Support thread for those of us who are requesting an ELCS after a previous traumatic delivery

[withorwithoutyou]

Hello everyone.

I have noticed a lot of threads regarding requesting ELCS lately, probably because I am in the process of trying to request one myself!

I just wondered if it might be useful for us to have a support thread where we can talk this all through as I know it can be a challenging process to go through.

Can I please also ask in the nicest possible way that anybody contributing to this thread can respect our desire for ELCS over VB? Thank you!

Anyway, I'll start - I have one DD, born 20 months ago by forceps after failed ventouse. She weighed 9 pounds 11 and I am concerned this one will be heavier! I am 30 weeks and have my first consultants appt tomorrow where I will be requesting an ELCS!

Good luck again onebaby - just want to second what hazeyjane said about DH not being there, I didn't take DH to any of my appts and I think it did help me to be more honest about things. Will be thinking of you today.

Hazeyjane - ouch!!! That sounds absolutely horrendous, well done for b/fing at all in those circumstances.

Hazeyjane that sounds an awful experience of bf for you - I really hope it goes smoothly this time but I also hope you (and I) know when to embrace alternatives if needed. Hindsight can be a marvellous thing ....

I can appreciate the honesty level can be more graphic if a DH is not there - with my psychologist I have been able to say things a lot more brutally than I would otherwise as I am alone, and also in my consultant appointments which I have also been to alone this time round. Much easier to say you fear no sex life due to the vaginal pain last time for months and a leaky bladder without a DH to consider - don't want him to have it too much in his head too when we eventually get some kind of sex life back again! Bad enough that I will be worrying about my bladder ....

" I hope I don't get a registrar too."

If you get a registrar and he/she is NOT supportive after your consultant has been supportive just sit there are say you would like to see your consultant please. Repeat as necessary (always with a please and a smile) until they give you a date or you see your consultant.

Thanks all - saw my consultant today who was completely marvelous & I'm booked in for elcs (which he is actually going to do - yes!)on Friday 11th June!! Yeehaa! What a relief! I can't tell you how much better I feel!

At least I can relax & get a bit excited now!
Finish work on Friday too so I'm looking forward to a whole week to chill out & get sorted! Feel 100% better than this time yesterday!
Cheers for the support xx

And ouch, jeeze that sounds painful HazeyJ!! Good luck this time round!

That's great onebabyplease! I'm so glad your consultant was so good, how great that he's also doing the op! No stupid questions in the operating theatre that way!

Glad you're nearly finished work, my last day was yesterday, really enjoying not having to think about work any more.

Great news onebaby - so that's an elective baby due next Weds, Thurs and Fri!

I am going into major paranoia over every twinge now ... just a week to go and I so want to turn up to the hospital calmly with DH in tow.

Scarily DH has to be away tonight until Saturday morning (8 hours drive away). Stay put baby! I've managed to line a friend up for emergency toddler cover if I do go into labour, but I'd really like to do this the planned way. MIL arrives Monday evening so after that it would be a lot easier, but I'll settle for DH being here for the birth!

Lovethesea that does sound quite nervewracking. The sr m/w did assure you that it very rarely happens that people go into labour before their ELCS date but it doesn't stop you worrying I know.

Are you on your own with DD now til Saturday then? That sounds like hard work.

Just thought I'd let you all know I found some good cheap pyjamas for hospital - I wanted something with high waisted black trousers and easy boob access that wouldn't be too hot so got these not my usual style! But nice and cheap and hopefully very practical.

Yup, just DD (18 months) and me ..... she is usually lovely but has started the battle of wills so gets very wriggly at times when she doesn't want her nappy changed/get in carseat/go up or down stairs/walk in a straight line etc! Along with the occasional impressive shriek/fake crying ... which of course I am cheerfully ignoring and talking through while trying not to pull a muscle as she arches her back and wails. Such drama!

It is reassuring to know most people make their elcs deadline - it's lovely and sunny here but I am actually too nervous to do piles of washing for the line because DH is now away. Sad but true! Carrying up and down stairs and bending I am limiting to essential DD care ....

I've packed 4 very cheap pink nighties for hospital - not my style at all, I'm more a fitted t-shirt and pants girl and never baby pink! Can't wait to wear them and bin them ... my mum has sent up some nice pj's which I will wear once I'm home and can bear something near the scar. I am also looking forward to binning the big pants I have had to wear for months now. Last time they all got so bloodsoaked it was brilliant to just dump them with the maternity pads and get another pair out.

Wow, hope it's all going ok being on your own with DD lovethesea.

That's one thing I need to remember to buy is big pants, must pick them up in the supermarket.

DD slept in her bed for the first time last night. It went ok except for she woke at 3 saying her bed was broken. She had kicked the sheets off so think that's what she meant but she went back to sleep fine after that and slept til 9. Long may it continue!

I thought the bed only got broken once they got to jumping on it stage

Time alone with DD has been a bit more exciting than I had hoped. Had a fluid loss in the night so had to call my emergency mum friend just after 6am so I could leave DD and go in to see if my waters had gone. I'd been up googling and calling hospital since 3am. The lovely friend drove me in and to my huge relief an hour of tests and an internal showed cervix shut. So either a dodgy bladder as usual or watery vaginal fluid.

I had been having little leaks as I leant forward after peeing on and off for a few days. I had presumed bladder but suddenly in the middle of the night I realised it might be the same if my waters were slowly leaking. Panic! I could feel bean moving fine but I know infection can be so serious and I felt just awful not having thought of it before then.

So DH is now driving home again, either to arrive in the early hours or tomorrow morning if he stays over en route. I am doing nothing physical that I can avoid and I am praying that Bean stays put until Thursday! MIL arrives Monday night, pre op Tuesday, Weds take tablet and fast in evening and then Thursday meet my baby!

I have an old mobile so no internet access until I get home I'm afraid, but I will be on here asap to update you all. The support has been amazing and I promise to be honest.

Oh how scary lovethesea, I'm really glad your DH is driving home and you won't be alone.

You must be on tenterhooks with less than a week to go. Glad MIL is coming and you can hopefully put your feet up and rest, rest, rest until the Thursday.

Will be thinking of you and hope you don't have any more scares.

How worrying, Lovethesea, especially with your dh away.

I have had a couple of similar panics, but I think it is because I am drinking so much water in this heat, that my poor pelvic floor can't contain it all.

If you go into labour early will they still do a c-section? The consultant that I saw said they would with me.

I will keep everything crossed for you for next week.

Thanks all - yes, the plan would be go in asap and they will do an emcs instead. I'm just nervous because with DD I went from nothing at all to waking at 4am with intense contractions. After the first 20 mins they went to 2-3 mins apart with no real break. I'm just scared I'll be really fast and if Bean is not stuck as DD was I might be in trouble getting to theatre before the main event!

And I am so looking forward to NOT being exhausted from labour before recovering too. But hey, nearly there now! DH crawled in at 2am bless him.

Good luck Lovethesea!!

I wonder if anyone on here has or is using Wishaw Generel hospital, Lanarkshire.

I had a very traumatic experience with my DD1 and it has taken 6yrs to get pregnant. Meaning mentally gear myself to the thought of giving birth again. Also to convince DH that 2nd birth SHOULDN'T be as bad as 1st.

On meeting MW for first app she asked about previous birth and on hearing my story asked if I had thought about a elcs. I had thought about nothing else!!

She said that I should have an easier time with 2nd delivery (things have stretched, body knows what to do etc etc). I said no more.

I am now 30wks, I have seen my midwife THREE times and no other HCP. Is this normal for 2nd pregnancies. I feel great and have had no health concerns.

I have been trying to focus on an active birth, you know the story if at first you don't succeed, but to be honest the closer it gets to my due date memories of last birth are haunting me.

I remember looking at my DD1 when she was delivered and placed on chest and thinking horrible thoughts. Still think to this day i have trouble bonding and know that the terrible birth experience was the reason I returned to work when DD1 was 9wks old.

Anyway How do I see a consultant/registrar? All pregnancy care is now provided by community midwifes in my area? The operation is not the scary bit for me (I work as a theatre nurse and know exactly whats involed) its post Op care. How long do they keep us in? I was in for three days with DD1 and then demanded to go home as couldn;t sleep on post natal ward and didn't get much help with DD1. She didn't get first bath for 36hrs as they thought i had done it!!!!..i couldn't get out of bed on my own due to too much pain anaesthetic given AFTER the birth.

Sorry for ramble but getting soooo stressed now. Any advice gladly welcomed.

Hi mumtoblaire.

Firstly, I'm really sorry to hear of your first birth experience.

I have no experience of the hospital you mention, but if you want to see a consultant then you should just be able to request seeing one. I got fed up with the m/ws fobbing me off and saying I'd see a consultant in time and in the end just phoned the hospital directly and booked an appt with a consultant over the phone - it doesn't have to be arranged via a m/w.

If you're 30 weeks and getting nowehere I would strongly suggest that you do that. Even if you decide on a VB rather than an ELCS in the end a consultant appt should really help you to make up your mind.

I can't help on the post operative side of things as haven't had my ELCS but I have been told that if everything goes according to plan we should be home after 48 hours.

Sorry to hear your care so far hasn't been very good. The only advice I can offer you is to be as pushy as you possibly can. If you want an ELCS then keep pushing and asking, one thing I have learned is that if you don't ask you won't get.

Thanks withorwithoutyou

I am not very good at talking to people and find myself just agreeing with them.

My next app is 2nd july after my 34wk scan(low lying placenta detected at 20wk scan)
Do you think this is to late to wait to ask?

mumtoblaire - I would definitely try and see your consultant asap - if your placenta has moved up when you are scanned then you might find your 34 week appointment is just a cursory 'Oh you're fine for a vb now' meeting with no time for discussion. The elcs v.vb for previous traumatic birth is a different question altogether.

If your placenta is still too low for a vb I presume they will suggest an elcs? How would you feel? Relieved? Glad the choice is out of your hands? Anxious? Upset about not trying a vb? Does that scenario help you work out your gut feeling on what birth to aim for?

I found it really helpful to have a list of questions and points with me for my appointment. Otherwise I tended to get all emotional and incoherent. I would maybe write yourself a list of concerns and fears and the pros and cons of an elcs v.vb and see what addresses it more for you. Would you be helped if someone could go to the appointment with you? Some of us have found that being alone means we can be brutally honest in a way we would temper if our DH's were there - others have found their DH a great support when they felt railroaded by the consultant.

I found the postnatal time in hospital awful too - I was in 6 days with DD as I was so damaged from the rotational forceps. This time I have been told it should be 3 days following my elcs. I'd rather be home the same day, but I do feel more geared up for being in (have packed earplugs, a million snacks, and will be more demanding if need be). For me the recovery time I know I will have in and after hospital with an elcs is easily balanced against the months of outpatient care I needed last time and the possibility for me of lasting worse damage.

I've an 18 month old toddler so we've organised for MIL and then my Mum to come and stay to help. Not ideal but for me the likely elcs recovery is still going to be a better experience than my vb recovery. Obviously you know the details of what affected you, and your DH, so badly last time and how that might be avoided more by an elcs or a vb.

Hi ladies - sorry this may be long - I have been thinking about posting here for a while now, but been trying to reconcile the argument in my own head first - have failed! I am about 7 weeks pregnant and have only thought about the birth so far.

I had rotational forceps delivery just over 2 years ago, after getting to hospital fully dilated after only 8 hours labour. I was then pretty much left alone for a 9 hour second stage which ended in rotational forceps so I am not sure why this happened, as DS only 6lb 15oz. I haven't been through my labour notes with anyone as didn't see the need until now.

I just wanted to run the questions I have past you to see if they seem reasonable, as I am going to ask to see a consultant to discuss CS option.

Firstly, I want to understand if the same thing is likely to happen again (e.g is pelvis shaped wrong for delivery).

If not likely, are there any circumstances where I would have to have rotational forceps again (rather than EMCS), as I am not willing to consent to this again due to damage already done.

Lastly, given my recovery and damage, would CS be sensible option.

I felt that it took over a year to start to feel like recovery was happening and I know I will never feel the same again. This is quite horrible but I basically have a constantly leaking bowel (not so anyone would notice - but am never "clean" if you see what I mean) which I really don't want to get any worse obviously, and I am concerned that even the pushing through a "normal" delivery would do further lasting damage.

I am really tired of thinking about this all the time so would just appreciate any input anyone can give.
Thanks!

crumblequeen - the Royal College of Obstetrics says that:

12. Future deliveries

What advice should women be given following an obstetric anal sphincter injury concering future pregnancies and mode of delivery?

1)All women who sustained an obstetric anal sphincter injury in a previous pregnancy should be counselled about the risk of developing anal incontinence or worsening symptoms with subsequent vaginal delivery.

2)All women who sustained an obstetric anal sphincter injury in a previous pregnancy should be advised that there is no evidence to support the role of prophylactic episiotomy in subsequent pregnancies.

3)All women who have sustained an obstetric anal sphincter injury in a previous pregnancy and who are symptomatic or have abnormal endoanal ultrasonography and/or manometry should have the option of
elective caesarean birth.

Guidelines here

This is advice for those who had 3rd or 4th degree tears with previous births - which I am presuming you had given the forceps and bowel issues, or at least your damage (if caused by an extremely long second stage compressing nerves etc) is very similar.

I think you are very wise to hit this head on straightaway in your pregnancy. If your consultant seems not to listen to you then request to be moved to another consultant.

I think finding out why your (relatively small) baby didn't come out when you were fully dilated is vital. In my case I had a long second stage because DD was Occipito Transverse - her head was engaged side on and there was no way she could descend the birth canal. A midwife error left me being told to push her out for hours which did a lot of damage to my bladder and resulted in DD's emergency forceps arrival in theatre as her heartrate crashed.

I have been told there is no reason why this baby should get stuck OT again, no reason why I would need forceps again, no reason why I would tear badly again - but for me there is also no reason why those things wouldn't happen again! I was very active and prepared lots for my first birth, did all the positioning stuff advised, but to no avail. So while I know they aren't interested in looking into my pelvis shape I am personally taking my history into account and don't want to risk another stuck baby with potentially great damage to the baby and me.

I know my consultant told me that at times it is safer for the baby to use forceps than a c-section. In my case because I had been dilated for hours and she was past the spines of the pelvis and wedged there. A cs would've had to pull her up again to get her out which would apparantly be more risky than rotating and down. I was prepped for an emcs in case the forceps failed. So I felt that I also wanted forceps nowhere near me ever again, but that a situation could arise where they were the baby's best chance and I would need to agree to get them safely out.

An elcs would also save your pelvic floor from another huge stretch as the baby's head (and forceps!) come through it. My physio told me that would lean her towards an elcs for me as I have ongoing bladder incontinence and could do with retaining the strength I have left there. Might depend on the reason for the bowel issues but perhaps worth considering as I believe the pelvic floor muscles help with controlling bowel movements as well as bladder(?).

Lovethesea thank you for the comprehensive reply - that is really helpful and reassured me that I am not being unreasonable in thinking of requesting CS.

Good luck for your ELCS!

Glad to help - you are not being unreasonable at all. Think longterm as well as the few weeks/months immediate recovery post section. Post menopause symptoms of incontinence often worsen as hormones change - and I am expecting an early menopause as my mum and nan had one.

I found it really helped to list my fears of another birth and to see where an elcs or a vb addressed them more.

Another comment while I think of it ... my booking in midwife said it wasn't my birth that made her think an elcs was my best option, but the long recovery that did. And that was after I sobbed my way through my birth story to her! I found it a very traumatic experience but even for those looking purely at the length of recovery and ongoing issues alone there was a good case for an elcs.

That said I do understand why others weigh up the odds and go for a vb. For me, wanting only 2 kids, it's a gamble too far. My gut says it wouldn't be a waterbirth joy this time either and I would so regret any injury to the baby or me that an elcs could've avoided. I'm seeing birth now as a means to an end, not as a 'moment' in itself.

Let us know how your thinking goes!

Lovethesea - Iknow what you mean by 'a means to an end' thats how i feel.

I also now suffer with some bladdder incontenince and wind issues. I also developed IBS after the birth of my DD1, after lots of research turns out a lot of woman may develop it after a traumatic birth!

I always wanted 3 or 4 kids but since birth of DD1 i did think that maybe she would be an only child. How many times can you have cs before the scar tissue becomes to inoperable? anyone know.

How do i see a consultant. Phone hospital?

Hi crumblequeen and welcome. I'm really sorry to hear of your experience.

You do sound as though you have a very strong case for an ELCS and in your position I would at least be wanting to discuss one with a consultant.

I can't give you any better advice than Lovethesea already has, I hope you manage to speak to someone sooner rather than later. Is your midwife sympathetic?

Mumtoblaire - yes, just call the hospital. It should be quite straightforward, I think it was the antenatal clinic I called but they didn't have a problem with me going direct rather than through GP or m/w.

I don't think there's an absolute limit on the number of c-s you can have but I've heard people say they like you to stop at 4 - not sure how true that is. The c-sections.org website says the most any woman has had is 7!!

How many c/ses are recommended seems to vary, some places say 2, others 3. After a couple it is generally safer to keep having c/ses as the risk of scar rupture increases. A woman at my playgroup has had 5! And was in great shape about 2 months after the 5th, pushing a double buggy half an hours walk to playgroup (probably not recommended but she didn't have a car). She told me that the surgeon who did her 5th c/s said he had done an 11th c/s on one woman.

Quite a few people seem to have 3 with no ill effects, the risks do go up but not ridiculously so (I think - not an expert).

Someone was asking about how long to stay in hosp after c/s - after my emergency one I was in 5 days and they have said this time I can stay in 4 or 5 days too - but I know people who have left after 48 hours after an elective (and I think I've read on MN of people leaving even earlier than that). I'm in 2 minds as I know I will miss dd but I want to get some rest for a few days in hosp too as we have no family around to help out once I'm home.