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.

"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"

Of course not. Why do you think you'll have to do 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."

Yes - a protocol. Not a rule that can't be broken. My hospital's protocol for women with gestational diabetes was no food in active labour, cfm and induction at 40 weeks. Despite having gd, I declined induction, arrived on the labour ward at 7cm dilated, eating a cereal bar and told them I wanted to use the pool. The midwife walked in, said 'you know our protocol is to discourage eating in active labour - but don't worry, as long as you understand the reasons for this I'm fine with whatever you want to do'. I used the pool for a while, then had cfm and augmentation - but refused to get on the bed. I stood and swayed next to the bed for 2 two hours until I was ready to push my baby out.

Honestly - you can say 'no' - I don't want to do that'! Usually it's fine and people are accept it, as long as you're firm and straightforward with the way you communicate your needs.

TBH its your choice, if it were mine, i would have the planned, calm, section.
you can't really count on much statistics wise as they are completely biased lol, which is awful.
however, my consultant told me that an elective section for non medical needs have just the same amount of risk as a spontaneous vaginal birth. - ( just the messenger! don't shoot! )

If you had not had such a horrific birth experience last time i would say go ahhead with a vbac. - ( which pretty much always ends up with induction and medical intervention rgds to monitoring etc. )- but you didn't, you had a horrendus experience, infact i don't know how you got round that to have another baby lol!

I would also want to know why your baby was in an awkward position? was he too big? is your pelvis an odd shape? was it due to him not being low enough etc?

at the end of the day, elective sections really arn't that bad, and shouldn't be scoffed at just because its not 'natural'
yes our bodies are designed to give birth, but 50ys ago a big baby was 7lbs! now thats the average, and our bones haven't grown to accomodate an easy labour.
your last baby was 9lbs, chances are this one will be similar or bigger.

realistically, you have to imagine worst case senario with each choice:

vbac-
failed induction
lots of monitoring - internal + external
babies cord could be in wrong place/wrapped around neck
long painfull labour= not strong enough to push baby out = ventouse and or being cut
baby not descending properly, but too far down for section - forceps.
baby being starved of oxygen in birth canal
baby or you being damaged by forceps
extreme loss of blood
infection
damage to bladder + bowel
damage to cervix-can't carry another baby
RISK OF DVT

elective section with spinal with ( room full of specialist equipment for every eventuality + 6 staff

reaction to spinal - shaking, being sick - medication to stop this available
uncomfortable sensation whilst section underway
cold feeling
extreme loss of blood- blood will be there for transfusion.
damage to bladder
hysterectomy- no more babies
risk of DVT - slightly higher than vaginal birth
infection

those are the ones i came up with when i was choosing.
there probably are lots more, but these are most important. - i think anyway
you can make your own list.

i may also add, i recovered much quicker than my other friends who had a problematic vaginal delievery. they were all quite angry lol

at the end of the day, your DH just wants you and bubs to be safe, and he feels like i do, that it probably would be better off with a elective section.

but if you don't feel like this is what you want ot disagree, hun, do what makes you happiest, just don't let guilt or fear rule your descision. xx good luck!

not to mention this fact: A cesarean section poses documented medical risks to the mother's health, including infections, hemorrhage, transfusion, injury to other organs, anesthesia complications, psychological complications, and a maternal mortality two to four times greater than that for a vaginal birth.

"A vaginal delivery at least once before or after your prior C-section increases your chances for a successful VBAC." Mayo clinic

I honestly would just go with what your heart wants and if your head is doubting you then go for the c-section. Im not a fan of CS's but at the end of the day, if your labor doesnt progress as you would like it to, then there is that option, before even having to have forceps. There is no harm in trying.

cheelesgirl, im wary of what you've put as elective sections with no medical are in no way to be compared on the same way to a emergency section, ive tried to find info on unbiased stats for this, but alas i only have the info that my consultant gave me, who also chose 3 sections over a vaginal birth, and shes a professional in this field, that spoke volumes to me.

Take a look at this page at vbac.org - it has excellent referencing.

The mortality rates of elective caesarean and trial of labour are comparable. The morbidity (complication/injury) risk is higher for ELCS. You're likely to sustain greater levels of injury or complication from an elective caesarean.

This is assuming a low-transverse single scar.

Also, Chellesgirl is right that given the fact the OP has had a successful vaginal delivery, her odds are even better for a successful VBAC.

not tedious at all! thanks for replying to everyone

you've had alot to digest here, so good luck with the consultant and let us know how you get on. you know what, so long as the baby and you are healthy...thats the most important thing, and we are lucky enough to live in times that we have such high sucess rates

I am still shitting it though!!!

I also BAWLED at one every minute.....

Why are you wary??? Every section whether EM or EL has the same risks??? apart from the ones where mother /baby may be in greater risk of losing thier life/lives. Now the above risks are for all sections. Now some people aregue that EL's are less of a risk...but my thoughts, well a woman who is undergoing a EM CS has already started labor and the hormones have kicked in, baby may well be already on its way out...so here we have all the natural hormones helping baby to 'get through it' where as if you have an EL CS those hormones are not there...labor does not start naturally therefore other complications can arise and one being the biggest for baby..respitory distress. The birth process helps a baby to breathe once he is born as labour prepares the baby?s lungs for breathing. Babies born by caesarean ? particularly elective ? do not go through this and may be more likely to need to be taken to the neonatal baby unit after birth.
Plus this isnt a risk, if you dont see it this way, but EL's have a less sucessful rate when it comes to BF. When your contractions start oxytocin is released, this hormone is not released during a EL, until very very long nipple stimulation happens, oxytocin is the main hormones that plays the role in BF as you all know.

But a traumatic vaginal birth also screws up bf for a lot of people. I developed deep breast tissue thrush - like hot needles being driven into your breasts 24/7, especially agony when feeding but genuinely had me in tears many times a day despite still being on very powerful painkillers. I took 20 days of drops for DD, cream for me and tablets for me but couldn't shake it.

I am convinced I couldn't fight it off and had to stop bf at 5 weeks because I was so torn and damamged down below. I had catheters at home, a lot of stitches, tears, piles, episiotomy and bladder trauma. My body couldn't fight pain on so many fronts. Once I stopped bf (feeling horribly guilty and a total failure after the forceps birth too) I started to improve quickly.

I have also been told by my consultant that a cs when fully dilated is more risky than an elcs because the baby has started to descend a little and so has to be pulled back up again. I have no doubts my body can get to 10cm as I did it fast last time, I am not confident though that the baby will come out without significant damage to me either through more tearing or forceps again.

"who also chose 3 sections over a vaginal birth, and shes a professional in this field, that spoke volumes to me"

She's a woman and a mother who's been exposed to traumatic births every day of her working life. Her perspective and her confidence will inevitably be skewed by that.

Midwives - who are involved in a far wider spectrum of birth experiences, from the normal to the highly complex, are actually more likely to choose to give birth in a MLU or at home than members of the public.

Now that speaks volumes to me.

love
was you induced?
did you at all have a pictocin drip?
did you have constant fetal moitoring?
Was you 'scared' tense when you went into labor?
And did you have an anesthetc when being stitched? I would probably think you did if you had an episiotomy.

What was your bladder trauma from? did you hold your wee in before labor, was you allowed to go to the toilet during labor? Did you have any intervention such as trying to turn baby or push baby out from the top of your uterus while having forceps?

I know some vaginal births can be traumatic and from my belief there has to be an underlying issue there either with not good med care or within your body that you didnt know about. Now breastfeeding is a different ball game. I am sorry it didnt work out for you - as it didnt work out for me (due to other reasons) and I too feel guilty, but you shouldnt.

Dis you try contacting LLL instead of going to the docs? Was there anytime which you had to have antibiotics??? And was baby treated too? There are so many things that affect breastfeeding and drugs can play a massive part, so can not getting support at the beggining and even the womans body 'just not wanting to do it' - but thrush is curable and yes you couldnt stand the pain and I hear you...I just dont think you can blame the vaginal birth for the thrush.

please can this not turn into a "natural" vs "drug/elcs" thread, this is not going to help the OP

Porca - couldn't agree more!

I think it is not a question of whether either method is 'better', it is about what the OP and her DH want for the delivery of their baby and for their family. I agree with everyone who says it is a good idea to talk it through with the consultant etc but I would also say, why not have a plan of what to do in different circumstances?

I have had 2 sections but my second was a failed VBAC. I produce enormous children (!) and wanted a VBAC, but did not want another late-stage EMCS or to endure lots of internal damage from pushing out an enormous baby. Our consultant was great, and basically said that we would take a view on progress throughout labour and, if the labour stalled, take that as an indication from nature that things were not as they should be. I think he wrote 'VBAC with no heroics' on my notes . Why not think through something similar with your DH and consultant? So you would try for VBAC but if it became obvious that things were not progressing in the way you and your DH would like, you move to an EMCS at an earlier point than you might have done in a first labour, for example?

Not sure if that makes sense, but just trying to suggest a compromise that would give you each some comfort?

it makes sense DBP and would most likely be a very good idea for the OP and also a reassuring one for her DH.

To answer the queries in case it helps the OP:

I was not induced. Waters went naturally 11 days over and started labour at 4am on 12th day overdue. No drips. No constant monitoring. Just threw up 4 times then went into 2-3mins contractions straightaway and stayed that way for 11 hours with no progress and no breaks. Was mentally prepared to work through labour but was totally exhausted within an hour and could barely move physically after first few hours. Was kneeling on bed and on ball but just wanted to collapse I was utterly weak.

Had only G&A once in hospital and that was removed for last 2 hours to 'help me focus'. Rushed to theatre for forceps as DD's heartrate crashed so given spinal and over an hour of repair done afterwards internally and externally because of the number and depth of tears and episiotomy.

Bladder trauma probably from combination of DD pushing on bladder area for 11 hours in wrong position to descend canal (mw error) and mostly forceps rotating her then dragging her out.

I had antibiotics when labour began because of gap from waters breaking - I don't blame the vb for the thrush, but I blame the forceps for doing so much damage to me that I couldn't fight off the thrush as I was too unwell internally and externally. I used the NCT breastfeeding specialist repeatedly and was in hosptial 6 days postbirth having the latch checked over and over by people who said it would stop hurting soon. But it got worse.