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I want a C-Section - how do I broad this with my midwife?

(29 Posts)
onecrazycook Tue 20-Sep-16 21:20:52

I have my booking appointment tomorrow and I am adamant Prince Charming, that I want to have a c-section so that I can have my tubes tied at the same time.

Has ngoni got any experience of this and was it a battle with your midwife? How do I insist on this?

OP’s posts: |
SpookyPotato Tue 20-Sep-16 23:11:44

Several midwives have told me that anyone is actually able to have a c-section, even if not had one before or no medical reason. Consultants can refuse but they have to pass you onto another one who will do it. Your midwife might try and steer you towards a natural birth but just keep insisting if they do.

onecrazycook Tue 20-Sep-16 23:20:18

So is it best to tell her tomorrow at the first appointment?

OP’s posts: |
SpookyPotato Wed 21-Sep-16 08:00:13

Yes say it from the beginning. I told mine at my booking in appointment so it could go on my notes.

Frazzled2207 Wed 21-Sep-16 08:05:50

Different reasons but I wanted a c-section, told the midwife and was referred to a consultant. Consultant wad very nice about it, didn't exactly talk me out of it but helped me realise that a 2nd vg would probably be ok (and she was right). If I'd stood my ground she would have agreed, despite there being no physical reason why I needed one.

However if you want to be sterilised I think you may struggle to get approval if you're under 30.

Frazzled2207 Wed 21-Sep-16 08:06:35

A 2nd vb (vaginal birth) not vg dammit

neonrainbow Wed 21-Sep-16 08:09:01

I want a section for my twin pregnancy. I don't want to give birth vaginally because of all the risks involved. I don't want forceps or ventouse or an emergency section. But every appointment so far i have brought it up so far they just say "vaginal is better" and even wrote it on my notes aim for vaginal. So good luck getting what you want because even though aparently i have the right to choose, nobody has actually listened to me so far.

DartmoorDoughnut Wed 21-Sep-16 08:11:40

I had an emcs first time around so at booking in appt said I'd like an ELCS, was referred straight away and it was booked in at the 20 week scan. They discussed the potential issues but said the potential issues for VB too so no dramas here. Good luck!

SpookyPotato Wed 21-Sep-16 08:21:01

neon rainbow Be pushier. You shouldn't have to be but some midwives don't want to hear it. Just keep repeating it and they have to refer you to a consultant who will agree it.

onecrazycook Wed 21-Sep-16 10:22:13

I'm 39 and overweight. Apart from wanting my tubes tied I have a problem with my hip and I also feel like it would be a safer option for baby

OP’s posts: |
DartmoorDoughnut Wed 21-Sep-16 11:14:07

From what I've heard Rainbow if they sense hesitation/uncertainty they will push for "normal" delivery. So def just call them up say you've been honking about and discussing it and you are certain you want a ELCS so can they refer you.

Cordypants27 Wed 21-Sep-16 12:15:55

I had an elective section 12 days ago, I have hypermobility and my joints became really bad during pregnancy so I decided I wanted a section as it would be safer for my in the long term physically to be able to look after my child, but boy did I have to push for it but if you stick to your guns then they cannot refuse you. I had to meet with several different care givers who all pushed for 'vaginal birth' but not one of them could answer my concerns regarding long term disability if something went badly with my hips/pelvis during delivery.
If you have a good enough reason (for you) and you show you have done your research then they will give into your wishes eventually. I found that the consultant was the most reasonable about it, the midwives etc pushed very hard for vaginal but that is their job.
Stick to your guns if that's what you want because at the end of the day it is your body and your baby.
My baby turned out to be breeches anyway which we had been given no indication of prior so it's a good job we had the section booked in.
Go with your instincts but please do your research because it is still surgery x

neonrainbow Wed 21-Sep-16 18:55:25

Thanks pps. I've already been referred to a consultant and i havent seen him yet, just another doctor in his clinic. (Only 17 weeks ) Next time my midwife said ask for him specifically to talk about my options. Nothing I've seen suggests a vb is better for me personally and ive been getting quite anxious about it all. If i was having a single I'd be much more willing to give vb a try. The worst case scenario for me is vaginal delivery for the first and the second baby then needing emcs. Ill be more pushy next time i see the consultant!

onecrazycook Wed 21-Sep-16 19:55:39

As expected, the midwife thinks my consultant might refuse me. WE WILL SEE ABOUT THAT!!

OP’s posts: |
quicklydecides Wed 21-Sep-16 20:03:38

I'm all for elective sections, having had one myself.
But if your main reason is in order to have your tubes tied then that isn't a good reason.
Having your tubes tied is a minor key hole procedure.
There's no need for it to be open you up surgery like with a section.
All those extra risks, a huge scar and a much longer recovery....
Have the baby vaginally, recover quickly, then decide when to have tubes tied as a day case with a very very quick recovery.
Sections are not less risky for baby unless there is a particular reason that makes labour/ birth especially risky.

HyacinthFuckit Fri 23-Sep-16 18:01:02

I could be wrong, but you might find more difficulty getting your tubes tied during the procedure than getting an ELCS per se. It is possible to get a purely elective section on the NHS, not always, but it happens. I was under the impression, though, that best practice is to do the tube tying later. Something to do with swelling. I have a relative who had it done during a section about 25 years ago, but thought that was no longer the done thing.

Quicklydecides I think the problem is you don't get to decide whether you get the sort of VB that allows you to recover quickly! I agree the tube tying during an ELCS may not be the optimum choice here, but OP says she is 39 and overweight so a simple VB cannot be presumed.

SpookyPotato Fri 23-Sep-16 18:06:16

onecrazycook Then that consultant has to refer you to one who will do it. Maybe not the tube tying as that could be done simpler but the section.

RedToothBrush Wed 28-Sep-16 10:59:18

You are extremely unlikely to get an ELCS and your tubes tied at the same time. I would be amazed if you do.

The general recommendations on sterilisation is to not perform it within twelve months of having a baby (unless of course there is a pressing medical reason to do so).

In part I believe this is to do with mental health and how pregnancy and hormones can have an effect but I also believe there may be physical reasons why this is not necessary recommended.

As I understand it, sterilisation when giving birth, really is pretty unheard of in this country nowadays.

If your primary or sole reason for the CS is the tube tying is the sterilisation, you are highly unlikely to get one.

If you want an ELCS for other reasons, then you might get one. However you CAN NOT insist on one. You have no 'right' to an ELCS no matter what anyone says or how much you quote NICE guidelines. You only have the 'right' for the most appropriate care for you circumstances.

I think you will struggle to make that case unless you focus on something in particular and form a strong counter argument to a VB.

Being overweight is not going to help you. Statistically, if you are obese you are more likely to end up with a CS (you just say you are overweight so I don't know whether you heavily overweight or just mildly overweight so I don't know how you fit in with this). However this is a result of being a higher risk in the first place and in these circumstances the risk of complication is much higher than in someone who is a normal weight. This is why doctors will try and avoid a CS in someone who is obese even though they are more likely to get one.

Having a hip problem, may not help you either. It would depend on what the source of your hip problem is - particularly if it is pregnancy related. Many consultants will try and avoid a CS in women with pregnancy related hip problems because surgery could hinder recovery and mobility further. Others will say that the risk of damage during a VB makes a CS better option. As I say, it will depend on what exactly is your problem and what the cause of it is.

I do not want to be the bringer of bad news - I am very pro-choice on the subject (having had one myself), but do recognise the need for women to be properly informed and for it to be done for the right reasons rather than on flawed or incorrect belief in order for both mother and baby to get the best care for their circumstances. You also need to be very aware of the hurdles you might face, and how you can tackle them as part of this process of making a decision with your consultant. The subject is highly politicised and very dependent on individual hospital policies. You need to be realistic in how you approach it. Simply 'demanding' a CS will usually get you nowhere as you do not demonstrate that you fully understand the implications. You have to demonstrate you are properly informed and understand the risks.

From your posts here, I would say you have a fair way to go before you get to that point. Do your homework, show you have really considered the alternatives and be reasonable in your approach and you'll have a much better chance of achieving what you want, though I do say that I really do think you need to adjust your expectations for sterilisation at the same time. I will be gobsmacked if you manage to get that as well and it could well undermine your argument for an ELCS.

Drmum123 Fri 30-Sep-16 20:45:17

I am booked for sterilisation at section. It has a higher failure rate, if they use clips because everything is swollen so when the swelling goes down the clips can fall off. However, my consultant is going to cut my tubes instead and so says failure rate should be reduced. So they definitely do still sterilise at section..... But I have no choice but to have a c section, so don't know how they would feel about doing a c section in order to perform a sterilisation, think would need other reasons. I suspect they would argue that vaginal birth and then later laparascopic sterilisation would be a better option?

TurquoiseDress Sun 02-Oct-16 19:34:24

I managed to get an ELCS for maternal request.

Quite simply, I wanted a CS rather than vaginal birth (having weighed up all the associated risks linked to both methods)

I tried discussing it with all the various midwives I encountered at my appointments (never the same one, but that seems to be entirely normal for London).

In the end, I just went to see a (sympathetic) GP at my practice, told him why I wished to have a CS and he referred me immediately to one of the consultants at the hospital where I was booked in and the rest is history.

So, if you are not getting any progress just go and discuss with your GP.

I will add that I was 35 weeks pregnant at the time so time was most certainly ticking away.

Cannot comment on the bit about being sterilised at the same time, however, I would agree with previous posters re possibly undermining your request for ELCS if it is to facilitate sterilisation at the same time.

Good luck

ButtMuncher Sun 02-Oct-16 19:40:01

I was allowed a requested ELCS two days before having it - I was 38 weeks, and had numerous reduced movement issues, an induction that wasn't working and horrendous panic attacks. On technicality, there was no reason (other than the thread of reduced movement) as to why they performed the ELCS, but it was a quick request, and a quick approval - I'm not sure whether my failure to progress much with induction was behind it, or whether mental health issues made up most of the grounds for agreeing to it, but it wasn't very difficult to request.

I was beyond scared that I wouldn't deliver my DS safely, due to the rising level of panic I felt and the fact I'd not slept in 5 days. I suspect this made up the majority of why they did it, tbh, so I'm not sure how they will see the tube tying in terms of reasoning. Either way, there is no harm in asking.

SpookyPotato Tue 04-Oct-16 12:42:26

Red I think it depends on your area. All the midwives here (west yorks) have said anyone can choose their method of delivery and anyone can have a c-section. They say consultants might say no but then they have to refer you to someone who will. Guess it's luck of the area!

CatchingBabies Tue 04-Oct-16 19:26:59

I think you need to do some research. If your 39 and overweight then actually the risks of Caesarian section far outweigh those of a vaginal birth for both you and baby.

Look at the rates of resuscitation and respiratory distress syndrome for babies born by elective section, you will be really shocked. Labour is what primes the baby ready to breathe.

Don't get me wrong Caesarian sections have a place and are vital to some women, just make sure you are informed and know what you are choosing.

HyacinthFuckit Wed 05-Oct-16 08:32:12

Yes, do do some research. Ideally consisting of a bit more than reading broad generalisations from someone who's never met you and whose very username indicates perhaps a bias towards a particular type of birth...

Tomkat79 Mon 10-Oct-16 16:36:13

You don't even need a keyhole procedure to be sterilised. We do the Essure procedure whilst you are awake and it takes about 15 minutes.
I had a section 2 years ago and am praying for a vbac in the next 10 days as it was awful. Don't be too hasty to make a decision.

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