My husband wants me to have a section

[anna26anna]

Sorry for the dramatic title, not intended to get 'natural birthers' across the country up in arms. I have a great husband, and it's not like he's twisting my arm, but I just know that he would prefer if we were planning an elective section this time around, rather than the natural birth I want.

Some history: I had one C/section due to failed induction at 38 weeks, in 2005. I was induced due to liver disfunction (cholastasis) and labour did not progress. Classed as emergency section but no immediate danger to baby. Was really disappointed with section, although recovered was easy. I always felt I would want a VBAC next time.

Second time, in 2007, I tried for a VBAC and ended up with a nasty Kiellands forceps delivery (that article from the Daily Mail someone posted the other day made my hair stand on end, this was the same type of procedure). I wasn't being militant about it but wanted to deliver vaginally if possible and do feel guilty that my desire for a VBAC led to a horrid delivery for DS2 and long recovery time for me. I wouldn't have another Kiellands, would be resigned to a section as a more sensible alternative (although would try to take control of things earlier to identify/turn posterior baby and not be in the clueless position I was then). My husband's classic quote some months after the birth was 'Do you know how they were able to calculate how much blood you lost?...' (I was really hazy by this stage in procedings) '...They collected it in a Kenwood Chef bowl'

This time, I'm back on the bandwagon looking for a (relatively) natural delivery (35+3 today). At no point has the consultant or his team recommended a section - most women with Kiellands deliveries go on to have natural deliveries in subsequent pregnancies. I'm happy to hear this of course. I'll have a struggle with some hospital policies like continuous monitoring, because it really impeded my progress last time (midwife would not let me move from a lying on my back position) - but I'm trying to prepare and give myself the best chance possible.

My DH totally has my welfare, the new baby's, and our existing children's welfare at heart when he desires the easiest birth and recovery time for me, and safest for the baby. It feels like the right thing to want a natural delivery, but when I talk to him, it feels like a very selfish 'me' thing (he doesn't call me selfish, but thinks the natural delivery that I crave is unnecessary and that a C/S shouldn't make me feel any less of a woman or mother. He blames a lot on social/peer pressure and probably thinks my time spent on Baby Greenhouse /Mumsnet is highly influential ). He accepted the doctor's assumption that we will try for a natural delivery, but I know he would still be happier if at my next appt (at 36 weeks) I asked for a section. He is to be my birth partner, and if we proceed with a natural delivery as planned, I'm a bit worried about the support I will get. I'm also a bit worried that at 35 weeks I'm wavering now!

Yawn, you must be bored by now. Not sure what sort of replies I'm hoping for, other mums are bound to think 'sod him, it's your body' - but I need to look at the whole picture.

You poor thing, sounds as though you have not had the greatestof experiences so far. It is a bit late, but would it be worth you trying to get a doula to be with you and generally offer support to you and DH?

You say you recovered well from the CS but not so well from the forceps (I had the latter so I can imagine). Also it sounds as if your DH was genuinely scared by your blood loss second time round.

I suppose part of it is weighing the 'birth experience' against the 'arrival experience' of the first weeks with your DC. I had a traumatic birth but the recovery took months and that was the most damaging to me. This time I am choosing an elective because while I hate the thought of a cs recovery, I would hate the repeat forceps recovery more.

My fears are of worsening existing bladder problems or adding bowel incontinence to the mix.

What concerns do you have about a cs birth and what concerns about a vb? Which are more likely to impact on you longterm?

anna am a bit confused about this. You would like to go for a vaginal delivery, despite reservations etc based on previous experience but your dh doesn't want you to, and wants you to have a section?
I can't really understand how having a section will be any easier/less painful/ safer etc than trying for a normal delivery. The only advantage I can see to booking an elective section is that you know when the baby will come, no waiting for induction or labour to start.
I can see that if your dh is worried that you will have another difficult delivery similar to your second one, then he would want to avoid that, but I just can't see that signing up for a c-section is a better option.
I have had 2 c-sections and am booked for a 3rd... but if I could I would try for a normal delivery, just because assuming all goes well, the recovery time etc will be so much easier than from a section, especially if you already have 2 kids at home.
Maybe you could sit down with him and your midwife and discuss your hopes/fears and try to get him to explain his reservations so it is all out in the open and then he can be reassured and you can be confident he understands what you want?

I think that in some ways the experience has been even more harrowing for him than for you - he got to be fully conscious and watch while you and your second child went through such a traumatic birth (and then the recovery). In comparison to that the C-section for the first birth was probably much less worrying.

Can the consultant talk through both options and the associated complications? - both have their own risks and at the moment your husband is only seeing the bad side natural birth, not the risks associated with a c-section.

You know your husband and yourself best - how strongly do you want the natural birth? What is the best way to get across to him that last time was an extreme situation and this time things are most likely to go completely smoothly?

You've had the equivalent of one c-section and one labour as a primigravida.

This is your third baby but your second labour, and is likely to be very, very different from your other one. The vast majority of second time births are straightforward, even when the first has been an instrumental birth. I remember my midwife telling me (I had the jitters when I was pregnancy with ds, following a difficult forceps birth with dd), that second babies are 'beautiful babies to birth'.

BTW - have you considered getting a doula? Sounds like you and your dh might benefit from one if you have a vaginal birth!

If I were your husband I'd want you to have a ceasarean too

Is he aware of the increased maternal mortality rate of a c-section? If he's left to raise 3 kids by himself because you've died because of the section he insisted upon, how's he intending on explaining that to his kids when they're old enough to ask?

If you're not being recommended for a c-section by your ob then listen to him/her and not your selfish DH.

He's not bring selfish and the mortality rate from sections is not high. You talking as though he wishes his wife dead is very unpleasant.

foreverastudent - I dont think that this husband is being selfish, he is totally concerned about his wife's wellbeing.
anna, I think you should consider your longterm quality of life given how debilitating lifelong incontinence is and the thought of being doubly incontinent! How will that impact on your childrens lives when you will necessarily be limited in your activities.
Also given your previous history will you not be wired to a monitor and forced to stay on your back again?
Whatever you decide the very best of luck and may you receive the very best of obstetric care.

I don't think your DH is being selfish (and I think foreverastudent's post is really insensitive and unhelpful, actually...)

He is worried about you. He doesn't want to see you go through hell again. I feel quite sorry for him in a way, as he obviously feels a bit powerless and useless.

I had a section after failed induction with DC1 and another section because of OC with no.2 (they needed to deliver me early because of appalling liver function, but my my hospital wouldn't induce women who'd previously had sections). I had originally planned a VBAC. DH was quietly supportive, however, when I had to have the section, he was visibly relieved. I hadn't realised just how very worried he was about me (having seen me go through a long failed induction and emergency section previously).

This is really your choice, though, and you are not being selfish to want to try for a vaginal birth again. I sympathise with how strongly you feel about this. It's definitely a tricky situation.

I wouldn't deign to offer advice (sorry, not helpful!). I just think you should keep talking - calmly, considerately - to each other about your feelings and play it by ear for now.

Out of interest, do you have OC with this pregnancy? Will you need to be induced? I'm not a big fan of induction, to be honest, and think it stacks the odds against you for having a natural, intervention-free birth. Might be something to consider.

If it was me I would jump at a c-section. Ignore the maternal death thing, because it includes emergency cs as well, where there is already a problem and it is a rush job, especially when you add GA into the mix. You won't have any of that with an elective. I do think you need to consider the long-term damage another instrumental delivery could do to you. You will not be able to have a nice active intervention-free birth anyway because of the monitoring and having to stay on your back, making intervention more likely (I think?). A planned c section would be nice and chilled.

I don't think your dh is being selfish but I don't think he is right. Even planned caesareans are more dangerous than low-risk vaginal deliveries and the former forceps delivery doesn't have a strong likelihood of reoccurring.

I'd suggest getting the consultant to explain this to him and perhaps hiring a great doula might be reassuring for both of you.

At the end of the day, he wants what he thinks is best for you but it's you that makes the decision and you mustn't be guilted into what anyone else wants.

"I do think you need to consider the long-term damage another instrumental delivery could do to you. You will not be able to have a nice active intervention-free birth anyway because of the monitoring and having to stay on your back"

You don't 'have' to do anything and you don't have to lie on your back even if you are being monitored!

The OP is statistically unlikely to need an instrumental birth again this time around and has a very good chance of having a normal labour and straightforward deliver.

At least by opting for a VBAC she's giving herself a very good chance of coming through without a serious birth injury. By opting for a c-s she's making one inevitable!

foreverastudent, WTF, so not helpful

I agree that this has been very traumatic for DH too, he has had to sit through it all too, bless you both

I am in your DHs camp TBH, I really get where you are coming from BUT I think he cant face another VB after what you've been through. I also share your concern that given what you've been through he may not be the most supprotiuve birth partner.

However, if you do want a natural birth I'd also suggest a doula, as if he is that scared and worried its not that fair to put him through it.

I also question (and this is for me too) how natural a birth can anyone have when they are monitored and not allowed to be on their back? This means you cant manage pain so well, and might go for the strong pain killers.

good luck whatever happens

I'd have a chat to your consultant and take your dh along and discuss all the issues you have raised in your OP. The consultant will have a different perspective (and I'm not saying will not have own prejudices) and may bring other points into the mix that either of you had considered.

All births are different, I had a ventouse after being inducted with ds1, then with ds2 I had a horrendously quick labour and birth, and he ended up being delivered by dh at home before paramedics/midwives got there. I know to this day he is found both expereinces awful and it put him off having any more.

Your dh is defo not being selfish - can totally understand where he is coming from. I think bobblehat's suggestion is a good one. If you are determined to go ahead with VBAC maybe you could plan in advance at what point you would consent to CS if all was not progressing well. It is worth considering though that em cs recovery is much slower.

People always talk about CS recovery time, but I saw my freinds revocer OK. They were not in nearly as much pain as I had with my episiotomy

I don't think your dh is being selfish, just very concerned. I think ladylush made a good point about discussing with the consultant about what type of labour you want and at what point you would consent to a cs rather than another instrumental delivery maybe? You should also discuss your worries about being on your back and cfm before labour starts, maybe writing a birth plan before you go to the next appointment and discussing it with the consultant, maybe that would ease both your concerns.

And I couldn't sit up unaided for weeks after a CS. Ho hum. Anecdotes aren't massively helpful.

The evidence would suggest that vaginal deliveries usually have faster recoveries than caesareans and less complications. Obviously there's going to be exceptions to that, but OP's doctor sounds happy for her to try for a natural delivery so there's nothing to suggest the previous problems have a high likelihood of re-occuring.

Also, bear in mind the psychological effects of birth. If your dh doesn't want to be involved (understandably), then I'd take the earlier suggestion of getting a doula along and letting your dh take a more backseat role. But you HAVE to do it and be fully involved, so you need to pick what's right for you. You're the one doing it and to maximise your chance of success, you want to pick the way you feel most comfortable, safe and happy. Doing it anyone else's way may have very difficult after-effects imo.

Could you ask your hospital about telemetric monitoring? It's a wireless monitoring system, where you can move about much more easily. Also, I have had 2 VBACs, one a forceps delivery and the other induced (fabulous, easy) delivery. I was encouraged to move around even with the wired monitors on - if I shifted the pads, the mw quite happily resited them for me, so I was on a ball, walking within the limited range of the wires, leaning on DH etc.

Might it be useful to talk to the consultant mw at your hospital? Sometimes they are more helpful than an obs consultant. In my hospital, my cons asked for the head mw to come talk to me, so she could help me decide the best birth for me with DD3. She was fabulous, although due to needing an induction with DD3, I didn't quite get the birth we'd planned

BTW, I can completely understand where your DH is coming from. When I was being induced with DD3, I had to have synto (my hospital does not use pessaries with VBACs) and was offered an epidural first. They left us to discuss what I wanted, I asked DH what he thought and he said 'Well, Poledra, contrary to popular opinion, I really do not enjoy watching you in pain even if it is for our babies.' I had the epidural, then synto and DD3 was a great birth (I fell asleep during the contractions!).

I hope it all goes well for you

I agree that anecdotal evidence is somewhat unreliable but it is probably useful for the OP to get an idea what kind of experiences other women have had. I personally found that I recovered much faster from a CS (my nether regions took a battering during the previous delivery and it was many months before I felt ok down there)but if I was crazy enough to contemplate another I would probably opt for VBAC (though with a robust plan in place as would want to avoid a prolonged second stage as per my first labour).

Thanks everyone for the thoughtful replies. I wasn't sure whether I'd managed to convey that he's not being a selfish oaf (and I hope I'm not being one either) but by your replies I can see that you get it. Really good idea for him to come along to my appt next Tuesday, I have mentioned it to him and he'll try to free up the afternoon. Must check that there's somebody reasonably senior doing the clinic - last week it was a total numpty, an SHO who didn't impress me at all - I just think a more professional dress code and a less sloppy attitude are minimal efforts to make when you lack experience.

Just to respond to a couple of individual comments:
tummytime, standandeliver, I did think of a doula but they are in fairly short supply where I am (rural N.Ireland) and not commonly used. I consider an IM too, but couldn't justify the extra expense. I feel like a bit of a bluffer, on birth #3 and still requiring extra support, but the history of the previous two have definitely left their mark (I can't see a video clip of a delivery or anything like One Born every Minute without dissolving into tears... seem to have issues ) I do think that eitherway, I need to have the hospital midwife assigned to me, on my side - regardless of who else attends, her support is important.

waswondering, thanks for your reply, it opens up my mind again to not ruling a section out.

lovethesea, you asked a good question: What concerns do you have about a cs birth and what concerns about a vb? Which are more likely to impact on you longterm? With a section, I'm just concerned that I'm opting for unnecessary surgery, that my body is ultimately made for giving birth and just a series of unfortunate circumstances have resulted in heavy medical intervention the last two times. With a VB, I guess there's just the fear (mostly my husband's) that it's a bit of a game of roulette, which could potentially end badly (but likely won't). Long-term effects, I'm not really concerned about either - not sure how I would get by without being able to lift my toddler, or take the 4 year old to school for 4-6 weeks, but those could be worked out. I birthed a 9lb baby second time and had the pleasure of forceps in my uterus and birth canal for at least an hour (very slow procedure to turn the baby in the uterus) - so really the way should well and truly be open for the next one to arrive easily, without any extra damage. There is an element of roulette though, no?

Humptynumpty, agree that a natural vaginal delivery will offer the best and easiest recovery, as long as no complications ensue. Will arrange a chat with doc/midwife.

Thanks, ChunkyPickle, I think it was only yesterday that I realised how strongly he feels about this (and bless him that he hasn't been insisting, but he should have a chance to talk through the options). Hopefully we will still opt for a natural trial of labour, but we should lay out the pros and cons of both.

standandeliver, smiles at the expression that second babies are 'beautiful babies to birth' - this is effectively my second delivery and I do expect it will be faster and easier. Will be making every effort to not be lying on my back for CFM - last time all my physical instincts were to just turn over onto all fours, and one horrid midwife wouldn't let me do this for hours (another eventually did, but my big-headed posterior boy was well wedged and we had to wait for the Kiellands).

WorzselMummage and BrahmsThirdRacket, I do see his point too I guess I've been ploughing on with my plans regardless, and need to take his opinions into account - he can be pretty dogmatic though, and not easy to get him to see my side

Hi, foreverastudent, I think he probably doesn't have great perspective on the risks of C/section (after a tedious few days of failed labour, we were wheeled into theatre and emerged after 30 mins with a perfect baby). The statistic he came out with the other day is that before doctors started to intervene, childbirth resulted in mortality rates of up to 30% (don't know where he got that one from ).

Gailforce1, you're right, and I really can't do another trial of labour lying on my back, so without wanting to be rebellious I will be finding another way around this - I have to be able to move a certain amount.

TweedyneeCole, regarding the OC questions. I do have reoccurance of the itch which led to OC diagnosis in my first pregnancy. It tends to escalate around 35 weeks, both times, and second time I was lucky that the bile acid levels didn't get to a critical level before I got to term. This time, it's pretty much the same - rising levels, but slowly enough that I hope to get to term without early induction being scheduled.

CarmenSanDiego, he does want what he thinks is best for me, and I love him for this (am just concerned that he may have the idea that we will reach a point in labour where he takes over and puts his foot down!).

tittybangbang and porcamiseria, I just can't lie on my back for hours this time, it was horrid not be able to respond to the instinct to move. Don't want to be belligerent, as the negative vibes won't help anyone, but have to find ways around this. The registrar who listened to my concerns at my 16 week appt has already documented in my notes that she advised me that CFM is hospital policy with a previous section.

P.S. It must be evident by now that I'm a pretty new poster on MN - have previously been used to responding to posts one by one, is there a better way to do this, as this long post must be so tedious to read?

Not tedious to read at all. I'm having my first and have been advised to have an elective cs so don't feel able to offer much advice as I'm in a genuine pickle about it myself.

Good luck with whatever you decide.

Sounds like you are doing all you can to look at it from all angles and gather your information.

I actually wouldn't mind a breech baby this time just to make it not my choice for a c-section ... daft I know (and I know some breech can be vb) but it's the choice that's hard.

I'm finding it helps to keep talking it over with everyone relevant - had to go in for checks at triage this last weekend at 23 weeks and was reassured then by the staff seeming very positive that I'm planning elective after so many bladder issues (mw's and registrar).

At my booking in the mw said something useful while I mused on elective/vb ... 'It's not your birth that worries me, it's the length of your recovery that concerns me about another vb for you'. That helped me so I throw it in here - how was your recovery time? Lots of follow up appointments for months?