Uncatheterised C Section

[MumComingSoon]

Hello ladies, my husband and I are planning to try for a baby next year. I have some huge anxieties about birth, and as well as having a medical need, will be opting for an elective C sec. However, I suffer from persistent, horrendous, debilitating UTIs. I will not be able to have a catheter, due to this. Which I feel leaves me in a catch22 and I am getting extremely anxious and upset.

Has anyone had a similar experience to me? Are doctors understanding, and able to offer uncatheterised sections? Thank you everyone. Feeling completely full of nerves

pubmed.ncbi.nlm.nih.gov/23132469/

Hi I'm afraid you will need to have a catheter inserted for c section surgery to keep the bladder empty and as small as possible to prevent injury and out of the area of surgery.
The procedure is normally undertaken after the spinal anaesthesia has been given and checked to be working. It is an aseptic technique that is used to insert the catheter so infection risks are decreased. You will also be given IV antibiotics whilst in surgery and your catheter will be removed a few hours post section.
Goodluck and Congratulations on your baby.

I’ll second what’s said above - not having a catheter means you’d be at incredible risk for a bladder injury during the operation and so I doubt they’d be a surgeon in the land that would agree to do it

I've had a nasty uti after every catheter ever. When I had my c-section I begged them to take it out as quickly as possible. I made sure I was up and moving around within about 4 hours, showered and mostly dressed (joggers and loose T-shirt) by 8hrs post birth. They took it out at 12hrs and let me go home at 22hrs. I escaped without an infection thankfully and recuperated at home much better than I would have on a noisy ward.

I'm not sure if they would be willing to do that incase of damage to your bladder, but I suppose you could ask. It's definitely worth letting them know your concerns though, they might give some IV antibiotics as a precaution when you are catheterised for example.

Can you have prophylactic antibiotics and use a catheter?

It's not possible to have a section without a catheter I'm afraid.
I suffer from UTIs and have had a catheter twice during childbirth, it didn't effect me at all.

Thanks ladies. No babies for me then

@MumComingSoon

Thanks ladies. No babies for me then

Is it not possible to try a natural birth? CBT could help with anxiety around birth. As mentioned above there's no guarantee a catheter would cause a UTI - I never got one from either catheter.

Medical need

There’s actually been quite a few trials looking at this around the world and the research so far shows a reduction in UTI and no cases of bladder injury. So it is possible, though I’ve never seen it.

The other thing I’ve not seen any mention of in the articles is what happens once the operation is over and you can’t get up to the loo for 12 hours. I guess the option is a bed pan but it’s a rigmarole getting on and off a bed pan and I wouldn’t fancy it when in pain from major surgery but it would be doable.

The rigmarole of a bed pan is bliss compared to the immense suffering I’ve been through with UTIs! I have read the studies you’re referring to and so I’m confused as to why everyone thinks it is an impossibility in the UK.

obgyn.onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2010.02802.x

I think you need to talk to a specialist and not base your decision on whether to have children or not on what some people on Mumsnet say. Ask your GP first where you need to go with it.

@MumComingSoon

The rigmarole of a bed pan is bliss compared to the immense suffering I’ve been through with UTIs! I have read the studies you’re referring to and so I’m confused as to why everyone thinks it is an impossibility in the UK.

It isn’t impossible. It’s down to a person’s informed choice. Even if the doctor thinks there’s an increased risk of bladder damage that’s your choice to make if you’d rather risk that than a uti. Which as a fellow sufferer I understand (by the way have you heard of the LUTS clinic).

If I were you I’d contact the local maternity unit directly and ask if they have a consultant midwife and if so ask to talk to them, try and get some reassurance that this is something they’d be happy to do. But also remember they can’t put a catheter in without consent, it would be assault.

I had bladder damage post 2 hour labour.. A year of self catheterising..Next pregnancy went fine. Had extra scans.
Few dc later I needed a emcs... And had a catheter in. No issue. No uti.

@MumComingSoon

The rigmarole of a bed pan is bliss compared to the immense suffering I’ve been through with UTIs! I have read the studies you’re referring to and so I’m confused as to why everyone thinks it is an impossibility in the UK.

Because the damage to your bladder could cause a fatality. A c section is already a major surgery, a handful of studies aren't conducive to everyday childbirth in this case. It would be near impossible for you to get on and off a bed pan after a c section, and not emptying your bladder fully after birth is also a risk for a uti. Both times after birth I've been unable to leave hospital until I've passed a certain amount of urine, to check all is functioning as is meant to be. They do encourage you to do a wee ASAP, which after a section and a spinal block, I can't imagine the midwives would be able to even get you into a position in a bed where you'd be able to pass urine. Not to mention you won't be able to actually move until the spinal block wears off, or feel the urge to urinate, which is another reason they use the catheter.

Speak to your urologist. They may be able to help. I had prophylactic antibiotics throughout pregnancy - is this an option?

@Starcaller

I think you need to talk to a specialist and not base your decision on whether to have children or not on what some people on Mumsnet say. Ask your GP first where you need to go with it.

But also this 💯- a specialist will be able to correctly inform you, such a huge life decision shouldn't be made over mumsnet.

What is your medical need? Tbh a c section would be more painful than a uti anyways

Pregnancy itself can lead to increased risk of UTIs and a while other host of unpleasant symptoms.
I assume if your UTIs are so severe that you’d forgo having a baby, I think a preconceptions chat with a doctor may help you

I have interstitial cystitis which has caused me horrendous pain ‘down there’ for years. I opted for an elective c-section due to this, as I couldn’t bare any pain from another vaginal cause to add to the interstitial cystitis.

I’ve had two c-sections in the last 18-months, and I can honestly say - please don’t let the cystitis out you off having babies! The first time round, I was no prepared. I didn’t drink enough water and I held in my wee because the section site hurt so much.

The second time, I drank an absolute ton on liquid, asked them to remove the catheter as soon as was possible, and made sure I tried to wee every hour - and I had no problems. I haven’t had a flare up since, x

Ps. I’m not sure if you already take these - But Waterfall D Mannose tablets were recommended to me by my private urologist and they are excellent. X

2 main reasons for catheter: first one is to empty the bladder to prevent injury during the section from surgical instruments. A full bladder will sit right in front of the lower part of the uterus so the risk of injury without a catheter is high. Second reason is that spinal anaesthesia blocks the nerves to/from the bladder temporarily so without a catheter you can develop acute urinary retention which is very uncomfortable. So it’s not just the rigmarole of getting on and off a bedpan- you may not actually be able to pass urine at all due to the effects of the spinal.

I suppose it's finding a surgeon confident enough to go against what is "normal" and still considered "best practice" here. All of the obstetric consultants (lots- I'm "high risk" due to a few different medical issues) I have ever met have been very set in their ways "I know best"/ "my way or the highway" types. I know all doctors are different but the ones at my local hospital all sing from the same hymn sheet and won't consider anything out of the ordinary. One laughed in my face when I enquired about a "natural section" as the idiot thought I meant without pain relief 🙄... another told me that my vbac would make me a baby murderer because they didn't agree with vba2c. You get the point.... 🙄

If a catheter being sited is enough to make you not have children then it may be worth approaching your GP or local maternity hospital with questions like these in order for you to plan care appropriate to you. I've had two sections then a vbac. I am prone to UTI's and have a a couple of excrutiating kidney infections as a result but never got one after the sections despite all of the other problems with them. I think mainly because they absolutely batter you with antibiotics during the op. Obviously that was my experience though and you have your own medical history and circumstances. You can contact consultant midwives or even ask PALs if there is anyway of meeting with someone/ having your concerns addressed via letter etc. If any of the studies you've read are based on UK data/ surgeons then you can contact them directly as you can choose the place that you receive care- obviously if that surgeon is in Edinburgh and you're in lands end then it'd be a right faff but the option for care choice is yours.

I had constant UTIs before I had my children. The catheter was the thing I was most scared of, but they put it in when I’d had the anaesthetic so was totally numb and took it out about 24 hours later - didn’t feel a thing.
It had no effect on my waterworks. If anything, my constant cystitis cleared up after having kids!

I’m just completely and utterly terrified of the whole thing. Husband is already fed up of my birth anxiety and I’m not even pregnant yet!