Disabled and feel pressured into a natural birth -similar experiences?

[Beed2017]

I am currently pregnant with my first. I have cerebral palsy in both legs. It severely limits walking, movement and joint range. I also suffer from spasms and have been told by countless professionals I have little to no core strength and global muscle weakness in my legs.

I have concerns about my ability to give birth naturally and so far my medical team have been dismissive. My difficulties are such that to be in stirrups or having my legs help up would be beyond my natural range of movement and could cause damage. I also find that when I am tired/ stressed or in pain my legs spasm so much that they practically turn to stone and this travels into my lower back. I’m not sure how a vaginal birth is possible with these circumstances and really do not want forceps etc and the possibility of a EMCS.

I asked my obstetrician about a planned section and she was completely dismissive. I feel powerless and pressured into an option that I strongly feel is not the best for me or baby.

Does anybody have similar issues to me and could share how they managed?

I would definitely ask to see another consultant and get a second opinion. This is terrible that they are not taking your worries seriously. Sorry I haven't had a similar experience but I urge you to kick up a stink - it's a shame this is what has to be done sometimes to get taken seriously. Or alternatively could you speak to PALS at the hospital they can be very helpful as an additional advocate in times like this.

Do you have a different doctor for any cerebral palsy issues? Could they write a letter/report detailing the range of movement and lack of function for you to give to your obstetrician? If your GP knows you and your condition then they could intervene on your behalf?
Keep pushing for a c section, it sucks that they aren't listening to you!

This makes me so cross. How dare they be so dismissive. You know your condition best. I can only recommend you keep asking. And make sure your midwife refers you for an anaesthetic review too. You’ll need one whatever your birth plan because they’ll need to think about your pain relief options. You may find they’ll be a powerful advocate for you as well. I also recommend Leigh East’s book about planning a ceasarean section. It’s on amazon and very useful.

I have very different, much less debilitating conditions but I was also having twins and was suffering with terrible labour phobia due to previous traumatic gynae procedures. Consultants were extremely patronising and wouldn’t even entertain a discussion early on. After a lot of pushing they did end up agreeing to an ELCS although I ended up having an emergency one earlier.

Have a look at the Birthrights website and get some support, is your midwife supportive? Mine even came to a consultant appointment with me to back me up. You are entitled to a c section if you want one, even without the extra factors - look up the NICE guidelines.

I'm angry for you! Ask for an appointment with a different doctor and read up on the NICE guidelines first.

Be a broken record. Keep saying you do not consent to a vaginal birth and you want an ELCS. If your consultant refuses, ask to be transferred to the care of another one. Dont let them bully you.

You have a right to an ELC anyway but sounds like yours is needed. I agree with the broken record thing. Practice it in front of the mirror. I have considered my options and I do not consent to a vaginal delivery. The consent word makes it hard to ignore. If they pressure you. Say, excuse me, are you saying that because I’m disabled you are going to force me to do something against my consent?! If saying that seems too hard, find a bolshy relative, friend who will say it for you. Also being a letter that says you do not consent.
I was pressured into a vaginal birth first time round and deeply regret it (scars and issues to tell the story). Even though it’s hard, this is something worth fighting for.

This sounds crazy!! The point of "natural" birth is that it tries to avoid unnecessary intervention, lets the body do its thing and then IF NECESSARY interventions happen. In your case, a calm, elective c-section would be what offers unnecessary intervention!!

Agree about using the word consent and the rest of what was said above. Your body and your birth. Can you take someone else with you to an appointment? Or ask to change dr.

Are you in the UK? You definitely need to be assertive about this, but you will get the birth you need if you keep pushing it. I had different but similar reasons for wanting an elcs and felt like I had to jump through hoops to "prove" my case, but in the end they signed off on it. Horrible as pregnancy can be stressful enough as it is! I would write a letter to the consultant outlining the reasons you feel a natural birth wouldn't be safe for you, and escalate to pals. Once it's all in writing and on file it's much less likely they'll argue against it. Good luck!

You need to be very assertive here - I had similar concerns, was dismissed, and ended up with permanent damage.

Broken record: I have the best knowledge of my own disability and what my limitations are. I am not going to consent to a vaginal delivery, because it is not safe for me. If you cannot help me arrange the Caesarian, please refer me to somebody who can.

I feel so cross on your behalf! It is your right to have the birth you want.

Thanks for everyone’s advice. I have another appointment with the obstetrician in a few weeks and very much plan to be assertive about mine and baby’s needs. I’m going to take my husband with me too. I’m going to look into PALS and have no problems saying I don’t consent. It’s hard not feeling supported. Especially since the pregnancy has not been an easy one so far. Thanks.

Having had a bit of a struggle to get my elcs (due to a serious pelvic injury from horse riding accident) I know persistence is key. They have targets to meet on reducing ‘Mother’s chocie’ Sections. I’d had 3 different healthcare professionals write and say my injury made a natural birth a very bad idea and it was still a struggle but I got there.

Under NICE guidelines your consultant doesn’t have to agree but does have to refer you to someone else who will, in my case a different trust. I’d tell your consultant that if they were not willing to perform your elcs they will need to refer you to someone who will. You’ll get there and find a lovely compassionate consultant, it’s shouldbt be this hard though!