Birth after an EMCS?

[QueenOfCatan]

I'm not currently pregnant but dh and I plan to stay trying for our second soon. Our dd is 18mo. One thing that is really putting us both off trying is our feelings to what happened during dds birth and how we (I) plan to proceed this time.

We were told that I was a good candidate for birth at the local MLU. At 41 weeks I got a sweep, waters broke in the early hours after that and went fully the next morning. After 21hrs we were sent to the hospital as I wasn't progressing well. I categorically did not want an induction, everybody I knew who had had one ended up needing assisted deliveries, I was/am terrified of ventouse and forceps and did a lot of research on inductions and talked it through with my midwife, stupidly I didn't really talk it through so much with dh as I didn't think it would come to it or that I would be in a position where I couldn't advocate for myself. I was pressured into agreeing to an induction as opposed to a c-section (my preference) at 6am the next day at which point I was visibly struggling, having been awake for 27hrs and having only slept for 2hrs before my waters broke, and dh backed down on the no induction stand when I started backing down.

Labour took a while to get going, I got very delirious by mid-morning, dd became back to back in the morning too, I was apparently given pethidine but I don't remember it at all, got to pushing stage in the evening but dd was stuck. We aren't sure what happened there though (dh was told at the time but he had also been awake for a long time and they were bombarding him with information as he had to consent to my c-section due to my state).

Ended up having an EMCS in the early hours which I was thankful for as I could not have refused forceps at that point and one of my few memories was the sheer relief at the surgeon saying that it would be too dangerous to try it. Dd was taken to NICU for a few "quite minor in the grand scheme of it" reasons and I was also relieved by that as I didn't feel safe being left with her, which still bothers me to this day. I am also very aware that my mental health would have been in tatters had they gone down the forceps route for a number of reasons.

So now we're a bit stuck. Whilst it wasn't a particularly bad birth experience so much, it wasn't great, I wasn't taken seriously because I was a first time mother and it really unsettled dh, especially when I became delirious. He's scared of the same happening again and whilst he is supportive of whatever I choose, I know that he thinks an ELCS would be a better choice this time. I am also scared of it happening again, but there is a part of me that would like to try for the experience that I missed out on before. Our home situation is different now so I could have a home birth if they agreed, and half of me wants that but the other half just wants an ELCS after what happened last time! We don't actually know why dd got stuck either and how likely it would be to happen again.

Sorry for the essay but just wanted to fill in the details! So, if you had an EMCS for dc1 what happened with dc2?

Hi Queen. I had an EMCS for first baby,I didn't dilate and was in labour for a couple of days (not induced,just slow). I felt like I'd been run over after!

2nd baby,I couldn't decide whether to have an ELCS or Vbac as like you I wanted to try and have a baby the usual way. In the end I booked in for an elective,however I went into labour before it so gave it a go. Ended up with a c section as I didn't progress this time either!
Although it technically planned as such it was very much like a regular elective,I have to say it was absolutely amazing!Wonderful staff,a fun and relaxed atmosphere. They pulled the screen right down as DS was born,showed us what sex he was as we didn't know.

There is no right answer really. Also,my hospital (Kings in London) are very relaxed re Vbac,you can still have a water birth for example so I think that makes a difference.

I guess I felt like I needed to try and have a Vbac as some women manage,sadly not me but I feel at peace as the elective was a very positive experience for me.

Thank you for that, that's really reassuring! If I did go down the vbac route I would definitely be doing it with the hope that we'll go straight to c-section if things didn't progress again so I'm glad that it is possible to do that.

I keep reading through the elcs threads and seeing that it felt very chilled, which was what I wanted for dds birth, hypnobirthing was originally the plan! Though I found it really useful despite not actually getting her out vaginally! So that's something that makes me lean towards elcs.

I think part of my reluctance to go straight for an elcs is that I was so close with DD, I feel a little cheated that I was at pushing point but nothing happened.

It's all so unpredictable and that's the problem!

Your birth experience is very similar to my first. I look back on it now, grateful she was delivered safely. If this had been 100 years ago, we probably both wouldn't ha e survived it.

Second 2 were elective sections with a spinal block and very different experiences, they were lovely deliveries in comparison. I was awake, DH present - healthy babies delivered. What's not to like?

I had a very scary emcs with my first.

I had a wonderful vbac with my second. I felt empowered and happy. It was a great experience.

My third was a sort of planned section. The consultant had various concerns and wanted me to consider another section but was supportive of a second vbac however events overtook us and my baby had to come out early. I was really upset that I had to have another section but I was also very, very relieved to have my baby safe.

For me the recovery on a section was incredibly difficult. I have terrible pain still 8 months later. My vbac I was up and doing straight away. Didn't even spend a night in hospital.

The thing is that other people's experiences are theirs and you will have a different story. I think make a plan for each possibility- emcs, elcs, vbac, induction etc - and see what you think. Discussing all the options with your partner and your midwife will help clarify things. There's a vbac group on Facebook that's really good and the Ina May Childbirth book is excellent. Hypnobirthing whether you are doing a section or a vbac really helped me.

Best of luck, op.

Sarah I know, it makes it so difficult to work it out when in actual fact you just don't know what will happen!

MrsDilber I also look back on mine with similar feelings thankfully as we were in a similar boat RE if it were 100 years ago apparently, the only thing I look back at with any real upset was my concerns about induction being blown off and being pressured into it regardless, and a midwife who was covering one of the two I had's lunch break who was really nasty and treated me like a child who'd been naughty.
She tried to ignore my request of informed consent (sexual abuse history, the rest of the staff were fantastic with this even whilst I was utterly delirious according to DH, he had to give them permission to do a few things during surgery prep and they still talked me through what they were going to do and tried to get my consent) and then got arsey when I asked why she needed to examine me when the midwife had just before she left. She had a student midwife with her as well which made it doubly awful and DH wasn't with me at the time as nice midwife had sent him to get breakfast. I wish I'd complained about her officially as she was really nasty.

The calm delivery is definitely something that is a massive pro for ELCS.

Alec
Thank you for sharing your experience, I'm sorry to hear that you're still in pain 8 months down the line.
You are very right of course with everybody's experience being different, I won't know until I get there but knowing the potential range of pros and cons to both options will help me feel happier about whichever decision I make I think. I will definitely be considering each option more thoroughly this time, despite having a pretty relaxed birth plan I never expected to have anything other than a nice calm waterbirth at my local MLU, and as the labour went on more and more things kept disappearing from my birth plan and it completely threw me, especially as during my hypnobirthing classes they didn't really talk too much about alternatives to vaginal birth, they were very good at talking through things related to that (pain relief options, things that may go wrong during vaginal birth, tearing, episiotomy, etc) but there was only a brief "you may end up needing intervention or a c-section but that's unlikely for most women!"

I did find hypnobirthing techniques very helpful though and I will do it again from an earlier point next time around.

Home birth after emcs May be a no go due to risk of uterine rupture and you'll need continuous monitoring whilst in labour if you choose to attempt a vbac.

I'm pregnant with number 2 at the minute and had a consultation with a consultant at my first appointment she gave me the hospitals VBAC protocols and explained my reasons for having my section last time and why I was a candidate for having a VBAC this time and has ultimately left it up to me to decide what I want.

I had an induction of labour that resulted in emcs and was left traumatised for weeks on end by the whole experience so I'm thinking I will give natural labour a go if I go into labour myself but otherwise I want a section as I don't want another induction!

Ds was a long labour, failed forceps after 2 hours pushing and an emcs. His brother or sister will be born next week by elective section as no one has been able to give enough reassurance that ds was pure bad luck.

I've found the hospital to be hugely supportive, I have ptsd (non birth related) and I had pnd after ds and the level of support has been amazing. I've found most things to be negotiable, for example they happily agreed that if I did try for a vbac, I wouldn't have to be in bed on my back as that is problematic for me.

Dwangela That'a a point I never thought of, there's an MLU at the main hospital so I'll find out if that is an option instead of home birth. I basically don't want to be in the same space as I was last time if I'm going to attempt VBAC, it felt very closed in and uncomfortable.

I categorically will not have another induction, I wish I'd been in a better state to put my foot down about it the first time around. DH is now very aware of that wish as well. It's good to know that the consultant talked you through what happened and your options for this time, I hope to have a similar experience. We have a midwife team here who are independent and they guarantee that you will have one available to you during your birth, even if they are there as support at the hospital (not allowed to take lead unless it's a home birth) so I'll be self referring to that service this time which I'm hoping will help too.

dinosaur I get that feeling of not being reassured by it being just bad luck. That's really great to hear as well though about the hospital being supportive.

I wonder was part of it a question of terminology and you being misunderstood? Generally "induction" is the word used to try to get labour started when you aren't already in labour. One of the drugs they use can also be used if you are in labour but your contractions aren't actually helping your cervix to dilate - in this case, they usually say "augmenting" your labour, rather than inducing it. Of course they should have made sure you fully understood and fully listened to your concerns in any case. But for a review discussion with your doctor, it might help to be clear on the terms used (if I understood correctly that you were already in labor when you went to the hospital).

Do you know why you became delirious? Was it due to an infection or fever? Or a reaction to the pethidine? Or sheer sleep deprivation? Was anyone able to explain it to you?

You seem to have a lot of pressure on yourself regarding delivery. Of course it was right and appropriate for your ill child to be taken to NICU for the treatment she needed, and of course you were relieved that they weren't planning on leaving her for you to attend to while delirious, exhausted and post-surgery. Your relief is not something to beat yourself up over. It was relief that your daughter was getting exactly what she needed at that point in time.

I really think a detailed discussion of all your options and your history would help. Best wishes.