Could do with some advice. ELCS or VB after traumatic first birth?

[karensb]

I am an emotional wreck after meeting with the consultant today. I had a horrific first birth 6 years ago that left me with what I am sure is PTSD and PNT ( got over that on my own after about 9 months) . It took me 4 years to even consider having another and only after I checked with the GP that I would be allowed a ELCS.

Things didnt go so well initially and I had 3 successive miscarriages. This pregnancy is now at 30 weeks and I am terrified.

The consultant has said I can have a CS but wants me to go and have a debrief and look around the birthing centre nearby. She thinks that giving birth out of hopsital would be a totally different experience and even wanted me to have a homebirth.

Trouble is I had a PPH so would never consider home birth and also am worried about pain relief on top of everything. I had continual vomiting from first contraction and gas and air made me vomit too. I eventually had pethidine but would never consider that again as made me feel so out of control.

I did not want an epidural as wanted to avoid ventouse/foreceps but ended up with ventouse anyway.

I just dont know what to do. I dont think my emotional state is that good as when dc was one my sibling was diagnosed as terminally ill and diied 9 months later. So basically I just feel emotionally worn out as last 6 years have been rather hard going.

I want to just have CS and not face all the emotional turmoil of waiting for labour for next 10 weeks but know there are risks attached there too.

The consultant has been really supportive and just wants me to know all options. I just dont know how to make this decision! I would love to avoid major surgery but since no one can guarantee that this birth will go smoothly< i just dont know how to cope with lack of pain relief and labour etc. Oh and both current dc and this dc have crazy big heads, off the scale on the measurements! A family trait from dh!!

Sorry for ramble, but could really do with other people's views who are in or have been in this situation.

Have you considered a doula? It made a huge difference to me this time around to have someone with me to support me. We had a trainee one so wasn't expensive but a real one would have been worth their weight in gold.

It might also be worth speaking to a supervisor of midwives. I had been arguing to give birth at home as I was so scared of going in but with my history it wouldn't have been sensible and they did a lot to prepare me and prepare for me.

I personally wanted to avoid another c section so was going to do all I could to ensure that. Looking back a planned one wouldnt have been as stressful as the emergency one but I really wanted to be able to cuddle my other daughter after.

Thanks for all your posts. It has been a lot of help reading them as feel I am not alone with this dilemma.

I have considered a doula and even thought about remortgaging to pay for an independant midwife, just to have the additional support. However, it doesnt get past the point that I am in a bit of a pickle regarding pain relief as cant have gas and air, pethidine with my last vb left me horribly out of control and an epidural may lead to the same complications arising again.

Thats why the consultant was pushing for a water birth as a way to control the pain. However at a mlu I have read that you cant get in the pool till you are 6 cms so what would I do until then! I used a tens with my ist birth and didnt do an awaful lot!

The consultant does not think the same situation should arise again so wants me to have a better birthing experience and also incase I want a third child.

But the other issue is my first child had and still has an enormous head. Seriously, off the scale at the scan measurements and was in an adult sized cycling helmet aged 2.5 yrs! This babys head measurements seem to be even bigger so cant help worrying that they would get stuck again.

It will be useful at the debrief to find out if the head size was a factor to the disaster of my birth. I know I had an awful midwife as just shouted all the time and on the 2 occassions that the consultant had to rush in to sort out the situation, he was yelling at the midwife for letting it get to that situation. Another reason my current consultant wants me to go the the mlu, to get better support.

Bu what if I had another dodgy midwife, or the baby got stuck again, or my bp roceketed again, or the birthing pools were full? All these worries stop me being able to think clearly.

I love the idea of a vb and being able to go home straight away etc. But i never had that with my vb and was bed bound for 2 days and had t stay in hopsital for 3. So I might not get that anyway.

I have done some reading and the stats about problems with an elcs were scary. I am in such a muddle. My midwife has just retired so will have a new one at my next appt so dont have anyone professional that I know to discuss it with.

I have even been wishing that I wasnt pregnant this week just so I dont have to deal with this. The way things stand, I dont really think I have a choice from an emotional point of view, but to have an elcs.I am in enough of a worry after a few days of thinking about it, let alone 10 weeks. I just cant have the same birth again as could not cope mentally. Bringing up all the emotional trauma from 6 years ago is just too hard and I want to enjoy this one! Hoepfully will get debrief soon.

I had to laugh about the large head! I need to ask this too! Ds's head was 98th centile, and he is also wearing adult hats at 2;3. Though it's not really funny!

It does frighten me a lot, because ds was 8lbs 13 and of course this one could be bigger, and if the head size WERE an issue, then... well.. I just don't want to think about it, with risk of shoulder dystocia etc and all of that rising with larger babies.

I have done a lot of thinking about this and if I find it hard going at all in labour I am going to push for an epi. I think I had decided that an epi would cause difficulties again, but you know, since I started to think this I have realised that HUGE amounts of people have epi's with no need for instrumental deliveries/emcs etc. They have mobile epidural at my hospital and in my last labour I could move about, so I want to see how upright/mobilised you can be because I suspect that some adjustments could make things easier e.g. not lying on my back. Though I also have this suspicion that if it's fast this time and I am a second timer they won't give me pain relief/will stall etc and I am afraid of that too..

I have also booked for a hospital with 3 birthing pools (it's the one in OBEM!) as this would be preferred option, but I am ruling out nothing because it was stressing me out far too much to consider a birth without pain relief.

I need to sort out about my "official" debrief for birth again as the consultant booked me to meet with delivery suite team at my 12 week scan yet apparently when midwife followed up they can't see me as there are "30 on the waiting list" . I suspect that actually I wasn't put on the waiting list, so need to check this out and play merry hell if not...

I had dd 8 years ago and it was truly horrific . I didn't have Pnd but I was adamant I wasn't doing it again. Fast forward 6 years I wanted a sibling for her . I had counselling ( nhs) and discussed my options . They told me I wouldn't be allowed a c section so I accepted that . Well I had ds in June last year via c section due to pre eclampsia . It was classed as emergency but truly it wasn't . Yes it was scary but it was ok . The recovery is much worse and takes longer but overall I'm really glad I didn't have to have a vaginal delivery again . I have a scar and a flabby tummy which I didn't before but on the whole I'm happy with the way it went .

bishboschone you sound like me! I also had pre eclampia last time round which I am sure made my delivery worse as had to be on my back being monitored the whole time.

I may end up with it again and my midwife thinks a elcs is a good idea as may end up with emcs if bp goes up during delivery.

I find idea of cs scary but cant be as bad as thevb I had..i hope!. I dont care about a scar or flabby tummy as never wear bikinins!

I would prefer the pain of c section recovery than the mental anguish i was i last time. I truly would have given dc back if someone said I could and rewind time, not to have that happen. A horrible thought as dc is wonderful.

I would definitely go with a cs with your history Karen.

There's every chance that you may go home sooner after an ELCS than a VB. Like I said, i went home after an EM section after 36 hours.

What stats did you read that were scary? I mean, I know the problems themselves are scary, but I don't think the stats are that bad, especially for EL. If you read the stats for high-risk VB you may be equally scared.

I honestly did not find the recovery from the section to be that bad at all, much better than I had feared. Yes it's major surgery but if you follow all the recovery guidelines it's really okay.

If you think you could only deal with a VB under circumstances A, B and C, and there is no way to guarantee A, B and C, then I think it's a pretty risky thing to do.

Yeah I had PE with both but much worse with ds. I felt the same . I was petrified all the way through pregnancy about the birth . If you want my advice take the cs ! . When I say it's scary I mean being in a theatre etc but it's a controlled fear . My first birth was induced due to PE and just petrifying . I was in hospital for 4 weeks before ds birth and given the option of trying an inducement or cs and I chose cs . I don't regret my decision . I am crap at giving birth and am pleased I don't have to do it again. I can even watch one born every minute now which was a terrifying thought before .

Oh I definately don't think it's as scary as my first birth by a long way . My ds was whipped off to scbu but if I had him with me I don't think I would have cared about being sewn up . It was pain free and I didn't even get that pulling sensation despite him being only 33 weeks and quite high up.