I'm unlikely to get the birth i really want... so how i can i still have a good experience?

[deemented]

I'm 32 weeks with DC5, and i know the odds are heavily stacked against me for getting they type of birth that i want.

I'm overweight, i have PGP and back problems, i've had an emcs previously, a 3rd degree tear previously and i have diabetes.

I really want to give birth in water, and for it to be as hands off as is possible.

With DT's i had an emcs, seven and a half years ago. We knew DS1 was going to die soon after birth, so it was all rushed and incredibly fraught.

With DD i had a VBAC, and tbh it was pretty horrific. I went into labour naturally at 38 weeks, but they insisted on breaking my waters so they could put a monitor on her head and then they wouldn't let me get up and move around and i ended up having just gas and air and a 3rd degree tear.

With DS3 i was induced due to GD at 39 weeks exactly. It wasn't a brilliant birth, i wanted to avoid being flat on my back again, but again they insisted on monitoring on his head and i was flat on my back. I ended up with an epidural, but no tears that time.

They have said that they want to induce me again, and although i can't say i'm delighted at the prospect, i do understand. But i'd like to be able to be in water - this would help the PGP immensely, as well as normal pain relief. At the very least i want to be able to move around and not be flat on my back yet again.

So, i'm kind of resigned to the fact that it won't be the birth that i want, but how can i still make it a positive experience? This will be the last baby i have and just for a change, i'd like to be allowed to do it my way. Obviously i know that anything can happen, and i need to be flexible.

What do you think?

I think that if there is anyway you can make this best, most positive of your births, then you must try to make it happen (within the bounds of course of what is safe).

I guess it's all rather dependent on

1. you being assertive.
2. you getting the support in this from your birth partner and midwife
3. the medical needs of you and your baby.

I am hardly an expert (one DC, EMCS as did not go into labour following induction), but it seems that to me from reading on MN and speaking to friends, that avoiding continuous monitoring and keeping upright help enormously, as does avoiding an epidural (because this tends to lead to continuous monitoring and lying down). Maybe an independent midwife who you trust to get the balance right between minimal intervention and maximum safety?

Of course the other option is an ELCS. If you have chosen that, it's as much "your way" as a VB. Even mine, which was unplanned, was a wonderful, calm, pain free experience, followed by a relatively fast recovery. Definitely 100% positive.

Given your previous history the hospital is always going to recommend continuous monitoring but there are ways around it. Ask if they have telemetry which is the mobile monitoring where you can be mobile but within range of the home base unit. Lots of hospitals have them now. Or if they don't have that you can still have an FSE (the clip on baby's head) and stand/sway/sit on a ball/ walk a little. If you are willing to accept the risks of no monitoring then they can't physically force you to have it - plenty of other threads discussing that.
I think you have a pretty good case for a less managed birth if you can write down the positives you have already achieved:
2 vaginal births after a CS, 1 of which was with no tears after a third degree tear. You can emphasise that being restricted in your movement means you feel the pain more and if you want to avoid an epidural (maybe you don't?) then use of the pool would be a huge benefit.
Is your diabetes well controlled? If you can maintain even sugar levels that will be another plus point in your favour for less intervention.
Do you have a supportive diabetic nurse/midwife? She could be a huge support. Good luck whatever you decide.

Thank you both for your replies.

I do want to try to avoid an epidural this time - the only reason i had one last time was because i was feeling the contractions most in the area of my csec scar, and they said i either had an epidural or another csec.

My sugar levels are a little high at the moment, and they are adjusting my insulin because of this, sometimes three times weekly, but overall they seem happy with them.

I'll speak to my diabetic midwife and see what she says.

I was planning a 3rd home birth this time but ended up being induced at 14 weeks. I met my me the day before and they kindly went through my birth plan with me. It was agreed that they would rupture my membranes and then if baby was happy I would be allowed time to go into labour, we agreed 3-4 hours once n established labour I would be allowed use the pool at the hospital.

On the day they broke my waters and there was meconium in them so the pool was out, I then didn't go into labour so had to have syntocin. I did however request the wireless monitor so was able to move around which was great, managed 2 hours with hypnobirthing but found it very intense so opted for an epidural which was great pushed out dd no problem 2 hours later no tears and was by far my easiest birth. What helped was being in control and rolling with it when things didn't go to plan having a really good mw who let me make decisions but told it in very black and white and although I had the epidural and was pushing on my back which wasn't working taking control and deciding I was getting up, the other mw who came in thought I was insane but trusted I knew what i was doing dh helped me prop my self over the back of the bed and being upright definitely helped. I would think about the possibility of an epidural with syntocin I have had big babies with G&A but this was very different. Don't see it as a failure if you don't manage not too it's not like normal labour you don't get that lovely build up of oxytocin.

I have just had an induction with drip, epidural and continual monitoring (not a clip though) and I was able to stand holding the bed/sit on a ball throughout. No-one suggested I lie on the bed, quite the contrary. It was great.

Maybe discuss the lowest possible dose epidural they do and ask can you be monitored in a way that allows mobility?

Moving around does help if you can manage it at all. When I was having DS they wanted to put a trace on me and a clip on DS. As it turned out the clip thingy wasn't working so that was out and I just refused to get on a bed as it was far far too painful so they had to draft in a midwife to hold the trace up to me as I moved around. Remember they can't make you do anything you don't want to do.

Mobilization is the key to a good birth. A clip on the baby's head will allow the heart rate to be monitored more easily, given your size (You don't say how large you are) and will allow you to continue to move around. Take the CTG machine with you if you go out to the toilet, if the lead stretches far enough.

When you induction first starts spend some time off of the unit mobilizing up and down stairs, then spend some time in the bath (try and get in a pool (its only a big bath) if you can). The longer you cope in labour, the further on you will be before you are officially diagnosed as 'in labour' and put on continuous monitoring.

You are in control. You do the allowing! You are the one to give your consent to any procedure offered. You are at liberty to change your mind whenever you choose.

off not of!

Also, even in hospital, with an epidural etc, you can still have your choice of music, low lights (you can bring your own bedside lamp if you like), essential oils (a bulb top diffuser or similar, not flames). You can have your choice of birth partners, bring games, reading or other distractions, most stuff you might want at home could be adapted for the delivery room. I know one doula who carries a light throw to put over the EFM to put it out of sight and mind (because it becomes a huge focus if you let it)
Also, are you doing prenatal yoga or anything? Physical preparation is really helpful, and a good teacher should be able to give you things you can do (remembering yoga is also about breathing techniques and relaxation).