EC due to personal history??

[mrsbettyb]

Trying not to make this too long!
My husband and I are planning to try for a baby soon and I am very excited by the thought of pregnancy and having a child together, but I've really been nervous about going ahead because my great fear is the various procedures during pregnancy and birth. I endured many years of sexual abuse and then a very traumatic miscarriage as a teenager, all of which is known by my doctor. I would like to have an EC because I know myself and my own body well enough to know I couldnt cope with the physical procedures involved in giving birth naturally (mainly VE's) and want to ensure that this birth would not have any negative connotations for me, however, my concern is if I spoke to a midwife about an EC they might for some reason think I was 'not over things' or somehow unable to cope and start questioning my abilities to be a mother simply because I have concerns about childbirth.
I should emphasise here that my past is very much behind me and I am a happy and confident person, been with my husband for years, never had any involvement since 'life happened' in childhood with Social Services, but as an adult I do find physical exams highly distressing still and work hard to manage these stresses. You hear such ridiculous stories in the press these days I dread the thought of someone misunderstanding my fears into something sinister. So my question really is, has anyone else asked for an EC for personal history reasons and how have they been responded to?
I would appreciate any advice or thoughts. x

mrsbettyb, it sounds like you've had an awful time but noone will think that makes you unsuited to be a mother

anyway, having a biological child is not like adopting one: the authorities don't get to tell whether you should do it

I am sure they see a lot of genuinely unsuited mothers, and they still have to make the best of it and provide the best care under the circumstances

no seriously, they will be sympathetic and (if worth their salt) should be bending over backwards to support you and discuss options with you

it is far better to broach this subject with the midwife than to keep silent and risk ending up traumatised

You don't have to accept VEs if you don't want to if you have a vaginal birth. And lots of mothers who experience a good vaginal birth with a similar history to yours, find it all very healing, so long as it's within their control. Try reading 'Stand and Deliver' to learn about the importance of feeling in control of your labour and birth and how to acheive that.

Also, bear in mind that you may still need to have a few VEs if you have a caesarean birth as it's a useful diagnostic tool.

I think you may find it helpful to find some real experts to discuss this with to make a decision that will suit you best. Maybe a homebirth with an independent midwife who has the time to really understand your individual needs and feelings and who won't insist on VEs and will let you be in total control of your birth would be an option for you?

BettyB, we seem to have very similar histories, and are in a very similar positions! I am about to discuss my situation, and request for an elective CS, with a midwife consultant, after an initial meeting with my midwife. I am currently 13 weeks pregnant.

I would be happy to let you know what happens etc if you think it would be useful. I would prefer to do this privately, though - I don't know if there's a way you can message me on MN? Or I can message you.

I think you are very brave to post here about your fear. Braver than me. I've sought out threads here and elsewhere in the past, and I don't think this is a fear that many people understand or take seriously. To be in a situation where you desperately want children, but are so terrified of VB that you may delay or avoid having children altogether is so sad. I wish there was more willingness to understand this.

Anyway, I came here to be helpful, not miserable! If sharing my experiences privately might help you then great, no worries if not. And very well done for being brave enough to ask in the 1st place.

I can completely understand your fears, but I don't think a c-section automatically 'comes' with fewer VEs than a vaginal birth. I've had two c-sections and had quite a few VEs (although quite whether they were strictly necessary is debatable...)

If it is the birth itself that worries you, that's a different matter. But if it's the VEs, I don't think a c-section will necessarily be your answer (as well as being a fairly drastric measure).

I think this warrants plenty of discussion with a sympathetic midwife and/or consultant, and that they should probably find a sensitive and appropriate way of mentioning this issue in your notes so that all the HPs you come into contact during your pregnancy and post-natally treat you with the sensitivity you require.

I wouldn;'t give a moment more worry to whether this will colour HPs views of what sort of parent you will be. No decent person would think such a thing.

Another one here in a similar position - also planning to start trying in a few months, but like you am nervous of going ahead because of fears that buried memories will be stirred up and I won't be able to cope. We have been putting off starting a family for the last 4 years because of my fears.

I entirely empathise with your worries about medical professionals judging you if you disclose your concerns, but if it helps at all, I disclosed mine and so far have found my GP unfazed and very supportive. In fact, she was the one who suggested an EC as something to consider (I didn't raise it - she did) and she offered to support me in whatever I felt was the best way forward and to refer me to a sympathetic consultant if my choice was the EC route. We've moved house and had to change GPs, I have only tentatively broached the subject but so far, found the new GP practical and supportive. I haven't discussed with any other medical professionals yet as we haven't got that far.

There are, sadly, an awful lot of women out there who have memories in their past of things which should not have happened and will have similar fears as a result. So while not exactly a "routine" daily occurence (thank goodness), chances are that your GP and midwife will have heard similar fears before and should not mistake what's driving them. This fear and distress - so I'm told - is normal for someone with your history. It absolutely does not reflect on you or your ability to be a mother.

On the other hand, I've also read somewhere that 60% (or some high figure like that) of midwives in a survey said they weren't confident they would know how to support someone who disclosed a history of past abuse. I don't take this as meaning they would be judgmental in the way you fear - but I guess it does mean that some people may be clumsy, or not know the best way to help.

A book which has been recommended to me, and has some good reviews - though I haven't read it yet - is "When Survivors Give Birth" by Penny Simkin. www.amazon.com/When-Survivors-Give-Birth-Understanding/dp/1594040222

Barkfox, I hope your meeting with the consultant midwife goes well. I would really like to know what happens if you are willing/able to say. Appreciate your desire for privacy (as you can see I've changed my name for this post!), not sure how messaging works here though...

Hi There,
I am a doula and I have supported a few women with histories similar to yours.
You should be able to discuss your history with a senior midwife (ideally a Consultant midwife) and make a plan of care.
This could be an elective cesarean or it could be a vaginal birth/home birth where it has been agreed there will be no vaginal exams and the midwife attending would be briefed and sensitive to your history.
You could also consider a doula to support you (www.doula.org.uk to search for one in your area).
I have talked women through the possible effects of previous abuse/rape on the birth experience and early parenting which I beleive has been very helpful.
I agree with the other posts that birth can be a very healing time, and you should be supported to have an appropriate plan of care.
This should not 'flag' you up to social services or anyone else.
Generally NHS care is very good but if you do experience any difficulties, this organisation can be very helpful-
www.aims.org.uk/
This book may also be useful to you
www.amazon.com/When-Survivors-Give-Birth-Understanding/dp/1594040222
Hope that helps.
Selina x

Hi - just quickly to update BettyB and Namechange, I had a meeting with Consultant MW today.

She listened and was sympathetic, and was very clear that their (MWs) job was to understand and support the women they care for - not force them to go through experiences they find traumatic, or to pressure them into accepting decisions they aren't happy with. Which sounds obvious, but was good to hear. I mention that only because I know others with similar issues have not been treated as sympathetically as that by their MWs, and I feel very relieved and reassured that I was.

I have been referred to a consultant obstetrician and also a mental health care team - their remit is to provide support for women during and after pregnancy, so includes support for PND and general depression during pregnancy. The plan is to discuss elective CS, but also a careplan which means that they can treat me sensitively throughout pregnancy and birth. This is to help them as much as me! If they are briefed in advance, and key info is in my notes, then they can approach things like VEs or any other intervention in a way that we have jointly agreed is best. The way the consultant MW explained it was that the mental health care team could help advise them about providing the best care for me.

[this all ties in with SelinaDoula's outline of ideal care so far, btw - obviously I've only had the meeting with the consultant MW so far, not anyone else, but there's the plan. I feel more confident about the next stages at any rate, and like I can 'relax' a bit more]

I hope that's useful - I'm happy to share more detailed info, but only privately. There is a PM facility here, called CAT, so I'm going to see if I'm competent enough to set it up without breaking mumsnet!

CAT seems to be set up OK - namechangeforthispost, if you want me to send you a message with my e-mail address (and mrsbettyb or anyone else), then you need to go to your 'My Mumsnet' details, then to e-mail options, and make sure you've set 'C-A-T messages from other users' to Yes. Then I can send it to you. No worries if you don't want it, totally up to you!

Barkfox, thank you. I think I've pressed the right buttons and not broken anything. Time will tell :-)

Heh - namechange, it's not letting me message you for some reason - says MN can't find a talk user called 'namechangeforthispost'. I'm not sure if that's because you've changed back to your original talk name, or if I'm doing something wrong! I'll try and find out....

Thanks all very much for your posts, it's nice to find a place where you feel you can ask 'the honest' questions and I appreciate the time you've taken to post. x

Hi Barkfox, can I ask, what's MN? I know you have to subscribe to use CAT and I wanted to find another way if possible. Thanks.

I think with this sort of back ground you can request an EC and there ought to be on problems getting one.

Now the but: It is quite common for emotional turmoil to begin during pregnancy and after giving birth. For someone close to me it resurfaced at menopause so it is not just this phase of your life you would have to be conscious that it could resurface.

Midwives know that this happens to women so it is better for them to be aware of the previous abuse so they can look for sign posts of it and get support for you asap.

I think that your GP could also recommend you for therapy to deal with the fears you have.

But can also tell you that you do not ahve to have any VEs during labour. In fact, you don't even have to have one at the 6 wk check post birth either. I had awful issues with my first highly medicalised birth and it put me entirely off VEs so I understand how you feel. With my second, I wrote into my plan that I did not want any as long as I was comfortable that labour was progressing normally.

I also hired a doula who I completely trusted to support me in labour.

Another way you can ease your way into maybe having a vaginal delivery is to hire an Independent Midwife is finances permit. the one to one care they provide, mental and physical from the time you sign up with them to 6 wks post birth will go a long way with helping you overcome any difficulties.

You sound like a strong woman and sound like you want to get to the best support out there. Lots of clever people on MN who can point you in the right direction.

Others will come along. I jsut wanted to share my thoughts with you. Good luck on whatever you decide and more power to you.

BettyB, I just shortened 'mumsnet' to MN. I've subscribed to CAT, so I'll see if I can message you - I think once someone has my e-mail, they can then just e-mail me if they want without using CAT. I think CAT is just a way of 'opening the door' and protecting people's e-mail adresses. I think! I'll give it a go,anyway.