The different categories of c section, can anyone explain?

[MamaPingu]

I had an emergency c section early in September and later read my notes to realise it was a category 1. It also said "immediate threat to the life of mother or foetus".

I was wondering if you could tell me with some detail about each category of c section?
Eg. How long to get the baby delivered?
It broke my heart when I realised he was at such risk and still upsets me when I think about how I could have potentially lost him! I think it'd help me to know more about the categories to help me understand better

Bump

I had this on my notes with ds and looked it up a while after he was born. Afaik there are 4 categories. I wish I could link but I don't know how to on my phone. Google is your friend.

Essentially 2 emergency categories:
1=decision to delivery less than 15 minutes
2=decision to delivery 30-45 minutes
Then
3=earlier than planned
4=at convenience of mother/team

Category 1 often for severe foetal distress (eg very low heart rate) or bleeding in mother and often requires GA as generally quicker (not always) than establishing a spinal.

Sounds like the right decision was made for you, congratulations on your new arrival!

Actually the NICE/RCOG accepted terms, and those which are worked towards in maternity units in the UK state:

Cat 1 - Delivery within 30 minutes (usually done via GA or "fast" spinal)
Cat 2 - Delivery within 75 minutes
Cat 3 - Either planned CS done early, or unplanned CS to be done within the next day or so
Cat 4 - Planned CS timing to suit mother or staff.

I'm sorry you feel traumatised that you had a Cat 1 CS, please remember that at the time in labour your carers felt that there was an immediate threat to either you or the baby - however usually at the time of delivery they may disover that to not be entirely correct (i.e. baby comes out screaming and wasn't suffering at all). But they can only work with what they have at the time (usually heart tracing - CTG - which can be hard to interpret).

If you feel you need to discuss it further there will be trained midwives at your hospital who can talk through your notes with you and tell you exactly why the CS was categorised as it was

xx

My first was a Cat 1. I was already in theatre, spinal already in place as they were attempting a manual rotation and ventouse. DD's heart rate had been decelerating and staying down for a while and it suddenly dipped right down, stayed there, then they lost all trace. I was 'lucky' that I'd had a spinal already and they did an immediate cs. My second was a Cat 2. Same problems started to happen as first time round (stuck baby due to malpositioning and undiagnosed pelvic problem) and they took the decision to deliver via cs within the next 75 mins before foetal distress occurred.

It is very shocking and reading your notes can bring it all home. Have you had a midwife go through your notes with you? This kind of debriefing can be very useful. Also, the birth trauma association is brilliant. If you'd like to talk about it then I've been there. Please do PM me or ask any questions on here. It's normal to feel wobbly. Don't ever feel that because everything was alright in the end, you can't feel traumatised or wobbly. Talk about it. To whomever you need to. It's very early days atm.

How is your little boy? What did you call him? Does he do those cute baby sneezes?

Just wanted to say that getting answerd and coming to terms with a traumatic birth is a good idea, I've just had my second poor birth and I have really struggled.

Also OP my dd1 was at risk, her trace was pathological and she crashed inside me. The hospital did not do an emergency CS despite me meeting the criteria - dd1 spent two weeks in NICU with her first week in a coma, she has lifelong disabilities. I can completely understand why you are so upset about the CS as I had to have one with my second child - to this day I don't feel like she is my baby, all very odd.

Thankyou all for your replies it is greatly appreciated!
It's strange cause at the time I was relatively relaxed and accepting of what was happening. It was when I read "immediate threat to the life of mother or foetus" it just broke my heart! I had no idea of the severity of he situation which was probably a very good thing, me being scared wouldn't have helped!
The staff were brilliant at keeping things quiet and calm, because when I look back it was so obvious there was something going on as they were monitoring him constantly for 24 hours really!
I asked why his heart rate was dropping and one of the reasons she mentioned was a lack of fluid around him and I had lost a tonne.
I think I just feel so so lucky he's perfectly fine! During my pregnancy I was convinced I'd lose him or he'd be I'll when born, purely cause I couldn't believe I'd be so lucky. Then when I realised he'd been at such risk it makes me feel sick that if maybe the staff hadn't been so wonderful it could have been missed and my gorgeous boy wouldn't be here! I can't bare to think about it

Stumpy - His name is George (the royals stole his name, I swear! ) and he's absolutely lovely. A right healthy big boy! And he does those sneezes he also had the cutest hiccups when it was silent in the doctors waiting area, everyone was smiling

Red welly - that is so sad I am ever so sorry you had to go through hard times with both of your babies.

May I ask why you think you feel as though your child isn't yours? If you know that is!

My first birth although traumatic and almost lethal for my first child was vaginal, it was a short labour, I knew she was my baby - I knew I'd had a baby. My second I had no feeling of having had a baby, my stomach is like some kind of hideous scar fest, but the bits that should be sore aren't.

IYSWIM.

RedWelly I have not been through anything like you have but I can totally identify with not feeling as though my baby is mine. He was born 3 months early i had a horrendous labour/emcs and he had to stay in NICU for 3.5 months. He is 15 months old now and I only just feel like I have any kind of bond with him at all. I feel awful, I do obviously love him but I have just felt very detached from him, almost like I'm just looking after him for someone else. Anyway don't want to hijack the thread.

You're not hijacking what so ever! Don't worry about it.
It's interesting a few of you've brought it up about not feeling as though your baby is yours. I've felt like that a little, I'm not sure why though. I love him to bits I really do, but I'm not flooded with emotion like I was expecting to be if you get me? I thought I'd be smothering him with love haha. I also feel a bit like he's a family baby not mine, but that may be to do with living at home for a while when he was born!

From the people I've spoken to who have had both a CS and VD then it seems that they 'get' what that feels like, because quite honestly when you've had a vaginal delivery you've just pushed something large out of something small and the whole area is a little um 'tender'!

Whereas with my CS I had none of that, just presented with a baby - I am 100% gutter tbh because despite asking for opinions from so many (and on here) nobody mentioned that was a common feeling and after my first spent so much important time away from me compounding that with a dislocated feeling on my second baby really really wasn't helpful.

At all. And I won't have another

Absolutely know what you mean when you say it doesn't feel like your baby. I felt the same, had confusing feelings, until I read on a CS website that put it into words for me, when i read it i cried buckets because it made sense of my feemings which i just couldnt explain before. Something about the 'primal need' to feel or see your baby being born to 'know' it's yours. Friends who have had vaginal births never get this, because of course there's no doubt they felt it, or saw it. I didn't feel a thing, or see her emerge, and felt disconnected from the whole thing, and felt like I'd just been handed a baby. I've come across this quite a bit on mumsnet so it's obviously not that uncommon. Which is a comfort.

MamaPingu, I think the way to look at it is that it doesn't always mean there is an immediate threat to life. But more that if the baby wasn't delivered in thirty minutes then there would be a threat to life. Does that make sense?

I've been presents at loads of Cat One sections and I can't really remember a single one where I thought there was a likelihood that either baby or mum might die.

Ooh - wonder what mine was - never thought to look at my notes!
Went for a scan at 35 weeks because of ongoing high bp. Consultant was called in who said she wanted baby out within the next 40 mins. Actually waited 5 hours on a monitor because a freakish number of emcs were brought in in established labour?

redwelly We could so easily have been in your shoes. We were lucky to have her out in 15 mn from first sign of major problems. I hope your DD makes good progress.

Meant to say I didn't really feel she was mine either for ages. In fact she's over 4 now and I've only just started to feel fiercely protective of her in the way I did with her siblings. For a long time I felt that anybody could look after her as well as I could.

Aah George is a perfectly marvellous name. I love the sneezing/hiccupping/laughing. They just chuck their whole bodies into it.

The feeling disassociated thing is normal. You spend so long planning labour. It feels like something you are gearing up to something your body is preparing for. Everybody tells their labour story, what they did, how they felt. And then in the event you feel like a passive bystander while somebody removes your baby from you. I seriously felt like they could have presented me with a piglet and I wouldn't have questioned it. I felt so detached and guilty and disbelieving. It took a long time to come to terms with it.

Happily, I've had a second cs which wasn't such an emergency though still an emcs iyswim. I had the opportunity to exercise choice over the events that time. I felt fully involved in the decision making process and in the surgery. I asked for dh to watch the cs and have him describe it (my insides look like lasagne apparently). I had the screens lowered for the birth, had immediate skin to skin etc. I think that what happened second time round is that I felt involved and informed. It was a lovely, positive, empowering experience and ds felt like mine straight away.

Interestingly though, I had a massive rush of love moment with dd (first cs) despite the trauma and diassociation. With ds when I felt at peace and positive during and after the cs, I had no such thing. It took months and months for me to feel that overwhelming love. I suspect that like most things to do with parenting, it's not simple to predict.

Thankyou I love the name George it's traditional but I know people of all ages called it.

Thankyou so much for replying Stumps it has been a big help and has made me feel happier about what's happened. I do feel robbed of the experience of having my baby and bonding with him properly. I do love him lots but it doesn't overwhelm me as I imagined it would and that's possibly why. He's never truly felt like mine and it breaks my heart.

I wish I'd have known about this before the operation so I could have took steps to try build the bond how you did. I think if I had another CS I would definitely request to watch the birth, I think that would have made all the difference.

I love him so much and feel a sort of guilt that he doesn't make me all mushy things just don't feel right really! I hope they improve soon.
I wish I had someone to talk to really because I don't know if I could tell anyone in RL about how I'm feeling I'd feel silly or I'd be worrying they'd think I didn't love my son

I really do appreciate everyone's replies it has made me feels miles better

I think my main issue is that I've spent the last 4 years kind of expecting her to be whisked away again. It was so close. I've only just really started to truly believe that she's here to stay.

Do you mean you feel she's not yours to keep? If so that's how I feel I kind of don't accept he's going to stay. Me and my partner both felt as though he was just something we got to look after in the hospital haha!

Not really. It's worse than that. I keep thinking something is going to happen to her (like she'll get ill and die). It's horrible. She came after 6 years of infertility and then the birth was pretty bad (although the best it could be in the circumstances) and I have a mortal dread of losing her.

Sorry for gatecrashing thread but just wanted to pop my head in and say that I had a completely uneventful vaginal birth and I was totally expecting the overwhelming feeling of love when I saw my baby for the first time, but it really didn't happen like that, nor for any of my friends who've had the same experience.

I was expecting it to be like the movies with the overwhelming emotion and tears of joy. Nope, nada - I was so totally zoned out and whilst really happy to finally meet my baby and finding out he was a boy, I was so high on adrenaline that it was more like staring at an alien. I took one look at him and said "but the kid doesn't look anything like me!"

My friend too had the same thing, she gave birth to her baby girl and didn't even hold her for about an hour, she was mentally so detached and this is completely normal too. The overwhelming love comes later (often weeks later) for a lot of people and this is completely normal no matter the method of delivery.

A friend of mine has just delivered her second baby girl by elcs yesterday and said that she requested for the screen to be lowered so that she could see her baby being born and she mentioned about the primal urge to see the birth to associate the baby with herself as someone had mentioned that prior to her op. It's definitely something that women should be warned about, especially those undergoing crash or emergency sections so that it is easier to understand that feeling of detachment which is completely normal.

Congratulations on the birth of your baby boy