Points in Support of Elective Caesarean Section
During my previous birth, rotational forceps were used following around 6 hours of second stage labour, during which the baby did not turn (despite a small baby, optimal positioning throughout labour and no restrictive pain relief).
I feel that the second stage was badly managed, in that there was very little guidance given on pushing, or on the lack of progress. I was also not advised to try to urinate until it was too late and I was unable to do so, at which point a catheter was needed. I am understandably reluctant to risk a similar traumatic experience again.
I have several problems which have arisen from the previous birth, which are noted below:
- Previous damage
I have a persistently leaking bowel (toilet paper always dirty, even when not passing bowel movement), which suggests some muscle/nerve damage has occured either during the long second stage or the forceps procedure. I obviously do not want this to get any worse and I feel that even the pushing in an unassisted and quick vaginal delivery would cause further damage and weakness.
In addition, I can still feel that the episiotomy site is tight and damaged skin, for example when I squat down or move in an awkward position, and I do not want further damage to the perineal area either through tearing or episiotomy.
The pelvic floor strength I do have needs to be preserved to avoid further long term problems.
- Previous recovery
Recovery from the previous birth was very poor, which I feel is due to the damage sustained from the invasive forceps procedure. For example:
a) I was unable to walk comfortably to the local shops (a ten minute walk) until after four weeks
b) Antibiotics were required to treat episiotomy infection
c) Sexual intercourse was extremely painful for over 9 months
I am requesting a C-Section as, although the short term recovery is going to be hard and I understand the risks, I feel that the long term recovery will be more certain and quicker. Also, further to point 1, as the damage will be in a different area, I feel that a C-Section will not worsen existing damage.
- Future risk of instrumental delivery
Given the above factors, I am unwilling to consent to the use of forceps again. I have been very anxious about this throughout pregnancy, and even making the decision to become pregnant again was clouded by the thought that this may mean a risk of instrumental delivery again. I could not attempt a vaginal delivery without this anxiety being at the forefront of my mind and I feel that this "mental block" would increase the chances of intervention/emergency C-Section being needed anyway.
I am also aware that there are some circumstances where rotational forceps may be the safest option (for example where the baby has descended too far for an emergency C-Section to take place). In light of this, I am also requesting an elective C-Section in order to remove the risk of forceps being used again.
- Future births
I am not planning any more pregnancies after this one so there will be no future issues in respect of risks of multiple C-Sections.