Consultant will not do an ELCS until 41 weeks!!

[BigMommaOfAlmost4]

Is'nt that later than usual? I always thought they did them from 38 weeks.

Discussed ELCS versus VBAC today with her (she is actually only a registrar as the consultant has retired and they have not yet replaced him ).

Obviously I do not want to put baby in any jeopardy but as 37 weeks is considered 'full term', why would the patient not have more say in when it happens? Baby is measuring big (6lb at 34 weeks), I have OCD which has worsened considerably during this (4th)pregnancy and also SPD is starting again! I would hope to go into labour naturally before 41 weeks and try for a VBAC but if that does not happen and I get desperate I would go for a ELCS (especially as they can't do a full induction with a VBAC and I could end up waiting and have to have an ECS anyway which would be just my luck!!). Am getting more and more worried about a VBAC as time progresses (sounds nice in theory etc and the OCD is not helping with my choices!!)

Any ideas on what arguments to use at my next appointment??

BTW last pregnancy was twins with 1st one being breech hence the need for an ELCS at 37 weeks (different hospital)! They weighed 7lb and 6lb. I know the reason they delivered them at 37 weeks was because they were worried about me going into labour spontaneously.

Had previously delivered twice naturally.

I am having an elcs and the policy at my hospital is for 39 weeks. It is meant to give best chance of the baby needing no help with breathing and also the mum not going into labour before it. Obviously some specific conditions might push it to 38 weeks such as placenta previa etc.

I presume with you they are leaving it to 41 because the plan is to vbac if possible?

if you are hoping for a VBAC, then waiting until 41 + weeks for an IOL or c.s is going to give you more chance

if you want an elective, no trial of labour, then 39 ish weeks is best.. the outcomes for babies are far better at 39 + weeks for elective c.s WRT to breathing etc...

decide if you want an el c.s or VBAC and the rest should follow..

Mine would only do from 39 weeks, but would wait until 41 weeks if i wanted to try a VBAC. I decided against a VBAC and was booked in for 39 weeks exactly

It could be perfectly reasonable to have an ELCS at 41 weeks, especially if avoiding induction was a big factor. Did the doctor discuss with you what you wanted to happen if you went into labour before that - whether you would want to try for a VBAC then or proceed to Emergency CS?

My consultant wanted to do my planned CS at 39 weeks. He was keen to leave it as late as possible. In the end it was moved up because I wasn't well. The other consultant seeing me ('twas complicated) had expected 38 weeks so 41 does seem a bit late.

Not sure what you mean by 'if I get desperate' - what would be your cutoff point for this? Before 39 weeks? Are you now feeling more like you would rather just go for the planned CS?

Mine was actually done at 36+6 and I still had to have steroid injections as these are required before 37 weeks to improve lung development if baby won't wait any longer. So they will certainly want to go past 37 to make sure of that. I would expect 38-39 weeks to be the norm. Can you find out what is usual hospital procedure?

What arguments to use depends whether you want a VBAC or a c-section. If you want a VBAC then the 41 week ELCS is only 'just in case' you don't go into labour before that. If you want a c-section not a VBAC it would be at 39+ weeks normally.

You say in your OP that you would hope to have a VBAC before 41 weeks and only have an ELCS if desperate, which all fits with the 41 weeks timing.

But then you say you are getting more worried about the VBAC. Is there a bit of you that was hoping an ELCS booked for 38 weeks would 'get you out of' having to try VBAC? Because it's ok to want a ELCS straight-off if that makes you feel more comfortable about the whole thing.