When to discuss c-scection

[Moanyoldcow]

I wondered if anyone knows at which point the consultant will discuss they type of delivery I should have?

I had a previous emcs which was a bit complicated and I'm high risk and consultant led this time too.

I've got my 16 week appointment next week - is it likely they'll discuss it this soon?

Ideally I'd like a vbac but I suspect it won't be recommended.

They generally don't start discussing it until your third trimester. I am currently 33+4 and am under the consultant on close observation due to pregnancy complications (also due to severe complications in labour of my first ds).
My consultant only started the delivery options discussion at about 28 weeks.

I had my consultant appointment at 13 weeks, and then have another at 34 weeks (I think it is) . Basically had a chat, got given the info / options etc to think over and we will make a decision at the 34 week appt.

Why do you think Vbac won't we recommended? What complications do you have? You can request any kind of delivery you want and for many women this is discussed at the first consultant appointment and a plan confirmed at 34-36 weeks depending on your appointment schedule. A consultant will outline their reasons for suggestions whatever options they have laid out and you can do the same. No-one can insist that you have a vbac or a section, all decisions are ultimately your responsibility.

Ok, thank you both for replying.

It does feel a touch early so I'll just wait and see what they say.

Fingers crossed it all goes more straightforward this time.

At my 16wk appointment I told my midwife that I was unsure what I wanted to do in regards to trying for vbac or a planned section. They referred me to the consultant midwife team, have an appointment with them at 27 weeks to discuss my previous labour, and my options more in the depth. I'm 25 weeks currently.

Thanks for the reply reikizen.

Last time I was induced at 40w for a variety of reasons and it failed spectacularly. Ended up with EMCS and I lost a lot of blood.

General consensus was my original dates were correct so I was only 38 weeks - I was brought forward owing to very large baby (11lb at 38weeks).

It appears my pregnancy is progressing like before - SPD at 15 weeks, dates brought forward etc. and if I get the same complications as before baby will need to come out before they're entirely ready.

But I just can't go through another induction to fail again - it was utterly miserable.

I'm hopeful this pregnancy will not have the same later issues but I just want to do the safest thing for me and the baby.

Thanks Merlin - I'll mention it to the consultant and see what they say.

I was told that if you have an induction that ends in emc you don't get induced again second time, not sure if that's true

I heard that too, Ladypug. My midwife said they would recommend an elective if it got to induction stage. Only recommending a VBAC if labour was spontaneous. Definitely speak to your consultant, they should go through your previous labour with you.

I had a first discussion at 16 weeks and then made a decision at 34 weeks and confirmed at 36 weeks.

Thank you - I've had a Google and it seems you are correct - VBAC after EMCS for failed induction is generally only indicated if labour is spontaneous.

I'll try to cross fingers BP doesn't go haywire this time!!

I'm pleased to hear about the cs after previous failed induction ending in emcs. I definitely want a cs this time but am worried they'll say no.

My ds was born by emcs after nearly 3 days of induction with several failed epidural to boot.

With both mine the possibility was discussed at 20 week scans. The dates of my c sections were't confirmed until 36 weeks though.

You could agree a plan where for example you would be happy to labour if you do so spontaneously by 38 weeks but a planned section if not. It is not very common to be induced if you have had a previous section and even then the method is very different. Please have a full discussion with the team looking after you, spell out your preferred option and see what they think - then you can be sure you have weighed up all sides. I would think they would recommend a section for you anyway. Have you had a glucose tolerance test this time around? What about serial growth scans?

I have my consultant appointment today to discuss delivery options and I am 26 weeks + 1 day 😀

I've got my 16 week consultant appointment today. IIRC this is when they scheduled the extra growth scans last time (not that they were very useful).

@Reikizen - GTT is at 28 weeks. I would be happy to go for 'fingers crossed for labour but ELCS at 38 weeks' so I hope I can make it that far. Fingers crossed for it all to be more reasonable this time.

I'm not holding out hope though. The SPD is back with a vengeance 8 weeks before it started last time and I'm having several severe headaches a week.

In my trust we have a birth options clinic which women are referred to at booking and seen at around 20 weeks. It's with a midwife who goes through the notes from the previous Labour so a bit like a debrief and talk about what you want to do this time around. They usually take your choice as final, unless the request for a cs is not for medical reasons then they will refer you to a consultant to discuss it further. Nobody is forced into a choice they don't want.

It's also worth mentioning that (possibly different in each trust) you can be induced after a previous cs but they dont use the prostaglandins due to the risk of hyperstimulation and uterine scar rupture - in our trust if you opt to be induced you have your waters broken (if cervix open) and hormone drip. If cervix closed at the time you have elective cs.

^Seen between 20 and 30 weeks, I meant to say

You can definitely be induced after Caesarean section it's just very trust dependent. My trust offer IOL using pessary (prostaglandin) or balloon... also use syntocinon Drip if required.
It's early days yet for you. Get the if information, see what your options are and go from there

I wasn't able to discuss birth choices until 34 weeks and CS was booked at 36. However, I have the opposite situation - I had a traumatic delivery and wanted a CS this time.

I had same as you on first baby. Induction etc due to preeclampsia finally ending in emcs. In 2nd pregnancy I wanted vbac and was told they wouldn't induce with gel etc again. If they could break waters they'd do that to try move things along but otherwise unless I went into spontaneous labour I would end up with section again. Thankfully I got my vbac and also didn't develop the preeclampsia second time around. So hopefully same for yourself. Best of luck. Oh and also I discussed all of this at my first consultant appt

Thanks for all of your replies.

Just to update you, my consultant said they would ideally aim for VBAC but as there is a possibility of not being able to go full term, they could induce using a balloon catheter before going to CS.

I feel happy with these arrangements at this stage but who know how I'll actually be in Feb!