No c sections available

[RunningAlong]

My partner is 35 weeks pregnant and due to gestational diabetes has been told that the baby has to come out by 37 weeks. The baby is breach and we requested a c section right at the start however none was booked. When we saw a consultant yesterday we were told there are no dates available until February which would put my partner at 43 weeks. What happens now? We are getting no answers from anyone.

They will not let your wife, with GD, go to 43 weeks with a breech baby. As has been said above, it is quite early to book a date. I got my date with breech twins at 35 weeks (and full term for twins is 37 weeks not 40). It will be a case of no more bookable slots for planned sections so they will be waiting to squeeze her in.

If it reassures you at all, I was booked in for a Wed but admitted to hospital on the Monday. They got me a space on the Mon, Tues and Wed on the emergency list but decided each day to wait another day due to the lack of nicu beds. So your wife absolutely will get a slot. Hopefully you get it sorted with the new consultant tomorrow.

Please listen to @MKSlava and the other sensible posters on this thread. If you medically need a section you'll get one. So much misinformation on here.

Remember all hospitals have different procedures etc regarding giving dates and it's not unusual to not have a date at your stage.

To be fair the facts described by OP - ie the consultant showing them the diary and saying the hospital is fully booked, and writing ‘no c-section’ on the notes - are alarming. I agree that it’s overwhelmingly likely to be a miscommunication of some kind (because denying a section to a mother who’s had a previous section, has GD and has a breech baby contravenes virtually every guideline in the book) but either way it’s extremely poor communication given the level of confusion and fear it’s obviously caused and people are right to advise OP to question it.

I need a section - my consultant explained very clearly and pleasantly to me at a 34 week appointment that he would put a request in for a caesarean but they aren’t booked into the diary until after 37 weeks, so I shouldn’t expect to have a date for a while but that I would definitely have my caesarean booked. That’s decent patient communication. What the OP describes is not.

Just to keep everyone updated so far they have missed the telephone appointment and no one is answering the phone at the Labour ward. My partner is incredibly stressed and scared especially as today our baby has barely been moving.

@RunningAlong

Just to keep everyone updated so far they have missed the telephone appointment and no one is answering the phone at the Labour ward. My partner is incredibly stressed and scared especially as today our baby has barely been moving.

If your baby is not moving call labour triage immediately, she needs to be seen today. They will put her on a ctg monitor and she’ll be reviewed by a consultant and offered a growth scans

Could your partner ask to have her care transferred to a regional specialist maternity unit (women's hospital or maternity unit with high level NICU attached) that might have more capacity.

If the baby’s not moving much you need to call either the cmw or Labour ward.

You need to go to the hospital now ,this is serious if the babies movements have reduced don't chance it it could be too late.

As with all episodes of reduced movements you need to phone the number for us it wasn't the labour ward. If no answer head straight to hospital. Not quite sure why you haven't already? It was clearly said to me at most appointments and was written in multiple places in my leaflets/booklets/notes.

I’m so sorry this is happening to you

The issue is theatre staff being moved to icu and being off sick with covid

So no elected surgery is being cancelled, it’ll be emergency surgery only

It’s incredibly worrying all round as their are staff shortage and then this makes matters worse

Hopefully you’ve gone to maternity to get checked over

Thanks again hes fine he clearly doesn't like stress. When we eventually got in touch with someone they reassured us a bit and promised to ring again Monday. Apparently since then he's been very active.

This is worrying. What part of the country are you in? I find our if my baby is breech next week and having previously been relaxed about this am now very nervous

Please update us on Monday.
@RunningAlong

FYI FOR OTHER CURRENTLY PREGNANT WOMEN

I saw this when it was first posted

Appreciate its not OPs intention but it really stressed me out and made me very anxious regarding my own birth I am currently 28 weeks.

Luckily I had my consultant referral last Friday they cleared me for a c section after reviewing the risks with minimal fuss and have put in a request for my provisional date. I told them about this post and my concerns and anxiety regarding my elective c section being cancelled / moved/ not possible

They were very reassuring and said that there would be no issues with my C-section, they have good provision even within a Covid context and I should not be concerned at all. This was likely an unlucky/unusual case.

This was at the royal free in London. they said while they couldn’t speak nationally that certainly within London it was not going to be an issue.
I should have a confirmed date in the next two weeks.

Appreciate the OP is facing a very real issue themselves but this was pretty distressing for me (and probably other expectant mothers to read) so thought it would be useful to add some context and my own experience.

Agree Totalwasteofpaper I'm 38 weeks with a "stubbornly' breech baby, I've just been booked in for an elective, but if there hadn't been an ELS space I'd have been given a day to turn up and wait for a slot in the other theatre to get my baby delivered.

I'm sorry your partners anxiety is so bad OP, but the NHS won't allow women to die because there's no room in theatre!

My C section was booked as an “emergency” at 40 weeks, as the consultant (and I ) weren’t keen on an induction for various reasons. What happened on the day is that my cervix was checked and they went through the motions of thinking about breaking the waters. I was nowhere near ready so got the section.
What I am getting at is that maybe there are no official elective slots left but there’s always room for an emergency . Have another chat with the co sultans as soon as you can - maybe this is the plan.

Those who keep saying ECV, she’s had a previous section so she won’t be offered ECV.
Her diabetic nurse can’t decide when the baby should be born, that’s a consultants decision.
If there’s no space on the ELCS they’ll admit her to await category 3 section which is done when there’s space on labour ward

Present to maternity triage now. Don’t call just turn up, both wear masks.
So this every day. Be very firm, polite and articulate. Don’t take no for an answer and ask about the NICE guidelines/ evidence base for every single thing anyone says to you. (Unless it’s “would you like a cup of tea? 😂)

@RunningAlong

We really dont want an emergency c section as she had 1 previously and nearly died. They haven't booked anymore appointments either and as I say its impossible to contact anyone

What is the difference between an emergency c-section and a planned one? I had an emergency c-section and will probably have a planned one with our next child in a few years

OP, I had gestational diabetes diagnosed at 34-34 weeks and reduced movements from 37 weeks, delivered my son by ELCS at 38+5. He too was breech until 37 weeks. If your partner has GD she must have a consultant obstetrician-diabetes specialist assigned to look after her - she may not have met him/her yet, I met mine at 36+5. Before I only dealt with the diabetes midwives. My delivery method was discussed with the consultant obstetrician and obstretrician-diabetes specialist. Would it be the case your partner is awaiting this appointment? It's not for the midwives to decide on the delivery method, it's your partner's decision and if she has GD it should 100% be discussed with the consultants. Request this now if they haven't done it. Go via PALS if needed. Request a section at a different hospital as a plan B. If your baby remains breech that is a 100% caesaran even if she didn't have GD complications.

Do not be fobbed off - GD is a real risk, starting from reduced movements to a potential stillbirth/complications during the birth. I'm not saying this to cause you stress, but to be aware that you shouldn't put up with their attitude.

I wouldn't think the labour ward would do anything tbh, unless you are requesting to speak to your partner's consultant?

I think the difference is in if you have laboured first surely? I had an emergency CS but had an elective planned. No real differences. I had placenta praevia and started bleeding so they did a CS immediately. It was a lovely experience.

I had a planned section, it was booked for a certain date when I was just about to turn 37 weeks (happened at 38+5). That's ELCS. An EMCS is if it becomes required after labour has started for various reasons or if for example you have a planned section scheduled but there are some unexpected issues prior to that date, such as baby in distress, repeat incidents of reduced movements etc. So then they effectively do what you had planned anyway a bit sooner.

Final update a doctor rang first thing this morning and we have a date booked at 38 weekd and a scan booked the week before to make sure everything is ok. The doctor we saw previously has been removed from our case and we won't be seeing her again

Great news, all the best for the big day.

One more update he was born yesterday by emergency c section and while he was a little early and is in neo-natal its very minor and should only be a few days. Mum is already home and I've nothing but praise fir every member of staff we've come into contact with yesterday and today.