Can I insist on early section?

[Icklepickle101]

36+4 with DC2.

DC1 was delivered at 38 weeks by planned ELCS after the consultant decided i’d “Suffered enough”. I have an old horse riding injury where my pelvis got crushed which doesn’t cope well with the strain of carrying a baby, plus spd on top sonik taking 240mg codeine a day. It makes baby sleepy so frequently have reduced movements. Have a c section book for dead in 39 weeks.

At my cons appointment 2 weeks ago I asked about flexibility about the date and had a little cry as I was really struggling with the pain, cons agreed to see me again at 37 weeks but she didn’t like delivering babies at 37 weeks unless it was really necessary due to the percentage of babies needing help breathing. Do I have any say in the final decision of delivering early? I feel like the risk of continued opiate painkillers is just as high as the risk of ‘early’ delivery and honestly I’m in so much pain I’m just not sure I can hold out until the 25th. I’ve upped DC1s hours at nursery and DP is inn annual Leave until September so I’ve made as many adjustments as possible

You can't insist no, they are the ones performing the surgery...however go back and re go over all of your concerns. Have they discussed giving you steroids? Tbh at 37 weeks its most likely the baby won't be ready to be born, especially by a cold section but like you say, the opiate use is also going to have an impact. Maybe ask to see a different consultant or get them to liaise with the neonatal doctors to ask which they think is more riskier, early delivery or continued opiate exposure. Hopefully they'll be a good solution!

I’ve been admitted after they weren’t happy with the CTG after reduced movements. Will wait and see what happens!

My baby was born at 36+6 by emcs and really struggled. In hospital for 8 days, 5 of them in nicu. So based on dates alone I wouldn't. However I don't know anything about the risks of the painkillers and a dodgy ctg is a risk too so I don't know what I'd do.

I would try and hold off.

I had much earlier babies (30 weeks and 28 weeks respectively) and during there neonatal stays we saw a lot of 36/37 weekers in with different issues.

I really sympathise it must be awful to be in so much pain.

I’m still in hospital and while the cigs aren’t massively concerning they are lacking the 2 reassuring factors (variation and accelerations).

I’m 37 weeks Wednesday and kind of resigned myself to it being next week where I’ll be 37.5+

I believe the risk of continued opine exposure is respiratory issues so it’s very much a balance act of the respiratory issues she’s face as a 37 week baby are a better or worse option Han that of continued opiates. As much as I’d love to be able to stop the drugs for the last few weeks it just isn’t an option.

CTGs - I’m not smoking!

I was or oramorph the last 15 weeks (was supposed to be weaned off but DS had other ideas) DS had no withdrawal's.

That’s interesting, I was going to ask the doctors today if there was an alternative. The codeine is just making her so sleepy she can go 24 hours without moving at all. Did you have DS at full term?

My DS has no withdrawal from codeine when he was born but it didn’t affect him this much when he was on the inside!

I would be guided by the medics, which do they think is the bigger risk? The medication or an early delivery. Both my boys were delivered by section and both had breathing difficulties. One of them ended up in NICU for a few days and it’s really not nice.

Have you tried acupuncture? I was in a very similar position and it worked wonders for my pain. I only needed the codeine at night and could manage without it in the day.
I hated the way the codeine made me feel and I couldn't look after my DS as i was so spaced out, but I was in tears without it until I had the acupuncture. I think I was about 36 weeks when I started it and had it weekly for 4 weeks.

for you btw, it truly sucks

I had this discussion with my consultant. Although I am not in pain, I just desperately don't want to go into labour so I am not feeling horrid like you are.

They flatly refuse to do an ELCS here any earlier than 39 weeks here unless it's very risky for the baby to stay in (my friend had one at 35 weeks for example but she had vasa praevia which is potentially fatal).

I'm having mine at 39 weeks on the dot.

I'd say you have little chance unless the painkillers are going to actually harm your baby but no risk in going back for another discussion. Personally unless it was actually unbearable pain I'd put up with it until the risk to to baby was low enough that the professionals were happy to deliver.

Just to add a bit of balance to the ones who had breathing difficulties after barely-term c-sections (though of course there is no way of knowing which way yours will go and the medics are reluctant/cautious for a reason):

I had DD by CS at 37+0. I’d already decided on an ELCS for various reasons and we had some questionable CTGs and reduced movements plus concerns about her growth rate. I did have steroids for her lungs (ouch). She had a known heart defect and so neonatal doctors were there to check her as soon as she was out but she had no difficulties at all and didn’t need to leave my side.

I’m not suggesting it will be the same for you, just wanted you to have a more positive story if the doctors decide to deliver soon. Good Luck!

It has been really good to get everyone’s experience. I was going on my own experience of DS at 38+0 and DSD at 35+6 not needing the slightest whiff of help but appreciate that isn’t always the case

If I were you I would do my very best to hang on in there. I had elcs with my ds 10 weeks ago at 38+6 but had been given steroids the week before as it looked like he was going to make a surprise early arrival. ((My god those injections are sore!!)) I know how awful the pain of spd is as I had it myself but the risks for the baby really are greatly reduced the closer you can wait to their due date. I'm so sorry that you are suffering, and this heat is probably not helping you either. Take care of yourself, and good luck with the safe arrival of your new baby

Dd2 was 36+4 and we nearly didn't bring her home. She was resuscitated twice and in scbu for 10 days. It was very frightening so I really would say, hang on in there! It's hard now but a baby in scbu with stats changing every 30 minutes when you're post c section it even harder.

Have they given you the drugs for her lungs yet? I had my DTs at 38+2 and both ended up on CPAP in SCBU for a couple of days. I was given the injections for their lungs but only when it was queried at my pre-op assessment 24 hours before and I don't think it was long enough for them to work.

I had the choice between morphine or section at 38 weeks. I’ve chosen the steroids and section next week, will stop the painkillers 2 days before to minimise any respiratory distress.

I thibk we came to a good compromise and fingers crossed she is ok!

Good luck!

My baby is 21 days today. My elcs was 3 weeks ago at 37+4. She needed steroids ahead of time but was fine.

I didn't want to go to 39 weeks due to labour onset preeclampsia in my last pregnancy and a whole host of other complications. My consultant was hesitant to offer it at 37 weeks initially but wasn't too concerned before signing it off.