Non judgemental advice needed

[Little]

Hi:) I'm new here.

I'm TTC, but I need to clarify certain very important things with a good OB regarding my mode of delivery before I conceive.This is where I need your help.

My family has a history of uterine prolapse post childbirth. Almost Every woman in my family has had some degree of prolapse and has had surgery to fix it.
Fecal incontinence post childbirth also runs in my family.

I have a history of sexual abuse which will make vaginal birth traumatic for me. I've had therapy for it, but I still can't even get a pap without bursting into tears and having flashbacks.
I also suffer from stress induced asthmatic attacks- I'm worried that the trauma and worry of labour will cause an attack which can lead to a c section.

DH and I only want one baby- one pregnancy will be tough enough on me emotionally:(

Given that I am already high risk for prolapse and incontinence, my past abuse and that my asthma may trigger off in labour and lead to a c section anyway, I feel it's better if I opt for a planned c section at 39-40 weeks.

I'm aware of the longer recovery and it's not a problem. My mother and mother in law are both coming to help, so I don't care about the recovery. The longer hospital stay doesn't bother me either. The complications for the next birth don't bother me either because I only want one child. I'm fully informed of the risks, so I hope this won't turn into a debate on VB v/s CS.
I'm convinced I'm better off with a CS.

Your advice on how to find the right doctor will be appreciated.

My GP in UK has already suggested a c section. How do I put this across to an OB here?

[janben]

Do you have health insurance? Is pregnancy covered? I would just tell the OB exactly what you have told us here. I dont think you will have much of a problem from an OB in requesting a cesarean for the reasons you mention. Good luck with it all

[KC's wifey]

Wow, that is a lot of stuff going on. I'm so sorry you have to deal with all that. :hugs:

I am typically not pro-planned c/s unless there is a medical reason for it, but I think you DO have medical reason for it, both physically and psychologically.

I'm not really sure how to go about finding an OB that would be on board with your plans other than to get references from people you know in the area, or start cold calling and asking OBs how they feel about planning a c/s with your situation. If they are not willing, then hang up and move to the next one.

Best of luck to you! I hope you find a fantastic empathetic OB and you have a wonderful birth experience. And welcome to APA!

[Hopeful12]

Wow, that is a lot of stuff going on. I'm so sorry you have to deal with all that. :hugs:

I am typically not pro-planned c/s unless there is a medical reason for it, but I think you DO have medical reason for it, both physically and psychologically.

I'm not really sure how to go about finding an OB that would be on board with your plans other than to get references from people you know in the area, or start cold calling and asking OBs how they feel about planning a c/s with your situation. If they are not willing, then hang up and move to the next one.

Best of luck to you! I hope you find a fantastic empathetic OB and you have a wonderful birth experience. And welcome to APA!

I agree with this!!

[hopeful1]

I have a friend who had none of the issues or history you have and she had her OB do a planned C-section on her first baby. She was just scared of laboring for hours and hours and then ending up with a C-section anyways, so she planned it from the beginning. I'm sure you'll find a sympathetic OB, just tell them your story. I'm so sorry for what you've been through. :hugs:

[haydensmom]

Wow, that is a lot of stuff going on. I'm so sorry you have to deal with all that. :hugs:

I am typically not pro-planned c/s unless there is a medical reason for it, but I think you DO have medical reason for it, both physically and psychologically.

I'm not really sure how to go about finding an OB that would be on board with your plans other than to get references from people you know in the area, or start cold calling and asking OBs how they feel about planning a c/s with your situation. If they are not willing, then hang up and move to the next one.

Best of luck to you! I hope you find a fantastic empathetic OB and you have a wonderful birth experience. And welcome to APA!

I agree with all of this! Huge hugs! :hugs:

[Little]

Thank you so much everyone:) Is it weird that I can actually feel the hugs?

I think my insurance will cover maternity care, but it might not cover an elective surgery. I was told they will pay for a standard birth at the hospital, and have me pay the balance out of pocket.

I'm OK with that- I've got some money saved up.

Thanks for not judging- most people give me such dirty looks when I bring up a c section:(

[LaurenMomof2]

I think if you discuss your condition with your OB they will take your concerns seriously. I don't think you will have a problem with the insurance as I don't think there is a code when claims are processed for "elective c-section". I think if you find a doctor to do the surgery the insurance will be covered just fine. :hugs:

[KC's wifey]

I *think* if your OB deems it medically necessary then insurance should not consider it elective. Don't quote me on that, but I think that's how it works.

Sorry you have gotten dirty looks. :( C-sections are major surgery, so they shouldn't be taken lightly. But its there for a reason, when momma and/or baby need it. It shouldn't be looked down on, just used when its appropriate... which is what I think you are doing. :)

[Babidol]

I also think there are lots of OB's sensitive to your needs. Many OBs will give you a consultation or meet and greet appointment.

BestforBabes is a wonderful resource for women with your history and circumstances. They often cover books and blogs on this very topic.

Lastly, I think if your doctor codes it as medically necessary they will cover it. Doctors know how to work insurance companies. I hope you find a great OB. Welcome to APA!!

[babyjoy414]

I just had a c-section because I suffered a prolapse after my first vaginal birth which was surgically repaired. I had 3 OB's tell me to do that. My mother also suffered a prolapse in her early 60's. I was told I suffered a prolapse because of the size of my baby and also because of "bad genetics" essentially lack of collagen. I think you should have no problem requesting an elective C.

My surgeon for my prolapse, his wife had an elective c-section and there was nothing wrong with her except she knew what could happen.

[Rae_1478]

I have a friend who had her baby (naturally) on 11/10/11 and she was THRILLED he came that day and not a day later because most of the doc's at her hospital were booked on 11/11/11 for electvie C's just so the baby could have a cool birthday date. I don't think so many people would choose to do that if insurance didn't cover it. It sounds like you are very informed on C's recovery and other aspects of it.

I don't think you'll have a problem finding an OB who will do an elective C once they know your history. For you, it sounds like the right way to go.

[BabyLove1]

I'm with everyone else. Do what you feel is best for you and the baby. Cs are pretty safe and really common now so it's not like you're asking for something strange. It seems like you've really thought it thru and know what's best. If the first OB you see won't agree to it, try another! You will be able to find one that is sympathetic to your situation and agrees to the planned C.

[BabyLove1]

BTW if you want to post where you live, even just the state, I'm sure people on here could suggest good Obs in their area. I live in Metro-Detroit Michigan and I have an awesome OB office who I guarantee would take your request seriously. They are very good like that....

[mla]

Wow, that is a lot of stuff going on. I'm so sorry you have to deal with all that. :hugs:

I am typically not pro-planned c/s unless there is a medical reason for it, but I think you DO have medical reason for it, both physically and psychologically.

I'm not really sure how to go about finding an OB that would be on board with your plans other than to get references from people you know in the area, or start cold calling and asking OBs how they feel about planning a c/s with your situation. If they are not willing, then hang up and move to the next one.

Best of luck to you! I hope you find a fantastic empathetic OB and you have a wonderful birth experience. And welcome to APA!

ITA. You *do* have a medical reason for planning a c-section. PTSD alone would be a reason for it, but when you add the instances of uterine prolapse in your family, I think it puts you firmly in the camp of medically necessary.

I think you're just going to need to interview OBs. I think I'd look at more traditional practices that are more medically oriented -- maybe a practice associated with a big hospital in yoru area or something.

I hope you're able to find the care you need.

[Little]

I just had a c-section because I suffered a prolapse after my first vaginal birth which was surgically repaired. I had 3 OB's tell me to do that. My mother also suffered a prolapse in her early 60's. I was told I suffered a prolapse because of the size of my baby and also because of "bad genetics" essentially lack of collagen. I think you should have no problem requesting an elective C.

My surgeon for my prolapse, his wife had an elective c-section and there was nothing wrong with her except she knew what could happen.

I had to tell you- you're so pretty!
And your kids are so cute:)

I'm very sorry to hear you had a prolapse. I've personally seen what it's like to go through it, and it's awful. I hope you've recovered well:)

Women have babies all the time, and we sometimes forget that childbirth can come with so many complications and can sometimes have many long lasting effects on the body.

I'm not surprised that your surgeon's wife had a c section for non-medical reasons. A lot of doctors decide on c sections for themselves or their wives because they are more aware of the complications of a VB than the average lay person.
This isn't to say c sections don't have risks, because they do.

[Little]

I *think* if your OB deems it medically necessary then insurance should not consider it elective. Don't quote me on that, but I think that's how it works.

Sorry you have gotten dirty looks. :( C-sections are major surgery, so they shouldn't be taken lightly. But its there for a reason, when momma and/or baby need it. It shouldn't be looked down on, just used when its appropriate... which is what I think you are doing. :)

Hi! Thanks for your supportive words!:)

I agree completely, c sections aren't a joke. However, sometimes a VB can cause complications such as incontinence, prolapse and obstetric fistulas which are so hard to deal with. Both modes of delivery come with pros and cons. I guess it's just a question of choosing your risks.

[Little]

I also think there are lots of OB's sensitive to your needs. Many OBs will give you a consultation or meet and greet appointment.

BestforBabes is a wonderful resource for women with your history and circumstances. They often cover books and blogs on this very topic.

Lastly, I think if your doctor codes it as medically necessary they will cover it. Doctors know how to work insurance companies. I hope you find a great OB. Welcome to APA!!

Thanks for the warm welcome:hi:

Thanks also for all the tips! I will check out BestofBabes as soon as I get time. We're moving, so things have been a bit crazy lately.

I was unaware of the meet and greet appointment, this is really good news! Because I think it will be best to explain my situation face to face rather than over the phone.

[Little]

I'd just like to say thanks to everyone for their kind words and advice:)

[PreggoinWV]

Oh you poor dear! It sounds like you are dealing with a lot. I'm sure a good OB would understand and honestly it does sound to me like a c-section would be a medically necessary procedure given your own history and your family's medical history.

Good luck to you and baby! :hugs:

[misfit]

I'm totally having deja vu here from the last person from the UK looking for some in the US to do an elective c-section.

It sounds like you know what you need and just tell your OB here in the US everything you told us and I am sure it won't be a problem.

[Little]

Just a quick question- every time I meet a new OB will I have to have a pelvic exam? Is it possible to just discuss my concerns first, decide on a doctor and then begin with the check ups?

[mustangsally]

wow, that is a lot of stuff going on. I'm so sorry you have to deal with all that. :hugs:

I am typically not pro-planned c/s unless there is a medical reason for it, but i think you do have medical reason for it, both physically and psychologically.

I'm not really sure how to go about finding an ob that would be on board with your plans other than to get references from people you know in the area, or start cold calling and asking obs how they feel about planning a c/s with your situation. If they are not willing, then hang up and move to the next one.

Best of luck to you! I hope you find a fantastic empathetic ob and you have a wonderful birth experience. And welcome to apa!


this!

[cheeksy]

From what I hear in the US most of the OBs don't do any pelvic exams till you are in labour or for some serious reasons.

[Little2]

OP here.
I am sorry about the new user name, but I forgot my password.

I am soooo upset and just want to vent. I went to this OB and she was most unsympathetic.
She didn't take my family history of prolapse seriously and said "Maybe you won't end up having it."
She also insisted that c sections don't protect 100% from a prolapse. I agree with that, but it is also a proven fact that women who deliver vaginally are more likely to develop prolapse than women who don't. Secondly, prolapse does require major surgery to correct, so it makes little sense for me to try and avoid a c section on the grounds that it's a major surgery only to end up with a uterine prolapse and corrective surgery anyway.
She said he wanted to discuss the issue of a maternal request c section with an "ethicist" :headbang: before she gave me an answer and even then she said she wasn't convinced.
I feel so pissed off. I'm not one of those floozies who is asking for a c section in the 6th month to avoid stretch marks or because I'm sick of being pregnant.
I want a small family and I am willing to wait until 38-39 weeks or the onset of labour (whichever is earlier). I know about risks like infection and recovery, but I'm OK with them. She acted like she had never heard of a woman requesting a c section- where has she been?!

I feel like it's my body and it should ultimately be my decision to make. I am even willing to pay for it myself if insurance doesn't cover it. This just sucks.

[froggie83]

i am sure that is not the only ob in the area your in.... i would find a different one. and forget about that one. if a dr treated my concerns the way you just described i would tell that dr to go suck a lemon and walk out. you will be paying the ob to help you thru your pregnancy, labor and delivery. so you have the ability to 'fire' them if you don't like them. your their boss. so don't even consider that ob for anything. just toss them out and keep looking.
keep your head up and continue looking. i hope that you find the ob thats right for you and helps you have the birth you desire!

[LabLover]

That's awful; keep looking!! There are many wonderful OBs out there. You haven't said where you're living but if you are near Carbondale IL or Wooster OH I can recommend 2 OBs. And no, you won't get any exams right off the bat! They won't come til much closer to your due date; there's no need. You may have an internal ultrasound but those are fine and you get to see the baby sooner! Welcome to APA! This is the best resource I ever found. Keep us posted!

[mla]

Yeah. Time to look for a different OB. I'm sorry she was so unsupportive.

[tmbg1022]

What an awful talk with an OB you had. That is definitely not what most doctors would/should report. Was she working out of a university hospital? Maybe at the initial appointment you could ask under what circumstances would a first time mother be scheduled for a c-section and then present your background. In my area of the US it seems so easy to schedule a c-section that I think you should certainly be able to do it, as many people have mentioned.

Another idea might be to interview a midwife or two, they always work with OBs and you could get the physically hands-off care for the pregnancy but still be able to deliver via medically necessary c-section. Also, perhaps there are 'mother's boards' local to your area where you could ask about a recommendation.

Good luck! Please keep posting about your progress.