C-section for no 3 or go for another 'natural' delivery. Your advice needed please. (anyone with previous 3rd degree tears really wlecome!)

[babyno3]

Hi

I had ds 1 after awful induction. He was 11 days late, I had the pessary, the drip it was awful. I had G & A, then pethadine which made me very sick then epidural. After 27 hours ds 1 was distressed and he was delivered by ventouse. I had an episiotomy but tore anyway. I am 5" 2, size 8 and ds 1 was 9lb 1oz. I was traumatised and in shock after the birth.

I then had terrible pnd where I saw a psychologist for a year.

Ds 2 was spontaneous labour and I knew he was a big baby as I'd had growth scans as he was always at least 3-4 weeks ahead of dates. I was terrified of giving birth but went into labour keen to not be induced. I had another epidural which wore off down 1 side so I had G & A also. They knew he was stuck at 10pm yet I was asked to push. I had the most amazing pressure in my bottom which was unrelenting. A couple of hours later I asked for help as I was in agony and he wasn't coming down the birth canal. ( He wasn?t delivered till 2.24am) They said they could use forceps, I was worried about tissue damage but the obs said it would be okay. I had a spinal in theatre (as emer c-section would take place if forceps didn't work) Dh was ashen as I disappeared behind the theatre doors (he was able to join later) Our son was born after 3 tugs where I sustained a 3rd degree tear with no episiotomy. He was 9lb 15 1/2 oz. His shoulder were enormous hence he was stuck! I have had complications from the tear and still have severe pain when I need to empty my bowels.

I am prgt with dc 3 and are considering a c-section as I am worried about re-opening the tear (it will be 21 months between births) I am worried about having another birth that 'goes wrong'. I have lost all confidence in my body to deliver babies and just want a more calmer, plannable birth. I have been told by my Dr that 3rd baby's are bigger which worries me. I do understand the risks involved from a c-section and have had 2 births so def not too posh to push. A section would place difficulties for my 2 boys I already have.

I am so confused as to what to do. I can't guarantee am instrumental free 3rd birth and are wanting a major operation instead which seems crazy. I feel my body grows baby's that are too big for me to deliver -opposite to what the consultant told me with ds 2 'You can deliver a 12lb baby Mrs babyno3!!'
I feel I've lost trust in the professionals as I expressed concern about ds 2 being a big baby, I didn?t like forceps and expressed this but was told it would be fine yet it turned out exactly how I though it would be.

Any thought/opinions gratefully received?

[Gillyan]

Hi

Sorry to hear about your horrible experience.

I had a 3rd degree tear with DD and I'm 8 weeks PG now and I'm terrified of giving birth again.

I was told at my 6 week post natal check that I would be allowed an elective section next time but when I mentioned this to MW a couple of weeks ago she said not necessarily

I just don;t know what to suggest for you or to do myself, there are so many arguments for and against. Having a CS is major abdominal surgery and I know how painful the tears are and recovery and I too have problems when going to the loo but I don't know if it would be worse with a CS????

For me I'm scared about tearing but not nearly as much as I'm scared about the care I would recieve, I kind of think that if I had a planned CS then I would get better care and the whole thing would be less traumatic??

I read an article recently about getting your own way and if you decide that you really want a section then you have to go and see the doctor and have a practical argument prepared and if he refuses then ask for a second opinion and seek out the doc at the hospital with the highest rate for CS.

I haven't been muchhelp sorry but I so know how you feel xx

[JacksFirstChristmasMama]

Hi Munteria,
regarding your question about the forceps (if you need an assisted delivery and they say forceps do you have the right to say no and insist on a section) - yes you do.
Your consent is needed for any intervention, you or your medical proxy (your DH I assume) have to sign a consent form before they could do an instrumental delivery of any kind, and you can refuse forceps. You may piss the Dr off but it is your right. Here's the thing, and this may sound scary, but if an instrumental delivery is needed, it will be because they baby needs to come out. So they won't be able to take the time to faff about and argue with you about forceps vs section, especially if you stick to your guns and repeat "no forceps, no forceps". Good luck!!!!

[JacksFirstChristmasMama]

Oh and babyno3 - since you're my identical-horrible-birth twin halfway around the world - I had the same phobia about the hospital where I had DS (or, in fact, any hospital or medical facility other than my lovely GP's because her practice is in a lovingly restored Victorian-looking house). Every time I had to go to that hospital, or even drive past it, I felt sick and got the shakes. That's post-traumatic stress for you...
(((((hug)))))

[bessmum]

I had a third degree tear after Forceps delivery of DD (failed ventouse and episiotomy) and had some symptoms needing physiotherapy afterwards, though perhaps not as bad as yours babyno3. I had an ultrasound of the scar at after about three months and they found a lot of damage to the anal sphincter and advised an elective CS if I got pregnant again. (They said 30% risk of permanent incontinence with vaginal delivery even if I didn't tear again). I went on to have the elective CS for the birth of DS and the experience was so so much better than the birth of DD I don't regret it at all. I was up and about the next day, had very very little pain and felt pretty much back to normal within a couple of weeks. I did force myself to get up and about, did all the exercises they recommended and had an excellent consultant doing the op but couldn't believe how great I felt. I know that others have had different experiences of CS but the pain, distress and length of recovery were so much worse following my third degree tear - just my personal experience.

[munteria]

Hi JacksFirstChristmasMama

thanks so much - very reassuring. this maybe a silly question but would there ever be at time when it would be 'too late' for a emergency section, so would have to do a forceps delivery (e.g. if the baby has already started moving down the birth canal)?

sorry, if stupid question!

[JacksFirstChristmasMama]

That's not a stupid question at all.

I don't think it could be too late at any point for EMCS. Because I was told that I'd have to be moved to theatre and if they couldn't get DS out with forceps they would have to do EMCS. From what I know from my training, if forceps don't work even if baby's head is in the birth canal, they pull on his/her feet/legs/hips through the abdo incision and someone else pushes the head back up through the pelvic outlet. (Ugh, creeps me out to think about.)
Do you have a midwife app't coming up that you could talk to her about this? You sound really worried and I can't blame you. I think forceps are barbaric (well, I would, wouldn't I, after what they did to me so maybe I'm not the best person to ask.)

[munteria]

thanks. you are exactly the best person to ask! poor you, your experience sounded dreadful.

will def ask my midwide (have my 32 week check in a few weeks). will also put on my birthplan (if i can be bothered to do one this time round!) that want c-section over forceps

[JacksFirstChristmasMama]

Oh, good idea about putting NO& FORCEPS* on your birthplan. A girlfriend had her baby three days before I had DS, and her midwife discussed options with her and they decided together that if babe got stuck, and couldn't be got out with the ventouse, that she'd have a section. Oddly, she did actually have a section but not because her enormous 9 lb 3 oz babe got stuck but because she stalled at 6 cm dilated... she was up and walking the next day, and discharged herself the day after. I, on the other hand, was in for 5 days after, couldn't walk until the third day post-partum until they finally clued in that my hemoglobin was continuing to drop and gave me a transfusion, and it was - no joke- 6 weeks before I could walk completely upright without hunching over a bit... okay... done moaning now... (ferocious grin but not really amused emoticon)

[JacksFirstChristmasMama]

Hey munteria - it just occurred to me, about your question - there is a circumstance when there might not be time for an emergency section - when you don't have an epidural in place. If babe gets stuck in the last minute and there is no epidural or IV access, then they obviously couldn't proceed with EMCS. Then you'd have to have forceps or have the fastest IV of your life put in so they could do a crash section under general anaesthetic. And honestly, the trauma of that, to me, sounds worse than a forceps delivery. That happened to MamaG, she wrote about it in this thread.

[munteria]

Hi JacksFirstChristmasMama

god, just read the thread - sounded awful!

To be honest i am thinking even more about going for an elective section as not ocnvinced I can do the whole natural thing.

I definitely would have an epidural then worried it will slow the labour down and end up with a c-section anyway.

having some serious self-doubts about my ability to stand the pain of a natural course - maybe I need to go on a crash hypno-birthing course!

[JacksFirstChristmasMama]

Hi M, was just thinking about you and hoping you'd see my last post. About the epidural and being able to stand the pain - I don't know what got me thinking about this today, (DS was sleeping and I think my mind was wandering) but I started to wonder, if I'd been able to handle the pain during labour (DS was asynclitic - stuck fast with his head crooked so I had horrible back labour) and hadn't had to "give in" (this is me beating myself up) and have an epidural, knowing that it could slow my labour down, if I'd been able to tough out the pain and keep moving around, would I have dilated faster, would DS have come unstuck, would anything have been different enough that I wouldn't eventually have needed forceps? I have no idea. I remember how horrible I thought the pain was and how I came I finally came unglued and begged for pain relief. I guess at the time I couldn't handle it. Or was I simply wimpy, and did I in some corner of my mind think that once I had an epidural I'd be able to rest a bit and my body would take over and dilate and pop the baby out (as happened to a friend). I sat there thinking "I wish I could just be back in labour for a moment so I could find out, from this perspective, ten months later, if the pain was in fact as bad as I thought it was, or if I simply wimped out."
And I started blaming myself for everything that went wrong with DS's delivery. Which is really rather stupid. And proves nothing except that second-guessing yourself is the fast track to misery.
So... a hypno-birthing course sounds good. And you either will be able to handle the pain, or you'll ask for appropriate pain relief. Whichever you choose, whichever you end up needing, please just remember that you make the best choice you can given the circumstances, and don't second-guess yourself after.
(But I'd still put "no forceps" on the birth plan...)
(((HUGS)))

[JacksFirstChristmasMama]

Well, actually, if I were you, I would have that elective section.
When are you due?

[munteria]

Hi

Due in February

you shouldnt give yourself a hard time - as you say, you do what ever is best under the circumstances. saying that us women are very good at berating ourselves! And the most important thing is that your bab came out safe and sound - which we all need to remember!

I can see where you are coming from though as I cant help thinking what a wimp i was...which is making me think now i wont be able to handle a natural birth. hearing about other mums who didnt even have gas and air doesnt help, but blimey those contractions were awful. I think I will go for natural simply because i have a toddler i have to look pick up etc...and just see what happens. will def look into hypnobirthing though!

[JacksFirstChristmasMama]

Ohh, DS was born Feb 13... maybe yours will be too! {fsmile]