Previous Section - Hospital reluctant for second

[mystical]

hello am new here,could do with some advice on imminent birth. My daughter who is now 8 was 12 days over dd, basically they took me in, induced me, nothing happened waters broken, no dilation, delivered by section as she was in foetal distress, this was after two days of stop start labour. So now as 36weeks pregnant, have been to new hospital, consultant wants me to have a trial labour, have been for a scan this week baby six and a half pounds not huge, i do not want a trial at labour after what happened last time, i was so traumatised by it all, i was drugged up to my eyeballs, baby had jaundice and was under uv lamps for a week. It was just awful. I broke down in tears when they said they are going to give me a trial, she then agreed to see me again at 38 wks to see if i am still adamant about the section. My partner is no longer with me, he is a total waste, very controlling etc, so am on my own and its hard to come to grips with that as well as imminent nightmare scenario i envisage happening again. Anyone had similar, would be great to hear from you. Thanks x

Your second labour may not be anything like your first experience. You could agree to a short trial with the understanding that you want a section should there be no progress after a set period of time. I have a friend who had 2 sections (I think, 1st for failure to progress, second as a repeat section) and has just had a straightforward VBAC.

You could also simply insist on a section when they see you at 38 weeks - I understand that a previous section is a good enough reason to have a repeat on demand and seems to be the norm insome hospitals. (I'm not getting into an argument over whether you shoud need a good reason!)

Welcome to Mumsnet BTW I'm sure you'll get a lot of differing advice so you'll have a lot of things to think about. Good luck!

Thanks Soup, think my hospital are proud of the low rate of sections that take place there. Just getting really nervous i guess, sure everything will be fine. Great site. think i am becoming addicted, am on maternity leave now, housework etc just doesn't have the same appeal as mumsnet, although i should start buying stuff for baby, getting my stuff together etc, well there is always tomorrow, thats the way i am looking at things at the moment.

Hi, mystical. I agree with soupy - I can understand your desire not to go through the same experience as last time, but it might not be the same - it could be totally different and wonderful. OTOH they should not be able to dictate to you when you are so anxious about it.

My first DD was born by elective section when about 10 days over - they had been doing "stress testing" (this was in America, I think they call it challenge testing here) because she was very small for dates and had reached the stage where she was beginning to show distress and I was showing no signs of imminent labour they did a section then and there.

With second baby I wanted a VBAC if poss and was supposed to have a trial of labour but, like you with your first, induction had no effect (I was officially 14 days over by scan but was only on 40 weeks by my dates) and after 24 hours of nothing I asked for a section so they did one.

That was 19 years ago, so I can't understand why they are being so unhelpful now! It sounds from what you say as if it would be far better for the baby and for you to have a repeat section. Hope you will be able to have the baby the way you want. Good luck. XXX

Once MN has you in its grasp, mystical, it is very reluctant to let you go.

One other thing to bear in mind - given that your partner is not around, what support will you have after the c-section?

Also, I may be wrong, but I don't think they tend to go for inductions with VBAC as they can be too intense. From what I understand, an induced labour can be very different from a spontaneous one - if you're not ready to "go" then I guess it can be tough to get going IYSWIM!

Someone will be along who knows more... maybe Mears (a midwife) will pop in and give her 2pworth.

Poor you! I've just been to my hospital, Kings in SE London, and the LOVELY midwife said, "I see you had a section last time? What would you like this time"
Me: "I'd like another section please"
Her: "Absolutely fine. We'll book you in to see the consultant at 30weeks."
I nearly fell over as was expecting a fight.
I think if you really want a section, then you need to make it clear that it is your decision. The new 'clarification' on the NICE guidelines on sections make it very clear that women should decide how they want to give birth.

Thanks, I thought the NHS was all about choice these days, I have a problem with the incompetence at my hospital, it really is a conveyor belt. They havent even bothered to get my notes from previous hospital and am relying on my version of events, which is pretty hazy after all the drugs etc i was given. Sorry to have to say this but you know the one about if it was men who were the child bearers, it would be so different - how true that is!!! To give a urine sample at my hospital you have to walk through a crowded waiting room full of mums dads etc to get to the loo with your cardboard yoghurt pot in your hand!! I feel like sitting down in front of them all and doing it there!! lol

Soup, my sister who lives on the isle of wight has a week's holiday which she can take when i give her the go ahead, so thats fine, she has a really nice lady boss!!
Aloha I was thinking of changing GP's and going back to old hospital, but i think i may have left it too late. Your hospital sounds great, I used to sell flowers over the road in the Maudsley years ago, another life hey!!!

Sorry but what does VBAC mean and IYSWIM ?

vaginal birth after cesarean

mystical, I am NOT trying to suggest you try vaginal birth, but do want to say if you did labour it would probably be much, much easier (I've just written an article about this).That may reassure you if you do go into labour before getting a section - oh and as Soupy says, they're much less likely to induce you because of the C-section before.

But I really, really hope you get the birth you want.

Hi mystical

So sorry you had a rough time. The percentage of nductions that end in CS or instumental delivery are high nationwide. It is unlikely you would be induced this time, and also that your labour will be shorter. If your husband is not on the scene have you got a family member that could be with you when you are in labour? I can understand how daunting this birth will be but there is no feeling in the world like your baby being born naturally, it can be very healing if you have had a previous traumatic experience.
Also alot better for you and your baby!!

if you see what I mean

here are some vbac stories clickhere

Birth partner all sorted, have a good network of frfiends around me, so no problems there. Have read some of the vbac stories. Interesting, have to see what consultant says in two weeks time. Thanks for all of your help, am thinking a bit clearer now. x

Do consider keeping on bumping for Mears (mumsnet midwife - she ought to be on a retainer)
I take the view as previous cs, you'll get 'better' attention this time round as potentially difficult birth. Lots of evidence around that having quality support from a woman can make a lot of difference to outcome - discuss all your hopes and fears with your birth partner as you may need them to help 'advocate' for you.

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mystical - I had a c-section after a failed induction - pretty much like yours but no labour or foetal distress.
For my second, trial of labour was mentioned but in the event no 2 was late as well and they didn't want to induce...for reasons already mentioned...so I had another c-section.

try not to worry -take it as it comes - if you don't go into labour naturally you will get your second section.

And I found it easier to recover from the second section - I had less pain

Hi Mystical. I feel for you. My first (and currently only) child was born with an almost identical story. Overdue. Induced. Foetal distress. Emergency Cesarean about 35 hours after the induction started. Oh, not to mention that sweep... God the horrible. I will never again permit so many fingers up my... okay sorry. Ick!! I think that sums it up. By the time she was born, andI woke up in recovery I was shaking and cold (from the withdrawl of the many drub coctails I had been introduced to owver the previous day and a half that the offered me a shot to make me feel better. Found out later the shot was morphine. Bet that was tasty in my breastmilk! Anyway, I'm not pregnant but plan to be soon. And,I am definitely going to demand a cesarean next time round. A planned cesarean has to be better than that mess we both experienced. If I were you I would ask for a second opinion ASAP. I think(though I'm not sure) that you have a right on the NHS to a second opinion. It's worth a try anyway.

Hope everything works out. Who's going to look after the older one whilst you are in hospital.

mystical, i opted for a trial of labour after i had c/s first time - but only because i trusted by consultant's judgment. but we set time limits (together) after which I would have a c/s. in the end i unexpectedly had a crash c/s - but even this was managed calmly and dd2 is absolutely perfect. if you have another c/s then you will need help, as twiglett has said. i actually recovered more quickly 2nd time around, knew what to expect, took catheter out earlier etc and enough pain relief, but couldn't eg stack dishwasher for a couple of weeks (hurrah).

Midden, a natural birth is not invariably better for mother and child by any means. Both my son and I would have died during a natural birth. But we would have died very naturally, of course. Some people end up permanently disabled by natural births. For them, I think it is very true to say their birth was both unforgettable and that there was 'no feeling like it". They have the flashbacks and panic attacks to prove it. I really think sweeping generalisations aren't very helpful.

I can't be the only person on earth who managed perfectly well after a section with no help at all. I came home on Friday and my husband went to work on Monday (he'd taken loads of time off work to see me in hospital before the birth). I found the sleep deprivation infinitely worse than anything to do with the caesarian. In fact, I think I was in better shape than many first time mothers after a natural delivery. No 30 hours in labour for a start.

Mystical, I had to have a second c section last year.

The hospital policy was against vbac and UNDER NO CIRCUMSTANCES would they induce labour in a woman who'd had previous sections.

Anyway, I went against the senior registrar's advice and went for a vbac. With hindsight, in my situation I don't think I should have done it. I was considerably overweight when I started the pregnancy and had severe SPD for the last 3 months (could not walk without crutches).

For me, it just wasn't meant to be and after 2 fraught days I had an emergency c section, thankfully resulting in a healthy little boy.

I look back now and wonder why I was so bl**dy stubborn about it, as in my situation I really should have had an elective cs.

Basically I got it in to my head that somehow I needed to "prove myself" by delivering naturally - I had very very bad post natal depression after my first child and took to heart the "too posh to push" and "you did it the easy way" jokes I'd get from some other new Mums who had delivered naturally.

I'm crying now thinking about it, because I allowed those feelings of inadequacy to affect my judgement when it came to my second pregnancy.

Do what you feel is right for you mystical.

Hi Mysical - welcome to mumsnet

As a midwife I do not advocate repeat C/S for women who have had C/S first time around - unless they are so terrified of labour that it is unlikely they will labour well. The risks of C/S far out-number those of sponataneous labour and vaginal delivery. A woman who has had a previous C/S should have the choice of labouring as long as te risk factors for previous labour are not present i.e. if placenta praevia or pre-eclampsia were the reason for first C/S are not there for C/S second time around ,there is no reason not to labour.
In your case Mystical - if you do not go into labour yourself between 37 and 42 weeks, you should have a repeat C/S. Women who have a previous C/S labouring in subsequent pregnancy have a 'trial of scar'. That means there are time limits for labour. Should it not progress well, there will be a decision to perform C/S at an earlier stage in subsequent labour. I have seen many women have a successful vaginal delivery after C/S and I think that this should be aimed for. However, if a woman has a totally closed mind - it is not worth the hassle to her and staff looking after her. Stressed women do not labour too well. However, if I had a toddler at home, I would not want a major abdominal operation for the delivery of the next baby if a vaginal delivery was an option.

Hurray for Mears...!!!!!
Wish you could be cloned and available on demand!
My brief story.. emergency c with number 1 (failed induction, failed medical procedures etcetc) (horrible experience)
I vowed to try the natural route with number 2 (didn't want that option taken off me again) had reflexology from 6 months pregnant (to release my tension etc).. ended up delivering.. unexpectedly... but VERY HAPPILY at home, in the hall, with ambulance crew, dear friend , (dh was looking after dd downstairs- best place for him)
whole experience was much much better.. FOR ME.
but everyone is totally different... and I wish you well in whatever you choose (but sometimes the choice is taken away from us regardless)
also remember... birth is one thing... looking after them is another!!!

Aloha of course c sections can save lives of mums and babies, but remember we are not talking about an emergency section here for mystical.

My statement on vbac was not a sweeping one, I have researched the issue and also know many women who have experienced both a section and vaginal birth, they are the ones who say that no feeling compares to giving birth to your baby. If you look at the evidence(there is plenty of it) normal birth does have better outcomes for mum and baby.

"Overall, attempted vaginal birth for women with a single previous low transverse cesarean section is associated with a lower risk of complications for both mother and baby than routine repeat cesarean section."

"The morbidity (illness) associated with successful vaginal birth is about one-fifth that of elective cesarean. Failed trials of labour, with subsequent cesarean section, involve almost twice the morbidity of elective section, but the lower morbidity in the 80% of women who successfully give birth vaginally means that overall women who opt for a planned vaginal birth after cesarean suffer only half the morbidity of women who undergo an elective section." [1]

You might find this website interesting reading on vbac

Think it is very admirable that you coped so well after your section but unfortunately this is not everyones experience, just as very few are permenently disabled by natural birth.