C-sect or VBAC? They wont let me have elective c-sect

[BarbieDoll5]

Hi, I am fairly new to mumsnet but am feeling really down and need some advice.

DS1 was born 8 years ago after being induced due to 2 weeks overdue. 24hrs later still did not dilate past 5cm. SO had emergency c-sect. I was only 17 at the time.

Now 36 weeks with no.2. Spoke to midwifes as I would prefer an elective c-sect. They said fine, they would do it at 38 weeks..and was probabley better as did not dilate before, risk of scar rupture, and low sucess rate of vbac.

THEN saw obstratrician (spelling?) who said because of my age (26) she did NOT think I should have another c-sect. and that if i insisted then she still wont do it until I am 40 weeks...and if I go into labour naturally before 40 weeks then tough unless emergency!!!

Why are the midwifes and obs giving different advice?

Since she said this, I now cannot sleep,keep crying, have flash backs of DS1 trauma and am *&^tting myself about going into labour.

Reason for not wanting VBAC is did not dilate before and am terrified of going through labour and ending up with emergency c-sect anyway. (Also am a bit of a prude and cannot handle the whole dignity thing!) I know that I will not want more kids after this (as was dubious about this one at first.) I thought that if you had one c-sect they prefer you to have another?

Am interested in Mears advice or anyone else having elective c-sect?
dOES anyone know who I should talk to about my fears?
Thanks

I will also ask for a tummy tuck after!

LOL KBear - I know. Tch!

Oh, I missed "carved up". That kind of talk is not helpful to someone who clearly is seeking a casarean. Why oh why is a caesarean regarded as a bad thing?

I say good for you for seeking the medical which YOU deem to be best for you and baby. Good luck

Any chance you'd like to name and shame your hospital?

Barbiedoll5
I also had a C-S after failure to progress more than 5cm.

In my 6 week post-natal check the consultant told me that next time round was likely to be a lot quicker as the cervix has 'done it before'

The other thing is that if you do opt for a VBAC and fail to progress again, they won't try to induce you this time around. They'll just jump straight to a C-S so in a way it may be the best of both worlds?

Mears' advice, is, as always, spot-on. I think there are probably several reasons why they would not recommend an elective cs as a matter of course - it is a major operation and the recovery period would generally be longer than with a natural delivery. On a completely unemotional level, it also costs the NHS more so it is discouraged unless there is a sound medical reason for it. A vb is also usually better for the baby (as long as no complications). As already suggested here, it would probably be useful for you to discuss your fears of vb in depth (counselling?). I can empathise with your fears as when I had dd I suffered a cord prolapse which meant a mad rush into theatre. I was v. worried about this happening a 2nd time but after speaking to my midwife and GP I have been reassured that the chances of a repeat are slim. Tbh, I think the majority of women have varying levels of anxiety about labour - particularly if they've been through it once already (even more so if the 1st birth was not straightforward). However, every birth is different and I imagine that the chances of you having a similar experience to the first time are remote - no-one wants to put you or your baby at risk and therefore I doubt if the obs would even recommend a vb unless she felt it would be ok. It does sound as though she is not very sympathetic though - I would discuss further with the midwifes if you can and maybe see if you can change your obs. You do need to get this sorted asap - no pregnant woman should have to suffer this stress. Good luck.

Sorry did not mean to offend anyone with the expression carved up.... but that is how I felt even though it was planned due to a frank breech presentation. Sorry again!

BarbieDoll - I'm so sorry you are going through this. My experience was v similar - nightmare birth with DS which ended in a crash section and was possibly the most terrifying experience of my life. I was terrified when got pg with dd and determined to have a c-section. No one saw any problem with that except the consultant who said 'wait and see'. When I burst into tears she seemed genuinely shocked - she did a complete about turn and booked me in for a section then and there, then went over my notes from previous birth to see if she could alleviate the trauma!! Unfortunately she couldn't make head nor tail of what had gone wrong with DS either, so I remain traumatised but I least I got my section.

I think you should get in touch asap with her via the hospital and make it quite clear how you feel. Explain that had you realised that the section would be a problem earlier in the pregnancy you would have got counselling to address your issues but as you were led to believe you would get the section you have left it a bit late for all that. Make sure she understands the severity of your fear. Failing that, ask to be seen immediately by someone else. Go via your midwives if you are worried about approaching the hospital. Keep us posted.

At 36 weeks I think talk of counselling etc is really unrealistic. This baby may well come in two weeks, or four weeks.
I have had no opposition to my desire for a section this time round (had one first time for placenta praevia) and my consultant told me that while there are certain risks attached to an elective section they are absolutely tiny - to quote (roughly): 'you could say a risk is doubled, but double nothing is still nothing'. She also said that research showed that while sections before 39 weeks were more likely to see the baby go into special care, there was no increased risk if the section happened at 39 or 40 weeks. I was due mine yesterday (39+2) but have hideous flu so am delaying until due date (unless nature intervenes). I have been told categorically that I can still have my section if I go into labour, and that's fine by me too. I think what BarbieDoll needs is absolute reassurance that she will not be forced into having a vaginal birth against her will, and that even if she goes into labour the option of a section is still available and may even be the best possible outcome (ie sure that the baby is ready to be born, but also not having to endure labour as it was clearly so very traumatic). I think you need to make an appointment ASAP in which you really make it clear how important this is to you BD. Cry if necessary. Say you have researched this and know your risks but that you feel sure you don't want more children and are prepared to take the risks of a section but you are being made ill by worry. I wish you luck.

At 36 weeks I think talk of counselling etc is really unrealistic. This baby may well come in two weeks, or four weeks.
I have had no opposition to my desire for a section this time round (had one first time for placenta praevia) and my consultant told me that while there are certain risks attached to an elective section they are absolutely tiny - to quote (roughly): 'you could say a risk is doubled, but double nothing is still nothing'. She also said that research showed that while sections before 39 weeks were more likely to see the baby go into special care, there was no increased risk if the section happened at 39 or 40 weeks. I was due mine yesterday (39+2) but have hideous flu so am delaying until due date (unless nature intervenes). I have been told categorically that I can still have my section if I go into labour, and that's fine by me too. I think what BarbieDoll needs is absolute reassurance that she will not be forced into having a vaginal birth against her will, and that even if she goes into labour the option of a section is still available and may even be the best possible outcome (ie sure that the baby is ready to be born, but also not having to endure labour as it was clearly so very traumatic). I think you need to make an appointment ASAP in which you really make it clear how important this is to you BD. Cry if necessary. Say you have researched this and know your risks but that you feel sure you don't want more children and are prepared to take the risks of a section but you are being made ill by worry. I wish you luck.

BTW, I didn't feel 'carved up' at all!

Message withdrawn

Socci, the revised NICE guidelines do suggest that maternal choice should be paramount, but that choice should be informed - ie women should be told about risks. Which I do think is fair enough. There is evidence that counselling to persuade women to have a vaginal birth makes no difference whatsoever to what women want and may therefore be a complete waste of time and NHS money. That is not to say that I think women who have had traumatic births shouldn't have counselling - I very much think they should, and ideally early on, plus a debrief on what went wrong - but that counselling with the sole aim of putting people off sections is pointless.

Message withdrawn

I so agree. An informed choice doe not mean give information on the side I want you to choose. It means give all of evidence for both options and let the mum to be decide. Why are we dabating what is best here anyway. This thread was started voicing a clear preference for a caesarean. Th epatient has spoken. She isn't seeking information on VBAC. She wants a c-section.

Good point Uwila. The Consultant who queried my choice at 36 weeks asked why I was opting for a section. I told him that it was because of the nightmare I had had first time and guess what? He didn't even know that I had already had a baby. He hadn't even looked at my file. How could he possibly be telling me what was best? I stuck to my guns.

I am pregnant with my second child now (thinkI may have mentioned that already?) I asked to see a consultant at my 16 week booking appointment. The first thing she said was that is was way too soon to be discussing it. I said why? I want to gather the facts and have along time to ponder the options. If I wait until 36 weeks to come and talk to you then I'll be in panic mode before you even meet me. Basically I told her I wanted a planned c-section. She didn't exactly encourage it but said that we could meet again at 36 weeks and if I still felt that way I could have an elective scheduled for week 39.

Although when I read what she had written in my notes, her summary of the conversation was more like I just wanted to atalk about the options and I didn';t know what I wanted. So added my note to reflect what I wanted and said she agreed to it.

Good on you Uwila! Put it out of your mind, enjoy your pregnancy and sock it to them at 36 weeks!

haven't read all of these posts and am at obstetrician's response to you

but could it be an issue with terminology

ie she will agree to an elective section but in week 40 (my hospital likes to do them at 39 weeks), if you go into labour beforehand then they'll do a section ....but it will be called an emergency section as that is the term they use for any section not pre-booked in

sorry if I'm repeating someone else (and I might be wrong, but that's what I was lead to believe)

I had an emergency section with DD due to brow presentation. When I first went to the Drs to have the pregnancy confirmed, I asked if I'd be allowed to have a section. They told me I couldn't. I was induced and after 22 hours of labour, was given my section I'd wanted al along.

When I found out I was expecting the 2nd time, I insisted at every appt that I wanted an elective section. I met with the consultant at 36 weeks, expecting to have a fight on my hands but they just siad 'Yes, we think a section would be best too' I was shocked. She even went and got the diary to give me a date to have it done. DS was born at 38.5

once they had agreed to the 2nd section, I was told that if I went into labour before the date, I would automatically be given a c-section.
I think you should see the consultant again and tell them your fears.

BarbieDoll5

Good luck with your fight - I think everyone who says that you need to get in touch with your consultant ASAP and put your 'case' again is right.

You mention at one point that you are scared at perhaps blaming your baby if you have a traumatic birth. I think for most women (not all I accept), while there may be issues to resolve afterwards, the baby won't get the 'blame'. I also failed to progress with DS1, he was getting too distressed while I was stuck at around 8cm and so I had a c/s. For too long afterwards, I was hung up on what had gone wrong with the birth. Wiser friends pointed out that it had been an incredibly successful birth because I had a lovely, healthy son.

I chose to opt for a vbac with ds2 and thought that I'd had the successful birth I'd not really achieved with ds1. However, I tore really badly and now am advised that I shouldn't consider having another natural (vaginal) birth. I attach no blame whatsoever to ds2 for this. I know that looks silly as I've typed it, but what I mean is that the consequences of his birth don't seem to attach to him in the way that they did for ds1 - I hope this makes some sense to you.

However, I would stress that I had made the firm decision that a vbac was for me and I wouldn't promote it lightly. Mears I think points out that a great mw will help you with the breathing etc - this was my experience exactly (no helpful mw with ds1, absolutley brilliant mw with ds2 who taught me about the breathing, and how to use gas and air).

Personally, I think that the reason ds2 seems to me the more 'successful' birth is because I was more in control. If for you, to be more in control means to opt for an elective caesarian, then that is absolutely what you should demand.

Good luck again.

Barbiedoll I;ve had 3 sections.

1. failed induction at 40 weeks (didn't dilate at all)
2. elective - big baby and consultant felt that I had low chance of success
3. section following trial of labour (did jack all- didn't dilate)

What I will say is that labour number 1 and labour number 3 were totally different. If you've had a previous section they don't fiddle with you (they can't). They can't use syntocinon to speed up labour, they can't induce you, they won't let you go on and on. My recent birth announcement gives more details of number 3 (its titled something like jimjams mark 3 finally arrives or something similar). IN my notes it said something like "no augmentation of labour, no induction, early recource to c-section" I also wrote in my birth plan that I would rather go to section as soon as it looked as if it was going awol.

A good book to read is Michel Oden't book - the caesarian- he is hugely in favour of what he calls "in labour elective sections" rather than the traditional booked in at 38 weeks section. It made me feel very positive about giving labour a go, and the section I had was fine (pretty much best of the bunch I would say- and I was dreading it).

Please don't let your fears spoil your pregnancy. When I found out I was pregnant I sat and cried for a week as I was terrified about having another section- really scared, managed to convince myself I would die. And in the end it was absolutely fine. So much so could almost imagine doing it again (- not! 3's enough!)

Hi Jim Jams - where did you get the book from - sounds like a good read as I ponder my options!

the local bookshop- it's on Amazon but a long delivery maybe a local bookshop will have it.

Hi everyone,
just to let you all know that I went to see the midwife and explained my fears and how i felt. I got quite emotional and she didnt hesiate to book me in for elective on 2nd march !! yes!!

(Which I will actually be 38+5) She even agreeed that I would not have a trial of labour unless i decided i wanted to. Se was so much nicer and mopre sympathetic than the obs.

BD5 x