Back from patronising birth choices clinic

[Popeye44]

Hello,

I’m due my second DC in 4 weeks, my first birth was a couple of years ago and was hell, both delivery and recovery.

I was adamant that I would be open to a vaginal birth again and that I would try to relax and let nature take its course however in the last couple of weeks after talking to my community midwife who is lovely, has referred me back to the birth choices clinic (today was my second appointment there). Basically I want an ELC under the grounds that I had a large baby at 9lb 6oz back to back long drawn out delivery, episiotomy,failed epidural and vacuum delivery. The episiotomy has never healed properly I find intercourse very painful, even before I had my first it was painful so there is an underlying issue with my vagina anyway which I had to see a consultant for a year after my first child in outpatients.

This is the thing though, after explaining my problems I was completely shut down again today and told that I was putting myself at harm by having an ELC. I understand it is a very serious surgery with obvious risks that I have read about on the RCOG website and also on the NICE website. I am still in my early 20’s and the consultant has basically told me she will not be happy signing the consent form alone as I may want to have ‘5 children’ which I told her I did not. She continued to tell me she would have granted it if this was my second child and I was 40.
So the over exaggerating of the risks today was pointless after stating this.

-She told me all first births are difficult (I understand)
-if I went on to have further children they could be stillborn (I understand the risk but the way she said it was ridiculous)
-I wouldn’t be in pain after my second birth as she could gurantee it, and that I would not have to get another episiotomy if a senior midwife was on shift

Basically throwing around facts guaranteeing I would find the birth a guaranteed success and that I would regret an ELC

I have been referred to see another consultant this Thursday to try and convince me into the natural birth with a detailed birth plan

Sorry for the waffle, has anyone been through anything similar I stood my ground today but I found it so hard to get my point across and came away feeling very stupid

Have had my fingers crossed for you. Let us know how you got on.

Good luck for tomorrow.

I had a traumatic first birth (forceps, epistiotomy and PPH) and then an ELCS for my second. Thankfully the consultant supported my decision from the beginning. The ELCS was far far better than my first delivery. Stand your ground.

keepkickingbaby
I am in northwestern trust at altnagelvin and saw my cons on Monday for my dating scan. I brought up the subject of ercs this time again and after a brief chat abiut pros and cons she was happy to agree. Still have to do the vbac appt but I won't be changing my mind but am expecting to be pushed towards vbac. And cons told me that elcs are scheduled for your 39th week. That sounds like you were being bullshitted.

Hello everyone,

Thanks for thinking of me, saw another consultant today, she was absolutely said the ball was in my court, had a look at my episiotomy which surprisingly no one had bothered to look at since my first child turned one. Said it looked like it was aligned right and understood the pain I was in however alike others believes a natural birth might ‘stretch it out’

However she was lovely and said I can have a c section if I really want but wants to arrange a meeting with herself, me and the consultant midwife to draw up a possible birth plan if I opted for a vaginal birth. I have such strict arrangements I want to abide by like no/minimum intervals, early epidural and no episiotomy-straight to EMCS if I wanted however I still have worries that whatever midwife on shift will not abide my this.

I’m waitig for her to phone me tomorrow or Monday for an appointment next week to discuss and finally decide, she said they book ELC after 39 weeks

I feel relaxed tonight and hope I do not go into some form of early labour between now and then (36+1 weeks today) she has given me her number if I do for support

@Hairgician that is where I had my first baby but have since moved to Belfast

Sorry *aligned wrong

*internals

Sorry for the typos!

If a c's is what you really want don't let them pressure you into making a birth plan. Keep at them. Sounds like cons is on-board and that's half the battle.
I had my first here in 2013. Was induced which ended in cat 1 emcs. Was told I'd no choice 're induction. How naive I Was!!

@hairgician I know they are going to keep trying with the natural birth

Until you push things you don’t realise how much control you can have to a certain degree and how unnecessary some procedures are e.g internal examinations and instrumental deliveries

How did you find your emcs?

I sympathise as I had a traumatic and drawn out birth with my first, involving blue lights and transfers from a midwife only unit. It was so horrible I would not have had a second if he hadnt surprised us and I had to have counselling when I found out I was expecting again. I personally would be very sceptical about not needing an episiotomy the second time- my second birth with an epidural, was probably as good as you could hope for given induction after premature rupture of membranes but still needed a second episiotomy these have healed ok but after the second there was definitely the beginning of a minor prolapse which I have been kegelling like mad but I don't expect will improve as I go into menopause. Both times episiotomy has been needed too late to switch into CS. In your position and at your age I would be sticking to my request for an ELC. (And fwiw my sister has had 3 CS due to failure to progress the first 2 times, so your next baby will likely be ok too should you choose to have one.) Hope everything goes well

@Slightlypertubed I know exactly what you mean, my mind is holding me back, as a student midwife told me your perinium is precious and how true it is!

Can anyone tell me how their recovery from a c-section was like?

I'm so glad your feeling more relaxed Popeye.

Very interesting about the 39weeks Hairgician, if the 40w + 10 days comes up again I will ask about Altnagelvin and why there is a difference.
So glad it went well, Popeye. You asked all-about c-s recovery. They're all different but to say mine was emergency after days of full labour, induction etc. it really was a very smooth physical recovery. It was the emotional side and the shock I struggled with. Physically, the spinal block was definitely up there with the best moments of my life - the pain and worry were over. I felt in safe hands, the team were lovely. I was a bit scratchy/uncomfortable for an hour or two the next day and after that, just a huge ache, not pain at all. (Sorry that sounds like the pressure not pain line from hypnobirthing!) What I mean is that I felt like I had done 5 million sit ups...but not ever any pain as such. I was surprised at how weak and frail and pathetic I was the first day or two when trying to get up and walk etc. It was quite humbling but it made me take it slow. I took the pain medication whether I felt I needed it or not and I think that was a good strategy. I didn't do any heavy lifting or driving, I was very cautious.
I will say that it was my first child and I had loads of help. I did the baby and my husband/family did EVERYTHING else -cooking, cleaning etc. But it really was fine and albeit I'll have a toddler this time, I'm okay with the prospect of the recovery again. Hope I'll be as lucky: no infections etc.

My emcs was fab! Even though a cat 1 it wasn't a tense dash to theatre it was all very calm and relaxed. The team were brilliant, and I can remember even commenting how young they all were😂😂 don't really remember much of recovery ward after as really out of cos I took all the drugs going!! And didn't know til after that they give you a morphine suppository!

Re 39 weeks thing, I had thought that was standard across the board?? I'd seriously question That, what would be the point in planning one that late?? Surely it would be somewhere in the nice guidelines??

Have you spoken to them yet OP?

@Onion no she hasn’t phoned me yet I’ve phoned her twice and left a voicemail this morning so I am hoping she gets back to me

I wouldn't worry too much about her not getting back to you about a possible vaginal birth plan Popeye.

Hairgician, I am having my ELCS this week (had my pre-op today) and I am 39+. Again I was told it was standard for electives. TBH once a date was confirmed I was much more content and that made the last weeks more bearable IYSWIM.

@Dione that’s great news!! How many days past 39 weeks are you booked in for? I’m very scared of going naturally early, I’m 37 weeks on Wednesday

Just another perspective here OP... I had scar tissue from an episiotomy that was very painful (same story, ventouse delivery and underlying vulval pain issue then made worse by this). Recently had second DC and had a second degree tear this time along the line where the epis was. The midwife took great care suturing it and everything is already SO much better. The scar tissue is much less and the whole area is more comfortable. I'm not saying your desire for a CS isn't right for you, but a second VB was just what my body to heal properly.

Also OP, is it possible that you have vestibulodynia? Painful intercourse is often misdiagnosed as vaginismus when it's no such thing.

39+5 Popeye. I can't wait and poor DP is on high alert, freaking out at everything. DS had a nose bleed in the night, DP saw a bit of blood and came rushing in to wake me up this morning. Then I called him to hurry downstairs for the Doctors Halloween special, again he came crashing down as though pursued the hounds of hell. He's going to be a wreck tomorrow. This is his first.

@Bue thats what they are hoping for with a natural birth that it might ‘stretch things out’

I’ve the appointment tomorrow afternoons I hopefully will get some plan of action in place. I don’t know what the right thing is to do

@Dione that’s fantastic, good luck, I’ll be thinking of you and let us know how you get on!

Let us know what happens at the appointment. I appreciate it's a difficult one. I suppose the way I see it is that another VB is unlikely to make things worse (episiotomies really are very rare for second births) and might make things better. A CS avoids any further damage but then you're stuck with your episiotomy the way it is now. Every single friend I know who has had an epis and then a tear the next time, has had a much easier recovery the second time around.

@Bue see that is where I’m facing the dilemma, I still have to sort out the vaginal issue afterwards. I’m just so scared of a 3rd degree tear or worse and a large baby

Update:

Getting induced on my due date if I don’t go naturally before then, starting with epidural straight away before the consultant does an internal to a hopefully favourable cervix- breaking waters and starting the IV
She believes it should be possible as she is leaving it close to my due date, feeling optimistic!

She’s also going to try a controlled crowning method to prevent tearing and try to hopefully help the issue I already have

Great news popeye, hope it goes well for you! Hope you're feeling more in control now that you have a plan.