I wanted to write this post not to talk about a C-section vs natural birth (I’m none the wiser); it is really just to highlight the importance of having the facts and evidence on the risks vs benefits and make informed decisions. It shouldn’t matter where you live, but it has really brought home to us how invaluable good professional care is – whether that be in BA or London.
|Breech baby presentations|
Much to our disappointment, what my husband and I have found is that our concerns have been dismissed as foolish or simply ignored, with no willingness to enter a discussion. You’re simply meant to stay stump and do as you’re told without questioning the professionals. Perhaps I’m reading too much Ben Goldacre, but access to clear, objective information seems a real issue here.
Turn baby turn
This all started when I found out that the baby was breech, at about week 32 or so. Most babies turn by week 36, but mine hadn’t. That was ok as there was still time, I thought. So much so that my husband and I paid little attention to our first antenatal class, which was about having a caesarean, ironically. Except the part where it said you can’t talk for 10 hours after the operation, due to an accumulation of gases apparently (looking for a reference but can't find one).
Almost 39 weeks later, the baby is still breech position. We saw my obstetrician at week 37 he informed us that we would go to hospital the following week, on 29 December at 9am and he would perform a C-section at 3pm that day.
If I had been in the UK my doctor would most likely have offered a procedure called external cephalic version, where a medical professional tries to turn the baby to a head-down position. I asked my obstetrician about this but he pretty much ignored me, probably because he doesn’t know how to do it. It’s ok, we have the resources that we have and I have to work with that. Or I could have tried a range of exercises to try and turn the baby naturally, but at some point I just had to accept what was meant to be.
I know women may have to have C-sections at a moment’s notice. However, our obstetrician didn’t really explain why he wanted to do the operation at 38+2 weeks, other than vaguely saying it could become problematic if I went into labour. He didn’t tell what to bring, what to expect and basically said I’d be out two days later, when the norm seems to be three to four days.
The next day I couldn’t help thinking that it all seemed too rush. I couldn’t get my head around the idea that our baby could be born at the end of 2016 when her due date was around 13 Jan 2017. At every subsequent scan my due date changed from 6 Jan to the latest of 18 Jan.
Seeing as we had not really been given a medical explanation as to why the operation would take place at 38+2 weeks and not later, I decided to consult my handy friend the internet. Some studies have recommended that planned C-sections should take place around 39 weeks to give more time for the baby’s lungs to develop as any earlier could cause respiratory problems. However, this view is now being disputed, with other research stating that the risks between 38 and 39 weeks is minor. In a state of panic I rang my obstetrician to ask if it would be possible to put back the operation by a week.
Unfortunately, he took that to mean that I wanted to cancel the current date. That was not necessarily the case, we just wanted to discuss the risks vs benefits of having a caesarean at 38 weeks vs 39 weeks. Instead, he cancelled my appointment and told me he would book it in for the following week. End of story. He had not told us the new date nor the time, nor the fact that he only operated on Thursdays. When I called him back he was irate, saying that he would do it at 39+2 days and it was at our risk. The risks that he was not willing to discuss with us…
32 weeks the same as 38 weeks?!
Essentially our obstetrician had told us that we had put our child at risk as I could go into labour early. In Argentina, and in many places around the world, many clinicians and midwives are not trained in delivering breech births so they are becoming deskilled in this form of delivery. I certainly don’t want to go into labour while the baby is breech, but nor do I want our baby to suffer a higher risk of breathing difficulties.
Upset and unsure what to do next, we went to see our GP. She helpfully said everything was fine. It made no difference whether you have a caesarean at 38 weeks or 39 weeks, or for that fact at 37, 35 or even 32 weeks! I’ll hand it to her in terms of optimism but clearly having a caesarean at 32 weeks is very different to having one at 38 weeks. I’m no medical professional but even I know that. I don’t want to hear that it’s going to be ok. I’m pretty sure it will be; I want someone to be honest and tell us the risks vs benefits. This just something that is not forthcoming here, so is it any wonder that we go on to the NHS website..?
We saw the obstetrician again last week and while he still refused to engage with us in any meaningful way, at least we had maintained a professional relationship with him. Luckily I won’t have to talk to him for at least 10 hours after the operation.