did you have an elective section, what were your reasons?

[chocoraisin]

Hi all,

I'm having a bit of a palaver over my birth plan. I've relocated into a different PCT (marriage breakdown means I've had to move in with parents with my toddler) and here, no-body knows me. I was booked in with a specialist birth trauma midwife where I lived previously, who supported an ELCS due to my previous emergency delivery, my problems in pregnancy (SPD very severe) and general stress over the situation.

It was meant to be discussed and booked in here, but the consultant is pushing me to have a 'natural' delivery. She's suggesting I use stong opiate painkillers at a level that my baby would require withdrawal management from, to control my SPD. She says going through withdrawal is better for my baby than having a planned section. I disagree. I would rather grit my teeth through the pain, even though I'll be very, very tired, and have a planned section. I don't understand why the doctors are pushing me to have a 'natural' delivery when it means lots of drugs, total exhaustion and the likelihood that I'll need another instrumental delivery if I am too tired to get baby out. Last time I had emergency forceps in theatre, and took 10 months to recover from my pelvic problems :(

The main argument seems to be that a c-section takes 6 weeks to recover from. I don't really give a damn when I know that my last delivery/pregnancy took roughly the best part of a year to recover from. And I DO NOT WANT to take high doses of morphine for the next 18 weeks or so just to 'perform' as a woman :(

How do I get them to listen to me? Am I being unreasonable about this? Can someone more experienced come along and tell me why the doctors plan is better than mine? Feel very upset and pressured about the whole thing.

I had elective with DC5 as had already had 2 emergency sections and was very high risk after previous stillbirths and on blood thinners with a cervical stitch. They advised it, I would have preferred natural but was just wanting a live baby. Elective so much better than emergency/crash section. Was in 9 days after my crash section and needed further surgery. With the elective was in for 2 nights. Needed DH off for 3 weeks though and was in pain for that long.

I'm 34 weeks at the moment and am very small - baby is looking to be heading for over 9Lbs so I am planning on having an elcs. Remember that since the NICE guidelines have changed - they can't refuse you an elcs (they can try and talk you out of it!) - so don't give in - dig your heels in and insist!! Its your body - if you don't want to go through a natural birth they can't force you. Good luck!

Had an emcs the first time, this time they wanted me to vbac. I never felt I was a good candidate (given my previous failure) - so as per another poster, I threw the RCOG guidelines and facts at them, these I feel are more 'powerful' than NICE. I also compared these to the statistics of that particular hospital which echoed RCOG. I presented these facts plainly and calmly over 2/3 appointments until it was agreed.

As it transpired, my son would never have been born vaginally this time anyway - perhaps even Forceps wouldn't have done the job - it would've been a catalogue of intervention followed by emcs. My body does not give birth.

Definitely ask to see another consultant. I had 2 sections at my request, as I have a phobia ofchildbirth. Fortunately my concerns were taken seriously by all the staff I encountered, gp, midwives and consultant. Your concerns should be being taken seriously too.

It is important to arm yourself with as much info as possible, I agree looking at RCOG guidelines as well as nice is persuasive, but you shouldn't feel you need to be combative. All you need to be able to do is show you are making informed choice, and you shouldn't feel bullied into doing what you feel is harmful to you and your baby.

thanks for the advice guys - I spoke to my GP today, and basically got the same line. For a 'woman like me' it's 'generally' safer to have a vaginal delivery.

Still don't understand how I will achieve this normal vaginal delivery given my actual circumstances. Telling me that general statistics show blah... means eff all when I want to be told, ok, exactly how should I stand/sit/lie down during labour given my mobility problems? And exactly how will you manage my pain to make this happen?

Until someone can answer with something a bit more useful than a bloody statistic I am definitely not going to be convinced that this perfect, natural delivery will occur. How it can be natural with opiates coming out of my ears anyway is beyond me...

Hi op, I had one for my ds2 after EMCS for ds1. Ds1was a big baby, just under 10lbs, I wasn't dialating. I was told during first csection I would be should have a csection if I had any future children. When I was preg with ds2, my midwife supported my choice for csection, but consultant was completely against it. I got one in the end after demanding another consultant. I also requested my medical records. They kept trying to convince me that ds2 would not be as big, not believing the scans I had had showing him being big for.my dates. After a lot of stress, tears shouting and refusal to back down, they booked me in on my due date.

Don't give in. You have a right to the birth of your choice.

BTW, ds2, born by elected csection on due date was 10lbs, just as scans predicted.

Speaking to GP about is waste of time really, as the decision has nothing to do with them. I spoke to my consultant at my 20 week appointment and managed to be given my ELCS date there and then.

Asking questions like "Still don't understand how I will achieve this normal vaginal delivery given my actual circumstances. Telling me that general statistics show blah... means eff all when I want to be told, ok, exactly how should I stand/sit/lie down during labour given my mobility problems? And exactly how will you manage my pain to make this happen? " is a good start, as it shows that you've actually thought about it.

Write down a list of questions before you go in. Print out the guidelines and highlight the bits you want to talk about - preparation like that will help you in case the consultant tries talking down to you or derail your argument.

I had elective with dd1 as she was breech, fell pregnant twice and miscarried within 15months of having her finally got pregnant with dd2 and I pushed and pushed for c section backed up with research and a supportive midwife. Had my c section booked at 22 weeks and then turned out I wou,d ave needed section anyway as dd2 was transverse (was admitted 3 times between 34 and 38 weeks as had bleeding all through pregnancy made it to theare on Christmas eve for them to decide I could go home and spend Christmas day with dd1 wen back day after boxing day and scan showed ok, ended up back I on new ear day kept for night, went home for few days and finall had dd2 on 5th jan 2007

Excuse typos stupid iPad

What do you think would happen if you just said you wanted a secton? THey can try to convince you all they like but would they flat out say no and refuse to book it?
BTW I thought a CS was marginally safer for the baby and less safe for the mother. Could be wrong, happy to be corrected

Will message you

well so far I've been told no, the consultant suggested I have an epidural so I can sleep in early labour and that I will somehow miraculously then achieve an active birth and avoid lithotomy (which will damage my pelvis further) while having had an epidural. She would rather induce me than book a section.

I am seeing a psychologist to discuss my birth trauma, and have seen a pain clinic about managing my SPD, and am meant to see a midwife about birth positions etc.

I just don't feel confident at all that I will get answers, or be listened to... found my account of my first birth that I wrote for a trauma debrief which I will take. Had ongoing problems, with sexual dysfunction. My marriage ended when I was 12 weeks pg due to OW... which doesn't help! In summary this is how I felt:

Overall, I have been put in a situation where I feel that my value as a person has been trampled. I feel violated, degraded and humiliated. My plans for a large family have been left in tatters. My relationship with my husband is compromised, and the thought of being pregnant again (if we could even achieve that) is a sickening and frightening thing.

I'm going to take that along with my notes on the NICE guidelines etc and see what they say. If she still ignores how I feel I'll ask to be transferred to someone else.

So much for pregnancy being a happy and exciting time :( I wish it was for me!!

I'm so sorry :( Here's hoping for an easy CS, and that first cuddle with your newborn will make it all OK. BTW the look on the older sibling's face when they see their baby sibling is like nothing else - recently saw a friends DS cuddling his little brother and it really reminded me of DS's face at his first cuddle with DD. Sort of serious, full of responsibility and amazement.
...or maybe DS was just hungry and I'm reading too much into it :o

Third degree tear in first labour after theatre foreceps. Still hurts 3y on.

ELCS with DD2 6m ago was a breeze in comparison!

As soon as I said I had symptoms from the tear () they were fine about letting me have section.

Good luck! Just be firm (& cry?!)

choco - I second that. Cry to the psychologist. I cried so many boxes of tissues that the maternity psychologist said "Leave it with me. I will make this happen"

Dig in your heels and say you will not settle for anything other than a CS. Print off research that supports elective cesareans and their psychological outcomes for mothers with a history of trauma and take it with you. Print off the NICE guidelines and show them to this annoying consultant. If she still refuses, just flat out tell her you don't accept her decision and want a second opinion.

You have to be convinced of what you want. Read up as much as you can on this subject and just refuse to take no for an answer.

I should add that you don't have to see a psychiatrist. Women who want CS are not in need of mental health care- they are in need of people who will respect their decisions regarding their own bodies.

OP - what a rough ride you've had I've had two electives and was very happy with them - keep fighting xx

Poor you. I don't have any firsthand advice, but have you thought about getting in contact with your old trauma midwife? If she's on side, she might have suggestions for your new PCT, or be able to help out in some way? Sometimes they know their way around the systems, even if it's not their authority and can suggest things to do/say/reference to help you.

Or they might have heard of the particular consultant (I've heard a MNer comment in the past of a consultant on their first labour whose reputation seemed to span the country, and not in a good way) and suggest who to ask to be referred to.

I'm so sorry that they are making you battle like this. I went to all of the counselling suggested and then at 36 weeks went in armed with a very lengthy document detailing my feelings surrounding my first birth and this one. It felt like that finally had some impact - I think I'd been very inarticulate in my dealings wih people and that clearly laid out I'd thought things through and what the issues were. I would ask to see another consultant if you feel this one is giving a no (which they can't do, by the way) and then refuse to leave until you have got what you want. Is there someone who could go with you to any appointments to support you in getting your needs and wishes met?

Hello choco- I've lurked on your other thread, and frankly you deserve a sodding medal just to be getting on with life so well. I can't believe your consultant is giving you this crap...and frankly some of their reasoning is jaw dropping. Pumping you full of high strength painkillers? I had two doses of morphine (during/just post op and a few hours later) then nothing stronger than paracetemol for a fortnight.

I had an ELCS, first timer, simply because I had always, always been of the mind I would prefer that method of delivery- all the other women in my family had suffered massively (narrowly avoiding two dead babies and one mother) and I had no intention of risking it happening to me.

I managed to persuade my consultant after initially being refused; I also refused the counselling as I stated that this wasn't something I needed help getting through, but the rational decision of a competent woman. I wrote a letter to her, and then took it with me to my second consultation, and after going through it she agreed.

So- definitely go armed with a) your feelings b) your medical need c) NICE guidelines d) the rates of the various deliveries at the hospital you're at all in a letter, and perhaps do as I did and write to them in advance of it so that both you and your consultant know what will be on the table to be discussed.
I also included the fact that being forced to go through with a vaginal birth, that I didn't want, would be detrimental to my mental health.

And if they still won't do it, then go with your plan to be transferred. Good luck.