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Elective Csection

(34 Posts)
FrostyPopThePenguinLord Mon 09-Jan-17 18:11:12

Hi all,
Fairly new to this posting business but have been lurking for a while so please excuse me if I make any horrendous whoopsies or offend anyone, I can assure you it's not intentional.
Fiancé and I are in the process of trying to get me knocked up, so I thought it was high time I asked others about their experiences.
In the bluntest possible terms I do not want to give birth naturally, it's not a case of 'too posh to push' (good grief I hate that expression), but equally I would not say I'm deeply anxious about childbirth as a process or have huge fears over it to feel that I need psychological help.
However my decision to procreate has largely depended on wether I would be allowed an elective section or not, I've even emailed the maternity department at my local hospital to ask their stance on maternal requests.
My conclusion has been reached by what I hope is my (as far as possible) rational evaluation of the pros and cons of each method of delivery and my overall feelings.
Without going into the nitty gritty of stats and source material etc, which I have looked at fairly extensively, my overwhelming feeling is that I would much rather be cut open under controlled circumstances with highly trained medical professionals in the actual room they could save my life in if it all went tits up, whilst already being numb below the waist!
I know it doesn't always progress smoothly like that and there is always the possibility of complications, but so does vaginal birth and if asked to choose between the two sets of circumstances where I might be in danger I would much rather be already in there and ready to go.
The complications I've heard of with vaginal birth fill me with horror and quite frankly make me want to join a convent.
I've been quite careful to look at a balance of positive and negative experiences on both sides, but I have read things and heard things (I'm at that ages where all my friends are having babies) that sound pretty shit if I'm honest.
Episiotomy...my mum said she didn't even notice them cutting her with me.....I never want to be in so much pain that I can't feel my whatsit being cut with no local....nope not going to happen...
same goes for tearing...id rather a million people gave me shit for being 'too posh to push' than facing even the possibility that I could rip from stem to stern....that sounds like a nightmare.
Forceps...no...just no.
And after all that effort like 1 in 4 women to be told I might need a section anyway....sod that.
Why would I want to push my body and my baby to the point where they have to potentially operate so fast I can't even be conscious because we are in so much danger, I'd rather already be in there.
My mum tells me there is no need to be quite so aggressive about what I want and I'll only get people's backs up. I genuinely don't want to be pushy and awful about it but from what I've read over several years now it seems to be a massive battle from start to finish to get what I deem to be a perfectly valid choice which I have reasoned through in a balanced and adult manner, not a last minute panic.
The majority I've read seem to either think you need to be phobic in some way, have had awful previous experiences or medical reasons.
Medical science has come such a way that I think that c section should be as valid a choice as a water birth or home birth (sorry guys you lost me there, you want to be miles away from the big clean building with the people who save lives and the medicine that makes it not hurt??).
I can't understand why there has to seemingly be something wrong with me in order to justify a choice I want to make about my medical care.
Also all the judgement is completely insane, I have nothing but respect for people who can give birth totally naturally with no pain relief etc....One of my best friends did with both her babies and they were huge and she had a wonderful experience, another friend had 52 hours of labour and forceps as well as more stitches than she wanted to think about, my mother gives birth as easily as a dairy cow and loves being pregnant.... I think you are totally nuts and incredibly brave, those things are not mutually exclusive!! But I would never look down on them or belittle them for their choice in childbirth just because they don't fit my worldview.
I would love to hear from people who had a truly elective section with no medical need and their reasons if they don't mind sharing, I know I'm not alone but it seems to be quite difficult to find people who have decided it is the best choice for them, not because they have had previous trauma or medical issues but just for the simple fact that they think traditional birth is not for them for whatever reason
Thanks guys
X

mimiholls Mon 09-Jan-17 20:26:27

Most hospitals don't allow 'maternal request' c section because they are not funded. They have to justify why it is a necessity to the clinical commissioning group and mental health reasons or tokophobia would usually tick the box whereas a straightforward request wouldn't. I understand your reasons but you may find it hard to get this agreed on the nhs depending on your hospital. If it's a deal breaker for you I would go and talk to your GP before you get pregnant.

Helspopje Mon 09-Jan-17 20:32:58

I wanted one before #1 to preserve my pelvic floor as best possible
Declined as was the way then
Have since had 3 rapid non interventional normal deliveries (lingest 42 mins start to finish) and now utterly desparate to avoid a csec for #4 who is currently breech as i dont want major surgery, a spinal and all the associated risks of both.

Might be worth finding out more about what you consider that you are 'choosing' between.

Ilovecaindingle Mon 09-Jan-17 20:33:59

Following on with your blunt terms - fannys are designed for childbirth. .
C sections are major surgery that can take a long time to physically recover from.
For example : I had my ds in less than 3 hours from start to finish. No drugs. No cut. No stitches. At 6 am. Collected my 2 other kids from school at 3pm.
I had a ds by c section and couldn't lift a kettle. Or manage to get upstairs for a wee. Or drive. Or pick up my baby unsupervised.
I had to take morphine for a headache - a side effect from the epidural. My ds is 2 and my scar still itches and feels hot and sore sometimes. .
Will leave it all there for you..
. Research natural childbirth and not just the horror stories. .

hazeyjane Mon 09-Jan-17 20:35:16

It is difficult because both vaginal births and elective sections can have complications (for the mother and the baby) and can have long term effects.

I have had 3 day labour with, episiotomy, 3rd degree tear. Quick induced labour with 2nd degree tear and an elective caesarean. The csection was by far the worst birth experience and recovery - but there will be others for whom their section was amazing after a traumatic vaginal.

InTheKitchenAtParties Mon 09-Jan-17 20:43:55

OP if its important to you, can't you start saving and have your c section done privately?
mimi is correct. AFAIK an NHS hospital won't agree for an elcs because the mum wants one. Only when medically necessary.

babyblabber Mon 09-Jan-17 21:15:53

I kind of fall into the category you're looking for in that I technically didn't have medical need but requested a section. I'm in Ireland though where it's much cheaper to go private so had a good relationship with my consultant.

My story is, DS was born 14 days late after a two day long induction, forceps so episiotomy and he weighed 11lbs. It was not pleasant although thankfully I had an epidural. In hindsight I think I was badly bruised and maybe even damaged some nerves from the forceps as I couldn't properly use my left leg for a couple of days. I also struggled to sit and go up and down stairs. My stomach muscles also suffered as he was so big and this led to a condition called diastis rectii which made it hard for me to walk upright without supports belts and I had severe pubic joint pain AFTER he was born so needed a belt for walking for around 3 months. All of this meant I was fairly immobile and movement is key to healing so for me, my episiotomy was very sore for 8 weeks so I was taking painkillers daily.

Now I made a full recovery, sex was exactly the same as pre-baby (although didn't try for a few months out of fear!) and my pelvic floor can even handle trampoline fitness classes.

But when I was pregnant with DD1 all of her weights at 28 weeks, 32 weeks etc were bigger than DS and so it looked like she could have been even bigger than him. I got a great book called "a Caesarian birth" and after a lot of research asked for a section. I said if they could guarantee she'd be 11lbs or less I'd be happy to have a vaginal birth but of course they couldn't. Technically, there was no medical need for a section and if I hadn't asked for it I wouldn't have been offered. DD2 was also section as a VBAC is unlikely to succeed given the large size of my babies.

I do feel it was the right choice for me but I am extremely jealous of the many, many people I know who have had vaginal births, including episiotomies, as no one seems to have been in such a bad way as I was after DS was born and there is no doubt that the recovery is much much easier than from a section. At most they needed a week or two and they were fine. C-section you are guaranteed to need at least 6 weeks to recover, I couldn't wear jeans for 3 months as they were too uncomfortable and have you heard of c-section overhang? Yuck.

If you have no medical reason i would say you should avoid a section if you can. Defo get the epidural, there is no need to feel the pain, but in terms of recovery immediately after and indeed your body for the rest of your life, a vaginal birth is by far the better way to go I think.

Imstickingwiththisone Mon 09-Jan-17 23:32:23

No NHS hospital is going to commit to an ELCS before you're even pregnant. If your decision to have children is dependent on this then you would have to go private to have any certainty.

FrostyPopThePenguinLord Tue 10-Jan-17 01:05:28

I'm aware that it's not the most popular choice in the world, and the majority of your points I have given careful thought to and looked into already, as I said this is not a spur of the moment thing, we have been gearing up to this for the last 5 years, I do have some points I want to look into further to remain truly balanced in my decision .
I think I was misunderstood about talking to my local hospital, I was made aware by reading posts and experiences with electives before that some hospitals and trusts etc have a very anti elective stance so I knew from the outset there was no point in me trying to reason with people who have already made up their minds, so I emailed my local hospital (starting closest to home is easiest) explaining my situation, asking that hospitals particular position on electives, it was fairly positive so I am happy to continue with them, of course they didn't agree to a section already, but I would have looked at other hospitals had it not been possible there.
Sadly private treatment is not an option for me as much as I would love to, but that's a totally different discussion.
I've not just read the horror stories I've read good experiences as well but things seem just as likely to go bad either way from my reading, personally I'm more comfortable with the surgical risks and acknowledging them from the outset than the uncertainty of the level of trauma that could be potentially sustained during traditional birth.
My mother thinks I'm totally nuts, all 3 babies 100% naturally for her, easy pregnancy, the whole lot, she is terrified of surgery, operations etc.
Maybe that's why I'm so comfortable with it, I've had surgery before, it holds no mystery or fear for me, the baby comes out either way, why not do what makes me feel safe rather than being forced into a position that I don't want to be in just because someone else says it's the best most natural way. I don't give a crap about natural, I refuse to be ashamed of wanting all the medical interventions I can get if it makes me feel better.

waitingforsomething Tue 10-Jan-17 01:17:40

If this is something you want so badly, even though you have no mental health, physical health, prior bad experiences or anxiety reasons to have an Elective C-section you should consider saving the money and pay privately. The NHS is on it's knees and a C-section is very expensive - your body is designed to give birth, if you have complications that pose a risk to you or your baby then they will perform an emergency C-section and you and baby will be safe.

C sections are performed for lots of reasons - they are not an easy option. You will have a scar, your recovery takes longer in most cases. I know two people that have had serious complications from C-sections unfortunately. Neither way of giving birth is easy, both pose small risks but an Elective C section is not the easy way for you .

Blahblahblahyadayadayada Tue 10-Jan-17 08:48:38

Go privately. Sort out your insurance etc before you fall pregnant.

welshweasel Tue 10-Jan-17 08:57:23

I totally understand where you are coming from. I felt similarly. If someone could have absolutely guaranteed me a normal vaginal delivery if have gone for that. But obviously that's impossible. For me, an elective section, whilst more risky than a nvd, was the best compromise. I requested a section at my booking in appointment. I saw the consultant at 20 weeks, and had the section agreed within minutes. As it was, I needed one at 35 weeks for medical reasons but already had a date booked at 38+6 by that point. The birth was incredible. I watched it all and we have photos of the entire process. I recovered quickly, was having lunch in the pub day 4 and driving day 10. You absolutely can get a maternal request section on the NHS. You may have a harder time that I did getting it agreed to but if you are firm from the start and do your research you should be fine. If the consultant refuses your request, they should refer you on to someone else. Most hospital have at least one consultant who is more 'section happy' than others.

neonrainbow Tue 10-Jan-17 09:05:40

I thought the same as you but for me it was fear of the unknown. However once i was pregnant a midwife led birth started to sound good. But then i found out for a couple of reasons that it would be a highly medicalised birth so my choice was about induction/epidural vs c sec. My body had other ideas and my waters broke and i went into labour 10 weeks early so agreed to try naturally. Things went wrong and a general anaesthetic emcs later and you realise that this stuff can't be planned and that the vast majority of women have a normal uncomplicated natural delivery and that really is better for the baby. You can't plan it and there's really no point stressing about it.

Also, having had a section i was absolutely crazy to ever think, however briefly that it would be the easier way to give birth. The recovery has been physically and mentally very hard and medically speaking my recovery has been relatively straightforward. I couldn't do anything at all for myself the first few days and couldn't walk any distances for 5 days. You'd be absolutely crazy to choose it over a natural birth.

Jackiebrambles Tue 10-Jan-17 09:09:38

I’ve had two c-sections – the firs t was an emergency one, and the second elective.

I decided once I’d already had a section for my first baby that I didn’t want to risk going through labour (again) to risk the chance of another EMCS. I also didn’t want pelvic floor damage AND a c-section scar (as I already have of course!). The midwives/consultants did try to convince me to have a VBAC but ultimately happily signed off my ELCS.

However, my circumstances were different to yours of course.
My friend felt the same way as you when she was first pregnant, and talked to her midwife from the very beginning about this. They sent her for counselling and would not sign off a c-section until she had done this. She was prepared to go private if necessary.

In the end her baby was breech so she had to have a section anyway!

So really I think you need to just wait until you have got pregnant and start the discussion with your midwives at the earliest possible time.

You should be aware though, that even with my ELCS, I was not ‘booked in’ for my operation until I was 36 weeks pregnant.

They just don’t sign you up for the c-section any earlier than that. So you need to be bear this in mind, you won’t know for 100% sure that you are having a section unless you pay for private.

janinlondon Tue 10-Jan-17 09:10:03

As above - you can get an ELCS on the NHS. Set out your medical reasoning and costings, based on original pubmed articles (not press reports or stories about people your aunt's cousin knows), with a list of references. If possible choose a hospital based on the consultants' published c section stance. Do the work, present well, and you will be given the section.

user1471441738 Tue 10-Jan-17 09:41:56

NICE guidance since 2011 is that wanting one IS a good enough reason to get one.

You may have to jump through some hoops and change consultant etc but you should be able to get what you want.

You shouldn't have to go private
www.nice.org.uk/guidance/cg132/chapter/Key-priorities-for-implementation

mimiholls Tue 10-Jan-17 12:34:39

Sorry but the NICE guidelines don't mean anything, hospitals are not required to follow them. You can ask to see another consultant if one refuses but the next one can also say no and the next one can also say no until you're out of time. I do know people who have had section simply for maternal request but this was in 2011 and 2012 when the guidelines were first brought out. Since they've now been out a while and more people are asking about it, many hospitals have now put a more concrete policy in place e.g. in my area everyone gets a letter at their booking appointment stating that they do not allow c section on maternal request and I know a couple of people who have been refused even when they pushed for it. It does depend on your hospital and what area you're in. I am not saying it's not possible but there is absolutely no guarantee. Mental health reasons are different and they would be obliged to address that the same as physical health reasons. Look into private health insurance policies that cover elcs. There are a few threads on here about it.

mimiholls Tue 10-Jan-17 13:12:28

Op have the hospital told you in writing that they allow cs on maternal request? If so that sounds pretty positive...

FrostyPopThePenguinLord Tue 10-Jan-17 13:32:51

Mimi, yes I asked their stance on elective section and they said obviously they like to encourage natural birth but if I can show an understanding of risks etc then they aim to give mothers the birth they want.
I'm not a total idiot, I know surgery is painful and recovery can be crappy, I've had abdominal surgery before (appendix) and it's not the most fun I've ever had, but I was fine and moving the day after surgery, obviously it's a different procedure and I may not recover the same way plus looking after a baby, but I could be equally knocked down by traditional birth, there are no certainties with child birth is the thing I have learned and it's about making the decision that you can feel happy with....I just made a more awkward decision x

SanityAssassin Tue 10-Jan-17 15:46:00

OP I felt exactly like you and had an ELCS on the NHS for maternal request. First child and no medical reasons this was also before the new NICE guidelines and I did have to fight for it. Also had second ELCS but that was easy to get as had a previous.

I had good quick recoveries with both.

mimiholls Tue 10-Jan-17 15:48:51

You are more than capable of making your own decision having gone through the risks and benefits of both options so I wouldn't bother listening to anecdotal experiences, there are good and bad on both sides. It just could be a battle on the nhs but the correspondence from your hospital sounds positive. Good luck with whatever you decide.

Imstickingwiththisone Tue 10-Jan-17 20:57:08

What your hospital has said is promising OP. You would have to demonstrate that you've weighed up the pros and cons of all eventualities and that you are certain about your choice, which you shouldn't have a problem doing. I had to fight for my upcoming ELCS and feel I have good cause to (traumatic first birth and damaged pelvic floor which I want to avoid worsening with an instrumental delivery). I was really worried about giving birth naturally but still managed to feel guilty about my decision as I had to argue it with the experts who said that I didn't need one. Even now I worry I'm being judged but would absolutely shit myself if ELcS was cancelled. Good luck OP

Tearingoutmyhair Wed 11-Jan-17 01:43:22

"Vaginas are designed for childbirth" is a foolish assertion. Nature is not a sentient entity that has any "end" or "means" in mind. Things happen, and the evolutionary process continues in response to an enormous variety of basic and complex environmental factors. Sometimes this results in the most incredible feats of precision and harmony and sometimes - as in the case of the pregnancies and births of humans and guinea pigs - in rather a third rate, ramshackle piece of engineering.

The peculiar rosetinting of the imperfect nitty gritty of life is strangely largely restricted to obstetrics. We don't seem so keen to fetishise other painful and dangerous but oft-necessary features of humanity.

The reality is that until the wonderful advances of more recent centuries that have rendered both vaginal and caesarian births overwhelmingly safe in the developed world, one went into childbirth with a bloody enormous risk that either mother or baby or both would not make it out the other side.

In order for a population to be sustained, the "requirement" (so to speak) is that two infants are born to each mother. Obviously several decades of fertile life presents the opportunity for rather more than two pregnancies, so for the overwhelming bulk of human existence, the population was kept in check by nature's rather unfortunate habit of bumping people off exceedingly young.

I understand the "trust in your body" mentality and it is not without value, but having arrived chiefly as a reaction against misogynistic and paternalistic obstetric practices of yore (not that they've entirely gone away) inevitably the pendulum has swung a little too far in the other direction. Women are urged to trust in the "wisdom" of what is ultimately a chaotic and totally amoral bodily process designed merely to propagate the species, and are so often left with feelings of guilt and inadequacy when they end up being one of the sizeable minority for whom the "body" turned out to have rather less noble ideas.

It's a complicated area, because the issue of the public purse - while hugely less pressing in the moral sense - cannot be disregarded altogether.

But your preference is entirely valid, and IMO should be respected, and I wish you the very best of luck in the months to come.

MrsBlennerhassett Wed 11-Jan-17 01:58:34

i had a natural birth. It was sold to me as being so much easier than a c section and better for the baby. It was awful. Awful. There was no way of knowing it was going to be like that tho my friend was only in labour three hours and was in and out the same day.
If i ever have another child i will be pushing for a c section.
Is there any way you can save to go private? I think you can use NHS for all the check ups to a certain point then just go private right at the end?

FrostyPopThePenguinLord Wed 11-Jan-17 14:58:40

Tearingoutmyhair, this said so many things better than I have put them, thank you.
It's not that I object to natural childbirth, more I resent the idea that I have to do it that way just because that's what I'm 'designed for'...I call bullshit on so many levels....if we were that well designed for it then why would we suffer so much when other members of the animal kingdom give birth with relative ease. The scientific answer is along the lines of babies heads got bigger whilst pelvis size remained largely the same because our bipedal stance and method of walking restricts the size the pelvis can be without interfering with movement, women walk differently to men anyway...as a consequence we suffer more pain and complications etc etc.
I don't see any problem with fully embracing how far our medical practices have come and using them to my advantage, I'm fairly sure 99% of you wouldn't refuse antibiotics for an infection or a hip replacement....you could suffer through without them and take your chances with the infection or pain, but why would you when it can be treated and fixed with modern advancements. Im lucky enough to live in a time where a csection (whilst major abdominal surgery) is one of the safest and most routinely done procedures there is, and I intend to make the most of it.

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