When to go to Hosp if Labour starts Before ELSC date???????

[MyBunnyRabbit]

Hi everyone,

I'm coming up to 33 weeks and have my elective C-section booked. Now I'm getting really nervous about labour starting spontaneously before my c-sec date. If this happedned to you at what point did you leave home to go to hospital.

at very first sign? not until contractions established? and how long did you have to wait to get your c-section once you arrived at hospital?? I dont want it to feel rushed like the emergency c-sec i had last time but also i was induced and so have no clue of what early labour will feel liuke and when to decide its time to go if i dont make it to my scheduled date.

elective is not for medical reasons but for psychological/emotional reasons after traumatic birth and loss of my first born. am really worried that if my consultant isnt on duty or i get a nasty midwife they wonr understand and will try to persuade me that if labour has started i shoule try for VBAC which i absolutely dont want.

please help reassure me....getting very scared now as still dealing with grief and struggling with growing bump and feeling stressed.
thanks
Mybunnyrabbit
xxx

My waters broke 10 days before my ELCS date (also for psychological reasons), so I was glad I'd had this conversation with my consultant and MW!

Their advice was - go to hospital as SOON as you think something may be happening. By all means ring in advance, but if the MW on the end of the phone (who may not know your circumstances, and be busy) tries to make you wait, ignore her and just go straight in.

This is just because very rarely, labour can progress very fast, and you want to make sure you get your CS before things are too advanced.

You can ask for it to be written on your notes that you have no desire for a VBAC, and that you want this to be respected. If you have an ELCS agreed, there is no reason at all why you shouldn't have one. You can say you are worried you will get people who will try and persuade you to do otherwise under these circumstances - that having got your ELCS agreed, you don't want to have to any conversations about it which involve going over distressing territory again with various different MWs.

I asked for the reason for my CS to be put in my notes, and for it to be written that if I went into labour early, there was to be no attempt at VB. When this happened, everytime someone said 'why are you having a CS?' or 'why do you want one?' I could just say, please read my notes.

All that happens if you go into labour is that they do your CS earlier. Technically it counts as an EMCS, but there's not the same 'emergency', IYSWIM.

My waters broke, and apparently I was contracting although I couldn't feel anything. That was late on Weds night - I went in the same night, and was told things weren't progressing fast, so I could either stay overnight and have my CS the next day, or go home and come in in the morning.

I did the latter, to get a sleep in my own bed - then came in at 8 in the morning, should have been in theatre by 10, but it ended up being nearer 6. This was just because there were a lot of EMCS's and instrumental deliveries needing the theatre, and obviously they take precedence. It was a bit of a long wait, but basically fine. They kept assessing me to make sure labour wasn't progressing, and they didn't need to bump me up the list.

I think your question is sensible, but if you can have a quick conversation with your consultant/MW, and ask them to write in your notes that you do not want to be encouraged to VBAC, that's a positive action and should hopefully bring you some peace of mind.

Good luck. My CS was great btw, a very positive experience with a very quick and easy recovery (and a very happily BF-ed baby).

PS I'm very sorry for your loss. You've obviously had a terrible time. I think it's entirely reasonable for you not to want to go over this territory and explain your reasons every time you see a different MW - having some clear info in your notes you can refer people to could be a huge help in that respect.

I'm Erika. AN independent midwife and I also work in the NHS. Please don't worry. If your consultant has written your plan the midwives will not try and change it on the day. They will understand the circumstances and will stick to the plan. You should go in if your contractions become regular, if your waters break, or if you are concerned about baby's movements. Youshould get at least 10 movements a day. Always call the midwives if you are concerned about anything. They really are generally wery nice and there to support you. Good luck with it all.

I would say, phone up as soon as you feel that contractions are regular and not braxton hicks.

But please do use your common sense. Birthplans should work the other way too. ie having an unplanned vaginal birth when you have booked a section. Be open minded. Sometimes nature has other ideas.

This is my main worry, as I progress very quickly. I am not booked in for an ELCS at the moment I am a VBAC but there are issues with my placenta which may change this but I won't know till 34 weeks.
I asked my Consultant and because of my history I am to go in with first twinge, if it is a flase alarm then great, but if it's not then they can sort everything out quickly, his attitude was better to be safe than sorry.
I am still hoping for a VBAC but at least if this isn't possible I am a bit calmer on this aspect, but I am sure there will be something else to worry about there always is.

Speak to your midwife and go through your concerns and hard I know but try not to worry.

Sorry - another poster has recommended that you wait until contractions are regular.

My MW and consultant specifically said NOT to do this. Similar to nunnie's post, the advice was to go in at the first twinge, or if you think things may be kicking off.

This is the opposite advice that women aiming for VB are given, who are asked (and largely prefer) to stay as long as possible.

I'm posting about this because the OP has lost a baby in a traumatic birth, and has had an ELCS agreed on psychological/emotional grounds, which she is keen to have. With ANY situation in life, there's an element you can't control, obviously. But there is also a good deal of sense in planning ahead as far as one is able. The same is true of a HB, a VABC, or for an ELCS.

I think with your history, it is what makes you feel comfortable and if this is going in straightaway then you do that. Once they see your notes then they should understand your concern.
When you phone delivery they are often busy and don't have access to notes so go off what you tell them, which when you are in a panic isn't a great system in the aspect of getting everything across quickly and precisely.

I think that's a good point, nunnie. The MW, consultant MW and consultant all said something fairly similar to me - that if you ring in and get someone in a rush, or someone who doesn't quite get what you're telling them (and to be fair, you may be in an unusual position, so not what they normally come across) -

Then ignore them if they say anything like 'stay at home and see how it goes', or 'have a warm bath' etc. That's advice which isn't relevant to you - if they need to bring forward your ELCS dates, it's much better for the hospital and theatre if they have some time to fit you in. It will be around cases where there's immediate physical danger to mother and/or baby, so obviously, if you go in early this gives everyone more flexibility. And if you have a long wait, being in very early labour is obviously more comfortable for you than anything further down the line.

I raised this with my consultant 2 weeks ago as I was concerned too and dd1 arrived in 2hours 5 minutes (1 and a half hours of which the mw said I wasn't in labour or was only early stages - turned out I was 10cm!), and he said to call mws so they can get ready and do the panicking before I arrived then go straight in.

The mw also instructed dh and I to be very firm about how fast dd arrived - she said most mws would be fine but it is unusual how dd was born and so we need to make a fuss if we're not being listened too. The consultant and his team are all lovely so I'm sure it'll be fine.

It's all in my notes but everytime I see a different mw they seem to want me to explain ELCS - straight forward reasons imo, traumatic birth with dd1, 32 stitches and now expecting ID twins. Consultant gave me a choice and when I said CS he said I think that's the right choice. So frustrating that professionals aren't checking my notes. I had a stand in consultant and she read everything so was clued up - it was so nice!

PrincessScrumpy, IME (my DD was born in 2 hours and 5 minutes majority of that time was stage 2), when I rang them with DS they asked if it was my 1st and I told them 2nd adn 1st came in 2 hours and she just said you know your body come in and we will check you over no arguments no fuss, I arrived pushing but he was brow so got stuck and needed an EMCS.
Hopefully you will get the same kind of response, try not to worry about getting them to listen, even if the advise you stay at home, it is advice and you don't have to take it, just go in if you feel more comfortable doing so.
I intend to do the same this time VBAC or ELCS I am not risking giving birth in my car