Previous traumatic birth- ELCS agreed but contemplating VB again - help me decide!

[Thandeka]

First birth was completely horrific lots went wrong, failed epidural (second one worked), failed cannulas, failed ventouse resulting in forceps, episiostomy and an oxygen starved very ill big baby (9.5lbs) who was in NICU for a week but is now fine.

Am now 12 weeks pregnant. Met with my consultant today and she is lovely and has agreed to ELCS based on my previous psychological trauma which is a huge relief. She has also given me option of trial of labour (with ELCS if I wanted) or ELCS at 39weeks. It is very empowering to be given the choice and there is part of me that wants a good vaginal birth experience as I think it would be a more healing experience than ELCS but also am too terrified for the same happening again.

Those of you who had previous traumatic first vaginal births- how were your second births? (whether you went for ELCS or labouring again).

What do you recommend! ;)

I had a traumatic birth with dd1 - very fast but mw didn't believe I was in labour so had no pain relief until dh requested a second opinion and the registrar told the mw to give me gas and air. She said it was too early and he shouted at her to do it - once through that contraction he said I was actually 10cm! I believe that the lack of support led to me having more than 30 stitches. This time, before getting pg, dh and I were referred to a consultant to discuss cs - he agreed and we ttc. I am now pg and expecting twins. I'm so glad cs is decided on and feeling very relaxed - if it was a single pg I might be tempted but I think it's hormones and my lady area has been changed enough.

However, that is me - only you can make the decision. I felt I might be being dramatic so asked dh what he thought and he is completely supportive.

wow congrats on the twins! (I was secretly hoping this one would be twins as would be more likely to get a section with twins! but its a singleton but they are letting me have ELCS anyway).

Would totally have ELCS for twins- enjoy the rest of your pregnancy how long have you got left?

I'm 12wks too with second pregnancy. With first I had an augmented labour with no pain relief after 48hrs stop-start labour & DS was back-to-back, 2nd degree tear, retained placenta & PPH of half my blood volume. I have definitely decided to have an ELCS if second baby looks posterior or there are any other obstacles preventing a more straightforward physical passage of the baby. Otherwise at the moment I think I will give labour a go with an epidural & the hope the second time it might be faster & easier

Have you considered any counselling for previous birth trauma, if you've not already had any?

Also if you don't mind me asking, did you have to "prove" you found the first birth traumatic? It sounds like you have a good consultant who has listened to you.

I have had a lot of counselling but major PTSD symptoms reared their head when I got pregnant again so I am being refferred for more.
The only proof they needed was me crying hysterically and at one point demanding a termination if I couldn't have ELCS, :s but I was also on a mission before I got pregnant again- I had a letter from a psychologist supporting my case and I also meant to see consultant before I got pregnant again but it didn't work like that as got preg but they rushed my appointment forward. I also wrote my consultant a letter documenting why I was requesting it in case I got too upset to make my case properly. Although it felt like a battle at the time it was actually very easy to get it agreed.

I really like your idea of checking positioning etc before making dec. My DD was in funny position plus 9lb5 so will ne having growth scans to check. Thing is lots of other things also need to be met in order for me to be ok so will have to see whether the hospital can meet my demands :)

a hypnotherapist specialising in birth issues could really help you. Many of the hypnobirthing practitioners are also hypnotherapists and could see you for sessions to work on the trauma. (Meaning if you look for them on the HypnoBirthing Institute you can find someone who could help, they don't just teach hypnoB.) Whichever way you decide to give birth could be beneficial to you.

Hi hun, i know we've 'talked' about this before. If you are considering vb there are lots of things that could help, ime especially-
a doula
seeing a chiropractor/osteopath in pregnancy
S x

Congratulations!

Was DD a Feb 2010er (was my original AN group under a different name and ended up in March 2010)

In your position I'd probably go for VB with the proviso of CS at the first sign of anything out of the ordinary. I think given your background you would be watched like a hawk by the Consultant/MWs so chances of anything going off kilter a second time is very, very slim.

I had 3a tear, forceps, PPH and MROP with DD and would still go for VB over ELCS next time (if there gets to be a next time!) and probably a HB rather than a hospital.

How are you physically? Did you have health issues from the birth? ie incontinence of bladder or bowel? If you had any symptoms I would be careful to consider your longterm health as muscle tone weakens at menopause and worsens mild symptoms.

I had a traumatic high forceps birth with DD, lots of mw error and ignoring my instinct that things were wrong, refused more pain relief when I requested it etc. Horrific day and horrific recovery as it became obvious my bladder was not functioning at all.

Months of physio improved it but it'll never be great.

I chose an elcs for DC2 because I planned no more than 2 DC so am not concerned for future risks, I felt it safer than him getting stuck like DD and me being ignored again, I also felt the normal exit route was very damaged and full of scars while the sunroof was better placed to heal up.

Birth was lovely, actually enjoyable, recovery simple compared to forceps, episiotomy and utter bladder failure, catheter etc. My only anxiety was about going into labour before the c-section date. I would've been down there so fast for my section!

Physically I am totally fine you can't even see or feel my episiostomy scar. Its the mental stuff that is my issue. A lot of tears hysteria and panic since i became pregnant again (in fact when I became pregnant with an ectopic in jan my overwhelming sense of losing that baby was "thank fuck I don't need to go through labour again!" I sought more counselling since then and have grieved for the ectopic) but there is no physical reason why I can't give birth again. But I have extreme reactions to stuff- I get hysterical if I see a One born every minute or hospital babies advert on telly for example. (even 2 secs of advert before I manage to switch it over causes a reaction!).

I have ordered a natal hypnotherapy book and CD as I figure if nothing else it will help with relaxation (am bit sceptical TBH) and I am hunting for a doula but alot of them seem a bit too dippy hippy for my liking (no offence Selina Doula!) as I want someone who isn't going to try an dissuade me from an epidural but basically to support me 100% and get me through a VB without breaking down into sheer panic.

P.S Flisspaps -DD was a feb 2010er but I wasn't in the AN group really as I joined one for my pregnancy before that ended in MMC and when I posted about the loss no-one really cared and didn't want to risk it again!

I'm not sure they would keep a close eye on me and whisk me to CS at slightest sign of trouble there was no way DD could have been ELCS as she was almost out just couldn't manage last bits and they keep banging on about how my last birth was fairly common and standard and they are only doing ELCS for pysch reasons but I know they would much prefer me to VB. I would have a big list of requests that they would need to pretty much guarantee as much as possible in order for me even to consider VB- eg. meeting and getting to know possible midwifes before (too difficult because of shifts etc apparently- so unless I find a doula or IM I click with then not good), having a waterbirth til 7cm or so if I can manage it that long then epidural for last bit. but biggest worry would be not getting epidural coz everyone else has one in!

Ho hum I guess it will a;lsp depend on growth scans and positioning- if next baby looks like a porker then no way! also if funny position no way! apart from that we will see....

No offense taken thandeka! we tend to say there is a Doula for every woman! Keep looking because there are plenty of 'non-hippy' doulas.
I place myself firmly in the middle, with a research and public health background but with a try anything to avoid harm.
S x
PS Not sure where you are based, but it is possible to push to have a known midwife, we are lucky here to have a consultant midwife but I have known them find a 'guaranteed' team to support women after traumatic births

am based in hippy dippy land (within 40mins of Glastonbury! ;)

I think it would be fab if they could find a guaranteed team think I will ask my antenatal midwife about that.

Check if there is a consultant midwife at any of your local hospitals.
And dont assume a hippy looking doula wont support you to have an epidural if thats what you want, its worth contacting them for a chat. Massage etc can be nice antenatally too and doulas are there to support your wishes, its very unlikely they would not want to support anything that you felt you needed to have an un-traumatic birth (even if that eventually was an ELCS) . Its about the journey to that descision too!

I'm 28w - mw still trying to convinve me to try vb as "you can always have vb for twin1 and then cs for twin2" - why on earth have two lots of stitches?! No thank you.

I also had a tough time with DS. 30 hr back to back labour, second epidural failed (after the first one had run out) 3.5hrs second stage (was left alone to push for 20 mins whilst the midwives ran about trying to find a doctor which was terrifying), in theatre for forecps, a lot of tearing, including internally up to my cervix and also had a manual removal of placenta. They were an hour stitching me up and the damage has left me with an anterior and posterior prolapse. I have not had a day go by yet (DS is 22 months) when I haven't spent most of the day thinking about how horrific it was. I'm expecting DC2 in November and am terrified about doing it again, DH was so upset by the first birth he isn't coming to this one. I intend having another vaginal birth but, I have hired a private midwife to stay with me in hospital so I know I won't be left alone this time, I am also consultant led at the hospital and have discussed it with the private consultant who has been dealing with my prolapse issues. Talking it through with everyone has been helpful, the consensus from everyone is that it his highly likely that it will be much, much better this time around but that they will be taking extra special care of me this time around after my last experience. I'm scared, of course, but I'm hopeful for a much better experience this time and hope it will provide some closure on the last one.

Hi,
I'd go for the c section to be honest. Forceps and a baby in intensive care is something that would scare the pants off me! Hats off to you for even considering a VB. I'd be too much of a wimp for that.
I would like to point out that your request for a VB, with a c section as soon as something goes wrong might not really be taken all that seriously. It would depend entirely on who is on call at the time. The OT might be occupied and to get the baby out they may need to do what they have to do.Basically, when you sign up for a VB, you sign up for all the good and bad surprises that come with it! I once spoke to a nurse who said "birth plans are a joke". Now, all of them don't think like that, thank god, but a lot of midwives/nurses might not treat your request with the respect it deserves.They are so overworked most of the time, one can't ever be sure how things will go. Besides,when you are in labor and worried about the baby and yourself, you might not stick to the plan yourself and regret it later.
So, my suggestion is the ELCS. I must say, you are lucky that you have been allowed one as they usually give grief over it. So take advantage of the fact and go for it:)
All the best and I really hope things go well this time. Do let us know, will you?