Consultant has booked for an elcs due to babys size

[Hopingforno2]

Hi im a type 1 diabetic and 34 weeks pregnant. This is my 2nd dc and with my 1st i was taken in the night before induction and found to be 2-3cm had a show overnight but was taken to delivery next morning had my waters broken and was put on drip anyway. I got to 10cm and pushed for an hour but could not budge ds so was taken to theatre for trial of forceps unfortunatley his hb dipped (id had pethidine) so i had an emcs.

This baby is measuring large 6lbs 4oz at 32+4 and my consultant said due to size it would be an elcs but not why size makes this neccessary? Would i be at more risk trying for an induction again? Is an elective section a good experience? My emegency was not! Any advice greatfully recieved

Poor you, sounds like you had the worst experience last time - labour, forceps then an emergency section. No two deliveries are the same, and chances are everything will be different this time. I'm guessing you might be quite small and consultant thinks there is a risk of baby getting stuck again, so offering you an elective section seems like a reasonable idea. Of course, you can ask more questions and you don't have to agree to it, but maybe get another appointment to discuss further?

I'm not sure what the risks are of you trying for induction again with a big baby but the overall chances of a successful VBAC are 75%.The main problems are risk of scar rupture.
I've never had an EMCS but I've had 2 ELCSs and both were very calm,straightforward and as pleasant as a surgical delivery could be so if that's what has been recommended I can reassure you that part is bound to be less stressful than an emergency one!Also,you know when it will be so organising things for DC1 is easier and you won't be knackered after a long labour.Good luck

Thank you, im fairly small 5ft 2 so myb why yes i have another growth scan and appointment tommorow so i can ask but at the same time i dont want to go through an entire labour again and end up with an emergency section but as i have ds recovery time from a section worries me and so does the lack of skin to skin after birth of baby.

DS & recovery time is definitely something to think about and I found that bit hard ,but can reassure you that after both ELCSs I had immediate skin to skin & was able to successfully breast feed both despite hearing that a section made it harder so hope can reassure you re.that part .

I keep getting told different things re skin to skin one midwife told that it was possible on the table even while being stiched but the next one looked at me like id grown a 2nd head and said no until at least i was in recovery, i was unable to establish breastfeeding with ds and think this was due to lack of skin to skin, him being taken to baby ward as they 'didnt have enough staff to keep a check on his blood sugars on the ward' and lack of support after delivery. Im really wanting to this time have written it on my notes but im not hopeful

The c-section rate in diabetes is much higher - about 50%. There are a number of reasons for this:

• larger babies making vaginal deliveries more risky (shoulder dystopia & birth trauma),
• small risk of Intra-uterine death beyond 38 weeks (so most units deliver at 38 weeks).
• at 38 weeks your cervix can be unfavourable, making induction less likely/successful
• add in risk of scar rupture and you can see how the factors stack up & conspire against you.

Certainly ask your team what size the baby is likely to be at 38 weeks (they'll be able to calculate this from the baby's growth charts).

Our unit has a breast feeding specialist who sees our patients in the run-up to delivery to discuss options such as expressing pre-delivery. We also have a neonatal hypoglycaemia protocol that clearly explains re: what will happen in terms of monitoring & intervention (sometimes this involves top-ups if no breastmilk available).

Ask your diabetes/obstetric team about this - they should know the answers!

Hope everything goes well for you.

Thanks lotsofcheese every unit seems to differ in how things are done slightly altho 38 weeks is the limit i was actually in labour when i went for induction 1st time 2-3cm tho i hadnt felt much lol

I will def ask re the breastfeeding how soon before do you start expressing?