Elective caesarean Holles street?

FURBALL18

My wife and myself are expecting a baby boy in August. We had the big scan in Holles street and everything was fine. My wife who is italian then went home and had a scan there as well. Everything was good except they noticed a thing called Velamentous Cord Insertion(VCI). As she explained it to me the cord is attached to the side of the placenta and not below, this can then rupture causing lack of blood/oxygen to the baby. Scary stuff. In Italy they were definitive in saying she would need a caesarean that the risk with a natural birth was too high.
On monday we had a visit with one of holles street's satellite clinic but the consultant wasn't present( somebody in his place). All we heard was how proud Holles street was of the number of natural birth's they have. This is making us very anxious altough they did arrange to have another scan. My wife contacted a midwife in holles street who altough helpful explained it was not normal for them to carry out a caesarean for VCI. Reading on the internet has only made us more anxious. What can we do, my wife is in a complete panic. Can they make her have a natural birth even though she is so worried about it. Who should we talk to?

January

Speak to the consultant and only the consultant, explain your concerns. They may be able to reassure you.

She Devil

Can your wife get a letter from her Italian consultant to suggest this is what should be done?! If these are medical concerns I would be very insistent with the consultant, the last thing you need is to be worried now! Also is it a case that this may move in the coming weeks and a natural birth will be ok?!

crazy cat lady

Must've been a very detailled scan in Italy! VCI usually isn't picked up until after delivery of the placenta here. To the best of my knowledge I can't remember anyone having a C-Section here for VCI, I also can't ever remember anyone that I have ever cared for having any complications because of VCI.

The best thing you can do is speak to your consultant about your concerns.

Yes Holles St may be proud of their percentage of natural births, but they would never put the lives of a mother or baby at risk to try and maintain a high percentage, so don't even be worrying about that.

I'm sure that by expressing your concerns with your consultant you will be able to decide on a birth plan that suits you

SanFran07

H.Street is definitely proud of it's low caesarean rate / vaginal birth rate which is quite different from it's rate of natural births seeing as routine intervention is policy. Natural is usually defined as a spontaneous onset of labour and no intervention....

If you do have a vaginal birth in H.Street it's worth knowing about the routine procedure of breaking the waters. In your circumstance if the waters are broken artificially with an amnihook there is an increased risk of complications if there are blood vessels close to the cervix.

Also cord traction in the 3rd stage might need to be reconsidered in your case....definitely lots to talk to your caregiver about.

Hannibal Smith

FURBALL18 wrote: »

My wife and myself are expecting a baby boy in August. We had the big scan in Holles street and everything was fine. My wife who is italian then went home and had a scan there as well. Everything was good except they noticed a thing called Velamentous Cord Insertion(VCI). As she explained it to me the cord is attached to the side of the placenta and not below, this can then rupture causing lack of blood/oxygen to the baby. Scary stuff. In Italy they were definitive in saying she would need a caesarean that the risk with a natural birth was too high.
On monday we had a visit with one of holles street's satellite clinic but the consultant wasn't present( somebody in his place). All we heard was how proud Holles street was of the number of natural birth's they have. This is making us very anxious altough they did arrange to have another scan. My wife contacted a midwife in holles street who altough helpful explained it was not normal for them to carry out a caesarean for VCI. Reading on the internet has only made us more anxious. What can we do, my wife is in a complete panic. Can they make her have a natural birth even though she is so worried about it. Who should we talk to?

I would ask to speak to the consultant again. The natural birth is the knee jerk automatic response you get, without them actually listening to what your concern is. Particularly if you're first time parents. I'm sure if you mention professional advice you got in another country and if their insurance covers them ignoring it should (god forbid) things work out as they predicted, they might be a little more receptive?

margaretmahey

How did you get on? I am currently attending Holles St, and there has been no discussion of mode of delivery. I have not met a consultant, and am concerned because I personally believe cs to be the safer method for both myself and baby. I don't want to be forced to have a potentially dangerous delivery.

any advice appreciated

Lola92

margaretmahey wrote: »

How did you get on? I am currently attending Holles St, and there has been no discussion of mode of delivery. I have not met a consultant, and am concerned because I personally believe cs to be the safer method for both myself and baby. I don't want to be forced to have a potentially dangerous delivery.

any advice appreciated

How far gone are you? I had my daughter in Holles Street almost a year and a half ago now and there was no talk of delivery until I brought up my birth plan at an ante-natal visit around 32 weeks. The reason that delivery is not discussed I can only presume is because everyone gives birth vaginally with the exception of any complications which may require a c-section, breech baby, pre-eclampsia etc. Have you any underlying condition that makes you believe a natural vaginal delivery would be unsafe for you or baby?

margaretmahey

Lola92 wrote: »

margaretmahey wrote: »

How did you get on? I am currently attending Holles St, and there has been no discussion of mode of delivery. I have not met a consultant, and am concerned because I personally believe cs to be the safer method for both myself and baby. I don't want to be forced to have a potentially dangerous delivery.

any advice appreciated

How far gone are you? I had my daughter in Holles Street almost a year and a half ago now and there was no talk of delivery until I brought up my birth plan at an ante-natal visit around 32 weeks. The reason that delivery is not discussed I can only presume is because everyone gives birth vaginally with the exception of any complications which may require a c-section, breech baby, pre-eclampsia etc. Have you any underlying condition that makes you believe a natural vaginal delivery would be unsafe for you or baby?

it should be a women's decision how her body is treated and with approx a quarter of births ending up as emergency cesareans, is it ok with you if I prefer to avoid the stress that would put on my baby and myself in the interim?
Your answer is not helpful!

Squiggler

margaretmahy, you need to discuss your birth options with your hospital/consultant.

Most hospitals in Ireland do not support elective caesarean without a supporting medical issue or a history of previous complications, but it may be possible for you to convince an understanding consultant (if you can find one) to acquiese to your wish.

I don't think "because I want to" will be a sufficient reason so you will need to make sure that you have done your research, have studied both sides of the argument and can quote recognised medical studies that back up your arguement.

By the way here did you get that statistic from (re emergency ceasarean rates), I'm not familiar with it?

Lola92

margaretmahey wrote: »

it should be a women's decision how her body is treated and with approx a quarter of births ending up as emergency cesareans, is it ok with you if I prefer to avoid the stress that would put on my baby and myself in the interim?
Your answer is not helpful!

It is no concern of mine how you deliver your baby but for what it's worth a C-section is major abdominal surgery in itself and therefore comes with its own set of risks to be considered.

You asked about the fact that the 'mode of delivery' had not yet been discussed with you in Holles St. I simply gave my experience of that same hospital and that I opened the discussion on labour when bringing my birth plan up! I also suggested that at the time I attended, the policy in Holles Street was that caesarean sections were only done in the case of medical necessity.

From discussions that I have had with other women and mothers who attended, you would need to be private with a willing consultant (I presume you are public, as I was, if you havn't seen yours yet) or have had previous c-sections to get an elective one in the NMH.

January

As someone who had an emergency section on my first there was some debate on whether to go elective on number two. Seems the doctors didnt really want to though, pushed for vaginal unless i really wanted the elective. I had vaginal delivery and would recommend it over section any day.

hungrypig

it is of interest to all child bearing women regarding c-section rates in our maternity hospitals. sections require far more resources, care and time in hospital and as our maternity hospitals are already so overcrowded , unnecassary sections would be a huge drain on the system. there is no way a woman should be given one unless there is a medical need. i have delivered twice vaginally in holles street and pg on #3. i currently have 2 slipped discs which cannot be treated until after the birth and have not been able to move from the bed for almost three weeks. i spoke to my consultant over the phone regarding delivery and even now he won't commit to a section and wants to wait and see. i trust his judgement and if i need one i will get one. there are plenty of emergency sections but very often the difficulties that arise just cant be predicted before labour.
furball you have very genuine concerns and make sure you insist on discussing this in full with a consultant. margret, unless you have any sort of medical difficulties, you are being completely irrational

Grawns

hungrypig wrote: »

it is of interest to all child bearing women regarding c-section rates in our maternity hospitals. sections require far more resources, care and time in hospital and as our maternity hospitals are already so overcrowded , unnecassary sections would be a huge drain on the system. there is no way a woman should be given one unless there is a medical need.

margret, unless you have any sort of medical difficulties, you are being completely irrational

This irks me in so many ways. It's unhelpful at best and offensive when you consider that someone is frightened and asking for help. Luckily the fate of other womens births ( or how hospitals organise their resources and respect womens autonomy) doesn't rest in the hands of the over opinionated on this board. :mad:

hungrypig

seriously grawns, offensive that someone expresses an opinion that sections should not be offered unless there is a medical need and it is not the safest form of delivery. yes the fate of womens births is not in the hands of all of us who share our opinion on this thread , it is in the hands of doctors. funny enough they will not give a section unless there is a medical need. i'm really not sure what you had to add to the discussion

Grawns

I was offended by you calling the poster irrational. What do i have to add to the discussion? well As somebody who requested and got a section with no medical need - A whole lot.

What you have to add is reactionary, one sided, biased and anti women. Give me a doctor any day.

hungrypig

anti woman, now thats just embarrassing grawns. vaginal births are safer for both mother and baby unless there are medical comlications. to request one without any medical grounds at all is irrational, get over yourself.

Grawns

Charming open minded and helpful

hungrypig

grawns, i'm not sure if you read my op but i have actually requested a section after 2 vaginal deliveries so i am obviously not anti section. sorry if you feel it is unhelpful for me to express an opinion that sections should not be given unless they are needed for safety reasons. my opinion is based on medical research .

Grawns

I appreciate your moderated tone and yes I did read your post. You did not say you had explored an elective section with your consultant.

If I were you I would be angry that the risk to your long term health are not being taken seriously by your consultant. I would do a lot more research on what the potential long term damage outcome would be if you were to proceed with an attempted vaginal birth with your current serious back
Issues. Me- personally - I would not trust your consultant to put your well being above the need to save costs or meet some ideal quota on sections. If you want a vaginal birth - good for you and i hope you get the birth you want. Me - I never did and happily I had a wonderful elective section. Live and let
Live is my motto. I try to be supportive of all manners of birth as I don't have a specific agenda just a happy birth story and a strong belief in women's rights.

hungrypig

moderated tone............i feel like i'm back in school.

grawns, what risks to my long term health are you referring to ? are you a dr. i consulted with the nuerosurgeon i attended for my initial back injury. he is one of the best in the country, he said that a vaginal delivery poses no extra risk to my back condition but would be a lot more painful at the time.
i then consulted with my ob/gyn, a previous longstanding master of the national maternity hospital with exceptional experience and he would not commit to a section but has not ruled it out. for him as a professional, he understands that sections generally pose extra risks to both mother and child and therefore only performs them when there is a medical need.
you say you would not trust my consultant. i absolutely trust him, i carefully selected him and he has safely delivered my 2 sons, the last one 11lb and back to back.
my preference is for a safe delivery wether it be by section or vaginally,a good outcome is the most important thing to me.
every health organisation in the world recognises that unnecassary sections pose an extra risk to both mother and child and the world health organisation are very concerned about the increase in elective sections.
my opinions are very much based on medical facts i absolutely stand by my opinion that sections should only be given when there is a medical need.
it is totally beyond me why someone would opt for the added risk of surgery and the disadvantages to a new baby unless they absolutely had to.

Ms.M

I don't think "irrational" was meant to be an offensive term. It is completely understandable why some women are petrified of having a vaginal birth. Hungrypig was just saying these fears are irrational because there are more dangers associated with a section delivery. It could be easily seen as reassuring rather than offensive.
It might be more "rational" to be afraid of a section as it would be more risky for the baby. However, if a woman is so terrified that the fear itself (whatever the degree of rational thinking involved) could risk the success of a vaginal delivery, I can see why a section could be a less risky option.

I just don't like to see people fighting

hungrypig

ms m- there is a genuine psychological condition called tokophobia , if therapy is not successful for these women then i would fully support a section but this condition is very rare