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?!

I've got no experience of GD but I do think you sound very worried about a VB and it would help your mental health to have an ELCS. I had an EMCS and it wasn't easy but my 3 day Labour wasn't great either. I think if it had been planned and I had a time and date, calm atmosphere, calm doctors and calm DP then it would of been a lot better for me post birth. In regards to the weight, my scan at 39 weeks had my son at 7lb, he was born at 42 weeks + 3 6lb 4oz. I hope you manage to get the c-section if that is what you feel is the right choice for you and your baby.

If you and the the baby are healthy enough to have a natural birth why put more strain on the nhs because your to worried to push?

There’s always one idiot isn’t there? For your information I was really excited to have a natural birth until I found out I had GD and my baby’s size is way bigger than average.

Thanks to all other posters for the advice. Feeling slightly calmer about things today. I haven’t had a chance to read everyone’s replies yet as it’s been busy, but will have a proper read and reply tomorrow.

Thanks again

What about an epidural? No pain but full brain power!

She’s not worried about the pain. She’s worried about shoulder dystocia.

You have every right to request a c-section and if the consultant won’t agree then they must refer you to one who will agree. I had an induction which led to an EMCS (not sure to diabetes, due to baby’s restricted growth) and it was awful. Many people have positive stories but the whole labour and EMCS was horrific. Second baby I had an ELCS and it was amazing. So calm and lovely.

I've had EMCS and ELCS. The ELCS was lovely calm and I recovered well. The EMCS was awful, I was left with a wound that didn't heal for months.

Right now I'd want a vaginal birth if possible as you're more likely to be out of hospital faster and less chance of getting corona.

OP my fears were very similar to you. I spoke to 1 consultant who recommended a vaginal delivery with no induction. That gave me the fear. I did my research and at around 38 weeks I spoke to another consultant who obviously told me the risks but said he could completely understand my concerns. He contacted the hospital and due to reduced movements booked me in for 39 weeks on the nose. I felt very validated when DS was born weighing 10lbs 10oz. Maybe I would have been able to birth him myself. Maybe he would have got stuck. I'll never know. But I don't regret my decision one bit.

Please don’t let people make you feel bad for wanting a c section. I had a very interesting conversation with a health professional when on the antenatal ward - their perspective was that elective c sections are actually less work for the staff because whilst you need more staff it’s all planned in an hour so less bed time than a long induction (given most people have enhanced recovery) and less resource intensive than a EMCS.

Op I do understand that you must be nervous as it's your first DC. DC1 was induced, as lots of first children are, a simple 3 and a half hour labour and near 9lb baby. DC2 was ELCS due to her being breach, they damaged me removing the placenta - unsure whether I could get pregnant again or if it would be safe. There are risks. Tragically birth injuries can occur, even where the risks are very very low, but they are rare.

Jumping in here my daughter was 10.05lbs :D long labour due to being back to back but easy other than that. The scans all predicted her to be 7.5lbs. My friend's baby was induced early as they thought he would be huge and he was 8.1lbs. It really isn't a very predictive game unless bubs is small.

My advice would be to, as people said, go in and have a chat with the consultant. If you are STILL measuring big at 38 weeks THEN push the c section. This was my friend's experience with GD, the baby was large and she had a c section and he was very large indeed. But the consultant made the choice at 38 weeks. This is most likely what will happen with you :) Just be as reasonable as you can. I know it's scary (I was rightly convinced my daughter was massive!!!) but it is rare your body will grow a baby too big to birth and if you follow the GD diet hopefully he or she will grow to the perfect size for you.

Diagnosed with gd at 33 weeks. They had talked about induction, but I thought it was a last resort if my sugars weren't in control. Diet-controlled, only went over twice in three weeks, testing six times a day so 2 times out of the 120 times I tested my sugars.

36 comes around and they want to because they messed up my chart from my last appt. Sonographers were saying he wasn’t big and consultants were saying he was. I went with my gut and said no because I could feel my baby and he could easily move around in my belly. I could feel his head or his feet, but not at the same time. I was monitored for an hour twice a week and for two weeks they talked about stillbirth stats despite the Doppler showing no problems. I said no. They said I was killing my baby if I didn’t induce and I caved.

39 wks, Induction failed, dilated to only 3 cm after three days, ending in emcs. He was 6lb 13oz, our blood sugars were normal and remained that way when checked afterwards. I was left traumatised by the experience.

I reported them. Hospital looked at all of my notes and found that there was no medical reason to induce me nor for me not to have been able to wait for labour to happen naturally.

Trust your gut, ask questions, if something doesn’t sound right ask for clarification and if they just keep repeating the same thing over and over again ask for a second opinion. That was my biggest regret. I didn’t know I could ask for a different consultant (was under a team). If I had, I would have asked for a different one much earlier and probably would have had a better outcome.

You need to take into account birthing at a time of Covid-19. Some comments here are not really relevant to birthing right now. My hospital have stopped water births as the MLU is closed for Covid positive women and no pools on labour ward. Epidurals are also cautioned due to lack of anaesthetists so have been advised I may not get one. You need to look at all this info and make a decision as to what is best given the current circumstances. Personally for me, no water birth and possibly no epidural means I have opted for an ELCS as I feel thats best for me right now. I also have well controlled diet GD.

As long as you are aware of the risks and benefits of all options, you can make an informed decision based on your personal circumstances- be that a section or vaginal birth.

@phoenixsrosehere there was nothing that you could have done at the time. You listened to your Dr and put your baby first. I took the other option, in that they pressured me to be induced (there was no medical reason, just that I had an underlying condition but all scans and stats were completely healthy for me and baby), I refused and refused, I then went over to 41 weeks gestation. I had 1 day left before I would definitely need to get baby out (42 weeks), and went into labour totally by myself. I never fully dilated, they had to induce me, which failed, baby was too big for my body (each pelvic width is different), and had to have a c-sections anyway. Very traumatic. But there is nothing you can do, or predict the outcome. We chose 2 different paths and ended up at the same point, and most importantly with a healthy baby. One thing I learned was that you cannot plan a birth. As long as you and baby are healthy, that's all that matters. You did your best with the information you had. The teams are overrun and take the safest route to get baby out. As a mum you want the best for your baby, but its not always the way you think it will go.

Sections are virtually NEVER the safest option, all
things being equal.

I've had lots of babies and lots of sections. Electing to have one without really solid grounds is nuts frankly. You've read one bad case and you've gone into overdrive.

Calm down. Breathe deeply.
Your baby will almost certainly be significantly smaller than the scans suggest.
Your diabetes is being controlled.
You'll be heavily monitored while labouring.

Step away from google.

You are entitled to a section if you're adamant that is what you want and no other option will be doable for you emotionally.

Yes they come with their our risks but ad least the risk is controlled, planned and you're prepared in advanced for it. A vaginal birth gone wrong can go a lot worse, quickly.

If they're set on being awkward with you, since you are entitled to a section if you feel unable to cope with a vaginal, say it is either that or a home birth then..that'll wake them up

Weight estimates are entirely arbitrary. My DS was estimated at 10.5 2 weeks before he was delivered at 8.12.

Calm down. Breathe deeply.
Your baby will almost certainly be significantly smaller than the scans suggest.

You can’t say that, you have no idea. I was scanned the week before having both my babies and both times the estimated weight was very accurate, within ounces. While there is a chance the OPs baby will be smaller or bigger than the scans suggest you cannot say it certainly will be significantly smaller. You have no idea.

@Virgo

He wasn’t healthy when he came out. We didn’t learn until after the appt with the hospital that he hadn’t been breathing and that protocols had been broken during my care. There were things done that I hadn’t consented to because they never asked me and hcps they were suppose to have me meet and didn’t. Dealt with two verbally abusive doctors during labour, one who was made to resign afterwards (had form for this and there were five witnesses). The only reason I wasn’t induced sooner after I caved was because they had fully booked days for inductions. My son is a SEN child. I will hopefully find out once things turn to normal if his SEN issues are genetic or if they were a by-product of my labour. I had to go through CBT, my husband still gets upset over it 5 years on because it has to be discussed when talking about our son’s needs.

An unnecessary induction is not the safest way out. It is actually more unsafe than an elcs that’s why you’re supposed to have strong evidence for one which they did not and hospital agreed that they didn’t. An unnecessary medical procedure is never the safest option.

I did have much better care and more positive experience with my second, same hospital since it was the only one closest to us (45-60 min to the next) and the doctor I was supposed to meet had taken over as head of the department and was doing seminars about consent for pregnant women. I was supported throughout my pregnancy, I was listened to and they were happy to compromise with me on certain things. They made sure the issues from last time didn’t happen again. I went into labour naturally at 40+4, a successful vbac, and baby was 7lb 6oz.

@Alonelonelyloner Female doctors are more likely to choose a section with no medical reason though when they have their own babies. I wouldn’t personally do it myself but it really isn’t ‘nuts’ or less safe- it’s just a matter of what risks some women are happier to take or not.

Sections are virtually NEVER the safest option, all things being equal

Sorry but what a load of shite. It’s actually quite an offensive thing to say for the VERY many women who have suffered birth injury as a result of vaginal birth.

I’m pleased your births went to plan @Alonelonelyloner but that doesn’t give you the right to be dismissive of the very real and downplayed risks of a vaginal birth and the experiences of so many other women.

@thekeythesecret that's a very good point. We all have our own limits and experience.

Mine is what it is. For what it's worth @OhClover precisely none of my births went the way they were planned

@Alonelonelyloner I’m sorry if they didn’t go to plan, genuinely, because I want every woman to have a positive experience. But not going to plan, and safety, are not the same thing. Lots of women (myself including) suffer life changing birth injuries of various severity. Vaginal birth is not necessarily safer. It is not necessarily easier to recover from. I will never physically recover. There is in fact evidence that elective sections are safer for women without risk factors for surgery.

It's not about pain. Epidurals are crap as just numb you but often cause more body damage long term and increase need for c section anyway!

You have a valid reason. Some countries with more money in healthcare would do ELCS without question for GD. The NHS is amazing but c sections are expensive and it's government funded. You still have a right to have one. You can be given all the info in the world but it's your choice in the end and they can't refuse.

Everyone has a different experience, but you need to feel happy and enpowered with your choice.

I pushed for CS and my recovery was amazing. My 2 friends tried vaginal birt, both failed forceps and ECS anyway. One of them said she was still glad she tried vaginally first, the other is unhappy as she wish she'd pushed ECS.

Pushed ELCS

I had gestational diabetes and had a natural birth. I was diet controlled until 30 weeks and then went on metformin. The website you have linked to is incredibly helpful and got me through my diagnosis. If you explore the website further you will find positive birth stories, this is an example of a worst case scenario. Your GD has been diagnosed and is being managed and you will be having regular scans.

I was told my baby was measuring big - she was born 6lbs 6oz much smaller than they said she would be. I was told I could go to 40+6 before they’d induced me, I went into labour at 39+6.

And just to reassure you a natural birth, whilst not risk free with GD, can go well - my baby had shoulder dystocia. She got stuck but my midwife spotted it as soon as her head was out, a buzzer was pressed, loads of doctors filled the room and she was out within seconds - no need for the intervention just a manoeuvre with my legs. Yes it was scary - I think more for my partner at the time than me as I was high on the gas and air - but it went well.

If you’re nervous there is a FB community linked to that website where plenty of us have posted our birth stories and it’s a fantastic support - they may be able to help reassure you.