Electing for a caesarean - advice needed please

[kissyfur]

Hi All,

I wonder if any of you mumsnetters would be able to give me some advice.

I'm 30 weeks pg with my first baby and as I was born with a congenital heart defect (which was corrected when I was 3) I have been told I will have to have an epidural as soon as I go into established labour. I was hoping for a water birth so was a bit sad about that to begin with but now my obstetrician has told me that I'll only be allowed to push for about 20 minutes and that after that I'd have to have an assisted delivery. she said she'd use forceps as they involve less pushing than a ventouse. so I've been reading up on forceps and there is no way I want those things anywhere near me!
I want to ask for an elective caesarean as I don't think there is realistically any way I'll be able to push the baby out in 20 minutes, I won't be able to feel anything as I've got to have the epi so it's pretty likely that they will have to use the forceps. the thought of it terrifies me. I wondered what people thought about my reasons for asking for an elective cs? I know it's a major operation and that there are risks involved but I honestly think the risks of a forceps delivery seem much worse. would love to hear from any of you who have been in a similar situation or just have some advice. sorry for the long post!

I have no experience but thought I would bump you. Personally for a first I would say 20 mins without epidural is pretty hard I pushed ds posterior in 29 mins and dd in 2 and I would still say what they have asked is pretty unlikely with an epidural.

I am a big believer in natural birth but in your circumstance I probably would opt for a section births can go nasty even when there is no foreseeable problems but it sounds like you have alot going on here.

I am sorry no real advice but I hope someone comes and gives you some why do you have to have a epidural though.

I think by guidelines anyone can have a c-sec if you ask for one, but they'd try and talk you out of it if you dind't have a good reason.

However, I think if the hospital are putting those stipulations on natural birth then you are fully within your rights to opt for a c-sec.

Do you feel it is reasonable for the hospital to put these 'rules' in place ? If so, then I agree you are probably best having a c-sec. I've had 2 - 1st emergency, 2nd because my waters broke but I didn't go into labour in time.

I really wanted a natural delivery so I'm not someone to encourage c-secs but it'd be better than labouring and then ending up with a forcep delivery or c-sec after labouring I think.

Good luck - if you do go for a c-sec you can still make it personal and a good experience. We managed it with dd2 - screen lowered so we could see her being delivered and we knew first what 'she' was (no one told me for ages in my emergency), I held her almost immediately, DH took some photos as soon as she was born (not of me I hasten to add).

I have no relevant personal advice but there is a thread on here about forceps birth vs c-s that I read with interest and the outcome was pretty unanimous. I will try to find it. From what I have heard from friends who've had both procedures I would go for the c-s personally.

I had to have planned c-sections for my 2 DCs and it went very well, with very little pain afterwards. I understand women prefer natural births when possible, but from my experience and the ones of women around me, it looks like a good planned c-section is better than a complicated and medicalised vaginal birth.

here you go , hope it helps.

I had an elective section with my first due to my fear of pelvic floor damage among other things which sounds similar to your worries with the forceps. You can ask for a section but make sure you have researched all the risks of that and vb as they will try and refuse/talk you out of it. If you don't find a sympathetic consultant first time you are entitled to a second opinion. Don't let them fob you off and if you don't think you can be forcveful enough take your husband/pattner/friend to back you up.

I had an elective CS as I had a very long labour and EMCS with first DC.

Your reasons sound perfectly valid to me and I can't imagine that anyone would turn down your request. Because I had had a previous CS I was told that I wouldn't be induced and would only be allowed to labour for a fixed amount of time before they would EMCS anyway, so it's similar-ish.

I know CS is major surgery but I honestly have had no preoblems recovering after either of mine (despite the 50 hour labour first time round). I was up and about farily quickly - you do have to make sure you don't take on too much too quickly.

OP - Similar situation here. I am 32 wks pg with DC3. In the past year I had something called a vertebral artery dissection, where one of the main arteries from heart to head split. Obviously quite serious at the time, lucky not to have stroke/die etc. A few months down the line, we had a little accident and DC3 on the way!

My consultant first mentioned that we might need to discuss mode of delivery (around 16 wks). I hadn't even thought about the pushing element until she mentioned it. I was referred back to neurologists for opinions and they all said that a time limit would need to be put on the pushing - around 10-15 minutes. Now being the 3rd, the consultant felt that I might be able to do that. But, tbh, like you, there is no way on earth I wanted to go down the route of a vaginal birth, knowing that forceps or ventouse etc would be used if I couldn't push baby out quick enough. For a first, 20 minutes is nothing.

So, I told the consultant that I was v v v unhappy about this. That the assisted delivery was somehting that filled me with horror and why would I choose to go down that route? She agreed and signed me up for an elective c/s v quickly.

So basically, I would completely agree with you wanting a c/s, having researched it quite extensively myself and would suggest that you perhaps write a letter to your consultant setting out yoru concerns and then discuss that letter at your next appointment. If you are 30 wks now, you will prob be due for an appointment soon won't you? Get your date booked quickly because of Xmas/New Year period!!

thanks all for your replies

slushy - I have to have the epi as they don't want your blood pressure to rise if you've got heart issues.. the pain makes your bp shoot up aparently

can'tthinkoffunnyname - I hope my consultant is as nice as yours! bit worried that mine seemed so set on the forceps..?! I've made an appointment with the consultant for the 23rd so will write a letter and prepare to fight my corner! will let you know how I get on, thanks again ladies

Good luck Kissyfur. Really do fight your corner - take along your partner too as sometimes its easy to get railroaded ourselves but put him on the offensive in case you back down...

Really stress how much fear you have about assisted delivery - that should work (cry if you need to)!!!!

Under the circumstances I'm quite stunned that your health professionals haven't been gently nudging you in the direction of an elective CS anyway.

Ask for, no demand, an elective.