I would but probably only in the following circumstances:

- breech position,or
- baby's size tracks on growth charts as v big (bigger than DS 4250g)
- no sign of cervix softening at about 39 weeks

I had an unplanned C-section for DS when my cervix stopped dilating at 8cm (he had flexed his neck and I had an epidural so couldn't easily help him to shift position).
With this pregnancy I've developed gestational diabetes. So I'm in the position of trying for VBAC (no chemical induction, no augmentation, possibly continuous monitoring), with the extra bonus of GD complications.

If it looks like the baby is going to be enormous despite my best efforts to control blood glucose, then my first choice would be induction at around 39 weeks. For a VBAC chemical induction isn't recommended, so I'll need to be sure that things like Foley catheter and ARM are actually likely to work - so I'll want some sign that things are getting close before we start. If there's no sign of softening cervix etc then I think there's not point in even starting an induction and will go for ELCS instead.

It's a difficult choice to make - everyone talks about big babies and diabetes, but from what I've read, ultrasound scans aren't that accurate for predicting birthweight - they can be up to 500g out each way, which means if you were predicted an 8lb baby you could just as well get a 7lb or 9lb baby! my DS was big and I didn't have GD, so there's a genetic element too (DH is tall, long legs) so I'll be looking carefully at the proportions rather than just weight prediction. Big abdomen would be a pointer that the diabetes had impacted on the baby's growth abnormally, if everything is in proportion I might be more prepared to go ahead and believe that my body has grown a baby that it will be able to birth.

Having had a c-section before, I'm not scared of the procedure and have some ideas about how I'd like it to go in terms of seeing the baby's sex, skin to skin asap, even the music I'd prefer ot have playing - all these things should be possible to request.

Right, got to get DS into bed. Mammoth post sorry!

The only other thing that a T1 will need to be aware of is they often argue, irrespective of the babies size, that the placenta deteriorates alot faster so the age of the placenta at 38 weeks is more 40 weeks and its why the majority of T1's are induced. If the placenta is working fine then they will let them continue. If it is not they will induce. Placental deterioration will show as lower blood sugars and lower insulin resistance which for T1 climbs through out the third trimester.

So I still dont like my chances since I dont want to be induced

Hey Owly,

HUGE congrats!

DD1 was elective c/s, 40 weeks by my dates...it was all pretty textbook, I developed pre-e when she was born... I'd been expressing and keeping colostrum from 36 weeks...and that was given to DD when she was born. Continued to express and BF when she was born, and my milk came in on day 2-3 I think...

DS was a semi-emergency c/s, failed induction, pre-e, HUGE baby on board...little did we know how big...his head was HUGE...lol! He was born at 37 weeks, and came out feeding like a pro...he spent the night on cpap, being 37 weeks and c/s before he was ready...in the morning he was happy as larry and feeding like a champ!

DD2 my waters broke, and I went into labour, and considering having lost a baby, we were pretty keen to get her out, and with issues on the day too with her...she was an emergency c/s, oh and with DS, DD1 and DD2...milk all came in by day 3...and I have managed to successfully exclusively BF all 3 of them...something I'm quite proud I was lucky to achieve...I know it's not easy for some, and especially since we had quite a few road blocks...type 1, pre-e, c/s, lots of pain(with DD2), and all 3 of my babies ended up in the NICU...

All I can say...is PUSH for what YOU want...I did, each time, the c/s has been a very powerful occasion...I went in 110% with DD1 and DS NOT to end up in c/s, but at the end of the day...I just wanted a healthy baby! With DD2 I really didnt actually care I just wanted her OUT safe and sound...

Feel free to ask me any questions you may have!

And yes you totally can have an independent MW, I've had 3 and both the first two have quit being a MW and my 3rd one is just about to do the same thing I had shared care with an OB and the diabetes team too.

Ooo Ill pm you!

There are, but you have to know where to look.
I would be asking some serious questions. Why, why why? Where is the evidence? Can you back that up? Can I get a second opinion?

I don't have a medical condition personally (beyond carrying two babies in my uterus0. But I do know a little of navigating the system. I am carrying twins and have just come through an interview with fetal medicine regarding a fairly major limb reduction defect in one of our twins. I am planning to homebirth, at this point. I am open to changing my decision with compelling evidence, but at this point I see no reason to treat this birth as any different, other than needing more support and a little more awareness.

I put this to the obstetrician, and she was very respectful. No scare tactics. She did however stick by her professional opinion. I will be meeting with another (birth friendly) obstetrician for a second opinion and further discussion.

My midwife has been accompanying me to the appointments and will continue to do so. She is happy and very much willing to support us to follow what ever path we decide is best. She is assisting us with finding more information, more opinions and more support. I feel that I am absolutely recieving the best care.

I've had two c sections, one an emergency after failure to progress and fetal distress and the other we planned due to the previous birth and issues. The planned c section was carried out at 37 weeks. I probably could have tried a VBAC with DS2 but I didn't want to risk it.

However, I would definitely recommend you birthed in a hospital owlymonster - due to your higher risk diabetes etc. The closer you are to medical assistance and people who know your medical history is best for baby. IMO of course.

And lastly, congratulations on your pregnancy. Exciting stuff!!!

Congratulations on your pregnancy!

Like the others said, it is a highly personal choice and it is great that you are really looking at the options. You have the added complication of a medical condition and at the end of the day only you can decide what is best/safest for both of you.

I had 1 straight forward natural birth followed by 2 c-sections, there was no experience in my natural labour that would have made me chose a c-section but unfortunately for my pelvis I grow pretty big babies


The things I would suggest considering are:

1. If you do have a c-sec then do plan to have it as late as possible. I had one at 41w and one at 39.5 and both babies where strong, robust and had no issues feeding. You really want those sucking reflexes and digestive systems as mature as possible.


2. Chose your LMC well. If you want to try a natural birth then make sure your LMC is really experienced in your condition and supportive about how you want to give birth. One thing I have found is that specialists 'seem' to be more (struggling for the right word here so will chuck a few out there) cautious/medicalised ? so you will need to find one that is open to any ideas that you have.

3. Recovery - I recovered so much quicker after my natural birth, I think the worst thing about my C-Sec was being stuck in the bed whereas with my natural birth I was walking around in hours. Having said that, it was only a couple of days in hospital so not that long in the scheme of things and I was back running around within a week.


One other thing was that after my reasonably straight forward natural birth I found my c-section to be a real anti-climax :), It was an extremely boring, clinical and sedate experience (It is not a critisim of anyone's choice, just detailing my feeling based on my birth experiences)

Good luck, I am sure you decide on what is best for you both, a healthy mum and baby is all that matters in the end.

congrats

I have not had a c section, but I did have a very long and traumatic labour which ended in emergency spinal block and forceps delivery.
Orginally my waters broke(slow leak) and strong close contractions started immediately. (i never experienced a mild contraction) I did 20 hours of the labour at home as I had a water homebirth planned, then I insisted on hospital as I was in pain, worn out and only 3cm after 20 hours.
Then my contractions stopped and startedin hospital - i was on my back in bed with monitors and that was awful - i felt so ripped off that I couldn't go in the pool, and then I got induced and then pushed for 2.5 hours with no progress, baby was distressed, then finally got a spinal block which was HEAVEN and baby got forceped out. (41 hours after my waters broke) She had shoulder dystopia which means for whatever reason she got stuck at the shoulders in my pelvis, maybe her head wasn't the right way, or maybe my pelvis was too compact for her.

anyway, before that experience, I would have been anti c-sections, I was oh so natural, that labour would be so fantastic and beautiful, and for some women I believe that CAN and Is true, but unfortunately for me, that was not my experience and I was seriously traumatised from it,
so to any woman at all, for medical reasons or NO medical reasons, if you want to have a c section, that is fully your choice, and I would never judge you on that.
do whatever is right for you and your baby.

The biggest thing I have learned from labour is that it's not necessarily going to go how you think/planned, so don't get a stuck idea in your head of how it is going to go, because it ain't necessarily so.

If I had chosen to have another child (which I didn't) I would seriously consider and probably opt for a c-section, not because it's an easy option, but because I just couldn't go through a similar experience than I have already had again.

Nah, as a type one diabetic they will induce at 38 weeks. My midwife has already warned me of this


Again, I dont have much choice. I could have gone with a private obstetrician, but i would have run the risk of them not knowing how to handle my diabetes. Ive chosen to go with the high risk team at National womans I guess because I have a medical condition, it will be medicalised, nomatter what I want..

Hmm, one thing I had considered but only barely. We have a plan in place if I do go with a C section for the six weeks after the birth.

Still, I have been thinking about being induced and what that would entail. I guess another thing we need to think about is the effect on Izzy. If we go with the c section we know when it will take place so we can plan for what to do with him. If we go with the induction there's no telling how long it will take. We've already been told by one set of grandparents that they wont be able to take care of him unless it is the weekend and Im not sure how I would feel labouring on my own in hospital because my partner needs to be at home with izzy

A C section seems to make more and more sense in my mind

I've been under High Risk / Maternal Fetal Medicine at National Womens and think they're fantastic for what that's worth

In terms of recovery - I'm not really sure one is easier than the other TBH, more that the recovery is just different, although not driving post CS is a bit of a drag... I had an episiotomy with my 'natural' and WOW that gave me grief for several weeks post-birth at least the CS scar was easier to manage, well for me anyway.

Woops! Bit behind here

I had 2 ECS and I really enjoyed them both. I thought the first one was a breeze but the second one was a walk in the park. I'm not high rish "as such" but I would have had a medicalised birth like yourself, being gestational diabetic. It just happened that I have breech babies and no one in New Plymouth birth's breech babies.

I found nursing staff to be lovely and attentive Aftercare was great and having time to myself (looking forward to this part in August) was awesome. I think if you really want to be proactive about your aftercare then you have to know how you want to be treated. I refuse to have anyone push me out of bed nor down talk to me like I'm an idiot and I'm happy to ask for a change of nurse if I'm not happy. It's not a reflection on them, it's what I want, how I want to be cared for.

Looking forward to hearing how you go!

I had an ECS after a failed induction at National womans and everything about my birth experience was awesome. Happy to talk more about it if it will help

YAY! More info! Im going to have a chat to the obstetrician on monday,so I may have more questions after that..

Cool, happy to talk about anything. While I would have loved that natural birh I think we realised around 36 weeks (MW and I) that it wasn't looking good. Even so, she really did try everything for me to go natural, while not letting things go wrong. I think havig in my head: birthplan - would love a natural but whatever keeps me and baby safe is the best way - helped me get my head around it. They all commented on my happy jokey nature in theatre, and I think that it all helped me have a fabulous birth experience.

I think im quite content to have an ECS but want to see how things go. So if i get to 30 weeks and things are looking good,then im happy if my MW is happy to keep things going. Then same at 35 weeks,37 etc. The longest they said they'll let me go without issues is 39 weeks So, if i can keep healthy, bubs stays small, the placenta continues to work as it should and we have care for i set up then Im aiming for a natural birth. But if this doesnt happen then IM ok with an ECS too

And that is the best you an do, both for your mental health and for bubs! There will always be the 'wonderful' comments people make implying (or outright stating) that because you had a c section, you haven't 'birthed' your babies, but I htink if you are prepared for that (I wasn't the first time, it did come as a shock because as I have said, my birth experience was cool!) then it has less impact.

Hi Ancient,

I have just read through your thread and I am so pleased that you have decided to go for an ECS! People can be so opinionated when it comes to the birth of your baby and frankly it's none of their business! (I'm not talking about the comments on here just peoples' off the cuff comments).

I had an emergency CS (on Christmas Day!) with my DS at 32 weeks. The whole procedure took 8 minutes from start to finish and the staff at Auckland Womens were AMAZING! He was born at only 1.5kgs so spent lots of time in NICU.

We both contracted the MRSA superbug when we were in hospital (through my CS scar)so were put in isolation on the ward.

Still, DESPITE all the problems, infections, prem baby early CS etc I would not hesitate to have another CS next time and in fact in July this year (if I can get that far!), I intend to do just that!

If I had not had a CS then my 2 year old DS would not be here today. My ob says I am likely to have another early baby this time and therefore CS is likely. I am pleased she said that because it's what I want anyway.

I did not have any worries about the procedure or the recovery. All I wanted was for my baby to survive and thanks to the CS, he did...(and don't I know it now he's 2!).

In terms of recovery, I am a firm beleiver in alternative methods and I took Arnica to help the healing process. I was out of bed and walking down to NICU the following morning after the birth and my scar healed so well the doctors thought it was an old scar!

I think you sound like a strong person who knows what she wants and good for you that's what I say!

Congrats on your pregnancy and keep us up to date with what you do.

Haha...sorry I am not presuming you are 'ancient' om!

I did wonder if you were talking to me.. Yep, the name's om and im definitely not all that ancient. Well, i dont think 28 is ancient!

So, you say arnica helped you: IN what form did you use the arnica?

And I will keep you posted. Thank you for your support!!! And good luck with the coming few months with your little one

Now I am sure that I did some reading on arnica prior and it was suggested (by both medical and naturopath peeps) that you don't take it prior to birth or surgery in case of bleeding, but that it is great post birth for healing, so just make sure that you check out all natural meds for possible contra indications with all the stuff that you get filled with during surgery.