Expert: Catherine Beier MS CBE - 7/30/2009

Question
Dear Catherine
I'm 39 weeks pregnant on Sunday and was prepared for a normal birth. However at a consultation yesterday i mentioned to my Dr about the ongoing pubic pain I have experienced from about 33 weeks and wether he thought this would cause me any problems during delivery considering my history.  Five Years ago i was involved in an RTA and sustained fractures in the left superior and inferior pubic ramus and L1, L2, T12.   I obviously advised him of the above during our initial consultations (and have reminded him since) but he is now claiming that he had no knowledge of my history and he wont allow a normal birth due to the risk of a difficult delivery or further damage to my pelvis.

Apart from some discomfort in the pubic region (which i suspect is a mild case of SPD)I am fit and well and have had a good pregnancy. I am totally devastated that he is refusing to consider a normal delivery and time is running out for me to find a new Dr etc for a second opinion (I live in a small Mediterranean Island).

Any advice you can offer would be much appreciated.

Answer
Louise,

I know that time is tight, but I very much encourage you to find a different doctor/get a second opinion as soon as possible.


Basically, he's telling you that during the 9 months you've been his patient, he's been negligent in obtaining your relevant medical history and in listening to your concerns at your previous appointments, which is a huge red flag for me that he's not someone I'd want delivering my baby, by c-section or otherwise.


I agree that it sounds like you have mild SPD, as it's been over 5 years since your injury, which is definitely enough time for full healing to occur.  You should be given the option of a vaginal birth as long as you are informed of the risks/benefits of a vaginal birth vs. c-section, as this is your body and your baby.


If you cannot find someone else in this time frame, then I highly suggest you call the office and tell them in no uncertain terms how you're feeling - that he didn't adequately listen to you during your pregnancy and that you've been blindsided by this ultimatum.


You can then request detailed information on why a c-section is your only option and hasn't been mentioned to this point.  If you truly had pelvic indications that prohibited a vaginal birth, then they should have been apparent throughout your pregnancy.  If you hadn't mentioned your history again, and this time he actually listened to you, then you wouldn't be in this position, which does not speak highly of his level of care or professionalism.



I wish you the best in your situation,
Catherine