Not sure what to do re: birth

[CathyandHeathcliff]

So I need some advice. I have extremely bad anxiety and a tendency to have panic attacks. I am currently 18+1. I spoke to my midwife at the 8 week appointment and told her I wanted an elective c section. Even before I found out I was pregnant, I always knew I'd want an elective c-section.

I have an appointment with the consultant in July to discuss this.

Now since thinking about it in detail (the c section I mean) I'm now starting to panic about that too. Being on an operating table, unable to move and being cut open is a horrifying thought. I have a huge anxiety about anything medical, hospitals send me into a complete state of panic.

However, on the other hand, having a vaginal birth, also terrifies the life out of me. Not the pain as I've suffered with absolutely horrendous period pains for years and I know it'll be much worse but I don't worry about the pain. It's the possibility of something going wrong, getting stuck, head too big, labour not progressing etc etc.
I have a huge issue with instruments being inserted into my vagina, so the forceps would be a no go and I'd also asked not to be examined unless absolutely necessary.
I'm frightened of the emergency/panic feeling of something going wrong and then if it would cause me post natal problems e.g. More anxiety or depression or inability to bond with the baby.

I have no idea what to say to the consultant in July when I see him now.

Oh and my counseller (who I see regularly and have been for the past two years) said she'd write me a letter to give to the consultant to put my case forward.

I think you need to see someone about this before July. This level of stress and worry isn't good for you at any time, but especially not while you're pregnant.

If you trust a hospital and a team of midwives enough to deliver your baby then you need to trust that they know what they're doing and they will do what's best for you & baby. If you were going for a natural delivery but the baby got stuck then you'd have to trust that they will act accordingly. The safe delivery of your baby is what you should focus on. How they come out is really not as important.

@CocoLoco87 But I need to think about my own mental state too.

I do see a counseller every fortnight.

Firstly, congratulations on your pregnancy. I’m not usually phobic of stuff but I had similar fears around DD’s birth. I’d recommend:

Sign up to an antelnatal yoga / hypnobirthing course. It’s not all woowoo shantishanti, it can be practical and useful and personally I found it bery helpful.

Read a factual description of the stages of labour and birth (vaginal and c-section), in What to Expect or by attending an NHS antenatal class if available nearby. Try to pinpoint what your fear centres on: medical intervention? Pain? Length of labour? The unknown? From that point you’re in a better position to identify and resolve the issue.

It’s also perfectly fine to include in your birthplan that you object to the use of forceps / particular kinds of forceps unless critical. There’s no consensus on the attention paid/required to be paid to birth plans, but it’s worth writing and bringing up in discussion with your MW.

I disagree, it is important how they come out. It's important for the metal health of the mother.

You need to focus or find a counsellor to specifically help you with your birth fears.

I was also terrified of birth but my solution was a home birth which allowed a lot more control for me than hospital, as after I thought about it, I realised that it was the hospital experience I needed to avoid (obviously I would go in if needed). It went so well that I'm planning another one shortly. Is there anything you can think of that might lessen your fears that you could use?

I'm not saying it's not important how they come out, more that if you opt for natural delivery and it doesn't work out that way, then it's really important the baby is safe.

I understand how a birth can be traumatic. I was traumatised by DC1. And not by the delivery, but by the after care I received because I had torn.

What does your counsellor say about all this? I would push to speak to a consultant sooner than July if you can, to try and deal with some of your concerns.

Definitely be explicit in your birth plan about no forceps etc. Also tell your birthing partner of your wishes. You may need them to be your voice in the delivery room.

Everyone I know whose had an elective section has been very happy it's all been very calm and controlled and laid back.

I would ask for a plan of what will happen if you go into labour before your section date too. Get all your bases covered.

Knowledge is power. Take care x

Thanks everyone so far, really helpful replies.

I'm going to state in my birth plan that I want no forceps or instrumental intervention unless absolutely necessary.
I also don't want to be examined, same as above, unless necessary.

I don't think I can see anyone before July as that was the earliest I could get.

I have seen a mental health midwife but I didn't find she really helped me, in fact she kept on about the induction which is another fear of mine. So she clearly hasn't listened to what I had said in the first place.

I don't know what the solution is, I thought elective c section was my answer but now after really considering how very medicalised it will be, I'm starting to wonder how I'd cope with that.

Ask to be referred to the perinatal mental health team as a matter of urgency. You need expert, RL support.

@RexManning As stated above I've seen the mental health midwife. I'm not sure anything else is offered.

Sorry, we cross-posted.

I don't know the model in your trust but here the perinatal mental health team comprises clinical psychologists rather than midwives.

They don't do instrumental deliveries unless absolutely necessary but you could say that a c section should be prioritised above them?

I get what coco loco is saying - obviously maternal mental health is really important but childbirth is unpredictable and part of preparation for that for you may include preparing for that unpredictability with the help of a professional.
I have no experience of the mental health side of things but another option may be a vaginal delivery with an epidural or mobile epidural? You are "with it" so to speak, and sometimes have some sensation but wouldn't feel pain. I had a really positive delivery with epidural.

@Girlwiththearabstrap it's not actually the pain that bothers me, rather the medicalisation of it, hospitals, interventions or something going wrong.

Love your name btw - love Belle and Sebastian

Have you thought of / discussed a home birth with anybody? So that you are in your familiar comfortable surroundings?

really sorry you're going through this.

Whichever mode of delivering your baby you eventually agree on with your doctors I would highly recommend looking into hypnobirthing.

I have completed the digital course from The Positive Birth company, it only costs £35 which is a lot cheaper than most other options and I have felt much less anxious about things since doing the course.

The course has modules on c sections as well as vaginal delivery and the techniques learned could really help you at the time.

Thanks! I'd be going for the name Belle if DH would agree.
Well maybe birth centres or MLUs are something to explore when you have your appointment, As they would give you quite a home from home, hands off feel. I'm sorry you're going through such a time of it. Pregnancy can be a bit of a stressful time without any pre existing mental health issues. Is there anyone you could speak to about being seen sooner?

Definitely look at doing a Hypnobirthing course! It settled so many of my concerns around birth and kept me super calm during.

Have you considered the alternative of having a vaginal birth with an epidural to help manage the pain?

Could you consider a Home birth? The rate of interventions is much lower with Home births. You may feel more in control in your own environment too.

I had an elective c-section, overall it was a very calm experience. I had a spinal, which didn't hurt to have. I didn't have the feeling of being stuck on the table unable to move, as your top half is unaffected. You just cant move your legs, but I didn't find this scary or uncomfortable. I was completely unaware of any cutting, there was no pain at all. You get pulled around a bit as they manoeuvre baby out, it's a bit odd, but nothing horrific. I honestly didn't really think about what was happening, and couldn't see anything, just excited/anxious to see the baby. One thing to consider is there are lots of people in the room - about 12! Some might find this unnerving but is completely normal.

I had an elective because of my health issues, and some anxiety over my ability to cope with a vaginal birth. Certainly it being planned, knowing exactly what was going to happen and when, really helped me mentally prepare.

Definitely look into hypnobirthing, there’s a book by Sophie Fletcher which is really helpful.

What you said about intervention & instruments, the NHS is over cautious they will rush in & just do what they feel is necessary at the time.

So you either need to look a home birth or an elective c section.

Start looking at the hypnobirthing & pregnancy yoga, they will help.

Thanks all, I won't reply to you all individually, however I am considering a home birth but when I mentioned this to my midwife she wasn't sure I could have one because of my bloody BMI I also wouldn't mind a birthing pool, but again, same reasons! Although if I do decide for a vaginal, I'm going to fight for a water birth. She also said they don't recommend home births for the first baby.

I am still keeping elective c section top of my list and as I mentioned previously, my counseller has said she'll write me a letter to the consultant to help persuade them.

I just don't want to miss out on a potentially empowering experience during childbirth which my counseller said may actually help alleviate my anxiety, because of my mental illness.

I am certainly considering hypnobirthing very strongly.

Another issue is that all my partner's family have had big babies (over 9lbs) and all struggled/had to have a c section because they were too large. My MIL gave birth (with the help of forceps) to my BIL who was 10lb+ in the late 1970s! She's tiny and she said it was a horrendous experience. She was also 14 days late.

You can definitely get a home birth or the pool with a raised bmi. It might be against the protocol but a good midwife and consultant will be open to discussions.
I'd ignore anecdotes about partners families and sections etc. That's all they are, anecdotes. And it's not a clinical reason to request a section whereas maternal mental health would be.

Hi, sorry you're struggling with this. I just want to reiterate whT other PP's have said - I have a high bmi and I'm older and I had a water birth in a midwife led unit.
Well water labour and then I got out for an examination and my son decided he was in a hurry so was born on a bean bag.

I only had 2 examinations in my whole labour and my son was 8lb 9 so relatively large.

I did have an in and out catheter though and that was the worst bit of the whole labour for me.

I was dead against an epidural and pethodine. (Spelling!) so made sure my husband knew this so he could speak for me if I couldn't.

Also a home birth is a legal right so please don't be told it's not possible but you just need to consider if it's safe for you.

Good luck with whatever you choose.

An elective C section is a very calming experience! I've had much worse times at the dentist - although I was hobbling afterwards when other women were prancing around with their newborns.

It sounds like you are going to spend the pregnancy worrying about what might happen either way. There are so many unknowns about labour, no matter how much you read about it and write copious notes in the birth plan. If you really cannot cope with the possibility that interventions may be necessary, IMO you're a good candidate for a section. But don't rule out the possibility that you can feel on top of a vaginal birth either. Good luck.