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Elective C Section / depression / vaginismus
69

Lady929 · 19/01/2022 07:36

Hi everyone

I’m FTM and 24 weeks pregnant. I have my midwife appointment tomorrow and wondering if it is the right time to bring up my options of maybe having an elective c section.

I have anxiety and depression (no medication for a year as I’ve been trying to manage it myself). In the last month or so my depression has got to a really bad point. I’ve been so anxious all the way through my pregnancy due to so many friends having losses and things go wrong in their pregnancies. My mental health is not in a great place and I am just getting by.

I also have vaginismus. Well my doctor said I probably had it and referred me to the Gynae department a few years ago but I never went as I didn’t want to go through the trauma of internal examinations. Ive only ever had one successful smear test and have always had painful sex. The thought of maybe ending up having an induction or a natural birth that doesn’t go to plan is filling me with dread and I’m worried about my mental state if things don’t go to plan once the baby is here.

I know this all sounds really pathetic but do I have a reason to try and push for an elective c section or should I just try and get on with everything? I feel like I’ll not be able to stand up for myself if midwife tells me I’m not suitable for a c section anyway.

Thank you if anyone listens to my long rambling post.

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CreedBratton · 19/01/2022 13:14

Hi,

I would definitely bring it up with your midwife tomorrow - most trusts/health boards run birth choices clinics where you can meet with a senior midwife to discuss your birthing options. It would also be useful to discuss your thoughts with a consultant as they may be able to offer some good advice about what mode of delivery may be best for you. Vaginal birth can involve lots of examinations (although it doesn't have to, you can always decline this) so if that's something you don't think you'd be able to tolerate then maybe a c-section is the way forward. Obviously a c-section is a major operation so doesn't come without risks but your midwife/ another health professional should be able to talk it through with you!
I don't think you'd be unreasonable to request a c-section and even if it's deemed
'Not medically necessary' you can still have one as a maternal request - they may try and decline you but you can keep pushing for it and eventually nice guidelines state they should give it to you.

Hope that helps!

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Lady929 · 19/01/2022 13:17

Thank you so much for your kind message! That definitely does help. I’ll bring it up with the midwife tomorrow and see where we go from there 😃

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Chanel05 · 19/01/2022 16:55

You definitely just don't need to "get on with things". If you'd like an elective c-section, you get one. They might try to dissuade you but if you have a look up the NICE guidelines and quote it to them, it'll probably shut them up.

Yes, there are a lot of risks that come with a section and it is a major operation but if you are well informed then it's your choice. Mine was an emergency section, but from what I've read on here over the year and from the experiences of family, electives are usually very calm, positive births.

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Lady929 · 20/01/2022 10:35

Thank you for replying! Unfortunately my appointment didn’t really go very well.

I told her I was feeling low and it was probably because I was terrified of giving birth. Said it was because I have vaginismus and the thought of sweeps / induction etc. I told her i was referred to Gynae a few years ago after struggling with a smear tests to try and help but I was so anxious about having more internal examinations. In hindsight I know I should have gone and maybe it would have helped me but I didn’t because I was traumatised enough from smear tests.

So the midwife basically said to me well the baby is going to be coming and you’ve just got to get your head around it as everybody is scared. She was a bit nicer later on the more I explained (she didn’t seem to understand vaginismus as she had to ask me what it was called again) but it’s made me feel really embarrassed and ashamed of myself. It took loads of courage for me to bring it up.

She has said she will book me a consultant appointment but from how she was it just sounds like it’s going to be another horrendous appointment where they tell me I should have sorted this before having a baby and I’ll have to try and get on with it. I’m so upset and feel more depressed and terrified than I did before. Was hoping I would come out feeling a bit of relief.

I don’t know why I’m writing all this out I just don’t have anyone to talk to as I’m really embarrassed of having the condition anyway only my husband really knows. Feel so bad because I know with how scared I am that a natural birth probably won’t go well and so worried I’m going to put my baby in danger 😞

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Chanel05 · 20/01/2022 11:12

Is there anyone that can come with you? Tell them that you'll be having a section and that's the end of the discussion.

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OrDis · 20/01/2022 13:11

Hi OP. I wanted to say that I also have vaginismus (also didnt go to my gynae appointment out of fear), I did some self-management at home which allowed me to have less painful sex before we got pregnant, so it wasnt massively severe by the time I got pregnant, but I did still get some pain, and certainly during internal investigations etc.

I think you should speak to the consultant, hopefully they will have heard of this before and will be able to give you options. I did have a vaginal birth, with forceps in the end, and had a spinal. I was very unsure what to do beforehand, but wanted to try. Speak to your consultant, but consider having an epidural, which can totally get rid of any pain/feeling and so you won’t feel any examinations or contractions/birth etc.

I also want to add, as a bit of hope perhaps, that since giving birth, I no longer have any pain at all.

Anyway, there are options, and if you have a plan and go into the birth feeling fully informed of those options, hopefully you will have a really positive experience regardless of the method by which you choose to give birth.

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QuiltedHippo · 20/01/2022 13:15

Hopefully your consultant will be more understanding of your issue. Making a generalisation here but midwives are great at standard birth but consultants know all about the complications and are more willing to look at other options.
If you're terrified it won't help you have a natural birth and interventions are more like to result in a section, so tell them you'd prefer the certainty and would like an elective. Good luck

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Lady929 · 28/01/2022 10:02

@Chanel05 my husband said he would come with me :) I’m going to write everything down and be more prepared to fight for myself next time.

@OrDis thank you and I’m very glad things worked out well for you! I am definitely open to having a natural birth but without intervention. My mental health is really bad at the moment as well so as long as I can just talk to someone who seems to have a bit more knowledge about vaginismus than my midwife then at least that will be a step in the right direction!

@QuiltedHippo thank you! I l’ve seen so many ladies say there planned c sections were a lovely calm experience and I think it would massively put my mind at ease if I knew this was an option for me!

I will update on my situation when I know any more info :)

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Icklemissgem · 29/01/2022 10:58

@Lady929
Hi OP, I am sorry you are going through this and not getting the support of your midwife.
I also have vaginismus and am currently 36 weeks pregnant. I already have a daughter who is 4 who I delivered naturally (with forceps and epidural), however this time around I have requested an elective c section. Luckily for me my midwife seemed to understand the condition and put me in touch with the consultant who agreed it all and I have a date booked in. Hopefully as and when you get to meet with the consultant they will understand your anxiety, my consultant seemed to know a lot about it and it certainly didn't come across as though it was the first time they had heard of it which made me feel a lot better!
Happy to answer any questions you may have, I have struggled with this condition for years and just trying to get pregnant was a horrible experience 😔
Good luck xxxx

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Viviennemary · 29/01/2022 11:04

I think in your circumstances you should push for the c section. Being terrified of giving birth is a good enough reason IMHO. But therecis the recovery time afterwards. That would put me off.

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Lady929 · 10/02/2022 12:00

Hi everyone thanks for all of the advice.

Update..
Had my appointment today and been referred to a consultant. My midwife told me I would not be given a C section and need to try and get that idea out of my head (I’ve not actually even mentioned the c section to her just said I was really worried about a natural birth and having to have intervention)

Hoping my consultant will be better but I feel like I’ve got to accept I won’t be allowed a C section and need to try for a natural birth and hope it all goes smoothly. Feel a bit deflated to be honest as I’m sure they have to let you choose an elective c section but I feel I’ve got no chance of that now.

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ChickenRoseNugget · 10/02/2022 12:44

I had to comment as I had the exact same with my first. I was so scared of a natural birth it was making me so so anxious! I've never had a smear because I've always been scared of internal exams and just the thought of it makes me feel sick and dizzy. (I have to be brave after this pregnancy I know and go for one!)
Sex used to scare me too and anything like just thinking about tears during childbirth. Everything really! I told my midwife and she referred me to a consultant. Had the appointment and the consultant didn't even question my fears and agreed a c section date there and then. (I've heard if the first consultant refuses then you've got the right to ask for another consultant which would be willing)
Anyway I felt massive relief as I was petrified my entire pregnancy and I've felt this way since childhood!

Turns out, little one decided to come early and I went into labour the day before my planned c section! They tried getting me the c section still but it was very busy that night so I ended up giving birth to her naturally the morning of the planned c section! I had a second degree tear but I can honestly say it's the best day of my entire life and I'm so so thankful that she came early and I didn't have a c section! It's completely changed my life and I've gained so much confidence from the experience because I did something I didn't think I could! I've been far less anxious in general since and recovery was so so quick compared to c section! After a week I felt completely normal again. You're so in love and in shock that having stitches didn't even bother me! I refused all internal exams until the very end (which worked in my favour as they allowed me into hospital straight away).

Currently pregnant with number two and this pregnancy has been completely different, I haven't been anywhere near anxious as before (which I would have never believed, I'm such an anxious person!)
Also planning maybe a home birth 😊

Completely understand how you feel though, if you have any questions feel free to ask! Good luck ❤️

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fighoney · 10/02/2022 13:12

You absolutely have the right to a c-section if that's what you want. You also have the right to change midwives if you feel this one is not supportive.
I would say in my first birth that the bit where the baby comes out was way less painful, even with a 3rd degree tear, than the VE they attempted when in labour 🤷🏻‍♀️ 2nd birth I was far better at advocating for myself and refused VE in labour.
Remember a health professional has no more right to put their hands inside you without consent than a stranger on the street, so don't let anyone pressure you.

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JustWonderingIfYou · 10/02/2022 13:21

Why are you assuming you will need loads of internals/ sweeps/ inductions etc? Do you have any other risk factors? You can decline all of these and just have a normal birth.

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CountryGirl189 · 10/02/2022 18:15

Just wanted to add to this!

I brought up the topic with my midwife at my booking appointment and told her that the anxiety of giving birth was starting to take over my life and I couldn’t enjoy being pregnant because of it. She was so supportive and told me it is absolutely my decision to give birth how I want and so she referred me to a consultant and also a peri-natal mental health team.

One of the senior mental health nurses at the hospital gave me a call instead of the consultant and said absolutely no one can stop you having a c-section if that’s what you want, it’s just their job to make sure you’re able to make an informed decision - so she was brilliant too and has booked me in again to chat with the consultant and get it booked in (I’m still terrified of talking to the consultant, mind!)

My gripe has been today when I had my mental health assessment! Absolutely awful! The woman completely dismissed my fears and told me they could just prescribe me a sedative for when I went into Labour?! I’m now so worried the consultant will agree with her, but my partner is fuming with her and has said he will speak to the consultant if he has to make sure I get it!

Don’t listen to your midwife - YOUR BODY, YOUR CHOICE! I bet if men were the ones giving birth, they’d be offered an immediate c-section with a weeks all inclusive to get over it 🙄

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Lady929 · 24/02/2022 19:10

Thank you everyone for your replies!

So I’ve had two phone appointments with who I believe is the senior midwife. The first one two weeks ago, she was lovely, listened to all my fears about vaginismus, childbirth, understood completely. Said my options were an elective c section or maybe things like making sure I have an epidural earlier to help in a vaginal birth etc. she said she would ring back in a couple of weeks after speaking to her colleagues. I felt listened to and relieved that there would be a chance of having a c section.

Skip forward to today and the second phone call with the same woman was not so positive. She told me that they wanted to get me into doing some physio to help with vaginismus over the next few weeks. I’m sorry but the thought of having to go through extra appointments that are going to cause me anxiety when I’ll be heavily pregnant makes me feel sick. I burst into tears. I said I would be happy to do that after I’ve had my baby but I can’t face that right before. My vaginismus is not gonna be cured like that in a few weeks. Then mentioned I’ve got to try talking therapies, I’ve tried going through mental health services and they said the waiting list was long so gave me a self help guide about depression. She’s told me to chase them up again because I will be priority because of been pregnant. They know I was pregnant the first time and didn’t care.

My mental health has dipped so badly. Depression has kicked in and the anxiety of giving birth is literally taking over my life as well. I said to her I think an elective section would be better for me as I’m struggling to cope so she booked me one in “provisionally” as a last attempt if nothing else works. I feel like I’ve still got a lot of hoops to jump through to get what I want and my midwife will constantly be having a go at me now when I see her cos she’s so anti c section. I’ve read about all the rights of giving birth how you want online but it doesn’t feel like the case.


@CountryGirl189 how have you got on since your assessment? They just clearly don’t take us seriously. I’m so depressed and anxious that I’ve got to the point where I feel like I can’t carry on with how bad my mental health is. I feel broken and just want to be listened to. I hope you’ve had a better outcome than what you thought.

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CountryGirl189 · 26/02/2022 22:40

@Lady929 - so sorry to hear that you’re struggling with this! Just so you know, they CANNOT refuse a c-section and you have the right to request to be transferred to another hospital where a consultant will give you one.

I have my consultant chat on Wednesday and taking my partner with me, but all midwives I’ve met so far have said that they absolutely cannot say no to you and that at the end of the day, it is my choice. They can give me all the risks etc, but it will be my decision in the end.

I so hope you get sorted! It is a battle, which is ridiculous, but you need to get all your facts and risks and NICE guidelines together and go in on them hard x

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Kiopa · 01/03/2022 18:16

Hi @Lady929 how is this going for you?

I'm in a similar situation to you but a bit further behind the process. I'm 24 weeks and had a midwife appointment today. I have anxiety and depression so am looked after by the specialist midwife team, which I think has helped. I told my midwife today about having vaginismus and thinking that I want a c section (I'm not 100% sure but think I will want that in the end). She was kind and knew about the condition, so I'm sorry that wasn't your experience. She said that because it's the NHS you just have to go through a process where they will try and persuade you not to have one but that ultimately if I say I want to they will have to do it. The process with my trust is that I have an appointment with a senior midwife, and then after an appointment with the consultant. What the midwife said was comforting but I'm so anxious about it all. Especially because the midwife said the consultant appointment is normally around 36 weeks so I won't know until then for certain if it will happen or not. If I were you I would keep pushing for the c section if that's what you want. That's what I will do if I don't change my mind. I think my senior midwife appointment will be in a few weeks so I can let you know how that goes if you like?

I've also looked at papers about vaginismus and childbirth on Google scholar. I have a science background so I find it quite comforting, especially as you can see that these feelings you're having aren't abnormal - lots of other women have them too. There's a really good paper summarising all the current evidence and research on it here: scholar.google.com/scholar?hl=en&as_sdt=0,5&q=vaginismus+pregnancy#d=gs_qabs&u=%23p%3Db-8uQxUs_UEJ

(You have to click pdf at the bottom to read the whole thing)

I actually did have physio for my vaginismus and would really recommend it, the physio was so kind and helpful. It meant that I could conceive naturally without pain. But since we conceived we haven't had sex and I think maybe it wasnt fully cured because a lot of the same anxieties and pain came back when I had to have an examination recently. I think you definitely need to be in the right headspace for physio though and you can't let them bully you into doing it now if you don't think you are. Being pregnant can be so stressful and you don't need more stress!

Anyway sorry for the essay, hope things are ok xx

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CountryGirl189 · 02/03/2022 17:25

Just an update from my end - had my consultant appointment today and left having a panic attack 😩

She basically said that I have no right to a c-section and that the guidelines are there but that’s not how it works and proceeded to tell me for an hour about how if I had a c-section, I’d bleed to death.

She also kept dangling it in front of me, saying things like “I could book it right now for you in two seconds, but I’m not going to”. It was absolutely horrendous and to be honest, I now feel so detached from my baby out of fear of having to do something I don’t want.

I saw the mental health midwife after who could see how distressed I was and I told her that I’m so worried that this whole process is going to make me hate my baby.

I have to go back in two weeks to see the vile consultant again and hope and pray that she says yes, but highly doubting it at this point 😔

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Lady929 · 02/03/2022 18:08

@Kiopa

Hi! I’ve actually had an appointment notification sent through today for next month to see someone from obstetrics, I’m assuming it’s going to be a consultant appointment but I wasn’t really given any information. I’m going to try and fight for the C section but I think I’ve accepted that they are going to tell me no as they’ve just been pretty unhelpful and make out my issues aren’t serious enough. Although the senior midwife I spoke to on the phone did say I could have an elective section she seemed to kind of back track on this the last time we spoke.

I’ve just had a look through that document you’ve sent and will add it to my list of notes I’ve made to show the consultant, thank you it’s very helpful 😃

I agree that physio for vaginismus may be very beneficial but I would have to choose to do it after birth how. I have anxiety just going to midwife appointments and scans, add on extra appointments for something that feels too scary at the moment is too much for me to face before giving birth. Plus I know physio can take a long time to actually do anything, I don’t think doing it for about 9 weeks whilst heavily pregnant will be much use to me now, especially when I’m an anxious wreck. I did say I know I should have gone to gynaecology when I was referred years ago but I couldn’t face it then either.

I hope your consultant appointment goes well, I’m sure it will as your midwife sounds very supportive so that is a good start and I’m glad you’ve had better help than I have. Please keep us updated 😃X

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Lady929 · 02/03/2022 18:19

Oh @CountryGirl189 my heart absolutely breaks for you reading this 😞 After I had my phone call with senior midwife I was in tears and felt like giving up as even though she said she would “provisionally” book a C section date I felt so deflated and it sounded like they are going to refuse to actually to let me have one. I can’t even begin to imagine how bad you’re feeling.

All I can say is you do have a right to C section. I’ve read everywhere that if you have a consultant who refuses to do the C section then they MUST refer you to one who will accept it. Did you explain you knew about Birth rights org, NICE guidelines etc. Explain that you understood the risk of C Section. Did you explain your mental health will be majorly affected if you had to have a vaginal birth that didn’t go to plan and could affect how you cope with your new born baby? Sorry don’t want to sound like I’m being bossy just wondering if they gave you a chance to speak your mind?

The fact she said she could book it for you right now means she can allow a C section so she is absolutely awful.

What did the mental health midwife say to you? When you go back you need to really push the fact your mental health is going to really cause problems and that’s a much higher risk for you and baby. I cried my eyes down the phone and said what is the point, I can’t fight for myself and I’m close to giving up. I think the distress in my voice was pretty clear and that’s the only reason she said she would book a C section date in.

I’m really sorry I’m rambling, but I’m thinking of you and please reply as much as you want on this thread as it will probably be helpful for us to have people to talk to who are in similar positions. I know how drained you must feel right now and I’m here to listen X

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CountryGirl189 · 02/03/2022 19:36

@Lady929 - you’re not being bossy in the slightest!

We honestly brought everything printed off to the appointment and I’d typed out all my reasons etc and the risks I was aware of and she wouldn’t even let me finish it, she just kept cutting in!

Same with my partner, he kept trying to be really rational with her, explaining that he understand where she was coming from as a health professional etc etc and she wouldn’t let him finish and just kept banging on about how horrendously dangerous they are.

I said to her, I’m not making the decision with a smile on my face and I’m not particularly looking forward to a c-section, but that for me it’s the option I’m better able to cope with.

The mental health midwife was lovely and she could see that I was almost having a panic attack and helped me calm down. I said that I’m so scared that I’ll end up hating my baby because I’ll just associate it with all this that I’m now having to go through.

I appreciate there are risks, but doctors need to STOP ignoring the risks of natural birth and need to compare the two equally. Don’t sit there and tell I’m going to bleed out on the operating table, when the exact same could happen in the delivery room!!

Can you tell I’m on one now 😂

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neptuneandcoke · 02/03/2022 20:13

That's awful the consultant treated you like that @CountryGirl189 - I would put a complaint into PALS if I were you. To be so dismissive and antagonistic is awful. Can you ask to see a different consultant?

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Lady929 · 03/03/2022 14:31

@CountryGirl189 can’t believe she was so dismissive especially when you had your partner there backing you up as well. She sounds an absolute disgrace! The fact you have another appointment make me think she’s going to agree to the C section then, she’s obviously a nutter who’s took great delight in making you sweat a bit before she gives you a decision. I would be putting a complaint in.

Just put your foot down next time and say look you will have to refer me to another consultant who will do it then. They can’t refuse one. I’ve read so many positive stories of ladies getting a maternal request C section with mental health issues with no problem but some of us are having to fight ridiculous battles at what is already a very vulnerable time.

I think you will get your C section, you can’t not but I understand how shit you just feel waiting for the next appointment. I can’t enjoy any of this pregnancy anymore wondering what is going to happen when it comes to giving birth. I always said I would like two kids If we were lucky enough but I don’t think I can go through pregnancy again when there seems to be 0 support.

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RecklessRemote · 03/03/2022 14:49

Hi @Lady929

I have/had vaginismus and had my DS 2 years ago. I had a midwife who had never heard of it so booked me in with a consultant who wasn’t keen on a section. I went back to my midwife and said I’d want to have an epidural before any internal checks were done as I knew I wouldn’t be comfortable/ in agony.

I ended up being induced with a pessary against my advice and it took 2 people + gas and air to get it in. I bled and took it out 2 hours later and cried the whole time it was in. As soon as it was out the relief was immense. I ended up in labour but it wasn’t progressing and waited 2 days in the induction ward before they took me for a c-section. The midwives in the hospital we’re very understanding and didn’t push me for any examinations, monitored baby’s heartbeat etc and just asked me to time my contractions loosely etc.

My advice is, stand firm with your midwife. Tell them you won’t be induced with a pessary, tell them you will say no to any internal examinations without an epidural first. If these are unreasonable then you expect her support for a c-section.

If you go into labour naturally I wouldn’t worry too much as long as you get your epidural if it is the examinations you are worried about, pushing something out is not like something going in. I know that’s easy for me to say because I had a section but vaginismus is muscle spasms and fear, your body physically takes over in labour to push out the baby if able.

With regards to being referred to a gynaecologist for vaginismus - do it! Mine didn't internally examine me, the doctor did (very very gently just tried to see with a tool, the second I said it hurt she stopped pushing and was done). The gynae doesn’t examine but offers you stretching tools to use daily for 20 minutes or so a day, to get your body used to the feeling of something inside. Mine was absolutely lovely but did advise me not to do it throughout pregnancy so I would tell your midwife/consultant that whilst you wouldn’t fee comfortable doing it whilst pregnant it’s also not recommended as you are putting a lot of pressure on your vagina (and cervix if you have a short vagina as I found out during my section)!

Please don’t feel pressured into a situation you don’t want. But also don’t be too afraid to give natural birth a go as long as you have set boundaries in place with your midwife. Your surgery midwife won’t be with you during so realistically they don’t care that much as long as you/ baby are well enough during pregnancy. So fight more with your consultant/ ask to see another one.

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