Change of birth plan - gutted!

[illuminasam]

I'm in a very unusual situation and have had to change my birth plan from a lovely home birth to an elective caesarean suddenly. I'm really upset and angry and wonder if anyone has had any similar experience. I also have to make some decisions and am looking for advice.

The story is that I have a cervical suture as I have a short cervix. It went in at around 16 weeks. It has worked incredibly well to support the pregnancy and I'm now here at 37+5 (or 38 depending on whether you go on dates or a dating scan I had in early pregnancy).

Yesterday I went into hospital to have the suture removed - supposedly a simple 10 minute job under sedation and a local. Two hours later in theatre and the surgeon gave up. The stitch is now really high up and he can't get to it without risking damage to my bladder and trauma to my cervix. My only option is to book in for an elective CS and have the baby that way. They are keen to do this before I start contracting as obviously the stitch is still in place so it's been booked in for Monday 8th Feb, 4/6 days before my official due date.

I have been advisd that I need to think now about whether to have the stitch removed during the CS. They can leave it in and then in a subsequent pregnancy I wouldn't need another one put in but would definitely only have the birth option of another elective CS. Or I can have it removed.

I've yet to talk to my midwife and my consultant about VBAC and home birth but I would dearly love to have a home birth if possible. I was also booked for a home birth in my first pregnancy but it ended very prematurely due to cervix issues and I was induced in hospital. Now I feel that I've been let down again.

It's all happened very fast and it's hard to get my head round as this doesn't really happen with stitches - to the extent that I wasn't even warned that it might! I know I need to go with the flow and accept that I might not have given birth at home anyway but I can't help feeling a failure despite the fact that none of this is my fault!

On top of that, I'm 40 in a few months so it's not even a dead cert that I would get pregnant again and if I did, it would certainly be my last.

Does anyone know if VBAC at home is a possibility?

Does anyone have any advice for my CS? I am dreading another op so soon after yesterday and also dreading the recovery.

I think (honestly) that I would give up the idea of a homebirth. I did it the second time round because I had no issues at all with the first birth and no issues at all with the second pregnancy. I wouldn't have done it in your situation....for me too much risk

What you want at the end of the day is a happy, healthy baby and for you to be well as well - birthing is a means to an end rather than the end in itself so perhaps you should focus on how to best get this baby here - there are loads of positive CS stories here and if it's elective you have time to prepare for it, to make the most of that experience.

SandS - I can understand where you're coming from but I tend to think that if VBAC itself is a possibility, then surely VBAC at home is as well.

hannahsaunt - you're right of course and I'm going to attempt to turn this into a positive experience. Any advice on how to prep for a CS?

No - but I have a lovely friend on here (waswondering) whom I will prompt - she had a CS after a dreadful first delivery and I think being able to prepare in advance of the event and be as in control of things as is possible to be in the circumstances really helped.

Sorry if previous sounded abrupt - too many medics in the family who although have no desire to over-medicalise things, prefer people just to get on with the safest (for all) ways of doing things. I'm about to have dc4 and worried about how that will be.

Thanks hannah - and I do understand the "safety first" approach. CS is all quite new to me and VBAC even newer so it's all a bit overwhelming to have to consider it all at once.

Thanks for chasing the tips for me.

Could you get a second opinion about the stitch?
Maybe someone else would be able to remove it?
It is possible to have a homebirth after cesarean.
Selina

I was hoping for a home waterbirth VBAC, but it was not to be - my blood pressure came up, and in the end the advice was that the baby needed to come out. I held off as long as I could, and refused an induction, so in the end had an elective cs (though not really elective as was my only option). At the end of the day I was happy that I had a healthy baby, although I did insist that dh deflated the waterpool before I came home as the thought of what nearly was did upset me!

IMVHO it is not worth getting angry - you can't control your body and it's best to ride with the hand you are dealt as well as you can.

Good luck.

ps the elective cs was as good as it could be - a big change from the previous emergency cs. Could choose the music, was very relaxed going in, the team were very considerate, made sure everyone in the room was aware that we wanted to see the sex ourselves rather than being told, I held ds v soon after, while they were stitching, etc etc. The stitching up after took some time as had various adhesions following the first cs, but it was a totally different experience.

Selina - I've emailed my consultant this morning but didn't ask him this. I definitely will though.

crumpet - good to hear the elective was a relatively good experience. I obviously need to write a birth plan of things I want on the day.

I really feel for you having been though a simelar thing myself but i think you ought to focus on the fact that however your baby gets out doesn't really matter, you will have a lovely term baby at the end of it who you can bring home immediatly

I had to have a emsc with my DS at 27 weeks due to cervix issues and honestly, it was not that bad.. it wasn't on my living room floor obviously but it wasnt the horrific experience i had been expecting.

Thanks so much for the post and link Ww - I was concerned about the recovery but you have made me feel much more confident. I'm a keen camper too!

You're right about the plan. My midwife has advised me to make a list of everything I want at the op and that there is no reason I can't have my wishes fulfilled if everything is straightforward.

and Worzsel - trying to focus on the baby is of course the right thing to do.

I have been told by my home birth midwives this morning that they definitely would not rule out a VBAC at home in a subsequent pregnancy, although criteria for being admitted to hospital would be stricter. This has made me a lot more relaxed as I might yet have a slim chance of a home birth in the future.

That's excellent, illuminasam. At least you can feel 1. that you've been listened too and 2. that you might have some options. I've been reading your comments on the other thread.

I agree with what every one has said- all due respect for birth plans and wishes, your health (and baby's!) come first. you can still have a positive experience in a CS and it truly is not the end of the world. and it's way too soon to think about whether or not you can have a HBAC or VBAC- just concentrate on the task ahead, and you can deal with it when time's right I would definitely have the stitch removed now.

A CS can be a positive experience all you need to do is prepare yourself thoroughly. read whatever you can on the subject. talk to people who have gone through it. ask to have music in theatre if possible (it will help you relax), ask to have someone with you at the birth, ask for a slow and gentle delivery of the baby out of your uterus, ask them to give him to you for some cuddling in theatre, tell them to talk to you- describe what's happening (but if you get stressed by those kinds of things, just ask them to talk to you so you don't feel alone), and have skin to skin as soon as possible (beneficial for both you and baby).

tip for recovery: get up and walk as soon as you can- it will help you recover more quickly.

and smile - you can do it.
good luck!!

I had a wonderful cs with my daughter (planned rather than the not so good emergency crash section with ds). Didn't bother with music, but DH was with me, it was left to us to find out if a boy or a girl (make sure that is in the birth plan) I requested a spinal rather than an epidural and got what I wanted. They talked me though the whole thing both beforehand and during. DD was delivered straight onto my tummy for skin-to-skin, she wasn't interested in feeding straight away so we just stared at each other for ages. Then DH got a cuddle and she pissed on him, so we then asked how much she weighed.

I sometimes wonder what it would have been like to go through labour, but do not really have any hang-ups about having C-Sections instead.

Also recovered very quickly after both operations and very thankful to not have needed any stiches down below - or any worries about going to the loo.

Ww - "worst every aerobics class" - ouch, certainly but also not the end of the world!

And thanks for all the tips ShiriDoula, that's brilliant.

Is the risk of bladder damage with the suture removal operation significantly greater than the risk of this with a CS?

I think there may be a fair old risk of bladder damage with a CS as I remember lots of mentions of bladder problems in the document they shoved under my nose when telling me I had to sign for a section.

Peas - I have no idea. I think the surgeon was finding it hard to even reach the stitch and the bladder was getting in the way, even though he'd moved it as much as he thought was acceptable.

I'll find out more when I see my consultant on Wednesday about the exact anatomy of the problem.

Not keen on the idea of bladder damage from a section though! Hopefully an elective CS will mean things are calm and therefore more considered but who knows? It's all new to me.