Big Birth Debate

Me in Theatre – Delivery of K

The past week there has been a lot in the press about how women can now choose to have a Caesarean birth if they wish to.

The National Institute for Health and Clinical Excellence (NICE) says that women should be allowed to choose to have a Caesarean Section (CS) even if there is no medical necessity. Women will be offered counselling and be told the risks, but ultimately if they want a CS then they should get a CS. 

Now, I wonder if they will be told EVERYTHING about what having a CS involves. I wonder if they will be informed that their risk of having placenta previa and placenta accreta increases in subsequent pregnancies after having a CS?

I sure didn’t get told that when I was advised to have my first CS with my 2nd child back in 2007.

My first child, J was born naturally in 2005. I had an 8 hour 4 minute labour with entinox (gas and air) only. I did have to have a syntocinin drip to speed up my contractions as I wasn’t labouring properly (despite being 5cm dilated). J’s heart rate kept dipping at every contraction too. Unfortunately, J was born with his fist clenched at the top of his head and his elbow sticking out.

After birth, it was discovered that I had a very severe 3rd degree tear (nearly 4th degree). This meant that I spent over an hour in theatre, with a spinal block, being sewn back together.

When I fell pregnant with our 2nd child just 8 months later, I had to have a specialist ultrasound to gage how well my tear had healed. At 34 weeks pregnant, I saw my consultant. I was told that my scar, even though healed, would more than likely tear again during labour. I was told I had a 20% risk of tearing again. I was told I could end up with incontinence if I were to deliver naturally, and a CS was advised. At 22 years old, just hearing the word incontinence had be thinking I would be wearing Tena Lady for the rest of my life!!

The CS itself was a good experience. We went in to theatre and the spinal block went in and I was numb straight away. The operation started at 12:23pm and K was delivered at 12:26pm. Everything went well and to plan. I was even up and walking about 8 hours later. Within 2 weeks I was back doing household chores and at 4 weeks my GP signed me fit to drive as I had healed that well.

It really was what you would imagine an elective caesarean section to be like. It was tranquil and calm and I really didn’t feel like I had just had major abdominal surgery, and I healed a lot better and quicker than I did after having J!

When I fell pregnant with A in early 2010, it was a different story. Initially, I wanted to have a natural birth. I had read all about Vaginal Birth After Caesarean Sections (VBACS) and its something I really wanted to do. I wanted to experience giving birth again as it was such an amazing experience with J (despite the tear), so I was eager to discuss this at my consultant appointment at 13 weeks.

I went to the appointment and came away a bit deflated. We went through my history and my reasons for a CS. It was then that I was told that I could have actually given birth to K normally, and more than likely not have torn. The 20% risk of tearing was correct, but that relates to a 1st/2nd degree tear. The chance of me having a 3rd/4th degree tear again would only have been 3-4% chance, and as K was only 5lb 12oz (born at 38+6wks), I more than likely wouldn’t have torn at all! I was absolutely gutted! I wish I had know those facts back when I was told that I would need a CS. I just assumed that my doctor knew what was best!

I was sent away to have the test done to see how well my tear from J had healed and referred back to the Consultant team I was under with K.

At 19 weeks pregnant, I went back and saw the Consultant to get my test results and see what was in store. P and I had discussed it, and decided that even though we would like to try naturally, if its advised that a CS is needed then so be it. We have to trust the doctor. Unfortunately, a CS was advised. It was discovered that my tear has deteriorated from the pressure of pregnancy alone and is developing a small hole. I was told I will need reconstructive surgery on it at some point in my life.

I went along with the advise of the Consultant and booked my CS for 39+2wks.

At our 21wk scan, it was discovered that I had an anterior placenta. This is where the placenta is attached to the front of your belly. It basically means that baby is at the back of the placenta. It will also act as a cushion and therefore you may not feel the baby move as early as you would expect.

I didn’t really take much notice to be honest. Nothing was mentioned at the scan that it will be a problem, so we didn’t worry about it. Until 27 weeks when I started bleeding, then it went all down hill.

I have written about what happened here and here so I won’t bore you with going over the same story again. I will however sum it up.

I was diagnosed with Placenta Previa, where the placenta is low lying and covers the cervix (where the baby comes out). I had an MRI scan at 34 weeks pregnant which also led to the diagnosis of a condition called Placenta Accreta. This is where the placenta attached and embeds itself in to the lining of the womb. Or in my case…my previous CS scar tissue!!

Now, it was only after I was diagnosed, that I was informed that having a CS increases your risk of these conditions! I was angry that I wasn’t fully informed on this before hand. I spent weeks in hospital. I was put to sleep so my baby could be delivered. I had blood on standby. I had a bed on reserve in Intensive Care in case everything went wrong in theatre. I had consented to have my womb taken away in the event of an emergency that I bled so much that it was the only way to save my life. I would not hear my baby cry for the first time. I would not see her face straight away. I would not be able to hold her for hours. I would not be able to feed her!

I was in excruciating pain for days after. I could not move. I was made to get out of bed the following afternoon. It took me over an hour to just get out of the bed and in to the chair. I spent an hour sitting in the chair before begging them to let me get out and back in to bed because I was in so much pain. It took me ages to heal. I still felt a tugging on my scar for months afterwards, and to this day there is a certain area on my stomach that is numb from the surgery.

I was not informed when I had my first CS that it would cause me problems in subsequent pregnancies. I wish they had because I sure as hell would have thought twice about making such a hasty decision.

I have now been advised to now have any more children. Since I have had PP and PA, my risk of getting them again is even greater! Always having wanted 4 children for as long as I can remember, this is quite sad for me. If we were to have another child, then it would be delivered by CS again.

I can’t help but think that women are going to just want to have Caesarean sections for vanity reasons or because they are of the “too posh to push” culture and not know the real facts! That they’re going to get it in to their heads that they just go in to hospital, Doctor delivers the baby and they go home and back to normal! It doesn’t work like that and they need to be told the risks, not only for the first CS but for subsequent pregnancies.

Caesarean Sections SHOULD be for Medical purposes and Emergencies only…not just because you don’t want to have pain for a few hours! Believe me, I would rather labour pain than go through a CS and all the complications it entails!!

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2 Comments (+add yours?)

  1. The Princess Poet
    Nov 25, 2011 @ 14:54:16

    Great Post Rachel! I am so teary reading this. I suppose it hit a nerve. I had an EMCS with Ethan after dilating so well, He got stuck and off to theatre we went. I had to be induced in the first place but i made my birth as active as posible seeing as i was attached to the continuous monitoring machine. My scar did not heal for 6 months. I had 2 infections and no matter how easy i took it one side refused to close up. unlike all other aspects of my birth I hadnt researched the eventuality that I might need a cs so I didnt know what to expect. I really hope people do research thoroughly if they choose to go that way.

  2. Rachel Gully
    Nov 25, 2011 @ 16:51:24

    I think unless you're told beforehand that you need a CS then you don't go in to labour thinking about it. I very nearly had to have an EMCS with J but was lucky that the drip sped me up so it was avoided.

    I just hope that these women who automatically go for CS KNOW exactly what it entails and the complications of it and that it is actually major surgery!!

    Hope you're feeling slightly better about things now xx

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