Booked in for section on Friday....feeling sad...can I run this past you lot please?

[Elibean]

Following on from my 37+ and might be given a choice thread..
I'm now 37+4, and am booked in for a section on Friday, second pregnancy (first one ended in section after failed induction at 39+ weeks - my bp was rising, and baby disengaged and turned oblique at first hint of contractions).
I was originally booked for section due to baby being transverse lie - but in the last few days, she's been on the move. Head down, back to tranny, and last night (I think) head down again...and its thrown me!
OB said today a) unstable lie (spun sideways at touch of a finger) b) previous section c) mid forties d) bp needs medicating soon - better done with baby out, otherwise have to be admitted for monitoring whilst bp managed (which would be more disruptive for my 2.11 yr old dd) and e) I'm knackered from weeks of poor sleeping due to bad pregnancy itch.
So she said 'if I were you, I'd go ahead on Friday'. She's not knife-happy, she's pro natural birth when possible, she's nice and I trust her. But, she was in a rush this morning - and doesn't like 'surprises' as she puts it.
Medically, I can see it makes more sense overall to go ahead with section. Its a known risk, and a low one. Waiting, with all the factors involved, is complicated and very much the unknown: more risky.
Its just that emotionally, its harder to process my inevitable sense of loss of never getting to experience labour (and possibly vag. delivery) without that one, clear-cut, absolute reason for a section....its more of a judgement call as to when the scales tip in favour of safety for me and Bump v. what I'd like.
Any thoughts welcome....am confused..

[MarsLady]

Oh honey.

I had an elective section with the DTs for the exact same reason (oh and the cord was presenting) and that would have meant fatalities.

I know that you are disappointed and much as I'm all for vaginal births (and it sounds as though your consultant is as well), I think you should trust her. A caesarean birth is not a failure. Sometimes it is a total necessity. This is why they began them you know.

In an ideal world your baby would turn head down and labour would start spontaneously and you would have a vaginal birth. Realistically it would seem that this time it might not be the case.

Hold on to the fact that you are having a caesarean birth and will hold your spinning baby on Friday.

If it sets your heart at rest why not see if you can't talk to her again?

Will be thinking of you.

[cupcakes]

I saw your post on the Dec thread (I am due on the 21st Dec but have got way behind in keeping up with that thread!).
I had an emergency cs with ds (my first) and afterwards felt gutted. The feeling of failure and disappointment was definitely there and I can really understand how you feel. In my case though it was misplaced as I had to have the cs or I and ds could possibly both have died.
The doctors may be recommending a cs as they want to avoid you having a traumatic, dangerous birth. If you don't think she's 'knife happy' then I would tend to trust her judgement. It does sound though like you could have done with a bit more discussion about it with her. Can you speak to the midwife about it today?

[marymillington]

i think you need the comments of an impassioned pro-VBAC-er like lulumama to help you figure this out.

(i am dithering re elective section/vbac myself atm but just don't share that desire (valid though I think it is) to give birth vaginally. any degree of risk would tip me in favour of the CS)

good luck with whatever you decide.

[Elibean]

Thanks, Mars, that helps...just didnt' get to do the processing emotional bit this morning, and DH is seeing it from his point of view (fair enough, I might add) of just wanting us all safe and him feeling more in control of childcare with dd!
I want us all safe too - just finding it hard to trust its about that and not just about it being somehow 'easier' for the OB
Not sure talking to her is what I need just now, too emotional - and I suspect she'll just repeat her point of view - but talking to MN feels good!

[MarsLady]

the difference though marymill is that Elibean has a baby with a transverse lie that isn't stable in position and (as an impassioned VBACer myself) I think that Elibean should talk again with her consultant if possible, but accept that a vaginal birth may not be at all possible.

[Elibean]

Hello Cupcake! Y'know, I think part of it for me is that things being rushed this morning reminded me of the way the last OB handled things..and I didnt' trust him at all: he was MUCH happier delivering babies surgically than vaginally, even the MWs said so.
Its hard to separate the memory of dd's birth from this time...but I do need to, I see that.

And don't feel you have to catch up at all on the Dec thread, btw, people drop in and out all the time and it would be lovely to have you back if you ever feel like it

MM, thanks...and good luck with your own decision; I'm not a 'must have a vaginal birth' person really, just a tad wistful because this is my last baby, I'm terminally curious, and want to know what it feels like...(am I utterly mad)...

[Elibean]

I did say to the OB 'maybe I'll go into labour before Friday' (sort of joking) and she said 'well if you do, and baby is head down, we'll give it a go!'.
But I suppose thats a different deal to actually planning to go into labour, IYSWIM.
And there's still the BP issue. Its up to 150-160/80+ now.

[marymillington]

i wasn't trying to compare our situations, marslady, just offer some support. like you, i believe a healthy CS delivery is the very opposite of failure.

[MarsLady]

marymill.... the typed word doesn't convey tone. I wasn't getting at you, just thinking out loud. Your support is as valuable as anyones.

[Elibean]

I think I have a plan
If Bump still feels head down to me, without having spun meantime, on Thursday - I will phone OB and ask if its an option to come in and have BP sorted, or if she still thinks its better to take baby out at 38 weeks and if so, why.
But if Bump keeps spinning between now and Friday, I will happily accept that its not going to happen vaginally...there are too many risks, too few options for managing her position (EV, induction, etc all unviable for me due to bp).

God I'm glad you lot are out there. Thanks again.

[MarsLady]

Sounds like a good plan.

Trying really hard not to burst your bubble, but the day of my elective the DTs were spinning like nobodies business! How the pair of them managed it I don't know! I had a scan in the morning, then a hand held scan, then another at lunch time and one more before the section. They were in a different position each time. Sigh.......... if they had just stuck with the head down!

Anyhoo......... good plan Eli. I'll be praying!

[marymillington]

sounds good eli. i shall be looking forward to your birth announcement whenever it comes.

[Gem13]

Crikey elibean I didn't realise from my thread that you were in this situation. It sounds from your post that a section is the way to go but it is fine to be emotional about wanting to experience labour and a vaginal birth - I can understand that. But... and it's a positive 'but', could you allow yourself today and tomorrow to feel upset (there is nothing worse than feeling sad and then pulling yourself back from it, only to feel rubbish again a few hours later) and then on Thursday start getting excited about having your baby the next day! That has to be the very best thing. When I've felt confused about having a section, I keep thinking about the fact that the baby could be here in less than 4 weeks and we could all be together for Christmas versus unknown pain and problems at an uncertain time, say 7 weeks on New Years Eve...

Apologies for Pollyanna tone.

[Toady]

Have you talked to Debbie or Gina on this website They will be able to give you some advice based on facts.

As is known I am pro VBAC so if I was faced with the decision it would be easier for me but know this has been difficult for you.

a) unstable lie - yes babies can and will turn until you go into labour so dont really understand the reasoning here.

b) previous section - and??? as you know only risk is uterine rupture which is 0.35%

c) mid forties - I am a great believer in that if you got pregnant in the first place then your body can give birth

d)how high is your bp

e) elective section - 2.11yr old - this will also be disruptive

You will only be 38 weeks on Friday, seems quite early too me.

Just my twopenneth, lulu will be along later

Sending you lots of positive vibes and hope you get some sleep

[lulumama]

yeah...what she said!!

as an impassioned pro VBACER - i do have to say there are some situations where you have to know when to say....it might not be the best course of action.

i would say in this instance

with having a non knife happy, pro birth consult, who has given you every reasonable chance to birth vaginally.... it might be best to accept the c.s as a positive outcome.


if you had a regular shaped uterus , i;d be more inclined to say wait..

i wish i could say , do X Y Z and baby will go head down and stay there..the shape of the uterus, the unstable lie in conjunction with the other factors do make me think..what is REALISTICALLY the best possible outcome.

i know how it feels to want that experience of birth..but the odds for me were totally different. i had a vertex presentation, that was vertex from 28 weeks and never moved....

your situation is completely different.....

you need to make the decision that sits right with you. give her another call if you can .... take the time to look this decision in the face..

it is not a failure..producing a healthy baby and healthy mum is the best possible outcome....a c.s might be the way to go here.

i do hear what toady is saying ...esp re rupture & your age etc...

but the unstable lie & blood pressure are added factors....

[lulumama]

and having 'spoke' with elibean on numerous occasions.. i know how much this means to her....

i wonder if you can wait a week more?

speak to the consult. again?

i just want to say , yes, go for it..but here, i don;t know if it is appropriate.....

sorry to be so crap !

[Toady]

"if you had a regular shaped uterus , i;d be more inclined to say wait..

i wish i could say , do X Y Z and baby will go head down and stay there..the shape of the uterus, the unstable lie in conjunction with the other factors do make me think..what is REALISTICALLY the best possible outcome."

Have you seen an osteopath or chiropractor?? Would they help??

[Toady]

Can you go into labour naturally and see what happens then???

[Toady]

sorry to be such a dumbwit but when they say unstable lie does this just mean that the baby is changing position all the time

[Daisymoo]

Elibean, have you tried posting on the uk midwifery yahoo group There might give you some different points of view to consider.

[UCM]

Elibean, I know this won't mean alot at the moment but I hope it works out for you like this. If you were following a dream and emigrating to Austrailia to live for the rest of your life, it wouldn't matter if you went by ship or air, you would still get there and have this lovely life. I think what I am trying to say is that it really doesn't matter how they arrive. It's a day or so out of a lifetime.

[lulumama]

yes..but forgive me eli, if speaking out of turn,, the shape of eli;s uterus is making baby transverse most of the time,.,and there is no mechanism for vaginal delivery of a transverse baby and as eli said in her OP, the baby spun at the touch of a finger...so it is not as simple as could be head or bum down..but could well not be either....and therein lies the rub...

[lulumama]

toady..you are so not a dumbwit!

[MarsLady]

Toady, with me the unstable lie meant that the DTs were constantly turning and not just once or twice a day. In the course of one hour they had turned completely in another direction. It meant that there was no way of knowing how the wee darlings were going to present themselves should I have gone into labour. In the end as they delivered DT1 DT2 headed off towards the birth canal.

[Elibean]

Wow, thanks guys - been out at b'day party with dd and just back online.

Toady, it seems I have a slight septum in my uterus - not something a chiropracter or osteo can help with. Age isn't a major factor - if it was the only one, my OB wouldn't bat an eyelid, its just an additional 'hmm'. I got pregnant with loads of intervention, if that makes any difference (not sure it does, but if). I'm tired from weeks of little sleep, and am 46, but age per se isn't my own major worry either.

Unstable lie...the OB's point is that if I go into labour while baby is transverse, there is a risk of cord prolapse. If she's still 'spinning' all the time at 38 weeks, that risk is there - and they're saying 38 rather than 39 as its my second pregnancy and I could go earlier, or faster.

My own main concern is the BP - this morning, first thing, it was 153/82. Its not been below 140/80 the last few days, and its been as high as 160/80-87 a couple of times later in the day. I also have history of PIH with my first pregnancy: it went out of control after delivery, and I was re-admitted and medicated when it hit 170/100 or thereabouts. I was on Nifedipine for six weeks, then it returned to normal - but the exact same pattern has happened in this pregnancy, only a little faster.

If I DO decide to wait and try for a vaginal delivery, I will almost certainly have to be admitted for BP meds to be started within a week - and that also carries a risk to the baby, so I will have to be monitored for 2-3 days till stabilized. Whereas if she's already out, they only have to worry about me - not her.

Personally, I'm not worried about scar rupture, but the BP does worry me. And repeated admissions to hospital isn't ideal for me or my family.

Toady and Lulu, I really appreciate your experience and input - thank you both SO much. Lulu, I know you know a bit about me and my history, and it means a lot that a pro-VBACer says what you say. TBH, its peace of mind I'm after - much, much more than a VBAC. I don't want an unnecessary section, but I don't want to take risks just because I feel sad about not knowing what labour feels like (its not THAT sad).