changed their minds now im pregnant about being allowed an elective c section after having a previous one

[nickiwilkie]

hi,
i have a 3 yr old boy who i ended up having an emergency section with as he went into distress. After the surgery my very nice surgeon came to see me on the hospital ward and discussed with me that next time i could choose an elective c section if i wished. i knew from that second onwards that that would definitely be what i wanted.
i am now 9 weeks pregnant with my second. i saw the midwife last week and told her i am planning on having a section. she told me that things have changed since what my surgeon told me and i probably wont be allowed that option anymore.
this has really upset me, as it has been my plan since having my previous child and i feel like they've trapped me (telling me i can have 1 then once im pregnant saying 'ha ha we're not going to let you now!')
i almost didnt try for another after watching a friend going through severe post natal depression as i am terrified of getting it. i really feel like having the section last time was a big factor in me not getting it then as i was very happy with it, not in a lot of pain, not very tired even though i did go through labour first and having the 3 days in the hospital after to recover and be on my own with the baby + having my meals prepared and served to me(i must be the only person who actually enjoyed hospital food!!) really helped. anyway i came to the decision in the end that since i could have a planned section then it will probably help me again with not getting depression so we went ahead and got pregnant again. after the midwife dropping this bomb on me i am really worried and not sure what to do.
can i beg for a c section??
can i pay for one privately and if so how much??
would another hospital have a different policy??
sorry for rambling on im just very confused, it has always been the way that you could opt for a section after having a previous one, i was not expecting this to change.

How upsetting for you. Firstly, deep breath! It is the norm for women to be offered a repeat section regardless of the reason for the first one so if I were you I would wait for your appointment with the consultant and discuss it then. I am sure there will be no question of begging. The midwife may be misguidedly trying to offer you a choice when in reality you seem to know what you want already. Bear in mind that some women feel strongly they want to try for a vaginal delivery so she may be trying to do right by you. However, it is not her decision. Good luck.

Oh, forgot to add that you can book to deliver at any hospital (within reason!) so if your local one doesn't suit, have a look around at other local units and see what their policies are.

here

Nicki - I was worried about this too - see my thread above, which gives some useful tips and questions for your consultant appts, and a positive ending.

HTH

thanks for the quick replies.
glad you are able to have your section.
i was expecting them to try and talk me out of it but she was adamant that the consultant will say no unless there is a medical reason. she told me he will not make his final decision until after i am 30 something weeks(cant remember exactly) incase the baby is breach or something. but then went on to say that even if it is breach they scan you now before you go in for surgery and if it has turned you get sent home! how cruel!
i guess ill just have to wait for my appointment with him(not until november)and see what he says.
do they do any exams at this appointment or is it just a discussion and look at the scar or something? i have no clue.

I don't think the midwife should have told you that and if I were you I would discuss this with her superior.

I had an emergency cs with my first pregnancy two & a half years ago and all the way through my second pregnancy I was told it was entirely up to me how I gave birth. If you've had an emergency cs you might be likely to encounter problems again and an elective is automatically offered. Or if you are passionate about trying for a natural birth this time you can, but you are heavily monitored during labour and usually have to have a small cut to speed things along. There is a tiny chance of the previous cs scar rupturing, but this is very rare, so they like to have you in early just in case, and they also won't let you labour for too long.

I was in the same boat. I swore I would never get pregnant again unless I could have an elective cs. I made this clear when I fell pregnant, but half way through I started to change my mind, on the strict understanding that if things got tricky in labour they would perform a cs before it all got traumatic. They said fine as long as I came in nice and early when I thought labour was on its way. In the end I was in a gentle kind of labour all day cos I refused to believe it was the real thing as I was two weeks early. When it became obvious I was having real contractions not practise ones dh whisked me off to hospital and dd2 arrived an hour & a half later totally naturally with only gas and air cos I got there too late for an epidural to really be of any use. It's amazing what your body can do when it has to!

It is entirely up to you how you give birth and if you really want an elective cs then bloody well demand one from everybody! Nobody has the right to deny you one. Also a stressed and terrified mother will probably not do her baby much good during birth or bonding afterwards. That's how my first birth experience went. So well done to us for doing it again. Good luck!

if you want a c.s due to previous c.s and birth trauma you should be able to request one and if your consultant and/or MW is not supportive then ask to see someoen different

I am nearly 33 weeks pregnant with my second child, having had an emergency C section with my first. As I understand it, you should be encouraged to try for a natural delivery if you have previously had 1 C section. Hospitals are, I believe, being tasked with cutting down their C section rates and encouraging more natural deliveries where possible. However this does NOT mean you can be refused one as far as I'm aware!

My hospital run VBAC (vaginal birth after c section) clinics where you are given all the statistics etc about the chances of delivering naturally second time around, and offered the opportunity to ask questions...you then see the consultant around 30 weeks to make a final decision. As long as you have taken the time to attend the clinic, they accept any decision to opt for a second section at the consultant appointment (I too am going for a second C section).

It sounds to me like the midwife has been told to tow the party line and encourage you to think about natural delivery - which is what she should be doing but not in the manner she did it! As far as I am aware though you cannot be refused a C section if you have had one before. Don't panic.

I'm like you, I had an emergency CS last time and now I'm PG again I think I would prefer a planned one to risking all that again. I'm hoping they will agree.

However I was actually offered an elective CS last time too, although I chose to try for a normal delivery. The reason was that I really don't like internal exams and am a bit phobic about them and was freaking out about it. I was surprised to be told I could have a CS for that reason but the consultant said "If you are very anxious and distressed, that is a valid reason".

So if you are that anxious, let them know. Tell them how very scared and traumatised you are and that you are dreading going through the same thing again. Burst into tears if necessary, if they're not taking you seriously. Your feelings and fears do matter and so does your instinct - if you feel you cannot do it, you may well end up with another CS anyway, IYSWIM.

I agree with the others in that if you've had one c-section you'll be allowed to have another.

They will want to go through the risks with you though which is fair enough. However I found that i was able to discuss/argue why i wanted an elective after a pretty traumatic emergency c-section and they agreed.

The procedure around me is to see a registrar at around 20 weeks and then consultant at 34 weeks to actually book you in.

Good luck!

Oh - just had my 3rd c-section and was chucked out of hospital after 24 hours!!

I'd totally ignore the mw to be honest. At the end of the day it's nothing to do with her and it will be your consultant who would agree to it anyway. You're entitled to the birth of your choice and after having one section they are really really unlikely to decline a second one. It's often the other way round and they're not always keen on vbacs and ladies have to fight for them.

I've had 2 sections now and will be having a third with this one. Couldn't give 2 hoots what my mw will say. They just like to encourage natural births, which is fair enough, but not always right for everyone.

I had an emergency c.section for my last birth and I made it quite clear that I want an elective section this time. The consultant was happy with this once she was satisfied that I was aware of the risks and benefits. I would ignore your midwife and ask to see a consultant to discuss your birth.

Havent read the full thread just your op and am annoyed. Your midwife is filling you full of rubbish. I had emer sect 4 years ago due to pre eclampsia and fetal distress, i have a consultant for this pregnancy and he is totally supportive of what i decide, i have decided to have an elective c section as i suffer from panic attacks and also got post nantal depression so would rather know what was going to happen. I would ask if you could have a consultant or a different midwife, a lot of midwifes i have spoken to have not been supportive over my decision to have another section but in the end everyone is different and its not there bodies!! Rant over,i will now go and read thew rest of the thread

new name - sorry. thanks for all the replies it has made me feel a lot better. i will demand what i want. i have an appointment with the consultant 26th november. the midwife i saw is thankfully not the one i am going to have as she was on nights at the time so not met her yet. hopefully the consultant will be nice although im still a bit worried that maybe its just their policy in my area (blackpool)

See the NICE clinical guidelines here

A previous c/s is actually a medical reason for an elective c/s as your risk of uterine rupture is increased. Obviously if you want to choose to try a natural birth that is up to you but it is wrong for your m/w to tell you that you ccannot have one.

The NICE guideline recommends the following:

RECOMMENDATIONS
The risks and benefits of vaginal birth after CS compared with repeat CS are uncertain.
Therefore the decision about mode of birth after a previous CS should take into
consideration:
Caesarean section
94
GPP
? maternal preferences and priorities
? a general discussion of the overall risks and benefits of CS
? risk of uterine rupture
? risk of perinatal mortality and morbidity.

Personally i would complain about the m/w and at the very least take the guidelines in to show her and ask her as to why her advice is not in line wiht their recommnedations!

Forgot to say that i had a similar issue with my ds2. MW was v. pro VBAC and really pushed it. I said i wasnt sure and wanted to actaully have a DISCUSSION about it...she basically wouldnt discuss the c/s option at all even though i genuinely hadnt made up my mind what ot do. In the end i had to ring her superior to enable me to speak to the consultant after my 20 wk scan. He was happy to go with either option. In the end i decided to book planned c/s for just after 40 weeks as i couldnt bear the thiught of going overdue and to VBAC if i went into labour before then.

I did get into a right state at the time and got v. upset at m/w refusing to really acknowledge what i was asking of her...ie to talk about risks/benefits of both.

As it happens did go into labour 1 week before, got to fully dialted but then another em c/s as ds2 was in distress and lots of meconium in waters when m/w broke waters. Basically an exact reapeat of ds1!

thats great, thanks loads for that i will take a copy with me when i see the consultant

Just wanted to add that in our local hospital, you could stay in up to five days, irrelevent of how you had your baby. They were more concerned that you were happy and confidant about being settled and feeding your baby before turfing you out. I did actually have an emergency cs and know what you mean about being glad to stay in hospital for 3 days! Might be worth asking about the hospitals policy on how long you can stay.

I'm having a caesarean because of various problems with my hips, and when I went in to see the consultant for my booking in appointment one of my questions was "what do I do if the baby decides to arrive before the caesarean date?" He said that to ring and come in immediately, but he also said "Ignore any midwife who tries when you arrive to convince you to start off trying a natural birth, because they are very likely to do so. Stick to your guns and keep telling them that it has been agreed with the consultant you are having a caesarean and that is what you want".

My impression from talking to various consultants and midwives at the hospital is that it is the consultant's decision, not the midwives' and consultants can and will overrule them. The consultants that I've met are far far less bothered about what kind of birth you have, and will utterly support you once you have agreed with them you will be having a section.

Im just reading this with interest as Im in a slightly different position. I had placenta previa therefor an emergency c-section (went into labout before date of section)last time. This time, because ive been told by consultant that the fact ive had placenta previa, then a section, if I have another section then they would not advise a third PG due to various risks with placenta and blood loss.
Im terrified the next one is a section and the choice of a third is taken away from me.
Then just reading thehairybabysmum answer, im now terrified to have a natural birth - help!!
Is there quite a high chance of rupture then?

I have a three year old DS, who was delivered by Emerg CS, and am expecting again in 3 weeks. I have opted to try for a VBAC, but an elective CS has been, and continues to be an option for me. It's something you will need to discuss with your consultant rather than a midwife, as it will be up to the consultant.

bevlin, im at work so will try and hunt out figures later but if you read the NICE guidelines there is a table atthe back with the actual risk stats in. The risk of a rupture is still v. low and you will be monitored (if you want to be).

As it is a VABC they will be more cautious than if you had not had a c/s so for instance ds2's heart rate kept accelerating which they were keeping an eye on, but that plus the meconium plus my previous c/s meant another c/s for me IYSWIM. If i hadnt had a previous c/s they might have let me try and deliver him myself.

What about my post has terrified you?? I should clarify that ds2's distress was not linked to a rupture in any way...he was just not happy int here for some unknown reason. He and I were both fine.

Having looked at he stats i still couldnt decide to VBAC or not as the risks seem pretty even each way with regard to various risks to you and baby (though risks still low overall of any harm to either of you).

Thanks thehairybabysmum, I think that is enough to reassure me that it's 6 and half a dozen. It might sound a bit odd but I think I will not bother to look into it as Im a natural born worrier and the more info I get, the more I worry. I will just go with the flow!