Mind if i take over for a mo? Got my consultant appt tomorrow, asking for an elective. Any advice would be welcome. Below is what i am taking with me;
NICE Guidelines - CG132 Caesarean Section
1.1.1.2 Give pregnant women evidence-based information about CS during the antenatal period, because about one in four women will have a CS. Include information about CS, such as:
? indications for CS (such as presumed fetal compromise, 'failure to progress' in labour, breech presentation)
? what the procedure involves
? associated risks and benefits
? implications for future pregnancies and birth after CS. [new 2011]
1.2.5 Placenta praevia
1.2.5.1 Women with a placenta that partly or completely covers the internal cervical os (minor or major placenta praevia) should be offered CS. [2004, amended 2011]
1.2.9 Maternal request for CS
1.2.9.1 When a woman requests a CS explore, discuss and record the specific reasons for the request. [new 2011]
1.2.9.2 If a woman requests a CS when there is no other indication, discuss the overall risks and benefits of CS compared with vaginal birth and record that this discussion has taken place (see box A). Include a discussion with other members of the obstetric team (including the obstetrician, midwife and anaesthetist) if necessary to explore the reasons for the request, and ensure the woman has accurate information. [new 2011]
1.2.9.3 When a woman requests a CS because she has anxiety about childbirth, offer referral to a healthcare professional with expertise in providing perinatal mental health support to help her address her anxiety in a supportive manner. [new 2011]
1.2.9.4 Ensure the healthcare professional providing perinatal mental health support has access to the planned place of birth during the antenatal period in order to provide care. [new 2011]
1.2.9.5 For women requesting a CS, if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS. [new 2011]
1.2.9.6 An obstetrician unwilling to perform a CS should refer the woman to an obstetrician who will carry out the CS. [new 2011]
1.8 Pregnancy and childbirth after CS
1.8.1 When advising about the mode of birth after a previous CS consider:
? maternal preferences and priorities
? the risks and benefits of repeat CS
? the risks and benefits of planned vaginal birth after CS, including the risk of unplanned CS. [new 2011]
1.8.2 Inform women who have had up to and including four CS that the risk of fever, bladder injuries and surgical injuries does not vary with planned mode of birth and that the risk of uterine rupture, although higher for planned vaginal birth, is rare. [new 2011]
1.8.3 Offer women planning a vaginal birth who have had a previous CS:
? electronic fetal monitoring during labour
? care during labour in a unit where there is immediate access to CS and on-site blood transfusion services. [2011]
1.8.4 During induction of labour, women who have had a previous CS should be monitored closely, with access to electronic fetal monitoring and with immediate access to CS, because they are at increased risk of uterine rupture[4]. [2004, amended 2011]
1.8.5 Pregnant women with both previous CS and a previous vaginal birth should be informed that they have an increased likelihood of achieving a vaginal birth than women who have had a previous CS but no previous vaginal birth. [2004
Consultant Appointment ? 17th April, 09:45am.
? False labour started Sunday 8th May. Back pain. Was examined at hospital and found to be barely dilated. Was given a sweep and sent home.
? Sunday night, waters broke. Was examined at hospital and told my waters were still intact and I wasn?t contracting frequently enough (they were more frequent at home). Was sent home with co-codamol for the pain.
? Woke on the Monday to nothing. No pains, no labour.
? Tuesday morning woke in pain. Was due to see my midwife but waited a few hours until the contractions were painful and went to hospital. Was 3/3.5cm dilated. Still unclear as to If my waters had broken so was allowed to remain in Willow ward.
? A decision was taken later that day to admit me to labour ward as it was still unclear re my waters. I was about 3.5cm dilated still.
? I was connected to the machines without being changed into my nightdress and there I remained.
? I was ok with gas and air mostly and eventually had pethadine ? it is unclear to me if this was late on.
? I was put on a drip to induce me I believe, and baby reacted to this and his heartbeat dipped. All the midwives came rushing in to turn me as I was in too much pain to move. I was moved both ways, the drip was turned off, and a heart monitor was attached to baby?s head.
? I was told at this stage that if things didn?t progress soon I would need a c-sec. I recall this being about 9pm, and only being 4cm dilated. I was scared stiff when told the drip was being turned back on and increased slowly, in case baby?s heartbeat slowed again.
? At 1am I was told I was having a s-sec, and still nothing happened. The surgeon apparently went into theatre. I was left until 4am by which time I was in agony and couldn?t manage without the gas and air.
? I recall feeling slurred when I came round and not being aware I had been put under due to baby being stuck and me needing a blood transfusion.
? At no point was I told baby was back to back.
? I am not prepared to risk going through all this again.