To demand a caesarean

[angel772]

I’m 33 weeks pregnant and have gestational diabetes. I’ve been discussing birth options with my midwife and she’s adamant they should induce me early if the baby’s getting too big, or let me go to 40 weeks if not. I suggested a caesarean but she said induction was the preferred route with an EMCS if required.

Having looked into this, I came across this link and am now absolutely panicking that my baby could have oxygen starvation during birth, leading to severe disabilities:

www.gestationaldiabetes.co.uk/ceiras-story/

I can’t for the life of me understand why the hospital are even considering making me try for a vaginal birth given the huge risks to my baby, who is already on the large side (5.5lb!!) and so could very easily get stuck. I feel women are offered caesareans for much less and can’t see why it’s not been put forward as an option for me. Why are they risking my baby’s health and WWYD?!

It feels like they’re playing Russian roulette with my baby’s health

Bear in mind that the weight estimates are often very inaccurate, and that basically births where mothers have HD are common.

But also, maybe ask for a second opinion since this is really worrying you.

A Caesarian is major abdominal surgery, that comes with risks to you and the baby also. It is not the easier option.

Don't go in demanding, go in and ask to discuss the option with your Consultant.

I think you are right to insist on a cesarean. Sounds like that would be safest and it’s what you want. Tell the midwife that’s what you want and keep insisting.

The story you have linked to sounds very worrying- however it is an account of a woman who had uncontrolled and undiagnosed diabetes, this was the issue and not the vaginal birth. It is, of course, completely up to you if you would prefer to request a section.

It is worth remembering that weight estimates are quite inaccurate. My first baby was estimated to be over 10lb and he was 8lb7.

Good luck with your birth, whatever you decide.

Hospitals are under pressure to keep c section numbers down. It's worth standing your ground if you think it's best after discussion and research and if it's affecting your mental health. Fwiw a df of mine is a consultant in a maternity hospital and had elective sections for both dc despite having no major pregnancy complications

A Caesarian is major abdominal surgery, that comes with risks to you and the baby also. It is not the easier option.

I’m not saying it’s easier, but having read the link above, it appears to be the option that is much, much safer for my baby. I don’t know why the hospital aren’t seeing that?!

Have you spoken to a consultant about it at all? Can you ask to be referred? I'm not sure "demanding" is the way to go, but YWNBU to be firm about what you want and why. I don't know much about gestational diabetes, but if you do your research and bring copies of actual medical studies showing the increased risk of vaginal birth with you to your appointment it might help. Good luck!

The story you have linked to sounds very worrying- however it is an account of a woman who had uncontrolled and undiagnosed diabetes

That’s true, but I’m scared that hospitals are under huge pressure at the moment and even though they know I’ve got GD, one missed signal that my baby is in distress could lead to catastrophe. Whereas an ELCS would not come with those risks. I think I’m just shocked that they’re not offering me one automatically and I’m having to fight for this?!

It's not huge risks to your baby, don't let one bad story put you in a complete tailspin. Plenty of people birth bigger babies with no problems and equally some smaller babies will encounter difficulties and get stuck. They are suggesting early induction as this is currently a safe option. Presumably you are getting regular scans and monitoring so they can keep an eye on things and keep you informed on what options are available and safest. It would be risky if you were looking at an 11-12 pounder but they're not planning to let you get to that point.

C-sections carry their own risks so doctors won't just suggest carrying one out when a safe, natural delivery is still on the cards. Stop reading horror stories and try to get into a positive headspace as that will help you whatever birth you end up having. Have you tried hypnobirthing?

I was in your situation but baby was measuring even bigger- full term equivalent 7.5 pounds at 35+0. I was induced at 38+4 but induction failed and I had DD by EMCS at 38+9. She was 8lb12 which is pretty chunky but hardly ginormous and less than 1.5lb bigger than she had been measured at nearly 4 weeks previously. Scans and measurements are not an exact science and babies all grow differently so don't panic.

@TrashKitten10 yes I’m being monitored (due another scan at 36 and 38 weeks). I know scans can be inaccurate, but people usually say that when the baby measures big and actually comes out smaller. It could also be the other way round and baby could be larger than they think!

I just can’t see how induction and a potential EMCS (risking the baby getting into serious distress and starved of oxygen) can possibly be safer for a big baby than an ELCS.

I don’t want to be forced into a dangerous birth because the hospital need to meet their targets - I just want what’s safest for my baby

You are allowed to have an elective section for any reason including personal preference. So just ask for one.
I think you may be worrying more than you need to about the risks, though.

All births carry risk, this is why you need to ask for an appointment with your consultant to discuss the best option for you and your baby.

Unfortunately the consultant agrees with the midwife that induction is the best way forward at the moment. I’m thinking of getting a private consultant to give a second opinion as I just can’t believe an induction is safest after finding that link. I know it’s only one story but it’s extremely frightening all the same.

The safest birth is by far a vaginal delivery. Most babies stop growing from 38 weeks and 5.5lbs at 33w isn't actually that big, plus your gd is a controlled (assuming you are following dietary advice)

Personally I think you are panicking and overly anxious from reading one single story. The thousands of stories of where everything was fine don't get published as they're not interesting enough ..... With current circumstances in the nhs - midwife led will be best too.

One report doesn't overcome the thousands of births that happen at your hospital every year. They do know what they are doing.

If you really can't calm down then you can request a cessation (rather than demand) but you don't seem to have a real medical need to have one. Honestly they will be putting the safety if you and your baby first.

If you were in my position would you trust the midwife and consultant or push for a caesarean?

Why wouldn’t you trust the professionals with experience and medical training?
That’s a horror story that’s nothing like your case.

Cs carry far more risks - both during the birth and complications in recovery. It's major surgery. They would not suggest induction if they didn't think it was safe - I know several people who have had 10lb babies vaginally without any complications.

I had gestational diabetes with my first and I had a normal birth no problems, second birth no issues and with my third I had high blood pressure so I was induced. I would always chose a normal birth unless mine or my baby's life were under threat then obviously I'd have the caesarean.

In your case I'd follow the medical professionals advise and have a vaginal birth. You've got yourself into a panic over one article.

The safest birth is by far a vaginal delivery.

How can it possibly be safer for a big baby when there’s a risk of oxygen starvation, the shoulders getting trapped and the baby getting into distress? That’s what I can’t understand. Okay the baby might miss out on some good bacteria from the birth canal if I have a caesarean, but that’s nothing compared to being deprived of oxygen resulting in permanent brain damage!

I think I would ask to be referred to a consultant to discuss it and find out their thoughts on a section. My SIL has type 1 diabetes before pregnancy and she had an elective section for her son.

I had an EMCS (failure to progress and a baby in distress) then ELCS a long time ago. It is no picnic but I would at least want a referral to a consultant. My ELCS was agreed just after my 20 week scan. But I have scar tissue and complications so I think my case was easier to argue as it was a second section.

Be fully aware of the risks to both yourself and your baby from a vaginal delivery and a section, just so you can show you are informed.

If you then read a story about a horrendous caesarean birth what would you do? You cannot base your entire opinion on one example. Next time you see the consultant ask them to explain everything to you properly, ours was very good at explaining the risks as a percentage which was a much more factual and rounded way to weigh things up than just reading one story.

Why wouldn’t you trust the professionals with experience and medical training?

Because I’ve read that hospitals are often reluctant to offer caesareans to meet their targets and I’m worried thats why they’re not offering one to me.

Cs carry far more risks - both during the birth and complications in recovery.

I can’t see what risks caesareans cause compared with a vaginal birth for a big baby. The baby won’t be at risk of oxygen starvation through a caesarean section for starters. I’m not too bothered about the recovery as that’s on me, not my baby. All I care about is the baby’s health.

You’ve read.
Based on what evidence?