Friday, 26 October 2012

Decisions. Part 2 - Time to Decide


Firstly a quick apology, I'm now on maternity leave and had been intending to update this blog a lot more. Unfortunately I've so far spent much of my leave waiting around at the hospital for routine tests, in bed with colds or dealing with a three year old with a vomiting bug! Fingers crossed that's all done now and of course I'll have loads of spare time once the baby arrives (hahahahaha...)

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I'm now 36 weeks pregnant, sadly neonatal teleportation still doesn't seem to be on offer on the NHS so at my Obstetricians appointment on Wednesday it was time to make the decision; try again for a vaginal birth (VBAC) or plan an elective caesarean*.

I've been thinking about this ever since E was born, at the time I was desperately disappointed and utterly shocked to have had an emergency C-section. In the bubble of middle-class London mums with ante-natal yoga, parent blogging and NCT groups, childbirth isn't just something that must be endured to bring your baby into the world, it's supposed to be a life enhancing, "empowering" experience with bonus points if you home birth with no pain relief and minimal medical assistance. C-sections, even emergency ones, can be looked on with suspicion. They are an easy option, or an "unnecaesarean" caused by mothers too weak to stand up to doctors who are terrified of being sued, desperate to do some exciting choppy surgery stuff or just in a rush to get to the golf course. My NCT teacher made it quite clear that my surgery meant I had failed the course exam.

So before I was pregnant again I was sure I would try for a VBAC, re-sit the test and see if I could get a pass mark this time. The first 24 hours of my last labour were really fine, sure it hurt but had E been smaller and in a good position I'm pretty sure I would have got her out without much medical intervention.

But then we got that little pink line, it all started to become real again and I changed my mind.

So on Wednesday I went to the hospital and booked myself in for an elective caesarean. Here's why:

Yes a successful VBAC should mean an easier recovery, I could perhaps even lay a few demons to rest by finally joining the "wonderful birth experience" alumni, but the problem with the term "successful VBAC" is the "successful" bit and that is far from guaranteed . I'm told recovery from vaginal birth is generally better than from surgery but I know from experience that recovering from both labour and surgery is, frankly, horrendous. If I'm honest I am now a bit afraid of childbirth and of the pain involved (which I wasn't last time), but both of those are passing, what really terrifies me is feeling as physically and emotionally shocked, exhausted and broken as I did after E was born, but this time with two children to look after. The only way to be sure to avoid that is to opt for an elective caesarean, rather than risk an emergency one.

Statistically an elective C-section is a tiny little bit safer, and a small part of me does worry that, although things went badly last time they could have been far worse - what if this babys head makes it through but it's shoulders get stuck? What if my scar ruptures? All very very unlikely but I still struggle to believe my luck that we both survived last time, that I have a healthy child and another well on it's way. Even in our western world of modern medicine I know those who haven't been that fortunate, who am I to risk it all, even with the odds on my side?

Finally, it looks like that much aspired to natural birth wouldn't really be an option anyway, to make a VBAC as safe as possible I'd have to be on a bed strapped to a monitor with an antibiotic drip in my arm (I tested positive for group B strep). The movement and water pool that helped so much in the early stages last time wouldn't be an option and without them I suspect I'll be reaching for the drugs far quicker.

So there it is, after swinging back and forth on this for years I've made a decision, signed a form and I'm happy with it. I'll never have that natural child birth experience**, and I will always be a bit sad about that. But what I can do is get my second baby safely into this world, with me in a fit state to care for him/her and that is an experience that millions of women across the world, throughout human history and even today can never have. So people can call me too posh to push if they like, I don't care, the baby is more important than how it arrives.

SB

PS. Of course sods law dictates that this baby will now turn up early. If I go into labour before the C-section I'll just have to decide what to do on the day as there are too many variables to make that choice in advance.


* I'm lucky enough to have been given a free choice by the hospital. It's often thought that once you've had one C-section all subsequent deliveries must be surgical, but modern techniques mean this isn't the case and in fact at the hospital where E was born the policy is to insist women try a VBAC. This is similar to many maternity units in the UK where the ceaserean rate is monitored, with targets to reduce it. In other country's especially the USA repeat C-sections are the default and it can be very hard to find any doctors willing to be involved in a VBAC because of the fear of litigation if anything goes wrong.

**Even if we were to have more children, after two C-sections the risk of scare rupture is much higher in subsequent labours, so the hospital have warned that they would be very anti- VBAC in that situation.

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