Timing of induction/elective C-section

[archersfan3]

I went into labour at 41 weeks with my first, had an EMCS due to fetal distress and failed forceps delivery, he was small (just over 6lb) but otherwise fine.
Second baby is currently at 6% estimated weight, it has maintained that line from 32 weeks (when I had the first growth scan) to 34 weeks so is growing and blood flow (dopplers) and fluid levels etc all fine, no other issues on scan.
However the doctor I saw to discuss the scan seemed to be convinced that baby needs to be delivered at 37 weeks. I was hoping for a VBAC but baby is currently breech so it looks like it will be a Ceasarean at 37 weeks unless it's turned by then. However the doctor was then saying that I will need steroids to help baby's lungs be ready for birth and baby will most likely have to go to special care overnight. So I don't quite understand why they would do that if it's growing and seems happy enough- is there a reason they wouldn't wait until 38/39 weeks? Can I ask to wait until then?
Also, if baby goes to SCBU and I have had another Caesarean so am immobile from the epidural, does that mean it has to be formula until baby comes back to me? I fed my first for 12 months (though he had a bottle of formula at birth due to fetal distress during labour) so am keen to breastfeed but can't see how that will be possible if we are in separate places. I really hate the idea of being separated from baby for 24 hours.
I know that it's all relative and there could be much more serious issues going on but I'm just feeling a bit fed up. I wanted to avoid another Caesarean as I will have a lively 3 year old to look after, mostly by myself as husband works long hours and no relatives nearby.
I'm not sure my hospital is the most progressive so I'm not convinced I will be able to do things like skin to skin after the caesarean. There is a limit to how much I'm willing to argue with the doctors though as I think to some extent it's safer for medical staff to do what they're most comfortable with rather than persuade them to do something they're not happy with. Not to mention that if, for example, I ask them to wait until 38-39 weeks and then (God forbid) something goes wrong, I will always feel like it's my fault.

Also, I'm not ready to have the baby in 3 weeks time!! The room is still full of other stuff etc etc....
Sorry that's a bit of an essay, just needed to get it out.

Hello, so sorry to hear that you are stressed out. I was induced with DC1 at 37+2 (had to have two sets of steroid injections on two consecutive days). Ended up delivering at 38 weeks - long story. Try and think that you will be considered full term at 37 weeks. There must be a reason the doctors want to deliver the baby even if they haven't communicated it effectively. Definitely ask for clarification so that you're making a fully informed choice!!

As for bfing. I know a couple of mums to premature babies that managed to bf. I assume that they pump/hand express colostume for the baby to have even if they aren't together. I would also ask about skin to skin, etc...if it's important to you.

I had a horrendous first birth so I totally understand why you're anxious. Second time round was more straightforward though (second induction) and I hope it's the same for you. Good luck!

Thank you for wading through my hormonal rambling...
I thought I was quite relaxed about the idea of having another CS but I thought it would be at 39 weeks...
I think I have sort of organised my thoughts into three main areas:

1. Timing: why 37 weeks and not 38 or 39 weeks? This is something I need to discuss with the medics. And yes I agree with you that it's the reasoning behind it that I don't feel they've fully conveyed to me: if I had high blood pressure or something I would completely understand the risks of waiting but as far as I could tell the only reason seems to be that baby is looking small, there are no other health concerns about either of us.
2. Breastfeeding: how this will work if baby is taken away.
3. How I'm going to manage 3 year old after CS.

I still feel quite emotional about baby spending his first 24 hours or so on his own in special care rather than with me, but rationally I guess there isn't much I can do about that.

I am glad your experience was more straightforward the second time.

It sounds very stressful for you at the moment

Your list of thoughts seems like a good one to take back to your consultant; at the very least I think you need to be reassured about exactly why 37 weeks is optimal for your baby. Perhaps you could ask about the earliest date you could give birth without requiring steroids? I had an ELCS last week at 38+6 and one of the reasons my consultant gave was that she could go ahead without needing steroids.

In terms of breastfeeding, I believe expressing is supported and encouraged in our local hospital, although it may not be the same everywhere, so something to check with your consultant?

I have a nearly 2 year old toddler and, very fortunately, a lot of help. He's actually adapted well to me not being able to lift/interact with him in quite the same way as before the CS. I'm 4 days post CS and last night was able to assist with his bath (DH did the lifting/bending) and bedtime. It's really made me feel like I'm coping and helped him realise things are getting back to normal. I've made a list of situations where I'm going to need DH to do the physical side of things for DS until I'm better (everything from baths to getting stuff out of the bottom of the fridge) and this has helped us both to manage our expectations for this first couple of weeks. It's been tough at times but there's also a sense of achievement that we're doing ok as a family of four.

Thank you Duggee, I have been feeling quite stressed since the appointment yesterday but feeling a bit calmer now (though did also embarrass myself as it was toddler's last ever day at his lovely nursery today and I got a bit tearful when I picked him up....!)
I'm glad to hear you are still able to get involved with your toddler. If you haven't already got one I recommend a litter picker for picking things off the floor - it was v useful last time and I've dug it out for picking things off now I can't bend very well with a big bump. Although I'm also training toddler to pick things up for me! (With mixed success...)
I'm not convinced our hospital is hugely supportive of breastfeeding in practice (despite all the posters around etc about the benefits) as didn't seem to be any advice or support available last time, despite baby's blood sugars being dodgy which surely suggests feeding needs some attention. But it might be different if it's a planned situation so I will find out.

I had prem twins at 34 weeks by section, both breech and with intention of breastfeeding. 3lb 14oz and 5lb 8oz. They went to scbu and they were very much for BF as soon as possible. They helped me hand express colostrum in the recovery room while my babies were being admitted. Then it was on to the pump to help my supply whilst they got established with breastfeeding. Mine did need to have formula as well though.

archers thanks for the grabber tip - I think I'll be investing in one tomorrow as I seem to have become very clumsy since giving birth again!

On the breastfeeding front it might be worth contacting La Leche League or looking up local lactation consultants to see if there's any support available eternally to the hospital if you think there might be a gap in provision there?

Thank you Minty, I'm glad your hospital was helpful with breastfeeding, I will ask about it. I think they do have a breastfeeding clinic/cafe at the hospital but I couldn't get to it last time because I couldn't drive after the CS.
But yes I think it might be worth phoning one of the helplines too: they were very helpful when I phoned up at about 6 weeks with my first - 10 minutes advice on the phone sorted out the issues I'd been having for 6 weeks while going back and forth to the health visitors... So I will be a lot more proactive this time about phoning them. I don't think it was LLL that I phoned but I can't remember which one it was.