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?!

Because if you say you’re worried, etc and maybe don’t sound determined it might be that when you say you’re worried about x and then they come up with a counter arguement you then need to say ok, but you would still prefer a section. Otherwise they will think you’ve been convinced by their counter argument.

Perhaps this is where I’ve gone wrong - I’m not very confident in real life and am not very good at articulating my points and concerns.

Hi OP

I’m a bit late to the party so I haven’t read through the whole post so sorry if I am repeating something already said.

Few things, first I work with doctors/consultants on a daily basis (I am not a doctor). And there is a principle in medical practice called “conscientious objection”. This is not allowed to be dispensed with, regardless of COVID. It typically applies to doctors who personally object to performing abortions but also applies to those who want to object to performing a ELCS! If they don’t want to do it they have to refer you to someone who will! This is in the NHS info page as well.

So my sitch - I am 27 weeks and my waters went at 25 weeks. I’m trundling one for now but the plan was to induce me at 34 weeks. After lots of my research and my chat with my consultant we are going for an ELCS. Yes there is a risk to what a PP has said to their lungs - “wet lungs” - if delivered by section but there is similarly a risk to a baby (esp premeature) during labour of distress and needing an EMCS which is totally different! There are Risks inherent in either birth approach but ultimately you need to decide which tips the balance for you - for me gentler birth of a premature baby by section won.

Both my cousins had GD and both had an ELCS and neither have had any problems with their children’s health. Both their babies were big and presented the risk involved with delivering a big baby! My cousins counselled me when I found out I was going to need a section as opposed tl my natural vaginal birth and honestly they couldn’t have rated it higher. I know every woman and her baby is different but my families examples are fantastic!

Finally Inductions (CAN but not always) make the labouring process longer and more painful and harder on the mother which in turn increases the stress to the baby. There is also a higher risk of a instrumental delivery in an induction - more problematic with a larger GD baby... This is from the horses mouth or two obs and gyne consultants I have recently worked with!

Everyone will have lots of different opinions on what’s best for you but I think your approach is spot on and one I’m going for! X

Perhaps this is where I’ve gone wrong - I’m not very confident in real life and am not very good at articulating my points and concerns.

I do think sometimes medicine can be a bit paternalistic and doctors assume once they’ve said something that you agree with them. Ime if you listen to what they say but then calmly and clearly say that even after hearing all of that you still would like a section you’re much more likely to get somewhere. Be polite but firm.

Though I’ll be honest I have no idea about your chances in the current coronavirus times. Like previous posters have said this may have some impact.

Op you might have got an answer about your concern regarding section birth and the not squeezing air out of lungs.
I had a booked induction on my due date from having a major bleed (unexplained) at 31 weeks.
Induction didn’t really take and my waters were broken. Labour started nearly straight away. 8 hours of active labour I hadn’t dialated to even 5cm as baby had turned and got stuck. Was showing signs of distress and struggling.
Off to emergency section.
He was born about 30min later and next thing I knew the panic button was hit and the room flooded with specialists.
My baby had 20mils of air and 30mil of fluids around his heart and lungs. It took 40min for them to work on him but luckily he was ok.
It was touch n go if he was going to be sent up to NICU but skin on skin with me did the trick.
I have struggled with recovery from the section. The first night he was born I couldn’t even get up in the middle of night to tend to his crying which broke my heart.
I couldn’t walk for couple of days as the pain was unbearable and I have a high pain tolerance.
I know everybody has different experiences and I was unlucky to have a average one but my baby is perfect and won’t remember any of that.
Though I will say my partner did not cope with it all and he thought he was going to lose both of us.

The post you've linked

Hers was h diagnosed and uncontrolled

Is yours undiagnosed and uncontrolled?!

I've had 2 very tiny children.

They very rarely get it wrong and think you've got a small baby and it's huge.

I would 100000% trust me dr

My first was horrific. I nearly died. Spent almost a year after giving birth in hospital

My second I had a high risk dr. He was hands down (even to this day) one of the best drs I've ever met. I trusted him implicitly!

They do know best. C section is a massive operation. Some women don't get out of bed for 5 days. You can't drive for weeks. It's not fun!

My very big baby was born at 39+1 by CS (ELCS was scheduled but I went into spontaneous labour and still got my section). He spent his first day on CPAP in SCBU due to respiratory distress. ELCS is not a guarantee against respiratory issues.

@MrsRose2018 thank you for sharing that.

@wheresthehope I’m really sorry to hear what you went through and glad it turned out okay in the end. If you’d had an ELCS rather than EMCS would that have made any difference to your situation or not do you think?

They very rarely get it wrong and think you've got a small baby and it's huge.

They think I’ve got a large baby with a huge head!!

They told me at a 38 week scan Dd was already 7lbs10oz. She was born 2 weeks later and was 6lbs 8oz.

I’ve had both. Elective caesarean was pain free and felt safer and was much less traumatic. Trust your instincts, OP, but you need to be prepared to explain your wishes very clearly, because they don’t like doing them.

You are not going to be the only person to have had a baby with this condition. Why you don’t you ask to speak to someone at the hospital (midwifery services are no more or less under pressure than normal) and discuss you concerns. I had a c section for numerous reasons and it really affected me and isn’t always the best option. You need to weigh up the pros and cons. There are plenty of women with no known medical problems who have had awful labours, you could read page after page of horrific experiences and potentially have everyone who’s pregnant wanting c sections. One bad experience isn’t you but you also need to talk to someone so you have a better idea of what’s what.

@angel772
I’m not putting my baby at risk because the hospital is reluctant to perform what is a very basic surgical procedure that takes them 1 hour tops.

It is major abdominal surgery. You could end up with permanent physical damage, a hysterectomy, a colostomy, a permanent catheter, with an infection or even dead. A section is not the 'easy' option that you seem to think it is.

I have also seen them take a lot longer than an hour, although tbf they had had previous surgery.

Not sure where all this hate is coming from 🤷‍♀️ @angel772 it's your body and your baby. Yes you can insist on a c section and I don't blame you one bit. My induction with DS1 was horrific. For every person throwing around horror stories of c sections, there's a woman with an induction horror story too. No one has the right to tell anyone else how to give birth and not all vaginal births are safer than c sections. What matters is mother and baby getting through it alive. Some babies are born vaginally and some come out of the sunroof. Who cares as long as they're safe? I say this as a woman who is very pro natural birth too. DS2 was a home birth and I loved it. Mental state going into labour is proven to affect the outcome - do what feels right for you.

@IHateMyPassportPhoto I don’t think the OP said it was easy - an elective caesarean is a major but a routine operation. The chances of any of that happening to OP are extremely small.

An induction is a very risky procedure and the birth injuries the OP could suffer are wide ranging and many are awful. You can end up with a hysterectomy, permanent physical damage, infection and death from any VB, but the risks are higher with an induced VB (before we even get to the issue of an emergency section)

Induction is hardly a minor procedure. I won’t elaborate because I don’t want to scare the OP who is clearly very anxious but I have no time at all for people who go on about risks of caesareans without acknowledging the horrible risks of VB.

@OhClover
👏👏👏

It’s possible that elective would have been less stressful on my baby that’s for sure. It was so bloody scary not being able to help him. Not that I could as I’m not a doctor but I was stuck on a table unable to move
My recovery has changed how I feel about having a second but I’m not sure now if I want to go through that again. Mayb once it’s little further from my memory I’ll rethink! He’s 6 months now so still fresh.

It sounds like you really want to go for a c section.. which is your choice. Push for it.. it is your right to choose how you want to deliver your baby

Op ultimately you’ve researched all the options and your gut is telling you that a c section is the right choice for you and your baby

Listen to yourself and ask to speak to the consultant (or a diff one) about c section specifically and soon. If they’re putting up resistance you need to be persistent and get seen ASAP in case they want you to see other teams first to sign if off (I’ve read about some women having to see the perinatal mental health team first, this isn’t my experience however)

Induction is hardly a minor procedure. I won’t elaborate because I don’t want to scare the OP

@OhClover please do elaborate if there is anything to add - I’d like to know the full extent of what I’m letting myself in for if I do have to be induced.

Op ultimately you’ve researched all the options and your gut is telling you that a c section is the right choice for you and your baby

@Willow4987 I will try to push for one but I fully expect to be knocked back.

It is major abdominal surgery. You could end up with permanent physical damage, a hysterectomy, a colostomy, a permanent catheter, with an infection or even dead. A section is not the 'easy' option that you seem to think it is.

@IHateMyPassportPhoto I don’t think I’ve said anywhere that it’s an easy option What I have said repeatedly is that I’m not too fussed about the damage to me - it’s my baby I’m worried about. And all of those things you’ve listed apply to an induction plus possible EMCS anyway!

Do the consultant and midwife genuinely believe an induction is the safer and better option for me and my baby?!

Do the consultant and midwife genuinely believe an induction is the safer and better option for me and my baby?!

Yes. Induction is safer for you and your baby and is safer for the majority of women. Otherwise everyone would have a section.

They do know best.

No they bloody don't. The op knows her own body and her own mind. They don't get to tell her what will be happening to her without her say so. I shouldn't have listened to the doctors, but i was terrified, and in pain. If i had listened to my own instincts, i wouldn't have gone through the traumatic experience that i did. When i recounted the way id been dismissed and treated as though my wishes didn't matter, the specialist midwife counselor and my CBT therapist were aghast. Like you i wasn't confident to speak up. At that time i believed the doctors knew best, and that they would advise me properly and take my wishes into account.

I'm not advocating for you to have an elcs. I'm advocating for you to decide what you want, and speak up for yourself. You need to be a broken record. "I do not consent to that."

Op please contact the birthrights charity. I follow them and they are giving information on giving birth during covid. I'm absolutely sure they can help you with what your rights are, pandemic or no.

It's a balancing act OP

Please PLEASE remember that the doctors and midwifes DO know best. They train for years and years and the courses and retraining and continual professional development they have to do to remain a practicing doctor/midwife is EXTENSIVE. They absolutely 10000% know better!

HOWEVER i can't stress enough how important it is to advocate for ones own medical treatment. You would be astounded the debate and difference of opinion there is in the medical community on the same point - look at the debate on here alone! Medicine is rarely clear cut!

Doctors make mistakes at work like every single person in the world, except their mistakes have graver effects. They are not infallible and they do not know EVERYTHING. If after careful careful research and a proper balanced discussion with your doctor you think a ELCS is best for you then you absolutely advocate for that and there will be a consultant who will agree to do your section as much as there is a consultant who doesn't think it's the "safest" course of treatment. COVID should not take away your right to have an ELCS, which is your right to request under the NHS!

Just don't go into this thinking you know better or that the medics have a hidden agenda etc. X

I read that you get offered counseling if you go for an ELCS. I feel totally calm and relaxed about an ELCS - it’s the early induction that I need counseling for!!

If after careful careful research and a proper balanced discussion with your doctor you think a ELCS is best for you then you absolutely advocate for that

Isn’t that a contradiction though? If the doctors know best then the doctors know best, so how can I possibly advocate against their decision?

I’d love to know what they’d advise their wives or daughters if they were in my position.

I wish to god I had the money to go private and take away all this stress and worry.