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.

I think it's understandable wanting control but some elements of vaginal birth are beyond your control. I wanted a very similar birth to what you describe but ds was pressing into my sciatic nerve and therefore moving around became a risk to both of us because I kept falling over.

Our hospital MLU only has one pool so access is dependent on no one else being in it.

How will you know you are fully dilated or close to?

I didn't want forceps either but when it became obvious ds was stuck mid pelvis, they insisted on trying before going to a section because of the risk to both of us. In our case forceps didn't work and I was so drugged up, I felt nothing but for reasons similar to yours, I found the bruising traumatic.

Ds was born by emcs. My recovery was easy, up and dressed within 5 hours, walking to NICU within 24 including a flight of stairs. Pushed the trolley around Costco within days. I know women who had far worse recoveries than me from both types of birth.

Currently 37 weeks and going for an elective this time around because it's the only way I can guarantee maximum control over what happens. According to my consultant, we arrive at the hospital, will see whoever is doing the surgery and the anesthetist plus the midwife who will be with us in theatre/recovery to go over birth plans etc/finalise any paperwork etc etc.

Our hospital runs two theatres, one for emergencies and one for electives so shouldn't have to wait too long. Dh can be there for the spinal. They are okay with lowering the curtain a bit if you want and the anesthetist should talk you through what's happening. Baby arrives, is held up and then quickly checked over, given a nappy and a hat and brought to you. They stay with you whilst you are sewn up and then you and them are taken to recovery. Your partner takes the scrubs off and meets you there. Once they are sure you are okay, you go to the ward and fingers crossed get out the next day.

I can't quite remember what they said about eating, maybe midnight because they want you to eat a high carb snack at 10pm the night before apparently.

My birth plan was like yours including absolutely not wanting forceps and episiotomy EXCEPT in the event of the baby being in distress and needing to be born quickly - turns out that's exactly what happened! While it wasn't my ideal, the key thing was that the doctors were very proactive in realising my baby wasn't coping and so we were able to have quite a calm discussion about it before it became an emergency. They were very respectful of the reasons I hadn't wanted those particular interventions and did their best to give me as 'gentle' a forceps delivery as possible. Before birth it would have been my worst nightmare but in the moment getting the baby out safe took over. So I completely empathise with your fears but in the event of something like the above happening there might not be much choice. I would have obviously been able to request an emergency section but I personally preferred not to. So as pp have said, maybe an elective might be the best as it's by far the birth situation that you could have the most control over. I did literally everything I could to have a natural birth and managed for 24 hours but baby had other ideas!

Wish you the best of luck with the rest of your pregnancy.

You might find reading a hypnobirthing book v helpful OP. Control is not the point really, birth is a natural process that you don't need to control. Intervention will only take place if you or baby is in distress, and that is not something anyone has control over anyway. Hypnobirthing explains it really well and will give you tools to combat anxiety.

The hypnobirthing will be fantastic for whichever way you choose.

My last two births were precisely as you describe your ideal. The main thing to enable a birth like that however is to remain entirely calm and focused, something that may be difficult if you’re too anxious? That’s where the hypnobirthing comes in. I also had some cards of positivity given to me, they were great to keep in mind.

ELCS process - mine was:

• couple of days before - pre clerking appointment, blood pressure, blood test, prescribed a ranitidine tablet to take on the day of the section to suppress stomach acid for the op

On the day:

• 6am able to have light breakfast eg tea and toast. No eating after that
• 11am take tablet
• 11.30 arrive at hospital, shown to labour ward
• gown up, put on anti embolism stockings, DH gowns up, canula inserted in my hand (after they had applied numbing cream so I didn’t feel it - at my request, I am very bad with canulas after it took a number of attempts to have one cited in my first labour)
• 1.30 walk into theatre with DH and midwife. Introduced to the theatre team. Sit on the operating bed. Small local anaesthetic injections in my back, so that I did not feel anything in a small patch of my back, spinal block (larger needle) cited once local had taken effect. Lose feeling in legs, lie down and operating curtain put up. Surgeon tested to ensure that I was numb. My music put on. First cut about 2pm DS born 5 or 6 mins later, DH was able to shorten the cord (they cut it long when they lift LO out, delay clamping slightly then let DH cut it down), then immediate skin to skin. Sewn up while cuddling DS skin to skin. Op complete about 45 mins after it started. Moved to recovery (DH and DS with me the whole time) for about 2 hours after that, brought tea and toast. Moved to postnatal Ward about 5pm.

All very calm and honestly a good experience. Hope that helps a little.

Have you thought about a homebirth? Elective Section is medicalised birth, a birth in a theatre setting with additional people can only really be medicalised. I am a midwife and planning my 3rd homebirth for a couple of months time. With my first I had one vaginal examination and with my second none. I'd recommend hypnobirthing too.

@dreamingofkfc I have considered a home birth, but the Midwife didn't seem to happy about that when I mentioned it.

I don't want to be negative but really the only thing you control about an elective ca is what date you are booked in for. Once you are in theatre and have the spinal anaesthetic in and can't feel anything or move from the chest down and are surrounded by lots of people, lying flat on your back, it's possible, depending on what triggers your anxiety, that you could feel very out of control. I am not trying to worry you but I would just think very hard about it and not necessarily view a CS as the option where you would have control.
As others have said it's not always possible to control everything about birth, whichever option you choose as things can change and emergencies can happen but it is possible to maintain as much control during a vaginal birth as u can during a CS.

I'm seeing the consultant next week to try and schedule my second ELCS. First one was due to SPD, but by the end of the pregnancy I'd also become incredibly anxious about the lack of control and unpredictability of vaginal birth - I have autism, which I think made this worse.

My ELCS was honestly really good. I felt very secure, and like I knew what was going on, what would happen and so on. I had DH with my the whole way through too.

I actually started off wanting a home birth because I wanted to minimise the interventions, but I realised the uncertainty of it - potential of having to be transferred and so on - was just too much for me.

Mine were homebirths. Best choice ever

As many others have said, it doesn’t always go the way you want it.

I’ve got to be induced on Friday at 39+3 due to the baby’s slow growth. This is really not what I wanted and I’m scared but I want to do what’s best for baby.

I hope it goes the way you would like it to.

I'm really torn on which avenue to choose

Thanks for all your help and advice last night, I am considering waiting until I've spoken to the consultant at 28 weeks. I'll weigh up the pros and cons with them then and decide. I'm leaning towards the elective c section if they allow me to have one on mental health grounds. I like the idea of having my own music playing.

Good idea to talk it through. Would it help to know exactly, step by step what's involved?

I’ve had an emergency C-section which honestly wasn’t that bad (I felt fine after a week and had to keep reminding myself not to jump about and pull my scar ) and I have several friends who’ve had electives for various reasons (breech baby, previous bad birth, diabetes etc) and they all LOVED them. All said they felt calm and happy and relaxed and in control. Hope that helps! I’d also suggest a fantastic book called ‘birth skills’ by juju sundin which really focuses on relaxing and coping with any type of birth.

I think the consultant and mental health maternity team are probably best placed to talk through both scenarios and what's best for you. We can only really offer our experiences and opinions.

Maternal mental health is so important and it's vital that you have some input into the planning process but ultimately birth is unpredictable, and it's not just about you. It's about the safe delivery of your baby. I gave birth on Tuesday - don't worry, no horror stories here, it was fine. But because my blood pressure went up, I wasn't allowed the pool - so it's not always an option. I still managed the whole thing on gas and air despite the syntocinon drip and was mobile until the end so it was still quite hands off. I didn't have forceps but they were very nearly needed and the doctor explained calmly that if my daughter didn't arrive in 2 pushes they would be needed urgently and were the safest option. I'm not saying this to scare you, just to show that any type of birth can be unpredictable. In the end I didn't need them and got 2 strong pushes!

OP apologies if someone has mentioned this already but you know that there is a "Childbirth" forum on Mumsnet? Lots of information about C-sections and birth generally on there, and others with similar questions.