Can I INSIST on having a caesarian?? also how are caesarian op dates decided?!

[MissDelighted]

I am 5 weeks pg with DC1 and am due to see the doctor next week. I wondered if it is possible to insist on a caesarian (in a normal NHS hospital) or if it is down to the doctors/midwives/hospital/postcode. I am certain I do not want a natural birth and want to make this clear as early as possible to the medics.

I am so set on a caesarian birth I am prepared to use savings to go private as a last resort, although I don't wish to have to do this.

Also, for anyone who has had a Caesarian - do they perform them bang on your due date or is it down to the baby's development nearer the time, or even beds available on particular days? How is it decided?

I would really appreciate any info/advice prior to seeing the doctor as I want to make sure I am armed with enough information not to be swept away with what she thinks should happen. Thanks in advance

[ButterflyBessie]

[chocbiscuits]

Why do you want a ceaser so badly MissDelighted if you don't mind me asking?

[expatinscotland]

Well, most who have csections have a medical reason for having them the first time round.

So it's either at a certain stage in their pregnancy depending on their medical condition - for example, a breech baby may be delivered at 39 weeks - or an emergency when something has presented in labour that warrants a csection.

You can insist, and they can say no.

[MissDelighted]

That's helpful, butterflybessie

[NigellaTheUndomesticGoddess]

can i ask why?

[expatinscotland]

because they are definitely going to ask you why.

[Piffle]

If you have honest birth phobic or physiological reasons for wanting a c section then midwives and consultants should assist you on that without hassle.
may I ask what is your specific reason for wanting a section? I'm curious genuinely

[ButterflyBessie]

I pride myself in being helpful.

Don't do it - there you go, that is being helpful

Been there, done that and got the scars to prove it

[mrslurkalot]

Hi there, I have had 2 sections first an emergency and the second planned 3 days before my due date.
My understanding is that they try not to do planned sections before 39 weeks as babies can have breathing difficulties before this.
I would imagine whether you can 'demand' one on the NHS will depend on your reasons for wanting one. If you are terrified of labour, I think you would be offered counselling and then it would depend on your consultant to make the decision.
I was very frightened of labour the first time around, to the point where it really ruined my pregnancy but when it happens I can honestly say it's not scary - although I obviously didn't have to do the pushing bit after all! Second time around I was very relieved to have it booked!

[cazboldy]

Do you think you will need one?

I can understand being scared of giving birth - I think everyone is at some point..... but my overwhelming fear with all 5 of my pg was having to have a caesarian!

[cazboldy]

which thankfully I never did!

[MissDelighted]

I know that I am a funny shape inside, and have been referred to gynacologists just to have a simple smear performed because the practice nurses just couldn't do one because of my internal shape. Down below I bend backwards and sideways at the same time. I am convinced that I would have problems giving birth naturally and my worst fear is the baby being suffocated as it has got stuck in the birth canal. I am also fairly narrow. I don't care about myself and am not frightened of the pain of childbirth. Far from it. Nor am I "too posh to push". I am genuinely convinced that a natural birth would be a disaster and just want the baby lifted out safely with no harm to it.

[expatinscotland]

the baby's size and length will generally move the uterus during pregnancy.

i have a retroverted - tilted - uterus and it's moved forward as my pregnancy advances every time.

having narrow hips has NO impact on a woman's ability to give birth vaginally.

you really need to discuss your fears with a midwife and/or consultant, who would go over this with you no matter what if you insisted on a csection.

[finallypregnant]

They are not offered where I live. Only through emergency or some genuine medical reason. I'd hate to demand one and then have all the threatre staff dealing with me when someone comes in REALLY needing it.

I think all you really can do is speak to your midwife/consultant but don't be surprised if they say no just because it is preference. I think private hospitals might be the same but I've never looked into them as we don't have any private locally.

[eekamoose]

I asked for a caesarian and NHS consultant agreed without really arguing against it. However, this was my second c/s.

Mine was done at 39 weeks + 2 days. 39 weeks exactly (I think the preferred gestation atm for electives) for me fell on a Saturday and they delayed until the Monday just because there were more staff on duty.

They won't leave you til 40 weeks if you're having an elective as there is a higher risk you will have gone into labour naturally by then.

[meemar]

You say you are convinced you would have problems giving birth but have you spoken to a doctor about your condition and researched this?

You might be worrying unneccessarily.

[NigellaTheUndomesticGoddess]

i like to think that the NHS will provide you with a team competent to make the assessments necessary so that depending on your physiology they can advise you of the best course of action whether a section or not.
I very much doubt that you could just request a major op because you fancied on - much like most drs wouldn't remove your left kidney because you wanted it out.
if it is safest they would recommend a section. if they think a normal delivery will work then they will tell you that.
i have no idea if you can just request to pay for a private one.

[lisad123]

My first DD was C section but emerency, I wanted a 2nd Csection with DD2 as I had blood clotting problems, heart difficulties, and SPD, my consultant refused. They do know best, and your better to ask your doctor and discuss all your concerns before charging in there with a "I want a CS"!!
If they think there is any risk they will of course do a cs, but if they say its not needed, please trust them.

[tissy]

if you have a narrow pelvis, then an obstetrician should be able to assess that and tell you whether you can deliver or not.

As for your peculiar shape....women come in all shapes and sizes, and that in itself won't preclude delivery- hormones soften all the tissues, and baby's head plus contraction will stretch any soft tissue you can name.

You need to discuss this with an obstetrician, but suggest you don't go in with guns blazing- you'll just get their backs up!

[Piffle]

do ask for help about your condition first.
I have dead narrow hips 30 inches but popped out 3 babies quickly and more easily than most people I've met...
tis not cut and dried.

[2point4kids]

The baby cant suffocate on the way out. They dont breathe until after they are out.Babies get oxygen through the umbilical cord until then.
It would be a good idea to ask your midwife at your booking in appt to go on consultant led care. Then tell your consultant all your fears. S/He will then give you more accurate information and you can decide between you whether the best option will be VB or CS.

[Ellbell]

I agree with tissy. I think that going in and insisting (your italics) is designed to put the consultant's back up. Why not go in with the approach that you are concerned because of the gynaecological issues you've had before and ask for the consultant's advice. You could say that you feel you'd be safer/happier with a section and see what s/he says. I don't know enough about your condition to say whether or not they are likely to agree, but I think you'll be a lot more convincing if you start from the point of view that the consultant is the expert and that you would like her/his advice.

(And, yes, I do not kid myself that all obstetricians are omniscient figures who always have the woman's best interests at heart and never make mistakes or need to be talked around to seeing things your way. However, I do also know that they are a lot better qualified in obstetrics than I am - despite all the time I spend on MN .)

You are only 5 weeks pregnant. You have loads of time to get this sorted, so you don't lose anything by keeping an open mind for now. (In fact, 5 weeks is very early to be seeing an obstetrician. Is it your GP you're seeing. Your GP won't be able to do anything except refer you to an obstetrician, who probably won't want to see you till you're about 20 weeks pregnant or so anyway.)

FWIW, I have had an elective section and a vaginal birth. They were both fantastic. I had my section at 36 weeks for medical reasons (placenta praevia) but they won't do it that early unless they think it could actually be dangerous (life-threatening to you or baby) to wait.

Good luck. I hope things go well for you.

[MissDelighted]

No, I haven't spoken to the doctor yet. I will consider all the facts in advance however I seem to come across an awful lot of emergency caesarian stories recently. I have been told this is worse than a planned one as it there is not much time to do things as well as they could be done if it were planned. I know a lot of people are against caesarians except when it is a total emergency but - if you have spent nine months growing a baby, to have it go wrong at the end is just awful. If the technology is available for a caesarians then I can't see why that technology shouldn't be used.

Finallypregnant - I respect your opinion but don't agree with it. Surely the medical staff would be dealing with me just as much if I was having either a natural birth OR a caesarian. Particularly if it was a natural birth going wrong, or if I had insisted on a homebirth for example which ran into difficulties and led to an emergency situation without all the relevant equipment to hand? I can't live life thinking "what if I am taking something from xyz if I do this/that/the other". I would not consider a caesarian a selfish action as is hinted.

[expatinscotland]

The technology IS used. When it's necessary first time round.

But that's for a consultant to assess.

Because it's a major operation that is not without risk to both mother and child.