Mental prep for unwanted repeat CS

[Kalodin]

Consultant has said she would struggle to support me having a VBA2C. She said she would strongly advice a repeat CS, hopefully a planned one this time but she said I need to be prepared that given my history it may be another EMCS.

I cannot explain how sick I feel at that thought. At 14 weeks I have begun weekly monitoring.

But I really was hoping for a VBA2C, I thought I was a good candidate. As we would have a pregnancy plan in place this time. My first birth was a spontaneous vaginal birth and my 2 CSs were not due to repetitive reasons, and I did get to 8cm with my previous one. My last CS is over 3 years ago and on the scans my scar (the 2nd CS went through 1st CS cut) has healed really well.

I'm terrified of another CS. I cannot explain how awful they have been. And how awful my experience with epidurals have been in all 3 births. I vowed after my 1st I would never have another one, but then I needed CSs.

As soon as I found out I was pregnant with this baby I was researching VBA2Cs, already started on habit building for labour and doing a course.

I know plans change but I just feel terrified of a CS, can I ask for it under GA? If not then how do I prepare for this? I am so scared.

He’s, you can ask for it under GA. And a planned section IS better than emergency.
But I say this not as a criticism, you need to relax. Googling and obsessing will not be good for your blood pressure or your stress levels, and in turn it won’t be good for baby. Step away from Google, breathe and relax, and enjoy your pregnancy safe in the knowledge that the team will look after you both.

• yes

I'm not sure where you think I've been Googling? I haven't been googling CSs, ive been through 2 i dont need to Google them. Although I'm going to have to do something to mentally prepare myself for another CS, that's what I don't know what to do.

I did read peer review articles to understand if I could be a candidate for a VBA2C with my individual history. I found it reassuring at the time that it seemed another CS wasn't my only option here. Until yesterday, I had felt relaxed and confident.

I just find it hard to trust in another CS after the trauma of them. I.E. second CS, no believed me that the anesthetic has worn off and I lay there begging for help whilst I kept being told "it's nearly done". The review post birth revealed that the Anesthetist hadn't realised how long my CS was going on for, it was 9 minutes the MW recorded from when I first said I could feel something until I finally was out under GA.

And I know people will say "it won't happen again, they won't let it" but I've had the same problem with epidurals all 3 times I've had them. And each time I'm told, "don't worry".

Hi OP, I used this hypno track with my ELCS and it helped a lot with nerves.
https://www.natalhypnotherapy.co.uk/shop/Prepare-for-a-Caesarean-MP3-9781910756645.html

Also how about some counselling? You're only 14 weeks, you've got time to work through some stuff and feel better. EMDR is great for PTSD, made all the difference to me.

Honestly I am a mum of 2, all my friends have had kids, and the ones who've experienced birth positively are needles in a haystack! Both my births were brutal in their own ways.

Also, because my CS was elective, I had a "spinal", not an epidural, so it's just an injection then needle straight comes out - I think it's much better and you might feel the same?

You definitely can ask for a GA if that's what you want though.

Hey thank you @WoolyMammoth55 , currently been waiting for 3 years for help, for a long time the MH team in this area kept saying it wasn't severe enough for me to be put forward as I was still able to maintain a job and look after my kids. I ended up having a breakdown start of the year and was finally told that yes they think I do have PTSD and so here I am still waiting for the EMDR, been having letters through saying "we are just letting you know that you are still on the waiting list and will be in touch when we have an initial appointment for you"

I'll ask about the spinal. Really hoping I get to that point where it isn't an emergency. With the needle, I am scared about that too, is it 2 sharp prices I'll feel or just one? As previous 3, it's been 2 pricks and the first isn't too bad but each time that 2nd one has been awful. They've each made my body spasm? Last time my leg shot out straight and wouldn't stay still and my MW had to hold me down whilst everyone was shouting at me.

Just previous babies been 28weekers (so why I'm thinking about it now).
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That sounds horrendous @Kalodin no wonder you're worried about another CS.

You say you got to 8cm with your last section? Were both of them energy sections? Because I believe there's quite a difference in experiences and recovery between elective and emergency. With an elective the body doesn't have to recover from going into labour and the time it takes is much more planned and controlled. I had a spinal and it was only one injection, baby out in 10 mins and immediate skin to skin for rest of operation, no pain at all.

Personally I would be inclined to think if a consultant strongly recommended something there much be a reason for that, as they don't recommend a CS except for good reason. You can also ask for a second opinion and see if that's the same?

Emergency not energy!

Both have been emergencies @TheSnailAndTheWaaaail Due to infection.

I did ask why, she explained its just her stance on all women after they've had 2 sections, not because of me as an individual.

I think there is generally a higher risk of scar rupture during labour after a couple of c sections which is something they may not be able to predict. Maybe you could look into the chances of that happening? If you already have an epidural in during birth they will top that up for an emergency section but if I was you and I knew I didn't react well to any epidural then I would ask if they would do a spinal instead of you were to opt for an elective. Epidurals can be patchy but I've never heard of a spinal not working personally.

You can certainly ask for a general anaesthetic, but they come with higher risks.

Yeah I've looked into those stats of uterine reputure when considering the VBA2C;

• all births 0.22% risk
• VBAC 0.7% risk
• VBA2C 1.4% risk
• Repeat CSection 0.7% risk

Succes rate of vaginal delivery for VBA2C is 75%

So yes I suppose there is double the risk of a uterine rupture with a VBA2C but its still reasonably small and those stats are based on all situations rather than my particular situation.

When I consider my situation and history, then it does appear I have good chance of success. I feel saddened that it's just a blanket "no" by my Consultant. Although she did wavier a bit and she said about how she does of course acknowledge that my first birth was a spontaneous vaginal delivery which does indicate positively.

But I suppose stats aside, it's the fear of it all again. The awful pain of every aspect from the epidural to the actual op to post recovery.

You can ask to see another consultant, one who would look at your individual circumstances rather than have thier own blanket policy, plenty of women do have VBA2C.

If another medical professional has a thorough look and helps you wiegh up risk vs benefit, it might make you feel more at peace if they also say that a c-section is advisable.

If you’re not happy I would try and get a second opinion.

I was told that after this c section (first emergency and this one planned) then I would have to have a c section if I had another child as their trust doesn’t do vbac’s after 2 c sections.

I had a spinal with my emergency c section as for some reason they said I couldn’t have an epidural. No idea why but the spinal was fine going in and I went numb immediately

I don't know if I can face seeing another consultant. Althoigh I know I should. Just this Consultant had been amazing with us. She was the only person (when she was a Registrar at my previous hospital) that listened to me when I said I didn't feel well (sure enough waters had gone and infection markers in blood), everyone else had kept sending me home. Then I followed her to her new hospital to help with last pregnancy and again she did really listen to me and she predicted correctly when i would go into labour, just unfortunately infection set in again.

It's just this we now seem to be not aligned on. I'll be seeing her next week, I am going to go in with what I do know and ask if we can have a conversation about my individual circumstances and make various pregnancy and birth plans with her.