Help me decide - should I ask to see another consultant?

[MyNameIsInigoMontoya]

Here's the background (sorry, bit long):
I had EMCS with DS1 due to failure to progress - he was a big baby with big head and in a bad position ("stargazing") so I was not dilating properly. Am now PG with number 2, so I am automatically on the "high risk" list and have to decide whether to try for VBAC or ELCS this time.

I had an appointment with the consultant after my 20-week scan to discuss the options, but was VERY disappointed. He was over an hour late, then his whole body language and tone was very dismissive and "go away I'm busy". DH and I had read up on VBAC and we are keen to try for one rather than ELCS, but had lots of questions about options, risk factors etc. But the consultant didn't seem keen to discuss anything - all he told us was that we had to decide between VBAC and CS, and that the main factor was how many more children we thought we would want - "but you won't know that anyway as nobody ever does in advance", then he gave us a leaflet to read and told us to come back at 36 weeks. That was about all the info we could get, and I did think it seemed a waste of time and he could just have put the leaflet in the post or something if that was all he was going to do!

Ironically I looked at the leaflet later, which said something like "your consultant will give you an assessment of your individual chances of successful VBAC, based on your history" - this was one thing I was hoping he would do, but he didn't mention ONE word about DS's birth or my personal circumstances/chances of VBAC, only the "average" rates. However he is the person who actually WROTE the leaflet!

I discussed this with my MW afterwards and she was surprised at how it had gone, and said that if we wanted, I could ask for another appointment with a different consultant to get all the information I would like - that would mean a special trip to the hospital and arranging care for DS though. The alternative would be to wait until 36 weeks and then see the (same) consultant again, but that just seems a bit late given that he didn't really answer any of my questions, plus I don't really want to get the same attitude again.

So - am wondering what you would do, and whether anyone else in the same situation got more useful information from their consultant appointment or not? I am already pretty sure I want to try for VBAC, but would like to know more about my options wrt things like monitoring, what happens if I go overdue etc etc. Also I don't really know how much influence your consultant has over your actual birth experience, and whether seeing a different one would be likely to make a difference? Thank you!

16 weeks is a long time to wait to get a clearer idea of your best options are. For the sake of your peace of mind, I would go through the inconvenience of arranging another appointment.

And hopefully, the second consultant will be less of a tool and will actually CONSULT with you, which it his/her job, after all.

I'd also want to see someone else for a proper consult. Hope you can get things all arranged ok.

Not had your experience, but do know how good it is to have a properly supportive consultant. They do exist, so ask to see someone else!

My tuppenace worth - i was sent to see a consultant and i didn't even know why, i even asked her why i was seeing her and she remained vague!! I was shocked and didn't really get my act together enough to ask what was going on, she asked all the rest of the questions.

She booked another appointment with me and during the wait i pulled myself together ready to get some asnwers. When i got there i was seen by someone else as she was away - a totally different experience, she explained everything.

Moral of the story for me was that sometimes another person is able to meet your needs/discuss your needs better. In future if i felt i was not having my questions answered i would not hesitate to have the MW help me get an appointment with someone else!

At my hospital they don't discuss your birth plan/options until about 34/36 weeks when you have an apoointment then.

Perhps its just the way they do things rather than fobbing you off. Lack of info is poor though since you specifically asked.

(and i know what you mean about it being a bit late as DS came at 36 weeks so i had another EMCS!)

My sole contact with my consultant was after my 12-week scan. It was brief but she did give me an assessment of my chances of VBAC - over 90%.

She said I'd have to come into hospital at the first signs of labour for constant monitoring, and my antenatal midwife said the same. However when my waters broke and I phoned the labour ward, even though I made sure they knew it was a VBAC they still didn't want me to come in until labour was well established. So a lot depends on who is on duty at the time.

I had a second appointment with the consultant at 41 weeks but gave birth 5 days early, so I never saw her again.

I'd be inclined not to bother chasing up your consultant, to be honest.

Hope all goes well! It did with me (month old DD now asleep on my lap).

Thanks all! I am going to think about it a bit more, but am now leaning towards seeing another consultant after reading your comments - one who will actually "consult"!

Well that meeting sounded like a complete waste of your time. Makes you wonder why he bothered to turn up at all! I would definately arrange to see another consultant for your own peace of mind if nothing else.

Bar my own very limited experience I know very little about problems in childbirth. However, that said I would definately recommend googling 'optimal foetal positioning' as it seems like you'd have had a much easier time of it if little one had been facing the right way! I did read that most women can birth large babies in the normal way so long as the positioning is good.

Good luck with whatever you decide

I'd ask for another consultant. Word of caution though - I had an emcs with my first (long labour, didn't really progress,baby in distress), v keen not to repeat so saw consultant who was very helpful and talked through my previous birth (he actually delivered DD1) and he was positive about my chances of vaginal delivery. So I went for that option feeling like I'd had good advice. But with DD2 had almost an exact repeat of first birth experience only he came faster and it was far scarier. I felt the midwives didn't have all the facts about my previous labour and therefore didnt identify what was happening quickly enough to avoid another general anaethetic/scene from ER type nightmare. I wish with hindsight I had demanded to see a doctor as soon as I got to hospital. I do wish I had opted for an elective with DD2, but maybe I would have always wondered if I could have done it naturally and regretted it. As it is I have two healthy, happy boys but do feel cheated at having missed both their births and having held them for the first time with tubes in every orifice. I'd fight for your right to make informed choices and stick up for yourself now and when your baby starts coming! Hope all goes well.

Your experience sounds like mine at 20 weeks. I got the wobblies about the 'terms' of a VBAC before my 36 week appointment and my midwife arranged for me to see the consultant midwife instead. She really allayed my fears and went over the circumstances of my emcs and arranged for me to be allowed to labour in a normal midwife-led unit and in a pool if available. (see this thread for more info on how a positive consultant can make a difference re. VBACs).

I'm overdue, baby hasn't dropped and it's head is to one side so I'm not sure what my chances are at the moment, but I remain hopeful!

Ooh hobnob I would love to be allowed to use the pool again! I started in the pool last time round (till it all went pear-shaped) and found it really good for me.

Well I saw the MW yesterday and have decided for now not to bother with another appointment - though I can still ask for one later if I get the wobbles. Main reasons are 1) that she gave me some good advice herself (although she is not based at the hospital), 2) that she said the consultant I saw is normally quite good and she was surprised at my experience - so I'm hoping he will be better when I see him again (and am going to make SURE he does answer my Q's this time!), and 3) I just have so much on right now - about to move house among other things - that it would just be extra stress to go at the moment. But all your advice has certainly made me feel more positive and also more able to ask for what I want at the next appointment, so thank you all for that.