Interesting feedback from consultant obs. regarding CS

[bubble99]

For anyone who is considering a CS for whatever reason but is worried that they may be put off by clinical staff. I spoke at length to the consultant who had been in charge of my recent antenatal care, but not, unfortunately the delivery. She said that if a woman asks for a CS, her junior doctors need to give her (the consultant) compelling evidence as to why she should not have one. I, for one, had always assumed it would be the other way round.

Intersting bubble. Thanks for that. I am now 36 weeks pregnant and have an appointment with a consultant to discuss caesarean (I absolutely want one -- no doubts or shades of grey involved with me). But, of course when I mentioned this at my 16 week booking appointment the whole conversation was discouraged. Good thing I'm not the bashful sort.

Hi uwila. With hindsight I would have never entertained the idea of attempting a VD with my twins Good for you. Stick to your (seriously loaded ) guns.

yes that is interesting. I was like you uwila. I was determined to have a CS after my ds was born by emergency and I was told by doctor my pelvis was too small. Four yrs later in different hospital (we moved) I asked at 22wks for an elective cs and was told by registar that my consultant would not way allow it. I arranged to meet him and have my notes sent from previous hospital. Eventually at 32 wks (it took that long to get notes) I met him and even though he had my notes he absolutly refused me quoteing "I cannot comment on what another hospital told you so I am not giving you a section, you can have a trial of labour" I was beside myself when I left him and burst into tears in front of the midwife and demanded to change consultant. They were a bit put out but agreed and after two very stressfull appt with my new consultant as she didnt want to go against the other consultant she eventually agreed to book me in at 39 + 5 days so cutting it fine (excuse the pun). I then thought that if I went into labour naturally I would give it a go after reading all the info on mumsnet about vbac's. But thankfully that didnt happen and she had a lovely delivery. Sorry to go on but I think you should push for what you want and not allow bully consultants sway you. Good luck ...

bubble99 - please do not blame yourself for attempting a vaginal delivery with twins. Many twins are successfully delivered that way even with first pregnancies. Had you received adequate care Bo would be here too. Quite frankly you should have had your request for C/S listened to at the time.

IME, women who are requesting C/S at our unit have their reasons discussed with them - are informed of the risks of operative delivery and therefore make an informed choice. Sometimes women ask for C/S without any knowledge of what that entails and they subsequently change their mind.

Uwilla would have no problem getting a C/S IME.

I still cannot believe what happened to you Bubble.

Ah, but you don't work at Queen Charlotte, do you Mears?

I did incidentally discuss this with a consultant back in December. She didn't want to talk about it, said it was too soon. But, when I asked her point blank if I still want one and request one at 36 weeks, can I have it? She said that if I insisted she I could have one at 39 weeks. I think I will get it. But, I am mentally preparing myself for lots of resistance. This said 36 week appointment is on Thursday... wish me luck!

Uwila - I am sure you will get the C/S you want, no problem

Uwila. If you CAT me I'll give you the name of my consultant at Kingston. The maternity unit is however horrendously busy, no space available for July this year. In the event of any unwillingness to let you have a CS, although as mears has said, I'm not sure why there would be, could you ask for a referrral to Kingston via your MW/GP?

mears, no I still can't believe it either At the enquiry I asked The Head of Midwifery Services how she would have handled my care. She pointed to a section at the beginning of the armfuls of CTG traces and said

Ah, thank Bubble, but this brings an interesting chapter to my Hospital Saga. I tried to get into Kingston many months ago, when I was 6 weeks pregnant, and they said they were full and couldn't take me because I'm outside their catchment area (I live in Sunbury). I did then and I still do regard their response as a load of crap. I was 6 weeks pregnant six weeks and they were already full? Oh come on, not everybody goes to their GP and writes the hospital that fast. It's about NHS budgets and closing their services to those who live outside the catchment area. My GP incidentally is in their catchment area, but they still said no. As did West Middlesex. Anyway, I landed at Queen Charlotte, which I am quite happy with in terms of the hospital quality and reputation. I have my appointment with the consultant tomorrow, so it may be that it all goes well. Hopefully...

uwila, I just can't understand the resistance to cs you are experiencing at QC. I had to fight so hard to get the chance of a vbac, as I was going against the hospital policy which is against vbacs and 100% behind elective cs after a previous one.

Good luck tomorrow .

Bubble - I didn't realise you were at Kingston. I had ds there and although the labour was fine the antenatal was shockingly bad. I ended up going to St Georges under cover of a pretend emergency to get real advice, but wasn't able to transfer. The consultants at Kingston were appalling imho.

In case anyone interested, I found what I think is the latest guideline on caesareans . In case my link doesn't work, latest guidline on caesareans at: www.nice.org.uk/pdf/CG013NICEguideline.pdf

I wonder, bubble, if this woman is one of those rare dedicated doctors who makes decisions based on her own training and expertise rather than what some guideline tells her to do in case of circumstance A or B or whatever. I wonder if this is her own view (and a good one in my humble opinion) or if this is the view of Kingston Hospital as a whole?

Hi uwila

I think it's her own personal opinion. She noted at our meeting that Kingston has a high CS rate and said vaguely

A friend of mine went into Kingston and requested an elective cs as her first had been an emergency. At 36 weeks the consultant she saw told her 'he'd like her to try a natural experience'. At 38 weeks she went back and saw someone different and was booked in, no question, for an elective at 39 weeks. So guess it depends who you get. I had dd at Kingston 15 weeks ago and I think it was quite clear to everyone I was going to end up with a ceasarian but they tried everything to make it a natural birth (I had good care all along - I suspect Bubble I may have had the same consultant as she was v. compassionate and caring when I was having problems (not remotely on the scale of yours). I felt quite guilty that dh and I had called her a scarey woman before we'd even met her !

Good luck Uwila.

We had DS at Kingston nearly 15 weeks ago (must have been there around the same time as Hazellnut) -- I was offered an elective CS up front (I think we may have had the same consultant too) but I wanted a trial of labour, then they did what they could to make it a natural birth but when there was failure to progress they were happy to go for a section with no messing about.

Which makes it all the more appaling what happened to you, Bubble -- there are staff there who would have handled you and the twins properly, but the luck of the draw meant that you didn't get them. That shouldn't be allowed to happen with something as important as this. It's shocking that the standard of care at one unit can vary so much.

Kingston's a huge and busy hospital and they're turning patients away at the moment. I changed health authorities at about week 30 and was really shocked at how patchy the antenatal care was in the new area - in my previous GP's surgery I saw the same midwife every 2-4 weeks and/or was referred to the consultant - there was no question of seeing a GP who didn't even have a sonicaid. Luckily I did meet the consultant who later carried out my emergency cs. A couple of hours later she would have gone home. What happened to you was so sad but it's not any of your fault, it's down to chance and lack of continuity.

Well, good news. I had my appointment today, and I have managed to persuade him to book me in for an elective on 19 May -- only 2 weeks away! Yippee!!! He actually didn't kick up a fus at all regarding my preference for a caeasrean. Since I had a previous one, he was happy to say okay. But when we got to the scheduling I had to dig deep into my persuation skills. I am rather nervous about waiting until 39 weeks because I live so far from the hospital and therefore if I should go into labour, how would I get there??? Anyway, we settled on 38 weeks +4. Yippee!!!

Happy camper I am.

Glad it went well for you uwila

good news uwila ! Good luck. Look forward to reading all about it !