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

[Gussy]

I would have gone for IMWs too if we could have afforded it. I 'interviewed' a couple and they were fab. Snowboarder, I'm not jumping on my homebirth bandwagon but you really can still have a homebirth despite all but very extreme medical circumstances. I'm only saying this because I know when I had a toddler as well I didn't want to be off in hospital for a week or so and she not understand where mummy had gone. That's one of the major reasons I planned it at home in the end. Sorry, not pushing my point, just saying, if you're really worried about hospital, it is still an option worth exploring. There's detailed info on VBAC and 'big babies' on the website (http://www.homebirth.org.uk/big.htm) ...also at any point you can transfer in if you change your mind. I had such a different experience from my first in the relaxed environment of home and midwives tend to be a lot more chilled/attentive at home - generally you see the same person throughout and they come to your house for all the antenatal appoinments - bliss.

[born&brED]

Just to mention there is now a midwife-led birthing centre at Lewisham Hospital (i.e. free!) if you did want to try that 'home-birth-style but not at home' experience. From what I've heard it's kitted out really well, and just one floor away from the labour ward should any further medical attention be needed. However, they are fairly strict about previous birth records and problems experienced in pregnancy, and I have no idea if the labour ward there is anything compared to Kings.

[Fuschia]

You can have homebirth style but in hospital at Kings (although the rooms are quite medical) if you discuss and plan for what sort of monitoring etc you want. But it helps to have someone confident with you to stand up for your wishes.

I'm thinking no continuous monotoring, move around as you want, eat, drink etc, minimal examinations, no unfamiliar faces. All possible by negotiation unless meducal requirements really dictate otherwise.

[gwod]

I totally agree with what Woman of Dulwich said about letting go of the idea that one birth has more value than another....and infact with her whole post.

I think one way to improve your birth experience is to remain flexible in your expectations. First time round one is lead to beleive that you have the power to choose your birth experience, but of course you can only choose your preference for birth experience, often events require a deviation from the plan. This can leave you feeling guilty that we had somehow not chosen correctly, or that the mind body/mind had not performed as it should and that we have in someway let the baby down at the outset.

With 2nd or subsequent babies one is much less focussed on the birth itself, more on the new life that it produces, In my experience, this means less trauma around the delivery and hospital stay and more joy about the arrival of a new member of the family.

Regarding the hospital stay - I can remember that I did hate that part with number one, but with the others I noticed it less. I think I was more aware of my role as a mother. For example if one's toddler required a hospital stay, we wouldnt even consider worrying about how unpleasant it might be for us to be on the ward with them, or how to avoid it or keep it short, we would just turn up and do what's necessary. It feels more like that with number 2. Infact the whole thing's easier, so my advice is keep as many options open for yourself as you can, and remain flexible when the time comes...good luck!!

[alieh]

Hi snowboarder. We are in a very similar situation - c-section first time (mine for breech) and with the Lanes now ready for the second. Interesting, because my impression from talking to my Lanes midwife was that they would be very supportive of me trying for an HBAC (just that I would have to talk to a consultant to understand the risks, as a matter of policy). I think I am leaning towards hospital VBAC without continuous monitoring, and my impression is that the Lanes will be happy to support me in this.

I agree with you about the post-natal ward at Kings. My actual section was completely fine, but my stay in hospital was terrible. After two nights I sent my husband to find a wheelchair and discharged myself even though I still couldn't walk.

This time I am just going to stay focused on hoping the VBAC works out and that I can get home quickly and dodge the nasty post-natal recovery ward. Not sure if I'll be able to avoid freaking out closer to the time. Maybe worth considering a change of scene and trying Tommies? I think the Lanes will go with you there.

[newcomer]

Hi snowboarder. I don't want to add to the confusion but one thing you might want to consider is how emotionally you think you'd react if you attempt to have VBAC/HBAC and end up having to have a c-section anyway? You might actually get a better birth experience from having another elective section as at least you can plan with some confidence for the process. The risk with opting for a VBAC or HBAC is that you'll also need to mentally prepare for another c-section 'just in case' it doesn't go as planned.

If you do decide to have an elective c-section, perhaps you could improve your chances of a good experience by:

- arranging for a good friend to stay with you in hospital during visiting hours, so at least you have support for much of the day;

- reminding yourself that it's fine to push the call buzzer as and when you need help from the midwives - that's what it's there for!

- explaining your fears and concerns to the doctor in advance and ask if there is any way they could help to improve the experience for you (perhaps by ensuring you are in a quiet corner of the ward or by asking the head midwife to keep an eye out for you regularly throughout the day?)

Whatever you decide, I hope it all goes really, really well.

[snowboarder]

Thanks again eveyone for comments. It's amazing how emotional an experience birth is!! When it comes down to it the thing I want to avoid at all costs is a lengthy stay in the post natal ward, and feel have better chance of achieving this by having home or at least positive hospital birth. I don't know what the ideal answer is yet, but for now I have a lot of food for thought and am looking into all possibilities!

[Fidgetsmum]

Hi snowboarder,

My first experience was different to yours (big baby, more importantly big head, laboured at home, into hospital after 20hrs, third degree tear from rough failed ventouse and forceps delivery and 12 months pain etc etc - all better now though and due next one in December).

However here are the things I know/have researched/believe (all jumbled up below) about VBAC or HBAC, having spent a LONG time researching homebirth when I was pregnant with my first:

1) Unless there was a specific issue with your CS (not what led to it, but the CS itself), there is no reason to abandon VBAC or homebirth as an option. Uterine tearing is the main fear, but the chance of this has been dramatically reduced since they have generally changed how they stitch it back together

2) My sister had an emergency CS for her first (laboured at home, face presentation, cervix couldn't fully dilate, baby becoming distressed - she lives in the wilds of Norfolk and had a bumpy 45 minute ambulance ride to get to the hospital). Her second and third were both born at home in a pool, with an independent midwife in attendance - short labours, no drugs (less than 8 hours for the first, 3.5 hours for the second) slight vaginal tearing (more of a nick she said) which was healed within a few weeks - no uterine issues at all. Altogether a better experience. a) She made a point of finding a midwife who had LOTS of experience with VBACs HBACs - experience counts for a lot as they can spot things going awry pretty quickly. b) she did hypnobirthing (not a group course, but a one to one affair with a trained hypnotherapist who could deal with her specific worries about her potential for VBAC HBAC). c) she had enough people telling her that every birth is different, that her body a least knew how to labour (if not deliver vaginally) and that having had one, she could focus on the addition to her family rather than the birth, that ultimately she focussed on what she could do, not what she might not be able to do.

3) I am currently with Christine Neillands (Hypnotherapy) at the moment to deal with some specific aspects of my last birth, before I have to deal with this one, and I have to say, she is excellent. Not cheap, but well well worth it if you can (and you like the idea of hypnotherapy). Most importantly for me, she is tailoring the hypnobirthing principles to my specific way of thinking (I might have to be in Kings this time for the birth)

4) The homebirth website www.homebirth.org.uk is essential reading - read ALL of it, even the bits that don't apply to you as it's really helpful to see the fears and issues other women have who have come from different birthing paths with their firstborn

5) Going to speak to the hospital is essential too (Mr Marsh I'd presume) so that you can make a balanced judgement. I'm booked with the Brierley this time, in the hopes of a homebirth but went to speak to the hospital too for their opinion on where I should be, due to history of tearing (and excessive bleeding from a miscarriage in February). For tearing, by the way, they only insist on a CS next time around if you had incontinence issues - this (thankfully) was one aspect I managed to avoid

6) My best friend had an early CS with her first (early placental bleeding, baby better out than in even though a few weeks prior to 40 wks gestation) and a successful VBAC in hospital (not interested in homebirth) with her second. Interestingly, she felt she bonded quicker with her first baby and her opinion was that vaginal birth was not all it was cracked up to be - so it just goes to show, you won't really know how you feel until you get there

There. A braindump of all I can think of. Hopefully some of it's helpful. DO read the homebirth website, even for just their opinion on VBAC's generally.

Also look at vbac website which I think you can link to from the homebirth website.

Also take a look at american VBAC website- it's american (my mum lives there so I did research on english and american websites) - they have some interesting stuff.

I hope you can feel like you can make the right decision for you - I've learned through this pregnancy to keep asking questions of as many people as possible until I feel I can make the right decision - if you don't feel like you're getting all the options given to you, keep asking - but who's to say I don't end up with a similar experience to last time. But at least I'll know I looked at all the options and felt ready and comfortable with my choices to let nature take it's course, whichever way it wants to take me!

[new mother]

Snowboarder, My sections have involved 48 hours in hospital, and I was fit enough to leave after 24 but they prevailed upon me to stay and continue to enjoy their errr...hospitality.

(ha unintentional pun!)

[Fuschia]

I can second that Christine Neillands is fantastic and a very safe caring place to talk through birth fears and previous bad experiences as well as tailored hypnotherapy to promote positive thinking and relaxation for the next birth...

[snowboarder]

new mother Wrote:

-------------------------------------------------------

> Snowboarder, My sections have involved 48 hours in

> hospital, and I was fit enough to leave after 24

> but they prevailed upon me to stay and continue to

> enjoy their errr...hospitality.

>

> (ha unintentional pun!)

Yeah I would have left after 12hrs if I could but the baby wasn't in fab shape...hence the long stay...

[Ruth_Baldock]

I could have written this post myself, except I'm not currently pregnant (But if your New Bike Theory works...well, watch this space!)

No other words of wisdom, since I am still really conflicted about what to do when I do eventually have my second baby, but you have my sympathy and I really hope you get the birth experience you want! We're all rooting for you (and Baby SB 2!) whatever you decide to do.

[new mother]

am I missing something obvious?

[new mother]

(I was asking about Ruth's "new bike experience" - but the paragrpah got deleted somehow...)

have I broken some rule?

Sorry - I genuinely didn't/don't know!

[snowboarder]

Hehe - nm - saw ruth with her shiny new bike seat yesterday and just mentioned that I have bought 2 bikes in the last 2.5 yrs and each time I have rendered them redundant pretty quickly by getting pregnant....

[new mother]

Ahha!

so that's the secret! fertility units eat your heart out...

[Ruth_Baldock]

Definitely- don't bother with Harley Street (or wherever...) just head to Evans/BC Bikes and bobs your uncle!

[Kes]

hmmm, I'd been thinking about getting a bike but I might not now!

Thanks tho for all of the comments on here and to the OP for starting the thread, I'm not expecting number two yet or planning to be for a while but I seem to have been trying to figure out how on earth to make it better next time ever since I had number 1 (familiar story, long labour, lots of interventions, emergency section, bad after care).

The NCT published the results of a survey into postnatal care last week and it all seemed depressingly familiar, I was in the process of writing a blog post about it before I started reading this thread. Just published it here if anyone wants a look (not just trying to promo the blog btw, don't make any money from it or anything, but thought it fitted in well with this thread).

Best of luck to you snowboarder, I really hope you have a better experience this time.

K

[sillywoman]

Very good Kes, & I couldn't agree more about your blog comments on those (few) PN midwives who are doing the job as a 'job' not as a vocation. Especially postnatally. I just don't get it, why would you opt to look after women at their most vulnerable time in their lives if you have no empathy, or just plain don't care? Nope, just don't get it.

[Kes]

indeed and such a shame, as almost all of the many many staff involved in my daughters birth were excellent, their hard work was really let down by their colleagues. Oh and BTW it was St T's not Kings as we didn't live here at the time.

K

[Belle]

Kes - your story could have been written by me (though think I'd put it less articulately!) - I too was told off for crying after almost a week without sleep! Like you and the original poster, I still bear the scars of that postnatal stay, to the point that when considering if/when to have another baby, I basically end up trying to work out how we could ever afford to go private. not for the birth, which I felt the NHS did a fabulous job with, but the post natal bit. Hmm, will this new unit at King's be for labour or post natal too, does anyone know?

I do take encouragement from what an earlier poster said about it not being so intense with subsequent babies. But it's sad to feel it isn't an uncomplicated decision.

[Vickster]

Ditto Belle and Kes. Everything about my dealings with the NHS first time around were excellent, except for the post-natal care which fell only slightly short of negligent.

Due to a recently diagnosed medical condition I will need to be in hospital for number 2 certainly for delivery and a few days post delivery, and there is a high chance of needing to stay in to be induced as well. I was so desperate to avoid a stint on the post-natal ward this time around that this has been one of the most upsetting things about my diagnosis. Having just spent almost a week in a different Kings ward, I have experienced first hand the care and compassion with which nurses care for their patients. I am so disappointed that the experiences on the post-natal ward are so different when arguably their 'patients' are equally as vulnerable. Like Belle, I am seriously considering taking out a loan to fund private care.

[Countjc]

Has anyone here looked into St. Thomas' Hospital as an alternative? A few friends have had babies there and used the midwifery-led unit for a more 'homebirth' type experience and I think it is possible to pay for an individual room after delivery. I have no idea about costs but it means your partner or a friend can stay over with you and so provide a bit of extra support. I think we still fall into their catchment area out here.

Best of luck to you snowboarder. Am way off considering no. 2 but have similar worries to a lot of the posters on here.

[Mellors]

I was in the midwifery until at St T's for No 1, and, for the brief time I was in there, it was great.

They won't let you in there is you are VBAC or have any other complications/interventions/want an epidural though, so probably not applicable for lots of people on this thread.

It was also ridiculously busy when I was there (they turned me away twice and only finally let me in when I was 9cm dilated and about to give birth in the waiting room!).

[ClareC]

I had my daughter at St Thomas's, started off in the home from home (where if you deliver there you, your baby and partner get to stay together in your room for up to 24 hours post birth). Unfortunately for me I didn't give birth in the home from home bit, ended up with an ECS. That said, the care during the birth was fantastic! The postnatal ward was definitely the worse part and did let them down, although, it was nowhere near as bad as I expected and the food was good! There is private rooms available but they are expensive, @?700 per night I believe!