Elective C-Section after Emergency last time??

[TKV]

Hi everyone, sorry if this has been covered before.
I really like to hear from people who had to have emergency c-sections for their first births and what they chose 2nd time around.
I am pretty adamant about having an elective this time as DS birth was a horrible, traumatic 14 hours that ended in an emergency under a general and we almost lost him. They actually made the first incision while I was still conscious it was all so desperate in the end.It was terrifying to say the least and I never never want us to go through anything like it again.
My decision is mainly because I just don't want to risk anything happening to this one and to be honest, I didn't cope with the pain as contractions started two minutes apart and only go closer and I could have no pain relief it turned out as it messed with my blood pressure and his heartrate etc etc
I think my mind is made up but there is a tiny part of me that wonders if I should give it a go....?? DH if pressed, thinks it would be worth a shot.

I'm seeing my GP this Thursday and was going to tell her that I want a caesarian, which I know won't be an issue.

Any thoughts?

thanks :-)

Uwila I didn't even think of that, I'm just off down to the shops to get myself a packet of salt and vinegar crisps !!
I'm in Pimlico btw

MissTuesday - if you function well with low blood pressure, I really don't see the problem. Are you symptomatic of low blood pressure?

As a midwife I have bever seen a woman unable to have an epidural or spinal because of a natural low blood pressure (what is the reading out of interest?).

Tha anaesthetist would be able to control the blood pressure with IV fluids and ephidrine. He/she is the person you would need to speak to.

I had a general for my c-section and that was one of the reasons I went for the vbac (epidural didn't work).
It obviously isn't ideal but if it is the only option you are left with I would go with that.
Can the doctor recommend a safe way of raising your bp to normal levels?
If you do have to have a general at least you will be prepared emotionally for it. Maybe find out what the sex is beforehand? I found out my baby was a boy from the midwife when I woke up - my dh was with ds in special care at the time which was not a fun thing to wake up to. Maybe plan everything as much as possible so you feel involved (ie no phoning relations before you wake up!) - hopefully dh and baby will be with you when you come round.
I myself would favour an attempted vbac before commiting to the general but I totally understand your preference for a c-section!

The other thing I would be interested in is when active labour was diagnosed in your notes. You can have painful prelabour contractions for a number of hours (sometimed days on and off) especially with first babies. Although you had contractions for 14 hours, they may well not have been true labour ones despite them being painful. It really would be advantageous to go through your notes with the consultant.

I think my preference for the section is for two reasons the first and most important is the baby's safety. The second is tbh, the pain. I personally found it to be 14 hours of horrendous, excruciating, agonising, soul destroying pain that I could get no relief from no matter what I did. I truly went in to labour thinking 'how bad can this be? I have a high pain threshold....' and could not have been more wrong. I know for some women it is different but for me, it would be like someone asking me to have my leg amputated without anaesthetic to go through that again.
Good tips about preparing for the General too if it turns out that way, thank you

thanks Mears, I will definitely go through the notes. I'd surprised if they ever called it active labour to be honest as I didn't ever get beyond 3cm.....

Miss Tuesday - I do know 2 women who had that sort of problem (massive pain and not dilating and really feared labour.... they tried hypnobirthing and it made a huge difference !
BTW - were you induced ? that's a classic case of having very strong unhelpful labour !!!!!!

hi again Mears

I had a lot of problems with fainting and dizzyness in my first pregnancy because of low blood pressure and the problems with ds heart rate started when they tried to give me an epidural after about 12hours of labour. I passed out and his heart rate dropped so they took the epidural out. Then when they tried to give me another one to have the c-section the same thing happened only much worse this time re his heart rate so they had to quickly go for the general and get him out.
I certainly function absolutely fine normally. My reading last week was 90 over something....?? I can't quite remember

I know what you mean about the pain. Prior to labour whenever anyone asked me to describe a pain on a scale of one to ten (ten being the worst pain imaginable) I would have put a bad headache at about 8... more fool me!
I think that was one of the reasons I felt so traumatised afterwards - I was so totally shocked by the awfulness of the pain. There's just no way you can prepare for it.

no I wasn't induced, I went into labour naturally, 5 days after due date but there was maconium??? ( i REALLY can't spell that) in my waters so I had to go straight in and was put on constant monitering straight away. I was put on the drip though sytocin?? to 'speed things up'..

Well that was a managed birth... that isn't pleasant in ANYONE's book

I was induced first time and I believe it really made a difference to the pain levels. First time round they were overwhelming, I truly wanted to die to stop the pain. With my vbac although there was screaming (I won't try and dress it up for you!) and pain it all seemed manageable and I still felt human throughout it all.
Just wondered if the drip would have made a similar impact.

The drip can make it unbearable as you don't build up enough endorphins (natural painkillers)... if you have the drip put up when you are in active labour it's usually easier to manage and doesn't necessarily require an epidural though I see plenty of MWs offering it as the "special of the month" get 1 and you get the other free ... it really doesn't help women's confidence to be told you can't have the drip without the epidural.... yes you can in some cases!

MissTuesday - interesting about the blood pressure thing- you would need to speak to an anaesthetist about how that can be managed next time.

The fact that you went on syntocinon immediately when you were admitted means that your labour was induced. Since you did not get beyond 3cm, that means you were technically a failed induction of labour. In your case I would consider giving labour a go if you went into labour naturally. Last time your contractions were 'forced' by syntocinon because of your waters breaking and the meconium staining. Your body was not ready to do it.
If your waters broke in the same way the next time, if they were clear then they would wait for natural contractions to start on their own. If they did not start then you would be offered C/S.
Your experience last time was that of an induced labour which can be very different than a natural one. No wonder you found it horrendous.

Pupuce - found your comment v interesting about toleration of the syntocin drip and active labour - I had a syntocin drip as I wasn't progressing at 5/6cm dilated - wasn't offered an epidural(!) but it wasn't the nightmare that I thought it would be - did have a second short of diamorphine though (the first shot being probably being why I needed the syntocin in the first place!)

sorry to hijack

I wouldnt' get too hung up on the blood pressure thing - having an elective section would be a different kettle of fish anyway from the BP point of view! If the anaesthetist knows you have low BP they can compensate. Don't eat too much salt!!!!

I had a horrendous first birth with 3rd degree tear first time round. Could hardly walk for 6 wks and was in shock - cried all the time and was generally very fragile. Second time round I had an elective caesarean, which was a very positive experience. Recovery was quicker than with my messy 'natural' birth.

I too have what is classified as low blood pressure and when I had the epidural just before the c-section I started to go into a faint (can always recognize the symptoms - go all cold and floaty). I immediately told the anaethetist and she put something into my drip which brought my bp right back up to normal again. They waited 5 mins to check all was OK then did the section.

If I was pregnant again I'd head straight for the operating theatre, I can tell you!

well miss tuesday I have no real knowledge of any of this at all (unlike Mears and pupuce who are pros and fab with it) but the thing that sets alarm bells ringing with me is you saying that you didn't dilate and neither of your sisters did with any of their 6 labours either! I really do think that how your uterus works in labour is genetically determined, and if I were you, I would say "fine, I've had one labour where I didn't dilate either - who am I to go against my genetic destiny" and book in for an elective.

For example after 3 children I now know that I labour hard, with no dilation at all and all the professionals saying "oh dear, those contractions are unproductive" and then when I'm ready I go from 1cm to 10 in about 15 minutes and pop out a baby 2 minutes after that. And my mother (3 children) recently told me that she was exactly the same. I also have a friend who had a horrendous 36hr labour but the baby couldn't pass through her pelvis and so she had an emergency C in the end. Turns out her mother had had 3 c-sections for the same reason, and her sister 1. WHY no-one told her it might happen to her I don't know!

Re epidural/general - I think you really need to talk to the anaesthetist and see what he thinks, but I wouldn't fight the general if he is inclining in that direction - not ideal for you in terms of not seeing the baby immediately but if it is safer? and also presumeably much less traumatic for your dh who sounds like he was in shock with the stress of it last time.

good luck....

MissTueasday did all these 6 labours actually go into labour or some of them did attempt and next time around went straight to theatre?
Basically are we talking 6 babies who started by a labour or are we talking about your mum and sis who both had no progress with 1st baby and then had elective for their other others kids. That's how I read it. Maybe I didn't iunderstand.

After 17 hours of arduous labour I ended up having an emergency cesarean and a 10lb 9oz baby! Next time round I am definitely planning an elective cesarean!

Why larlylou ? have you seen this ?

Thanks for the link, have just been reading through. I was 12 days overdue and had to be induced, meconium in my waters so was strapped to a bed then everything happened far too fast and was way over my pain threshold. After 17 hours of labour I only got 8cm dilated and ds never engaged - he just didn't fit so the only way out was an emergency c. I recovered really quickly from my cesarean, far more than my best friend who had a natural birth four weeks earlier and never had any trouble with feeding situations etc. This experience has really put me off wanting a natural birth. Saying all that though, I know I would always wonder what having a natural birth would be like and, I suppose, until I am actually pregnant with my 2nd then my thoughts may change but for now my choice would definitely still be an elective cesarean.

Larlylou.... when labour starts on its own... babies are often /normally/usually engaged so that problem would not re-occur + you'd have a much easier labour... and you would recover faster! Hey I am biased

Sorry, but I get really tired of hearing the dogged insistence on "you will always recover faster after a natural birth". I do realise that for "most" people that may be true, but I have to say that I and several of my friends have recovered a lot faster after a caesarian. I can't compare from personal experience, as I have had one emergency CS and one elective, but three of my friends had one emergency followed by VBAC and ALL of them were practically unable to walk for a few days afterwards, and could not sit down without a rubber ring for two or three weeks. I was up and about 24 hours after both C-sections, and the second time I had a busy little 2 yr old to care for (and carry up and down 3 flights of stairs!) as well. I'm not saying it was easy, but it seems to me I was in a much better position than most of my acquaintances. They were hobbling around complaining of stress incontinence for ages after the births, poor things. And obviously the second time round I hadn't had the hideous experience of a 24 hour labour before hand.

I should just add that of my VBAC friends, although they all say they would definitely go for an elective caesarian the third time, they also do all seem to have got a tremendous sense of achievement from having delivered "naturally". I do understand that for some women, this is extremely important, but I don't think we should all feel so much pressure to go down this route if we just don't feel that strongly about it. I have 2 healthy, happy children, and wouldn't change anything about my birth experience with either. I tried for a home birth the first time, but physiologically it clearly was not meant to be, and I was very happy to have things done more calmly the second time.

I think the most important thing is not to succumb to the pressure hospitals put on you to fulfil their quotas of vaginal births if you know you want something different. It is YOUR birth experienc, which you will have to live with and remember afterwards, so be firm about what you feel is best for you and your family, and don't let them try to bamboozle you with statistics.

Lulupop, my experience was just like yours. After my both my sections I was up and about in in no time. After my second I remember walking down the coridor and another new mum stopped me and said, 'I thought you were having a section?' I was walking fairly normally and she (normal delivery) was hunched over and walking with great difficulty.

It is important that everyone gets the birth they want (if possible). However to view a section as an automatic 'problem' is not always accurate. I had two sections, one emergency and one elective. They were both very positive experiences. I opted for a section second time around. As it happens it would have been a section anyways as I had pre eclampsia and ds was a footling breech and quite big (9 2 two weeks early). I have no lasting effects on my health or my children. A sucess all round!