Why do LTTTCers seem to prefer a c/s?

[Hollybolly]

I can most definately see the trend, but can only speak from my point of view as to how I feel - but I can imagine there are a few women in my position also.

I'm sure everyone knows my dramas by now - but we've been doing IVF & have been LTTTC now for over 70 months - due to secondary infertility.

After having huge issues with my reproductive system since I first got AF at 9yrs (lovely), I was told that my chances of conceiving naturally, if at all, were slim.

After numerous surgeries, I was lucky to fall pg with Luke when I was 20 - had him when I was 21yrs old.

Although I'd spent my teenage years believing I wouldn't have children without a massive struggle, when I did fall pg I don't think I considered myself to be a LTTTC (well, I wasn't really, I was 21!) and so the VB/CS thoughts were not due to this.

I have to admit I KNEW I would need the C/S (All of the women on both sides of my family have smaller than average cervixes, they all have had c/s births... Luke was a big baby, and at that point in my life, I was a tiny person) - the midwives at the hospital I gave birth told me I talked myself into it - mainly because when we did the classes, they were only showing videos/strategies to get through a vaginal birth.
I asked constantly about strategies if faced with having to have a c/s - they told me not to worry, I wouldn't need one, it was rare, etc (maybe it was then, that was 11yrs ago now?) - and were really hesitant to lend me the video of a c/s birth. I had to sign and take the video home - also had to sign that I was aware that the footage could cause me fear & distress due to its graphic nature (WTF???!!!) - and they WOULDN"T play it at the classes (despite playing numerous videos of different VB).

I took the video home, watched it and felt I was better in control if I were to be faced with a c/s delivery.
NONE of the other girls in my class would take the video home - out of 13 of us, 8 of us ended up having c/s... all emergency c/s

My birth was horrendous - I was in labour from 9am Monday morning until 2.38pm Wednesday afternoon (56 and a half hrs) - when they took me to theatre, I was still only 2.5cm dilated & Luke was stuck sideways across my body - his head had been engaged, but when he couldn't make it through, had tried to move & gotten stuck.

Once he was born, and they measured the size of his head circumference, with my small cervix, the doctor said he WOULD NEVER have fit through, and my scan 4 weeks before showing his head measurements would have shown this.

ANYWAY!

Due to an infection I contracted during the c/s, we now have to have IVF to conceive, as my tubes have been damaged and cannot be fixed to conceive naturally.
The infection went unnoticed for years, as I left Lukes dad soon after he was born, and was not sexually active for a while in between ExDH and DH now.

Although the c/s should have freaked me out, it didn't (even with the infection and the fate its caused me) - i went through 3 days of hell in really painful labour (my labour started when my water broke, so it was pain from the beginning) - and honestly, I was so delerious by the time they wheeled me up to theatre that I honestly believed I was going to die.

I have never known fear like that in my life - I can't describe how bad it was, and the c/s for me was like an angel saving my life.
Sounds extreme, but I was beyond scared. And I was 21 years old.

This time around, I will do whatever is advised by my OB - knowing that I have a small cervix and knowing that I just didn't dilate last time, I'll just trust with whatever they suggest.
I also have other issues in the fact that when I was sewn up after my c/s, it was done wrongly and poorly, so my current doctor has concerns that my body may need an elective c/s next time round at about 36 weeks so he has the opportunity to fix the current scar for if /when there is a third pregnancy.

I'm not sure that my choices to leave it in their hands have much to do with the LTTTC part, but rather the fear from last time.

My c/s most definately saved Lukes life (and the doctor said mine as well) - thats a scary thing, and I'm scared as hell to be anywhere near that position again.
Add the fact that currently this next baby is still trying to be conceived after 6 and a half years... if the miracle of it DOES come, there is no way in hell I will do anything to risk it not becoming a live baby for me to hold in my arms.

Reading back that last statement, maybe the LTTTC does have a little to do with how I feel - but its only because it follows my experience of last time, if that makes sense?

If I got to the time, and my OB said it was safe, everything looked positive for a VBAC, I would choose that hands down - but if he said no way, then I wouldn't even second guess him.

I HAVE to put my safety (and my babys safety) in his hands.. and I have no issues doing that - I think that somes from the IVF and having no other choice but to put things in his hands.


In regards to breasfeeding, though, I can't say it has any effect at all.
I'm very pro breast feeding - I fed Luke until he weaned himself at almost 12months, and will do so (if I can ) for any further babies.

Because of his high risk birth, he had trouble feeding for the first few days, and for the first 2 days I breastfed via a tube.
I persisted, though - I was so determined that my body could do this after the birth.. and it was something I was sure I wanted to do from before I even fell pregnant.

I have lost a LOT of faith in my body since Lukes birth (and especially now after the too many years of TTC #2) - but I know my body did the breastfeeding last time, so I know I can do it again.

Maybe when the labour part comes around again, it might be different, but I have to go into it with my mind and my eyes open.

I DO look at the c/s as MY safer option - but thats ONLY because of my experience with my body & my circumstances.

(Good on you if you got this far!!!)

ETA - Bec, my whole post just makes the last statement of your post 100% correct!!!

[onthefly]

Hoobly - you make a really great point about control. In labour, I found I coped best and things progressed well when I let go and surrendered to it.
If I'm honest, I have to say that I do remember thinking during pg, when facing the uncertainty of labour and birth and worrying about what might go wrong, that perhaps a c/s would be better, for that sense (though perhaps illusionary) of control and certainty about what would happen. On reflection I decided the cons definitely outweighed the pros for me.

[happymel]

This is a great thread!! Its very interesting to hear everyone's thoughts. Initially, during the pregnancy, i was very pro VB. It was something that i wanted to go through, feel and have that special connection i thought that would come with a vaginal birth. But after long discussions with my OB, both my husband and I realised that by having a VB, we were putting our second baby at risk.
I know some people may not agree with this, but there is a greater risk to the second twin, and we wanted to eliminate that all together. My OB gave us statistics and research and gave us the decision, which didnt take long for us to make. It had taken us so long to get to this stage, we didnt want anything to go wrong. Our OB also told us that a number of second twins had died in the past year due to complications during a VB.
We would have had a c/s anyway in the end, with the babies being born early. If (big if right now!!), we have another baby, id love to deliver naturally. I dont even know if that will be a possibility for me, but i would love to have that experience. Not that our birth experience wasnt special, but it just wasnt the "natural" way. I dont mean to contradict myself in saying that, but we had a choice, and it was the right one, but if i had of been pg with just one baby, i would have wanted a VB.
As for BF, i was always determined to succeed no matter what. And i did, and have. It took 6 days before my milk really started to come in, and then the babies were in special care for 2 and a half weeks, but i got there!
I sometimes feel like IVF took something away from us. I wish that i could have the excitement of doing things "naturally", and finding out with a big surprise, wow im pg!! But it didnt happen, but BF was one thing that i could give my babies.
Sorry if i have gone off track! GL to everyone who is pg now, i hope that everything goes great for you all!!

[scooby]

Nixon I TOTALLY agree with you i think to much issue is put on either stradegy, we need to support one another not ridicule, this is were the mental issues of birth experiences step in and at the end of the day we are not going to comprise the health of ourselves or our babies for a "cause" only to feel guilty for the choices we make.

[sushee]

Firstly I'm not big on ridiculing someone's choices. I don't think anyone in this thread has done that. I suggest that everyone read the entire thread and everyone contributions before commenting.

Because I think using emotive words like 'forcing women' or 'making women feel like they're wrong' or 'ridiculing' actually starts to derail legitimate discussions like these. We are talking about why it is LTTTCers believe a c/s is safer, when stats and evidence show that a VB is safer. This is NOT a c/s vs VB debate, and while I don't like modding threads that I am contributing personal opinions to, I will make this point very clear - I don't believe questioning if the system, or the difficulties of the LTTTC journey, has let us as women down or failed us in some way constitutes persecuting people's choices, because no one has done that.

In fact I consider myself an IVF advocate, in that I believe women with fertility issues should be informed (and not kept in the dark by their clinics), they should feel empowered (at a time when they feel so powerless) and they should be given the support to heal themselves.

This is an extension of that - which is why I'm so interested in knowing what it is that changes in a woman's psyche when she endures the pain of LTTTC that she then makes decisions that may in fact put her and her child are more risk (like choosing a c/s without medical reason). It's not pro-VB to say a c/s carries more risk, it's a simple fact.

It doesn't make sense - LTTTCer are some of the most cautious pregnant women I've known. An IVF veteran tends to be the one who reads up so much that they know almost as much about IVF and the related technologies as a scientist. They make important, complex decisions about their treatment, yet once pregnant, this need to educate themselves seem to desert them. I just want to know why.

I'm typing fast because I had dinner on the fire, but hope I have gotten my point across. Before you comment, please read the whole thread and focus on the issue, and please don't make this a c/s vs VB debate.

[paradise lost]

LOL, sushee on my first readin i thought you said your dinner was ON FIRE! LOL. Yummo, charcoal, my fave

I'd be interested to see if the trend is stronger in those women who had to endure more treatment. Like the choices of women who fell PG on first cycle of AC as opposed to those who have had 3+ Stims and 5+ Fresh/frozen ET's?

The reason i wonder that is because it's SO SO clear to me how our own personal experience colours our views of what we can do and what is possible. I will hold up my hands, i concieved accidentally, i had a perfect nearly-natural Homebirth without trouble or complication. I didn't need stitches. I pushed only once and DD shot out. It is SO FAR from the "average" experience, yet my opinions are OF COURSE coloured by that view. Reading what Hollybolly went through i can see that if i'd had her experience i would not have my views. And i DO know people who tried for a homebirth and ended up with sections. I even know a couple who lost their baby during their homebirth. Would it put me off? No. But i'll tell you what, before that baby died i was really geared up for wanting a completely natural birth. With DD i used gas and air for an hour and i had the synto injection for the 3rd stage because about 10mins after birth the midwives were getting a bit twitchy, DD had been a bit blue, and i wanted everyone to feel happy and chilled like i did (DD had recovered by then!). But i was really keen to have a fully natural birth. I knew not only the couple, but the midwife at the birth where the baby died. It was a surprise breech, she got stuck, he head was completely unflexed and it took them 20minutes from the birth of the arms to get the head out. She was resussitated but died 5 weeks later from severe brain damage caused by the oxygen deprivation. I would still have a homebirth, because the fact that her head was unflexed, the cord was already white when her belly was born (though she was still moving at that point, so perhaps whatever went wrong had *just* gone wrong at that point) and the placenta came down fully detatched with the head indicated there was something wrong before birth. SHe turned breech during labour. It's incredibly rare. THat doesn't put me off homebirth at all (though it did for a time). BUT that midwife still isn't back to work. SHe was DEVASTATED by the experience. And now i feel that if my midwife is scared and wants to give me synto i will take it. Not because i think i'll need it, but because the cost to me of taking it, while relieving the fear my midwife might have that i will bleed out and die on her, when she is responsible for my life and that of my newborn, is nothing. So clearly that (long-winded, sorry) is an example of how my belief has been altered by experience.

So we look at the LTTTC woman who has been through many attempts with AC, IUI, IVF, maybe even ICSI to try for better quality embies, who has endured treatment after treatment, loss after loss. For such a woman it's not a case of her body needing a little extra push, or even a BIG extra push. For a couple who have their reproductive cells removed, mechanically united (as with ICSI) and then put back and perhaps had to take drugs in early pregnancy to maintain the pregnancy, their exprience of theor body and it's capabilities in the direction of reproduction is already going to be SO altered by all that. I do know that Ina May (i know i bang on about her, but she's the world expert in normal birth and the authority in figuring out who is high-risk before labour begins!) says that the more horrendous births a woman has had the more cautious she is about recommending birth-centre/home birthing, because it is in our NATURE to learn from our experiences and however chilled a woman can seem in pregnancy, the first contractions can often bring on paralysing fear at the memories of last time. She recommends therapy from midwife-counsellors who can talk to the mother about her previous experiences and fears so everyone can get a feel for how ready she is to try for a natural experience. We don't all react the same way. I saw a horrendous (to me, pretty standard to the midwives apparently) induction, and it made me want to avoid hospital at ALL COSTS. But i know a doctor who has seen horrible births in hospital and she is going to have a section at 38 weeks to avoid it all. She thinks birthing is so hard and said to me "Even with all the interventions we can offer it can go so wrong" - i think the intervention MAKES it go wrong! Similar experiences, totally different reaction.

Perhaps that's at the crux of it Sush? Perhaps when it comes to birthing LTTTC women are more likely to opt for cs because their own experience has shown them repeatedly and over a long period of time that their body will NOT do what it should? That's not really an intellectual exercise, and it's something that's difficult to override. If we as a species could override our poor experiences we'd have died out.

Happymel i had to smile when reading your post and seeing the ticker Twins are common in my family and DP's and i'm TERRIFIED of getting them because of the risk of cs birth. I have already exhausted myself with research and worked out my plan! LOL. If both twins are head down i'll hire a private midwife and have a homebirth. If twin 2 is breech/transverse i will go into hospital and allow them to site and test (but not put drugs into) the spinal/epidural so that i can be taken for a section immediately if need be. If both twins are breech/transverse i will show up for a cs in labour.

Bx

[sushee]

That's a great post from a different prespective, Bx.

I agree it may not be something we can ultimately over-ride, but honestly, I don't think that anyone's tried, at least no one I've come across. I mean, I'm sure I'm not the only one to notice that there is very little accessible support for women who 'graduate' from being LTTTC to being pregnant, and then to being mothers. It's something I've personally noticed, and something I've become quite passionate about - IVFers need support not only during trying to conceive, they should have access to support during their pregnancies, and through the early years of motherhood.

I know some women believe that, once pregnant, there is no difference between a woman who conceived naturally and a woman who conceived via AC after many many years of struggling with infertilty. I don't agree. I think you cannot go through such a life-changing event such as LTTTC and not be affected by it. So why do we as a society essentially ignore these same effects simply because the woman is now pregnant?

Now I'm not saying that there should be support for IVFers to the exclusion of other pg women. I think all women should have as much accessible support as they require. But I do think LTTTCers have unique needs that aren't being met.

This is a common theme among pg LTTTCers, and women who become mothers after LTTTC - they feel isolated and think their feelings of guilt, distress and anxiety is something to be ashamed of. They currently don't have the opportunity to work through those issues, mostly they don't even talk about it. They somehow believe that admitting that they aren't 100% ecstatic 100% of the time will mean they aren't 'deserving' of their good fortune of finaly having success.

And yes, I don't know if support programs, or even starting to discuss the topic in this way, where everyone contributes ideas, will make a difference to the way a woman feels in the long run - certainly whether it will make any difference in the relatively short period between conception and birth. But I want to try. I want to start talking about it. I want to bring it out of the shadows.

Just here on BB I feel like we're starting to talk honestly about how LTTTC affects the way we make choices in pregnancy, and influences the way we parent. So I hope, if nothing else, if allows LTers to continue talking about these sorts of issues.

[paradise lost]

So why do we as a society essentially ignore these same effects simply because the woman is now pregnant?

I think that's just an extension of the GENERAL view in our society of childbearing. We should do it, yes, but we shouldn't talk about it. We shouldn't let it "change" us or our lives, we should be back at work ASAP and showing no outward signs of anything having changed. The attitude i felt i was faced with was "Have a baby, but for goodness sake, shut up about it!" If this is the attitude to a normal woman, who had little out of the ordinary she needed to talk about, what would be the experience of an LTTTC woman, who went through SO SO much to get pregnant?

Bx