in with the intention of being firm, but once they start with their professional opinion I do feel obliged to listen and take it on board. Never know they might have the same opinion as me and push more for the ELCS. Won't know till monday. I am going alone which doesn't bother me too much, but my DH could have been firm for me when and if I start to hhmmm and aaarrrr, but he can't come so will have to read a good book in my long wait hopefully one on being assertive.

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