Advice on having a elective c-section

[stephmcuk]

I had an emergency c-section when i had my dd nearly 3 yrs ago. I am currently 33 weeks preggers now and really want to go for another c-section this time. I have to go to the hospital on the 3rd jan to talk to the doc about it and am scared he/she will say no you have to have a natural labour. can they do this? or if you ask for one then they let you.

also if you do have a c-section when they numb you (spinal) can the dad be there, i have read alot of birth stories when the dad had to wait outside is this routine?

Thankyou in advance

I am not sure you can demand a section maybe it depends on why you had the first one. What are your reasons for wanting another major op?

I had a really bad experience with my dd. I was in very active labour for 24 hours and never got past 4 cm. I was so tired i kept collapsing and had so much drugs i cannot even remember most of the birth or the day after. To put it bluntly am terrified of that happerning again and i really want to remember my baby being born. sorry if this seems like a weak answer but it really is difficult for me and i have had many sleepless night over this.

As far as where the father is concerned it depends on the hospital policy. Fathers usually aren't allowed if it an all out emergency and mom is under general anestesia (sp?). If you have a spinal fathers are usually allowed in. Sometimes doctors do make them wait while they prep you, and then the father is escorted in.

Talk to your doctor about why you had a section before. Tell him/her about your fears. Usually they give you the choice of VBAC or section. If you inform them of you fears and your feelings the two of you can come up with a plan.

Steph - I had an emergency c-section when DS was born and was told by my doctor at my 6-week check up that I could have a natural birth next time 'if I wanted one' - I took this to mean that it would automatically be a c-section unless I had a real desire for a natural birth. A woman on the maternity ward who had had her 2nd c-section also told me that once you have had one c-section, you can always choose to have another so maybe when you go and see the doctor, you won't need to ask.

I do think that it is true that the dad can't be there when they put the spinal block in - not sure why but it does seem to be the policy for everyone I know - my DH had to wait elsewhere whilst they did it for me.

HTH and good luck

i think it is fairly widespread practice to be offered the choice between an elective section or a VBAC in your position. it certainly is in this area (merseyside). i'd be surprised if you needed to put up a fight - but you might want to read up a little bit so that it will be clear that you understand the risks of a section. might be worth checking out the NICE (National Institute for Clinical Excellence) guidelines.

not 100% sure about procedures re spinals but i remember for my emergency section my DH had to wait outside until anaesthetist had done his stuff. he was allowed in stright away afterward though. HTH

Not a weak answer at all! I ask as my first baby was born by emergency section without me even going in to labour. A problem was picked up on a scan and it was a case of get him out. I was bullied in to a second section by a consultant I had never met before and it was booked for when I would have been 5 days late. I saw my usual consultant and he said not to have the op if I didn't want one. I had my daughter naturally 6 days late. Last year I had my last baby naturally too. I would try and go over your notes with someone and find out whether it was a problem with the baby or one with you. Every single labour and birth is different and all may go so well next time. Looking after 2 children when you have had a section is not easy and I hope you can find a way to have a better birth this time.

Also think about how many children you hope to have. If you have section this time you will probably be strongly advised to always do so.

You can definitely ask for an elective c-section. Just keep on saying that is want you want, that you understand all of the risks/benefits and that you have made up your mind. If the first consultant that you see refuses your request then you are entitled to ask to see someone else. Do not be bullied, it is your body and your choice.

I demanded an elective when I was pregnant with dd simply because I hated the thought of a 3rd or 4th degree tear or ventouse or forceps. I was much happier with the thought of knowing what would be happening in advance. My consultant agreed without any probs as she knew that I knew why I wanted one and was aware of the risks/benefits. In the end I had an em c section at 32 weeks because I developed severe pre-eclampsia. It wasn't without complications though tbh they were probably because of how ill I was rather than the section itself and I would definitely opt for another c section in a future pregnancy.

have to agree with NAB3 - if you do wish to have more children, and want to go for a vaginal delivery, you might find yourself in a difficult position

if you are still truamatised about the birth and feel this might be a reason that is holding oyu back from going for a vaginal delivery, you should try and sort that out before you have this baby

birth trauma association

The NICE guidelines do say that maternal request on its own is not enough to have a c,s on request..but based on your last birth, it is likely you can ask..

if you are afraid of going for a vaginal delivery, because you fear another traumatic birth, it can be worth debriefing yourself on the last birth before you make up your mind either way.

if you got to 4cm there is a really strong chance that you can have a VBAC, around a 70 % chance i believe..

the final decision is yours obviously, but bear in mind recovery from a c.s with a toddler to look after might be hard going, so make sure you get plenty of help!

steph, my hospital gave me a choice but recommended I attend a VBAC clinic first so that the midwives could set out the risks of either option, which is very sensible. I think if you have had one section, they won't generally refuse an elective.

But agree with NABS about how many children you want. You might want to consider VBAC if you are going for more than 2 or 3.

The policy at my hospital was as other posters described, husband not in theatre whilst I was being prepped for elective by anesthetist (spinal), but was present for incision and delivery and whilst I was stitched up. Dh took the first photos of ds.

Then I went to recovery with the midwife for about 40 minutes, before re-joining dh at the ward.

My dh was with me while the anaesthetist did his stuff for my emcs, policies obviously vary between hospitals.

and steph, ask the consultant to go through the notes of your first birth, so that he/she can assess the likelihood of success of a VBAC. If you never progressed beyond 4 cm, I wonder whether this issue could recur for this pregnancy.

I got to 5 cm with dd before em cs. I was advised that I would labour like a second time mum for the first stage (supposedly easier) and like a first time mum for the second stage.

the less you dilate the first time, the odds of a succesful VBAC increase ...there are very very few women who physically are unable to dilate

a lot of 'failure to progress' - IMO , can be due to being immobile, having an epidural too soon, being scared and overwhelmed and not feeling supported...all things that can be rectified ......

I never got past 2-3 cm in first labour ( something to do with being immobile in bed with an epidural for 7 hours................)

had VBAC.......3cm - 10 cm in 2 hours 45 and 30 mins of pushing, so all in all, not bad !

My consultant did not try to talk me out of my request for an elective c-section during second pregnancy and it was booked for 39 weeks about 3 months before. This was at King's, London. I think I did have exceptional circumstances, though. But never regretted it and enjoyed the whole experience. My DH would have been allowed in while I was prepped, but he goes wobbly at the sight of needles, so he stayed outside until they were ready to start the operation.

I too also had a toddler to contend with after the op. but was able to cope on my own when DH went back to work after 2 weeks.

Have faith in your own sense of what is right for you - and good luck!

i was petrified of giving birth naturaly an i fough tfor my elective and got one in a district which does not give electives then went in to labour naturally ns was talked into labouring naturaly which eneded in a section any way i had to go and see the consultant a couple of times but im glad i had the option just be civl honest and firm thats what worked for me

good luck

I had an elective csection at Royal London Hospital and my husband was allowed in the theatre the whole time and even helped to get me in the right position for the epidural/spinal (had both). He says it was "ok". I would imagine perhaps not all dads would want to be there, I think it is worse for them than us!

i have emergency c section with ds1 due to complications, but when i fell pregnant with ds2 i was adiment that i was gonna have a vaginal birth even tho i was told by all the doctors that i could opt for a c-section at any point. At 34 weeks scan ds2 was approx 7lb 4oz so we decided to opt for c-section as we was advised that he would be a big baby and that it may put too much pressure on the previous scar tissue. so we asked doctor for a c-section and his reply was yes i understand but thats not what you really want, it took an hour to convice the doctor that i was sure about my decision, and called a midwife in to book the c-section there and then. Just be warned that they may ask you if you would like to be sterilised while you are having your c-section, it wasnt something we had even thought about and they may not even ask you, but just if you was interested. With regards to the epidural, dh waited outside while it was done and then was brought into theatre once all the techincal bits were done, spinal, catheter(sp?) etc etc. If you are sure about your decision then you may have to fight to get what you want. hope this helps

My second labour had me stuck on 1cm for hours, jumped to 10cm in 10 minutes and 20 mins of pushing and our DD was born. Much quicker with my 2nd VBAC 1-10 in minutes and then 7 mins of pushing and our boy was born. I know people say subsequent labours can be quicker/easier but I didn't even go in to labour with my first child.

I'm with NAB3 on this. Be sure you definately want an elective before going ahead with it cos if you ever want more children you would most certainly be pushed toward a c secion for delivery after already having had 2 sections.
Also, can I point you in the direction of a VBAC group on Yahoo..health.groups.yahoo.com/group/ukvbachbac/...all the ladies there are so strong and have so much fantastic advise and support......you never know, you might be able to have a wonderful vaginal birth!
However, if you decide on the c section then just be firm and confident with what you want and why.
Good luck!

I would agree with what others have said here be sure that this is what you want, every pregnancy and birth is different, it will have implications for future pregnancies and deliveries as well.

If you are certain that c-section is right for you, from experience I would say that you probably wont have any argument from your consultant they may explain to you about vbac and discuss any possible future pregnancies.

I guess policy about dads being present during the spinal and in recovery vary so I would ask the consultant what the policy is in the hospital you are delivering in is.

Good luck with whatever you decide

Hi. Resurrecting a really old thread here but was searching old threads for info on VBAC and found this one. I picked up on Lulumama's comment that the less you dilate during first pg, the better the chances of successful VBAC.

I am 37 wks and currently wavering daily between VBAC and el-CS. DD (now 2) was undiagnosed breech and em-cs. However, I was fully dilated before anyone discovered she was breech. One of the things I've been told by consultant is that because I went through full labour last time, my odds of successful VBAC are good so quite interested to find out if 'full dilation' last time actually is not such a good thing (call me cynical but I do sometimes wonder if the advice you're given by doctors is meant to lead you in a certain direction).

If Lulumama or anyone else reads this I'd be really interested on your thoughts.

i hope that was right !!

i may have got it the wrong way round > will trawl through my books again

it is really good you dilated fully last time, sometimes, with a breech presentation, it can be slower to dilate as the bottom is not as good as applying equal pressure to the cervix as a head.. and feet definitely aren;t !

how come you were not allowed to deliver breech? what sort of breech position?

odds are, that you can do this, and that you did get fully dilated last time, you know you can deal with the first stage , it is just the pushing bit that is unknown territory.

if you want to give it a go, go for it.. there is no medical reason that you should not be able to deliver vaginally this time.. and i am sure particular attention has been paid to the lie of baby this time

i think , that if c.s due to failure to progress ( awful and outdated term IMO ) then the amount of dilation might be more relevant..

did that help at all, or am i confusing you even more?

Thanks for quick response and it is helpful - I think I just need some encouragement to be brave!

No idea about sort of breech position last time - it was all a bit of a panic I think because they found out so late and wanted to get me to theatre before I felt need to push. Doctor asked what we'd like to do (ie.cs or natural), DH asked what they recommended/pros and cons etc and all she said was 'it's up to you' - v helpful as you can imagine! TBH, I went on the fact that a friend had an el-cs for a known breech and I just thought 'if that's what they do when they know about it, it must be the best option' but no-one explained dangers etc. I don't regret having a cs in the circumstances but it did bother me for quite a while afterwards (wondering if I gave up a bit too quickly etc)

This time midwife had been saying for weeks that baby was breech again so had prepared myself for an el-cs. Had scan one week ago to be told baby not breech and no problem with VBAC which was quite a shock having got my read round cs again. To now have the choice is good but v difficult to make a decision.

Currently I'm quite settled on the idea of a vaginal birth which is what I had always wanted since DD. Not sure I can justify to myself a surgical procedure if I don't need one. I'm also really mindful of the recovery time and the fact I now have a 2 yr old to look after. I guess the worst that could happen is I try VBAC only to end up with another em-cs in which case I'd be no worse off than if I'd had an el-cs in the first place, just slightly less prepared.

Sorry, a bit rambly but v representative of state of mind ...!

I had a csection on 2nd November, and had a spinal my husband was present throughout and they even lowered the screen so we could see DS being born, they left a bit of cord on so hubby even got chance to cut the cord it was beautiful. I came home on the following Monday, so in hospital for only 3 days, I was glad to get home.

I had a csection on 2nd November, and had a spinal my husband was present throughout and they even lowered the screen so we could see DS being born, they left a bit of cord on so hubby even got chance to cut the cord it was beautiful. I came home on the following Monday, so in hospital for only 3 days, I was glad to get home.