Really upset- on verge of being refused a section

[weebigmamma]

I've been told by 2 GPs that I have a good case for an ELCS because of having had a 3rd degree tear in the last pregnancy but my hospital have been trying to put me off it to date. I had my 28wk appointment today and they've said they're 'not saying no' but that they advise against it and do I know the risks? I've now been told the risks 4 times. Yes, I bloody know the risks. And no matter how many times I tell them that the risks pertaining to having another baby don't apply to me since I am NEVER doing this again (I am 38 and I hate pregnancy) they keep on going on about it as if I don't know myself. They haven't listened to a word I;ve said and it's like they simply don't believe me that I had a bad tear or that the last birth was really traumatic. They won't discuss it again for another 5 weeks so i can't plan maternity leave or paternity leave and once again I have no idea what birth I'm going to be having. My best friend at the same hospital who is 2 weeks ahead of me has had no such problems and was given her ELCS date at her last appointment. I cried throughout my appointment today. They are going to force me to have a vaginal birth and I wish I hadn't gotten pregnant. I wouldn't have if I'd known it was going to be like this. I hate them and I have cried all day. Feeling like utter shit and terrified that they're going to make me have a vaginal birth again.

after all this they then took my b lood pressure which lo and behold was sky high and so I had to stay in for another hour while they repeatedly took it until it came down. So the upside of today has been that I haven;t been put on blood pressure meds for a condition caused by them. I suppose I shoudl be grateful for that. They're recommended I now get my BP done every week. No fecking way is that happening. I'm avoiding all medical professionals until my next appointment and I'm going to pretend I'm not pregnant until then as well.

Go to see your midwife, ask her to book you an appointment with another consultant as there's no point waiting 5 weeks to get this sorted, you want a ELCS and waiting isn't going to change your mind. Be stroppy.

Try talking to the Supervisor of MWs about your options. They are usually great IME.

There are many of us on here who had complicated "natural" deliveries, myself included, and were relieved to get a caesarean in subsequent pregnancies.

I had a horrendous battering and bruising from the so-called "natural" delivery of my first daughter. I tore badly despite an episiotomy and took months to heal properly. My second was much better but with no time for pain relief so I hated it. By the time I came to having my third (and final) I was trying to work out how to argue for an elective c-section, but my daughter needed an emergency one at 35 weeks when she began showing signs of distress. So I got what I wanted by default.

We are all well aware of the risks, but a natural delivery carries risks too, especially if complications set in. I much preferred my c-section to my vaginal deliveries, and I recovered from it much more quickly too.

Stick to your guns. Don't take no for an answer. If necessary perhaps ask your GP if you can be referred to a different hospital too.

I asked today and was told that there are no other hospitals in NI where i can have an ELCS.

Thanks for your help everyone x

Hmm, this paper shows that they carry out elective sections in all trusts in NI - I don't know where you are, but I know that for example the Royal in Belfast has quite a high cesarian rate in general.

Just don't let yourself be fobbed of, I've even read that one woman who wanted to opt for an elective was sent on her way by her consultant, who claimed that NICE guidelines don't apply to NI, which is a load of BS.

Having said that, I'm in North Down and I wasn't given a choice about which hospital to go to.

They are not handling this very well. Can you not go and see your GP and tell him/her you are not pleased with the treatment you are getting. But I suppose they have a duty to point out the risks of a section.

They are fobbing you off.

Right, here are the guidelines from the Royal College of Obstetricians & Gynaecologists, on the care of women with 3rd and 4th degree tears.

www.rcog.org.uk/files/rcog-corp/GTG2911022011.pdf

Skip to page 7, "Future Deliveries".

All women who sustained an obstetric anal sphincter injury in a previous pregnancy should be counselled about the risk of developing anal incontinence or worsening symptoms with subsequent vaginal delivery.

All women who have sustained an obstetric anal sphincter injury in a previous pregnancy and who are symptomatic or have abnormal endoanal ultrasonography and/or manometry should have the option of elective caesarean birth.

So caesarean birth is recommended primarily to women with symptoms. Have you had any problems?

Tbh, mental health reasons alone should be enough.

No I haven't had any symptoms and I healed well so they reckon I'm good to go for a vaginal birth. It's the Royal in Belfast that I'm at.

And they certainly haven't counselled me at all about any increased risk of it happening again, they haven't even mentioned it. And I noticed yesterday that the consultant has written on my notes that they 'discussed the pros and cons of a section' with me which is bullshit, they have only ever mentioned the risks. I'm going to et her to cross that out next time because they if they bully me into have a vaginal birth and it happens again I'll be going to someone legal about it.

It sounds to me like the hospital is actually now stressing you out so much about this that they've made you afraid of giving birth. How horrible for you. What about speaking to your GP and asking them to write to the consultant saying what a state you're in now and requesting they book you a section date as per the guidelines quoted - because you ARE symptomatic now. Symptoms of stress are just as real as anything else. If the Royal has a high C-section rate they're probably under pressure to bring that down hence the resistance you're meeting.

Thank you so much Ihaveseenmyhat. I cannot believe this document and the advice that the Royal have totally ignored. I will be printing it out for them since they appear to have never seen it before:

'There were no systematic reviews or randomised controlled trials to suggest the best method of
delivery following obstetric anal sphincter injury. The risks of a subsequent vaginal delivery after
third-degree tear were examined in four studies,5,49,53,54 which showed between 17% and 24% of
women developed worsening faecal symptoms after a second vaginal delivery'

First time I've EVER heard this.

Thanks NorthernLurker, yes you're right, I am now absolutely terrified and I wish I never got pregnant in the first place.

Look, this will work out ok. I know you're scared but use that fear to make your point and take back the control that has been taken from you. They can't deliver this baby without you You are the patient and the mother and the woman at the centre of this! You WILL be heard. Insist on this. And have a too

I know you've been firm, but I think you need to make it expressly clear to them that you are having a section and that's that. If they see you wavering, or they think there is room to convince you to go 'natural', then they will just keep saying the same things.

I understand taking the facts and figures with you, just be careful how you present it because it may seem like you're asking for their permission to have an ELCS, and you're not as your mind is made up.

It might get a bit awkward, but be very direct about it. If they keep on about the risks, say calmly "yes, I know this. We've been over this before, but my mind is made up." Keep repeating this.

It can be really hard to stay firm, especially when dealing with medical professionals because their knowledge can make you doubt your choices, but you know your body better than anyone else. Good luck

yes but the trouble is i don't feel firm about it any more.

you have to be firm. at least to them. end of the day you can change your mind NOT to have a c but its harder to change your mind at the last min to have a c.

Plan for both if you have to, but at least get the wheels in motion to have a c if thats what you ecide.

Just written a letter to the hospital. Thanks all x

OP I'm late to this but I'm in NI too. Both mine were born at the Ulster hospital in Dundonald. My consultant for ds2 was Dr Roberts and he is very good. They certainly do elcs there unless things have changed very recently, because I was meant to have one!

I suggest contacting your gp, community midwife and supervisor of midwives also perhaps the head of maternity services - complain complain complain. I'd consider transferring your care elsewhere as it sounds like you've lost confidence in the royal.

Emblosion, thank you! I suspected that 'You can't have a ELCS anywhere else in NI' might be a huge lie. I wrote a letter to the Health and Social Care Trust the other day to complain about all of this. I've heard allllll about the risks of a section so many times now and they have never once told me about the risks of having another tear with a vaginal birth, or anything like that. They are really putting pressure on me to choose a vaginal birth and the annoying thing is that I went into this pregnancy honestly feeling that I would take advice on the matter, but I don't feel they've given me all of the information and so I took it upon myself to do my own research, and now they don't want to listen to anything I say. All I wanted was the actual pros and cons and for a bit of advice and support from them, not a load of scaremongering.

The other thing that has really pissed me off is that they are still awaiting my notes from the previous birth to see what grade my 3rd degree tear was. They've said if it was a C grade tear then they would recommend a section! So what are they going to do if it is?- backtrack and tell me that actually a section is safe after all and it won't be horrendous and I won't have a horribly infected wound and all the other stuff they've told me up to now? It's like they're waiting until they've made up their minds about it before they start treating me like an actual person who is totally freaked out about the whole thing.

So not looking forward to the next appointment!

I could be wrong but I think you will find that number of c sections influence the cqc rating of the hospital...

What is the CQC rating?

CQC is the Care Quality Commission who carry out inspections to ensure hospitals meet national standards. They give each hospital a rating and these are incredibly important to the hospital www.cqc.org.uk/ You may receive a lower rating if you are seen to carry out a high number of c sections

Interesting, thanks! I know they are under pressure to reduce sections because NI has a higher rate of them than the rest of the UK. Thing is, all sections tend to get lumped in together in research- whether emergency or elective. It means that statistics are very hard to read and also that I don't particularly trust them when they say that statistically sections are more dangerous than vaginal births (it means they are also not counting planned vaginal births which end in sections, so the stats then look like all planned vaginal births end in a vaginal birth). I'm sure that medical professionals know this. Cynically I tend to think that it's about the money more than anything else.