What the hell do I do now? Refused repeat section

[Loopylouu]

I had my ds by elective section 11 years ago.

I am 29 weeks pregnant and finally saw a consultant today about having another. It was refused. Hospital policy apparently.

I was willing to literally sell everything to go private if I had to. Called the private consultants office today who I had met with when I was 9 weeks pregnant, she advised me to stay nhs as long as possible, until 36 weeks to cut costs. But now she is fully booked and can't take me on.

All the other private drs are a grand more expensive, I can't stretch to that.

I honestly don't know what to do. Mu husband is being am arsehole. His attiude is I'll just have to deal with it then.

I'm panicking and I don't know what to do. If is have known this was going to happen I may have re thought things at the beginning. I love my baby, I feel evil for saying that.

Demand a second opinion. Is your midwife at the very least sympathetic? She might be able to help engineer things in your favour.

What were their reasons for denying you the birth of your choice? I know VBACs can be wonderful and are undeniably a more affordable prospect for the NHS but that doesn't give them the right to refuse your request. I am sure the guidelines have recently changed to allow even first-time mothers to request a section, and these requests have to be fully considered.

What a horrible stressful situation for you.

I agree with pomder - demand a second opinion on their insistence that you undergo a risky VBAC against your will.

Ok... first things first. This doesn't mean the end of the road.

There are loads of threads like this and its very rare where in the end the woman hasn't ended up with a ELCS if thats what she really wanted. I'm not going to lie and say its easy but it can be done.

I think your real issue her is that your husband is being a complete dickhead. He should be supporting how you feel.

A request for an ELCS is usually for a reason and women who request them need extra support as a result - even if a hospital is refusing an ELCS they should be cautious about why you are asking and give you support to go ahead with a VB. The fact you are in a complete state shows they haven't down that and aren't looking after your welfare.

Do you mind me asking why you want an ELCS as it might help others to give you advice.

Also, since you said you've looked at going private, am I right to assume you are in London? Reason I ask is because I know that a few hospitals in London are being complete bastards about this subject. In some cases you might be best just trying another hospital because policy varies so widely for hospital to hospital.

I don't have 'a' midwife, I've had three appointments and seen a different one each time, been grunted at for two mins and been sent on my way.

I'm not even at the hospital I want to be at. I'm only there as that's where the private consultant works on the nhs. She told me to book in there and she's be able to see me on the nhs. Turns out she wasn't allowed to.

The hospital is a shithole on the other side of London. The hospital nearer me is full now.

They said it was hospital policy because my section was so long ago a vbac would be fine. I don't want one, two of my sisters had severe problems attempting vbacs, one ended up in ICU.

I don't know what to do.

Sorry if I'm sounding abrupt, I've got my husband being nasty over email telling me to grow up and get over it.

I had an elective section with my ds as I had no support. I was young and in an abusive relationship. I'd also been abused as a child and could not bear the thought of being touched.

I'm better now - I even have smear yeasts and internals are now fine (had a horrific mmc so had no choice, but in a strange way, it helpede overcome my fears).

I'm not telling anyone about past abuse this time though. A HV tried to set the ball rolling getting my son removed from me because I admitted id been abused. I'm not risking that again.

Your husband is in no position to say anything. I understand birth pain could be akin to being repeatedly whacked in the testicles for hours. I suggest you offer. To demonstrate until he realises what you mean ( not really just got very cross for you)

I thought you should be able to have one if you wanted one, I read something about the NHS guidelines as well. Keep going back until you get what you want?

Grow up and get over it!? Is for real? What a complete and utter wanker.

You are no evil for feeling the way you do. Its actually a lot more common to feel like that, then you might think except the subject is taboo so people don't talk about it openly.

Whatever, you need support and reassurance and to feel like you are being listened to. Your husband's attitude is appalling for this reason. He should at the very least listen to your concerns and help you find answers that make you feel better rather than acting like a monumental insensitive prick. Does he not understand that anxiety is not good for you and its not something you can just click your fingers and get over. Would he say that to you if you were depressed? Got to be honest, it would make me question my relationship with my partner if I had a reaction like that.

I think your next step might be to flag the fact this is making you extremely anxious. If they want you to go through a VBAC they have to give you more support than they are because of the amount of stress this is putting you under. You need to understand why they made this decision and why your circumstances would be any different to your sister otherwise you are going to have zero confidence in them and are going to be utterly terrorised about whats going to happen. Thats just not healthy for you or the baby.

You need to get hold of the NICE guidelines on CS and have a good read on their recommendations regarding VBAC and maternal request because the guidelines are on your side. Hospitals don't have to follow these guidelines but the knowledge that these have give you power to ask questions and to challenge their decision.

Like others have said, request a second opinion. And keep requesting if you are determined to have an ELCS. I'm afraid that persistence tends to be the biggest factor in this - and thats going to be made even more difficult with a husband who needs an education in support.

Are there any other hospitals at all that are an option in your area? It sounds pretty shit but I can't say I'm surprised sadly.

I asked for a second opinion. I got told that yes I can have one but that he can guarantee the answer will be the same, that in their opinion there was no medical need for a section.

My husband is a bastard. We've been havin problems anyway, as despite us trying for this baby (and the one we lost last year) he said he wasn't sure about it when I fell pregnant and sees it all as a massive pain.

Part of the reason I don't want a vbac as well is I have no one to be with me. My husband has behaved so terribly to me in his pregancy that I don't think I'd want him there telling me to get on with it or to grow up while I was scared, in pain and needing support.

All my husband cares about is the money really.

I had a horrible experience with ds. I knew I'd have to probably go private so I started saving when he was five. Long before I'd ever met dh, just incase I ever meet someone and wanted another child. He said to me today that was backwards and made me sound mental.

I'm not allowed to be negative or show any negative emotions ever. I just get told "that's life, get over it" if I'm down. But if he's down, the world has to stop.

Sorry, I know this isn't about my relationship.

Loopy, you need to make it clear what the reasons behind you having an ELCS. That may mean that you need to mention about abuse.That doesn't mean you have to go into detail about it at all. Whatever has happened before doesn't mean that someone will try and do the same again. Its well documented that there is a connection between abuse and ELCS requests. It should help you, not hinder you. I don't know how long ago the situation with your son occurred, but this is relatively new information which is changing how HCP handle cases like yours.

Is the need to be in control or anxiety over the process your bigger fear here?

Honestly, the way I feel now if this was my first baby I might feel differently about a vaginal birth.

But I am terrified of a Vbac. I'd rather go with what what I know.

I've lost count of how many times I've heard the line that trotted out about another consultant being likely to say the same thing. It seemed to be used as a way to put women off asking for a second opinion. And when they go for the next appointment they are built up for a fight only to find they have more sympathetic ears than they expected.

As for medical need. Your need appears to be psychological, so building a case to support that is the key.

You are NOT mental. If thats what your partner is saying to you, he is bullying you and emotionally abusing you. You might have needs that require mental health support - for anxiety - but that does not make you 'mental'. In makes you in need of support.

I think you might be wise to think that this isn't just one issue but is two major problems that are feeding each other too. I can't see your husband doing anything but be a hinderance to you getting support - whether that be to get an ELCS or help to deal with your anxiety. It most definitely IS about your relationship I'm sorry to say.

You said yourself that the idea of being in labour with your partner is one of the things putting you off the idea. I think that speaks volumes.

Do you have any other family or close friends who might be able to support you?

Write a letter of complaint about the consultant you saw stating the NICE guidelines and also your reasons for wanting a section. State that you understand the risks and quote these.

At the same time do not wait for a reply go and see your gp and ask to be referred to another consultant.

Hopefully either the first one will back down or the second one will grant it. Keep going.

It took me 3 appointments with a consultant and 2 letters before I got my elcs granted. (Due to previous birth trauma 11 years before).

Nope I have no one.

My mother is dead, my sisters I don't speak to haven't for a long while. I don't have any friends at all, certainly no one close enough to support me.

I don't want to go down the anxiety/abuse route. It caused so many problems which resulted in PND.

They wouldn't take a GP referal. Not from mine anyway, she tried. She's private though. I deregistered from my nhs go after ds was born.

Then you must re register and get a letter from that gp to an nhs hospital. It's the best way forward unless you can go privately with another hospital in another area.

By the way to get a maternal request on the nhs you should really emphasise the mental anguish route however much that is part of it or not as one of the reasons for agreeing to it are due to protecting mothers mental health.

If you don't go down the anxiety and/or abuse route I honestly think you are going to struggle to make a case for yourself and to get them to listen to you. I'm sorry if that sounds harsh, but that is the reality of what the NHS consider acceptable reasons for an ELCS.

If you are anxious now, it is probably MORE LIKELY to contribute to PND anyway as you aren't dealing with your problems. All you are doing is burying your head in the sand and trying to pretend you aren't anxious. Thats a recipe for disaster in my honest opinion.

If you get PND are you going to seek help? Is that more acceptable than ante-natal anxiety? It sounds suspiciously like if you got PND again, you would be reluctant to see help. Is that a fair reflection of where your head is at.

You have to put some trust somewhere into the system or you aren't going to cope at all no matter what happens. I second perhaps going to your GP over this if you have no consistency of care with a midwife. Do you have a relationship at all with your doctor? I think the HV you encountered has a lot to answer for and actually might be making you resistant to help you need.

You CAN do this on your terms even if you make this into an anxiety issue. It is more likely to ends up going out of your control if you ignore the problem.

In terms of the NICE guidelines, they say the following:
Recommendation
When advising about the mode of birth after a previous CS consider:
• maternal preferences and priorities
• the risks and benefits of repeat CS
• the risks and benefits of planned vaginal birth after CS, including the risk of unplanned CS.

You need to ask why your preferences and priorities are being ignored.

In addition with regard to maternal request they say:
• When a woman requests a CS explore, discuss and record the specific reasons for the request.
• If a woman requests a CS when there is no other indication, discuss the overall risks and benefits of CS compared with vaginal birth and record that this discussion has taken place.
• Include a discussion with other members of the obstetric team (including the obstetrician, midwife and anaesthetist) if necessary to explore the reasons for the request, and to ensure the woman has accurate information.
• When a woman requests a CS because she has anxiety about childbirth, offer referral to a healthcare professional with expertise in providing perinatal mental health support to help her address her anxiety in a supportive manner.
• Ensure the healthcare professional providing perinatal mental health support has access to the planned place of birth during the antenatal period in order to provide care.
• For women requesting a CS, if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS.
• An obstetrician unwilling to perform a CS should refer the woman to an obstetrician who will carry out the CS.

So NICEs main route to an ELCS includes referral to peri-natal mental health support.

I was never referred for mental health support- I just said that if they didn't give me an elcs that I would sue the hospital as part of my pnd included ptsd caused by the birth of my dd so if I had to go through another vaginal birth I knew this would trigger it off and I said I would sue the hospital for negligence. They seemed to listen when I said that.

TBF, thats similar to what my experience so far. I have ELCS agreed in principle prior to getting pregnant and I made it clear that I didn't want to go doubt that route due to that being part of my anxiety. They were fine about it, but I'm yet to see if they hold true to that.

However I do think this is the exception rather than the rule.

The NICE guidelines do say that you should be offered mental health support (and by default this means you don't have to take it), but in practice a lot of hospitals do seem to be insisting on it as part of the route to an ELCS.

I thought I'd be ok due to having a previous section. I thought they would take into account the fact that I don't want to have a vbac, that that alone would be enough.

The HV runnier my life. I can't go through that again, I don't want to go down the mh route.

Surely a previous section is an indication?

*ruined my life

Its not I'm afraid. I should be taken into consideration but its down to the policy of the hospital. They don't have to perform any surgery they don't want and even the NICE guidelines state only that hospitals should consider the preferences of a woman. The default position is still a trial of labour.

I think, under the circumstances, you are cutting you nose off to spite your face to be honest if you won't even consider going down the anxiety route. You have a strong case with it.

But I'm so scared of someone causing problems like they did before. I thought i was going to lose my son, I was put through hell for weeks. It took me ten years to try for another baby. There isn't a day that goes by when I don't think about that time.