ELCS due to previous stillbirth

[Jules125]

My first pregnancy (DD1) in 2009 ended in a stillbirth at 26 weeks due to severe pre-eclampsia. I was understandably incredibly traumatised - I got ill so fast and there were concerns for my life and health too for a while. The loss of DD1 hit me more than I would have ever imagined possible.

My second pregnancy was thankfully normal but DD2 was transverse lie at term so ELCS.

My third is due Nov 17. DD2 will be 23 months then. I want to request a ELCS but have already encountered some hostility to this. Whilst everyone would agree my first pregnancy was extremely complicated, the stillbirth was nothing to do with delivery so theoretically I could still be a VBAC candidate.

I am not tocophobic and don't have PTSD or any other mental health problems. I just want to be in control (as much as ever possible) - obstetric emergencies really worry me shitless after my first experience. I want a relatively calm ELCS during office hours (staffing levels in evenings and weekends also worry me!). Obviously this pregnancy is still high rsik due to previous severe and early PE, ELCS and my age. I understand the risks of ELCS (but believe my risks of EMCS would be really high if I tried to VBAC - and there is some evidence to support that - particularly my past medical history, age and

You are aware that anxiety is termed a mental health consideration? And if being in control is a significant part of your reasoning for an ELCS, because in your own words "obstetric emergencies really worry me shitless" then again, its pointing towards your mental health being a very important consideration in all of this. Despite what you have said in your post.

If your calm rational arguments aren't being heard as they are, there is a problem in my mind. You aren't silly, you aren't mad, but you have deep emotional concerns over the birth of your third child.

It is a mental health issue. It might not be the same as other people's but it is very real. And thats what you should be stressing - just because you don't have problems with your mental health now, it doesn't mean you don't have serious concerns that you might or that you might struggle to cope with a VBAC especially because you are less likely to have a successful VBAC with your medical history.

So yeah, pushing the mental health angle, might not be the route you are keen to take, but it sounds like it would actually be worth considering and has genuine merit and concern behind it.

Yeah, thanks, but apparently I'm not anxious enough for it to be a mental health consideration, so I was told. I need to get more anxious first! That might happen anyway!

I might not cope well with a VBAC which went wrong (and I would be mad about it too - I just think I've been through enough with pregnancy....).

I think I will probably get what I want with persistence but just feel I shouldn't really have to jump through all these mental health hoops or argue my case!

Sorry, sounds like a rant now!

Oh they have got to be kidding. Really annoys me. Assuming you cannot go privately, can you not insist on a section? Do they have the right to make that decision?
You should absolutely not have to jump through hoops to do this surely?
You really have enough on your plate worrying about this, can you get your DH / Partner to go in and blast them? Ie He will not have you stressed in this way, you are over wrought, you have enough concerns during pregnancy without them adding to it, he insists on section if only to ensure your mental well being is maintained for the duration of the pregnancy etc etc
I just think, you shouldn't bloody have to deal with this nonsense right now
And that's a rant!

No its fair enough, no need to apologise. You shouldn't have to go down the mental health route tbh, even though it is about protecting your MH. They don't care until you are in a state and thats wrong. Having to prove the level of your anxiety as being to a certain acceptable standard is ridiculous. Your concerns are just as valid as someone who is in meltdown.

Its a genuine health concern not a flight of fancy or fashion statement and you have looked at your risks and feel some are more acceptable to you than others giving you circumstances. Its appalling you aren't taken seriously. Being forced into something you aren't happy with just isn't right. Especially given your history.

Dunno, what else to say except tell you to be persistant if you think its the right approach for you.

First of all I am so sorry for your loss. Having had PE myself it is a scenario I played through for myself and my heart goes out to you. I am gobsmacked that your request is not being taken seriously. Any woman who has been through what you have been through should have the birth she chooses. I would ask to speak to another consultant and if they say no escalate it as a complaint. My DH asked if I could have a ELCS because of my last birth experience and got an instant yes. I am honestly flabbergasted you are having such an unhelpful reaction. Your body - your choice.

Very sorry for your loss.

I too am surprised at the lack of support you have received and would suggest you change consultant. I had an early induction for DC4 following the stillbirth of DC3 and everyone I saw was absolutely supportive of that.

Thanks. Its good to know that others think this is really a "non-controversial" CS request.

I think its a hospital policy and perhaps partly comes from the local PCTs refusing to fund maternal request CS, even after a previous CS. I reckon there is very strong pressure to reduce CS coming from somewhere anyway.

To be fair, I have been offered all kinds of support (counselling etc.) which I don't want for various reasons. And generally they are very supportive when I see them. I will keep working on this ...

I would calmly insist on it given your sad obstetric history. They cannot force you to have a VB. Best of luck with baby X

My first was an emcs and when I got pregnant the 2nd time I was offered a vbac or an ELCS and it was totally my decision. The hospital said that because I had had a c section it was my choice although they are very positive about vbac's.
You may have to ask to see another consultant or speak to the head of midwifery.
I would have thought with your history that you could have whatever you wanted!
Best of luck.

You are in a similar position to me. My first child died when I was 37 weeks pregnant with her, earlier this year. I still feel like lying on my bed and screaming and screaming. The worse thing is there was nothing wrong with her, there was a cord accident - if I had been in an accident or got ill the day before and had an emergency c-section, she would be here alive and well.
But now I am pregnant again and due in january. I really want a c-section. I was induced to give birth to my eldest child after she died, as I was not allowed a c-section. It took three days and there was a lot of waiting around to see doctors, I was constantly being told they would be there, but then it would be delayed by hours as they went to surgery etc. I also had a friend who was induced when she went past her due date. the baby was healthy, but got into difficulty during the induction, and because the staff just would not listen, would not check notes etc the baby died. So i am not keen on being induced again, but do not want to wait until 40+ weeks to go into labour.
The hospital I am in now is supposed to be one of the best for maternity care (or so I have been told), but the ante-natal clinic is manic. You have health care assistants demanding to check your bp in the waiting room, and asking about your obstetric history in front of everyone so I had to say in front of about my daughter and ended up in tears in the waiting room (this same hca marched in when I was meeting with a midwife to give her tea). When I went to see the doctor, they had not got my notes from my previous pregnancy yet, so I was left waiting for half an hour in the consulting room, it is difficult to get hold of anyone when you call to book appointments (they expect you to book the appointments yourself they do not make them automatically) etc. It probably does not sound much, but the overall atmosphere is one of manic chaos, and I am really reluctant to be induced there, and have the same sort of chaos and people not being on the ball when I am in labour. Yet they point blank refuse to even think about a cs. they told me not to think I do not have a voice, but they were not going to do a cs as some babies experience breathing difficulties. How is being induced for three days better? I would rather the breathed with difficulty for a few days, then they did not breath at all. It comes across like they just do not do cs end of story and my opinion is not important.
Any advice?

Anyadvice -

Your hosp sounds horrific - I would be making an immediate complaint to PALS about having to disclose your last pregnancy to a room full of people. Your not getting best mat care there are you.

Is there any chance you can go to another hospital?

Any advice...so sorry.
Unfortunately that sounds horribly familiar to me
I was lucky enough that my in laws paid for me to have a private ELCS after that.
No way would I have gone through it again. And as you say, with some medical histories, the babies are better out than in. I ended up emergency section with number 2 and planned ELCS at 36 wks with number 3

Anyadvice ... I am so so sorry to hear about your daughter. I can relate to your "if onlys". I can only say it does get easier to live with over time although I know how difficult that is to relate to in the early months (its now over 3 years for me). I can kind of accept what happened to my daughter (especially as no-one was to blame) but I still feel angry sometimes. I think its probably especially difficult to be pregnant again soon after a stillbirth (though I tried to as well but it was nearly a year before I conceived DD2.,.)

I am so sorry you are not getting better ante-natal care. I was generally treated very well in my subsequent pregnancy and with a lot of compassion and understanding --- even though its been difficult to get ELCS agreed. But that was because I was considered very high risk because of the extreme complications in my first pregnancy - rather than just because my baby died.
There is no way you should be asked to talk about your pregnancy like this in front of everyone and I would be emailing the lead obstetrician to complain and ask for a meeeting urgently as you are very unhappy with your ante-natal care. There is a risk of breathing difficulties after a CS but its low after 39 weeks when most CS are scheduled. I had my last baby at 38+2 by CS and was given steroids before the CS to reduce this risk (DD2 was totally fine at birth). I hope you can get this improved x

Thanks everyone. Its nice to feel not so alone, I feel very cast adrift by my antenatal care. The thing is I thought this hospital would be fantastic (it is tommies), but manic is the word I would use to describe it. I am really disappointed because it has such a good rep., maybe I have just been unlucky.