Trying to decide about birth

[CathyandHeathcliff]

I have horrendous anxiety, specifically about being in control. I was completely set on an elective c section due to this and have a consultant appointment on 28th July, however I'm starting to think it'll be too medicalised for me.

So I'm thinking if I have a vaginal birth, I want no forceps used, I want to be able to have an active labour and give birth on all fours, squatting or standing up, not on my back.

I would like the use of a pool, I am going to use a tens machine to start and around 30 weeks and from then onwards, I'm going to get my partner to give me perineal massage which decreases your risk of tearing.

I'm going to start listening to hypnobirthing CDs and doing meditation. I also want to stay at home for as long as possible, until I'm pretty much fully dilated, to spend the least amount of time in hospital as possible.

Does this all sound reasonable? I can't have forceps used, due to a previous traumatic sexual experience...I've never even had a smear test or any vaginal examination. The very thought of forceps makes me feel like a panic attack is about to come on.

Please, I really don't want to hear traumatic birth stories in reply. Just support, discussion and advice.

Hi, you may not be able to give birth in the position you are hoping for. When it came the time to give birth I had to have heart rate monitors across my stomach for the whole birth. They wouldn't let me move out of the position of being on my back as the monitors had to be in the same place. The whole time. I think it was due to my blood pressure being low when I first went into the hospital

Are you consultant led or MW led?
Perhaps talk to them about your concerns.
The thing is you can plan all you like but you need to be prepared for all eventualities. What if you can't use the pool or need to be monitored? If they said they wanted to use forceps what would be your alternative?
You've got time to discuss all this.
I've been lucky. Two straightforward births. One in the pool. Wishing you the birth you want OP.

You posted this the other day. You can’t control birth I’m afraid, what will be will be. Most births are uneventful but some aren’t. Some need medical equipment such as forceps to literally save the baby’s life. Sometimes c-sections are needed for the same reason. If it’s a choice between your baby dying and having medical intervention, you will go with the latter. Honestly, we can all have hopes of a wonderful natural delivery that goes to shit when we’re actually in the thick of it.

@Mousefunky I know I posted before but I couldn't find the old post.
Do you think an elective c section would be the way forward then? So I can be in control and know what's going to happen? I'm just worried it'll be too medicalised for me.

I do think the most controlled way for you and your anxiety is to have an elective section, yes. That way you know what date you will have your baby and you can be taken through what will happen if that eases your mind. You will also be in a room full of experts should anything happen (which it rarely does). I seriously would choose that if I were you. Birth does most often go swimmingly but there’s always a chance it may not.

In bald reality the only way you can maximise control over the birth of your baby is by electing to have a CS at (usually) 39 weeks.

A very very rough rule of thumb as to what gestation your pregnancy will be is if you know what your mum’s was like. That’s usually the best indication if baby will be early or late.

You have a serious case for an elective but you will need to have a conversation with a midwife or potentially a consultant about a backup plan should you opt for a CS and end up labouring early.

The birth you are hoping to have pretty much sums up both of my births, so it is most definitely possible, and all of your plan (especially hypnobirthing) sound like excellent preparation. I would highly recommend a course if you can afford it.

In regards to forceps, unfortunately there is no guarantee these won't be needed, however I can assure you that in the moment, when your baby is about to be born, if a Dr tells you they need to use forceps to deliver your baby safely, you won't hesitate. You will be acting on the safety of your baby and that's an entirely different mindset to how you will feel about it now. If someone told me to chop my arm off right now I would of course say no, but if it was to save one of my babies I would hack it off with a blunt rusty saw.

I'd talk through all your options with the consultant/midwife. So if they think you need forceps, but you don't want that, what happens then? Is ventouse ok? Can you go straight to c section at that point?

You sound like you want as much as control as possible and if that's the case, elective c section might be your best option even if it's more medicalised than you'd ideally like.

If you decide to go natural, be prepared that what you think you want now may not be what you want at the time. It's so hard to plan for birth. I thought I'd want to give birth on all fours, when it came to it that was the last thing I wanted.

I would also add that the recovery time for an elcs is far far longer than a vaginal birth in most cases, I was at the park with my toddler 2 days after delivering ds, whereas an elcs can take 6 weeks. It's major surgery and therefore imo a vaginal birth is far more desirable.

You’re going to get loads of feedback on a CS OP, in my case my CS healed like a dream and I felt “normal” after four weeks

@PaulHollywoodsSexGut My mum's was very straightforward and I was actually born on the day I was due (I was the first). My brother was born prematurely. So none have been late. Mum had gas and air. No interventions. But she did have an episiotomy.

I've heard so much confliction over how long recovery time takes.

The thing about birth is it doesn't always go to plan. I wanted a pool birth with my first, no epidural, active Labour etc. In reality my dd was having problems, I was on a monitor the entire time, had drip to speed things up, didn't work ended up with an epidural and emcs. Quite far away from the birth I wanted. If you really want to be in control I would say that an elcs would be the best option. But talk it through with your midwife and consultant of course.

Recovery time is different for everyone. I was feeling ok within a week, my sister who also had a emcs struggled for a good few weeks. It's massively variable as is the recovery from a vaginal birth I imagine.

Can anyone talk me through how am elective c section goes please? The procedure.

I don’t have any experience of a CS so can’t help with that.
I just wanted to say that it’s verh difficult to ‘plan’ how you want a vaginal birth to go. I’ve had two, my second was completely as you describe in your OP (laboured mostly at home, stayed on the birthing ball until the pushing stage, no intervention etc). For various reasons my first didn’t work out quite that way. If you want ‘control’ then I think you’ll be more likely to get that with an ECS

Just to put in a positive bit of personal experience on an elective c section - I had one with DS and recovery has been absolutely fine, really no problem, faster than friends who have had vaginal deliveries but torn. Beautiful, calm, controlled delivery with my choice of music playing throughout, and I was comfortably wandering around the hospital the day after. In for three nights but that was choice to get help for breastfeeding, was able to play with DD and manage short walks within a week, first proper trip to the park (about a 20 minute walk each way, plus about half an hour there) less than 10 days after delivery. Very little pain, healed brilliantly. My first was an awful labour and EMCS, which was necessary but horrid - can’t recommend the ELCS enough.

I had an elective section. Due to previous trauma I needed a level of control over the situation that vaginal birth just wouldn't give. I found having an 'end point' in sight very helpful and made the experience easier.

I didn't find it too medicalised. It was nice, very calm, the staff were lovely, friendly and chatty. We had delayed cord clamping and were able to establish skin to skin very quickly. The longest bit was the sewing up.

I was up and moving the next morning, I never had any issues with being able to lift the baby. I could do feeds and nappies with no issues. I had her on the Monday and was home by the Wednesday.

My recovery was very straightforward, I took it easy, but kept moving, I took the medication prescribed and kept on top of the painkillers and I felt absolutely fine after 2 weeks. I had something called a PICO dressing as well that I believe made all the difference in my recovery. It's a dressing that stays on for a week and has a vacuum pump attached. I don't know how it works but it does.

Whatever you choose, good luck to you.

OP I would definitely have an ELCS if I were you. I had an awful natural delivery - lots of intervention, very invasive and I felt totally powerless. Your birth plan, incidentally, is basically what mine was - active labour, birthing pool etc. Literally none of it happened. In fact, as I arrived at the delivery suite the midwife basically told me I may as well not have written it - she didn't even read it. My recovery also took longer than all my NCT friends, including one who had an emergency C-section. I now have terrible anxiety over childbirth and if I have another I will be requesting an ELCS.

OP I didn't have a c section but Mumsnet is full of positive stories about electives. Do a search and I'm sure you'll find some really reassuring posts.

Hi OP,
My original birth plan was almost spot on to what you've posted. Unfortunately I had a long labour and ended up asking for a pethodine and then an epudural, and eventually requesting a c- section due to dilation taking so long.
I panic when I'm not in control too, I'm also very impatient and it was the lack of knowing when it would be over that pushed me to get a cesarean. Plus I knew that lots of instances of 'failure to progress ' end with forceps and/episiotimy and I categorically did not want them.

I then had an elective c- section for my second birth and it was great for me to feel in control and know exactly what would happen when. I was a bit wobbly just before I had the spinal for the elective section but I think that was also to do with the baby hormones making me over emotional as I knew I'd see the baby soon.

Overall I was much happier with an elective as everyone knows what's going to happen and there's no guessing games with labour.

If it could have been guaranteed that I could have a low pain, normal delivery I would have gone for it, but as nothing can be sure with labour I felt I had to go for the elective and am very glad I did.

Thanks for all your replies.

I'm still not sure what to do, I'm leaning back towards an elective c section but not 100% convinced. Also how many hours beforehand can't you eat for?

OP I had an Elective due to previous sexual trauma. I was like you in that I wasn't sure what I wanted until the very end. But after a helpful chat with my consultant I decided that and worries I had about the section could be thought about and planned for.

I couldn't have coped with multiple vaginal examinations (like you I have also never had a smear) there was some vaginal swabbing during the section and a catheter but I was completely numb. The team were aware of my history and were very helpful and supportive and talked me though everything step by step so I felt really in control.

The section was very calm baby was on my chest after delivery and I had no problems
Recovering or with breastfeeding. Both things I had been concerned about.

Just saw your latest post. It's from midnight the night before if I remember correctly and you can have a sports drink type thing in the morning.

Another voice to say that if control is the most important factor, then a planned c-section would be most likely to meet your needs. You can't choose a (safe) vagibal birth, you can only choose to attempt vagunal birth. You may well progress smoothly and safely and deliver your baby without complications. Or you could have mild difficulties and minor interventions. Or major issues and need either an emergency section or other major intervention. And in some cases, if forceps are needed, there is no viable or safe alternative. Your doctor won't be able to guarantee that she won't recommend forceps - albeit the circumstances where they are the best option are limited and the vast majority of births are without forceps.

It sounds like a really difficult and traumatising situation for you and you have my full sympathy. Can you ask for an additional appointment with someone on your medical team to talk through your specific needs and to seek more advice? Can you explain a bit more why you feel a section is "over-medicalised"?

Best wishes.