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!

Hi all,

If anyone is local to us in Coventry, we (NCT Coventry Branch), run a support group for parents who have had a caesarean and/or traumatic birth experience and are considering their choices next time round (whether pregnant or not). We meet on the 1st Thursday of each month.

The group is run by mums who have experienced (all types of) birth after caesarean and supported by a supervisor of midwives (although she can't make tonight).

We meet in Earlsdon Methodist Church coffee lounge at 7:30pm. The group is free and open to all, we have loads of books and resources on vbac/ homebirth/preparing for elective caesareans to borrow and we're having mince pies and lovely stuff tonight as it's the last meeting before Christmas
If you are interested in coming along, give me a call/text/ email on 07974209882 or [email protected]

Wishing you all positive births-in the way that's right for you

Rachel xx

NanBullen I just wanted to post as I am out the other side now. had my elc last week and I can honestly say it was such a positive experience. It was totally pain free, extremely civilized and my recovery amazing. I was discharged the following day and 1 week on, do not feel at all like I have had surgery whatsoever. compared to the delivery of DS1 this was a totally different experience and I cannot stress how pleased I was that I pushed for this outcome. DD born with zero stress, fabulously quick recover and she is an angel. I don't have a single downside, except I wish that I could have had this birth experience for my first delivery rather than the horror of an induction and 3 day labour with a very painful forceps delivery and long recovery. I just wanted to say, I would urge you to push for what you want.

I'm so pleased for you LisaClapham and glad to hear that the recovery is going well!

I saw a much nicer consultant today who didn't patronise me. She wants me to see a counsellor as she thinks i may have ptsd (I burst into tears when i tried to talk about the birth ) and then i'll get a decision when i'm 36 weeks.

so its not a given that i'll get a c section but i do feel like i'm being taken seriously now and i feel a lot more positive.

For the best part of four years after my previous birth I had nightmares. I still hyperventilate before going into a maternity unit. The best bit of the birth was easily having the EMCS.

This time round baby has complications - we are told he is breech (cannot be turned - long story), will be either stillborn or die within minutes. I am told I must go through a natural labour and that I have no choice in the matter. Their reasoning is that there are risks in an ELCS (there are in a natural birth with a baby that has an abdomen his size, and a mum with PGP - but those seem to be conveniently ignored)and that a successful VBAC will be better for me if we have another birth. I can tell you now - if they cannot guarantee an ELCS next time round, DH is not going to be allowed to be intimate anywhere near me again!

I am being given the impression I should be grateful the Hospital are 'letting' us give birth there, rather than pinging us back to a unit that doesn't have facilities if something goes dramatically wrong (their original idea). Tempted to talk to PALS, but realistically are they actually going to do anything, and do they really have any influence?

so sorry to hear that karenHL

I do get the impression that some hospitals just do whats best for them/most convenient rather than whats best for the mother and baby.

I would definitely talk to pals. i contacted them about an incompetent consultant and tbh didn't really get anywhere but your issue is so much more important than that. if you don't get anywhere try your local mp or head of the pct. When you feel up to it obviously.

Look after yourself

xx

KarenH, am shocked by your story. I thought women were given the choice of an ELCS for all breech babies? In fact I have heard some women who would have preferred a vaginal birth complaining that they felt forced to have a cs in this situation.

Can you request a second opinion? I am very surprised that your hospital has enough midwives experienced in breech vaginal births to guarantee a safe delivery.

NanBullen, did you see HML? she's lovely, I think, and v sensible too. I really hope you get the birth you want. I think seeing the midwife consultant (Penny something, also lovely) might be an option instead of the head midwife. Do keep us updated! X

No I saw a Miss Bhatti but i have seen hml for a scan previously and she is lovely. I'll try and see her next time. Still haven't heard about an appointment with a midwife, i just get the impression they're not interested which doesn't bode well if i do have labour "naturally".

I'm seeing a counsellor on thursday, not really looking forward to it but it's what i have to do....

NanBullen, just wanted to let you know that if you do go for the induction with epidural then you could just refuse to let them put the syncotin drip in until the epidural is already in place. I did this last time, although it was when I transferred in from home at 7cm. I don't know what the policy is on putting you on it before labour starts, you could research it though. At least then you'd be guaranteed your pain relief.

If you ever have had anal incontinence I think they will definitely consent to the section, even if you only had it at first and it has gone now, I don't know if that's any help. They also consider things like no control over passing wind and extreme urgency to go as symptoms of incontinence. When I met with the consultant this time round at 20 weeks as soon as I mentioned I have this they put me straight forward for a section with no arguments.

Good luck

Thanks GruffalosGirl, I'll keep that in mind about the anal incontinence!

Also if it took ages to have a normal sex life again.

I told them it was about 9months least before we managed to have sex and also had some problems with faecal urgency, incontinence only happened twice but was definitely the thing that swung it for me. Got a section with no more questions asked.

Good luck

Hi all, I am now 28wks and after EMCS in labour for undiagnosed breach last time have just been told I can have an ELCS this time. The registrar I saw yesterday was very understanding and non-pushy and said it is my decision. Whata relief, for the first time I am actually really looking forward to the birth now. The choice should be available more widely, especially to those with previous CS or traumatic births.

Agree gruffologirl re the anal incontinence. My registrar who agreed the c-section said he would have said yes anyway based on previous delivery bit the fact I still suffer from bowel incontinence 3 years later means I should definitely have elcs. 6 weeks on Monday until mine, I am ready to get on with it now!

Well, finally saw the consultant midwife who refused to talk about a c section (i knew she would, she's trying to get the c section rate down)

She was really nice and we're writing a birth plan together. She wants to have me in the birth pool and walking around but i basically said i want an epidural as soon as humanly possible. none of that hippy shit (yes i actually said that! ) I couldn't breath let alone move last time so i think walking around is a bit ambitious.

She has agreed that i can have an epidural as soon as in established labour, which is nice of her

Anyway, i'm happy to write the birth plan but am still seeing the consultant in a weeks time (when i will be 37 weeks) to get her final decision about an elcs. At least my birth plan will be signed off by the top midwife so should be followed.

saw the counsellor a few weeks ago who said i had ptsd so i'm hoping that will sway the consultant towards a csection.

why is it so hard to get a csection?!

Hi all - this thread has been a great support to me... and I just wanted to ask if any of you could help with my post at:

www.mumsnet.com/Talk/childbirth/1117129-Birth-after-traumatic-birth-might-need-to-change-consultants-at-Queen-Charlottes-can-anyone-help

I am also wondering if I should be asking for/getting a recommendation for a psychiatric evaluation to push through the ELCS if I go over 40 weeks... QC's didn't offer me any mental health support. I was just told that I should be on anti-depressants... which is extremely unhelpful as I was actually on anti-depressants last time I gave birth and of course they don't make a birth less traumatic.

Well no elcs for me (i'm NanBullen btw!)

Just had my last consultant app (i'm 37+3) and whilst she was very sympathetic she said that i would only get an elcs for physical reasons and not psychological as the hospital has just changed its policy and will now not even consider maternal requests

tbh i'm really tired of the whole thing and just want this baby out now! I've been promised a better experience re: pain relief and availability of an epidural this time so I'll just have to trust that pain relief will actually be available this time.

All of the threads i see where a poster has been offered an elcs and they don't want it! I'll swap my vaginal delivery for their elcs any day!

Anyway, thanks to everyone's help and supportive comments.

Ithinknot/nanbullen just wondering if you have had your baby yet and how things went? Sorry you didn't get the elcs.

I had an 'interesting' birth after having elcs agreed without problem for 24 jan. Baby decided not to wait and went into labour on 22 Jan. Got to hospital within 1.5 hrs of feeling anything and was already 6cm so they started prepping for section straight away, which didn't seem a problem. No one asked if I wanted to try vaginal birth instead. Got spinal in place in theatre 40 mins after arriving at hospital and then they examined me and babys head was inches away so had to scrap section and try to push, which needless to say was pointless as could then not feel a thing! Those spinals are good for that!!

Anyway ended up with forceps delivery and episiotomy nd a beautiful DS2 at 7lb 1oz. I have no issues with them not doing section, they tried but he didn't want to wait and would have been dangerous to try and push him back up. Forceps were just small delivery forceps not keillands like last time and I feel much better at this stage than before. Just goes to show sometimes you can't plan

Well, this thread seems to have gone a bit quiet!

I posted back in October when I was in the early stages of pregnancy wondering about when to bring up the fact I want an ELCS this time after a traumatic induction leading to EMCS last time.

I am now 30 weeks and have my consultant appointment on Friday to discuss the birth and was wondering if anyone has any tips about what to say that will help me fight for an ELCS this time.

Basically my last section was due to failure to progress - I think I barely reached 3 cms dilation. I was 2 weeks overdue with no signs of imminent labour and induced on a drip and my waters were broken artifically. Contractions were horrendous and with little gap between. 18 hrs and an epidural later, there was some fetal distress and they took me off for an EMCS. I was very shell shocked and exhausted and didn't really feel like I could enjoy my newborn daughter for quite a while afterwards.

I have read the NICE guidelines and the RCOG guidelines which both say that maternal preference should be taken into account when deciding on VBAC vs ELCS.

Does anyone know the stats for the likelihood of a successful VBAC if I failed to dilate last time and have never given birth naturally? I know the general % is 70% success for VBACs but surely this will be much less for me? Also I have a family history as my mother had 2 sections.

Also I am aware that the instrumental delivery rate is much higher for VBACs - does anyone know what this is?

One issue is that I have moved to a different area of the country so the consultant won't have my notes from last time to base his decision on (seems ridiculous, I know). I have requested them from the previous hospital but am not sure they will arrive on time. It could either be a good thing or a bad thing that we don't have them depending upon whether what is in my notes would be enough to persuade him an ELCS would be a good idea this time.

So that's it - any advice would be much appreciated! Also, I am in the East Midlands (Leicester) so if anyone knows of the hospital VBAC policies around here, that would be most useful. There is nothing on the hospital website about what their policy is so that is useless.

Hello. First time on this thread and it's really interesting.

Lola- I'm 16 weeks with my second, having experienced emergency CS with DD (now 2). I wouldn't assume that you have to 'fight' for an elective- I think that 'policy' and attitudes vary betwen hospitals and consultants.

I have not seen my consultant yet but when I mentioned that I was nervous about this birth, I was offered an appointment at the 'birth options clinic' - not called VBAC clinic. The consultant midwife was really supportive and clear that she was there to give me impartial advice. We talked about all the options including ELCS and homebirth, the concerns I have relating to my previous birth (basically, DD was in significant fetal distress before labour, she would have been stillborn if this hadn't been picked up by a chance appointment with my independent midwife)and the plusses and minuses on VBAC.

I'm pretty decided on an elective CS but it was really useful to talk it through to get my concerns straight in my head and for someone to reassure me that I'm not totally neurotic!

I've changed hospitals too. The VBAC stats are very poor where I am. 70% try for VBAC and 40% end up with EMCS and 30% with an assisted delivery. They are very risk adverse, insisting on CFM etc. It's useful to ask your consultant these figured for your hospital. And to make it clear that you have read the guidelines and know the pros and cons. Also, remember if you don't get on with the Dr you see, just ask to see another next time.

I'm hoping to get my ELCS agreed at my 20 week appointment as like you, it is very present in my mind. I'm going to be on 2 weekly scans (baby was inexplicably tiny last time, couldn't cope with labour) so I'll have plenty of opportunities to harass her I suppose!

Best of luck.

Thanks Helzapoppin. I hope I won't have to fight for it but am aware the some other people on this and other forums have been point-blank refused an ELCS after EMCS.

Incidentally, I notice that this issue is currently being hotly debated on AIBU:
www.mumsnet.com/Talk/am_i_being_unreasonable/1161798-to-think-elective-repeat-caesarian-is-a-valid-choice

Although they seem to have become sidetracked with a general ELCS vs VB discussion rather than ELCS vs VBAC. However, it is interesting.

lolaclaire Re tips for getting c/s, what about saying that on religious grounds you will not allow anyone to touch certain parts of your anatomy and you are declining consent?

There was a recent case where a woman was offered an induction and refused because she wanted an elective caesarean. No caesarean happened and the baby died (I am not quite sure of the details of the cae - this bit is from memory). The bit I can remember clearly was that she sued, the hospital blamed the mother for contributing but the court upheld the mother's case as her request was reasonable in the circumstances and would have saved the baby's life.

I would also write to your MP. MPs seem to think all women want vaginal birth at home without pain relief. Some do but not the majority. The message of the other side needs to shoved under their noses. I could throw a brick at the TV when I hear them talking about offering women choice in maternity care. Yes, their choice!! GROWL

Really interesting thread !
I had a forceps delivery 5 years ago with my first child and have been left traumatised by the experience. I also had to go back in for surgery to be repaired 6 months later.
I am expecting our second child in the spring, I'm 33 wks, but it has taken me a long time to feel ready. I just didn't feel that I could endure that amount of pain & damage again.

I saw my consultant at 12wks and he was really sympathetic, I cried whilst telling him about my experience, I still feel really emotional about it.
He offered me an ELCS then and booked my date at my 28week appointment. He is offering it to me more on psychological grounds than physical reasons.It has made me feel much calmer about it, I know things could still be unpredictable, but fingers crossed

They should just listen to the mother's wishes, it shouldn't depend on being lucky with how your consultant feels about it !!
Ladies, Really hope that all your concerns are heard too x

Well, i went into labour and had dd on feb 2nd. Luckily i did get my epidural at 4 cms with not much hassle this time and so it was a completely different experience to last time! 7 hours from start to finish although in hind sight i had been uncomfortable in bed all night so probs in early labour then.

i was a lot calmer actually this time. dh had to tell me quite sternly to ring the hospital as my contractions were 5 mins apart. they just didn't feel as bad this time! . anyway, my birth plan ws followed to the letter. the nasty consultant appeared when i was pushing and was adamant that the epidural should be turned down so i could feel when to push. needless to say she was given short shrift by me, dh and the midwife! at one point they thought that dd was in distress and were prepping for a cs and weirdly i was really disappointed! i just thought, i've got this far, i'm not in pain, i want to push her out! anyway, 2 pushes later she was out

all in all a very positive experience, helped by amazing support from the midwife and the amazing epidural!

Just need help with dds sleep at night now