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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Emergency c section before labour even started properly

42 replies

Ilikepistachio · 30/07/2023 14:59

Hi all

Sorry for the long post!

I gave birth a few weeks ago to my 2nd child (39 weeks) and I am still feeling sad and frustrated with my experience. I just want to know if anyone has experienced what I have and if what happened to me was valid.

My waters broke Saturday evening. I had no contractions or anything prior. The only sign I had that labour is imminent is losing a bit of my mucus plug. I was booked on the home birth team and so called the triage and told them what was happening. They sent 2 midwives over to my house to make sure it was my waters (at this point I wasn't sure) but they couldn't confirm so they advised me to go to the hospital and get it checked. I decided to go next morning.

When I got to the hospital, before they checked my waters they did a fetal ctg to monitor if baby is OK. Now thinking back I don't understand why they needed to do this and for some reason I failed to ask this question. They eventually did confirm it was my waters. At this point I had been hooked to the monitor for a while because the midwife and doctor were both saying that the ctg was failing to meet the criteria but at this point there was no alarm bells. At this point my hope for homebirth was disappearing. The midwife did a sweep to help things going.

As it was coming to 24 hours since my waters broke, I was told I'd have to be induced. The ctg of the baby was still suggesting the criteria wasn't being met. At this point I am still not experiencing contractions, just random braxton hicks.

They finally got a room ready for me and moved me to the labour ward. They put me back on the ctg monitor and now it was saying that every time I was having small braxton hicks, the baby's heart rate was increasing to like 176bpm. So the doctor said this baby is not going to cope with full on labour and my only option now is a section. I really didn't want this so I asked can we wait to see if things change. They gave me 30 mins and nothing was changing. The doctor said baby is in distress and we need to get baby out now.

I was so defeated at this point. I was 2cm dilated and being rushed to theatre. Things were happening so fast. My daughter was born and the recovery was brutal. I'm still not over the birth and I just can't help wonder did things get escalated too quickly. We got to the hospital at 11am and my baby was born 6pm.

I can't help but think should I have waited, was it the continuous monitoring that set me up to fail and led to a cascade of interventions. Was it the fact I was on my back for hours that distressed the baby a bit. If my waters never broke would the baby be in distress silently?

I'm going to book a birth debrief soon but I was hoping if someone here could help me make sense of this. I just feel like going from trying to have a homebirth to the other end of the spectrum with a c section is too much for me to comprehend. I'm sad most days and I just want to stop feeling like this. If I ever want another child naturally, I've now got to consider all the risks that come with vbac. If my c section was unnecessary, it makes me so upset that ive been left to deal with going down the consultant led pathway, continuous monitoring again which I cant help think is what led to the c section. I believe I'll be set up to fail again. I genuinely never want to go through a section again, it was horrible for me and I can't help feel like I was rushed into it.

OP posts:

ladydimitrescu · 30/07/2023 18:45

My team failed to monitor my unborn daughter, left it too late for a section, and my child was born with sepsis and didn't breathe for 7 minutes. I would rather die than experience that again. By some miracle she didn't suffer severe brain damage, but I have been left with PTSD and anxiety that cripples me daily.
The monitoring and their care and swift realisation that your baby was in distress, is the reason you have a healthy baby in your arms right now.

rosegoldivy · 30/07/2023 18:52

RedToothBrush · 30/07/2023 18:38

A few things.

They spent two midwives to your home to check you. They were perfectly happy and had the staff to facilititate a homebirth. They were not anti-homebirth or cutting corners.

They gave you control of when you went to the hospital to get checked. They were happy for you to do this.

You were almost at 24hrs after your waters were broken and you had no contractions. There was therefore only a short window left before medical intervention with induction was going to have to happen. At this point your chance for a homebirth were slim to none.

Add to that, the heart rate monitoring were showing a problem. That means you were always destined for a hospital birth with some degree of significant medical intervention needed.

They listened to your request to wait for 30mins. They didn't dismiss you or say it wasn't possible. Instead they monitored the situation. You say: They gave me 30 mins and nothing was changing. The doctor said baby is in distress and we need to get baby out now. The situation actually WASN'T no change in the situation - the situation was getting worse with the baby showing continuining distress which was unsustainable.

I was 2cm dilated and being rushed to theatre. Things were happening so fast. This is telling.

I refer to this from the NICE guidance:

Use the following standardised scheme to document the urgency of caesarean birth and aid clear communication between healthcare professionals:
Category 1. Immediate threat to the life of the woman or fetus (for example, suspected uterine rupture, major placental abruption, cord prolapse, fetal hypoxia or persistent fetal bradycardia).
Category 2. Maternal or fetal compromise which is not immediately life-threatening.
Category 3. No maternal or fetal compromise but needs early birth.
Category 4. Birth timed to suit woman or healthcare provider

and

Category 1 caesarean birth is when there is immediate threat to the life of the woman or fetus, and category 2 caesarean birth is when there is maternal or fetal compromise which is not immediately life-threatening.

1.4.3 Perform category 1 caesarean birth as soon as possible, and in most situations within 30 minutes of making the decision.
1.4.4 Perform category 2 caesarean birth as soon as possible, and in most situations within 75 minutes of making the decision.
1.4.5 Take into account the condition of the woman and the unborn baby when making decisions about rapid birth. Be aware that rapid birth can be harmful in certain circumstances.

Your own words: 'rushed to theatre'. Looking at the classification criteria you were classified as CAT1. Not CAT2. Your baby was demostrating persistent fetal bradycardia. You were in the HIGHEST risk group. It couldn't wait any longer. You were allowed to wait for 30mins before this point.

As for this:
was it the continuous monitoring that set me up to fail and led to a cascade of interventions

My local maternity unit was briefly put into special measures because of a higher rate than normal of problematic births. They identified that a lack of cfm WAS the problem.

In the context of multiple maternity unit scandal - which consistently highlight LATE intervention and a drive towards natural birth at all costs, you need to think very seriously about just how much you've been almost radicalised into the hype of a homebirth / natural birth by birth evanglists who have been found to been in no small part responsibl for harms to women and babies.

It sounds like they did everything RIGHT and its YOUR expectations and desire that you have a natural birth that is the problem here.

Your baby is healthy. You are struggling and that shouldn't be minimised. It is NOT true that 'all that matters is a healthy baby. A woman's mental health is important too. However there is a problem with expectation management: women who have a very fixed expectation of birth and then have an experience which is very different are MUCH more likely to experience birth trauma than women who have a more flexible / less set expectations of childbirth - regardless of how they actually give birth. And thats where you are at and what you will need to reflect on most if you want another child.

You sound like you ARE experiencing trauma - which isn't something to just ignore. But it needs context and you need that debrief. But from what you've said, it very much sounds like they did things perfectly for the situation that was arising and it would have been extremely foolhardy to wait for labour (which may not have even come). The risks were simply too high.

This is so interesting to read. From what the guidlines state i would have fallen into 1.4.3 category as i was rushed to theatre as soon as possible and EMCS was done immediately.

For OP I agree with previous posters. Honestly think about it like this, What if they hadn't done checks and didn't know your baby was in distress?
An EMCS is not the end of the world, but I imagine leaving the hospital without a baby would be.

Don't be so hard on yourself.

RedToothBrush · 30/07/2023 18:58

I should add that the NICE guidelines are bang up to date: they were last updated June 23 AFTER recent scandals have highlighted systematic problems in maternity across the country.

Yourebeingtooloud · 30/07/2023 19:03

OP I’m sorry you had this experience. It’s brilliant that you and your baby are healthy but it’s also completely ok that you feel disappointed things didn’t go the way you were hoping.

I had a similar experience with my first dc’s birth. Whilst I could rationalise that ultimately it was necessary because they were at risk (it was a cat1 section), I also felt I had failed and was to blame for decisions I had made earlier in labour. I felt sad for a long time and cried about it pretty much every day of their first year. I just stopped telling other people how I felt because they all trotted out ‘but you and the baby are healthy and that’s all that matters’.

It’s great you have already thought about accessing birth reflections - that definitely helped me understand more and they also put a plan in place with me for future deliveries which I found very helpful.

Ultimately though, what helped me come to terms with it all was just time. Would I have preferred something different - absolutely - but that dc is 12 years old now and their birth is the tiniest part of our journey together. I hope with time you’ll be able to find similar peace.

Everywherenowhere · 30/07/2023 19:09

You were told your baby was in distress with an escalating heartbeat and was unlikely to survive labour. It was over 24 hours since your waters broke so risk of infection also high. What part of that makes you think it was an unnecessary section? You should be thanking your lucky stars your baby is ok @Ilikepistachio well done to that doctor and team for ensuring your baby survived.

Capricornandproud · 30/07/2023 19:12

I’m sorry you had a trauma such as unexpected major abdominal surgery - which IS what a C Section is. However, I 100% agree with the sentiments above saying most labour wards, consultants and midwives would MUCH rather you went naturally! In my experience things are pushed right to the last minute with the women I know, and only then are they rushed down for a section. I desperately wanted one and it was a nightmare to secure. I think you should focus on the fact they caught your LO distress early and managed to keep you both safe.

Everywherenowhere · 30/07/2023 19:15

I actually can’t believe you asked them to give you more time just because you selfishly didn’t want a c-section when they had clearly told you your baby was in distress and might not make it. And now you’re complaining they ‘only’ gave you 30 mins. Shocking. You are so lucky they didn’t listen to you or your baby might have died @Ilikepistachio

User1437957 · 30/07/2023 19:18

Congratulations on your baby OP,

I would take what you have written on here and discuss it all at your debrief. It will give you some answers and closure. It’s all very well to say that your should be grateful for your baby but you matter as well. your mental health is important so please ask all questions you have at your debrief.

note down any questions you have.

for my first birth, my labour was very mismanaged at hospital and I was put on ctg like you and it ended in a crash section. I never recovered fully from the mental trauma.
I have had a VBAC since then and no CTG was on my birth plan. I would I rather have straight to c section than the agony of being bedbound with ctg. and despite that I had to fight with the midwife in labour. In the end they used a Doppler intermittently.

Emmamoo89 · 30/07/2023 19:54

User1437957 · 30/07/2023 19:18

Congratulations on your baby OP,

note down any questions you have.

Having a ctg is normal. I had one and glad otherwise wouldn't of known my son was being in distress when I was pushing.

PinkPlantCase · 30/07/2023 20:02

OP I generally find mumsnet to be pretty anti Homebirth and with a healthy dose of dead baby fear mongering added in.

I doubt this thread will give you what you need.

I get it OP, it sucks. C-section recovery is hard as is having things turn out so completely different to how you would have preferred.

Maybe you need to allow yourself space to grieve the experience you couldn’t have, the labour, birth and post partum time you had planned, researched and wanted.

Have you heard of people doing a ‘re-birth’ at home in a birth pool? I’ve come across a few people who have done it and found it incredibly healing. It’s where someone has hired a pool for use at home but didn’t get to use it as they were in hospital, when they come home they set up the pool, turn down the lights, enjoy some time with baby in the water and take some photos to look back on.

cansu · 30/07/2023 20:03

I think birth can be very traumatic. However I agree that you need to consider that hospitals do not do c sections in an emergency unless they are needed. You and your baby were lucky to be in hospital and being monitored perhaps saved your baby's life.

PinkPlantCase · 30/07/2023 20:04

Oh and if you want to find out more about continuous monitoring there is an interesting midwives cauldron podcast episode on it. I don’t know how it will sit with how you’re feeling so read the description first but you may find it interesting if you wanted to find out more.

mokebox · 30/07/2023 20:14

Sprogonthetyne · 30/07/2023 15:17

You weren't 'set up to fail' because you have not failed. You have had a beautiful and most importantly, healthy baby. If the babies distress hadn't been picked up on the monitor, then maybe the baby would have been born virginaly and been fine, but maybe it wouldn't have been. Better to do 9/10 sections too early then 1/10 too late.

This 100 times over. For whatever reason, doctors have picked up on distress. I would 100% rather know that & have it acted upon in the least risky way. Would you have rather left it to chance?

I understand you feel sad that things didn't go to plan but they rarely do. You didn't fail, it wasn't a test. Your baby is here safe, you're safe and your recovery will be a distant memory in a few weeks.

User1437957 · 30/07/2023 20:32

@Emmamoo89 it is definitely not normal.

Nursemumma92 · 31/07/2023 07:21

User1437957 · 30/07/2023 20:32

@Emmamoo89 it is definitely not normal.

No it is not routine however it certainly has its place. This baby was in distress while mum wasn't in active labour, after nearly 24 hours of waters breaking. After working in obstetric theatres, I have seen the crash sections with varying outcomes... this outcome for the OP is certainly the best outcome compared to the alternative.
That said, I totally understand why this would have been traumatic and has left OP feeling grief from her birth experience. I just don't think in this case that anything should have been done differently. OP was listened to by the staff, she chose when to go into hospital to be examined to check if her waters were broken. She was allowed to wait another half an hour with an abnormal CTG to see if there was any change... there wasn't and baby's heartrate was getting faster and showing more distress.

Emmamoo89 · 31/07/2023 13:35

User1437957 · 30/07/2023 20:32

@Emmamoo89 it is definitely not normal.

In my hospital it is

Creepyrosemary · 31/07/2023 13:51

First, congratulations on your baby!

You know when you read an article where the baby has died and it say: "lessons have been learned"? This is one of the lessons, if a baby is in such high distress before labour then get a section to save the life of the baby.

I think you do realise this in some capacity but that it all happened too fast for you to comprehend what was going on exactly. A debrief could really help you with that. I had a sudden emcs during labour and it felt like I was suddenly interrupted but then really massively. They made the right call though and the debrief was also helpful. It also helped me to watch a c section video on youtube because I just didn't know exactly what they did to me in detail and everything kind of passed me by while it was happening.

So, get the debrief and whatever you need to put this episode past you.

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