Opinions on whether I should have an elective c-section, please

[YeahBut]

I'm 37 weeks pregnant with my third and have been told that due to my previous history, I can request an elective c-section. I'm not sure whether or not to go for it and would appreciate opinions.
Both previous pregnancies had complications (baby not growing well) and I had to be induced both times. The first delivery was the most horrendous experience imaginable. I laboured for 36 hours, I couldn't have any contractions unless I was maxed out on syntocin which then led me to have double contractions. Baby showed signs of heartbeat deceleration but I wasn't seen by a doctor for nearly 3 hours because of staff shortages. Baby ended up horribly distressed, major panic alround, ventouse delivery that left dd1 so battered she needed a head x-ray. It now looks as though dd1 has learning difficulties as a result of neurological damage sustained through birth trauma.
When dd2 needed to come out early, my OB persuaded me to try for another induction-led natural delivery. Anyway, 24 hours, 3 lots of prostin and all the syntocin I could have later I'd only managed to dilate 1.5cm. They did manage to break my waters to see if it would progress things which it didn't (and believe me, that's not a pleasant experience when you're only 1.5 cm). The induction was deemed a failure and I ended up having a c-section.
This time round the baby is growing normally, thank goodness, but my (different) OB does wonder how well a natural delivery would progress given what happened before. He says I can go for it with some very strict guidelines on how the labour should be progressing before they would intervene and c-section me.
At the back of my mind is the worry that something awful is going to happen to my baby if I try to have him naturally and if it did, it would be my fault because despite my previous experiences, I didn't go for the elective. I can't get out of my head the image of dd1 after she was born. With dd1 and dd2, the first thing that went through my mind was not, how many toes, is it a girl etc. it was "Is she alive?" TBH, the only reason I am considering a natural delivery is that I feel that I am being silly and irrational. I'm also worried that people will think my reasons for the elective are pathetic. Anyway, am going round in circles here and would appreciate any opinions you may have. I don't have to decide until next Friday.

[SoupDragon]

As the baby is growing normally, you could wait and see if you go into labour naturally (the inductions themselves may have caused the problems you had with progressing), give labour a set time limit and then go straight for c-section if there is no progression or things start to look even slightly iffy.

Or if you're really not bothered about a natural delivery other than in terms of feeling you should, given you've had a previou section then just go for an elective. At least there will be no worry about a disaterous labour.

[ladymuck]

I'm afraid that I'm a pro-c/s person myself, so would be biased. You've had a c/section so you know the score, but at least you can plan for it. Recovery isn't ideal when you have 2 dds, but again you can make plans (and it is easier IME to plan for the known rather than the unknown).

There isn't a list of permitted reasons for c/section with anything else being seen as immoral or indulgent. It's your body, your birth - you should feel as happy as you can be. With your history I would be seeking my c/s appt now, but then I have had 2 very positive sections (1 emergency, 1 elective).

Good luck

[Aloha]

God, I don't think you are being remotely irrational! You have a child damaged by birth trauma, and a consultant advising you. I wouldn't think twice if I were you. Why do you not want the caesarian?

[crunchie]

I would go with a csection tbh. You have tried twice, and obviously your body doesn't seem to want to go into labour naturally, or progress well.

IME I had a csection 1st time around (prem baby/pre-eclampsia) and 2nd time wanted to go natural. When my waters (slightly) broke I went to hospital as suggested due to my history, but labour didn't start, and the baby was not in a good position, so I made the decision not to be induced. This way I didn't have 'trial of labour' and be in pain for 4 hrs to see if it would progress, and still end up with a csection. I felt far more in control once I had decided (like I said I waited until the day) and had a much better experience. Once it was over the Dr said it was a good call as even if I had tried labour I would have ended up with a section as there was meconium in the waters and the baby was still not engaged at all.

In your case I would decide you have tried twice, but why put yourself through labour again and possibly still have a cs? Go straight for the cs

[Kelly1978]

Hi,

YOu've given lots of valid reasons to go for the section, and your only reason not to is because you think you might be being irrrational. Re-read your post - you've got the answer there. Given your history, a section is the safest thing for you and your baby and will put your mind at rest.

[iota]

another vote for csection here too - why take the risk of another difficult birth, plus you already have a csection scar and that in itself can be a complication in a natural birth

[jetlagdZebra]

I don't understand... you had bad exeriences before when you were induced, and on that basis you think that a spontaneous labour with no interventions would go badly?

You've never gone into labour spontaniously... you don't know whether your body is capable or not; all you know is that your body doesn't react in a textbook way to synthetic hormones. So I'm not sure if any of the previous history is relevant.

Anyway, if it were me, I'd wait & see & go to hospital as late as poss. after labour started.

[heavenis]

I would go for c section and IME the second one didn't take as long to recover from as the first. Good luck with whatever you decide.

[Ags]

I had an emergency c. section with ds after non progression of induced labour. All was well with both of us at the end of it all.

I have opted for elective c section this time. I have no qualms about saying that psychologically the worry about non progression again would make me very worried. My reasons are very weedy when compared to all you have been through. But my recovery from the section was very swift and that also encourages my decision as I didn't find it as unpleasant as some do.

I don't envy your choices and I hope that you will get responses here which help. I think it is encouraging that your OB will make sure that you are monitored very closely if you go for another natural delivery. That is comforting for the safety and health of you and the baby. But also might mean constant monitoring for you and the inability to move about. I'm not sure if that is important to you but perhaps something else to consider.

In your position, I would most certainly plump for the section for my own peace of mind. But you must do what you feel is right for you. Good luck with everything and I wish you and your baby and your other children good health.

[NotQuiteCockney]

If you have previously had a section, you can go for a section at any time.

Given you have a history of slow and problematic labour, and you have a sympathetic consultant, you can do a very very gentle trial of labour. As Zebra says, you know don't cope well with induction. (FYI, my independent midwife always was against medical induction. Lots of people think induction is best avoided, if you can.)

I had a section with DS1 (footling breech). With DS2, we decided to go for a VBAC. But I had loads of prelabour, his head wouldn't engage, my waters broke, there was meconium in the water, and I wasn't even effaced (and he was still not engaged). So we made a decision to have a section, there and then. I had the section about 6 hours after my waters broke. No stress, no worries about DS2. With your history, nobody is going to say you can't have a section, at any time in the process.

So there is a middle way. You don't have to go all out for a natural birth, and you don't have to have a section. You can just see how it goes.

[NotQuiteCockney]

Oh, and another advantage of the "see how it goes" approach is, you know your baby will be fully ripe. They will be as big as they're ready to get, inside you, which means they will eat better and sleep better after they're born. If you end up with a section, they can hopefully still get the benefit of the contractions to help get the fluid out of their lungs. Your milk will come in faster, thanks to the hormonal changes of labour (even with a c-section).

[Hazellnut]

I had the same experience you had with your dd2 - baby not growing properly, early induction prostin/ syntocin up to max/ waters broken at 1 cm (agree - grim) followed by emergency c-s. I know I do not ever want to be induced again (even if it was an option) but would consider VBAC (not having had your first experience) but I think I would book an elective c-s for say 41 weeks to give a good chance of going into natural labour.

That said, I haven't had your first experience and think that, if I had, I would go for the elective. Your reasons are by no means pathetic (and who cares what anyone thinks) - as you said, with both previous labours your concern has been the baby surviving, by the sounds of it with good reason - modern medicine gives you the option to have some of the stress taken away and you know what to expect from a c-s. Make sure you have the support after the event at home so you don't have to worry about having to run after two other little ones !

Hope all goes well whichever way you choose !

[uwila]

I would have a section without hesitation. In fact I would be jumping up and down demanding it.

There is too much pressure on women to have a baby naturally, and the risks involved are sometimes brushed over. I think your concern are valid and very rational.

Besides, as you've already had one, what's one more?

[NotQuiteCockney]

Fair enough, aloha. My experience was probably unduly rosy because I had an independent midwife to fight in my corner. (Even without her, DH is pretty bolshie, and unafraid of doctors, as his entire family are docs, pretty much.)

If they had needed the theatre for an actual emergency section, when I got in with broken waters etc, then yeah, I would have been postponed. But they do that to you with elective sections, too.

[Aloha]

The theatre wasn't the problem, sadly. I wasn't even allowed in the labour ward. So much for 'careful monitoring'. I really wouldn't call being left absolutely alone all night on a ward, with a midwife who refused to even get out from behind her desk 'careful monitoring'. I'd call it 'couldn't give a shit'. Which is what I'd call her attitude, if I didn't suspect that actually she was enjoying herself.

[cori]

I am hoping for VBAC with this one, but if I had your experience I would certainly be opting for for an elective ceaserean.
You are not being silly or paranoid.

[blueshoes]

Yeahbut, sorry to hear about your traumatic births. I am amazed you have not been put off natural birth by your experiences - you are a stronger person than I.

I find the promise to monitor you carefully during labour rather ominous, assuming of course they do infact do so and don't abandon you. My philosophy is if the birth is going to medically managed in any way, to go straight for elective cs, rather than trial of labour which in those conditions would be stressful, medical staff would be jumpy, frequent and awful internal exams, hairtrigger interventions with high likelihood of emergency cs. If there is even any hint of an induction, I'd say go for elective based on your past induction history. In fact, I forget even not try to go into labour naturally under unnatural birth conditions. But that is JMO. Hope you find the answer

[bubblepop]

if i was in your shoes, elective c-section would be my choice, most definately.

[Aloha]

blueshoes is right IMO. Devil or deep blue sea - careful monitoring meaning on your back strapped to a monitor, internal exams and all that, or being ignored! Unless you feel an extreme revulsion towards caesarians or would really feel distressed by having one, then I cannot see why you are hesitating. This time you could make it really special - choose music to listen to, have the baby delivered onto your chest - lots of nice things.

[YeahBut]

Thank you to everyone who has contributed to this thread. It helped put things into perspective for me. I've decided to request the elective c-section and feel very relieved having made the decision.

[edam]

Only just spotted this thread but FWIW think you've made the right decision for you. Hope it all goes very well.

[CarolinaMoon]

I've only just seen this thread too - given your previous history, I don't know how anyone could recommend you try a vaginal birth again .

Hope your cs and the recovery go smoothly. Good luck .