Insisting on C/S rather than induction!? What happens?

[StarlightWithAsteroid]

Has anyone done this?

It's just that my birth plan stated this and it caused a bit of a circus when I went overdue (completely ignored until then), with insisting on my seeing a consultant to 'agree' blah blah blah. I refused the consultant btw.

No idea how it would have panned out as I did go into labour spontaneously close to the 42 week mark according to scan. But am wondering about it.

Oh well then - clear cause and effect.

It's not clear no, but it is using the research and what is known about the process to ensure the best and safest overall outcome. And that is NOT to stress out pg mothers in the last stages of pg.

Well it's similar to discussing induction isn't it? That doesn't get discussed until you are overdue so why would an elcs for overdueness (not an actual word I grant you) be discussed before that point either? Unfortunately staff don't have all the time in the world to discuss the why's and wherefores of everything that might happen if you happen to go overdue, because most women don't, most women labour within the 37-42 week timeframe, rendering such discussions unnecessary and saving time to actually talk with the women who need appointments.

So why discuss induction etc before 42 weeks?

To make sure people arent missed. if the nhs say you should be induced at 42 weeks then you need to be seen before that so a date can be arranged. if you werent seen till 42 weeks you wouldnt get induced till nearer 43 weeks. hospitals will only induce so many per day so a slot has to be found. the nearer to the date you need the chances are the slots will be booked with the more urgent inductions for high bp, etc.

Okay. Makes sense from a resource point if view. Not so much from a care point of view.

Hi starlight, I had the same birthplan as you pretty much and the midwife was totally supportive once she had discussed it with me and understood my reasons.

I wonder if part of the problem was that you were asked to see a consultant to 'agree' your plan, the implication being that the consultant was in control, not you? If they had asked you to see the consultant to plan your c/s, as a backup in the event that a VB wasn't possible for whatever reason, would you have felt differently about the meeting?

What Viva said. We don't book inductions until the woman is 41 ish weeks for when they are 42 ish weeks. We still find it difficult to fit people in. There is no way we could book slots for women before their due date 'just in case'.

Oh, I should add that I was pg in New Zealand, so one midwife from 8 weeks, 100pc continuity of care, all check ups at my house, as much time as I needed at each check up to discuss all the options at a speed and time that suited me, lots of support for HB. Birth the way it should be.

Yes, quite possibly. Though I would have needed quite a bit of support at the appointment as it was a consultant that was the final straw and a significant player in my first birth fuck up after hours of mw neglect (actually it was a SHO I later found out).

I have since had excellent mw care for my last 2 births btw, but the trust can never be regained because of the unpredictability of it.

Last post to Scroob

Oh that does sound great scroob.

Incidentally, after the birth this time I had a chat with hb mw Whikst she was waiting for end of feed to check me over, and I got a better picture of her rationale etc. I live in a fairly affluent area with high c/s rates, high elective rates and very low homebirth rates. Due to demand and current status quo, the system here is very poorly set up for hbs, and consultants control everything.

So what, you want them to wait until there's evidence of placental failure before they discuss the options? Seriously?

Well there aren't really any options to discuss are there?

I mean, these discussions take place all the time, in minutes for many other women in labour.

Yeah, it was great. I thought it might be useful to post because I think the rubbish time that many women in the UK experience is in danger of being 'normalised'.

I know resources are stretched but, really, if men gave birth, no way on earth would they put up with the treatment that women have to endure. And the whole 'consultant knows best' thing makes me furious - again, no man would put up with that attitude. Being able to give birth with dignity, and with control over decisons concerning your body, is a basic human right.

Yes, but presumably they wanted to make sure that you actually understood that by refusing induction in any circumstances (lets say placental failure for argument's sake) you are by default opting for a more risky procedure (c-section) or a do nothing approach that risks the life of the baby. They cant just assume that everyone knows/ understands this and as you were refusing induction they probably wanted to find out what you thought the alternatives were.

Perhaps a mw coukd have mentioned that shoukd I go over a certain date then she woukd prefer I met with a consultant about my c/s thing, earlier in the pg rather than pretend all was okay with plan and spring consultant meet on me at last minute!?

Richman - how about all the options being discussed with women throughout their pregnancy? And giving women control over their birth plans, not consultants. Why should any woman be dragged in at 41 weeks to justify to a consultant an uncontentious birth plan that the mw has known about for weeks?

X-posts, sorry starlight! That this is even an issue makes me at just how poor care has become for women, and how normalized it is.

Yes- I agree with your last point, that the MW should have explored with you what alternative you wanted/ thought was available when it wasnt an immediate issue, but given that this didnt happen, (MW's fault, not consultant's) I dont think the consultant was unreasonable to want to re-open the discussion when you were overdue.

Because if he didnt, and you refused induction or c-section and the baby died, then you could have sued because he didnt make it clear to you that that was a possible outcome.

I did. I agreed with the consultant that I would try induction but could have an ec the minute I wanted it.

i thought, if you got as far as a 42 week appointment, they throw in a consultant with that one, and you would have had an opportunity to discuss ECS vs induction at that point?

that's pretty much what i got...(though didn't as DS put in a convenient appearance)

To me it seems what happened, was the midwife didn't have the power to authorise this plan, she probably thought the whole issue might become contentious, but rather than face it head on, hoped she could ignore it and it would go away. Then as you hit nearer to being overdue realised it might not.

I'm stunned that anyone would think that wanting to discuss major elective surgery with a patient beforehand is seen as being 'poor care'.
Do you really think that people should just be able to rock up at the hospital, insist on a procedure and have it done straight away without the surgeon getting a chance to assess or ensure informed consent?

I though that happened all the time in childbirth.