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Childbirth

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

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Original poster

can i insist a c-section or is it out of my hands.

23 replies

dooky · 11/01/2009 18:30

Hi, i had a difficult birth with first daughter. was induced, had epidural and a LOT of stitches before giving birth to a 9lb 10oz little girl. I have been told that this is going to be an equally large baby and i cant bear the thought of going through that lot again. can i insist on a c-section ?

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LackaDAISYcal · 11/01/2009 18:37

You can discuss your options with the consultant and given your previous difficult birth it's probable that they will do a c-section, however they will probably encourage you to go for a natural delivery, because it's less risky than a section for both you and the baby.

there's no guarantee it will be as difficult this time around though, perhaps a trial of labour with an agreement to proceed to CS if things are looking bad?

iwantitnow · 11/01/2009 19:13

I'm 30 weeks currently and have had a couple of consultant meetings. If the scans at 34 and 38 weeks show that the baby is likely to be above 4kg (just under 9lbs) then they would be happy for me to have an elective. However, I did have an emcs with my first due to pelvic disproportionality. My DD didn't even enter my pelvis after 24 hours of induced labour.

Get an appointment to see a consultant as early as possible.

There are huge disadvantages in having a c-section especially with another child.

lilimama · 11/01/2009 19:23

iwantitnow...
I'm interested in your post as I also had a not engaged baby after more than 70 hours of labour resulting in a section. How was your pelvic disproportionality diagnosed...by scan or something?
Just wondering as I'm now 12 weeks with DC2 and hoping for a VBAC. Where I live the medics bandy the old pelvis too small issue about really happily but I want to actually find out for sure.
Thanks!

chancelloroftheexCHEQUERS · 11/01/2009 19:28

Dooky, I want to know the answer to this myself.

I had a difficult labour (stuck baby) and large baby (9 pounds 11).

Interested in this trial of labour idea as I can't face another instrumental delivery (ventouse, forceps, episiotomy).

I don't know the answer, but offer you a virtual hand hold.

violethill · 11/01/2009 19:33

As others have said, you need to speak to your consultant.

But the size of the baby doesn't necessarily mean you'll have a hard time. There is not logical reason why you should need to be induced again, and it may be that you want to push to not have an induction, rather than push for a CSection.

The epidural would have increased the likelihood of further interventions and stitches, so it may be worth looking at other options there too.

Lulumama is good on this - so maybe she'll be along soon. I believe she did it the other way around - CS first time and then a VBAC which she felt a lot better about!

I have had a CS and although you avoid the pain of labour and birth, it is major abdominal surgery - you will be laid up for a while afterwards and that won't be easy with another child already.

iwantitnow · 12/01/2009 10:33

There is no test for pelvic disproportionality. They can't really know until you try and go into labour. In my area they try and tell you it doesn't exist or is extremely rare. However, as DD was pulled out they said her shoulders were too big to come out - DD had a 98th percentile head. This baby currently has a 99th percentile head but awaiting more scans. Its not the actual weight of the baby thats the problem is the size relative to you. I'm only 5ft and a small frame and genetically seem to have big babies.

snowleopard · 12/01/2009 10:40

I was very scared of giving birth - not actually because of the birth but because I can't bear internal exams. When they asked me about my birth plans, I burst into tears because of this. I was offered a CS on a plate. (I actually wanted a normal birth, and tried with an epidural, but ended up with a CS anyway as I didn't dilate enough and DS was big.)

I do agree that a CS is NOT a walk in the park, and you need as much help as you can get afterwards - do consider it carefully. But if you really want one, don't be shy about letting them see how worried you are. It is a valid reason for a CS, IMO (and that of several midwives and doctors who dealt with me), if you are very scared or worried.

MrsTittleMouse · 12/01/2009 11:21

I was offered a C section with DD2 due to the trauma of DD1's delivery and the sorry state that my bits were in. There wasn't a problem with it at all. In the end I decided to try for another VB though, with the proviso that if anything started to go wrong that I would have a C section. This was after getting lots of medical opinions and doing lots of research. And I had a pretty good VB experience, even though it was a longer labour than I had expected. It's well worth talking to the midwife and consultant to check out you options.

cali · 12/01/2009 11:24

Had a bit of a struggle to get CS for dd2. After dd1's delivery, nothing could persuade me to even try for a vbac.

Was told that the same thing might not happen but that they couldn't guarantee it wouldn't, so went for an elcs, best thing for me but realise it wouldn't be everyones decision.

treedelivery · 12/01/2009 11:25

Be reassured by Mrstm, people assume the medics will want to do the opposite of what we want them too and ther will be a fight. The obstetric team will be happy to discuss the plan with you and weigh up pro's and con's.

MrsTittleMouse · 12/01/2009 11:29

treedelivery is right - I geared myself up for a fight and took DH along to back me up. Then I described DD1's birth to the MW and she suggested a C section before I did!

treedelivery · 12/01/2009 11:30

ooo and it's a good start to have a look at the nice guidelines on c/section for your own knowledge, and to be able to enter into a good 2 way discussion when you have your appointment. You may have done this already but if not they are all on line to be downloaded in pdf. Good luck with your decision making and delivery

traceybath · 12/01/2009 11:37

I think if you've done your research and put your case forward sensibly and calmly to the consultant you're more than likely to get a c-section.

I had an emergency c-section with first DS and then an elective with DS2. I'm small and both babies had 99th centile heads and according to surgeon wouldn't have come out vaginally.

Am currently pregnant with number 3 and will probably have a c-section again however for me its a harder decision this time as DS2 had breathing problems at birth (was 3 weeks early) and was in NICU for a week. I guess i blame myself and the c-section for this and wonder if i'd done it naturally if this wouldn't have happened. Pretty irrational as don't think he'd have come out vaginally but hey - since when would being sensible or rational stop a mother feeling guilty.

treedelivery · 12/01/2009 11:46

I nearly whispered I was considering a section whilst looking at the floor and I could hardly look up. When I did they were all just looking at me and nodding and smiling.
Burst into tears of relief and offered to hug the mw. She backed away at that point
Didn't opt for it in end btw, for various reasons - it would have been today.

witchwithallthetrimmings · 12/01/2009 11:50

If you have had a previous section the protocal is that the choice to go for an elective or not is up to the woman. There is just no way of establishing categorically whether an elective is safer for mother and baber than a trial of labour which may end up in an emergency section. There is also the emotional side, many woman rightly just cannot face the possibility that they may have to go through exactly the same thing again.

so don't think about is as a battle it is up to you. Treat the meeting with the consultant as a chance to ask about procedures and for evidence rather than to fight your corner.

good luck
witch
p.s. am now 40+4 days had emergency secion with dc1, booked in for section on wednesday

CoteDAzur · 12/01/2009 11:59

Of course, there is a test for pelvic disproportionality. It's called a "pelvis scan" - basically, a low-powered x-ray of your pelvis, with measurements that show various points of your pelvic passage, size of baby's head, shoulders, etc. I had one when pregnant with DD.

Still, all that shows is the bones. It does not take into account the soft tissue (i.e. your lady bits) that may or may not stretch enough to permit the passage of a large baby without tearing/episiotomy.

madwomanintheattic · 12/01/2009 12:01

witch, not in all circs.
i had a cs with dd1 (she was scanning large and the german obs was not prepared to take a risk - i'm small) and was not given the option of cs for ds1 or dd2, despite asking on both occasions whether it was an option. cs was narrowly avoided with ds1 (he was back to back and wedged despite that awful james herriot turning technique), and dd2, well, that's a whole different story.
i'm not great at vb tbh, and now have a consultant's letter which says if i have dc4 i should be given a cs. (dd2 has a birth injury)
dooky, just be calm and firm, and discuss your options. ultimately it depends whether your consultant believes it is in the best interests of you and your baby. i do often wonder whether if i had been firmer with the consultant about a cs, dd2's outcome may have been a little different.
good luck - i am sure it will all be fine either way.

witchwithallthetrimmings · 12/01/2009 12:09

have a look at the NICE guidlines, (page 39 of this document). It clearly states that the views of the pregnant woman are one of the most important criteria

see page 39

madwomanintheattic · 12/01/2009 12:47

one of the most important criteria that are 'considered' lol. lots of others to take into account
so it is not your choice whether to opt for cs, whether you have had a previous cs or not, but under NICE guidelines your wishes should be taken into account - whilst the doc makes his/her own decision lol. they could still decide vb despite your wishes.

ohmeohmy · 12/01/2009 13:32

have you seen bigbabies.org.uk?

ohmeohmy · 12/01/2009 13:33

sorry that should be bigbaby.org

ohmeohmy · 12/01/2009 13:33

sorry that should be bigbaby.org

blueshoes · 12/01/2009 13:48

You can get a cs on the NHS for psycological reasons even for a first birth. This is something hospitals (understandably) don't like to advertise.

Read up as much as you can. Make an appointment with the consultant and ask him/her about the statistics and likelihood of you tearing again. Show that you have considered and taken on board all the risks. Ask the consultant whether he/her can guarantee you will not tear/end up with an emergency cs because your fear is causing failure to progress. The answer is of course, 'no'.

Then very matter-of-factly say you have considered all the risks and that you want a cs. If he/she refuses, ask to change consultant. If that does not work, ask to change hospital.

Keep at it. They have to give it to you.

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