is there any circumstances other than emergency that an ELCS would be performed at 37 wks?

[applejacket]

i think i am right in saying that 37 weeks onwards is generally considered to be safe for a baby to be born?

i have an elcs booked for 39+0 - i am 22+3 atm

but i am having a terrible time mentally and emotionally. i am extremely low, i don't want to leave the house, i feel completely detached from everyone i love, in fact i am permanently angry and tearful, and detached from the things i normally like doing. i hate myself and my body, freak out about every pound that goes on, i feel massive and disgusting and the thought of another over 16 weeks of this kills me. and in the worst times i wish i had not got pregnant and even worse that i had had a termination (as between 8 - 12 weeks i was crippled with the most awful sickness and seriously considered a termination as i just was not coping) (i am sorry if that upsets anyone btw :( but i want to be honest about how i am feeling) i think its more than just normal pregnancy blues and from what i have read it sounds like ante natal depression

i am also suffering from awful back pain which my MW does not seem to give a shit about, i have been referred for physio but god knows when i will get an appointment, i have been wondering if its sciatica or SPD as its so much worse than it was in my other pregnancies (have 2 other dcs) but its debilatating at times, i can't do the things i normally do as it sets it off, and it keeps me awake at night

and as long as it was safe for the baby, i would be happy to have the CS at 37 weeks, but would they do it that early other than an immediate emergency, would ante-natal depression (if thats what it is) and back pain be a good enough reason?

please help x

37 weeks isn't safe for the baby, applejacket. I'm sorry you're feeling so very poorly though.

Research shows that that the risks of immaturity of the lung is halved if you have an ELCS at 39 weeks instead of 38 weeks.

Are you getting any help for your depression?

Sorry to hear you are having such a bad time x

37 weeks is not a good time to have a planned caesarean, because the risk of breathing problems for baby is higher than it will be than at 39 weeks, and having a baby that may need to be admitted to neonatal unit is not going to make the beginning any better for you. Having said that, my friend's baby was delivered at36 weeks for falsely diagnosed failure to grow (he was almost a pound bigger than predicted by scan) and he was fine, as are many babies born a little earlier than ideal.

If money is not an object, see an osteopath about your back. Their treatment is not expensive but often far more helpful than trying to get anything done going NHS physio referral route. Of course there are great physios out there, but I know endless stories of waiting 8 weeks to get an appt only to be tokd by the physio to be 'careful when lifting' and 'look after your back'! Search the internet for support belt/brace, these can be very helpful and these days easy to find. They kind of hug your back and pelvic bones together which reduces the pain when walking and trying to get on with daily life.

I have little practical suggestions to offer otherwise, because I am not an expert in antenatal depression, and haven't been through it myself, but I am sending hugs and sympathy anyway. I hope you will be offered counselling with someone who really knows their biz and helps you start to feel better soon.

Sorry you are feeling so awful, ante-natal depression really sucks. Being in pain and not sleeping makes it so much harder to bear.

Please go to your GP about the depression, I think I heard that even in pregnancy, depression can be treated with anti-depressants, and it is better for the baby.

Are you wearing a support belt to help with your back/hips?

DD was induced at 36 weeks (due to OC) and she was absolutely fine. She was 6lbs, so quite little, but we were discharged 12 hours after her birth.

Not sure why people are saying 37wks isn't safe..it's considered term.

37 is considered safe, I gave birth naturally at 37+3 and was allowed to go to the birthing centre as low risk. I think anytime between 37-42 wks is considered safe. If money is not an issue could you go private?

Personally I would recommend seeing a chiropractor, they can help with physical and mental problems in certain cases.

There is a difference between giving birth naturally at 37 weeks and a CSection at 37 weeks though.

Babies born by csection are statistically more likely to have breathing problems anyway because their lungs haven't been squeezed during the birthing process.

This happened to my DD, she was born by EMCS at 41 weeks and had mucous on her lungs that caused laboured and noisy breathing at first, although it wasn't too serious and only lasted a couple of days. But meant we had to stay in hospital a bit longer.

I think babies born by csection before 39 weeks on average have a harder time of it wrt breathing problems, and this is why they won;t do one before then unless there are other health risks to baby or mother.

That said it sounds like you do have valid health concerns and I'm sorry you're having a hard time - have you had an appointment with a consultant? Could you asked to be referred to one to discuss if it would be possible, or see if they can help in other ways?

37 weeks is safe when a baby is born naturally, although newest research suggests that it should still be considered 'pre-term'.

A baby born by C-section hasn't had the natural process of squeezing down the birth canal, which helps to expel mucous from the lungs in preparation from birth. It means that their lungs can be 'wet' and the baby can be grunty, requiring support after birth.

A baby born by c-section at 39 weeks has 2 more weeks of lung maturity.

I too had terrible spd and sickness, I couldn't actually go anywhere for the last 8 weeks of pregnancy because I could hardly walk and was getting depressed from just sitting around all the time but my consultant would still not bring my ELCS forward, I had my DS at 39+1. It was a long wait, but the time does go and before you know it it's over, my DS is now 8 weeks old and pregnancy is a horrible but distant memory, you will get through just hang in there!

Ok I stand corrected, learn something new everyday!

I had my last baby by emergency section at 37 weeks as my waters broke. I was always due a section as had 2 previous. This time I had diabetes and the baby was breach and I was on crutches from 19 weeks having physio and hydrotherapy for SPd and the consultant still didn't book me in til 38+5 due to risks.
As I say my waters broke dead on 37 weeks and our son has had a few breathing problems since, he has also been in hospital for a week due to a strep infection which is more common the earlier babies are born at 5 weeks old and suffered prolonged jaundice again due to being early. He is 9 weeks old and there hasn't been a week gone by he has not had some kind of hospital visit . I know how horrid it is believe me you only have to read some of my threads to know I hated my pregnancy and was desperate to have an early section. However seeing the difference 2 weeks less had on my baby I would say hang in there xx

hi all thank you for replying

and thank you for not judging me for the things i said in my post i was worried people would think i was awful

we are ok for money but couldn't stretch to a private birth i don't think. am i right in thinking its about 15k for a c section?

but a chiropractor might be an option, i agree that NHS physio will probably be useless, i was not as bad last time but was still referred and it was rubbish, a load of us sat in a circle being told how to lift things correctly etc everything we already knew as we werent stupid then i was given a Tubigrip type thing to wear round my bump which didn't work or help at all.

my MW knows i am low but all she has said is go to GP for anti depressants. i don't particularly WANT anti depressants, and the last time i went to my GP re being depressed (at about 10 weeks pg iirc) he was spectactularly unhelpful and really upset me, treated me like a silly little girl, basically saying i just needed to get a grip. he did prescribe me citalopram but i never collected the prescription

Applejacket, why would you think that anyone would think you were awful? YOU ARE ILL! You are almost certainly suffering from depression which sounds pretty bad from the sound of it. I don't think you need to be a doctor to work that out from what you've said! Please do not beat yourself up over this.

You sound very much like you are in need of support rather than drugs as its a combination of physical as well as mental issues that you seem to have going on.

Are you under the care of a peri-natal mental health team or do you know if there is one in your local area? If there is, you should consider getting referred there. They aren't as widespread as they should be unfortunately though.

As for your GP. Time for you to change GP if your relationship with your current one is so bad. Not just for this, but for any other reason. If you don't feel you can face seeing them, then they are about as useful as a chocolate tea pot.

Either way it sounds like somehow you need a diagnosis of ante-natal depression, one way or another. If only to reassure yourself that you aren't a bad person and this is beyond your control, and actually its ok to feel like this because its natural in some cases to do so. Do you have anyone who can support you in finding this help? Friend or family?

I think wanting an ELCS earlier at 37 weeks isn't really going to help things in the end tbh. I think you are focusing on the 'end game' rather than the here and now. Instead of dealing with one day at a time you are looking at the whole picture and the length of time is just daunting and making you feel even worse about it, because it seems never ending. You know the saying about "eating the elephant one biteful at a time" rather than trying to swallow it whole? Well that.

NICE state that ELCS should be at 39 weeks or later due to issues with breathing which are significantly higher at 37 weeks. Given you are already in poor mental health, you do need to consider how you would feel in a situation where you had an ELCS at 37 against this medical advice. Be honest with yourself - would you be beating yourself up over this too if your baby had problems - and it had been down to your choice? Is it wise to set yourself up with a scenario which might not give you BOTH the best start together? All the focus on this 'end game' doesn't let you think about whats beyond that either.

As you said in your OP, unless its an emergency, then is it a good idea? I personally would potentially include your mental health as a health reason too here though. Emergency on the grounds of mental health to me would to me mean whether you were suicidal or self harming in some way. I don't know just how bad you are; but if you are getting close to this sort of terriority then I just think it highlights just how much you would be in need medical help now, rather than waiting until later in your pregnancy.

Please look after yourself and realise that, the fact you are asking on here for some sort of advice says far more about you than whether you are saying 'bad things'. You clearly just want to get better and you are struggling to cope right now. In my book that makes you are 'good person' who recognises their weaknesses and isn't afraid of asking for the assistance they need.

My DS3 was born by ELCS at 36 weeks. This was more down to my feeling mentally unable to go further than for any medical reason. In hindsight I wish I'd held on a little more - my DS developed RDS and then to make things even worse one of his lungs collapsed. It's easy to think that at the later gestational that all will be well.

I hope you get some proper, useful help with the rest if your pregnancy and that you have supportive friends and family around you, things sound tough.

AppleJacket, is there a different GP you could see, one who might be more helpful? I know you say you don't want anti depressants but they might be helpful as a short term thing while your hormones are playing havoc. You could also ask for a cpn referral/counselling? I'm worried that you might develop postnatal depression as you're this down already.

If your mental health is very fragile its possible they'd consider a section at 37 weeks. They'd give you steroid injections beforehand to help mature the baby's lungs. You need to ask for a consultant referral to discuss this.

i had a c section at 36+6 due to IUGR, i had a calcified placenta and my baby had stopped growing.

do not let people terrify you telling you about breathing problems, they can give you steroids to help this. my baby was a tiddler at just 4 pounds, but had ZERO breathing problems. she was perfect!

good luck.

Please go and see a different GP, and get in touch with the peri-natal mental health team if you possibly can. There are several ways that you can be supported, including but not exclusively medication. If you have other children, you could also seek support through the Health Visitor team, ask if they will go through the Cambridge test with you. I hope you are able to get some help soon.

Um, Kelly, no-one is trying to terrify the OP when telling her of possible breathing problems. It's better she knows that there could be a problem even at such a late gestation. Saying your baby was fine doesn't mean everyone else's will be.

Hello! I had a ELCS at 37 weeks for reasons similar to yours. I was given a shot to help the baby's lungs and she was absolutely fine - weighed 4 kg so not small at all! I begged the doctor to do it earlier but he said that 37 wk was the minimum. Hope all goes well for you.

oh thanks all i am absolutely sobbing at your kind replies, particularly redtoothbrush

the absolute last thing i want is for my baby to suffer and / or have any health problems but seriously i am in absolute hell here, i don't mean to be a drama queen

and renovatinghouse are you in the UK? how did you manage to persuade them to do it at 37 weeks? pm me if you would rather discuss off this thread

and yes i have other dcs, they are 4 and 7. i had them by elcs (my choice) as well so i know what to expect.

also i am pretty sure i will end up with PND whatever happens as i got it quite badly after both my other dcs were born. i am also still mentally recovering from a traumatic miscarriage in April this year where i lost twins so this pregnancy has been very stressful as apart from everything i have already mentioned i have been scared something will go wrong. (and still am. )

Apple, I have had 2 CS due to placenta praevia. With DD1 they wanted to operate at 38 weeks which was in line with the then NICE guidelines. I negotiated as 38 weeks was my birthday and I had been in for 4 weeks (due to unstable pp). They were very unwilling to go airliner than 38 wees.

With DD2 I had been in and out since 24 weeks so they agreed to an ELCS at 37 weeks, even though the guidelines were then 39 weeks. I actually had an EMCS at 36+1. Both babies were fine, but due to unstable pp, I had been given steroids at 34 weeks and second time round at 26 weeks.

I have a friend who suffered with severe PND, please look after yourself and don't delay seeking help. Listen to your partner, as they often see more changes in you than you see yourself.

God luck.

Must preview posts

Earlier..... But I like 38 wees!

thanks fionas

am sorry to hear you had so many problems but glad you and your babies were both fine in the end

Hi Applejacket
I have not read all replies so I don't know if I am repeating anything here, I am so sorry to hear how you are feeling, but I can 100% understand. I am currently suffering depression , I am 18 weeks pregnant with our third baby, we have a 14 year old and a 8 years old and this baby was not planned, only happened as I had a op in may to have a ovary removed with a cyst and they put a mirena coil in to stop me ovulating to help save my remaining ovary, but it turns out they forgot to put the coil in and never told me.

So as you can imagine it has come as a complete surprise, I a very lucky and have a very supportive husband and family but from finding out , to now I have hit rock bottom, I have been to Docs and they have refered me to a councillor but it has a four month waiting list , and when I had a assessment because I am not suicidal that why I have I wait 4 months. I have only come on here today , as I am at home sobbing and trying to get some light at the end of the tunnel from somewhere. I am self employed and work from home and since finding out I am pregnant my work has suffered terrible as I don't want to do anything other that, wander around the house aimlessly.

I also have to have a c-section, had two already, and they we both preformed at 39 weeks and so will this one. I would say that maybe trying to get the section at 37 weeks is not the answer, it seems more like you need help and support from either a trained professional and just someone you can talk to and be there for you, as if you dd have section at 37 weeks and something did go wrong, then it would be very hard to deal with.
I hope you can get some help for your back and I would say keep going back to your docs / midwife until someone listens to you.

I hope this made some sense and I hope you get a little comfort from this message