Know it's been done before but please hep, ELCS for firstborn following pregnancy loss trauma and PTSD?

[StarsInTheNightSky]

I know it's been done a lot before, but I'd really appreciate some advice on how likely it is that I'm going to be able to have an ELCS and also and advice on getting one approved please.

Brief history is that I have PTSD from being abused as a teenager, and we've had previous losses, although only one second tri loss (last spring).
The second tri loss of DS1 was very traumatic, hospital gave incorrect doses of medication so couldn't start my labour properly, then sent me home saying they'd try again the next day only for labour to kick in at home where I collaped from blood loss and got rushed back in by ambulance where I was stabilised and gave birth to DS1.
Midwives and hospital staff in general were very uncaring to the point of being cruel which didn't help (I got told to pull myself together as "lots of women have dead babies" I was just sitting crying quietly with DH, I wasn't being a nuisance). I was given painkillers and antibiotics which I was seriously allergic to (despite DH telling them what I can't have) and so ended being rushed back into hospital with severe blood loss again and anaphylactic shock.
I went into cardiac arrest and had to be resuccitated. The saga goes on a bit, and I ended up with bad infections and in a lot of pain which took several months to clear up, and the whole thing was extremely traumatic for DH and I. Our GP complained to the hospital board, and we had a formal apology from them.

We have changed hospital now as I can't bear going back to the other hospital, and touch wood, all seems to be going well this pregnancy (now 25 weeks) and the hospital and staff are fantastic. At the weekend though, I started getting very strong braxton hicks, and the normally extremely active DS2 didn't move for 12 hours. I went into hospital for monitoring, and the doctor couldn't find his heartbeat, everything went very panicky for a while, doctors rushing round, shouting etc etc. It turns out that their machine was faulty and the doctor hadn't noticed, and DS2 is absolutely fine, thankfully. I went to pieces a bit though, as it brought back a lot of memories from when we lost DS1 .

I've been trying not to think about giving birth, as whenever I do I have severe panic attacks as I get flashbacks to DS1 being born. The past couple of months my anxiety has been increasing a lot, and I get very bad night terrors every night about giving birth to DS2 only to find he's dead. The night terrors are so bad that I don't get much sleep, and then as soon as I go back to sleep they come back. I've also been getting more and more panic attacks during the day, and now I get several a day as I get intrusive thoughts with the same stuff as the night terrors.

I've had a lot of therapy and CBT in the past for my PTSD, and I have been using what I've learnt again now but I just can't break through the conviction that if I have a VB either DS2 or myself are not going to make it.
I'm terrified, and yesterday DH suggested that I ask for an ELCS, I started thinking about it, and almost instantly, the majority of the fear went away and I didn't get night terrors last night. When I think about ELCS, I can actually think calmly and happily about giving birth, and can almost look forward to it. I am convinced that ELCS is the way forwards for me. I have had major surgery several times before, so I know opting for surgery isn't something to be taken lightly, and I know the recovery can be tough, but I really can't face having a VB.

I know I don't have a medical reason for it, but do you think the hospital are likely to ok it? I've got a meeting with our consultant tomorrow to talk it through initially, so I was just wondering if anyone had any advice. I also wanted to say that I know a lot of people have it a lot tougher than I've had it, and I don't mean to offend anyone or whine. Thanks for reading.

You poor thing - that sounds terrible, so sorry to hear about your loss. Based on everything written above, I would think you have very strong grounds for wanting an ELCS but I'm not a proffesional.
All I'd recommend is explaining all the above to your consultant and hopefully he will agree.
Good luck.

*professional

You know anxiety IS a recognised medical reason to have an ELCS don't you?

Given your history, the fact you have had a formal apology for your treatment and the fact I assume that your PTSD was officially diagnosed you have a good case to present for an ELCS. You can conclusively prove that the treatment you received affected your mental health and that there may be need to take steps to protect it when it comes to this birth.

The NICE guidelines on CS are very much geared up to supporting women in your position. Not all hospitals follow them, but even if you are at hospital that didn't, given your history they would be extremely unwise not to listen to a request from you. Even more so, because you have had CBT and it hasn't helped.

I also think the fact your reaction to your DH's suggestion is definitely worth mentioning in any discussion you have about an ELCS too.

Daisy thank you, that's really helpful and reassuring. Our consultant has been very supportive so far, so hopefully he'll be ok with it.

Red thanks, I knew that anxiety was, but I didn't know whether they'd think mine wasn't severe enough to count. Yes PTSD was officially diagnosed, and the trauma with DS1 was officially diagnosed as to have brought my PTSD back again. Thanks again, that really is helpful, I'm making notes to take with me (tend to forget things when I get stressed) so I've put down to include my reaction.

Daiso sorry - type due to uncooperative preggo fingers!

PSTD is definitely on the list of anxiety related conditions that are medical reasons for an ELCS. The severity and whether you have a case is purely down to how you feel and how it is effecting you now. Having nightmares and flashbacks its obviously bothering you to a level that you are struggling to cope with.

I definitely second writing things down as it will help you, and save you from panicking and forgetting things in any discussion about an ELCS.

TBH if you don't think that your case and history isn't 'severe enough' to count, then I wonder who you think they are for! You are EXACTLY the type of women who they are designed to help.

Red that's really good to know thanks, and yes, it is disturbing me a lot now, usually I have a very good handle on my PTSD, but I am really struggling at the moment. I've never had a smear test as I can't cope with it, and the internal exams I had to have when we lost DS1 really set me back, particularly as the doctor doing them was very rough and hurt me, so I don't think I'd cope with that aspect of VB either. Obviously I'll do whatever it takes to get DS2 out safe and sound, but if possible it would be great to be able to do so without more trauma for me, I don't mean that to sound selfish.
I don't know, I just think that you always hear people who have horrendous experiences multiple times, so I suppose I thought they would be the ones who were allowed ELCS. Thank you, I really do appreciate your advice.

Stars, I have an ELCS agreed in principle due to anxiety. I have never had a baby before. The only thing that is counted when deciding is whether it is distressing you NOW. You don't have to have 'an X measurable' past experience to prove you have a case for an ELCS. Of course, in your case, your background does really back up what you are saying so it is helpful, but its not an essential part of a request.

Red thank you, and I'm really glad you've got your ELCS agreed, I really hope it didn't come across that I was diminishing your, or anyone elses anxiety, I didn't mean it that way at all. I'm just a bit ignorant about ELCS, I don't know anyone who's had a c section, and I'm just worried they'll refuse it .

No I didn't think that at all! Don't worry. I've read a lot of threads like this and it never fails to amaze me how many women like you somehow don't think they have 'had enough bad things happen to them' to make a case for them to have an ELCS. Even if they have had some sort of horrendous experience. There seems to be a need to reassure women that their feelings are valid and that they aren't being in someway 'pathetic' (or whining as you put it) or simply not justified.

I think in part its a way of putting up a mental defence against what happened as a coping mechanism. They can't admit that their experience was as bad as some others they have heard about, because then they have to face the face in some way that they had an appalling experience themselves and they are 'that poor woman' too. I hope that makes sense.

Thing is, its not a competition and you shouldn't make comparisons with other women. This is about YOU and YOUR ability to cope - or inability. Another woman might well have had a 'worse' experience but for one reason or another, is better able to cope with it. It doesn't make you a lesser person or her a better one. Just a different one.

Its weird. I also do think part of the problem is the way this is discussed in the media and the negative press given to maternal requests. There isn't enough understanding of what is accepted as a medical need and why. If people understood better, then maybe they would be more comfortable about making a request.

It is completely possible you will get a negative response from your consultant tomorrow. If this is the case, and you do feel that an ELCS is the right way to go in spite of that, don't be put off. There are a lot of politics going on with regard to the subject unfortunately, with vulnerable women getting caught in the middle of it. You can challenge a negative decision if you really feel it is wrong.

All you need to know is that whatever you are feeling and whatever reaction you are having is ok and probably pretty understandable or normal. Have the faith to trust your instincts and to do what you feel is best for you. Don't feel you have to justify yourself constantly!

Thank you Red and I'm really glad I didn't offend! I think you're right about a coping mechanism, it makes a lot of sense, and also I think that I don't want it to 'beat me' as it were, but I want DS2 to have the best possible start in life (and best possible life) and I am convinced that having an ELCS would help with this massively.
You're right about not comparing too, and since I've admitted/accepted that I'm not going to be able to cope with a vb, I do feel quite a lot better in myself.
I definitely agree about the media, and as you say, if there were clearer guidelines which were readily available then it would make it much easier all round.
I am prepared in case the consultant says no tomorrow, and I am definitely going to challenge if he does.
Thank you so, so much once again, your posts have made a huge difference and have made me feel much better about things. Thank you.

I think you stand a very good chance of them saying an immediate yes to an ELCS. I was offered one based on historical reasons that didn't make it physically necessary but mentally important.

Haunted thank you, I really hope so, that would be fantastic, I'm preparing myself to have a bit of a battle with it, so anything other than that would be brilliant

Star first of all I'm so sorry to hear about your little DS1. How awful that an already traumatic time was made worse for you.

My DD2 died shortly after birth, she was born at 35 weeks, I was allowed a c-sec for DD3 without an ounce of fuss. I know several mothers who have lost babies and gone on to request c-secs for subsequent births and none have had any trouble getting it agreed. A good consultant will want to support you through whatever birth plan feels most acceptable to you given your previous loss. Needing control over the birth is totally natural. Good luck

We lost our son after an emcs at 27 weeks and currently 27 weeks again. My consultant care has been excellent and have had no problems when I asked for a csection again. My consultant advised that after a previous loss they like to get the next baby out on or before your due date whether by induction or elcs but that might vary between hospitals.

As others have said PTSD and anxiety are valid reasons to ask for an elcs.

Good luck!

I noticed that you said tHT you 'didn't have a medical reason' for an elective section. Well, I think you are wrong about that, as diagnosed MH issues are relevant. I'd set about his by getting your MH team (ideally consultant) to talk to your obs consultant to set out the reasons why this is necessary. Clear evidence from a clinician that ELCS is necessary given your pre-existing MH diagnosis should make it happen.

It makes me cross that women have to fight so hard to have the birth they want. I hope your consultant sees sense straight away and supports you in this decision. It might be helpful to make a few dot point notes to take with you to the appointment.

I wonder if along side having the Cesarean if you could hire a doula. There are some lovely Doula who have experience supporting women through Cesarean births. The Doula would be able to talk through with you things that may make you anxious leading up to and during the birth and can watch the staff are helping you in respectful and caring ways. The doula should be on your side and help make you feel safe and secure.

I had a term stillbirth last spring and am having a section for mental health reasons. I told them I refuse to lie there for hours listening to the heartbeat of my baby expecting it to stop each time I hear a pump and that it is counter productive to a) worry about delivery through pregnancy and b) be inconsolable when I am being induced.

This IS a valid reason and a medical reason for a section.

I do not want surgery - I just want my baby out!

Hello all, sorry for not replying sooner, I tried to go to my appointment yesterday but got taken in as an emergency instead and ended up being kept in and monitored. All seems fine now though, thank goodness, and the problems were with me rather than baby.

Whatever thank you, and I'm really sorry to hear about your daughter. That's really helpful, thank you.

Rosduk I'm so sorry about your son, but thank you, it is reassuring to hear from other people who got ELCSs agreed.

Edith thank you, that's really good advice and I'll get them to do that, I was worried that my issues wouldn't be seen as severe enough, but everyone on here has given me a lot of hope.

hazchem that's a great idea thanks, I had thought about it briefly a while ago, but I'm going to look into it. I think it would really help DH as well, as he's terrified of losing me and/or our son, so it might help him too.

tsw I'm really sorry to hear about your lost little one. Your post is exactly how I feel, I just want him out safe and sound, and I don't trust my body to be able to get him out safely.

Thank you so much everyone for sharing your experiences, although I didn't get to my consultant appointment yesterday, I saw a different consultant from the maternity unit (who is more senior than our own consultant) whilst I was being monitored, and he was brilliant, he listened and was really kind, and he's said that if my consultant won't support an ELCS he will, which made me feel masses better. So I suppose if our consultant says no, I just ask to be referred to the other consultant instead.
The head midwife/matron was also absolutely brilliant, and said that she 100% supported me having an ELCS, and that she would send an email/memo to our consultant saying that. Both her and the other consultant have also written in my notes that they strongly recommend ELCS, so hopefully that might carry some weight.

Thank you all so much once again, I really appreciate all of the advice and support.

That is really good to hear. I'm so pleased the HCP are supporting you in this.

the other thing you could do is look at getting one of the Hypno Birth CDs they do a specific one for Cesarean section. I know a friend who found having done that really helpful when she had her cesarean and it maybe nice for you and your husband to do together.

Glad all ok with both of you. You know what, of the midwives are on your side and the senior consultant too then you've got it sorted. :)

Don't worry too much if they don't book a date yet. My ELCS was agreed very early on with an antipated date. They didn't actually put it in the list until about 3 weeks beforehand and the consultant came down to do it rather than the usual registrar.