Elective caesareans

[martha7731]

Hi all - I'm new to this board, and I know this topic has been covered elsewhere but I have a few specific questions that I'd really appreciate if anyone can help with.
I'm only just pregnant (4 weeks) and very happy about it, although I have suffered for the last five years or so from extreme anxiety, and have always known that I would be psychologically unable to cope with labour and that if I got pregnant an elective caesarean would be my only option - despite its attendant risks and disadvantages, of which I am very aware.

I'm seeing my GP for the first time next week, and I'm hoping that I will be able to have the baby on the NHS and find a midwife/consultant who is sympathetic given my psychological history. However, I also want to look into private options, as I'm not willing to wait until week 36 to find out for sure that I will be allowed to have a caesarean. So my questions are:

1. Is there any way at all a midwife/consultant on the NHS would commit at such an early stage to an elective caesarean? I would be happy to go for counselling as long as I had a 100% guarantee that if it failed to address my fears, they would perform the caesarean.
   
   
2. If I want to book privately, how soon do I need to do this for the various London private hospitals?
   
   
3. Is it possible to book privately 'just in case' and then not use this place if I later find that I don't need it?
   
   
4. If I go private, would I need to have all my antenatal care privately too or is it possible to have antenatal care on the NHS and just the caesarean privately?
   
   I'd really appreciate any help anyone can give me on the best way to proceed

[Lulumama]

I don;t know about private care, but if your anxiety and your psychological issues are so great, i would imagine you would be able to elect for c.s on teh NHS. Have you had any other counselling before? is it the birth it self, the pain , being out of control .. or soemthing else that worries you? there are lots of ways to address the anxiety, and keep the safety net of a c.s too...there are some mumsnetters who have had their babies privately, i'm sure they will be along soon with some helpful info

[martha7731]

Thanks for your message. Pain and lack of control are part of it, but if it was just me, and just the pain, I would consider risking it. It's the fact that I know (from previous experience, my level of tolerance for pain etc.) that even if I got through the labour fine physically, I would be left in a psychological state where I was unable to cope with anything for quite some time, never mind looking after a child.

As you say, all I feel I need at the moment is a 100% 'safety net' of knowing I could have a cs if I don't change my mind on this, which is why I'm after more info about private options etc.

[Lulumama]

if your GP has prior knowledge of your anxiety issues , he might well be able to advise re your options , or your midwife

[dal21]

Hi martha - re. the private options, you do need to look into availability sooner rather than later. i booked in after my 12 week scan - and half the costs were payable immediately. the remainder of the fees were payable to the hospital and consultant at 34 weeks and post delivery respectively. refund were not an option.
although as lulu says - i am sure that with your history, your gp should be able to advise you.

where are you located? what are your hospital options?

Congrats on your pregnancy.

[martha7731]

Thanks for your reply. I'm in North London (Muswell Hill, N10) and not seen GP yet so not totally sure of hospital options but from friends' experience would guess some combination of UCH/Royal Free/Whittington.

Can I ask where you had your baby, and whether you were happy with?

[dal21]

hi martha - i am n. london too. avoided portland/ john and lizzies as wanted to go private at an nhs hospital (i have had friends who did not have positive experiences going private on non NHS - but am sure there are also many people who deliver at both with no probs). ended up at qc and cannot speak highly enough of my experience there. everyone was exceptional with my care.

do you have anxiety issues around the delivery only or the actual pregnancy aswell? If you are fairly chilled about the pregnancy - then defo investigate your NHS options. But if you want and need reassurance throughout this whole process then I do recommend private - I had continuity of care and was always able to get hold of someone to speak to (my consultant even called me once on a sunday to make sure I was on my way into hospital for a trace as he had advised me to come in for)

hope that helps, feel free to ask me any any more q's.

[martha7731]

I wouldn't say I'm 'chilled' about the pregnancy exactly, but at the moment the delivery is the main thing worrying me - though that may yet change!

Can I ask what the cost came to for you in total?

[Lulumama]

martha, have a look at this babymoon antenatal classes near to you.... they are run by a most wonderful doula and childbirth educator ( who is a mumsnetter! ) and i think that simply having some classes, and some ante natal prep will be of such value to you.. you will feel prepared, less stressed and able to make the right decision for you. even if the right decision for you is an el c.s, then you will be going into it in a positive frame of mind... would be greatly beneficial to you to feel more positive about the pregnancy, you have 8 months to get through before delivery, so you should try to enjoy it as much as you can.

[ScottishMummy]

martha - congratulations on your pregnancy. N10 mums can go to whittington and Royal free

try to get support and counselling for your identified anxiety issues, raise now at antenatal clinic that you are anxious

C Section is major abdominal surgery - not undertaken lightly. i recommend you read about C section, their after care and post-surgical management. make an informed choice.

a consultant recommendation is requires to proceed, this can include reason of anxiety that will adversely affect your mood, pg as it proceeds

obviously your consultant will need to assess you, gather a history and account of your presentation before deciding

anyway - best of luck what ever decision you chose. hope you have a great blooming pregnancy

[dal21]

martha - dont really want to put the amount on here. But the costs are substanitally more for cs over vb due to theatre fees/ anaethesist fees and increased length of stay required - min three nights.
Call private patient care at QC and they will give you a ballpark for costs / availability on the phone.
Have you considered methods like hypnobirthing to help control your anxiety? I did a hypnobirthing course and it completely changed my mindset. Unfortunately medical complications ruled out a VB at 34 weeks; but the course basically changed my mindset from one of apprehension to really positive and excited.

[eleusis]

Martha, you can probably get a section without going private. You have to be quite determined and stand your ground. You might have to change GPs or refuse to book into your local hospital to get what you want.

I would look birthchoiceuk.com (or something like that) and seek out a hospital with a high caesarean rate.

You can also look on drfoster.com (or something like that).

I had an elective caesarean at Queen Charlotte and would highly recommend them if you can get in there.

[ClaphamLauren]

Hi Martha

I am in a similar situation with some serious fear, anxiety and lack of control issues as well as some physical problems to boot and like you, I just know that I need to have CS option and I needed to know early on it would be possible! I am 21 weeks and saw the consultant at my hospital - Kings College - last week and they confirmed that on the basis of everything they would give me an elective cs.

I thought I'd have a real battle on my hands but I explained my reasons and they looked at the physical and emotional - I cried a bit too - then told me it was 100% my choice and they couldn't force me into a natural birth. I was so relieved! However, I do want to get over my issues and there is a risk of going into labour before the CS as it's done at 39 weeks. I have opted to see a 'birth counsellor' to see if we can change my attitude and alleviate fears.

Knowing at the back of my mind the CS is booked, my choice and they can't force me to try naturally has alleviated a hell of a lot of the things I was worrying about. I've done loads of research and I am confident that this is the right choice for me whilst it may not be for everyone and the peace of mind is amazing.

Good luck! Also, if your consultant won't do a CS they are obligated to refer you to someone else who would.

[BagLady75]

You need to book quite early at some of the London private hospitals - for instance Lindo Wing you would want to be sorted by 10 weeks, I believe same at John & Lizzies. Portland I think you can book a bit later. Good luck!

[snowleopard]

Congratulations Martha! I can't answer all your questions, but like some others on this thread I had some serious anxieties about labour when pregnant. I don't think they were even as bad as yours, but I did cry and explain my issues at length and I was offered an elective CS on the NHS without even asking for it, soon after my booking appt at 13 weeks. I decided to aim for a vaginal birth, but I was reassured that I could change my mind at any point - eg on arriving at hospital I could say "I can't do this, I want a CS" and I would get it.

In the event my labour was very slow, painful and non-progressing and I did have a CS after 24 hours of it.

This is in Scotland, so it could be slightly different, but generally I think the NHS staff are very sympathetic to this kind of anxiety.

[Pazza]

Hello

I'm expecting twins, I'm now 9+5 - EDD May 22nd.

The EPAU nurse and midwife have both told me CS is safer for twins, especially as it's my first time. I.e. the risks of the surgery are outweighed by the reduced risks of second twin getting into trouble.

I am quite happy to go with elective CS if that is indeed safer, in fact I probably prefer it if I have to be in hospital anyway. Was hoping for home birth until twins popped up as I live right near the Homerton, but not sure I would have had the nerve anyway!

I live in Hackney E5. Homerton apparently have a good SCBU but they don't have a private wing - does anyone have experience of post-natal care after CS and/or with twins, either there or other London hospitals? If I need to stay in a few days cos of CS would I be in a big ward, would the munchkins stay with me etc etc. I kinda like the idea of my own room and my own bathroom, although it could be more fun to be with other new mums.

SIL went private at Guy's/St Thomas and had a fab time but it did cost a fortune. Also, I like the fact of being just 15 mins from home at Homerton.

Any advice would be really really welcome.

Pazza xxx

[Lulumama]

Pazza.. if you start a thread in multiple births, the lovely twin mums can advise you, and marslady, a doula and mum of twins has lots of experience of london hospitals.. so you might well get more answers.. if both twins are in a good , head down position, then you can certainly go for a vaginal birth, you cannot be made to have a c,s. by all means do lots of reading and research yourself, and make a decision you are happy with. congratulations and good luck x

[loopyredangel]

I have not read through all the messages, but having had a csection with DS1 and about to have another 2 weeks today, I must say a cs is by no means the easier option. I had alot of pain, and recovery takes longer, read as much information as you can.

[MarsLady]

Pazza.... email me again and I'll send you some info. (mars)

[bunnyhunny]

Hi Martha

I was in EXACTLY your position over a year ago wrt elective cs. I was terrified of birth - I am tiny and thought a baby wqould never fit out easily! , mum / gran had bad tears, scared of interventions / lack of contol / privacy etc etc. I had extreme anxiety and depression about it. In fcat, I think that these fears were what stopped me having children earlier in my 12 year marriage .

my mw and doc were really supportive and recommended me for c/s, but consultant after initally granting me one, decided to refuse me one later in my pregnancy. I was horrified!!!!!

Anyway, I went to NCT classes, hypnotherapy, did LOADS of research, and eventually opted for a homebirth (more control, less intervention etc). I felt truly empowered when I went into labour, and was not anxious or anything, despite all of fears for the past 9 months.

When it came to it though, I didn't progress in labour, and I ended with an emergency cs anyway!

Good luck. I hope you have more success than me, but I am just saying that you can get past any anxiety by really educating yourself. NCT classes were the answer for me. I would NEVER have thought I would be able to enter labour with a sane head on my shoulders, but I really did.