Pre-eclampsia- would you have an elective c section 2nd time round?

[newby2]

Hi, this is my 2nd pregnancy (25 weeks) going well.

1st a disaster, failed induction, emerge cs with severe pre-eclampsia. Delivered at 36 weeks after they watched my bloods and baby deteriorate for a week beforehand in hospital and were NOT going to deliver me despite a week of begging until my dd was poorly enough to warrant delivery!

This time round I'm petrified I'm going to die as I almost did the first time round (she nearly did too due poor birth timing). Unbelievably at our consultant appointment in same hospital she said I would have to go for VBAC even though Im adamant I want an elec cs. Changed hospitals now, cons appointment in 3 weeks. Again, petrified he's going to say the same thing.

Any ideas on helping to state my case? Any-one else been through similar?

Blimey - I am having the exact same dilemma but I am amazed that you are not receiving more support.

I was induced at 37 weeks because of PE and IUGR. Managed a VABC eventually but went on to have a PPH, ERPC, blood transfusion (Placenta had already started breaking up) and a 2 week stay in hospital as my liver was going crazy. I can clearly remember laying on a hospital bed twitching and thinking there was a chance that I may die. why the hell are we doing this all again?.

However, my care team are being amazing. Happy to consider whatever options I put forward. This time there is no sign of PE - in fact the opposite and the baby is huge. My consultant and I are having a more detailed discussion on a plan as I get closer to term and I am monitored every 2 weeks. We are aiming to sit down and reevaluate the plan at 36 weeks. Perhaps try having that conversation - ie this is what I think I would like but lets keep reevaluating. I think you are perfectly justified to request an ELCS. If a reasonable approach failed I would escalate this to PALS or ask to see another Doctor. To be honest - she can advise you but she can't tell you what you can and can't have - it is your choice and unless she thinks it would put you or the baby in danger then she needs to justify her refusal.

I would be really interested in seeing what others say. I am still torn as to which route to take. After such a traumatic time with VABC I am keen to avoid the experience but also trying to focus on the fact that no 2 birth experiences are the same. Currently ELCS seems the thinking woman's option as I know PE can strike again at any time and being well now is no indication that it won't come back at some stage.

Let us know how you get on. I am honestly surprised that despite your last experience your consultant is not more open to your wishes. At my first appointment they basically told me I could do whatever I wanted as long as it was safe and it worked towards lessening the awful experience I had last time.

Gosh, I'm really glad you're having a good pregnancy and have all the support you need. Can I ask which part of the country you live in without compromising your anonymity?

It feels like I may be bashing my head against a brick wall but hopefully I'll be heard at my 1st appointment at my 2nd consultant appointment.

I'm interested about people's experiences too.

I well and truly feel like im on my own!

Of course, I am in London. They are bending over backwards to keep me calm and sane. You deserve the same.

Basically yes. This is now my third pregnancy. First (2008-9) ended with severe pre-eclampsia at 26 weeks. My baby girl died. I nearly died (the midwives were sent out to get DH as they weren't sure I'd last the night at one point). It was devastating and horribly traumatic.

Second pregnancy in 2010 was normal but ended up with ELCS anyway as baby was transverse at term.

This is my third (29+ weels) and I've had a bit of an argument but now seem to have ELCS verbally agreed though not written in my notes yet - but I think I will get that so long as I stick firm.

Its not always straightforward to get agreement even with an extremely complicated history (and losing my first baby). I am also basically terrified of obstetric emergencies which is why I want to the ELCS. But I think if you remain insistent you probably will get wat you need...

Good luck

Oh Jules,

You are incredibly brave and thank-you for your supportive message. No-one will know how it feels to have been in your situation, unless you have. I'm amazed that you don't have automatic right to elec c.

I will remain insistant and be referred to whom ever I need to be referred to in order to have an elec c. Even if it means going a long way for it.

Best of luck with the rest of your pregnancy, it sounds as though things are going well.

Jules So sorry for your tragic loss - every persons nightmare and a reminder of how serious PE can be (and how lucky I was despite everything). Hope you continue to have a PE free pregnancy. Are you both taking asprin?

I am much the same as Jules in so much as they have verbally made all the right noises but not written it in my notes - think they may try and make me change my mind...In my mind if there is even a whiff of protein or BP then I want in and I want him out ASAP. No messing around and no discussion. Good luck to you both and keep posting so with progress on getting the births you deserve.

Jules- my sentiments exactly. What really worries me is not having a concrete agreement and some idiot consultant refusing on their watch and having to wait until consultants change again to have the baby out.

What I find stressful is pregnant ladies I meet now who are allowed an elec section for pain relief issues the last time or non life-threatening issues and I'm having to endure the pregnancy convinced I'm going to die and leave my partner and daughter.

Will let you both know how I get on in 3 weeks.

Sorry that should be Midgetgem- my sentiments exactly.

Thanks for the sympathy ... I can accept what happened now to my first daughter (mostly) but of course it has a legacy on my mental health and especially when pregnant again !

I agree that choice (of place and type of delivery) should be available for all women where possible, but prioritised for those with previous very traumatic or complicated pregnancies.

I hope you get the ELCS you want. In reality, I think you are at very very much lower risk of dying or any serious complications this time as both you and your hospital are aware of your past history and will be on the look out! Its understandable to be scared; but my first two pregnancies were just totally different. I try to remember that ever pregnancy really is different.

Hope this helps and you get what you want agreed soon ....

I agree that choice (of place and type of delivery) should be available for all women where possible, but prioritised for those with previous very traumatic or complicated pregnancies.

They are!

Re Newby - as pre eclampsia may not strike again they probably wouldnt grant you one based on that issue alone.

So if you faught for one it would probably based on your previous section which is also not neccasirly regarded as a good reason as lots of ladies have v bacs, or the mental side - which is your fear....

I wouldnt cristise or be little ladies who have been granted elcs based on thier previous experiences either or their fears... - it just means they have met more enlightened consultants who will grant them one which is what we should all be fighting for.

Enlightenment.

I had a cs at 34 weeks due to pre-eclampsia that started about 28/29 weeks and IUGR.

All the way during this pregnancy I've been asked what way I want to deliver this time. As I have had cs before my consultant agreed that I have the choice of cs or vbac, which is why I'm quite shocked at your consultant's attitude newby

My own experience is I couldn't give an answer re delivery as really I was just playing the 'wait and see what happened' . Thankfully this pregnancy is totally different from my first - bp fine, placenta still functioning and baby growing well. Finally decided last week, at 37weeks, I would try a vbac. My consultant had told me they are only on certain conditions; I will not be induced and should I go overdue or my bp go up (has started to a little) I have to have a cs. One worry of mine is my bp went sky high after delivery last time but I'm aware that may happen whatever way I chose to have the baby.

Good luck whatever you decide. I found it such a difficult decision to make and can only hope I've made the right one.

Eliza, interesting- it's exactly the vibe i get. Good luck to all the vbac ladies including Ballroom, good decision making not based on fear which is very brave. You're right about the bp afterwards being unaffected by method of delivery.

I'm medical myself which doesn't help- when you know the consequences of actually looking after very sick babies it's a different point of view.

I'm sure this pregnancy will be fine and was probably was meant to pop lots of babies out effortlessly!

Thanks ladies for the support and understanding.