Consultant Appt - Advice?

[Laura_C]

Hi girls,

I have just had my first appointment with my consultant due to my Emergency CS last time and also I have a gynae/skin condition which can present problems during a normal delivery.

My natural instinct tells me to try for a VBAC and it's not the VBAC itself that concerns me, its my condition Lichen Sclerosus/Sclerosis. If I had just had a previous section and had no other complications I would most certainly be pushing for a VBAC this time. My condition wasn't diagnosed until after I had my daughter, so I can go into this pregnancy/labour prepared.

Lichen Sclerosis is a skin condition which effects my perineum and lady area (TMI ALERT!) it causes the skin to be fragile and it tears and bleeds sometimes on contact, making DTD impossible. For three years me and my OH were not able to DTD and we got married during this time, it was awful.

Once it was finally diagnosed I had an operation to help things down there as the condition was so severe it had causing 'fusing' down below and basically made my opening begin to close so to speak. I had a Fentons procedure which was a success but obviously I still have to manage the condition. There is no cure for this, just use of steriod cream to alleviate symptoms. I have to be checked yearly for any skin changes as there is a 3- 6% risk of cancer/malignancy.

I have just been for my consultant appt and unfortunately it was just the registrar so she didn't really have a clue, except for the fact she was pushing me to try for a VBAC. She has said they can put a note on my plan that I will require an experience doctor to stitch me up afterwards and she said she thinks that should be sufficient, but I have my doubts, as we know things don't always pan out that way!!

I have not gone into everything and tried to keep this as short as possible but I just wanted to get your opinions on whether you would push for an elective section or go for the VBAC in this situation? I am concious they will want to save money, but I don't want to put myself at risk of further complications due to their money saving antics! I selfishly am concerned about my quality of life afterwards also, as I don't think I could go through years of this again.

She has booked me into the VBAC clinc next week to discuss further, so I just want to be prepared with all the facts and go from there. If there are more pros than cons then I think my questions will be answered - just interested in what you girls think??

Ta xxx

 

[AugustMum]

As I dont know much on your situation I dont really feel able to help but I can deffinatly say that its not selfish of you to think about your quality of life after the birth! By the sounds of it, the whole thing was a very tough time for you and wanting to avoid that again is totally understandable.

I really hope you can work out what you would like to do. I have to say though, after having an emergancy section I will be hopinhg for a vbac next time, however, if I was in your situation, Id be tempted by the scetion. xx

 

[Me, My Girls & I]

tbh hun, i think i'd push for a nother section! its not selfish at all to think about quality of life afterwards! i had 3rd degree tears with my two and with the best will in the world, even the most experienced doctor can find it hard stitching up! i've had 'difficulties' after being stitched up and *tmi* it still looks like edward scissorhands has had a go downthere

do you have a consultant specific to your condition? it might be worth pushing to see them cos they know what they're doing! are you at stepping hill? ive found the consultants there to be blood useless!!

 

[flexilexi394]

whats a VBAC? x

 

[Mrs_B]

It is a difficult decision. Can you see how you feel nearer the time and how your condition is before making your decision. I dont think you are being selfish if you choose a section.

flexi VBAC is Vaginal Birth After C-section

 

[Laura_C]

Thanks for your input everyone, really appreciate it.

I am going to VBAC clinic on Tuesday to discuss further, although my condition is relatively unknown except for exp gynae docs and dermatologists. I can talk more about things on Tuesday and then they have said I have until my 37 week appt to make a final decision, as they usually do sections a week before in Stockport. What concerns me is my consultant at another hospital who manages my condition has specified he thinks I should have an elective, he has operated on me etc so knows my condition. I have a routine appt with him in December and he doesn't know I am pregnant again yet, so I will have a good honest chat with him about things.

Alice - yeah it is at Stepping Hill, didn't even get to see the bloody consultant!! Lol!

 

[JJ Mum]

Oh Laura you have had a tough time of it, do you know the moment I read your post, I thought section all the way. You would really risk undoing all that work with your Op to be having a VBAC, I would love a VBAC but can't now, but in your shoes wouldn't have done it either. mines due to previous bladder surgery, and the consultants were really descisive about it right from first baby, and said no to a normaly delivery for me, cause of the damage it would do to prev op. I would be guided by your skin specialist to be honest, you need your body for a long time X

 

[Laura_C]

Well I have VBAC clinic tomorrow and my hubby has managed to get the time off work to come with me this time so I will feel a bit stronger then being on my own. I just go with whatever they say, don't get me wrong I'm not a pushover but I have this overwhelming desire to try for the VBAC, yet in my head I know its not a good idea given my history. Just gonna listen to what they have to say re pros and cons and go from there. I am just not sure if there is much point in going as for me the VBAC is not the issue, I need to speak to someone who understands my condition in relation to childbirth!! Argh!

Been having a look on the internet, doing my research about vaginal vs c section with my condition and most do say elective section should be advised, people have had vaginal deliveries obviously and have ended up worse off or it has aggravated the conditon and they have require further treatment/surgery. I just think I can go through that again. I am living with it everyday anyway, but it is relatively under control. Mine was classed as severe, due to the fact I had to have surgery. The doctor I saw last week feels that as I now have my condition relatively under control I should try for the VBAC. I just don't see the sense in underdoing all that surgery and also the effect on my lifestyle/relationship, need I go on! I don't fancy putting my husband through another 3 years of no sex or myself for that matter, with the strain it causes and how depressed it made me feel. My hubby is the most amazing man, he put up with so much and would always stand by me no matter what and always said if that meant no sex so be it! But the effect it had on me was terrible, feeling like freak, like I can't undertake my womanly duties and obviously at that time TTC would have been totally out of the question. My daughter was a miracle, we literally managed to have sex once in that period of time and I fell pregnant, we were both so shocked!!

My consultant has already said before I was pregnant that if I had anymore children I should be having an elective section and I am inclined to listen to him, he has been my lifesaver! He was the only doctor to diagnose me in over 3 years and even though I have moved out of the area I still travel to see him for my check ups.

I'll keep you all updated x

 

[serenitylove]

i have to be honest in your position id prob go elective as if you have things under control down below you dont want to make things go pear shaped but i understand how hard a choice it is

 

[Laura_C]

Just got back into work following my appointment at the VBAC clinic, all went well, I feel as though I am now being taken seriously at least - although I did totally breakdown into tears!! I was so embarrassed but I just couldn't help it! I saw a lovely Consultant Midwife who was obviously extremely experienced and we went through everything for a straight forward VBAC and I was totally honest with her and said that if I didn't have other complications I would most certainly be pushing for the VBAC. She totally put me at ease about that, but unfortunately that wasn't really what I have concerns about!

I went into my condition and explained that this is what is concerning me and that my consultant has advised an elective section. She listening to everything both me and my hubby had to say and is now going to contact my consultant directly and also try and find a specialist at my current hospital so we can go through it further. I explained my desire to have a VBAC but don't fancy going back to square one with my condition as those 3/4 years were total hell. She agreed that I wasn't being selfish at all in wanting to prevent that and that they will do everything they can to support me.

She has taken my mobile number and said that I shouldnt be left until 37 weeks for a final decision to be made, so she is starting to put together a plan now so we can all make an informed choice. I think basically she wants to look further into the cost implications for vaginal vs section and consider worst case scenarios and if it is cheaper and more straight forward for the section then thats they way I think they will go - me, cynical NO! LOL!! If I have a vaginal there is significant risk of much more surgery for me after baby is born anyway.

At least I feel as though I am being looked after and taken seriously, so feeling much more positive about things!!

 

[Snappykat]

Great news Laura, glad you are feeling better about things now x