Is ECS possible with first baby?

[TigerseyeMum]

Hi

I'm not pregnant yet (well, I might be but if I am I don't know it!)but I have major reservations about natural childbirth.

I am not just being chicken about the whole thing, I have 2 medical reasons that to me feel valid enough. Firstly, I have endometriosis to stage 4 which has in the past caused major internal pain and adhesions which mean my inner bits don't move around much. I also get excruciating internal pain in places I won't mention

Linked with this I have 2 prolapsed lower discs at the point where the spine supports the womb. They were badly damaged and although they have recovered it took me 3-4 years of intensive osteopathy and this is the first time in my life I don't have serious backpain. My physiotherapist I had a few years ago also said my hips are wierd and don't move properly which also causes pain.

I know neither of these conditions are life or death. I just cannot in a million years see my body pushing a baby out. I don't have a baby-making body at all so getting pregnant will be a miracle in itself.

What do I need t do to discuss an elective? Or am I an absolute no-hoper?

Sounds like you may have good grounds for ECS. You will have to discuss with MW who will refer you to a consultant. If labour will put undue stress on your bones then I can't see why a doc would refuse you a CS.

Good luck!

In light of your medical history you could request an appointment with a consultant to discuss your options. I'm sure midwife could arrange this but doubt it would happen until later on in a pregnancy.

You'd amazed at the human bodies capacity to squeeze out a baby though!

Thanks - I think if I got pregnant I may be elligible to see my specialist gynae consultant who deals with the endo,so perhaps he would be sympathetic?

It's quite scary to think I wouldn't know if I could have a CS until I got pregant. I can put my back out just being constipated!

Sorry, may have been TMI!

But seriously, when my back goes I can't do anything. I watched my neices and nephews grow up without being able to get on the floor and play with them, or being off my face on painkillers the whole time, and I don't want that with my own child :(

I am aware that CS is not a breeze though and carries serious risk of further endo adhesions.

Thanks for your comments :)

i am no expert, but it sounds like your medical issues would cause more problems with the pregnancy itself than with a vaginal birth.

as molly says, you'd be amazed at what your body can do, with regard to giving birth!! so personally i wouldn't rule it out completely, as a vaginal birth is safer for you and the baby

but it's definitely something you should discuss with your midwife. they will refer you to a consultant to discuss it all

hope all goes well!

If you are planning to ttc then I don't see why you shouldn't make an appointment with a MW now to discuss your situation and see if they could arrange for you to see a consultant prior to the pregnancy to talk about CS.

You should be able to see a MW at your local GP surgery, just ring and ask for an appointment.

ahh ok you aren't pregnant yet? I think that if you are under a specialist already then you could contact them and just discuss it over the phone. I don't suppose it would give you any concrete answer right away, but they certainly would be able to talk you through all the diffferent scenarios and what would be best for you

At some point you ought to have an appointment with a specialist obstetric physio to talk through your labour options. You may have to push hard for this referral, though.

If you have mobility problems, waterbirth is worth considering, as it allows your body to move far more freely than on land where you have to fight gravity.

Elective CS is also an option to be considered. At the moment you are assuming you won't be able to birth vaginally, but it may be possible. Make sure you know for certain before you commit to a surgical route.

I have chronic back trouble from an injury when I was 21. My pregnancy with dc1 was the first time in 22 years that I was consistently free from pain. I had been expecting a deterioration. A few months after the birth I was back at the physio as usual.

Wishing you a fruitful 2011.

Thank you thisisyesterday I agree that pregnancy, if it happens, would be a tricky thing. I still have back pain and getting out of bed/into the car/etc can be a trial at the best of times!

Little flurry of comments there - thank you :)

In the new year I will speak with my GP and see what options ther are re: consultants etc. My gynae is not at my local hospital but they are a specialist teaching hospital so I may prefer appointments there.

I am a baby novice, being the youngest child, so no clue really! And we are TTC but it's a secret as I assumed I was infertile due to severe endo, I'm a late starter! So no one really to discuss it with!!!

Thinking about it now c section means cutting through the stomach muscles which isn't great if you have problems with your back.

From that point of view vaginal may be better if it's possible for you.

They do not cut your stomach muscles for a csection - they pull them apart. Pregnancy will weaken you stomach muscles regardless although they will still have some strengh using them will be slightly painful and your core stability will be ompromised for a while. If you want a csection ASK for one - you need to need to see your consultant for that. You cang et one if you're persistant if it's what you really want.

In the event of you getting pregnant then I you would probably have consultant led care. Also you should ask to see an obstetic physio. Obstrictians are not experts on joints.

You would need to have the discussion about having a ECS with a consultant. People with far more stupid reasons have c-sections.

However c section may not be the best option for you. People often exaggerate the pain of childbirth. It is best to ignore the horror stories.

Thanks all :) The pain I had from endo was so severe it is apparently the same as labout pains, it hurt (understatement) but it passed. I am more worried about lasting damage.

Well, if and when it happens at least I know now that there will be people I can speak to :)

I don't know what endo feels like, and I don't doubt you if you feel the pain is extreme and severe, but please don't let the comparison with labour scare you. Labour pains are different. They are not like other pains.

In labour you know that the pain will build up and fade away and you know that it wil end. Often you know to the second when it will end. That is not something you have with other pains, and it is very reassuring. You know that you will have a rest between contractions. You coped with the last contraction and so you know that you will cope with the next one. There is a rhythm to it, and you get into the rhythm.

Also, you know that each pain is bringing you closer to meeting your baby. This can help you to perceive the pain as a positive thing, to welcome it.

Oh, and Gas & Air rocks

Yup, gas and air all the way

My friend also did autogenic relaxation to help, which is something I have used in the past and might use again. It's a form of deep relaxation a bit like self-hypnosis.

I am more concerned about the pushing and my back, and also tearing because I already have a few problems.

Certainly something to think about anyway :)

I had a partial discectomy 10 years ago and apart from occasional 'bad days' over recent years I thought I was relatively ok now.

I've just turned 18 weeks and I have been stuck in my house for 5 days due to my back giving up the ghost - with the worst part the extremely limited range / impact of painkillers which you can take when pregnant.

I was marked as high risk as a result of the back operation and spinal fusion I had but am not seeing a consultant until 30 weeks which will be my first real opportunity to discuss a CS.

Having suffered the horrors of back problems for several years when I was younger (and using a walking stick / not being able to walk at all etc) I am not going to risk trying to give birth naturally with limited strength in my back for the sake of budgetary concerns of the NHS or some people saying that you don't really give birth if you have an ELCS - imho it isn't worth it.

I would say the best thing you can do before getting pregnant is go to an osteopath and look into pilates or yoga to help build up strength - I wish I had known about these before getting pregnant.

I'm hoping that my current back problem rights itself or is just a 'growing' pain, but I would not wish anyone with a back problem these kind of difficulties when relatively early on in pregnancy.

Good luck :)

I second the poster who mentioned back problems as a result of the c section. I did.t have any pre-existing back or abdominal issues, but post section (11 weeks, my back is so weak it really restricts how long I can stand/walk/sit in an upright chair for . I didn't realise how dependant your back is on your stomach muscles.

Hope you're able to find out about your options and make the best choice for you

Again with the back problems. If they have to cut through your core muscles you have nothing supporting your back. I have suffered from PGP for 5 years and been on crutches for 2 years. I had no choice about the section as it was a crash situation. They've told me since that it's why I didn't get over PGP and that I'm fortunate I had generals because sticking a needle in too would have made things a lot worse. The first time gave me PTSD too which is quite common with births under general anaesthetic if not handled well.

Hi. I am currently pg with my 2nd DS. I have endo too but only stage 2 or 3 (cant quite remember) and gave birth naturally to an 8lb 11oz baby. The problem I had was that I broke my tailbone when I was a teenager and it broke again when I gave birth. When I saw the midwife this time she said it was likely to happen again so I am currently awaiting an appointment to see the consultant and I will be pushing for a ECS as I know it is not an easy option but I was in pain for over a year with it and had to have regular injections in my spine, Ive also been warned if I keep breaking it, it wont heal!
I think it depends on the individual and the consultant will be honest with you and tell you what is best, it will then be down to you to make your final decision.

Good luck x

"The skin incision is almost always a transverse, or "bikini", cut low on the abdomen. A few circumstances dictate the use of a vertical skin incision in the midline from just above the pubic bone to just below the belly button. In neither incision are the abdominal muscles cut. Rather, the two strips of rectus muscles are only separated in the midline and return to normal position after healing. The second cut, the uterine incision, when done transversely (crossways) as is most common, is the one that allows VBAC safely in the next pregnancy, regardless of the type of skin incision that was done."

That's from an American site - but it does say no muscles are cut, I imagine the UK surtgeons do the same?

Thank you, I now know that this problem is all in my head and my team have been lying to me...

Regardless of whether they cut through the muscles and push through with their fingers the fact is they're still going through them and it still weakens the support on the patients back. Sometimes it's unavoidable and a lifetime of crutches (talking about myself here) is better than the risks of delivering naturally. For most people who don't have back issues it's not going to make much difference but it is something people who do have problems need to consider.

Eh? I never said anything about it being in your head, no need to get snippy. You said they cut the muscles but they don't, just wanted to give correct information.

The muscles don't come with a baby shaped hole! Whether you use a knife or your fingers to get through is irrelevent, you've made a hole in there that weakens the muscles and can cause back weakness, if you already have problems with your back it can agitate them.

If sections don't weaken the muscles then it must be all in my head that the sections weakened my back. What else would you call it?