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?!

Also just to add re advocating, there are lots of posts and things you can read about tips on advocating for yourself during pregnancy!

A big tip is to take notes in with you - not only does it make you look more prepared and therefore more likely to be listened to but you can check off the points you wish to make so you don't forget any!

You don't need to have an essay but a pro can con table in bullet points is very useful as it will allow you to see as well as focus the respective pros as well as cons which shows you are giving things balanced consideration rather than plowing down one treatment path.

Make a note on any guidelines/studies/Cochrane Reviews relevant - I can actually tell you NICE comes down in favour of induction/VB but the studies and Cochrane reviews are all "inconclusive" on whether an ELCS is better and more data is needed.

But mainly remember this is your body and your pregnancy and in the absence of a lack of capacity they can't make you do anything medically or with your pregnancy you don't consent to! No matter how much confidence you feel you lack, remember that x

I had GD with DS and was induced. They do only like to do c sections if it's an emergency or the induction isn't working. The baby's measurements aren't always accurate though

Also was not allowed to go past 38 weeks with GD at my hospital

*Isn't that a contradiction though?
*
Oh it absolutely is! It's a minefield. But it's context specific! so you would never try and say that smoking was good for your health or taking morphine on a regular basis was a good idea! That's because there is a clear body of pretty much indisputable opinion which shows that's not the case.

C sections, antibiotics, antidepressants, HRT there is endless debate in the medical community as to the right course of treatment. You have no idea how many medical conferences are attended and papers are written where debate and discussion takes place!

The ELCS vs vaginal delivery debate has gone on for years and will continue to do so! Where there is a justifiable difference of medical opinion feel free to advocate for yourself and QUESTION the medical opinions if you feel it's right to do so x

@SpillTheTeaa you can’t be ‘not allowed’ to go past 38 weeks. The hospital can strongly recommend it, but you have to agree to it.

Also having read a lot of threads on Mumsnet and other forums, the positive ELCS stories hugely outweigh the positive early induction stories. In fact finding a positive early induction story is like finding a needle in a haystack.

Okay I worded it wrong, jeez.
They PREFER you not to go over 38 weeks because the consultant talks about baby's can get bigger in the last 2 weeks and talk about shoulder dystocia.
Do you have diabetes midwives at your hospital OP? I found them to be the most informative for me.

For every positive there is a negative and vice versa.

The difficulty with pregnancy is that no two women is alike so it's hard for o get a defined "best" course of action.

Yes in a nice low risk straight forward birth a natural birth is probably better than a section, however that doesn't account for the damn flukes were the baby gets stuck or you don't progress or the myriad of things you can't account for.

A woman's age, mental health, general health, weight and whether it's a day starting with an 'M' will make two women have totally different outcomes from the same thing.

Eventually all your forums and research and stuff will actually just confuse you more! Pick an approach and go with it! I AGONISED over whether to go for an induction or an ELCS but now I have I'm not interested in what other people say because everyone's different x

Just been reading about forceps. They sound totally barbaric! And there’s yet more risk of serious damage to the baby if they’re used. I can’t believe they’re even attempting to put me or anyone through this horrific method of birth.

@angel772 nobody posts about the good experiences though. I had to have a spinal operation and it was an emergency, either have the op or be paralysed. The risks were spelt out to me of paralysis, going blind, loads and loads of risk.
After the op I was reading stuff about it online, (I had cauda equina) and I struggled to find much positive stuff at all
Everyone saying the surgery went badly, constant pain, left with paralysis, needing a catheter, unable to ever exercise again etc etc
I've never posted really about mine so it wouldn't come up on google search. My results? Some numbness in my right leg and the odd bit of back pain. Normal life, able to exercise etc

I mean think about it, if you give birth and need forceps and it's anywhere between good - fantastic, you probably won't write about it. Like when people who get good customer service only tell maybe 3-5 people, but if they have an awful experience they tell everyone (and then post on FB!)

You can advocate against a doctor because you’re an individual with your own feelings. What is safest and what is right for you as an individual are not always the same thing.

You seem very set against vaginal births and are being scared by reading anecdotal stuff rather than research. Which is understandable. So now if you are so anxious about a vaginal birth it may well not be the right mode of delivery for you even if it’s the safest.

And I could tell you a lot of positive induction stories, positive forces delivery stories, etc. Like others have said you tend to find more of the negative stuff on social media.

If you still want a section you could always quote Montgomery vs Lanarkshire at the consultant and see what they say.

RE COUNSELLING.. they tried to book me in for that when i told them i wanted a c section. I said politely 'no thank you, ive made up my mind'. It sounds like you've made your decision. Just be firm and you will get your choice. Good luck!

You don't need to take into account anyone's anecdotal evidence. Look at the facts and decide for yourself which risks youre willing to take.

I don’t know what I’m missing here. This thread seems to be going in circles. If you want an ELCS you are entitled to request one. If your consultant will not perform the procedure then you can insist on being referred to another consultant who will. You may be offered counselling by the perinatal mental health team in line with NICE guidelines.

Incidentally, however, you said several times upthread that you only care about your baby, not your own health or recovery. Please reconsider this. I know it seems that this should be your instinct but once the birth is over your child will need you for many many years. It is not selfish to prioritise your long-term health.

I had a forceps birth OP, and I agree it is barbaric. Better than the alternative once you’re having a vaginal birth going south - but utterly horrific. I had a Pessary which was in for 24 hours supposedly, but more like 36 due to induction ward being busy. If that doesn’t work they burst your waters manually with some big needle thing out through your cervix. If that doesn’t kick of labour, you go on the drip which is horrific in terms of pain.

My labour progressed so fast that there was no time for pain relief, but because of feral distress they used scissors to cut my vagina open and put forceps in to yank my daughter out, in doing so tearing away my pelvic floor from the pubic bone, which can’t be repaired. It has left me with prolapse which will probably need surgery, incontinence and pain, and there’s nothing they can do. 49% of women who have forceps suffer some form of muscular avulsion like this.

So for my part, I’ll take my chances with a wound infection from a section (I got an infection in my episiotomy anyway). I just don’t understand which part of having an elective section is worse than what can happen to so many women who have a vaginal birth.

@VivaLeBeaver what criteria are you using for “safer”? Only maternal death? What about long term birth injury, are you saying that is safer with vaginal birth too, and if so on what basis? The definition of “safe” is fairly important here.

I’m a lawyer and Montgomery is a great example of why doctors unduly push vaginal birth don’t always know best. The Supreme Court took the view that the medics in that case made a moral judgment on how women should give birth. I have dealt with numerous cases where VB has been pushed or mismanaged and the baby has suffered injury.

And yes I know lots of women will have a good recovery from forceps. Lots of women will have great recovery from elective section. You can have a good birth experience with any method, but OP is clearly concerned about what could go wrong.

You seem very set against vaginal births and are being scared by reading anecdotal stuff rather than research.

@VivaLeBeaver I really wanted a natural vaginal birth and that was always my plan, but that’s no longer an option thanks to diabetes. Natural birth is fine - I was even looking forward to it. It’s induction that completely freaks me out - especially an early induction.

I doubt I will get another appointment with the consultant so will ring the midwife and say I need to have a section or will switch hospitals.

@ClientQ I know what you mean but I have read a lot of positive caesarean stories on Mumsnet though.

@OhClover. Nope, not just using maternal mortality.

Thinking of maternal and fetal mortality and morbidity inc birth injuries. Obviously rates of perineal trauma are higher with vaginal birth but don’t underestimate birth injuries from sections. Scalpel injuries to the baby, I’ve seen fractured clavicles, I’ve seen tentorial tears, wound infection and break down, permanent and painful scar adhesions which cause problems for years. Impact on future pregnancies such as placenta accreta, higher risk of uterine rupture.

All these things are rare. But the catastrophic injury following a vaginal birth is also rare. But people will have different acceptances of risk depending on their personal circumstances which is fine.

There was a lady opposite me who had an 11lb girl. Who was a c section

Then she had a 13.8lbs girl. Also c section. Because the drs said the baby was too large to have a normal delivery with.

Both ended up in neo natal for weeks.

However. The consultants knew that she could t birth it and there was no question. Of a c section.

So if your consultants think you can birth this baby. The. Trust then.

@VivaLeBeaver To me all those things sound more likely to happen in a rushed EMCS (again, another likely outcome of induction) compared to an ELCS.

If you want an ELCS you can have one for any reason, I personally think your reasons are justified, I was a ten pound baby and my mother gave birth to me naturally and had an awful time and recovery, many years later she developed a prolapse and is very debilitated by it. She wishes she would have had a C section, so if I knew I was carrying a large baby I would push for an ELCS as well. For me, it’s not just about the birth it’s the medical problems after giving birth to a large baby, that in many cases can only be managed and not cured.

Both of mine were induced labours. Ds1 was forceps, due to his own position, he was estimated to be 8lb9oz at 38 weeks he was 6lb1 and scrawny as hell. I walked 5 miles two days later with feck all but ibuprofen n paracetamol. I had an epidural the minute my waters were broken n felt nothing pain wise the entire time. Fragmin jags to take home were the worst part.

Ds2 39 weeks reduced movement, literally nothing for two days and two kicks on the day of induction, estimated 7lb 14 was 7lb11oz so pretty close this time. No forceps, no pain killers, one pessary to get me started.. waters broken baby a few hours later. Discovered gas n air doesn’t work for me at all.. if you ever chain smoked cheap rags as a teen that’s all the feeling i got. Took paracetamol in hospital, was allowed to go home within 3 hours but opted to stay overnight to establish feeding and having a 1 year old at home actually sleep for a few hours. No jags or anything but iron tablets to take home with me this time.. well besides the baby obviously I swear I didn’t leave either of them.

Neither of my inductions were horrific. My friend couldn’t move properly or pick up her baby without tears after her csection and my aunt had an open wound they couldn’t close (private and nhs) for a year.. she couldn’t look after her child at all and bed bound in agony. They don’t speak about their births often as they find it gory, disturbing, fucking terrifying to any women about to go into labor themselves.. catch my drift.

It’s also a percent thing, more women have vaginal births so there’s more stories and therefore more talked about.