Your experience asking for planned section?

[eaiand2]

DH and I are just starting to think about TTC again after having our DD just about 15 months ago. My main worry is about delivery..

I had a spontaneous labour and vaginal delivery first time around, but DD was large (9lb8), had a third degree tear, then uterine atony resulting in 3 LITRES (well, 2.8l, but near enough to) of blood loss. It was an emergency situation immediately after she was born and it was very frightening. My husband thought I was dying. They patched me up, I had several transfusions over a few days and then when I finally did get to go home I was on 'bed rest' for a couple weeks and took iron supplements for 8 weeks.

When I met with the obstetrician at 6 weeks post birth for my check she told me that blood loss like I had is one of those things that can just happen and risk factors include large baby and long labour, but it could just be random, and when I asked if it could happen again she told me it's more likely now that I've already had a big PPH.

Sorry, essay! Anyways, because of the horrendous time I had the last time around and that I'm likely to have another big baby and subsequent bleed, I'd like to ask for a section next time. That way if my uterus doesn't contract I'll already be in theatre with doctors here working on me and I wouldn't face the same stressful situation I had before. Has anyone else felt the same and successfully requested a section? Blood loss aside, a 3rd degree tear is not something I ever want to experience again

I was told I could have a section following a traumatic first birth if I wanted. This was by a consultant when I was complaining a year later. Decided against it as statistically it was likely I'd have an easy VB and the recovery would be quicker, ended up having EMCS anyway!

Hi I'm sorry that you had such a traumatic experience. I had a big baby (10.5lbs) and she was estimated at 11lbs (nearly 5kg in new money). I freaked out and requested a consultant appointment to discuss options. I was very worried but actually the consultant was lovely and agreed that with this size of baby a section was preferable due to risk of baby being stuck. Given your past history I would have thought that you would also be offered this as an option. Also my trust is one which states we will not perform sections except for medical reasons in the big bold block capitals on the front of notes - so it is possible. Good luck!

In Bahrain. The Middle East - cs are very popular and the surgeon I saw said that he only allowed women to labour for 14 hours before going ahead with a cs.

I have seen threads about this before and a lot is to do with your ability to be calm and say why sensibly- also it can't be disregarded out if hand by a mw or consultant- they have to have a reason, not " ooh, better for baby" and fobbing off- when baby might be like the last one:)

The cs is major surgery. I wish I'd had a doula before and not relied on the the years of experience but still managed to fuck up everything anyway mw.
Maybe I'd have given birth naturally. Who know?:)

However I have never been in labour. Do not feel I missed out. (!) and bf DC for at least 2 years.

I had 2 elective sections. my only point here is not to assume your next baby will be bigger. my first was 10lb 8oz and my second was 9lb 11oz.

however, I think with your history you should be given a section regardless of whether baby number 2 is a big or small one.

move to my trust they kept trying to make me have one so i could meet my baby sooner and get off there ward into post op ward i moved hospitals and the consultant there was push harder and get this baby out or we will be giving you a csection (i pushed)

so i heartily recommend my area (west midlands) as the most cut friendly place i know

Had a 3rd degree tear after induced birth, big DS at 9lb8oz. Asked for an elective cs for my second pregnancy even though after DS1 I was told I would probably be fine, I was still concerned. I was expecting a big debate but it was accepted immediately. I'm in Scotland, however, although our NHS has its funding issues too.

My CS recovery was a million times better than that of my tear.

If I'm denied a ELCS I'll be going private, no doubt. I have no interest in risking tears and incontinence thank you.

Does anyone have experience of private ELCS and how much it costs?

I wouldn't panic yet Apatite. Despite being told my risk of further tears and incontinence was basically nil (stereotypical arrogant consultant attitude) I still got my ELCS. I'm not sure you'd get much change out of ten grand if you went private.

Thanks sealove. I'd prefer to have baby in NHS but £10k very doable for me so that's reassuring. I've attended births where women have sustained horrific tears and I don't fancy risking it. Risks of EMCS are higher than ELCS too.

I'd like to see an arrogant consultant try and get the better of me though, I'm one myself, the non arrogant sort of course

chicken I'm sure it wasn't your intention but your post sounds quite disrespectful, "(I pushed)" and the most cut friendly place I know.

This thread is pro-choice and pro-mums being listened to. I'm pleased that your decision to refuse what was being advised and continue to push worked out for you. The 'threat' of CS as somehow being a failure to complete your VB 'job' is an engrained culture which results in a skewed view of when CS is the best option for both mum and baby. I would've loved to have been offered a CS during my VB (it was on my birthplan that I wanted this instead of instruments). My baby was stuck in deep transverse arrest and the forceps I was coerced into having scarred her face (still there now and she's 6) and caused me anal incontinence, so being cut friendly would have been highly preferable to me.

Many women in labour who are advocating for the opposite to you (whilst still in pregnancy) are not so successful and that is the subject at hand here.

Chicken, I doubt them considering a section had anything to do with 'getting [you] off their ward.' It would be offered if they believe you baby is in distress, and it's pretty common for it to be mentioned if mum is pushing for an extended time and exhausted, potentially unable to muster the energy to finish the job. Sometimes all the pushing in the world does absolutely nothing! My daughter was basically crowning over and over as I pushed. The head would start to come out, then between pushing would retract back in and I basically was getting nowhere. Sure, I didn't have an emergency section because the ventouse was successful, but many women in my situation have then had an emergency section after two attempts at assisted delivery with baby's heart rate dipping. It has nothing to do with them just wanting to be done with you.

For all I'm expecting a fight to get an ELCS I do honestly believe that the doctors and midwives want the best outcome for their patients.

Apatite1, I've seen A LOT of these threads on MN over the last 5 years or so. In all that time I have seen only two instances where an ELCS hasn't been eventually agreed. The first the woman went into labour early and everything happened too quick. The second the woman changed hospital as she was facing so much opposition and had her baby on the NHS by ELCS there instead.

That's not to say that some women haven't been through the mill with arguing their case. Some have had a real battle. But in the end they have got their choice through persisting. So you shouldn't need to part with your cash, if you are prepared to fight.

Plus apatite if you're a consultant, I'm guessing you may well be 35+. Your age, the fact that it's your first birth and your own strong preference combined with enhanced ability to put your case and be taken seriously are all very much in your favour.

This thread is very interesting. I'm 29 weeks pregnant with second DC. Had a traumatic first delivery with DCDC1. Back to back delivery, episiotomy and ventouse. I was pushing for a very long time with DD crowning over and over but nothing happening. We were left without a midwife for extended periods while this was happening because the ward was shortstaffed. I ended up depressed and in counselling a year later. I had an appointment with a consultant midwife this week to plan the birth of DC2. Just going thought my notes from last birth had me sobbing and unable to speak. I asked why possibility of me having ELCS this time. She said it was possible but not recommended and that I should try for a VB as the likelihood is that it would go to plan. DH is very against me having ELCS. But I just don't know if I could risk what happened last time.

Sorry for the typos. I should have checked before posting.

Oh, ginzilla (())

Have you discussed what happened with your H and how feel about it? Why is he so against a section?

I've not discussed at length with DH, but the knows I want a section and hasn't questioned it. I'm think he even agreed.. But then I honk he was just as traumatised last time as within minutes of DD being born all the doctors rushed in, he was handed a crying baby and then the crowd of people rushed me out of the room and he was left alone, not told what was happening, where I was going, how long it would be, etc. he was left alone in a room with nothing but his new baby and a pool of blood is how he described it. He called his mother and cried. An HOUR later a student midwife came back to get him and tell him I was alright. Shocking, but I suppose that might be why he would also prefer a more controlled experience where he gets to be in theatre with me.

Oh you poor thing eaiand2
for you too.

DH is worried that if I have ELCS it will be a tough recovery and tricky for me to copea when he goes back to work as we don't have family nearby. He's also worried I'll regret not trying for a VB. But I regret nearly everything about DD's birth. It felt brutal and out of control. Also I injured Mr back during delivery and it's become very painful now I'm pregnant again. I'm not sure I would cope with a delivery like last time. So hard to know what to do.

*my back not Mr back!

Would you consider having a family member come to stay with you to help out? Would that be a help? My sister had a section with her second because he was breech and our mom went to stay with her when her husband went back to work. She mainly helped with her toddler so she could focus on the new baby, but I know it worked well for my sister.

Yes, my mum would come and stay I think. My thought is that a well planned ELCS will be easier to deal with than another nightmare VB. But maybe I'm being naive!

Thanks redtooth and muff. I'm 37, first birth and I want it to be as controlled as possible. Being medical with a medical spouse means we automatically fear the worst if anything goes awry. I think of giving birth as a risky business already and would not deal well with the unknowns, I'm getting palpitations just thinking about it actually. I'm going to try my best for an NHS ELCS. I will report back on how it goes, consultant appointment in a few weeks.

Eaiand2 I'm so sorry that must have been a such a traumatic experience for your poor husband!

Gin I wouldn't take no for an answer in your case, you definitely deserve the ELCS if you want it. I think you have a very strong case indeed, based on your history.

In case it wasn't blatantly obvious, I'm very pro choice, provided all the risks are properly and accurately explained. What I don't like to see is midwives and obstetricians expressing disapproval based on thier own subjective opinions, when a woman has made an informed and valid choice. The woman should be fully supported in her choice without prejudice.

Thanks Apatite.I feel more muddled now since my meeting with the midwife. I'm seeing my mum next week and am going to sit and talk through the options with her as I think it will help (she's very supportive).

I hope your consultant appointment goes well - and same to anyone else going through this process.

In case my experience is at all helpful:

I asked for an ELCS for my first pregnancy aged 40. I had no 'reason' to do so other than strong preference for a CS -- as others have said, a desire for control and predictability was key. I'd also read extensively about my chances for an instrumental birth and didn't fancy the odds of pelvic floor damage etc. And to be quite honest, even if you could have guaranteed me a 'normal' vaginal delivery with no tearing I would have preferred a section.

I met with a fair bit of resistance from my teaching hospital in central London. They put me on the tokophobia/anxiety 'pathway', which I am sure was at its inception a very enlightened idea but which in practice has, I believe, become perverted from its 'woman-centred' aims. The midwives who ran the pathway pressured me to have counselling, the constant implication being that I needed to be cured of my unnatural unwomanly resistance to my own body...(do I sound paranoid and bitter?) I turned down the counselling, as I was not happy with the way they referred to its outcomes as 'successes' (60% went on to have vaginal births). The 'failures' were not mentioned.

I did not feel supported -- in all honesty I felt like they held me in contempt. They told me I thought too much. They told me that lots of women these days were influenced by celebrities, implying I was one of them. They told me that I was an anxious person who was probably nervous crossing the road. That I should disengage my 'rational' brain and be more like an animal, who went and had their babies behind trees.

In short, they treated me like I was a fucking moron, and spoke the biggest load of unscientific, natural-fallacy, misogynistic, essentialist bullshit I have ever heard. Giving me a permanent distrust of midwives.*

Eventually, and I wish I'd done this earlier, I asked what would happen if I didn't undergo the counselling. At long last, and with a sigh of recognition that they had failed, they said that would simply refer me straight to an obstetrician. I went on the have a wonderful, wonderful section (and lovely DD!) and it was the happiest day of my life.

Good luck to everyone undergoing this stressful ordeal - and at the worst possible time to have to fight battles with huge, faceless bureaucratic organisations....

*Disclaimer: the midwives I had during and after my section were lovely. They must just save the insanely prejudiced and scientifically illiterate ones for that particular bit.

Christine, I agree that the way counselling is being suggested and framed in the context of ignorance and frankly ideological bigotry is a huge barrier.

There is no point in having pathways for anxiety if you are treated like that, because in essence its like telling someone who is depressed to 'stop being miserable and belt up and get on with it.' If you have anxiety you just can't do that and that type of attitude just makes it worse not better.

If you don't have anxiety but have a rational preference for an ELCS that doesn't help either. Its more likely to alienate women and create mistrust and paranoia. Oh wait.. isn't that starting to step into the realms of anxiety...

The sheer lack of understanding is appalling, as it creates a climate more likely to allow anxieties and distrust to thrive and grow rather than helping to tackle them. Even in women with no pre-existing anxiety!

The logic of allowing every woman to have an ELCS from the word go and then working backwards to build a relationship with midwives and then talk about the underlying reasons behind requesting an ELCS is the ONLY one where the balance of power is even and the woman is always in control of the situation rather than being at the mercy of others. It is, imho and ime the only model that works for women as the priority.