9 days overdue - refusing ELCS?

[littleshoutymouse]

Hi all,

I'm now 9 days overdue and I've been through every emotion possible!

I've had one bout of false labour (mildly painful contractions for 5 hours every 7-10 minutes about 3 nights ago which stopped as if by magic! Little bouts of the same lasting about an hour at least once a day since) My plug has gone (3 days ago). I'm completely effaced, soft cervix, 3 sweeps, pooping for England, either ravenous or totally not interested in food and my emotions are all over the place - I'm either sobbing, in good spirits or so anxious I feel like I'm going to keel over. In all honesty, I feel like I am about to go into labour, except each day passes with nothing happening.

I'm going insane, I swear! I keep thinking I have imagined the random bouts of contractions.

I have an ELCS booked for Thursday (41+6) which was the latest I could convince them to let me book it to buy some more time. My first DD was a EMCS, 2 years ago.

Would I be a damn fool to refuse EMCS when it's booked for a push it back further/just keep waiting (if it hasn't happened by then?). My midwife appears to think so and the stats/advise scares me.

But part of me thinks - no, my body seems to be gearing itself up. Things are happening, just agonisingly slowly. I'm otherwise healthy, which is why I've been able to wangle a later CS date. I really, really want to VBAC, provided it's safe for me to do.

I just can't work out what to do.

I've not had a baby yet and I'm not a midwife or doctor but I would say go with your instincts. 42 weeks is an arbitrary cut off in many ways and if you and baby are still ok then no good reason to be forced into a birth you'd rather not have? good luck and I hope things move along for you

I was in a somewhat similar position recently (I took the c-section). I wasn't so much worried about the stillbirth risk at 41 weeks (though I would start getting worried by 42 weeks +), but the chance of a VBAC being successful goes down after 40 weeks, and (to me more important because I knew I had a large baby as well), the risk of scar rupture goes way up. So I do think you may be more likely to end up with an EMCS now, unfortunately (doctors may be more interventionist too), than you would have been if you went into labour naturally at 39 weeks.

But if you can live with that (I really really wanted to avoid a scar rupture) why not see if you can push it for a few more days?

I pushed my midwifes to allow me to go further in the end I was 9 days late.
Although I was in a different situation to you I had 2 normal deliverys before.
I was desperately wanted a home birth as the other 2 I barely got to the hospital, I wasn't having this one on the side of the road & felt the risk of a unplanned roadside birth was worse than a birth a few days late but in a safe calm environment.
The cut off time is usually 41 weeks for home birth but because I was vocal about what I wanted the midwifes were very supportive.
I don't know if the statistics are the same if you've had a cesarean previously but the actual risks if I remember correctly move by . Something of a % & are not considered statically significant & for some the risks are higher of something going wrong if you are induced than if you are left alone.
Honestly I'm very analytical & I found it complicated so I think half the time the medical professionals just want to be cautious but at the end of the day we are all individuals. For example there is a gestion difference between white & black women, if the baby is a boy or girl.
What I'm trying to say is be guided by the professionals if they find anything wrong then by all means allow intervention but if it's just case you've gone past 40+9 then you don't have to be induced (or whatever).
My hubby & I discussed it decided to make a decision & live with what happened.
On a positive note I had a quick healthy home birth & thank goodness I pushed for it cause I was right I would have delivered at the side of the road, without any medical support which could have been more dangerous.
Hopefully you are in labour now

if you want a vbac why have they booked an elcs ?

Thank you for the replies

unicorn - still no labour... Gaahh!! Just been on yet another walk to get things going...

GreenGoblin - because the longer the pregnancy goes on for, the higher the risk of uterine rupture and stillbirth as I had an emergency c-section previously due to pre-eclampsia. Generally doctors regard a c-section as less risky than VBAC at such a late stage. But as unicorn says we are all individuals, so I'm conflicted.

I really dwelt on DD1's birth, I felt pushed to have an induction at 37 weeks, which failed after a long traumatic labour (50 hours) culminating in EMCS and DD in SCUBU. In hindsight I wish they'd given me the option of a planned c-section given my health at the time. It was never mentioned or offered and induction and it's risks were never fully explained to me. I felt, and still do, that I made the wrong decision for me and DD at the time.

This time round I am having a healthy pregnancy, its honestly been a walk in the park, and it just seems such a shame to end it with a c-section (if it isn't needed - but then how would I ever know).

Argh, 4 days and counting to decide!

yes I know about the risks the longer a pregnancy goes on for.. I had an emcs under GA for first baby but was given option of elcs or vbac and chose vbac so was booked for sweep for a week after due date but luckily had 2nd baby two days after due date. are you booked in for elcs because you don't want to be induced again ?

OP it sounds as though your body is gearing up for it, all the things you say are pointing in the right direction. I am in the camp that believes sweeps only really work if you are probably going to go into labour soon anyway.

With my vbac I was 10 days overdue. At no point did anyone medical mention inductions or c sections, they allowed me to play it be ear. Like you, I had had several episodes of 'false' contractions (though they had been doing something, I'm sure of it).. when I did go into labour at 10 days overdue, the whole thing was 1 hour 50 mins start to finish. It was fast and furious, but I am sure my body had been gearing up to it. At no point did anyone mention about the risk of scar rupture increasing the further overdue I went. I would be interested to know what the stats are relating to scar rupture and being overdue. Remember that due dates are an arbitrary date and that really you aren't properly overdue until you are over 42 weeks. Stay positive, have faith in your body and it's abilities. Keep active and hopefully things will kick off soon 😊 Good luck!! My vbac experience was amazing and so incredibly healing after my emergency c section first time around.

Also just to add, even if you get to the date for your c section and nothing has happened, you are not obliged to have the operation, you can decline and opt for daily monitoring instead. Are you in the vbac support group on Facebook? There are some incredibly knowledgable people on there who can give you extra info and stats if you want to read them. I don't suggest that in isolation of medical advice, just in addition to if it helps you to make your choices and decisions.

A lot can happen between now and then. I had a similar experience to you, had had contractions which suddenly stopped, and was all set for induction on 40+12. I was convinced I was facing either induction or having to persuade them to let me carry on.
Anyway ds arrived fairly swiftly on 40+10.

If you plan to leave it keep a very close track on the baby's movements. I know someone who after a very healthy pregnancy with no complications had a still born baby at 40+12. She went in as soon as she noticed reduced movements but it was too late. Still born is a very real risk. Her experience influenced me to go for an induction when I went overdue. I'm glad I did, it was an easy 5 hour labour. Intervention isn't always a bad thing.

goblin - My hospital doesn't seem to agree to induction after previous c-section (although this is a discussion I may reopen with my consultant), my midwife was adamant that it wouldn't even be an option, which earlier in the pregnancy suited me fine, as I always swore I wouldn't go down the induction path again. My last one was 50 hours, it sucked, and messed with my head after. A friend of mine in a similar situation but different hospital was 'allowed' - with the omission of the pessary she says (so just the drip), meaning there was more control over the induction 'strength' (?) I have to say I don't know much about that option but might ask the question on Wednesday at pre-op appointment.

norman - I will certainly take a look at the FB page, thank you, I didn't know it existed. Your experience sounds like my perfect outcome... thank you for sharing!! Fingers crossed for 10 days for me too. It's amazing reading about different approaches from different hospitals and consultants, it does make me feel like standing my ground a little more as so far I've felt a little bullied, or at least made to feel like I am being 'difficult'.

I would absolutely go for an ELCS and be sure that I would have the lowest-risk delivery at this point in time.

Honestly a planned section is so much better than an emergency. I was induced at 11 days over with my first and it was hell and resulted in an emergency section.
With my second I was advised to have a planned one as she was measuring so big. And I'm so pleased I did. All very calm, and recovery time was so much quicker. I was up and about and walking straight the next day. Hope that helps as I know how horrible an EmCs is

I was desperate for a VBAC but when it got to 13 days overdue I decided on a c-section. I looked at induction but the increased risk of rupture was enough to convince me that I would rather a healthy baby and healthy mother than a VBAC . When ds2 was born he was definitely 'over done' he had very little fat on him and was red with peeling skin. I dread to think what would have happened if I had waited longer.

Honestly? I really hope you go into labour before then, but if you do reach that point I would go for the ELCS. Having seen the physical and emotional aftermath of a overdue VBAC related rupture, I wouldn't wish it on anyone.

How are you doing OP? Has that baby made an appearance yet? Hope all well

Waters literally just went during a sweep, so we are off!!!

Thank you everyone.

Eeee

I was induced 9 days over and labour didn't start till I was 12 days over. She arrived 13 days overdue via emergency section.

I was miserable and terrified about the elusive "14 days late" stats.

Please take their advice, it's their job

Best of luck!! Keep us posted

Great best of luck x