ELective C-section??? don't know what to do...

[sw11mumofone]

Hi all, I'm sure there have been threads about this before but I would like to see if anyone can share their opinions with me anyway. I am currently 13 weeks pregnant with DC2. I have a DD who is 2 and 2 months. My first birth was awful. I don't want to bore everyone with loads of details, but in short, I was induced at 42 +2. I had 18 hours worth of the gel which caused me a lot of pain and at the end of that I hadn't dilated even a cm. I was then induced by drip (the highest dose as nothing was happening). I was told I had to have an epidural due to the amount of drip. The epidural failed. They tried to re-site it. That failed. Two hours later they took it out and did it again. That failed. So I ended up with 18 hours of maximum drip with no pain relief. My contractions were lasting 90 seconds, with 10 seconds in between for the last 6 hours. Hideous. She then got stuck and I ended up with a ventouse delivery 42 hours after I started. I was so traumatised by the birth and by then being stuck straight on the post natal ward and my husband being sent home, that the first few months are a blur. I sobbed through a lot of it. I then suffered from PND at 9 months and a counsellor related the majority of it to post traumatic stress from the birth.
So - what to do this time. i just can't go through that again. But at the same time I also don't love the idea of a c-section. I like the idea of the control but the thought of being cut open when i'm awake and then the recovery after terrifies me. However, if I chance a natural birth again I'm petrified a potential epidural wouldn't work again if I needed one and that i'd end up traumatised yet again.

I went back to the hospital for the first time since the birth to do my 12 weeks scan. When I arrived at the maternity unit I could barely breathe - it brought back so many hideous memories that all I could feel was panic welling up inside me. I do have an appointment with a consultant in a couple of weeks to discuss my options, but feel if I don't go in there with my mind made up they''ll just push me into a natural birth again.
I just don't know what to do. Can anyone share any similar experiences? thanks and sorry for the long post!

Big unmumsnetty hugs.

I felt as you did after a similar experience with DC1 (but mine ended with an emergency c section under GA).

When pregnant with DC2 I broke down into tears with my consultant who then offered me an elective c section as I was so upset about the birth of DC1.

In hindsight what I think I really needed was an experienced midwife or a doula to talk to (my midwife was dreadful) and perhaps some counselling to get over my feelings of failure over the birth of DC1.

Perhaps think about going down that route, before you elect for a c section.

Is there any chance you can ask for a debrief of your first birth? I have read of women on mumsnet having these and them being helpful. Or would second the recommendation of counselling.

Also, you don't have to make your mind up until much nearer your due date. I finally decided to have ELCS at 35 weeks after months of dithering.

I had a god awful time too OP. It ended in a C-section anyway and i that was the best bit! I will be asking begging for a c-sec this time too. The fear of nearly losing my DS outweighs any inconvinience of a lengthy recovery time. Let us know how you get on x

Thank you both for your responses. I appreciate it. I did actually have a private midwife at the birth and I think it would have been even worse if she hadn't been there. If I go the natural route next time I think I would definitely try and take her with me again.
I believe that the appointment with the consultant will also be a debrief of the birth. If not, then I will definitely ask for another session to go over that.
I just can't decide whether the physical recover from a c-section would be better or worse than the potential psychological recovery from another natural birth.
Blackteapleaes - what made you decide to go for an ELCS - if you don't mind me asking? And how was it?

Ask for an anaesthetic review. I might not help but you can speak to an anaesthetist prior to labour about why those epidurals didn't work.

Thanks IShotJR - I'm sorry you had such an awful time too. I think they are obliged to let you have a c-section aren't they - if you've had a bad experience before. I just wish I knew which the best option would be for me!! I will let you know how I get on with the consultant appointment in three weeks. Until then I suppose I will continue to have a lot of sleepless nights!!! x

Yes i think it would help to know whether epidurals just don't work on me or whether there was another reason. The first guy actually seemed pretty useless - he burst a vein in my hand trying to get the drip in and then didn't give me enough local anaesthetic so the epidural just shot me through the ceiling. He just shrugged and said Yeah, sorry about that - I thought it might not have been enough!!!!
I have a close family friend who is an anaesthetist in obstetrics in another local hospital so I plan on also getting her advice too.

I think a counsellor who diagnoses PTSD has gone way beyond their training and competence.

If you think you fit the symptoms of PTSD and this is still a factor, then ask your GP for a proper referral for a psychiatric assessment. You may need interventions, and the recommendations of a psychiatrist will be very relevant and carry a great deal if weight as you are seeking early consideration of method of delivery.

EdithWeston - the counsellor was a Cognitive Behavioural Therapist to whom I was referred after my GP diagnosed me with post natal depression.

I don't really think I am suffering with PTSD now and the PND is also history. HOwever, I am very concerned about it happening again. Maybe I need to go back to the GP then?

CBT my be a way ahead for those diagnosed with PTSD (see eg MIND website), but that does not mean that CBT counsellors are necessarily competent to diagnose.

PTSD arising from single-issue exposure, when that single issue is about to recur, is something I would want definitely to seek a further referral for - if the nightmare/flashback/reliving reasserts itself, you will want immediate intervention, rather than waiting for the standard 'nigh on daily for a month' diagnostic criteria to be fulfilled. So I think early into the system is better, to be on the safe side IYSWIM.

Hi OP, I haven't had my ELCS yet. I am booked in for the 12th September, having decided about a week ago. I did have emcs for dd though.

I didn't have a really bad birth experience, dd was a missed breech at 40+12, only picked up after my waters broke with meconium in them and the fourth MW I saw that day thought to get an ultrasound. But there was lots of chopping and changing about what the plan was, sent home, back in, induction in morning, c-section in morning resulting in emcs in the middle of the night.

Basically I argued that I argued that I wanted to reduce anxiety levels by going for ELCS. I saw a senior midwife who tried to talk me into a VBAC at 22 weeks. I then had a consultants appointment at almost 35 weeks where I stated my case for ELCS and he agreed and gave me a date there and then.

Good luck with whatever you decide.

Your birth story sounds very traumatic. If I were you I would ask for a section on the basis of your previous experience?

I had an EMCS and then a vaginal delivery (forceps assisted) and have decided on an ELCS this time round. From my perspective, the EMCS recovery was a breeze (a week) and the VBAC recovery took about a month.

I know that each birth and each case is different though. For you it sounds that if you want to face your birthing fears you definitely have to "work through" the traumatic experience you have had.. so if you are up for it and have the time to dedicate to it, it may be "healing" to have another bag delivery. (Also second births are usually considered to be quicker and "easier".. but that wasn't enough to convince me to repeat the VBAC).

Good luck!

of course i meant: "it may be "healing" to have another vag delivery"

That's why i'm so unsure. On the one hand I feel that a c section may be less traumatic psychologically, but on the other hand I feel that I would love a natural birth without the trauma of the last one. But of course no outcome can be guaranteed. Hence not having a clue what to do. I will start by talking to the anaesthatist and consultant and possibly my GP and see how I feel after those conversations. As mentioned previously i have a while yet to decide. However, it is causing no end of sleepless nights so I feel that I would benefit from making an early decision!

Sorry you're having such a hard time mumofone. I was in a similar situation to you when pg with my dd. My ds had been a very traumatic birth, also with an anaesthetic trauma (except it worked too well and stopped my diaphragm working, so I had to have a GA and be ventilated). My recovery time was long, and I also suffered from pnd.

When I became pg with dd, I had meeting with my consultant and the consultant anaesthetist. They talked through the options - spontaneous labour with a very specific birth plan e.g. timings for the different stages going to a cs if things went on too long, or an elective cs with either a spinal or a cs. I was lucky in that they were very factual and didn't push either way.

After a lot of discussion with my dh, I decided on an elective cs with a GA and it was a very good decision.

They key for me was actually making my mind up. I had decided by 20 weeks, and had a date for the cs, and it was a huge weight off my mind. I could actually start to enjoy being pregnant again.

The recovery from the cs was for me, very easy even with a toddler to look after as well. Also, I had never been a 'must have a natural birth' person. For me a birth is a birth, so the decision wasn't too hard.

I would definitely recommend asking your consultant for all the options and pin them down for a further appointment after you've had time to think it through. Good Luck.

Lakeofshiningwaters - that is really useful information, thank you. I am not really a "must have a natural birth" person either. Just terrified of surgery!! And a lot of people have said to me "Do you know what it does to your body? You must be mad to go through that when you could do it naturally" But then maybe they never had a birth like mine!

Its a good idea to make another follow up appointment - I hadn't thought of that and i suppose then I will have the time to make up my mind.

Its great to hear that you didn't have a difficult recovery. That is a big factor for me and actually it did take a few weeks last time for my physical recovery and as mentioned, a lot longer for the psychological recovery.

Don't be terrified of surgery sw1 There is a massive difference between elective and emergency. I had no problems and all I am left with is a thin silvery scar. Recovery the vaginal birth was long and awful.

Good luck
xxx

OP, I had a wonderful ELCS - very emotional and joyful, and painless. The recovery was amazingly easy, and I couldn't get my head around the idea that ELCS is described as major surgery, as it seemed so straightforward, and not debilitating at all. There are lots of people who post on these boards about what a lovely experience an ELCS can be. Good luck with everything.

Thank you Ushy and Seoladair. That is so lovely to hear. The more I hear stories like that the more I think I should just get it booked in and forget about it and enjoy the rest of my pregnancy. Thank you for taking the time post.

I have to say i felt a lot happier once i'd had the agreement to go ahead with an elcs .

It IS still major surgery though. Don't over look that. You may just have a thin scar on the outside but it's far more than that on the inside.

Sorry. Not a very helpful post when I read it back

I have a complex obstetric history (don't we all!!) but some of the issues I had with DC3 would have been avoided had I had a successful VBAC with DC3. This probably colours my thinking with respect to c sections!

Hi Meg
so sorry you had a rough time. I'm guessing you had emcs?

Ah yes, three c sections in total, two of them under GA, last one was complex due to scarring from previous sections - placenta accreta led to hysterectomy and 7 litres of blood loss/stay in intensive care. They nearly shipped newborn DC3 to a hospital nearly 50 miles away as they wouldn't let DP take him home and there wasn't space in the hospital baby wards.

So, when people talk about how simple and not really a complex op at all, I find it difficult to stay quiet.

I have the greatest of sympathy for you

But from what I can gather, EMCS is riskier than ELCS for various reasons, including the fact that it's more difficult to cut through a contracting uterus, and also that if it's an EMCS, the surgeon has to rush. If a woman is in great pain and/or distress, that can make the operation harder to perform as well. Hence the recovery from EMCS can take much longer than ELCS recovery.

I'm pointing out these facts to reassure the OP - for many women, ELCS is a wonderful way to give birth.