Will I be able to request a ELCS at Kingston Hospital with dc2?

[GoodnessMeNoGinInTheHouse]

I had my dd in 2011 at Kingston Hospital. I did have placenta previa during pregnancy, but it was decided the placenta had moved enough (an inch or two away from cervix) to go ahead with a vaginal birth. As soon as labour began I was bleeding a lot. After 3 days of labour, I ended up having a category 1 EMCS (due to fetal distress) it turned out she was back to back and had the cord round her neck twice which was only picked up at c section. The equipment also failed 5 times when they tried to get a blood sample from dd to decide if c section was the way to go, putting her at risk of lack of oxygen. The whole experience was hugely traumatic for me and my DH and I ended up with PTSD and had to have counselling afterwards due to horrific nightmares and upset. I know people go through far worse experiences but this hit me hard. We were all ok and in a good place now.

I am now 10 weeks pregnant with dc2 and already know I want to request a calm ELCS. We'll be at Kingston Hospital again and that makes me nervous too. I am fully aware of the risks involved having a CS but can't go through the potential of what happened before happening again. DH also feels more comfortable to have more control over the arrival of dc2. I know the hospital will try to push for a VBAC but I really start having the sweats just thinking about it. I have my booking in appointment in 10 days and want to make my intentions clear on wanting a ELCS from the start.

Does anyone have experience of this? Or this request at Kingston hospital? How did you assert your wishes?

I wouldn't bet they'll push for a vbac. I was at the Whitt and told the doctor I wanted a Vbac - and she wrote "elcs" in my notes! There would have been no problem if I had wanted a repeat cs.

I had a v traumatic first birth with Kingston & in my booking apt I was offered elective c section for dd2. I've rather strangely (sometimes don't understand my own decision) decided to switch hospitals & go for a home birth with dd2 in a few wks as I'm too traumatised to want to give birth in a hospital again.

Based on my experience I think you'll have no trouble at all getting elcs at Kingston

Likewise. I had a cord prolapse during delivery at Kingston in November 11 (no fault of theirs - it had happened without my knowledge before I arrived at the hospital) and my DS subsequently died from the effects of lack of oxygen.

An ELCS has been on the cards for me ever since I had the booking appointment with this pregnancy, even though there are no medical indications for one. From the start I've known that I can have one if I want.

It's definitely helped that I've seen the same ante-natal midwife and consultant as last time round - are you seeing the same people as before?

Hi,

I'm in the same boat at Kingston, wanting an ELCS at Kingston after a traumatic vb with ds1, but not had such a great response to my concerns abut a vb. This time round i'm a placenta previa candidate, 22 weeks and it still hasn't moved and experiencing bleeding. I'm scared to death of something going wrong even if the placenta moves and don't think I can go through the stress of all the unknowns of vb.

Anyhow, all I can say is so far despite me describing how concerned I feel about everything the first midwife I saw just said it would all be different this time round, which it could well be, but wouldn't discuss it further and the second was trying to get me to have a home birth?! They seemed totally immune to my distress about all this. I have just seen a consultant and raised my concerns again but they won't even discuss my birth until I've had my placenta rescan at 32 weeks. All I can say is in my experience it seems you have to be pretty direct and forthright from the off, it seems like unless you scream "I demand and ELCS" (which is not really in my nature maybe I need to be more aggressive) you get carried along with the generic protocol of the hospital and I'm sure part of that is the fact that all hospitals now have cost-saving targets to reduce the rate of c sections and epidurals they perform. I'd be really interested to hear how you get on. I'll let you know what happens with me!

xx

I had bad first birth - pre-eclampsia causing induction at 36 weeks and ultimate cat 1 section again because of chord and fetal distress. I'm at Kingston for dc2 and consultant led - was concerned about having to fight for an elcs but was happy that my consultant suggested it so no pushback at all! So far found the consultant led care there very good - my consultant is doing do many scans and tests I totally feel well cared for - best of luck!

betsybo - don't be too disheartened. If they're considering your ELCS request on the basis that you have placenta praevia, rather than because of your traumatic experience, then they're unlikely to consider it before 32 weeks anyway, because things might change. If you still have PP at 32 weeks, then things will start to happen. I know that doesn't help how you feel but it doesn't mean that you can't have your ELCS.

I had an appointment there yesterday and there was a notice on the wall saying that the updated NICE guidelines did NOT mean that ELCS was now available at maternal request. It means that a request should be discussed and reasons for not wanting a vaginal birth should be explored before any decision was made.

Update: I had my booking in appointment today at 11+3. The midwife was well aware of my first traumatic birth experience. She has said that I have to be referred to the VBAC clinic to the most senior person there. I have also been put under the ISIS unit to keep an eye on me in case of depression/anxiousness etc, I said if it was going to help me discuss the fact that I would like a c section with more senior staff please go ahead and refer me to it. I apparently won't get to discuss the birth option with a consultant until 36 weeks. If that is the case it is going to make so a very anxious pregnancy as I really would like to know which path I am on, which I will bring up at the VBAC clinic appointment which I'll have around at around 16 weeks. So as per the NICE guidelines, they have to explore all options before letting you know either way or granting any requests. As predicted I'll have to fight my corner. I do feel at the moment they are pushing for a VBAC but only time will tell once I speak to further people in the VBAC and ISIS teams... I'm actually feeling even more nervous now as I have to talk about some private feelings with so many strangers. I wish my first birth experience had been different and I could feel confident in my body and the hospital but I just don't, so I really feel they have to hear me on this one...

It does seem to be procedure that you have to discuss the pros and cons of a natural birth vs a CS before they will agree to a CS. I had a phone call out of the blue yesterday from a consultant midwife trying to make an appointment with me - I had no idea I needed an appointment with them. She said something vague about 'discussing birth options with me' - even though I've been discussing them with my consultant. I THINK this means that I have to jump through a hoop of meeting with midwives and appearing to consider the natural birth option. I'm not very happy about it tbh.......