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Childbirth

Share experiences and get support around labour, birth and recovery.

How to record birth phobia on the ELCS booking system?

9 replies

PixieCake · 23/09/2010 13:04

Hi all,

I am having an ELCS because I have had some psychosexual problems in the past. It has been a bit of a long road getting it agreed, but it is finally all signed off and booked in.

At my appointment today, after I had seen the consultant, I was shown into a room where a woman sat at a computer booking it in. I don't think she was medically qualified. She asked me what my reason was for having the CS - she needed to enter it on the system. I didn't want to go through it all with her (it was upsetting enough having just gone through the whole process with the consultant) so I told her it was for personal reasons.

She then put 'social reasons' on the booking system, but told me that I would be the first to be moved to another day if it got too full as other reasons (eg high blood pressure) get priority.

After I left I wished I had come up with something better to put on the form, but I thought I would burst into tears if I had to tell that woman all my personal stuff.

It will take a lot for me to psyche myself up for the operation etc, and I really feel that my situation should not be belittled as 'social', which to someone trying to sort out the bookings might sound like 'too posh to push', so I would be first to get struck off the list.

So I'm thinking of phoning up to ask them to change what it says in the system. Do you think I can do this? Who do you think I should ask for on the phone? What do you think I should ask them to put?

Thanks in advance

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Ephiny · 23/09/2010 14:45

Don't know the answer, sorry, but I do agree 'social' sounds wrong - it's not as though you're having a CS just for convenience, to fit with your busy schedule or something. Can you say it's for psychological/mental health reasons, without going into more detail than that? Not sure how this would affect how you're prioritised, presumably you'd still be 'bumped' if there was a real life-or-death emergency, but it might mean you're taken more seriously.

If you don't mind me asking, did you find the consultant was very reluctant to consider to CS for those reasons? Just asking because I will probably end up wanting to discuss CS for similar-sounding reasons (once I actually manage to get pg, which I'm not yet) and wondering if I'll have a fight on my hands or if I'll have to go private to find a sympathetic consultant.

PixieCake · 23/09/2010 15:09

Thanks Ephiny,

I would totally understand being bumped if there was a life or death situation or someone with a greater clinical need than me, and of course I would want them to be seen to first, I just wouldn't want to be bumped because the list was looking a bit busy or someone else was making a fuss about their dates etc (for social reasons maybe!!!).

I think I will try to get it changed just so it is more clear.

My consultant was very understanding to my problems. I didn't have to go private in the end (although I was prepared to if necessary) but I did do a hell of a lot of research first about how to go about requesting it, and who from. I feel that I know quite a lot about this area now so feel free to message me when the time comes for you and I will do my best to help. There are some v helpful threads here on MN too.

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barkfox · 23/09/2010 16:48

Hi pixiecake - I had ELCS for primary tokophobia (same as you) - it was recorded as 'Maternal Request'.

I wasn't happy with that really, but never challenged it, as I was just relieved to be taken seriously, and to be having a CS. You might well get MWs asking why the CS was at your request when they see your notes - it is a good idea to have a brief 'formal' reply worked out, so you don't get into either painful emotional conversations you don't want to have - or be judged as 'TPTP.'

I don't know if they have a specific 'code' for birth phobia. I assume if there was one that said 'For Mental Health Reasons', that's how mine would have been recorded. There is another thread on here for women who are requesting CS's after previous traumatic births, most of which would count as for psychological reasons - I'm not sure how there CS's are recorded, it might be worth asking them.

The whole question of priority is straightforward, though - if a baby is in immediate danger, or a mother is in severe distress, you will be 'bumped' down the list as you and and your baby are not in immediate physical danger. CS's are done on the basis of clinical need - if there was a patient booked in for a CS due to breech presentation, say, they would be bumped in the same way for an emergency. Someone with high blood pressure would (rightly) be given priority over someone like us, as they could die if their condition suddenly got worse.

It happened to me - I waited virtually the whole day from 8am to 6 something for my CS, as theatre was busy with other cases. Frustrating, but nothing you can do about it, and once you think there are some babies (and mums) in very high risk situations in there, it's easier to wait.

barkfox · 23/09/2010 16:59

PS ephiny this thread www.mumsnet.com/Talk/childbirth/954334-Anyone-asked-for-ELCS-for-first-baby might be useful for you.

Ephiny · 23/09/2010 17:44

thanks both, I'll have a look at that thread and may have more questions for you PixieCake nearer the time.

Good luck with getting this sorted and with your ELCS!

PixieCake · 23/09/2010 17:58

Thanks Barkfox, I was hoping you might be lurking here somewhere as you were so helpful when I was trying to get my CS agreed in the first place.

Totally fine with more urgent cases being seen ahead of mine - So do you think that I should leave the booking system saying what it does?

Also, what did you have ready as your 'formal' answer when asked your reason for CS? I haven't even discussed it with my midwife (not that I have ever seen the same one twice).

My main concern is going into labour before the scheduled date, and having to deal with
a) labour starting
b) making sure I get my CS
c) having to explain why I need a CS to the duty team.

Do you have any words of wisdom?

I think you had your CS quite recently didn't you? How did it go and how are you recovering? Hope your little baby is gorgeous and has made it all worthwhile x

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barkfox · 24/09/2010 19:23

Hi Pixiecake -

My reply might be a bit hasty - I did indeed have my CS recently, and so I now have a lively demanding beautiful 10 week old DS to look after!

In no particular order - I actually had a very supportive MW, and consultant - the consultant rang up to book in my CS herself, and so I didn't have to offer an account of why it was necessary. I had seen a perinatal psychiatrist in order to be recommended to the consultant for a CS, so I may have gone down a slightly different route to you.

I had a closed letter on my notes from the psychiatrist, which gave a brief history of my problems (previous abuse/depression/birth phobia), so that if any HCP really needed or wanted to know more about the background to my CS, I could simply refer them to that letter, and not go through difficult conversations again.

(Closed letter just means it couldn't be read by anyone 'browsing', but was part of my records if needed. I thought that was a very sensitive way of dealing with it all).

However, I did have to deal several times with 'why are you having a CS?/what's the reason for your CS?' from MWs and nurses. To be fair, I think they were asking in case there was a physical medical problem (high blood pressure/diabetes etc), which they needed to be aware of.

When asked, I said that the consultant had recommended it on mental health grounds, and that this was a decision I was happy with. Only one person pushed for more details, as far as I remember - and I said it was due to previous trauma, and there was a letter on my file if they needed more details (they didn't open it). So that was my 'formal' answer. I imagine if pushed again, I would have said the decision had been made and signed off, and I didn't want to have unnecessary and distressing discussions about it.

I also had it recorded in my notes that if I went into labour before my CS date, I was to be given a CS - no 'trial of labour' or change of plan.

As it happens, my waters broke ten days early! so I did have my CS earlier than planned (DS was full term, just short of 39 full weeks). I never went into labour, thank god - just had premature waters breaking. I rang the hospital, told them, went in so they could monitor baby's heartbeat, which was fine, and then went back in the next day for my CS.

My MW had warned me that if I thought I was going into labour before the planned date, to get on the phone and go in asap. Not to wait and see if it really was labour, or let a MW on the phone put me off, tell me to have a hot bath, wait and see etc.

This is because if (and it would be unusual) I did go into labour early and it progressed very quickly, there was a very small chance that I would be too advanced for a CS to be carried out. This was a very very slim chance, btw - I found the idea terrifying, and I'm sure you do to.

I'm no expert, and I'm sure they do things differently everywhere - but it might be an idea to make an appt to talk to your consultant, or your MW, about your concerns (fear about what happens if you go into labour before CS date, anxiety about having to argue for it or explain your background).

It may be that they can add notes to your file such that you can refer MWs and HCPs to it, without needing to start a whole new and difficult conversation each time. I certainly found being able to refer people to my notes VERY helpful.

Have to go now, but I can try and answer more questions if you have them - in a nutshell, my CS was a great experience, and my recovery was/is very fast and pretty easy. My DS was born with an Apgar score of 9, we established breastfeeding very quickly and very well, and he is exclusively breastfed and healthy and quite porky! at 10 weeks.

Btw, if it helps, there are some excellent detailed and honest descriptions of elective C-sections here on the thread for women asking for CS's following traumatic births.

Best of luck, let me know if there's anything else you want to know and I'll do my best.

Chynah · 24/09/2010 22:35

Pixiecake,I had a ELCS for maternal request. On the day (39+1 weeks) there were a lot of emergencies and so I was bumped down the list and eventually had DS in the afternoon (arrived originally at 7.30am) I was starving!! I'm sure they willget round to you but do have to deal with medical emergencies arising on the day first (and by saying that I mean absolutely no disrespect to the ordeals you have been through).

I never had to give a reason when booking other than I would just say I had issues regarding VB and it was alwaysb accepted.

Barkfoxes post speaks alot of sense.

PixieCake · 27/09/2010 10:04

Thanks both. What would I do without you?!
Maybe I will have a word with the MW and try to get some more detail in my notes about not letting labour progress.

Barkfox, so pleased it all went well for you and huge congrats on the birth of your son x

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