C section at 37+6

[Ellielou22]

Hello, so I’ve been advised by a specialist consultant that due to an anomaly with baby, called an Umbilical Vein Varix, that I should deliver at 37 weeks. I was then referred back to my local hospital and original consultant.

Yesterday I had an awful meeting with the local consultant. She knew nothing of the issue, I told her of my anxiety (UVV is linked to a number of issues and blood flow/clots) so I’m very worried even though baby is doing well and it hasn’t been or expected to be an issue.

I’ve researched into induction that early and have seen that if your body isn’t ready, nothing is going to make that baby come and a sizeable percentage are failed and you end up with a c section. The thought of being pumped full of synthetic drugs and then going through the exhaustion of hours of contractions and then having an emergency c section is just awful…

Due to my anxiety and with the issue, I think an elective C section is the best option for me. The local consultant reluctantly agreed, but we pushed the date to just before 38 weeks to give baby some more time to develop. Her whole attitude was completely non caring, I found her rude.

She mentioned steroids, but failed to give me the leaflet mentioned in my notes… and told me it was my choice but then there’s no information about that choice.

There was no advice, no mention of the steroids and impact on my diabetes and as I don’t have the paper she mentioned if I want the steroids I’ve no idea who to call, when to have them etc.

On the c section pro-forma she incorrectly put me at risk 1, whereas I have gestational diabetes so that’s risk 2…

If I have steroids it will impact my blood sugar which I’ve read may need some time in hospital to stabilise… no mention of this…

So in general I don’t feel informed of my choices… which is the whole point of making these kind of decisions. Being told to effectively chill and stop googling out isn’t what you expect from a consultant who fails to give you the information she says she has.

Has anyone else had an elective C at 37-38 weeks, or induction? Did you have steroids?

I’m back on the phone to the hospital on monday to see if I can find out more and hopefully speak to someone who might actually give some good advice… I’ve had to do so much of the organisation of these appointments throughout, the coordination and management at the hospital is crap to say it lightly which has proved stressful.

Thanks for any advice 🙂🙂

It sounds very likely that you don't need steroids, baby shouldn't need them for a section st 37+6.
Best of luck for your section

I was induced at 34 weeks and 2 and had an emergency c section at 34 and 5. I wish I had known more about the different hormones they were pumping in my body. We decided not to go for steroids and my baby is 13 months and doing perfectly well. The information we received from different teams regarding the pros and cons of steroids was contradictory and it was difficult to know what to do for the best.

I had steroids, my hospital advises them for c sections before 39 weeks.

I didn't have diabetes though so can't advise on that. I'd ring the maternity assessment unit today and ask to speak to a Dr about everything. In my opinion they haven't done a good job if you've left feeling confused.

My births have to be timed due to antiphospholipid syndrome. Usually induction but like you I don’t fancy going through up to 5 days of induction to end up with an emcs. I opted for an elective section.

Ask your hospital for their stats. For my demographic - first time mum, BMI over 35, and age over 35) I had a 25% chance of it all going smoothly, 35% chance of forceps etc, and a 40% chance of it ending in an EMCS anyway. No thanks.

So I had a 37 week elective section and steroids 2 days before. I had gestational diabetes but that hospital policy wasn’t automatically to do the sliding scale (the monitoring you mention). My blood sugars were already uncontrolled and I really think they should have done, I ended up back in hospital the day after with reduced movements, had reduced movements again the morning of my section, and when baby was tested after birth his sugars were so low they couldn’t get a reading. This was covid time though so I think it might have been different otherwise. My recovery was excellent, didn’t need painkillers past day 5, and driving and back to normal by day 14.

Same will happen again in July. I’ve had GD since I was 12 weeks. Having a section at 37 weeks, but I’ve changed hospital due to moving house and this time I’ll be admitted for 24 hours at 36 weeks for steroids and put on a sliding scale.

Best wishes x

I’ve just remembered - All of the diabetes information I’ve had from my hospital recommends delivery between 37 and 38 weeks so I would ask again about timing.

Hi type 1 diabetic here. My first I was induced at 37 weeks, which didn’t work so had a c section. It was an emergency c section but remember there are different levels of emergency. Mine was emergency simply because it wasn’t advanced planned. It was very calm and the recovery was very easy. I didn’t need steroids, as far as my consultant said you only need steroids if it’s before 35 weeks.

That being said, I have had steroids in the past and didn’t find they had any meaningful impact on blood sugar.

This time I have opted for an induction at 38 weeks. All diabetics are advised to deliver between 37 and 38 weeks. So I am going for the full 38 weeks! I choose an induction purely as 38 weeks falls on a bank holiday and they won’t book in an elective c section on it and I’m not willing to go three days earlier. However, I am comfortable that if the induction doesn’t work, I’ll just tap out and ask for an emergency on the day.

Sounds like your consultant isn’t very helpful. I felt the same last time but luckily this pregnancy has been much better!

Sorry to jump on a thread, but @Littlegoth thank you for your post! I too have APS and have trouble finding info about it, like real life experiences, so your post was super informative!

This sounds really stressful. This is the info on Royal College of Obstetrics and Gynae regarding steroids and there is also information regarding gestational diabetes and steroids.
What is your midwife like? I would also be in contact with her on Monday to try and see a different consultant that can advise more clearly and come up with a plan as to whether steroids would benefit your baby, given the risks of baby being born with a low blood sugar.
In my trust, they are not given unless you are likely to deliver before 37 weeks or there are separate concerns regarding baby's lung development.
Really hope you can get some better advice, another route if you are struggling is to contact the PALS department of your hospital and explain your situation and your poor experience of seeing that particular consultant. They should not be writing in your notes that you have received info that you haven't.

Best wishes with your pregnancy and birth x

I went into labour at 37 weeks, baby was born at home, good apgars and no need for any treatment.

@wanttoplayboardgames message me anytime x

Thanks so much for the helpful advice, I shall be following up with the hospital on Monday, just another added stress, it’s certainly been a rollercoaster! X

https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/corticosteroids-in-pregnancy-to-reduce-complications-from-being-born-prematurely-patient-information-leaflet/#:~:text=If%20you%20are%20given%20steroids,admitted%20to%20the%20neonatal%20unit

Sorry realised I never posted the link earlier!

Thank you for the advice, I have my community midwife but she seems to defer to the consultant when I ask any in-depth advice, it’s just incredibly frustrating to not have a direct contact that I can ask for further information. A consultant who tells me to ‘chill out’ when I speak of my anxiety over this all is way out of line. I’m sure it will work out but they keep banging on about ‘informed choices’ and I feel like have to do the legwork myself which isn’t how it should be!

I have type 1 diabetes. I had a planned C-section at 37+3, a week earlier than expected due to a diabetic complication. I was not given steroids then, but I have had them previously for Crohn's Disease. I had to increase my insulin by approximately a multiple of 4, so they do have a profound effect on blood glucose. Good luck with everything, I hope you can discuss it soon with your care team.

3 ELCSs here & no steroids (35, 36 & 37 weeks). My consultant gave us the pros and cons re steroids but her view was that due to the gestation of my babies the negatives outweighed the positives. She put quite a lot of emphasis on the fact prenatal steroids have been found in studies to heightening the risk of your child developing autism. Do your reading, go back armed with questions if you need & make an informed decision. I hope your next meeting goes better than your last. Good luck!

How sure are you of the hospital's dating? Both of my pregnancies were moved forward at the 12-week scan. One only by 4 days, but the other by 9 days. I knew dating exactly, because in both cases we'd only had sex once, about 12/13 days into my cycle. So I would have regarded 37 weeks as more like 35 1/2 with #2.

If you think the dating is correct then I don't think steroids would be a good choice (balancing benefit and risk) at that gestation, which is not premature.

I hear you on the rude consultant. Nothing in my life has been as humiliating or as dehumanising as the NHS medical care I received in pregnancy.

You will get through this. The situation itself doesn't seem worrying to me. (Though pregnancy is obviously worrying when you're experiencing it.)