Bit confused about consultant appointment re VBAC or consultant - any clarification v welcome

[itsalwaysthequietones]

Had MW appt this morning. 16 weeks preg with DC 2. DD was EMCS. she was really uncommunicative and basically just jotted notes throughout and only spoke to me when I asked questions. Complete contrast to MW I had at last appt who was brill.

Anyway, I asked at what point I see a consultant. She said I wouldn't see a consultant unless I wanted a CS - did I want a c-section? I said I didn't know and had been led to believe I'd have a chance to talk through the pros and cons with a consultant at some point. She said fine, I'll book you in with one instead of coming to us next time. I said, oh right, I thought it came later, like at 32 weeks or something. She said "no, we don't see you then but you can have a CS confirmed at 36 weeks".

So what I'm not clear about is: who do I confirm with about the CS bearing in mind that I wouldn't in normal circs be seeing a consultant? Would I just say to the MW 'right I want a CS' and she'd say fine I'll add it to your notes? And also, will the consultant want to see me at 22 weeks or will it just be a waste of her/his time? Does it need to be later in the pregnancy so they've got a better idea whether there are any unusual risks?

I just assumed there would be rather more discussion about the whole thing. Anyone know any more about this?

I had a consultant appointment scheduled in as standard immediately following my 20 week scan, as my last delivery was a CS. I see him again at 34 weeks.

That sounds a bit crazy to me,

I also had EMCS first time round and am PG again - saw the consultant a couple of weeks before 20, (I forget exactly what time) to go over last birth and discuss VBAC/ElCS.

Have another appointment with the same consultant at 36 weeks to confirm plans/talk through any other concerns.

If I were you, I'd try calling the midwife you had last time(!) or perhaps even the hospital you are under, where your consultant would be based.

Hope that helps!

PS - your midwife sounds rubbish! Perhaps she was having a bad day

I saw a consultant twice during my last pregnancy which was for VBAC. Sorry can't remember when exactly but it was definitely standard procedure. Have you got a phone number for a different midwife who you could talk with about this? Or ask at your next appointment, hoping it will be the nice midwife again?

My first baby was born by EMCS and I was automatically given a consultant and several appointments with him.

I was also booked in for a section at 40+5 by a different consultant who had never seen me before.

I saw my usual consultant and told him I didn't want a section so he said to not have it then.

I had my baby naturally at 6 days late and my next baby naturally too though I am not saying either birth was without problems.

Usually it depends on whether the section was due to something with you or something with baby though my neighbour had a VBAC after having a section due to a too small pelvis. Was fine with baby two.

Thanks, that's really helpful. Think I'll just see what happens and whether an appointment with the consultant materialises and take it from there.

BTW - what did you both decide re VBAC ELCS?

hi,

I assumed that if you had a previous CS you were automatically put under consultant care for a next pregnancy, at which point you would discuss the options for the birth. Maybe it depends where you live though?

If you are being offered a 22 week consultant appt I would take it up. It will give you time to make a decision about what to do based on the information given. They will know from your previous notes what the risks are for you.

Sorry to hear you had such an uncommunicative mw - it's a real shame when they are like this isn't it?

I'm going to give VBAC a go, but on the condition that I will not be induced.

So I think the consultant will book CS for 41weeks, and if I go into labour prior to that, then will go for it!

It depends on so many things, though. Everyone has to make their own choice, I guess.

Wellies and Fab - thanks.

Fab CS last time was after 48 hrs of them trying everything to induce me (3 prostawotsit gels, breaking waters, synto drip) and me not dilating. Eventually got to 3cm but by that time DD was showing signs of distress so they did a section within 20mins. Basically the whole thing was a nightmare and left me knackered, struggling to heal and DD with a low-blood sugar, which screwed up BF cos she had to be given formula top-ups. So want to think v carefully before making a decision this time.

Meemar - thanks, yes, will prob go with that. Yup, was a bit disappointed re MW because I'd been really looking forward to the appt. Had lots of questions etc only half of which I asked because she just didn't seem interested. But anyway, perhaps it was just a bad day.

Buttercup - v good luck with your VBAC, FWIW a friend had a v successful one the other day and has a healthy 9lb baby boy to show for it. She said it couldn't have been more different to her experience with DS1

Thanks, love hearing positive stories!

Had EMCS with first. When I booked my 20 week scan an appointment was made for me to see the consultant.

Had the appointment this week and the consultant went over the pro's and con's of VBAC versus elective section. For me a decision doesn't have to be made until 34 to 36 weeks.

In our area a consultant appointment is always booked if your previous birth was csection however you plan to have the next birth.

I think my MW wants me to go for a VBAC. The consultant I spoke to was totally open minded. Thank goodness I have time to try and work out what I want to do.

sorry, just reread the title of this thread. Clearly didnt engage brain before typing. Was obviously meant to read VBAC vs ELCS... but I guess everyone worked that out

MW sounds odd! I saw a consultant three times (after EMCS with dd) was offered the choice of VBAC or ELCS. Went for VBAC, but ended up with another EMCS

I think it depends how long it's been between pregnancies. Just listen to the consultant, and make your choice from there. They will monitor you more closely in labour due to scar rupture risks, and may want you to go in earlier when in labour, rather than waiting at home. Good Luck!

twirly thanks for your response. See I know quite a lot of people who, like you, tried for VBAC and ended up with another EMCS - absolutely my worst-case scenario. If I'm going to have major surgery again I want to give myself the best possible chance of quick recovery by making sure I'm properly rested etc.

If you don't mind me asking, what were the reasons for both your EMCS?

It'll be just over 2 years between the two births for me so not that close together.

There was 6yrs between my two pregnancies. I laboured very well with both, getting to fully dilated both times. dd was apparently facing the wrong way, and didn't move down the birth canal, so after 2hrs of pushing, I had the EMCS. When I was expecting ds, the consultant said there was no reason for me not to have a VBAC, and I really wanted it, just because of recovery, not being able to drive etc.
Got to fully dilated with ds in four hours, but same problem again, he just wouldn't move down. Then they lost his heartbeat for a while (nightmare, but another story!). Buzzers going, room full of people etc. Whisked into theatre, by which time things had calmed down as the heartbeat had been found.
Very calm, lovely consultant, radio on etc. During the op, the consultant said 'Mrs x, you have a mans pelvis! You'd never get a baby through there. Fifty years ago, you and the baby would have died!'
So, not usual circumstances, I am a freak of nature!
Very cross that it was not picked up at first EMCS, would have saved all the stress.

Goodness, what a nightmare - must have been terrifying for you. So glad it all turned out ok in the end anyway - many thanks for sharing your story.

Thanks. Just remember, it doesn't matter how they come out in the end, as long as everything's ok. I was a bit gutted not to have a natural birth, and felt as if I'd been cheated, but a very nice mw said 'you can grow babies and look after them very well, you just need help getting them out'.

yes, quite agree. what a nice MW - hope I get one like that!

rubberplant good luck with your decision, hope you get the support you are looking for, whichever way you decide to go

Hi, ds1 1988 was EMCS after 26 hrs in labour, I was asleep for that birth. After xrays they said it was due to my small pelvis.

ds2 1991 was ELCS, awake with an epidural.

ds3 2006 was ELCS, awake with a spinal block

dc4 booked in for ELCS on 7th December 2009.

With ds 2/3 I got 1st cons appoint at 20 weeks, then at 36 weeks I got date of ELCS.

This time I got date of ELCS at 20 week appoint, this is due to it being my 4th CS and a snr cons will do the op.

ELCS with ds3 was great how things change in 15 years, only downside was the sickness during the op, it was the same as 15yrs ago.
I asked for the screen to be lowered and I wanted to see the placenta (i'v never seen1) but I got neither, durin the op I didn't care I felt so sick. I do feel a bit let down about it, but I will ask again during ELCS no4.

I am gonna ask can this cs be video'd or take a mirror in so I can see the delivery.

I look at it this way, I have a baggy belly but at least I don't have a baggy f...y.

I did ask for a tummy tuck at the last 2 ELCS, maybe they will pity me and take a bit of extra flesh off this time.

lisa - thanks v much. Really useful to hear of other people's experiences particularly in your case because I wasn't sure how many CSs you could have. What made you decide to go for the first ELCS in 91?