are they likely to allow me to have a c-section?

[olivo]

i am only early days pg (9 wks) but today was chatting with my dr and said i was hoping to have a c-section. she has made me doubt whether they will allow me to. she says i should mention it at my first hosp appt then leave it and see. I had a traumatic birth with dd, she was op, i had a failed ventouse, and ended up with an em c-sec. dd was in a very bad way, not breathing for some time, had swallowed a lot of meconium so in scbu for a week but remarkably and thankfully, no long lasting effects. When i went through my notes with the mw, she implied that i could either have natural or cs in the future.

are they likely to go back on this? I'm now terrified.

don't be terrified

you have a case for a c-section should you want it, especially since you have already had a section, but as much as you want them to say that now they will want to keep options open a bit longer because it is very early days (congrats btw )

you do need to deal with how you feel obviously, now and not when you are 39 weeks. Can you start by talking to your midwife or obs about how you feel? Your mental health is an important consideration.

thanks madmouse. i wont see a m/w till about 16 wks but will bring it up then. I had conveniently forgotten the trauma of dd's birth but i guess i need to deal with it. people ( including my gp)keep saying 'oh, dont you want to experience giving birth?@ - not sure what they thought i was doing in that delivery room for all those hours but i certainly dont feel badly done by that my baby didnt come out of the front door!

Hospitals usually allow mothers to opt for c-sections if they have had one before. "Maternal preference" is one of the NICE guidelines for when a cs is the better option, as is *previous cs".

What an unhelpful response from your doctor! Of course you gave birth last time - does she think the baby was teleported out?

As you've had one section I think there's an excellent chance of you being offered another if that's what you want.

I'd be very surprised if you have any trouble getting a c-s if you want one purely because you've already had one.

I thought anyone who has had a previous c-section is automatically given the option to have an elective? Your doc/MW sound bloody insensitive and unprofessional, btw.

Push for what you want. It's your body, your baby, your choice.

No automatic choice, but if you insist and explain, why not?

you can request, and your request is importnat, based on what happend last time, i cannot see that you would be refused

it is worht debriefing your birth before this baby arrives

and also, if you find your consultant is not keen on you having an elective, you can change to someone else more sympathetic

The "don't you want to experience giving birth" brigade can piss off IMHO.

I must admit I thought that if you already had CS they always gave you the option on the next child. They may try to push "trial of labour" but if you're sure just stand firm and stick to your guns.

Try not to get worked up,I know how scary it is. I had emergency section with my ds, very bad, we both nearly went, but with my dd 10 yrs later I was all for a normal birth, but hey ho, It wasnt to be, I had a cs, but I requested it after my labour etc went the same way, I could see it all before me and that was why I had 2nd cs.

My point to you and other mums that think and feel the same is this, if you are scared, frightened, you wont labour properly, and if you dont labour properly then thats when the trouble starts.

Its a long way off, but if you calmly and reasonably speak to your midwife and consultant about your fears, they will take note and mange you through the pregnancy, speak with them about it when you see them, let them know that for you it is an option you want to have, you have to enjoy your pregnancy, dont let this ruin it for you.

Eventually this baby will come out one way or another, and they will want it to be the safest way for you and your dc, they will understand, give them the chance to listen and they will take on board everything you say and feel and come to the same conclusionas you, they are more than white coats, they have children too so will understand how you feel.

Good luck,

thank you for your reassurances, everyone. I am going to ask them to go through the previous notes with me again. last time, i was fairly relaxed about the whole labour thing, probably due to nct classes and books where they tend not to mention the really scary stories!

I suppose i am scared that i will give it a try and it will end up with the same , but maybe not be so lucky. the dr did say that they might suggest a trial of labour.

i will definitely bring it up when i go to the hospital. thanks for helping me to realise i am not making an unreasonable request.

Hi olivo sorry to hear you had such a rough time with your first. I am 32wks with ds2 and have a similar story to you, ds1 failed induction, emergency c section 2 days nicu due to meconium aspiration. This time I want an elective c section and had written all over my handheld notes that my first birth was the most traumatic experience of my life, went in all guns blazing when I got my appointment with the consultant, but was only in there 30 seconds he didn't even blink just wrote mother to have elective c section! No one has once even mentioned vbac to me.Good luck

ah, thank you pipsy. let's hope my consultant is like yours. fingers crossed!

I have never heard of anyone who has had a previous section being refused one if they want one next time. They consultant might talk to you about VBAC options and whether you would be a good candidate for one etc, but if you want another section you really won't have any difficulty insisting upon it as long as you are firm. If for some reason the consultant was obstructive you can always ask to see another one. When I went for my consultant appt with DD2 I was v worried they might refuse me a section but in practice when I said I would prefer another section he just nodded, checked me over and opened his computer diary to book the date.

thanks Nelly, i am finding it cheering to hear stories like this. I dont know much about my consultant, only that I didnt ever see her before my dd's birth, just afterwards!

Most hospitals now are recommending that women who had previous sections should try for a VBAC. This is in response to the high rates of sections in the UK. As they have policies and targets around this, consultants are very reluctant to agree to a section, unless at 36 weeks the baby is exceedingly large or presenting breech.

So be prepared to have to put up a fight if you want a section. I would say about 20% of friends have successfully argues to be allowed a section. The rest had to try for a natural birth.

olivo, although i do think you have an excellent chance of having a c.s, it might still be worth debriefing your last birth and to think about if you might want to give VBAC a go. if you are still traumatised, however you give birth could bring back memories, so you need to go through it all

lots of women who have c.s for failure to progress / failed instrumental delviery can and do go on to give birth vaginally,with no problem

it is definitely worth 'putting to bed' the previous birth trauma and aftermath before this baby arrives

Nelly - how long ago was your experience in talking to the consultant? Attitudes have changed a lot in the past 2 years. For myself, with theis pregnancy, I have been categorically refused a section (have spoken to more than one consultant) unless I am prepared to pay £15k to have it privately.

This is despite a birth very similar to the OPs last time, including baby in SCBU and me in intensive care. In the view of the NHS, what occurred last time is unlikely to happen again, therefore a c-section is not justified. As I said in post above, they now have targets to meet in which their c-section rates have to be much lower than in the past, so will only approve elective c-sections in a limited number of cases.

spacetrain, and olivo, if you are being refused the mode of delivery of your choice, you should ask to speak with teh supervisor of midwives who can intercede for you and help you . and www.aims.org.uk can also be a big help, as can changing consultants.

thank you all for your advice. yuo are definitely right that i need to get my head around what happened last time, and i shall try not to worry about whatever the final outcome may be. i am sure they said I could have either though, in my post-birth 'debrief'.spacetrain - 15K ? umm, won't be affording that!!

Thanks for the advice Lulu. I've already been in touch with AIMS as I want a waterbirth, which the consultant is adamantly against.

Interestingly though, everyone I have spoken to (including the consultant midwives at two hospitals an one person at AIMS) has said that you are not automatically entitled to a section. So I cannot request one under the right to have the birth of my choice. So I'm fighting for a waterbirth instead.

You are not automatically entitled to another c/s having already had one.

Having said that, it does seem that consultants are more lenient with women requesting an elective c/s for 2nd babies (at least where I live). I had an elective with my 2nd and encountered less resistance from the consultant than I thought I would when I requested one. My 1st was em c/s due to poor position and failure to progress after a long induced labour, therefore no reason to expect same again.

When I saw the consultant at the 'method of delivery' appointment at the hospital, I was indecisive about cs or vbac, the consultant was very light hearted about it, and just said 'Have the Caesarean' as if it was a toss up between a cheese or tuna sandwich. Didn't expect him to be so blasé about the choice.

If you have had a previous caesarean, you should never be refused a caesarean section for a subsequent birth if you want one.If you are, submit a formal complaint and contact the Birth Trauma Association. If you google the Royal College of Obstetricians and Gynaecologists Green Top guide on 'Birth after previous c-section' you will see that there are risks and benefits of VBAC and C-S but generally repeat C-S is a safer option if you are planning no further pregnancies and you have never delivered vaginally. VBAC carries higher risk of loss of the baby and much higher risk of uterine rupture although the absolute risks are low. VBAC is usually safer if you are planning a number of subsequent births and have delivered vaginally before. The latter is a bit of a quick summary so you should read the RCOG guide and then it is important to talk it through with an obstetrician as certain forms of surgery you had for the original caesarean can increase your risks if you are planning VBAC.

I had an emergency c-section with DD. When I was expecting DS, I requested a C-section at every single appointment (and I mean every single one lol)
It wasn't until my appointment with the consultant at 36 weeks that it was agreed, the even booked me in during that visit.
I felt a lot more relaxed from that point on, shame they left it so late and let me panic for several months!

Good luck with getting the birth you want, I think you have a good chance of being able to have a c-section.