Can anyone here give me some feedback about having a C section when overweight?

[badassfeline]

I am having a C section on the 10th and I am scared out of my wits. All through the pregnancy, I was dead set against a section because of the fear of the risks involved. I have known for a few weeks that I would probably end up with one (Macrosomic baby, Insulin controlled GD, and Oblique presenting baby)

I am quite overweight, (size 22 pre pregnancy) and one of my biggest fears is that due to my size there will be complications and I will bleed to death (!) I know it sounds totally melodramatic and stupid, but I can?t shake off this fear at all. I am scared of not being there for the baby, and never seeing my family again! I have done loads of searching and reading about the process and am aware of what goes on. I really wish I could have had a normal birth but that?s not going to happen. I keep moping around the house, and bursting into tears. It?s totally taken over any excitement I had about having this baby, and I don?t know how I will get through this next week. Two of my closest friends have had sections this past year, and they said how great their experience was. I don?t doubt them and I have read on MN that a lot of women really enjoyed it too. I am just so scared because of my weight.

Is there anyone who is overweight like me, that has had a C section, and it all turn out OK? Are you more likely to have major problems DURING the surgery because of weight? I know the recovery is tricky whoever you are, but this whole thing has driven me to distraction.

TIA

I was a generous size 18 when I had my last section. All went well and there were no complications at all. I also had no complication with the emcs I had to go through when having dd1.
Not sure what else to say as I'm firmly in the 'don't read around whatever you do!' camp and didn't know about any risks

I wish i hadnt read around now! I have heard so much tragedy about sections online, that I don't think that has helped my fears much!

I think me and Dorris could be twins as I was also a geberous size 18 and had no problems and I choose not to read about the risks too much either

Are you more likely to bleed if you are overweight?

I don't know.. Its probably irrational thinking on my part, but i think that because of the extra fat and tissues to cut through, i am scared that it will involve loads of blood loss..

Although writing it all down like this has made me think about how stupid I am probably being as it all sounds ridiculous written down.. I just wish i didn't keep thinking 'I'm gonna die' 100 times a day!

Make this your mantra:
I shall not think, I shall enjoy
I shall not think, I shall enjoy!

By the time I got to your stage with Dd2, I knew she had to come out someway so the argument was pretty academic

If you are really so scared though, please speak to your GP or consultant.
I'm sure things will be absolutely fine. Looking forward to reading the birth announcment x

I wish I had had time to chat to the consultant about it before they sent me on my way, but now I won't be seeing anyone before the D day. I am actually being admitted the day before (don't know why)so maybe there will be someone on the ward who I could chat to beforehand. I would have thought I am not the only weighty patient they have had in for a section?

Thanks for replies. I appreciate it a lot.

Cant you book an appointment with your midwife or doctor to talk about your concerns?

If there were any issues with your weight then I'm sure the consultant would have mentioned it.

But I think you should try and talk to someone to reassure yourself

badass, I know others are encouraging you to not read about all the bad stuff that can happen and just try and relax and enjoy but the fact is that you ARE worried about these things and you have obviously read stuff online and have gotten as far as posting abou it on here so I am going to address the question you posed.

There are certainly additional risks associated with having a section and being overweight but bleeding heavily is not usually that much greater than a person of average weight. However, you do mention that they think your baby is macrosomic. Having a large baby (and therefore a potentially large placenta) is one of the risk factors for bleeding a bit more heavily. What weight are they actually estimating for this baby?, please note that growth scans are notoriously unreliable and inaccurate. You are at increased risk of having a large baby by having IDDM though so it is reasonable to be doing growth scans.

The oblique lie is something that can change from one day to the next - is this your first baby? When you've had a few babies, they tend to get themselves into awkward positions a bit more easily.

The main risk factor for being overweight and any abdominal surgery is infection, particularly if you have a large "overhang" tummy where the scar will be.

Ok, that's all the negative stuff, here's the positive bit....

In terms of your main concern - heavy bleeding. There are four main causes of heaving bleeding after having a baby - uterus not contracting down, vaginal Tears, retained placenta and blood clotting disorders. The easiest of these to deal with is the uterus not contracting down because there are some superdooper effective drugs that can be used to combat this. In your case, from what you describe, your main risk factor for bleeding is from having a big baby, therefore, large placenta, therefore, slower to contract down.

Ok,so maybe that was a bit brual and honest but I think you were looking for honest answers. Whether or not it puts your mind at rest I don't know but I hope you are reassured by the fact that IF you do require a section and IF you do bleed then you're in the right place for it to be dealt with and it is more often than not very easily dealt with.

I was a 24 pre-pregnancy and I had a cs due to a failed induction(at 40 weeks as they predicted a big baby) and then he refused to budge!

By and large it was ok -my horror story was that the spinal did not work properly and I ended up with a GA-very scary as they hustled DH out of the operating theatre but it was then over quickly (much worse for DH waiting outside, but they brought new baby out to him 5 mins after birth) and I was awake within an hour and got to hold him and feed him pretty much straight away.

I dont know if that was due to my weight, I think I let myself be convinced that it had worked before it had (apparantly they did not have to give me much GA so the spinal just kicked in a bit later). I would still try for a spinal again but would be absolutely sure i had no feeling before i let them go ahead with the section.

Other than that I had no real problems, recovered quickly and was out of hospital 2 days later (albeit with a wonderful husband who would not let me do anything but feed for at least 2 weeks.) You do have to be careful with the scar-I spent as much time as poss lying on my back holding my tummy up to let air get to the scar.

I really did not mind the section(although could have done without GA) and the bit I found worst (yes really) was spending 2 days with them trying to induce me so both dh and i were exhausted by the time we got to the cs.

Hope I haven`t scared you with my story, I promise I was not traunatised or anything else. I found out as much as possible beforehand and I think it helped that i tried to stay openminded about what would happen.

Good luck.

BTW -I did not have diabetes. The baby was 9lb3 so not huge, but surgeon said he was still very high (had to use forceps to get him out) and would not have been born naturally for at least 2 weeks and estimated 11+lbs so I was reassured we had made the right decision. HTH.

Two emergency sections at your size. Both were fine. Agree about being careful to let air get to your scar. Worst part for me was second time when I got very swollen feet afterwards which was a lot more uncomfortable than my scar but I don't think think it was down to the section.

The anaethetist sits up your head end and lets you know what is happening. Both mine were lovely and very reassuring.

Howdie

Thanks for the info! I AM worried but feel a bit better reading all these encouraging stories.. This is my first baby, and last week (36+3) baby was measuring 7lb 9oz (determined by scan) i am only 5 foot 1, also, so don't know if that has something to do with the OB's concern. I have been having (excellent) diabetic/antenatal care and have been having growth scans weekly since 30 weeks.

Baby has been Oblique since 28 weeks, and they don't seem hopeful h/she will turn head down.

Trock and Choc, thanks for your replies. I am grateful that you took the time to answer me. Trock - I do have a big tummy anyway, and something strange has happened since I got pregnant - I have a small amount of oedema which has made an 'overhang' definitely likely, so will endeavour to do my best to keep it dry post-op. The OB said the Oedema will go after baby is out - Just thought I would add that (!)

Thanks everyone - only 8 days to go.. Eeek!

badassfeline,
have just read all replies and agree. I had an emergency section after being in labour for 22 hours and pushing for 2. It was difficult (I was size 16-18) and I was knackered to say the least. I kept being told throughout my pregnacy that baby was going to be at least 9lbs and to worry, so I did! In the end he was back to back and his large head (thanks daddy!) got stuck so emergency section it was.. He was born via section 7lbs 5, how wrong they were!
I only wish I had not buried my head in the sand and read more about c-sections, the more you know the better. It is hard after, sore, not being able to put on your own pants etc... but its ok, it really is and you have a beautiful baby to look at and think, its all so so worth it..
You know whats coming so prepare and enjoy its the best gift x

Badassfeline, just wanted to add my story. Had an emergency cs with dd, I was a size 20 at the time. All was ok, apart from as with trockodile, she was high and they had to use forceps to get her out. I had no problems with the scar, just remember to keep it as clean and dry as possible, and was up and about very quickly after with minimal pain. My feet and ankles also got very swollen after the birth, good excuse to keep them up for a few days! Try not to worry too much!

2 sections here, size 20 first one bordering on 22 for second, absolutely fine, good recovery the only thing I wouls say is get some real nappy liners if you have a overhanging tummy as this stops the wound getting infected, kicthen roll works just as well, and get up as soon as they let you and regularly after that.

Good luck!!

I had two pre-planned c-sections at about the same size as you and the surgery was fine. Agree with everyone about infection risk though as I had infections both times due to 'overhang' . Big, old fashioned maternity pads folded in half and wedged under help keep it all dry. Good luck! x

I was 16/18 for first emergency cs and am an 18/20 now pondering elective or VBAC. I had a bit of a hangy tum before, but the cs has made this far worse. I still get a little rash there 20 months on, but after it healed found magic Sudacrem really helped, as do polo neck cotton pants to help it breathe.

Isn't excess weight a bigger risk for general anaesthetic rather than local?

Also, I have read about how being a larger mum means it can be harder for the baby to squeeze out through the fanjo due to fat in that area too. Honestly, the guilt you're made to feel for not being twiggy! Even our ladygardens are obese!!!

This is great! So much feedback, and so informative. I saw the Midwife yesterday, and blurted out the whole thing to her in a jumbled tirade without coming up for breath. She took pity and really did her best to reassure me, and talk me through my fears. She said that i had no need to be as anxious as I have been, and that the team who do the sections are great and the atmosphere in theatre is really quite jolly and jovial. She also said that they do about 5 elective sections for circumstances like mine a week and they tend to be on bigger girls so they are well skilled in dealing with any potential problems.

LOL @ 2Helenback. Fat Fanjos! So that's why I had problems having my HSG? (speculum kept shooting out - Added some well needed humour to that situation I can tell you..)