Have birth options changed in your area due to CV?

[MoonBlood]

Hi, I’m almost 30 weeks and I have requested a c section this time for various reasons. I saw my midwife last week who said that while birth options hadn’t changed YET she couldn’t say whether they would by the time im due and that I need to play it by ear and be as flexible as possible. I’ve had four vaginal births with no big complications but am absolutely terrified of doing so this time. I can’t explain it really. I’ve had severe MH issues that were being dealt with before the pregnancy but since finding out about this one (very very unexpected and a huge shock) things went south quickly and I got so much worse.

I’ve been on medication and having counselling which is all helping and I’m in a much better place, but having the option of a section gave me a sense of control and stability that I don’t have anymore due to everything that’s going on now and the uncertainty around giving birth.

My appt with the consultant to talk about this was on Monday but has been cancelled and I’ve got a telephone appt instead. The change has made me more apprehensive and I’m struggling a bit with all the fluctuations. I know it’s not an easy time for anyone expecting at the moment though so maybe it’s all just ‘normal’ worry as opposed to my MH issues flaring up again, or maybe a it’s a bit of both.

I suppose what I’m asking is if youre still on track for your birth plan or if you’ve given birth recently were your options and care the same as before this kicked off? Have you had any info or advice from your midwife about an upcoming birth? I know it’s noones fault but the lack of clarity has unsettled me massively.

I was preparing for a second home birth. This was particularly important to me to minimise the extent to which my PTSD is triggered.

No home births now. I'm terrified, and it's rubbish, but I understand why it's necessary.

That’s awful to hear, I’m so sorry :(

Same as that @FriedasCarLoad
But what can we do. I’m really hoping things change. I’m due 9th June.

I’m due the 14th so there is time for it to change. Whether it will be for the better or the worst though I don’t know 🤷‍♀️

I had my telephone appt with the consultant today and she’s refused the section :(

Hi,

I spoke with the hospital this morning and they said that I should stay at home until contractions are every two minutes consistently for two hours. Birth partners can only join once in established labour and have to leave two hours after birth...

This is my first baby so feeling quite concerned that I will be on my own for so long at home...

@MoonBlood was it refused due to the CV situation? Just wondered as I was reading on the NHS site and it says: If after discussing all the risks and hearing about all the support on offer you still feel that a vaginal birth is not an acceptable option, you should be offered a planned caesarean. If your doctor is unwilling to perform the operation, they should refer you to a doctor who will.

@jeca8 it seems to be the main reason yes. I don’t really know where to go from here :(

@MoonBlood if they refuse you a section they should forward you onto someone willing to perform it. What exactly did she say? I'm sure they can't refuse a section point blank. Maternity action might be your best point of call. I understand then limiting home births/MLU births and drawing all their resources to one place given the situation however shitty it is but to refuse a section seems absurd!

She said the main problem seems to be my anxiety and my mental state about getting pregnant when I didn’t want to be and that she will not be recommending me for a section. They are trying to reduce footfall in the hospital and are not giving women a section until 41 weeks instead of the usual 39. Her recommendation was to take a higher dose of my antidepressants and to accept one of the alternative contraception methods at the time of the birth, coil or depo. By this point I was too upset to speak and couldn’t continue. She said she will make an appt for me to attend the clinic after my due date and see what the situation is then but the likelihood is I will have to have a vaginal delivery and they will perform a sterilisation at a later date if I still want it when everything else has died down.

Have a read of this www.birthrights.org.uk/factsheets/right-to-a-c-section/ and carry on pushing. I think that's absolutely appalling. NICE guidelines state you should be referred to someone willing to perform the operation if one consultant refuses. I'd be tempted to take it further (head of midwifery as outlined via the link) and even publicly if it is still refused. They are limiting women's birth right far enough already without pushing even further.

@firsttimebumps Thank you, i'll have a read of that now x

@MoonBlood keeping everything crossed for you, keep.us posted x

@FirstTimeBumps That guidance you posted is prior to the current CoVid problem. My trust has stopped all maternal request c-sections as

a) it means a longer stay in hospital for you and therefore increases the risk to you and your baby of being exposed to CoVid.

b) it requires an anaesthetist to be present and they are needed in ICU to save lives instead.

Obviously this doesn’t apply to ones performed for a medical reason.

It’s unfair but the whole situation right now is unfair and resources can’t be diverted away from lifesaving procedures to accommodate choices or requests.

The home birth service being suspended in many areas is due to ambulance transfer issues. Ambulance services are so overwhelmed they cannot be available for an emergency transfer to hospital if a home birth emergency occurs therefore it’s not safe to go ahead with a home birth knowing there will be no or a very delayed ambulance transfer in an emergency.

Hi Fellow Mums,

Am due in Nov 2020 but am waiting for my 1st appointment, am a new mum to be and am so...worried. I leave in a area where 2 major hospitals are( Whippscross & Queens Hospital). Have seen their online review and some are really bad, could you please advise which one of them you think might be best to register and delivery my baby.

Please advise x

I was also wondering the same, due 26 May and was hoping for a planned c section this time after a c section for low lying placenta last time. Feeling seriously pissed off at the thought of being forced in to a VBAC.
Sorry to hear about your experience OP, i hope you manage to get a c section granted x

@indella I wish they would post updates guidance. Completely uncertain times for everyone least not pregnant women. For labour to progress efficiently women need oxytocin, which is inhibited by stress. All refusing elective csections is going to do is increase the number of emergency ones. What is the case in maternal request after prior section as the risks are elevated in this case compared to prior vaginal births (risk of scar rupture although still only small it is an increased for VBAC compared to a repeat section). I fear the birth trauma that many women will endure due to this. As I said I understand in relation to home births however women are now basically being bearded into a very fixed birth plan. There was a report today on increased numbers of women intending on freebirthing so this is already becoming out of hand. It just infuriates me that women are being put in this position when the government were well aware that a pandemic such as this would leave the NHS short of staff and resources.

Herded*

@Firsttimemama2017 I agree it’s unacceptable, I’m a midwife it’s awful for us. We HATE restricting women’s choices and denying their requests. We have no choice though, the decisions are being made much higher than us and we have to follow them. I agree updates would be helpful but the problem is it changes daily, sometimes even less than that, and every hospital has their own policy and their own guidelines depending on how they personally are being affected by the pandemic.

As one example we were told inductions were going ahead as normal. Phoned the inductions due for that day and told them to come in. Less than an hour later we had some CoVid related emergencies which meant no theatre was available at all and were told cancel all inductions and close the maternity unit. All the women were then sent home upset and frustrated, left in the dark.

It’s horrific working like this, it’s absolutely breaking staff and this IS NOT what we signed up for. The news that a midwife has now died isn’t helping staff morale either. We feel like we are risking our families every single day, I’ve had to write a will ‘just in case’ in my 30s. The whole situation is unacceptable but what other option is there?

@Indella I bet you get some of frustrated pregnant women too. I do feel for front line staff because as you've said your hands are tied and it's not you making the call. My MW said, but told me not to hold.her to it, that she doubted they would stop all.birth partners as midwives acknowledge how.important they are to women and they would themselves cause uproar if the hospitals tried to enforce it. I'm not due till October but even being that far off there's still major uncertainty. This initial lockdown is meant to end next Monday but were none the wise to the next steps. Just so much uncertainty

@Firsttimemama2017 when you find out about a repeat section Vs enforced VBAC if you remember would you let me know. Obviously were probably different trusts but it would be nice to know. I was a prior EMCS for undiagnosed breech following 32 hours with waters gone plus merconium and was hoping for a section this time based on the fact if I was to attempt a VBAC I'd like a MLU water birth which wouldn't be the case I believe because they reccomend continuous monitoring (which I know I can decline however my anxiety would be through the roof going against medical advice)

@firsttimebumps I honestly can’t see them banning birth partners either. There’s no need, once a woman is in active labour she’s in a side room away from everyone else. The main reason for banning visitors etc. is that in a busy ward it’s IMPOSSIBLE to socially distance, this doesn’t apply to labour. Plus we know full well that if we ban birth partners then even more women will freebirth and make it more dangerous that it already is.

@Indella I apologise in advance because you've now become the inside scoop haha. But moving all the women who would normally birth in MLU or at home to a delivery suit in the hospital. Are there even going to be enough side rooms and staff to care for them? I get focussing all resources in the one place when staffing is short but surely there are minimum staffing and space requirements. It just sounds like a disaster waiting to happen

@FirstTimeBumps In my trust the home birth rate is 3% and we didn’t have an MLU anyway. Nationally the home birth rate is a tiny tiny percentage of women so isn’t going to have any effect on delivery suite. Those trusts with large MLU’s may struggle more but I expect they are making provisions for that.

The space requirements really isn’t being adhered to though, it’s impossible! Try keeping people 2 meters apart when the room isn’t even 2 meters! Thinking of ultrasounds, community midwife clinics, consultant clinics etc. all done in teeny tiny rooms where socially distancing is impossible.

I’m 6 weeks pregnant with my 3rd and was expecting an elective csec this time. 1st birth emergency csec after three days labour, baby was stargazing and never passed 3cm, second birth I tried 4 days for a Vbac and same thing happened. Elected for a csec on arrival at hospital after dilation was checked (2cm) and baby was in exact same position and unable to move down. I was told if I ever had a third it would have to be a csec as my body obviously does something that prevents my babies descending in the right position and letting me dilate properly. I would be devastated if I had to go for another Vbac 😢 Both my babies were two weeks overdue and it was just hell, particularly with the 2nd. Would be interested to hear what different trusts are doing.