Trying to ensure a better birth experience...what to do?

[snowboarder]

Hello - right - second baby due end feb/beginning of March. I know it seems ages away but am starting to think about where/how to give birth this time. 18m ago ended up with an (unwanted but scared into it) elective c section (giant baby) at Kings followed by 6 hellish days in their post natal ward. Took me about 8m to mentally recover - just all such a shock. I'm now starting to get worried re second birth - especially as my options seem to be limited to either another elective c section or continuously monitored (does this mean strapped to bed?) birth at Kings. Neither sounds very positive - I would love to have a relaxed active VBAC (or HBAC) but my Lanes midwife is not making positive noises. And the thought of being in Kings post natal ward almost makes me cry! Does anyone know of any other options? Have looked at the Birth Centre in Tooting website which looks amazing but it is v expensive. A private midwife would presumably help re actual birth but not re post natal ward horrors (and am lucky to be with the Lanes - so they offer similar service themselves to some extent).

Hmm. Any ideas? Or am I hoping for too much and should just accept the fact the price of a busy but medically great hospital is a post natal ward where you're pretty much left to sort yourself out? Maybe as am prepared for worst would be not so bad second time?

[Fuschia]

If you have a vaginal birth you can leave the postnatal ward within a few hours.

I'd speak to an IMW re HBAC... I can recommend mine (PM me) also recommend C Neillands for hypnobirthing/reassurance to get over birth trauma

Doula also an option to spend time with you postnatally

x

[snowboarder]

F - your mail box is full! PM me details? x

[Vanessa3]

Hi Snowboarder, I too am expecting No. 2 in December & will be attempting a VBAC. I am also with the Lanes & discussed birthing options with my midwife. I too am keen on an active birth & want to spend as much time in the pool as possible. She said that monitoring in the pool is possible as they have hand held monitoring devices that can be used under-water. She told me an active birth is absolutely possible with a VBAC, providing there are no complications.

[darlin']

Hi

I also had elective c-sec with my first due to praevia and was very worried about my options second time around.

Have you been sent an appointment with a consultant midwife at Kings yet? I went to one sometime mid-way through my 2nd pregnancy and was told it was a matter of course due to first section. The lady I met (can't remember name) was AMAZING.SHe was all about having a natural VBAC and said there is no need for constant monitoring or to be lying on ned etc. She took a very long time to carefully talk through the options eg hand-held monitor and said it is even possible for water birth.

As it happened I had to have another c-sec due to constantly turning baby (she flipped from breech to cephalic to transverse on the day of her birth alone!!)

The second c-sec (which I was gutted about and cried a lot over) actually turned out to be a million miles away from the first experience. I don't know if it's just something to do with knowing what to expect, but I felt positive, the pain seemed less and I was walking around much more quickly. I was home within 48 hours having spent a good 4-5 days the first time. The staff were just as busy, but seemed very supportive and kind.

Anyway, what I'm trying to say is there is no good reason why you can't have an active birth without too much monitoring. Maybe try and see Mr Marsh consultant at Kings- he seems very forward thinking (from my memory!)And if you do end up with another c-s it really might not be as bad as you think.

x

[Fuschia]

Jill Demilew is a consultant midwife and very nice

Leonie Penna is also a very supportive consultant

[ClareC]

Do the Lanes midwives only attend births at Kings? I had an emergency C Section at Tommy's and I couldn'y have asked for better treatment etc. Was walking around within 12 hours and discharged less than 48 hours after the Op - only one night in post natal ward.

[new mother]

Snowboarder,

Can totally udnerstand you are excited and apprehensive and I am so sorry that what should be a fun, warm and wonderful time also brings back worrying memories.

What was the problem with the planned section? Could you try to work out calmly now, with the benefit of hindsight, what exactly caused the trauma and explain that to Mr Marsh. (eg the pain was not manged properly/the ward was not clean/you cldn't sleep etc)...

I know people with emerg sections often remember it for ages and kick themselves that they went through alot of pain to end up with a section anyway - which doesn't seem fair - but planned sections should be much more organised and cotnrolled, surely? (I have had two and was off painkillers and home in 48 hours, moving around and carrying things more or less as usual within 3 days so I'd thoroughly recommend it. Maybe this is unusual?)

[The Nappy Lady]

Yes, all I have read suggests planned C section experience much better/different from an emergency one.

Really hope you find a happy medium Snowboarder, whatever you decide.

Xx

[sillywoman]

Poor you SB. I wonder why your midwife isn't being positive about VBAC. In general Kings is extremely supportive of them & where physically possible they actively encourage. It might be worth speaking to another member of the Lanes team for another opinion or to find out specifically why they are not viewing it as an option for you.

Other than that I would echo what's already been said on here. Try and speak to a consultant midwife at Kings if you can. Jill Demilew is good, but it's not really her area of specialism (though of course she would be able to advise). Another really good one is Cathy Walton - an old ED-er herself. Speaking to the consultant Obs could be of help too, but I would want a clearer picture of what the particular issues are with this pregnancy that means a vbac is out before I spoke to an OBs. Leonnie Penna is fab.

Also, like the others, I would say that if vaginal birth isn't a possibility then most women I know who have had to have a planned CS have actually enjoyed the experience much more so than with an emergency CS. It's good you're planning ahead now. Get the facts and then see what's possible from there. You might be surprised.

[Gussy]

Hi Snowboarder, whilst I didn't have a csec with my first I had a very traumatic time and like you it look a long time - in fact until I gave birth to my second - to get over it. I even went down the route of requesting my notes as I was sure I had a case for legal action. The thought of returning to that hospital (UCH) and the postnatal ward made me feel sick. Anyway, I'm saying this because like you I was determined not to have a repeat performance so I took a lot of time to look at all my options and in the end I explored homebirth and it was what I went for. It was amazing. I was having a cuppa on my sofa and eating biscuits while my toddler held the new baby after half an hour. I was sceptical to begin with and worried about lack of pain relief/medical assistance, but I didn't have to worry at all. Have you seen the homebirth website (homebirth.org.uk)? It basically sets out all the info/evidence for a homebirth no matter what your previous circumstances - it also has a forum with amazing midwives and experienced mums who completely changed my mindset on birthing. I also hired a doula and she was a godsend. In fact I could of given birth without the midwives there, just me and her, I was so comfortable with her support. So arm yourself with as much info and I know everyone says it, but the second one is so much easier. You know what to expect for a start, and I found that half the battle, its also normally quicker. I also did some antenatal yoga, which again, really chilled me out as I was getting very nervous about another bad experience. Good luck x

[new mother]

Anyone know why second births are so much easier than first? HAs the body sort of "learned"? I know a lot of women who had a bad time then a very easy labour second time round, which is great.

[Saila]

My best advice would be to get a doula or private midwife or equivalent. Then you have *consistent* care which is so so important. I think cost can be as little as ?500

They may be able to fight your corner for admission to the ward, pain relief and/or breast feeding councillor etc

Also, they can be with you if your partner is asked to leave (as man arent' allowed in the wards at night)

I so wish someone had said this to me...

As for the wards; if you can afford to buy a room, then buy one. I was given a room out of sympathy last time and it was amazing.

i would (personally) take out a loan for the above two privileges

[Mellors]

I don't think you can buy a private room at Kings?

You know my story, but what I would say as well is you are much more likely to fight for what you want anyway in a second birth. 1st time I was kind of letting people tell me what to do and believing them/being weedy about my options. I took no sh*t second time and it was much better! Experience is worth lots.

[Fuschia]

I had IMWS for our twins who were with me in hospital as 'friends' but gave me confidence to leave hospital later on the day they were born.

[Saila]

>I don't think you can buy a private room at Kings?

in which case - ear plugs, blind fold and a fan

[hanstands]

I know a caring doula who offers pre, during and post labour services--she's really keen on natural births where possible incl VBAC's. I don't have her number to hand but if you were keen to call her let me know and I'll chase it up.

[The Nappy Lady]

New Mother, 2nd time is usually easier because your body has already stretched once, so muscles less tight etc. However, it does depend on what happened first time around.

If you ended up having a VB, despite a long labour then 2nd time as your body has done it before your cervix should open much more easily, so full dilation should happen sooner etc.

If you ended up having a CS, then depending how far baby got down the birth canal (if at all) you can still have a long labour, very similar to a first birth, because your body may never have stretched before so you are effectively doing it for the first time.

Equally, if baby got part way down first time around, but then you had a CS I know that can mean 2nd labour can be very fast, but has to be managed very well because otherwise you can tear badly, as when baby crowns, that part of you hasn't stretched before and speed of descent through the birth canal can mean too much pressure too fast at that point if that makes sense.....I know of a couple of Mum's this happened to and they were both told this was the reason why.

All interesting stuff. After my first birth was 5hrs 20mins I was always told the next one would be very fast...and it was at 1.5 hours. Glad I'm not planning on having a 3rd, hubby might have needed a baseball glove!

[hpsaucey]

HI. I had 3rd degree tearing and a difficult birth first time round and Kings said MOST places, but not them, would insist on a caesarian next time around. I was determined to make my experience different and I went to the Brierley for a home birth and had the wonderful Vanessa (now with The Lanes) (Birth was so relaxed it almost happened before the midwives could get there (LOL)).

Are The Lanes definatley saying has to be a Caesarian? Can you talk to them/another midwife there about the possibilities? Like other people here I can recommend someone. The truly wonderful pregnancy yoga teacher I had is also a doula/ experienced in birth rehearhals and teaching people how to birth in the best positions etc. See Ingrid Lewis's web site: http://www.aroundbirth.org/aboutingrid.html I put a lot of my lovely experience second time round down to her and to the lovely homebirth team and the confidence they gave me to be in control.

Also, I think I saw a note on the noticeboard near the toilet in Therapy Rooms on Lordship Lane about a VBAC group!

Good luck! I hope you get the information/help you need to make the best choice for you!

Helen

[snowboarder]

Hello - thanks for all comments and names of people at Kings - I will certainly start looking into everything. The problems last time were not with the C section particularly (although it wasn't quite a calm as a regular elective as I ended up bleeding and going into labour 3 days earlier than planned section!), but the post natal ward. I was fine but my baby wasn't really - nothing serious but low blood sugars/not feeding/jaundice - being allowed home then summoned back again for phototherapy - I just don't think they looked after him very well and I barely slept for about a week.

Think may have been unclear - I think VBAC is an option (maybe preferred) but I understood any home birth was not (and now scared re risks), and also do not feel very positive about monitored labour at Kings. But who knows I may have another giant baby! I kind of think you can meet all these great consultants who are reassuring, but they are not around when you actually give birth so in reality the carefully made plans go by the wayside and you are at the mercy of overworked labour ward midwives. I might try and talk to other Lanes midwives but not really sure how to contact them and no planned appt for 5/6 weeks.

All of this with added complication of a will then be 23 month old to look after - I'm suddenly realising it IS real and I need to plan! I can't help but have negative feelings about Kings but alternatives seem few and potentially expensive...Oh the traumas!!

[womanofdulwich]

Dont'beat your self up about vaginal/caesarian.

Both have advantages and disadvantages. You have not done anything wrong in having a caesarian and you are an equal mother to any other. You have the privelidge of having a baby inside you and have already had one.One birth is not of more value than the other. You just cannot afford to look back you just have to go with what you have.

I think a lot of how you are feeling is related to the shock of having a baby- no matter how planned- and it seems strssful and traumatic- but all births are like this first time- if you are in a safe place and have partner/ freind with you for whom this is not the first time this will be far better than last time, really. I think a private midwife is closer to ?2k, and you can buy a lot of help for this- like a maternity nurse which might be more helpful to you and your family. xxxxxxxxxxxxxx

[Saila]

apparently St Mary's is the best hospital for after care in post natal wards

somehow you can get into hospitals that's not in your catchment... don't ask me how but apparenlty you can

i know cos my sister did exactly this, just to have her baby at St mary's.. and get access their great after care

[sillywoman]

If it's St Mary's Paddington the healthcare commission report classed the maternity unit it as poor performing.

They graded it as below average on Women?s view of cleanliness of delivery and postnatal areas, & Quality of support in caring for the baby after discharge, and average on quality of Postnatal care of women and babies.

By contrast Kings was fair performing & scored the same for cleanliness. average for quality of support after discharge, & above average on quality of postnatal care.

Tommies did best of all, being rated as Better performing. With above average cleanliness, & average for quality of support & quality of postnatal care.

[new mother]

A maternity nurse is really not a bad idea - as an alternative way of spending the 2 grand. (of course we are all looking for ways of spending money these days, not!)

For us it was a bad idea as my husband was off work both times anyway so that was fine, but a lot of peopel swear by them around when you come home and thereafter for getting the new baby into a routine. That would pay dividends too in the long run surely?

[Fuschia]

Not sure I would want a stranger taking over the care of my baby during our first days together, but that's just me. Suppoort from a doula prob has some overlap.

For a quick confident exit from hospital and fantastic hand holding throughout, the ?3.5k we spent on IMWs with the twins was worth very penny. Came to see me at home late at night when I was having funny symptoms, tested BP and urine and took me to the labour ward, then viaited me daily when I was in with pre-eclampsia, came with me to scans/see obs while I was sinpatient and DP had to work. Were with me throughout induction, ensured all my wishes were met, liaised with hospital MWs who delivered me, gave me confidence to leave hospital as soon as was possible, viisted me as necessary at home to ensure the twins were feeding and OK. One was quite jaundiced, I fear we would have been rehospitalised except for close monitoring m=by the MWs and help with feeding.

Knowing a hospital birth was best for twins, but having a hospital phobia, having IMWs ensured we still got the birth we wanted.