Requesting c-section due to previous loss

[Laura2018]

Hello,

I'm ttc at the moment. I suffered a very traumatic ectopic earlier in the year and the thought of a natural birth really scares me. I know I would be lucky to even become pregnant but I was wondering if anyone has requested a c section due to previous losses such as surgery to remove an ectopic baby? Before the ectopic happened I was planning a water birth but this is out of the question for me now, there are just two many unknowns in a natural birth. I would just want the baby out quickly xx

Hi Laura, sorry for your loss.
Are you in the UK? On the NHS? It will likely depend on the trust you are with but in most cases a midwife will refer you to a consultant to have an appointment to discuss birth options. The consultant can then either sign off on a section or may recommend more counselling etc. Online you often hear the worst of the horror stories of women who've been through very traumatic previous deliveries being forced to consider inductions and vaginal deliveries. However in my online antenatal group almost everyone who wanted a section for a variety of reasons has been approved to have one.

If it might be useful I had a thread on here comparing various birth methods just to get some advice before deciding.

Bisquick thank you so much for your kind reply x

Bisquick I've just read your thread and I am so so sorry for your loss. How did you get on with your consultant? Xxx

We have a section scheduled for 38 weeks. Given that we don't quite know what happened last time all the consultants (on NHS and private) that we met were more than happy to sign off on a section without any questions. They were also open to inducing early and having a closely monitored vaginal birth if that was what we wanted but I think labouring on my back with continuous monitoring etc will be even more excruciating for me. And carry an unknown risk for the baby.

I wouldn't honestly worry about it while TTC but when researching hospitals nearby it would be useful to see what individual trusts say regarding maternal request sections. There are some that would flatly deny a request, but you have options and can move hospitals.

Hi Laura2018,
I'm really sorry about your ectopic and the trauma this has caused you

In terms of how this relates to a future pregnancy and delivery, there are a few things worth mentioning:

The first is that, depending on other factors that might be affecting you that I don't know about, I wouldn't necessarily think "I'll be lucky just to conceive" - you've still got well over a 2/3rds chance of conceiving in all likelihood.

The second is something that applies to many queries on here, and that is that your request for a CS would be on grounds of mental health/psychological wellbeing rather than a (biological) medical indication. If this really is what you want to pursue, then you can probably expect to go through various different counselling sessions or clinics with a consultant midwife etc. because although it should technically be possible for your request to be fulfilled, you're unlikely to get far if you come from a "it's because of my ectopic pregnancy" angle. Sadly, ectopic pregnancy is a relatively common occurrence, but very few women feel the need to have an elective CS because of it, and they will certainly wish to explore this more with you before offering it.

Bisquick thank you so much for your reply. I know its silly to worry about this whilst ttc but I think with my previous loss all the things that can go wrong are heightened if that makes sense? I hope everything goes well for you. Keep us updated xx

If your at the stage of ttc it's maybe worth asking for some counselling now before your pregnant - it sounds like you have a lot of anxiety and fear about birth already and the added stress is the last thing you need at the moment.

We did a 1:1 hypnobirthing course and although I was induced in the end I had a water birth and felt completely in control and cared for throughout. It really helped me accept my birth might not go the way I would chose when I was preparing to be induced and also keep calm during pregnancy when I was worried about being red pathway and high risk.

DoctorMonty thank you so much for your kind reply. I would be lucky to concieve and would never assume its going to happen as I have lots of friends who are struggling, so its not really to do with the ectopic. I'm not thinking about a c-section because of my ectopic (medically) i'm considering it because if how it made me feel. I've had months of depression because of it and the loss of control I had when it happened. I dont want to feel that helpess again. My sister was sectioned after her traumatic birth, my mother had ptsd after her birth and my best friend has had depression and horrible physical trauma after her birth with two operations to try and put things right. I'm so scared of natural birth, i'm scared of my mental health and if its something I would be forced into then I would stop ttc xxx

Cracklesfire thank you for the advise that is a great idea although I've had lots of couselling since and it hasnt really worked in in that respect sadly. I'm so glad you had a great birth and healthy baby x

Hi! Sorry to hear about your loss. I felt exactly the he same. I initially wanted a section for my second baby after my first was stillborn at 41 weeks. The stillborn delivery was traumatic with forceps, 3rd degree tear and obviously, the trauma of delivering a dead baby. Anyway, they didn't flat out refuse me but they really pushed me to have a natural birth. I agreed in the end and it was ok. Basically there's risks any way you go with.

Spottyparrot99 thank you for your reply, i'm so sorry that happened to you xxx

Spottyparrot99 yes there are risks either way but slighly less risk to the baby with a planned csection than a vaginal birth x

Hi! Yes, totally. And your mental health is very important factor in your choice. However, there are some benefits to the baby from a vaginal delivery and possibly easier on you than a section. C sections are very tough on you physically. From relatives and friends that have had to have one it is quite a recovery period and can impact future deliveries. However, you never really know how a vaginal birth will go and a c section is good for know exactly what'll happen when. Would you consider an induced birth with lots of monitoring as a half way compromise? Maybe even hire your own doula if funds allow? Just a thought!

laura I'm so sorry, it must be such a hard thing to try to cope with.

I had losses and it took us a long time to have DS and each month we didn't conceive pushed me further to the edge. Nothing in particular helped although I did find acupuncture good - I was doing something proactive & it gave me a bit of control while ttc and in the early weeks of pregnancy. It also helped with the stress I was under.

Have you tried mindfulness or meditation/yoga? Anything that's going to help you feel more in control of your ttc journey and help you look after your mental health - even eating healthily or exercise? I'm sorry if that sounds patronising but I really felt I only had control over the small things when we were trying and a lot of the rest was luck. Focusing on the things I could have an affect on and not looking at the bigger picture too often was the only way I got through it.

Cracklesfire Thank you for your message. Sorry to hear you had a tough time too. You are not patronising at all, your message is lovely. I do practise yoga and meditation about 4 times a week and eat super healthy. I'm just worried that my mental health will go back to the way it was before I guess. Xx

Just reading PumpernickleInaWarehouse thread and whats happened to her is my greatest fear! How disgusting that she was forced into that! Its so upsetting that woman are forced into a natural birth, so completely anti-feminist. Poor lady

I know, that's quite traumatising to read. I will say though that while extreme, it is rare. By and large consultants are not that ridiculous.

I'd suggest getting some counselling via your GP if possible prior to conceiving; taking along your partner or someone who can be a strong advocate for you to appointments once you're pregnant; and being clear about switching providers / hospitals if you feel your needs are not being met.

Tbh, we never know how births are going to go, and despite wanting a section I am aware that baby could decide otherwise and we just need to get on with it. I think it's more about retaining your sense of agency and control so you don't feel forced into things, but feel empowered. I found hypnobirthing and the advice from a sensible doula very helpful!

Hi Laura2018,

I'm really sorry to hear of your loss and the trauma you've been left with as a result of this.

I'm currently almost 30 weeks pregnant and met with my consultant for the first time yesterday to discuss my birth choices. I was absolutely dreading the appointment, envisaging the consultant to be very matter of fact and uncaring towards my reasons as they're non-medical. I could not have been more wrong!

My consultant immediately agreed with my choice to request an ELCS based on real concerns that I cannot work through. All she asked was that I knew the risks I would be taking by requesting this procedure - I had done my reading in advance so I was able to demonstrate that I was making an informed decision.

Good luck with TTC and when you do fall pregnant, if you're still certain that an ELCS is what you want, you have every right to push for it. You know you best, you know what you can and can't deal with.

NowApparently & Bisquick thank you so much for your replies. I'm actually two days late for AF and I'm now terrified to test! I'm scared it will be negative and i'm scared it will be positive! NowApparently can I ask what your reasons for a c-section are? Completely understand if thats private though xxx

That's alright, my reasons are purely down to the fear of birth injuries to the baby. It's something I've tried to work through but if it can happen once, it can happen again no matter how slim the odds. Without being too outing close friends of our's had a horrendously traumatic birth last year in which Baby's cord was compressed by shoulder dystocia. Baby went into shock and needed to be resuscitated, due to the time spent oxygen deprived Baby has incurred birth injuries that will potentially have a lifelong impact.

Good luck for when you do a test, and if it's positive just remember to bring up mode of delivery with your midwife and she'll refer you off to a consultant. Here's the NHS guidelines for asking for an elective section - www.nhs.uk/conditions/Caesarean-section/Pages/Introduction.aspx#ask

NowApparently thankyou for your reply. I am so sorry to hear about your friend. I think that is my biggest fear that the baby would be put at risk and after losing my first through an ectopic it's a risk I dont want to take. I know vaginal births can be brilliant but statistically elective c sections are slightly safer for the baby than a vaginal birth.

Online you often hear the worst of the horror stories of women who've been through very traumatic previous deliveries being forced to consider inductions and vaginal deliveries

Thats down to the imbecilic consultants they come across with archaic views.
Sadly, ectopic pregnancy is a relatively common occurrence, but very few women feel the need to have an elective CS because of it, and they will certainly wish to explore this more with you before offering it

This is where you need to stress op that you are not a sheep in a herd and that you are a person with feelings and emotions and responses that will be different to other peoples.

Some women have perfectly wonderful births and yet still feel traumatised by the pain, by the process and they all need to be listened too. No one in the world can tell us how we feel or whats best for us.

NICE has guidelines, wishy washy in some ways but its good to be aware of them on elc requests so you can get a bit heavy with anyone trying to bully you,.

ELC is a wonderful way to have a baby - it really is - good luck
*

now your consultant sounded like mine, mine had training in birth trauma. She agreed to mine without quibble.

I’m sure you can request a C-section, absolutely. That said, remember that a section is major surgery and recovery makes life after birth much more difficult. I’m 6w pp and had a vaginal delivery. My recovery physically and emotionally was hard, without being sliced through my abdomen. I can’t imagine coping with a newborn and c section recovery. Of course I understand your reasoning for wanting a section delivery.. but vaginal delivery can be very safe and natural.

Ps: I am so sorry for your traumatic pregnancy loss.