Want to request a c-section but can't see consultant til 36 weeks, can anyone help or has anyone had a similar experience?

[withorwithoutyou]

I am expecting my 2nd DC this summer. My first DC was almost 10 pounds and born by forceps.

I am experiencing issues with anxiety (well, terror) relating to birth and very much want to discuss the possibility of an ELCS with my consultant.

I am aware that it tends to come down to individual consultant whether they will allow you an ELCS or not, and that I can ask for a 2nd opinion, or transfer to another trust.

My issue is that the hospital I have chosen to give birth in are saying that they do not give consultant's appts til 36 weeks. I am very concerned about this for a number of reasons. Firstly because my m/w said I should be offered growth scans and screening for GD and I'm wondering if these shouldn't be done a bit sooner than the final month of my pregnancy?

Secondly, if I still do not feel reassured about giving birth naturally and still want an ELCS and am refused then that leaves me very little time to see another consultant or go to another trust - two of my friends gave birth at 36 weeks so this seems very late to me to just be discussing options!

I know consultants normally don't ask you to make your mind up for certain til about 36/37 weeks but everyone I know who has had an ELCS has had a consultants appt much earlier than this to go through options, risks etc.

As I am going to a hospital outside of my own PCT anyway the GP has sent a referral letter to the hospital and I asked her to request that I see a consultant earlier than 36 weeks. She was pretty dismissive though and didn't seem to understand any of my concerns re: GD, growth scans etc.

Anyway - I wondered if anyone has experience of this? Is it possible to push for them to see you earlier? I thouight I might phone them once the referral is through, or maybe I should ask my m/w to do this?

I am actually terrified of giving birth again and feel totally dismissed by the medical professional in general at the moment!

Thanks.

Hi, insist on having an appointment. The midwives I had tried to put me off and I had to ask for an appointment couple of times but you have a right to see your ob so don't give up. Your hospital may also have antenatal drop in clinic/centre - if so you can go there without an appointment. You may have to wait for few hours to be seen though.

Thanks Mingg, I hadn't thought to ask about a drop-in centre, I will phone to find out.

I wrote to a consultant at the hospital prior to ttc and arranged the elcs without actually being pg at the time. They were very understanding about this and I had it all in writing so that I felt safe to try for our 2nd child.

We also required growth scans, and appointments for these were made at the booking scan appointment for 28 and 32 weeks, plus consultants appointment 32 weeks.

So, I would definitely feel I was being fobbed off in your situation. I can't imagine them holding a policy of not having a consultant's appointment until 36 weeks if you were carrying twins, suffering from epilepsy etc.

I would try to track down a particular consultant by reputation, and address a letter directly to them outlining why you wish to see them earlier. Failing that, a different hospital without such a draconian policy may be the answer. Good luck!

i am wondering if you are being fobbed off.

i am going tomorrow to tell the consultant i do want the elective. i am 28 weeks.

i am having a growth scan and again at 34 weeks this is for too small not too big though

i was told they'll want to book the sec tomorrow but (not that i will) if i change my mind i guess i can at week 34.

when i originly went for dating scan the hosp. MVs told me it was their job to talk me into a vbac. at 20 week scan i told the consultant i wanted a vbac but may my change mind.

i have changed mind due to loads of reasons and my community MW told me that tomorrow i should just tell the consultant i want sec and they'll not try to change my mind.

i don't know about telling him, i have all my reasons, worries etc written down and MW put into hosp notes, but i guess he can still say no.

i would find a supportive MW go through all concerns and ask them to make consultant app. do not allow yourself to be pushed aside until it's too late

i guess it's alittle easier in theory for me to get the go ahead as emergancy sec with first but honestly my birth wasn't that traumatic. if i were in your shoes i would be doing everything i could to get my sec. first time sounded really tough.

i hope you get some answers and wish you all the luck in the world for a stress free birth.

Can you phone the hospital for appointment?
all my mw did was phone but I was about 30 weeks I thin and didn't get it sorted until I was about 37 weeks which was hugly stressful. Good luck.

Thank you everyone. I do feel fobbed off at the moment.

It took a lot of calming myself down just to go and speak to the Dr to ask to be referred to the hospital and ask for the consultant app.

I had a feeling I was going to be dismissed and although the GP did agree to request an earlier consultants appt she was very dismissive of my concerns re: size. I tried to explain the m/w had said that growth scans would be usual and the GP demanded to see my 20 week scan notes, declared the baby 'bang on the 20th centile' despite the fact that it's head and stomach are already on the 75th. I did try to explain that my 20 week scan last time didn't indicate that the baby would be big - I thought they do a lot of their growing in the 3rd trimester?

She made me feel like crap, if I'm honest, and I came home and burst into tears. Am so stressed about having more of this with everyone I try to talk to about this

I can understand why you feel stressed and fobbed off. To be honest I think the growth scan at 36 weeks is fine. If you had a growth scan at 34 weeks and it showed baby was normal size you would still be worrying about a growth spurt in the last 4-7 weeks. On the other hand if at 34 weeks it seemed a bit big they wouldn't do anything apart from scan you nearer your due date as it could be due to an early growth spurt and may be more of a normal size by due date.

But you should be assessed for GD earlier than 36 weeks. They should be offering a GTT or at least a Random Blood Sugar test at 20 weeks. This is something your m/w can do, you shouldn't need a consultant for it. So maybe thats why you don't have a cons appt till 36 weeks? Good luck and def ask your m/w about GD testing.

THanks stripey, I think you're right about the growth scan - it's just that my only experience of them is other people who've had them from a much earlier date, m/w told me they would usually start them at 32 weeks.

My main concern is that 36 weeks is very late to be told I can't have a c-section.

The GTT should be done 25-28 weeks I think - the midwife should be able to arrange this without a doctor's appointment. Growth scans generally done at 36 weeks - not much point before then as babies do a lot of growing at the end. I think they do growth scans starting earlier when they are worried about babies being small for dates and not growing - but little point in doing early in your case.

Call the ante-natal department at the hospital and insist on an appointment sooner - 36 weeks is way too late to be worrying about GD.

However, there is every chance that even if the baby is the same size you would have a straightforward VB - second births are generally easier regardless of size. My second child was bigger than the first but his birth was so quick and straightforward and no tearing (lots of stitches first time round).

everytime i discuss my wanting elcs i burst into tears and can't explain properly this is some hormones alot of fear and depression.

please write everything down, show you've looked into pros and cons vag. vs. sec and that your descision in being based not just soley on fear. they maybe more agreeable.

like i said earlier it does sound like first time was tough and its not like you are just being too posh(god i hate that saying) to push.

i did feel like crap when others don't understand all the reasons i want a elcs as there is no medical reason but i also think people can drastically underestimate the effect a traumatic birth can have on the mother. noone but you knows how stressed you are and this is no good for either of you.

i guess you can tell i'm not a 'just gas and air' kind of gal. more do what is short and long term best for you and babe. short term it is best you know what you are doing before 36th week.

on GTT tests, i am having one of these this week also but thats cause i'm bit fatter this time round (28wk)

Ok,thank you everyone. I have a m/w appt a week tomorrow at 25 weeks. I am going to insist that she sits and talks to me about all of my concerns instead of just trying to shove me out of the door like she normally does.

The whole vb vs c-s is a whole other thread and one I've already done lots of research on (plus threads on here, different name) so I already know what my approach with the consultant is going to be - I would just rather not have to wait 12 weeks to do it.

I would insist on seeing someone to go through your concerns as it really sounds as if it's stressing you.

If it helps put your mind at rest though my ELCS section last time was only finaly agreed 14 days prior to having it (at 39+1).

Do you have a sympathetic GP?? (or can you find one in the practice). It was some years ago but I'm fairly sure that it was my GP who got me the first apptmt to discuss an ELCS, and also backed me up when at a subsequent apptmt to discuss dates and timing a registrar tried to talk me out of it after the consultant had agreed - I called the GP and she got me another apptmt with the original consultant. Good luck - listen to all the points of view (it is an op after all) but if that's what you want be assertive.

You sound really stressed and your GP sounds horrid.

My suggestion would be phoning up one of the ob's secretaries (like someone wlse said, go for reputation, ask your friends) and explain to the secretary that you need an appt. s/he may try to fob you off to; persevere and INSIST on leaving your contact details. It may not work but sometimes just taking the law into your own hands can be the trick. Good luck!

Ok, the obstetrician's secretary is a good plan, I hadn't thought of that but will try it.

I am stressed about this I feel really distressed at the idea of giving birth again without anyone having listened to my concerns or reassured me in the slightest. I keep having flashbacks to the sensation of the forceps going in, and dwelling on the, frankly, horrible postnatal period.

Part of the issue I have with my previous birth is feeling totally dismissed when in labour - nobody wanted to listen to me then and I just feel like history is repeating itself as no one wants to listen to me now.

OK, if you are feeling like that OP can I suggest that you write everything down, maybe bullet pointed? Or,

-This is what I am concerned about

• This is WHY I am concerned about it (sensation of forceps etc, felt nobody listened to me etc)
• This is my ideal outcome

In an Excel spreadsheet (yes, I am very sad!)

I really do feel for you; I felt totally dismissed as well in my last labour. Don't get distressed. Get constructive! Take a bod with you (don't know if your DH is any good at that type of thing? Sister? BF?) Get EVERYHING in writing. If you have a meeting, ask for a summary of points to be typed up and sent to you. Be business-like and show you mean it. Don't go into a meeting with a MW/OB and let them decide what is discussed; go in with an agenda!

I'll shut up now! Best wishes to you.

hope you got on ok today.

as i earlier posted i was under the impression that i was going to be booked in for elcs today but apparently i got that wrong!

going for another scan in 4 weeks and they will decide at 36/38 weeks what is the best form of delivery i have been told that if there is any chance that this will be a long/difficult/instrumental vb that they'll book the sec then

this was not what i wanted to hear but i hope that you got on better x

How on earth will they "know" it will be long/difficult/instrumental at 36/38 weeks?

littlesilver i have no idea tbh!

for my case not op, i presume they're looking mainly at position. DS was back to back all the way through and only got his head down at 40+10 and still nothing happened until i was induced at +15

got practically all the way there but they could turn him or 'suck' him out(sorry!) which is why after an hour had emcs

problem is is like op, i guess i'm just not the type of person to demand a elcs and am just going to have to trust them - for now.

Sorry to hear you are still left up in the air jo.