How to request a C Section(19 Posts)
I am 34 weeks and I want to request a section. I have done a lot of research and I know this is what I want (won't go into details here). My hospital trust refuse sections unless on medical grounds and my midwife won't speak to me about birthing options until 36 weeks. I have no idea how to make this request and move things forward. I'm willing to switch hospitals/ trusts if I have to but I can't figure out how to start the process. Does anyone have any knowledge of this when there is 'no clinical indication'?
When I mentioned this to my midwife she just told me my hospital wouldn't give me one.
I know this isn't the common experience on here, but mine was agreed at 16 weeks during my first appointment. I don't have a date yet but that's only because DS is not due until December. My notes just say "planned CS - maternal request". (I am ancient though - will be 41 when he arrives - and have complex medical history).
I just told the consultant I was not willing to take the risk of incontinence and tearing from a vaginal delivery and that was it. She asked me a few questions to make sure I had done my homework, but I was all agreed at one appointment.
You need to request an appointment with the consultant who would grant your request. Ask to be referred. Your midwife wouldn't be doing her job right if she won't.
Do I need to wait for my 36 week appointment to ask for referral or should I get in touch somehow now? I feel completely disconnected from the maternity services here and struggle to speak to anyone who isn't just trying to fob me off and move me along.
Could you get the MW on the phone and request the referral? Failing that I think if this was happening to me then I'd get on the phone to my regular GP, explain that you are being refused a referral and see if you can get them to do it? I can't fault our maternity services here but I think that's what I'd do in your situation... I'm sure they're not allowed to refuse anyone a section after these appointments now.
Not sure of your circumstances but there may be a midwife who is in a counselling position and she may be able to help you. I was referred to the consultant who approved my section by the counsellor midwife.
Get the book 'Choosing Caesarian' from Amazon. It tells you where the law stands on this in the UK, so you'll be in a better position to insist that you are given the choice, as per the NICE guidelines.
I had an elective CS after a traumatic emcs with my first child. Despite agreement I was asked at every single appointment whether I'd try a vaginal delivery. In the end I asked them why they kept asking me and it was in case I wanted to change my mind, so prepare yourself in case.
I am becoming increasingly anxious as the weeks go by. My first birth was not traumatic but not what I was expecting either and I feel that having weighed up both options I would far prefer a section this time. I had hoped I would change my own mind but this hasn't happened and now I really want to be booked in for a section and to have it sorted and signed off. I can already tell it is going to be a battle but so far I have just been outrightly dismissed when I've queried and just been told again and again that my hospital doesn't 'do' them.
If you are getting anxious you need to speak to someone, if you are getting nowhere with midwife then try GP. I had a traumatic first birth and didnt deal with my feelings about it properly. After I got pregnant again I was fine at first but once I got to 30 weeks the anxiety was too much to deal with and I asked for help. My consultant was amazing and offered a section straight away.
My midwife never refused to discuss a section as such but she did always try to brush it off. Hopefully once you get to speak to a consultant you will actually be able to discuss it rather than being ignored.
It depends on where you are in the country I think. I have had a previous EMCS but my trust didn't see that as a good enough reason for a ELCS so I was pushed into a VBAC (they don't grant maternal requests) I agreed on the basis I didn't go overdue. I saw a consultant for the first time at 40 weeks and 1 day and had an ELcS 4 days later after the consultant agreed so maybe 36 weeks will be enough time for you- you could call the supervisor of
Midwife for your trust and ask the process
Being honest, you are cutting it fine now at 34 weeks without having previously discussed this with a consultant. You need to take action NOW, and not accept waiting for anything until you have that referral booked.
Please remember that mental health is a health issue and therefore a reason for a CS even though hospital will try not to openly acknowledge that. Mental health can be a 'clinical indication' though how this is defined can differ from hospital to hospital.
Even switching hospitals at this stage could prove difficult as you will have to change everything over and then book an appointment with a consultant which takes time.
You need to get tough and not take no for an answer. If they refuse to discuss the matter, you go over their head and say you are unhappy with how you are being looked after and feel that you are being phobed off and not listened to. You will need to go through the complaints procedure.
Do not take 'this hospital does not do them' as an answer. Its not an acceptable answer, as they are not properly addressing your underlying concerns that are leading to you making this request. This is unacceptable and is a failure of care. They need to do something to relieve those concerns - even if it is to start discussing your birth plan early and give you an alternative plan to help you cope with a VB rather than an ELCS.
This is the angle you need to take rather simply 'I want an ELCS'. They have a duty of care to address your anxiety, whilst you do not not have a right to an ELCS. This may mean that the best way to address your anxiety is to agree to an ELCS, but the point is that failing to act to support you if you are anxious is a breech of your right to the best and most appropriate care for your situation and condition. The difference is subtle but you need to understand the difference and why and how the system works.
The trouble you have here is that having previously had a VB and you yourself say it was not traumatic, you are not really making a case for a CS. Another VB statistically is safer for you and the baby with this in mind - UNLESS there is a mental health reason here. This does mean that they are probably more like you to encourage you to go down the route of a VB with more support / stronger birth plan unless you have a very compelling reason to dispute this.
You need to therefore think carefully about what your grounds are for a CS I feel. Bare in mind that 'traumatic' can mean distressing whilst physically 'textbook'. It is completely in the 'eye of the beholder' in terms of how you and you alone view it. But you need to be able to demonstrate what this actually means, how this is causing you anxiety and to what degree and most importantly have a consultant agree with this assessment.
Realistically, without knowing the ins and outs of your situation and exactly why you want an ELCS you may still struggle to get an ELCS, from what you've said here. Their failure here - and what merits a complaint - is them not listening to you and taking you seriously
It is down to you to be proactive and take control of the situation rather than waiting for someone to listen to you ultimately though.
And yes they CAN refuse a CS. The guidelines are just that. Guidelines.
It does happen, though it is rare. Though its a bit of a lottery and does depend on the policy of the hospital you are at more than anything else.
Thank you for all the advise. I have it in my notes from 16 weeks that I am struggling with anxiety. I will take it into my own hands now and see what I can make happen. My previous birth was upsetting but I am cautious about calling it traumatic as my best friend lost her baby during birth a few months ago- which makes my experience feel very petty to complain about. I had another night of nightmares last night about birth and am shattered today but will find the energy to start sorting this out in whatever way I can. At this rate I will be in a terrible state for labour and I'm incredibly worried about coping for the next few weeks.
My previous birth was upsetting but I am cautious about calling it traumatic as my best friend lost her baby during birth a few months ago- which makes my experience feel very petty to complain about. I had another night of nightmares last night about birth and am shattered today but will find the energy to start sorting this out in whatever way I can.
Stop right there about comparing yourself to other people.
It doesn't matter what has happened to them, however tragic. This is about you and your ability to cope, and what your threshold for that is, which might be lower. There is no shame in this. You are not weak or flawed. You are human. Don't be overly hard on yourself by making that comparison with someone else.
Please read the definition of what birth trauma is on the birth trauma association's website below:
The rule of thumb I suggest about deciding whether your anxiety is at a level where it is of concern and needs to be addressed by health professionals generally is 'Are you having regular nightmare and is it dominating your thoughts during the day?'. If the answer is yes, then you have a clear and legitimate case for medical support and that's what you need to focus your efforts on getting, rather than the ELCS as such. The ELCS is secondary to that need but might be part of that need.
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