Fighting for a c-section!

[CJ2010]

I had an awful birth with DC1, had a VB, but was stitched up incorrectly afterwards and developed a hematoma and ended up being rushed into theatre to have it drained.

What has left me so petrified is that after DC1's birth I was taken up to the ward and I was feeling really ill and weak. I knew something was wrong with me, losing loads of blood, but luckily I had DP and my Mum with me. The staff were ignoring my pleas for help, Mum and DP keep going over to them but they wouldnt come to my bed, I was in agony. It was only when DP went out to the midwife station for the fourth time that a midwife came over and raised the alarm. I was losing loads of blood and thought I was going to die. You get the picture! Luckily I gave birth in the morning because if I had given birth at night, Mum and DP would have been sent home and I was have been placed on the ward on my own and goodness knows what would have happened to me. I've been left feeling terrified.

I was Group B strep posisitve but because I laboured so quickly I never got the full dose of antibiotics. Also, neither I or the hopistal can recall when my waters broke, it could have been 48, 24 or 6 hrs before DC1 was born, so there was a risk of infection to DC1 from both of these factors. This was never picked up by the hospital after the birth and I had to demand DC1 have some treatment (antibiotics). Turned out DC1 did have raised infection markers and did require treatment. She only got it thanks to me! It makes me feel sick to think about it...

When I fell pregnant with DC2 (due in August) I raised these issues with my midwife and she booked me in to see the consultant as I was requesting a c-section due to the botched VB delivery. He was great, listened to me and apologised!!! However, he strongly advised against a c -section but said I was suffering from PTSD and he referred me to the hopsitals counsellor. I have seen her once, but found her very defensive and protective of the midwifery team (she is also a senior midwife at the hospital). She keeps telling me it wont happen again and how qualified the staff are, blah blah! Then she started trying to delve into my past, childhood, school life etc, but I had a happy childhood, so no issues there. It was a bizzare session! I've got to see her again this aftn for one more session and then she will write an asessment to send back to the consultant so that he can make his final decision as to whether I can have a c-section!

FFS!! Can someone please advise me on how I can get my c-section. The hospital fucked up my VB, so I now want a controlled and safer birth experience which I believe a c-section will provide. I feel sick at the thought of a VB.

Anyone else had to see a counsellor? What do I need to say in order to get a c- section?

Sorry for long post.

I'm surprised that the counsellor is also a senior MW.

Not that counselling/debriefing roles can't be carried out by MWs, that's usually a good idea - but is she a both a qualified psychiatrist, AND a practicing MW?

I saw a member of the perinatal psychiatric team when I had my CS agreed, but she was a fully qualified psychiatrist, not a MW counsellor.

It does sound as though you are dealing with someone who has a possible conflict of interests here - if she agrees that you are traumatised enough by your VB to have a C section, she's basically agreeing that you experienced a poor level of midwifery and post natal care at the hospital. Telling you the staff are well qualified doesn't mean you haven't had a traumatic experience, in any case. Or that it won't happen again. Presumably they were all well qualified last time.

FWIW, I would try and get another HCP involved - do you have a sympathetic GP, or can you talk to the consultant again? Or ask to talk to another member of the perinatal psychiatric team? Obviously you don't want to be in the position of relying on a letter sent by one person you don't trust. I think it is reasonable to mention, without being wildly accusatory, that you feel you are talking to someone who seems defensive about midwifery at the hospital, as she is one herself, and that this is influencing her views unduly.

AFAIK, I was given a CS because it was felt that the mental and emotional consequences of forcing me to go through an unwanted VB would be very bad. [my CS was for primary tokophobia, btw, not after a traumatic birth]. My anxiety levels and dread was so strong that everything from panic attacks, dissociation, psychosis and PND were likely, and my pregnancy up to the point I had a CS agreed was extremely stressful.

So I'd guess that you need to be very clear, perhaps in writing, what your feelings are now, and how much mental pressure you are under. Getting a GP or someone else to discuss and record this with you might help you be taken seriously.

Just as an aside - I'm very, very wary of making a lot assumptions based on one post! But it sounds to me as though a lot of your problems were to do with postnatal care at the hospital (which sounds awful). If that is the case (and there may well be umpteen other factors in your decision making), then I'm not convinced a CS would help you avoid a similar scenario. That sounds horrible, and I really don't mean it to. Just that getting MWs to listen to you post birth, getting adequate care and pain relief etc are part of a CS recovery as well as after a bad VB. If the MW counsellor you are dealing with thinks your concerns are mainly to do with post natal care, she may feel that recommending you have a CS isn't the right course. I think you would need to be totally clear what a CS would mean to you over a VB, in more than post natal care terms, IYSWIM.

Apologies if the latter thought isn't helpful, I just wanted to mention it.

Fruitybread, you don't have to be a "qualified psychiatrist" to be a counsellor! Lordy! You just (ideally) should have done a counselling course!

OP, I requested a section with my first baby, the consultant agreed, but said it was hospital policy to ensure that women were making an informed choice, and I had to see a midwife consultant to talk about why I wanted one. In reality it was a formality but it also gave me the opportunity to discuss other options and factors. As it happened it was all academic as I had a v lowlight placenta so was referred for ELCS anyway.
The session with the midwife was about 20 mins and at no point did she try and dissuade me, she just wanted to make sure I was being realistic and informed.

Low-lying placenta, not lowlight!

Have just had my ELCS agreed after traumatic first birth. The psychologist I saw in aftermath of DD's birth had written me a letter reccomending ELCS and I also wrote my consultant a letter documenting DD's birth and it's effect on me and that I had read and weighed up the risks and still elcs was only option. They agreed to it straight away although they would defo prefer I have a VB. They are also getting me more counselling although have had lots but it's not a mandatory part of elcs. The new NICE draft guidelines say if after counselling VB is still unacceptable then ELCS should be offered. Pm me an email and I can send you a copy of my letter if you want. Defo get your gp to write a letter too.

dh and I saw the consultant before ttc dc2 as I didn't think we could have a second baby if I had to go through birth again - partially due to tearing and needing 32 stitches but also due to lack of care, mw telling me I wasn't in labour (dd was born 20mins later) and all my wishes (standard ones like dh being by me etc - he was ordered to sit in the corner as he was in the way when mw was showing the trainee how to use equipment for monitoring that I didn't need). I could write an essay.

Anyway, consultant was ummming and ahing about it until I burst into tears and dh calmly explained what happened. Consultant ended up apologising and agreeing to CS.

I'm now 28w pg with ID twins (bit of a shock) but cs is still on my notes in big letters. Some mw try to get me to change my mind as apparently I could have vb for twin 1 but 2nd twin is likely to be cs - why on earth would I go for both and have stitches in 2 places!?

Put your foot down but get dh to calmly show his support - it seemed to prove to my consultant that I wasn't an emotional woman who hadn't given it loads of thought. I know it's not the easy option but I feel I can enjoy my pg knowing how it will end (to a degree anyway).

Good luck xx

Go back to the consultant who is the only person who can OK it anyway and tell him/her that despite 'counselling' you are still adamant that an ELCS is the best/safest option for you and your unborn baby and should you be forced into VB against your will you will be holding them fully responsble for you and your childs physical safety and mental health both during the birth and for any consequential damage (PTSD).

Good luck (you really should not have to be put through this cr*p)

Just wanted to say, thank you all very much for your detailed responses to my OP.

I met again with the midwife/psychotherapist last week and it was a very unhelpful session. As I said before, she was very defensive when I talked about the staff failings and kept insisting that I didn't need a C-Section. To quote her 'It's not as if you had forcepts or anything like that involved in your birth, so I don't really understand why you are traumatised'

She also kept banging on about how qualified she is, how much studying she has done blah blah. She kept talking about herself! Anyway, to cut a long story short, I very calmly and firmly told her that after reseraching c-sections I had made an informed decision that I want one. I do not want to go through a vaginal birth, I just can't face it. As my due date approaches, I am feeling increasingly anxious and scared. I am also experiencing insomnia. Told her all of this, but she just didn't want to listen.

So, she is now going to write a report up and send it to my consultant and he will now call me back for an appt to discuss her report. I asked if a copy could be sent to me as well as the consultant and I got told 'A copy will be sent to the consultant and placed in your notes, you can see it then'

Fucking useless bitch. However, what worries me is that this useless cow could have a major influence over the consultants decision.

I am really despairing now.

Chynah - I am def going to say to the consultant what you have said in your post.

Thanks again everyone. x

CJ2010, this woman sounds awful. If she actually said 'It's not as if you had forcepts or anything like that involved in your birth, so I don't really understand why you are traumatised' , then she's worse than bloody useless as a counsellor, psychotherapist, or frankly, as a midwife.

I would make a complaint about her. How many other traumatised women is she treating this badly? FGS.

I'm really sorry you are having a hard time over this. I do think you need to go back to your consultant, as Chynah says, and to anyone else who might help. Who is this woman's manager? You shouldn't have to jump through these hoops though, and it makes my blood boil that that's what passes for 'counselling.'

CJ2010 I really sympathise with you. I had a really traumatic first birth too which ended in a crash section, and I still had to fight my corner to get an elcs for my second. I think it does depend so much on the individual consultant involved. I'd definitely second speakig to your GP, I did this and they wrote to my consultant stating how it was all affecting my emotional health. I also drew up a list of all my reasons pro elcs and referenced RCOG and NICE guidelines. Good luck, can you ask to see a different consultant or even go to a cdifferent hospital if necessary? Not that you should have to do it, I'm pretty sure the new draft NICE guidelines state that maternal choice is now a factor in choosing a section and should be recognised.

Hi,
I'm so sorry to hear about your experience. It sounds awful. I honestly don't think that after what you have been through you should have to beg for a c section. As another poster mentioned, you should research the benefits and risks of a c section as opposed to a VB so that the consultant is convinced that you are making an informed choice. Maybe the hospital trust has very limited funds because of which they want you to go for a VB which is less expensive. From what I have heard, if you tell them what you want rather than asking for it and stick to your guns they will eventually agree.
Have you read the new NICE guidelines? I'll try to post a link. They state that if a woman has a huge fear of vaginal birth, her decision for a c section must be respected. So, maybe carry a print-out of those guidelines with you?
Try getting a psychiatrist's note. My 28 year old friend wanted to get her tubes tied after her first child and they refused.She got a psychiatrist's note saying that the prospect of having another child was making her anxious and stressed, and then the procedure was performed.
If you are in an area where there are private hospitals, could you possibly afford to have private care?
BTW, that midwife sounds like a disaster. I'm so shocked that she had such little sensitivity towards your trauma. Awful woman.

CJ Book a direct appointment with your consultant (via his secretary - the number will bein your notes) and refuse to speak to this patronising waste of space again. Clue yourself up on pros and consget hgubby to SERIOUSLY back you up (get him clued up as well) and go for it. You deserve better

Sorry wasn't suggesting your hubby was unsupportive or anything but I found that when my husband started his " for the safety of my wife and unborn son " speach the consultant really took ntice !

I am horrified that this woman spoke to you this way, "I don't understand why you are traumatised" - And this is what passes for counselling? Fucking hell. It is NOT up to her and you should not have to beg and plead your case this way.

Don't see her again, and make sure the consultant knows why.

I had a very traumatic first delivery, and needed post natal repair surgeries and lots of other treatment. When I managed to get pg again (practically an immaculate conception!) and asked for a CS, the consultant agreed straight away and said it was a perfectly reasonable request considering the circs.

You need to complain about this so-called counsellor in writing immediately. You also need to ask your GP to refer you to another consultant.

because it's a psychiatrist or psychiatric healthcare professional who should be diagnosing you with PTSD, not an OB consultant using it as an excuse to fob you off.

What a horrible shit hole to have to give birth (either way!) in. Why on Earth are you going back there? If I were you, I would be banging on the GP's door the second I realised I was pregnant asking for referral to a better hospital. I agree with the poster who said a lot of your probelms were post op. So I think you have two issues here:

1- Getting the delivery you want (i.e. sectio)
2- Reasonable post natal care

Your story really is pretty shocking, as are so many on here and in real life. There isn't a chance in Hell I would ever entrust my and my babys' lives to the place you have described.

I think back to the GP for referral would be my course of action.

I agree with Chynah's advice on what to say. But, I would go a step further and put into writing a ver clear statement of your absolute unwaivering preference for a c-section. You never know, that midwife/counsellor may have written that you were traumatised and still considering your options. So make sure the consultant knows that you are very clear in your own mind what you want.