Should I change my mind on elective c-section ??

[summerlovinvibes]

Due to the birth of my first ending in an EMCS after a failed induction, I am opting to have an ELCS this time. Main reason being that I absolutely hated being on the monitor / basically stuck to the bed and not able to move around (as monitor kept losing connection and they had to keep replacing / tried the clip on my DD head and it still wasn't great). I have back issues, and since an injury many years ago I've never been able to sit for long periods / sleep on my back. Therefore being on the bed / monitoring was awful for more, more than the labour pains before the EMCS.

However, I never wanted to have a cesarean, and again this time round I don't. But I would prefer to have one if it means not having to spend hours on the monitor & not being able to move freely. I've spoken to doctors and midwives and they have all said due to previous birth I would need the monitor to keep a check for the scar tearing. I would never risk mine or my baby's health, therefore wouldnt refuse the monitor.

But basically can't stop thinking about how I'd rather have a natural birth / hopes for a quicker recovery than c-section / have a toddler at home which makes recovery harder (supportive husband but still) etc etc.

Has anyone had this experience? And not had to be on the monitor much?

Do you mean the monitor that checks baby's heartbeat? I had that but spent my labour on the floor (my choice!) and there was no issues.. Now the midwife did want me to be on the bed and in previous antenatal classes another midwife had said its easier if we stay on the bed but I was adamant I wanted to be on the floor (for ease of movement) so maybe they just need to make sure they have a good monitor?

I had a mobile monitor with one of mine. Could walk around freely. Although I quickly opted for an epidural so was back in the bed.

Can I say that is absolutely not what you need to do. You choose what you do.

I had a VBAC at home now of course I couldn’t have a monitor but baby was checked every 10 mins and this was agreed and deemed as safe as any monitor that keeps falling off and losing signal. This can be done in a hospital setting if they don’t have a mobile monitoring unit. I had agreed this if I had to go to hospital. No constant monitoring and only Doppler by midwife however many times they wanted. But I refused to be restricted and not move freely.

Have a look at the AIMS website.

From my own experience and research a lot continuous fetal monitoring - all the evidence (from 'normal' labours shows that it does not improve average outcomes for mother and baby but does increase the likelihood of needing a cesarean. With VBACs there is some but very slight evidence that it may pick up impending scar rupture. However it could also theoretcially increase the likelihood of scar rupture in the first place if it restricts the mother's movement,decreases mobility, or makes the mother feel 'observed' increasing the length of labour.

The risk of uterine rupture is quite low and fetal heart monitoring is definitely not a failsafe way of detecting rupture - not all babies' heartrates will be affected immediately and interpreting CTGs in an inexact science. There are other safer ways to keep an eye out for signs of rupture- maternal pulse rate, intermittant ausculation and watching out for signs such as sudden cessation of contractions and/or abdominal pain between contractions. Anecdotally I know of a couple of women whose scar rupture went undetected for some time because the 'monitor' said everything was fine. I worked on a postnatal ward for 5 years.

But on the other hand, if you would prefer to be monitored and feel that the benefits outweigh any negatives then it is a good idea to try and get some agreement in advance that you will be 'allowed' off the bed and investigating the possibility of telemtry (or wireless) continuous monitoring - many labour wards have them but leave them in the cupboard unless someone requests them. You could also consider some sort of compromise whereby you spend 20 minutes on the monitor every hour or two. Whatever you decide is your decision and no one can force you to do anything.

You're in a situation where what you want is impossible, therefore instead you choose the least bad option that best meets your needs.

That sounds like ELCS - and no, it's not what you would want in an ideal world, but out of the options available in the real world it is what you want because it best meets your needs. Rejecting a CS won't make your ideal scenario possible.

If you frame it like that it will probably be easier to feel more positive and in control about it. (Although of course it's still ok to feel disappointed that your ideal option is not possible, just don't let that consume you.)

I had an EMCS the first time round due to failure to progress, the second time I booked in for an ELCS on my due date but said I'd try a VBAC if I went into labour beforehand, which I did at 37+3. My labour started in earnest at around teatime but I managed at home with a deep bath and a Tens machine until about half 9 when my waters broke and we got organised for hospital. I arrived at hospital at 23:08 and DS was born at 23:30. My second birth was so much easier than my first and I felt like I recovered in next to no time compared to my first.
Would perhaps a compromise like this maybe suitable for you?