All this talk of VBAC only policy....

[kblu]

Hi ladies, I wonder what your views would be on my situation. I had a very traumatic birth 3 years ago resulting in an EMCS under a GA. I developed severe pre-eclampsia as I went into labour 10 days overdue (I had signs two weeks up to getting it but no protein in my urine so they didn't diagnose and wouldn't induce). The day I went into labour I felt physically fine and I had the usual "take a paracetamol and have a bath" routine when I rang the labour ward that morning but I was in so much paid that I decided to take myself into hospital. Good job I did because I had my baby half an hour later. I was extremely poorly and my baby suffered HIE as a result of oxygen starvation and I was told whilst in intensive care that my baby could possibly be brain damaged as a result. I also suffered severe bonding issues as I didn't meet my little boy for two days after he was born due to me being too ill etc. etc. All in all completely horrendous experience for me and my husband and we decided we'd not have any more children because of it. That is until now!

So obviously we've some major concerns this time round. First of all i'm now 38 which isn't old I suppose these days in baby terms but it's still a concern for me as I never intended on leaving it this late to have my second (and last) child. I'm other major concern is that they won't give me an ELCS. This is an absolute must as far as i'm concerned because i'm frightened of the fact my PE came on so suddenly and severely when I went into labour that it would happen again. I just wouldn't put myself in that position. The only way i'd be comfortable getting pregnant again is if I had a planned C section at say 39 weeks, that would give me a massive amount of peace of mind and I would be able to have a relatively stress free pregnancy. I've read up on VBACS and it's just not an option i'd feel comfortable with. I really don't want to end up in an another emergency situation putting my life and my babies at risk like last time. I realise I might not get PE next time but I had a text book pregnancy last time with no signs of PE until the last couple of weeks so this is my concern!

So with this in mind I made an appt with my GP for some pre-conception advice. Although very sympathetic his view was that it wasn't a guarantee i'd get one but I would have a very strong case. He spouted all the usual government guidelines have changed routine and they are encouraging VBACS now etc. etc. He did however telephone the local obstetrics for me and their advice was that their hands were tied and couldn't give me a definite yes (I suppose until i'm sat in their office with a baby in my tummy). Seems madness. I then decided to go for a birth de-brief at the hospital and found this very helpful. The midwife remembered me as she had dealt with me in the maternity assessment leading up to my birth. She said to me that 100% I would get an ELCS and I didn't need to speak to a consultant for her to give me this guarantee. She said my case was so horrendous that she more or less gave me her word. I've also spoken with a friend of a friend who was recently given an ELCS at the same hospital because she had a first traumatic birth (she never had an EMCS the first time).

So this is my dilemma. Would you be more inclined to go with the advice of your GP or the advice of the midwife at Birth Afterthoughts?

Your views ladies! I'm really scared I would have to fight my case with a consultant once I got pregnant.

You could ask to be referred to a pre-conception appointment with a consultant. Your GP won't have been speaking to a consultant at the hospital (I doubt that consultants man the phones). Or you could splash out on a private appointment with one of the local consultants just to have a decent length discussion (obviously still having an NHS birth).

kblu, thank you for posting this, please let me know if you hear anything of interest. I had DS by EMCS in June after a failed induction due to pre-eclampsia & am now absolutely terrified that when we have future children I will be pushed into having a VBAC, the thought sends chills down my spine! :(

Breathslowly, he did say he spoke to 2 consultants apparently but albeit not with my notes in front of them so they probably would have just been taking a broadbrush approach, rather than my case on it's own. There's no nhs facility for pre-conception appts with consultants and we've considered private but gp's view is we'd be wasting our money although im not entirely convinced of that.

I was advised by the MW at my birth debrief to have a pre-conception appointment, so I think it must exist as an option on the NHS. I don't think that they can say there is no facility for pre-conception appointments, they (the hospital) can just book an appointment.

I have found (occassionally) that having a private appointment works quite well and consultants are happy to refer you back to themselves on the NHS. From a consultant's point of view you are paying them a decent amount, they get a reasonable length of time to deal with you (which in somewhat emotive situations is much better) and you can see the consultant you want to see. If you want to do this, contact the MW you saw to ask her opinion on which consultant you would be best off seeing and ask either your GP or another one in the practice to refer you.