Can I insist on an ecs after an emergency c first time around?

[mumtojohn]

Hi all,

I've just been reading some similar threads about getting an ecs after a traumatic first birth (and mine was), but mine is slightly different in that it ended in an emergency c. Given that a 'path has already been beaten' c-section-wise, can I insist this time around? And if not, has anyone any experience of how they managed to convince a midwife/consultant to do an ecs after an emergency c first time around?

My DS was born 16 months ago and I am now 11 weeks (fingers crossed scan is OK; it is next week, after my first MW appt). So, when the second baby is born, it will be almost 2 years since my first c-section.

The emergency c occured because of two things: failure to progress and the baby was in distress. The hospital experience was a horrendous one - right up until the c- section, when I was suddenly surrounded by calm people who knew what they were doing. Before it was realised that the baby needed to come out right away (and it was 'right away'; they cut me out of my clothes), I had been left in a cubicle for hours with no one checking in on us. I never saw the same midwife twice the whole 7 hours (before the c-section) we were there. We wanted an epidural, initally for the pain, but eventually I wanted it so I could just be given some attention and care. Once I had had the epidural, I was put in a delivery room, with the baby's heart being monitored, to wait. A new (about the 6th I'd seen that evening) midwife appeared and although it was apparent to my fiance and I that the baby's heartbeat was dropping and not recovering to the same levels with every contraction, the midwife seemed unfazed, barely even noticing. In the end my fiance asked her to get a doctor. Still, no urgency and he frog-marhced her out to get help eventually. The doctor examined me and immediately called out for a crash c-section. They were so frantic that they wanted to do a general, but luckily I had already had an epi so they just maxed it out. My baby was born and was healthy and I soon forgot about the horrid experience (although the midwife who had failed to notice a falling heartrate was very defensive afterwards and made a point of telling me she had donw the right thing (even though she clearly hadn't, until pushed)). At my 6 weeks check up I spoke to the consultant who gave me an address at the hospital to complain to and urged me to do so. To my regret, I didn't. I got caught up in my new baby and I never did, although every time I talked about the birth I got upset.

Anyway, here I am pregnant again (same hospital; it is 5 minutes away and it doesn't make sense to go further afield and we don't have a car) and about to have my first MW appt. I know that any attempts at a VBAC will just end in an emergency c section again (my cervix wouldn't open and countless gynos have told me in ther past that it is in a funny position) and I want to remove the 'emergency' element. Plus, I am scared of being left in labour again and knowing my baby could be in distress. A esc seems to me to be the way to have the inevitable c section in a calm environment, without the threat to my baby.

Any tips on how to make it happen?

x

I was allowed an elcs after an emcs with no problems. My emergency one was due to dd getting stuck cos of being a heifer, so chances were ds would be big too (and he was) but i think they are usually pretty reasonable about these things.

I think you'd be fine getting an elective C section from what you've said. I had an EMSC and asked for an ELCS for my 2nd and didn't have to fight for it. I told my MW at our first appointment, and was referred to the specialist team at the local hospital, who asked why I wanted one. Mine was similar to yours, failure to progress and baby in distress. Had really bad PNS and PTSD afterwards so didn't want to go down that route again. Consultant was fine with reason and that was that.

Just stick to your guns and don;t let them sway you if that is what you're sure you want.

once you have had a section you always have the option to have it again.
you don't have to have a vbac, they might try to encourage you at every chance, but if you don't want that after looking at all the facts/risks, then insist on what you want.

I would simply tell them you have no inclination of attempting a vbac at all, and any suggestion of it isn't going to change your mind.

good luck, and don't worry, you will get a section if thats what you want

I would be very surprised if they refuse your request to have an elective section, if they aren't supportive ask to see another consultant. You have good reasons to request an elective and I can't think of a good reason for them to turn it down.

The treatment you received is shocking. I have just had an emcs after a failed attempt at VBAC and my experience could not have been more different. I was officially in labour for around 18 hours and although I saw different midwives due to the changeovers of shifts, I received one-to-one care and was never left alone. As soon as my baby showed signs of distress doctors were consulted and tests were carried out.

When you have your 20 week appointment with your consultant raise all your issues and concerns with him. It might help to prepare a written list of things that you want to discuss and give the consultant a copy.

Good luck.

While a previous cs isn't listed as a 'reason' to have an elcs the next time round, I know anecdotally, personally and on here many women who have had an elcs following previous em cs, especially where birth trauma was concerned.

Be clear, show that you have researched the possible dangers to cs and understand them and don't be afraid to ask to be transferred to the care of somebody else if you are unhappy.

I was strongly pushed to have a vbac. They made it very hard for me if I had pushed for a elcs. The consultant just said that there is no reason why I can't have a vbac and walked out of the room. The hospital is trying to cut down. She said if you are healthy and the baby is healthy then why wouldn't you want to try for a vbac ? Well, they closely monitored me and at one point I had 4 midwives in with me due to a failed epidural as I was pretty hysterical with pain (that's another story). I certainly felt so cared for. They were brilliant. The problem is you never know who's on when you go into labour.

Anyway, I was told by my friends that I could fight for an elcs if I wanted to, but my consultant said she was following the NICE guidelines and that I should try for a VBAC. I did, and despite the failed epidural, I don't regret it at all. I could have a shower and walk around and hold my baby straight after the birth. I was on top of the world.

I am preg again and the same consultant has said the same thing - although it's now you had a successful vbac and there's no reason why you can't have one again !

I am a walkover and so I guess I'll try again and pray that the epidural works this time.

If you want an elcs just insist on it and you have the right to see another consultant if you are refused. Cut them off straight away and say you have no intention of trying for a vbac as one lady said earlier - maybe I should have done that !

Good luck. It's a hard choice, but because of your history they should monitor you very closely with your second.