Refused an elective section

[flowa79]

Im 28+2 with my 4th child. All my other births for health reasons were induced early and very quick, 20mins, 2hrs and 15mins. Fast forward 16yrs later and bubs 4 will b making an appearance in feb. Unfortunately my health has declined i broke my back have had surgeries still buggered my hips doslocate i have nerve damage on left side plus suffer from build up of fluid on the brain and need regular lps. Especially as off all meds during pregnancy. Iv thought long and hard about birthing this little one and decided that the best all around would b a section but my consultant has said a flat out no!! It wasnt an easy decision to reach and im now left terrified of the damage that could b done to myself and relationship with my baby if i go naturally. Am meeting consultant again on tuesday and would appreciate any words of advice that are both sound and helpful when i reargue my case

What were there reasons for refusal?

Higher risk of clotting. Was told vaginal or emergency those all thats open to me. Actually got an appt to c aneathitist at christmas so makes no sense whatsoever. Will also b in hosp for at least 5 days post birth due to having to stay on some painkillers so will b in right place if, god forbid, i did get a dvt. my neurologist and opthamologist and spinal specialist have shown concerns with a natural delivery but what they have written means nothing to her. Im concerned she is refusing due to cost more than health

That’s terrible. I asked about reasons as I had meningitis while pregnant with DC3. My OB amazing and had meeting with neurologist and anaesthetist with me to discuss best option. I also had terrible anxiety. I decided based on their recommendations to have an ELCS. I wanted to check because obviously if one of your other specialists had said, “we advised vaginal birth for medical reasons” then I would be thinking that was maybe best course.

Personally, I’d go back on Tuesday and say you’ve thought about over weekend, given what other experts written say you aren’t happy to have a vaginal delivery. If she refuses then ask for a second opinion. If she won’t refer then go through PALS - you aren’t entitled to second opinion.

Sorry you are entitled to second opinion

You need to push for one. I had an elective CS due to lower back pain caused by degenerative disc disease. Obstetrician discussed with my back specialist and they agreed to my request.

If your consultant has said flat out no and refused to discuss, demand to see another consultant. If that one says no, another. Don't budge and stick to your guns. Read up on the NICE guidelines. I would also maybe visit your GP and see if they will vouch for you, or previous doctors you've seen in relation to your health in the past. Good luck! It may seem a silly thing to say but try to stay calm as you have a while before baby comes and they wouldn't give you an elective until at least 39 weeks anyway!

Sorry you're going through this. I would demand a second opinion, it is your right to be referred to a consultant who is willing to give you a CS. Don't give up, you should be able to get your CS if you push for it.

Thanks for all the positive feedback. Iv actually written down totally sound reasons for going forward with section. Another consideration is not only were my previous labours extremely quick they were also preterm. If i thought id cope this time round i wouldnt hesitate as i dont really want to go thro major surgery, but i know i just cant put myself thro the hell i know it would be. Will let u lovely lot know if i have been successful on tuesday. Thank u all so much for the support x

The problem here OP from what information you've given is that as you've had three preterm labours previously, you're at risk of not going full term with this one and no obstetrician is going to book a planned c section pre-term. The majority of planned sections are 38, 39 and 40 weeks. Anything before that would usually be urgent/an emergency.

One of the other issues is that you've had a previously very quick labour, which could mean that even if your plan would be to have a section when in labour, you may not get to theatre in time to have a c section.

Realistically you need to go back to the consultant and ask questions. Ask lots of what ifs, ask what their concerns are with planning a c section.

You were induced previously for health reasons, are these still risks for you/baby? Will you require induction this time because of your history? And if you do, would the obstetrician agree for an early planned section? If you don't require induction and get to term could you have a planned section? If you get to term and labour could you have a section?

Write a list of possible eventualities and ask the consultant to explain their justification for not offering a section and what is their balance of the risk to your ongoing health issues and the risk to baby. You both matter equally in this equation.

First step is to request another appointment with consultant or a second opinion with someone else. May also be helpful to get another consultant from another specialty (orthopaedic/neuro etc if you have one) to speak directly with the obstetrician so they're working together on a plan which takes account for your needs and those of the baby.

Thanks for advice GuntyMcGee saw consultant this afternoon and raised with her all of the worries and fears i have. When i explained i only have my past experiences to go on and to base my request on due to the preterm previous births she just said that anything is possible about going later than i have before. I do have a huge fear of 36 weeks and at no point requested a preterm section just the reassurance that if i do make it to 37-38weeks that it b considered to ease mental anguish as well as physical issues. As its been made clear the damage to my lower spine is extensive. On top of that i also expressed a fear of being iced in. The rd i live on if icy is totally impassable and doesnt get gritted, a silly fear maybe i know. All previous health reasons for inductions r still there but yet again she flat out said no just told me to go back on the morphine and hope for the best with the baby!!! I was gobsmacked. She even said that if i was worried about being so far from the hospital closer to delivery move myself into a hotel closer. Am seriously beyond words. Read thro my notes just now and she has written that i want a section at 36 weeks when all i have said is im scared as iv never gone past that. Am seeing another consultant tomorrow as taking a weaker painkiller but still need monitoring and am going to raise my concerns with him. Really do feel like making a formal complaint im 38 but was made to feel like a silly little girl especially when she said that my medical history past pregnancies and anxiety were not good enough grounds. Feeling very vulnerable right now

I would contact PALS with everything and ask to be referred to another consultant but, honestly, you need to mentally prepare yourself for a vaginal delivery. Even though I am sure you will be able to speak to a consultant who will agree an ELCS, it will be on condition of you making it to at least 37 weeks and far more likely to 39 weeks.

Op I think you sadly need to kick up a fuss and speak to a new consultant. I can't imagine labouring with those health conditions, she sounds sadistic.

Please it's your right to see another consultant if first one refuses section and get second opinion. If second gave you very good reasons for refusing... Think about it but definitely get yourself a second opinion.

She isn't correct anyway, nice guidelines do say they are good grounds. I was granted one for far less.

Have thankfully seen a different consultant (head of department) and he was amazing. Listened to me and agreed that a section was best. He thinks tho i might go naturally within the next 4-6 weeks due to previous history but if i dont section planned for 37+4. He even got hold of my neuro and i have a lumbar puncture 1st week of jan to help protect my sight. I finally feel so relieved and can now enjoy the rest of my pregnancy

Flowa thanks for the update. So pleased you got a second opinion who has treated you decently. All the best for the rest of your pregnancy.