C-section second time around Post Reply

[hol78]

I had an elective c- section the first time around and want to have one with my second baby. I was told by my GP that a hospital cannot force someone that has had a c section the first time to have a VB the second time around because the womb wall has been weakened and should anything go wrong the hospital could be in serious trouble. does anyone know anything about this?

Also reading C&W website they strongly influence women who have had a good C section experience and good pregnancy to go down the VB route but I will not do this and therefore wondered what peoples experiences had been between St Georges and C & W - ie is St Georges slightly more understanding ?

Obviously I understand there is a higher cost etc so they dont just dish them out but does anyone know this for fact that the hospital cant make you have a VB after a csection ??

[rebeccablinstonj]

Hi there

I had both my daughters at George's. My first was elective c-section because she was breach the 2nd i went for VB. I was advised by the consultant that if i really wanted to go for an elective c section i would have to prepare a very strong case to the senior consultants because having a c section is very major surgery (and of course much more expensive). I went down the VB route and a few weeks after the birth i was glad that i had when i saw how long my close friend took to recover after her 2nd c section. However, if you do go down the VB route then you can't use the carmen suite (ie use birthing pools etc) because you have to be monitored. Happy to discuss further if you want to PM me.

[Googiesmum]

I had an emergency c-section st St George's first time round and managed to have an elective c-section with my second pregnancy.

Despite the midwive insisting at my booking in appointment that the hospital would be unlikely to support my request the consultant was really understanding and didn't put up any resistence to it. The circumstances were slightly different in that I had a terrible first experience of labour with subsequent PTS as a result but they said VB was still an option if I had chosed to go that route.

My advice would be to prepare a strong case before meeting with the consultant and be persistent.

Notwithstanding this the recovery from my 2nd c-section was long and not at all easy - think infected scar, pulled stiches etc. It was about 8 weeks before I could sit up fully unassisted so it is worth considering your childcare options for number 1 if this is the route you manage to take.

I hope all goes well.

[Fuzzy]

I had an emergency c-section for pre-eclampsia nearly two years ago, and I'm also interested in this topic. The latest NICE guidance (2011) says you can request a c-section and have one, but if there's no medical reason for needing one you'd be referred for mental health support first. Hope that helps.

1.2.9 Maternal request for CS
1.2.9.1 When a woman requests a CS explore, discuss and record the specific reasons for the request. [new 2011]
1.2.9.2 If a woman requests a CS when there is no other indication, discuss the overall risks and benefits of CS compared with vaginal birth and record that this discussion has taken place (see box A). Include a discussion with other members of the obstetric team (including the obstetrician, midwife and anaesthetist) if necessary to explore the reasons for the request, and ensure the woman has accurate information. [new 2011]
1.2.9.3 When a woman requests a CS because she has anxiety about childbirth, offer referral to a healthcare professional with expertise in providing perinatal mental health support to help her address her anxiety in a supportive manner. [new 2011]
1.2.9.4 Ensure the healthcare professional providing perinatal mental health support has access to the planned place of birth during the antenatal period in order to provide care. [new 2011]
1.2.9.5 For women requesting a CS, if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS. [new 2011]
1.2.9.6 An obstetrician unwilling to perform a CS should refer the woman to an obstetrician who will carry out the CS. [new 2011]

[Midwifejulie]

Hi
I agree with what's been said above.
I think it's good to understand where the policy about encouraging women to have a second vaginal birth comes from - the facts that are known about CS in terms of increased complications for mum and baby.
However, my experience has been that women for whom it is a truly important choice - like it sounds for you - are not forced into vaginal births.
If you feel you are having trouble being heard, you may want to contact a Supervisor of Midwives at your local hospital (should be available through calling switchboard or labour ward, 24/7, though sometimes it can be hard to track the right person down so do persist if necessary) and request a meeting with her and your consultant. They should get hold of your previous notes and talk through your past experience and your current concerns.
If you feel like you would benefit from a more informal and heart-felt chat about your feelings around this, I'd be really happy to do this with you as a birth debrief through my organisation. Sometimes women who choose to do are suprised by what comes out and how very useful it can be, so i do think it's worth considering. Body-based complementary therapies can also be really useful when addressing these things, as our bodies hold our memories and fears as well as our brains
PM me if you'd like to discuss it
all the best
Julie