Could you have coped with a 5 hour car journey 3 days post C-section?

[Daya]

I have a ELCS booked at a London hospital, I have for long and complicated reasons got to move to the North of England and have being told this morning that the hospital I am transferring to in the North will not give me a ELCS!

They do not do them on 'maternal request' and was advised that my only choice was to either not transfer my care from London and go to London for the ELCS or have a natural delivery at the new hospital.

I feel totally shaken up by this, really upset, I wouldn't be driving myself but would obviously have a new baby in the car with me. This is my first birth and don't know what to do?

Could you have coped sitting / laying in the back of the car for 5 hours post CS? Is it really unrealistic to plan this - at the moment I feel like I can't face having a natural birth now i've planned a CS for so long.

I have had 2 sections one emergency and one planned TBH the car journey home was bad enough, I couldn't imagine a 5 hour trip. Could the consultant in London discuss it with the hospital up north? Are there any other hospitals you could use?

Sorry you are in this position :(

gosh poor you.

Yes I could have managed but I had a very easy time with both my CSs. But not ideal. Could be a long journey too with all the stops for feeding.

I hope you can get some more constructive advice from other posters.

I'm sitting here crying at both prospects at the moment. I really don't know what to do, I have rang my hospital in London just now to see if they could write a letter or something to the new hospital but only spoke to the receptionist so not sure how long this will all take.

I feel like maybe it is going to be such a nightmare coming up I will have to give it up but am now terrified that I have to give birth naturally and the new hospital were so rude and unkind today that I have no trust in them at all.

No way could I have managed.

I don't think I'd be planning a 5 hour car journey with a 3 day old baby unless I had to!

Post CS recovery isn't predictable. Of course you're shocked and upset - I would be too if I'd planned a CS and that choice was being taken away from me.

I think you need to ask your consultant to request a CS at the northern hospital. If he/she refuses to do so then accept that you will have a natural delivery if it's medically preferable for you to do so.

You do have my sympathy - I hope you can be calm about the outcome.

Oh poor you, Daya, what an awful position they have put you in. The short answer is yes, I think you could, so long as you had lots of breaks and a very supportive partner. Remember that although the baby may sleep for large parts of the journey, there will still be nappy changes and feeding to be done. I would plan your route carefully and be aware of where you can stop and do those things as you won't be back to normal mobility 3 days after the op, even if it goes smoothly.

Is it worth asking your consultant to intervene? There's maternal request and 'maternal request' as I'm sure you know. I was basically told a section was the only way for me to give birth by two gynaecologists and an obstetrician, but it still went down on my record as a maternal request CS.

No, physically I wouldn't have been well enough, but also ds and I were still in hospital!

If you are having an elcs, then I assume you must have a consultant, could they not liase with the other hospital?

Do you have to move so soon - can you wait a week, or two, or three? Or can you move a lot sooner?

How far along are you? What are your reasons for ELCS? If they were accepted by your London hospital they must be considered good ones.

You need to talk to an appropriate consultant in the new hospital, asap.

No way, I was only discharged on day3.

The maternal request issue comes down to individual consultants' view not usually whole hospital. Did you speak to midwifery team? I would be sounding out whatever contacts you have up north re individual obs consultants or see if your current consultant is on speaking terms with any (it's a remarkably small world!).

I think I could have done, if I'd had no other option. I was delirious from exhaustion and heavy duty painkillers anyway, so it probably wouldn't have seemed so bad. You might find it will be 4 or 5 days after the section that you are discharged anyway, depending on your general recovery, so be flexible whatever you decide to do.

It will be a really long journey for you, with all the stops for feeding, changing nappies (and your pads), stretching your legs etc etc.

Is there an alternative hospital where you are? Somewhere else might be more accommodating of your wishes.

So slow on my phone! I would call your consultant's secretary, not an antenatal hospital receptionist (if this is the case). I think you may have more luck if your situation is dealt with on a consultant to consultant basis.

Absolutely no way, I didn't get out of hospital for eight days, and was in pretty poor shape for a few weeks after that.

Absolutely no. I wasn't discharged till day 4/5 because of other complications and NO WAY could I have coped with a 5 hour journey for a considerable time. I did 2-hour journey to stay with family 4 weeks later and that was a struggle with feeding, believe me.

You just CANNOT assume you will be discharged by day 3, let alone be physically fit, let alone cope with baby.

I think mine is more of a soft 'maternal request' - I have no medical reason to have one just that I am terrified of a natural birth, sisters and mother all had terrible births so bad family history. The planned CS just made me feel more in control of it all and my consultant in London was really nice and just said if that's what you want no problem.

I think this as lulled me into a false sense of security that every hospital went along with the NICE guidelines.

I am 36 wks, have no place to stay in London now. If I choose to have the CS my mum would pick me up from the hospital and would be as helpful as she could be.

I just have no idea how much pain etc i'll be in. Thank you for all your help.

I will try and call my consultant's secretary now thanks ghislaine I was only got through to the main reception before.

My mum could come any day so if I wasn't discharged day 3 that part of it would be ok.

When you talk about feeding to you mean being able to move enough to breasfeed etc or could the baby have formula just for the car journey which my mum could give her?

If you don't have a medical reason Daya, I can see why the other consultant won't let you have one. Don't let family history put you off - it needn't be the same for you. I've had both an ELCS (for med reasons) and 'natural' birth and they've both got pros and cons. I think that with a caesarian the recovery time is much longer - you've got to remember that what you're having is a major operation and your body needs to recover.

Feeding - I breastfed both of mine at first and regularly (say once a month) made 2-3 hour journey to in-laws and parents. When babies are very new they need feeding all the time, so you're constantly stopping and pulling over for a feed (which can each take around half an hour) and tbh when they moved over to formula it wasn't much better. On top of that there'll be nappy changes and crying just because they need to be held. If this is your first baby all this is going to seem very, very hard.

I'm sorry but I really don't think this is do-able

In short, no. I had hideous EMCS's both times though so I felt as if I'd been hit by a truck and then reversed over. As someone else said, the 10 minute journey home in the car was bad enough. Electives can be better but you never know how these things go. Some people just seem to have easier/better sections and recoveries than others and it seems wise to not assume that you'll be up out of bed leaping about happily on day 3 as some people seem to be.

I think if you HAD to do it then, sure, you'd cope as it's amazing what we can endure when it's emergency/sky falling in, but I'd advise you not to put yourself through it if you really don't have to. Five hours is a long time, even if you're on strong painkillers. Plus you could well set your recovery back putting yourself through something so arduous after major abdominal surgery.

As for the feeding, formula in the car would be fine as, as you say, your Mother could feed the baby and do all the lifting and carrying out of the car. However, if you're breastfeeding the baby then giving her formula during the car journey might make you very uncomfortable as you've no way of releasing the milk that you'd otherwise be feeding her with. You could hand-express but that's not great as you don't tend to get enough quantity off; certainly not the same as you'd remove on a breastfeed. I found I could just about go an hour over a normal feed time but after that my breasts went like torpedos and it was excruciating. Plus, your milk supply is a bit bonkers in the early days and still establishing. All of this is totally irrelevant if you're planning to formula feed but I thought I'd mention it.

Please don't. Can you stay with a friend for a week? As an alternative, can you ring your new hospital and ask to see a consultant and/or different midwife. They all vary so much and you will probably find someone very sympathetic to your fears, which are not insignificant.

Hope this helps.

i've had 2 emcs and i would not be in a fit state to go ona massive car journey. What happens (and i don't mean to be negative just realistic and based on my experience) if you are having trouble breastfeeding, you need to be somewhere comfortable to be able to establish it.

I could barely walk after mine and going over speed bumps etc was a bit of a nightmare. my second was a bit easier to recover from. Probably as it was not such a shock and i was better prepared for what was coming.

I understsand that you have concerns about doing it naturally due to your family history but i would consider trying. You could have your baby after a few hours labour and be fine the next day! Have you thought about having a doula to help you through it?

I knwo you have your heart set on it so i hope you get it sorted and i hope once you get to the north east you settle and love it. My DH is from there and we love going up there to the coast!!!

good luck!

Could you not try other hospitals within an hour or so distance from your mums?

Sorry but no no way after my emcs could I have stood 5hours in the car. I hope you get it sorted

Absolutely no way on earth I could have managed it. Also, my DS screamed constantly unless he was in my arms, so a journey like that would have been very distressing for him too.
Day three is a crucially important time for establishing milk supply; your baby needs to pretty much be attached to your boob non-stop at that time. Spending the best part of a day in the car could wreak damage on your breastfeeding relationship.
I hated having a c section and will do anything to have a natural birth next time. It really is not the easy option.

Right Daya, I'm going to kick your arse about part of your issue here but in the nicest possible way.

"I think mine is more of a soft 'maternal request' - I have no medical reason to have one just that I am terrified of a natural birth, sisters and mother all had terrible births so bad family history. The planned CS just made me feel more in control of it all and my consultant in London was really nice and just said if that's what you want no problem."

THIS IS NOT A SOFT MATERNAL REQUEST. THIS IS A REQUEST MADE ON MENTAL HEALTH GROUNDS. PLEASE DO NOT SAY THINGS LIKE THAT. YOU HAVE EVERY RIGHT TO FEEL THE WAY YOU DO AND IT SHOULD NOT BE BELITTLED OR IGNORED BY ANY HEALTH PROFESSIONAL IN THE WAY IT QUITE CLEARLY HAS BEEN.

Right got that off my chest. Sorry to shout, but its a message that needs to be got out there to so many people.

The attitude that, requests made on these grounds is somehow a cope out, isn't helping solve the problem for anyone. You do have a genuine issue which is affecting your and your mental health by making you extremely worried and anxious. The fact that you are considering going to such lengths, only show the strength of your fears. You wouldn't be doing that, if you were 'just a little bit afraid'. It sounds very much like you have a phobia rather than a fear and it should be being treated with much more respect. There is a RECOGNISED MEDICAL TERM for it - Tokophobia. Mental health needs to be put so much further up the agenda when it comes to childbirth. You might not have a psychical medical need for an ELCS, but you may well have a genuine case for a psychological medical need for an ELCS and you therefore should not be being phobed off, especially at this late stage, if it is causing you this much distress.

It seems you are familiar about the NICE guidelines, but can I ask have you read them in much detail? They are precisely for people in your situation. No it is true that hospitals don't have to follow the guidelines, but it makes it very difficult for them to refuse too, if you are prepared to make a fuss.

Legally, it creates a situation where if you are refused one and then have problems during and after birth, particularly psychological ones, they are leaving themselves wide open to getting their backsides sued.

I've seen far too many woman post similar things to you here and be refused an elective usually "because of hospital policy" rather than any consideration for the woman concerned. The majority I've seen though, who have put up a fight with the hospital have, do seem in the end, to have been granted their request. SO DON'T GIVE UP JUST YET! It seems that its difficult and stressful but can be done - if you are in a position where your alternative is to go to London for an ELCS, it may be worth seriously considering trying to go down this route too.

There a load of posts in this section on the subject. Have a search and read them for a tonne of good advice.

My shortened version of whats in those posts is this:
There seems to be a few tricks to getting your request granted. The first is demand another appointment with another consultant. The second is go in prepared, able to quote the NICE guidelines backwards, forwards, upside down and be able to show you fully understand them. The third is to go with your partner who is giving you full support for your request, for some reason when faced with a couple together, the request gets taken more seriously (which is completely morally wrong imo). The fourth is to play the mental health card to the full; its an aspect which is a medical reason and not a lifestyle one which makes it more difficult for you to be ignored. If necessary ask to be referred to a perinatal mental health midwife. And fifth and finally seems to be to cry and be very distressed about it all, something that I'm sure isn't going to be an act in the slightest.

Frankly its utterly outrageous and disgusting that there is such regional differences over this issue, especially given the history and background in which the NICE guidelines were written - precisely for women who have tokophobia and were struggling to get their fears properly diagnosed and an inconsistency of hospital policies nationally.

Good luck. I hope it works out for you.

The other thing to consider (on top of everything else) is that newborns shouldn't be in a car seat for more than about 90 minutes - 2 hours at a time, as the position they're sat in is crappy for their backs, so you'd need to factor in at least one, maybe two breaks into the journey regardless, which is going to add to your time out and about.

Personally, I couldn't have coped with a 5 hour car journey 3 days after either of my VBs, never mind a CS. It was two weeks both times before I felt that I could manage a 90 minute car journey to visit the inlaws.

I would also add that this would be medically inadvisable due to the risk of deep vein thrombosis. I don't think you will find it is physically possible anyway. Far too painful.

Thanks for the answers, I am trying not to be unrealistic but am so unprepared mentally to give birth naturally.

2 of you say yes and 9 no so it's looks like it would be a big gamble to trust I'll be one of the luckier ones who feel relatively ok post CS.

I feel utterly sick at the thought of giving birth naturally now, I am 90% sure it will end in disaster like it has for my mum / sister. My mother is so traumatised she couldn't possible attend the birth with me so it would have to be no one, not sure I can afford the £500 charge of a doula.

I'm waiting for a call back from the secretary now. I had spoke to the London midwives about transferring with the ELCS agreed on my notes and they had said they can't refuse you - quote the NICE guidelines etc so this is really unexpected.

I will have a look around bobanna but as it's the North East there is only a few main hospitals around and the rest MLU so i'm not hopeful plus it took me 2 and half weeks to even see a consultant here so time is running out.