Questions for consultant prior to ELC....

[elizaregina]

Would appreciate any questions about what they do in thier ELC's...

for instance

What will they stich me up with,

Do they have spinal or epidural

any other ideas.....

Pain killers they use....

Many thanks

this book is good, has a list of things to ask the docs in it.

www.amazon.co.uk/dp/0956848001/ref=as_li_qf_sp_asin_til?tag=tiskimocom-21&camp=1406&creative=6394&linkCode=as1&creativeASIN=0956848001&adid=10B9YV7DENHHVQZZPSZK&&ref-refURL=http%3A%2F%2Fwww.csections.org%2F%3Fpage_id%3D29

Posted the same question a few weeks back and didn't get very far
This is my list so far after extensive t'interweb research
VBAC
Pain management during VBAC ? are my pain mgmt. options more limited due to link between pain in scar area and rupture, or is monitoring a sufficient indicator should I require/wish to have an epidural?

1. Among women who attempt a VBAC after prior cesarean delivery, what is the vaginal delivery rate and the factors that influence it?
2. What are the short and long-term benefits and harms to the mother of attempting a VBAC after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms?
3. What are the short and long-term benefits and harms to the baby of maternal attempt at a VBAC after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms?
4. What are the non-medical factors that influence the patterns and utilization of VBAC after prior cesarean delivery? Birth position for example?
5. Is continuous monitoring mandatory and if it is, or I prefer to have it, are there facilities to be monitored in a birthing pool at this hospital?
6. Should I plan for early hospitalisation ? ie if waters break or contractions start naturally to allow for monitoring. What is the general practise in this hospital?

ELCS

1. Who will be my surgeon? Can I request the same surgeon as I had before if they are still on the staff?
2. Are trainee surgeons allowed to carry out ELCS's? Presumably not allowed to carry out EMCS's?
3. What are the risks of repeat caesarians ? What would be an optimum number of children to stop at in order to statistically avoid a high risk pregnancy eg: placenta previa, or post op complications eg: hysterectomy
4. My first CS was entirely complication free but what are the key maternal risks I should be aware of with an ELCS and at what rate do the incidences of these types of injuries rise with multiple caesarians. eg bowel injury, ICU admissions, post-operative ventilator use, cystotomy and more.
5. What are the key risks to the infant I should be aware of with an ELCS?
6. Under what circumstances are forceps used during a CS and am I at higher risk of this use as part of an ELCS if the baby has not decended? What are the risks of a forceps delivery to the child via an abdominal route?
7. Will my post op recovery period be shorter/longer with a second CS? Internally due to repeat surgery or shorter due to fewer drugs, lack of labour etc?
8. Will the incision be in the same spot or will I have two scars? Will you use the same method of closure? Any chance of a tummy tuck ?
9. If I go into spontaneous labour, and there is no medical reason not to try for a VBAC, what are the decision criteria for recommending I progress to a CS? My BP or Fetal distress is an obvious one, is there a time period after which Failure to Progress status is declared again and I have a second EMCS. Under these circumstances, do any of your answers above change?

10. My previous birth notes refer to a narrow pelvis repeatedly, but my daughter was also in a back to back position. Do you recommend an ELCS or a VBAC? Is it my choice? 11. If you are recommending an ELCS or I am choosing to have one (assuming I have the choice), when will it take place ? Week and date?

Hope this helps!

Do they do skin to skin? With the father/birth partner if you cannot do it yourself.

Infection rates.

Good luck! Mine went well.

Viking,

Thank you soooo sooooooooooooooooooo much!!! xxxxxxxxxxxxxxxx

Thank you oscawilde! I will be printing this when I go back to the consultant in a few weeks!

sorry Oscar, massive thanks to you too......

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