Elective C-Section Question...

Kiera, I really hope this thread has not totally confused you, and you are able to arm yourself with enough facts to come to a decision as to what you want.

Monnie, good luck in making your choice, I hope you are able to get all the info and opinions that you want.

Lisa, I think the term "nasty" was in reference to the comment that the surgeon is just looking after his own, not that private hospitals have high c/s rates. I don't disagree with any of the statistics you have quoted. I have read the French study that showed the 3.5 times highly maternal mortality rates.

It seems to me a lot of angst is coming from the implied sentiment that no one who had read all the facts and educated themselves would choose an elective c/s, or that someone who does hasn't got all the facts or has not educated themselves enough, when neither of those are actually true.

I know there are a lot of women out there who may be steered towards an unecessary op without haveing all the facts, and that many of them, when presented with all the facts, would possibly not choose surgery.

I do see the necessity for accurate information to be available, and understand the scare tactics that are out there. I've had the crap fill in OB who refused to attend active birth becuase he's 'not a vet' and that, and get this, its too risky, its much safer to have surgery or be flat on your back.

But it comes down to choice. If someone has none of the facts, is misinformed because someone wants to influence their choice, or only some of them becuase they don't know that they're available thats one thing. I'd get worked up about that becuase their entitled to all the factual information they want.

But if someone has done all their research, and chooses to have a c/s, well it's their choice whether we agree or not.

Hi guys

Many thanks for your words of support...much appreciated!

My Ob. did suggest to me that he would more than encourage me to get a second opinion...which I guess is good!

Shannon...he wasn't sure about the % risk of uterine rupture. I asked him whether they could do a scan to see how much scarring is on my uterine wall...but he said that generally the scans aren't accurate enough.

Although embolisation was a great procedure for me back in 2002 (I had severe heavy bleeding and was very anaemic due to my troublesome fibroids), it's a relatively new technique (ie. 10 years old) and therefore there really isn't much known about the impact on pregnancy and birth. In fact in many of the scientific papers I read, it suggested that the pregnancy rate is much lower for those who had embolisation, with a m/c rate of 30%...it took us 3 years to get pregnant! This baby really is a miracle for us!

In the biggest lit. review on embolisation (and it's not that big), 70% women who had embolisation had a c-section. The article certainly acknowledges that Obs. are very conservative when it comes to women with embolisation as they just don't have enough information on how well their uteruses deal with the surgical technique...especially when the uterus has to work hard in contractions! Most of the women in the article were in their mid-30's too (just like me!)...

So...although it is ultimately my choice (that's what the Ob. said)...I guess it's about weighing up the risks of rupture and the risks of c-section. The risks of rupture include emergency c-section, and surgery on the uterus (if it ruptures) which could ultimately (worst case scenario) lead to hysterectomy to stop the bleeding...

I also wonder how "natural" they would let me vaginally labour, given they would need to be monitoring the possibility of rupture fairly closely...

I have so longed for the experience of child birth...but more than anything, we've longed for a baby...

I've been thinking that the birth-baby concept is similar to the wedding-marriage concept...if I had to have a choice, I'd have a great marriage any day over a fantastic wedding...(thankfully I do have a great marriage!!!)...ultimately I'd love to have a great birth and baby...but if I had to choose...the baby is what I really really want!

Wishing you all the best with your decision. Take care :hug:

Thankyou Lynn...and Lynn, I'm so sorry about Cooper...wishing you all the very very best.

Monnie - it must be hard that it is such a new thing & there isn't much to go by. I really don't know what I'd do. I think you're analogy of the wedding/marriage is perfect, it really does make a great comparison. I think you are being very sensible about this. I look forward to hearing more about this if/when you get a second opinion. :)

Thank you Monnie. That means so much to me :hug:

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Once you become a parent, how you birthed that child doesn't seem so important

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I disagree. My labour and subsequent c/s had massive implications for me, physically and emotionally. I now have my hospital notes too and what the ob said was happening to my ds during labour was not true! It is like saying, 'as long as the baby is healthy that is all that matters', well of course it is but it is not the only thing that matters. My ob took away my right to a healthy natural birth, and i more than likely have some form of post traumatic stress from it. So women being informed about the risks as well as the pro's means they won't be pushed into decisions that can affect them for the rest of their life, including following pregnancies and labours.
Of course sometimes decisions are taken out of our hands if things take a turn for the worse, but to have another human being talk someone into having surgery is just wrong, especially when they are not being totally upfront about the repercussions(and I am only referring to my own situation, and that I do think what happens during birth matters later).

Bec, I know what you mean. I think what is being said though isn't that the birth isn't important - it SO is important. But just that (& I'm sure we all agree) that the baby is the most important thing. But yes, I do agree, the birth is a very important part, particularly to the woman. I know that this next birth for me is going to be a huge hurdle, both physically & mentally and it is very important to me that the experience is a more positive one.

Hi Monnie,
I had to reply to your post. I've had a c/sec, 2 VBACs, and another c/sec. I have a long and very complicated history which includes infections and uterine surgery.

Have you ever had a hysteroscopy, just to check the uterine cavity? As your doctor said, a scan can't tell you much about scarring but a hyst should disclose it (nothing is 100% accurate). Obviously it's not possible now, while you're pg, but I thought you might have had one in the past. It depends where the scarring is. If it's low down in your uterus, then the risk of rupture is very low (similar to a VBAC). If it's up in the fundus, which gets a big workout during labour, then the risk is higher.

Having done both, I encourage you to keep open the idea of vaginal delivery. I would view the monitoring as nothing. Both my VBACs were totally natural births, carefully monitored for my and the baby's safety. However, a vaginal delivery is definitely not something to do "at all costs". The marriage/wedding analogy was so good! I am very grateful for BOTH of my caesareans.

In my opinion, if your doctor is saying that ultimately it's your decision, then he probably thinks a vaginal delivery is fundamentally OK. If he didn't, he would be laying it on the line for you & would probably say that he wouldn't feel comfortable handling your care unless you planned a c/sec. Also, as others have said, I think he would have made it clear from the start.

I think a second opinion is a great idea. It might help you feel more at ease EITHER way. Even doctors like mine, who is widely known for supporting VBAC & minimally assisted delivery in general, will tell you if they think you really should have a caesarean.

I will be so interested to hear what you decide. BIG HUGS either way...it's very stressful to have something like this come up during pregnancy. Happy to chat more about this if you need to!

Just want to add is anyone else offended but Private OBS apparently looking after there own pockets???

I find this pretty disturbing Myself.....

I don't agree with it, but I'm not offended.

I don't know anything about your condition Monnie, but will be having a vbac so do know about the uterine rupture(though it may be different for you), and in my situation I actually won't be having close monitoring. I don't think it is effective, the efm's have proven false positive rates, and cause women to not to be able to move freely, therefore inhibitting progress of labour. Watching a women closely and trusting she knows what is happening with her body is a much better indicator if things are going wrong. Also there are other signs apart from foetal heart rate that indicate a uterine rupture. And it isn't something that happens instantly, so if you have a midwife watching you closely then they would pick it up way before a machine.
Good Luck with your decision!

Lose a baby and it really doesn't matter how it comes out, just being able to take your child home and watch them grow is the most important thing. Sure the birth is up there but having lost babies, it is definately not on my priority list.

I think that when presenting ones view on issues we should refrain from sweeping comments like "all women who..." or "the majority of people"... because quite frankly I take offence at that and it really does detract from your position.

I think the ultimate birth is one where the mothe has the birthing experience she desires, is comfortable with and is best for her, and therefore her child. Personally I'm a pain junky... I'd do a vb again, knowing full well that my hips will dislocate over having an a/c/s... but hey I just don't like being cut. But you see that's the crux of it.. its about personal choice. I prefer the pain of dislocation to a surgeons knife but thats me.

Ultimately I think you should look at ALL your options, write yourself a pros and cons list for both then go with the option YOU are most comfortable with. Honestly, if you are happy and confident with your decision then what other people thing is really not that important, they aren't the ones who have to live with your decision.

Thanks again guys...

Castle...that was really helpful information about the position of the scarring...I'll check it out...

I haven't had a hysteroscopy...so unfortunately can't access those results...

Thanks Shannon and becmc...much appreciated!

You guys have really been incredibly helpful...and supportive!

I'm so sorry to have hijacked your thread Keira...I hope that you are still finding some good information here.

Thank you Jo....yes a woman getting the birth she desired is the correct experience for HER., but somewhere along the line this has been totally lost.

I;m totally offended by this whole thread..............

Hey we don't need to get angry at myself or the moderators for this... everyone is so quick to judge us and that we are doing this for agendas... well I will tell you why I have kept this open in the hope that one day, you'll have some respect for myself, and the moderating team.

I posted in a midwifery list a few days ago and I said, this is not how to respond to someone you are trying to get your message through to. The message was posted in this thread early in the morning so none of you were able to see if, because of course, that message was quickly removed from moderators because we felt it was too harsh. Nothing harsher than this, but on par. So you are wrong.

I got alot of support for what I said, offline - they replied to me in private. But I also got lots of negative feedback on how I shouldn't stop free speech and how it needs to be heard to get through to people. Well, I didn't reinstate that post, but more posts were placed on this thread. I wanted them to see what would happen if they all joined in posting the way that original poster did - and clearly, it's not working is it ladies? Which I have said so.

So before you are so quick to jump down my throat or that of the moderators, please give us some credit. I am a mother like you, I have had an epidural, syntocinon, used formula and tried controlled crying too.