ok just thinking out loud here.....
wondering if you knw you are to have a cesarean but don't want to definatly book in for a scheduled cesarean, you want to go into labour firstly... then have the cesarean.
would this be allowed? and can you directly say 'no i am not booking in i plan on going into labour then having the cesarean'
I think you can. Or maybe you could at least book your c/s for the day you are due, or later iykwim?
Might depend on your ob.
I think it would depend on the reason for the c/section and if would be dangerous to labour eg low placenta preavia
Funny you should mention that...
I was just reading a pretty horrific story of a woman who had 4th degree tear and was told she would have to have a c-sect for any other Bubs.
She asked the same questions but was told that the baby may be too low by that point etc etc.
My thoughts are....
Why just wait until you are in labour? Why not just try for a VBAC as your already "half way" there?
I mean I don't know your history or even why you would know that you need a c-sect at this point.
Sorry if that comes aross as brash....I'm just trying to understand it from your point of view. :)
Hmm, I guess the reason for the caesarean would probably influence whether this was allowable. EG if it's deemed unsafe for you to labour or attempt a vaginal birth (like with placenta praevia, or if you have a previous vertical caesarean incision for example) they definately wouldnt want to allow you to go into labour. But if labour is seen to be a fairly safe option, then I guess they would be more open to the idea. I guess you never can tell how long or short a labour will be and how long it takes to get you into theatre IYKWIM.
It might be allowed, depending on the circumstances surrounding the need for the caesarean, but I expect you could meet with some pretty stiff resistance from the hospital. I asked about booking my elective c/s later rather than earlier, given that my first pg went to 42.5 weeks...but they explained if I went into labour before my scheduled date, it then turns into an emergency c/s. Often women go into labour overnight, so there can be a delay in finding surgeons, anaesthetics, theatre space, midwives etc, so the c/s may not be as calm and orderly as it might be scheduled during regular hours.
It might be allowed, depending on the circumstances surrounding the need for the caesarean, but I expect you could meet with some pretty stiff resistance from the hospital. I asked about booking my elective c/s later rather than earlier, given that my first pg went to 42.5 weeks...but they explained if I went into labour before my scheduled date, it then turns into an emergency c/s. Often women go into labour overnight, so there can be a delay in finding surgeons, anaesthetics, theatre space, midwives etc, so the c/s may not be as calm and orderly as it might be scheduled during regular hours.
Like the others said, it depends on why you are having a c/s. FWIW I did go into spontaneous labour first before my scheduled c/s date with DS. I had placenta praevia so it was an emergency. Never seen a bunch of midwives, doctors, etc move so fast!
having had previous c/s' aswell hon is a big risk factor in the eye's of those in the know ;) tearing you scar internally, heomoraging ect. What happens if you go into labour at midnight? Gotta tell ya from experiencel..anthetists crack it at that time of umm morning
Eg with tearing....I had emergency c/s with Dudie.....planned vbac with with tank until 33 weeks when early labour was stopped (thank god) but mario ripped apart me c/s scar internally and I was left bruised BLACK for 1 1/2 years after his birth were labour and contractions ect caused damage.
Yet with Mini me..I laboured for 3 hours hard..waters broke, 8cm dialated ect and still gave me c/s :( would not let me have VBAC due to c/s with mario and internal bleeding. Turns out this ob atleast had a look and said that my pelvis was that badly twisted that I givign birth naturally would be a miracle itself :(.
My point....its a risk hon. Id given anything for VBAC then have started labour and then had that snatched away from me when I ended it with my c/s
I think they prefer to book you in because a planned c/s is much safer than an emergency c/s. I had a planned c/s with DD2 because she was footling breech. However, my labour started on its own 4 hours before my planned c/s and I got to the hospital within 45 mins of labour starting - 9cm dilated. They gave me an injection in my stomach to stop the contractions which caused lots of complications. My uterus wouldn't contract on its own because of the drugs they gave me to stop labour - I had to have an oxytocin drip for a few hours after the procedure which meant when the drugs wore off I was having a constant contraction and it was extremely painful on my scar. I also had to lie perfectly still in labour and they said if my waters broke I would need a GA.
Then there are also the general risks that the operating theatre won't be available when they need it, the anaethesist may not be available or may be delayed.
Even with everyone at the hospital ready to go when I arrived, it still took them 1 hour and 45 mins to get the baby out after the injection in my stomach to stop labour. It was an incredibly scary and panicky time with people running everywhere - I had about six people preparing me for surgery and I have never been so scared in my whole life.
I should qualify all of this as being my experience and not necessarily how it would happen for everyone but I think if it is necessary to have a c/s and there is no chance of a vaginal birth, it would be very unlikely that they would let you go into labour on your own. You can ask, but I got the impression from most of the hospital staff caring for me (including the doctors) that they have their policies and procedures and very few of them can explain why they do what they do (they couldn't explain to me before or after why it was so necessary to have a c/s, just that it was safer).
I hope that helps - I am not trying to scare you or tell you horror stories, but it is good to know what can happen. Good luck with everything.
WOW!:
I'm amazed at what lengths the medical system will go to to keep everything under CONTROL!
Its obvious to me that your body knew exactly what to do through the quick dilation! 9cms in 45 mins is pretty good! Almost sounds like your body was rushing to beat the intervention that was about to come!
Can I ask...At any point, did you think to say...Seeing as I'm almost there, Can we just try and give birth? Or were you happy with the decision to do a c/s?
Sorry to hijack your thread Katones!
I might also add that I am in no way judging you for the decisions made. These were your decisions and you made them because it was right for you and your family.
The hospital is usually not keen on this although it does happen for various reasons. There are definately positives to going into labour and then having a c/s (in cases when c/s is inevidable for what every reason) obviously provided no placenta previa etc. Also it might depend on how many c/s you have had in the past. When you go into labour yourself at term the baby is ready to be born. Your reducing the risk of respiratory problems provided bub is healthy at delivery and not compromised from distress from a stressful labour etc. We often see TTN in neonates born via elective c/s as they are done before bub is ready to be born.
Is it possible to have a VBAC?
Also I guess you have to see if the risks outway the benefits. I mean where I work it is not always possible to have a quick emergency c/s as at night or weekend it means calling in a theatre team or if someone else is already on the table been operated on there can be a wait to get them of to get you on if that makes sense. But in some places with 24hr theatres running this is not an issue. I have also been in the position where I have had 2 women needing a c/s and fighting with the O&G who needs it first but I do work where only 1 theatre is running. You will have to decide if you go into labour can you then wait up to a few hours to be preparred and allowing time to do the c/s! I must say where possible I am always a fan of bub choosing when it will arrive. The thing with elective c/s is its expected and you usually predict what will happen. In an emergency its unpredictable and often medical professionals don't like that.
If you go into labour and then have a c/s maybe do your consents now, trim your pubic hair as it gets closer etc so they can just add the date when you do come into labour and little will need to be done to have you preparred. Just a suggestion.
I don't mind you asking at all. I did ask at my appointment where my c/s was scheduled if I would be allowed to deliver and they told me no but the doctor couldn't really give me any answers as to why, just that if she was a frank breech they would have let me try - hospital policy. She was footling so there was no chance of trying naturally. Through my own research I have found that it was probably concern about cord prolapse.:
When I rocked up at the hospital, I didn't know that I was progressed so far. The midwife gave me an internal to check on me and without saying a word, ran out of the room and came back in with six people - 2 doctors and 4 midwives. They all did things to me. I didn't get a chance to ask at that point I was too overwhelmed by what was going on and the fact that two of them were holding me still during contractions and the doctor was telling me to lay still because if my waters broke I would have to have a GA rather than just a spinal. At one point she told me to stop pushing (which I also didn't realise that I was doing). I didn't really question it at this point, I lay there crying while people did things to me - someone was shaving my tummy, someone else injected my tummy, someone apparently gave me an ultrasound (DH tells me they did but I didn't notice), someone was explaining to me about the c/s and gave me forms to sign, someone was holding me still, someone was stripping off my clothes and redressing me ... there were people everywhere.
I questioned it more afterwards when the midwife that took me down to the ward said 'Pity it didn't just happen for you naturally' - probably not the most encouraging thing to say to me at that point because that has left me wondering though she could give me no answers as to why what happened, happened. And neither could the doctors that came to see me over the next couple of days. It was just following procedure.
I think more than anything I felt powerless. Because I was in labour - and out of control of myself by that point anyway (I was pushing and didn't even know it), all the power of the decisions was taken out of my hands. DH was taken out of the room very soon on and gowned up. I was in the operating theatre for a long time without him - once they were ready to start the procedure they let him back in so I was also alone for a lot of it without my support team. We weren't even allowed to bring our camera with us but I am told other people can. It was all very strange.
I don't feel like you are judging me - you are really just asking a question that I have asked myself a thousand times since it happened. I was not prepared for it to be that way at all - I didn't really know what to expect and the opportunity never arose beforehand to discuss my options. The only way that I know that I was 9cm dilated was because they were talking about it while they were doing things to me - no one ever actually told me.
Sorry to thread crash also Katone. That is a bit off the topic.
Mildez - We live in a place with four operating theatres in the local hospital but there was a woman who was ready to wheeled into the OT when I arrived at hospital who had to wait until my procedure was over because mine was more urgent and there weren't the staff working at 4 in the morning to do hers at the same time. I assume everything was okay with her baby but hers was also an emergency c/s which presumable means that it needs to be done immediately, but she had to wait. I felt really bad for her as well.
Katones - there is a lot to consider with your thoughts - is it because you would like to attempt a VBAC? or because you would like to experience labour? i agree that, if you're going to have a c/s regardless (for whatever your reasons are), it's probably better to do it as an elective c/s - having laboured and then had a c/s anyway, i PERSONALLY think it would have been better for me had I been booked direct to c/s. the physical exhaustion i endured may have hampered recovery (i won't know seeing it happened - not like i ahve anything to compare it to!) - my milk took five days to come in and the LC believes that may have been due to the labour/cs combination.
perhaps you could book a c/s for EDD or a few days post dates if you need one for whatever reason - if you then go into natural labour before then, you can experience it kwim? IF we manage to fluke a natural pregnancy, this is what we have discussed doing. as much as i'd like to have a VB, due to personal health reasons, i need to be realistic. i would be very reluctant to book c/s 2 weeks early (as seems to be the "norm" for elective c/s).
it's a tough call and one only you can make. i honestly don't think you'd be able to book a c/s for when you go into labour though - you'd possibly need to discuss it at length with your care provider - the how, the why etc
As a middy I have seen footling breechs born vaginally. Although I would not recommend it if there was a choice. None have been pretty unlike the Frank breech. There are also 4 operating theatres where I work but after hours only one is available. Only one theatre team in on call and I have been in a situation where it was a life or death thing and they did not even attempt to call a second team in. To run a theatre you need a scrub nurse, scout nurse, anaethetic nurse as well as your anaethetist, surgeon, recovery nurse and usually a wards men for the transfers and cleaning as well as your CSSD staff for the instrument cleaning (then paed and midwife in c/s)
Emergencies are often catergories into areas as what is the greatest need. The most likely to go in would be your antepartum haemorrages (from uterine rupure, placenta previa, abruption, unknown etc) then others that are emergencies such as malpresentation it may even be possible to wait up to several hours (certainly not in your case Just me)
I was in that situation myself when I had a rupturing ectopic pregnancy and an MVA came in as I was getting prep for OT and 9pm Sat night. 3 people were operated on that night (only one survived) and I didn't end up going in until 9am Sunday morning. I though been a staff member they might have been able to call an team in but no. But we are looking at a rural hospital. I know some of the hospitals in Sydney have over 20 going at once.
Sorry to crash your thread. I have a dear friend doing the exact thing at the moment. And she did it with her last baby too and all was good. She was adament that her bub would choose when he was ready to come not be evicted when it suited others.
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Oh hun I am so sorry you had to go through that experience :hug:
Unfortuently when the medical world takes over they forget that there is a Mother and a Woman involved in all this too.
I guess all you do at this point is treat this as a learning curve. Its a hill that you have climbed and over come. Learn from it. Remember and move on.
I try and treach each of my pregnancies and births as learning tool and try and improve things for next time. Maybe you could do the same?
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