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Elective C-Section (medical/non medical reasons)

(828 Posts)
LittlePeaPod Wed 11-Sep-13 08:21:06

I understand this subject has been done before. I also know that ECS particularly as personal choice rather than as a medical need is an emotive subject and the debate about CS birth can be particularly contentious.

Considering 1 in 4 women in the UK experience a CS birth I have been disappointed to see how inadequate access to CS antenatal information is, so women can make a truly informed decision. Personally I think it's short-sighted to focus solely on VB and continually emphasise managing pain relief. The NHS is so focused on their target to reduce the 1 in 4 CS due to cost that they are neglecting their responsibilities to those women that choose or want a CS birth regardless of medical need.

I am currently 23+6 and I have chosen to opt for an ECS. There is no medical reason for a CS but this is a birth choice that I want. I understand that CS and VB both carry real but different risks but I believe these risks should be explained to women so we can make informed decisions about which birth risks we wish to take. Unfortunately this is not the case and the push for VB is so endemic in the NHS that women are not receiving the true facts on CS.

For those women like me that want an ECS birth. I just wanted you to know that due to the new NISA guidelines if you want/choose a CS the NHS now have to give you one. They will do everything they can to try and change your mind to the point of trying to scare you and make you feel guilty about your choice. But, regardless of medical need if you insist that a CS is the right choice for you the NHS have to honour your wishes and give you a CS. I am fortunate to have been able to privately pay for independent advice on VB and CS from three different very well respected professionals in the UK (two consultant obstetricians and one consultant in fetal medicine) and also received advice from a close family friend who is a consultant anaesthetist. I was shocked to hear how target driven VBs are in the NGS and how in fact this is what's driving the push for women been made to think they should have a VB and not the safety issue.

Ladies it is your choice how you have your babies and what you do with your body. If you want a CS you can have a CS regardless of medical need on the NHS. My DF and I have just spent a lot of money finding that out. I am 23+6 and the NHS have now confirmed I will be having an ECS and there is no medical or psychological need. I am having it because its my choice. I wanted to share this because prior to spending a fortune getting non biased information I was under the impression that I had to prove a VB was medically necessary, would psychologically affect me or that I had a fear of VB before a CS would be authorised by the NHS. Well that's not the case, its about personal choice. VB or CS you have a right to choose and the NHS have to honour your choice. It's just a shame and has royally pissed me the fuck off that if your choice is an ECS for non medical reasons the NHS are making it so difficult for you to opt for that choice in an informed way.

vj32 Wed 11-Sep-13 09:03:28

Its not just money saving though is it?
Its choosing to have major surgery, rather than choosing to at least try and avoid it.

Yes, more info should be given. But having had one and seen the mess it has made of my body, the horrible recovery afterwards from a relatively straight forward section (no infections etc) no way would I opt for one.

Its hard to give all necessary info without causing women to freak out!

mouseymummy Wed 11-Sep-13 09:19:56

I'm having an ELCS after fighting fot it. After looking into risks of having a vb after just a yr after an emcs, Im scared that a vb could go horribly wrong, scar rupture and other things.

I had an emcs after discovering dd2 was breech, then there is also my bodys tendency to go overdue, meaning a cs anyway... I may as well have the cs.

Tbh though, I've been asked by friends which to go for, cs or vb. Each one has been told to go for the vb due to the recovery, length of stay in hospital and the other difficulties I had. Simply imo, its easier for a vb.

The only reason I'm choosing the cs is, I have 2 children to think about, as well as the one I am carrying, I cannot justify the risk.

HaPPy8 Wed 11-Sep-13 09:20:07

Actually they don't HAVE to. Guidelines are just that - guidelines. They are not the law.

Not saying whether i think this is right or not, but to state that they have to give it to you is just not true. Having said that, if you jump through enough hoops to meet the criteria in their own guidelines, most trust will agree an ECS eventually.

LittlePeaPod Wed 11-Sep-13 09:32:42

Happy Actually I know for a fact having had consultations three senior consultant that work in this field in and work the NHS that they DO HAVE to. In the same way as we (in the fine ail sector) have to follow the FCA guidelines (historically FSA).

Currently at work so not able to respond properly but will do when I get home.

LittlePeaPod Wed 11-Sep-13 09:33:46

That should be financial sector... blush

HaPPy8 Wed 11-Sep-13 09:39:04

They don't. Im sorry but you are just wrong. The guidelines are just guidelines. They have no legal standing. The vast majority will, and those that won't will normally refer to someone that will as per the guidelines, but an individual NHS trust or consultant is not obliged to perform surgery they don't feel is necessary. That is why you hear of things like 'postcode lotterys' where national guidelines recommend certain medical treatments but local NHS trusts don't fund them.

For what its worth I think they should be obliged to do it. But fact is, they aren't.

HaPPy8 Wed 11-Sep-13 09:47:56

Also, mouseymummy - you have medical reasons to request a CS (previous CS) which is normally treated differently by most hospitals.

Bamboobambino Wed 11-Sep-13 09:52:33

FWIW, I entirely agree with you and have just had a section 3m ago. However, as the poster above points out, there is not a legal obligation on NHS trusts to offer choice LSCS, your interpretation of the NICE guidance is not 100% correct.
Notwithstanding that, as I said above, I agree with you. One thing that made me REALLY cross was the amount of investment locally that has gone into a shiny new midwifery led unit, with birthing pools, partner beds and hotel-like facilities. The consultant led unit is nowhere near as nice, and frankly run down! This is not on. People bang on about the cost of unnecessary sections, and then a trust spends any so-called cost savings on a 5 star 'natural birth' unit. It's daft. We are continuing to move towards an age of more complex deliveries in older women with multiple pregnancies, this is a FACT, so they need to out some investment into consultant led units, instead of trying to ignore the issue and pretend it doesn't exist. RANT OVER!

PinkApple86 Wed 11-Sep-13 09:54:28

So are you saying you want a ecs for no reason other that vb terrifies you?

thecakeisalie Wed 11-Sep-13 09:54:51

I don't think they should be obliged to perform unnecessary major surgery at the expense of the tax payer. I think if you want an elcs with no medical reason for it then you pay for it privately.

I personally don't understand why you'd opt for major surgery with 6 weeks recovery, spending days in hospital afterwards, scarring, possible complications when the body is designed to deliver a baby naturally. I appreciate CS's are a life saving medical procedure and I can understand why a woman who has previously had an emcs would then opt for elcs but as a first pregnancy with no prior trauma or medical reasons it seems very misguided.

Bamboobambino Wed 11-Sep-13 10:02:47

Not sure about the OP's position, but my own experience was of an elective section for twins, the presenting one of which was breech. I was out of hospital in 48 hours and doing most normal activities in 3 weeks, exercising at 6 weeks.

hatsybatsy Wed 11-Sep-13 10:05:36

OP - good for you that you are taking an informed decision and that your local NHS hospital will go along with it.

But you seem to be claiming that this is the best solution and that everyone should demand a CS because the hospital has to agree. Can you imagine the chaos if everyone thought along those lines? The NHS simply does not have the resources.

Personally, I had 2 CS for medical reasons and it took me a long time to get over that. If I had been allowed to try VB I would have done. Just because you have made your choice, you don't need to come on here and try to justify it to us all.

hatsybatsy Wed 11-Sep-13 10:07:42

and any anecdotal evidence of how easy CS recovery is is a waste of time - it just depends on how it goes in your own case. Some of my friends had nightmare VBs, some just breezed through it. Some women have nightmare CSs - very few breeze through it because it is still a major operation which takes weeks to fully recover from.

PassTheCremeEggs Wed 11-Sep-13 10:09:47

Cake - I completely agree. I had an EMCS with my first and am hoping on hope for a successful VBAC this time for DC2 (although baby is breech at 30 weeks so fingers crossed for it turning). My recovery was absolutely normal, no infection or any problems, but I hated the first 24 hours in hospital of being unable to move and unable to pick my new baby up on my own. Calling midwives for help to pick her up when she was screaming and (because the post natal wards are often so busy) having to wait ages for help with a crying baby next to me I couldn't help. The scar really isn't pretty either! (And now I'm pregnant again itches like hell - it's horrendous.) Also, you'll be discharged from hospital 2-4 days afterwards, and I was still in huge pain doing anything normal like laughing, coughing, walking up/down stairs, turning over in bed, sitting down, standing up from sitting down, sitting up from lying down...the list goes on. you name it, likelihood is you use those muscles to do it. Not to mention.......all the energy and effort it takes looking after your new baby!

In my view caesareans should be used only for emergencies or other medical need (breech baby/mother actually unable to deliver naturally etc). The safest way to deliver your baby is vaginally - as soon as you start intervening the risks increase and the recovery time extends.

Why anyone would choose to have major abdominal surgery immediately prior to what will be the most physically and mentally exhausting period of their life is totally beyond me...

PassTheCremeEggs Wed 11-Sep-13 10:12:59

Ps OP - why do you want an ELCS just out of interest? You say you don't have a fear of natural birth. I'd really be genuinely interested to know why you've made this choice?

LyraSilvertongue Wed 11-Sep-13 11:05:34

My hospital doesn't allow women to simply opt for a CS for no good reason.

I told the midwife at my booking in that I will probably opt for an ELCS as I've had a previous EMCS and a horrible VBAC/ ventouse delivery. She said that for those reasons I should be allowed an elective, but nothing is guaranteed yet until I speak to the consultant.

I don't understand those who choose a CS without a medical or psychological reason.

SoonToBeSix Wed 11-Sep-13 11:16:05

LittlePea I am baffled as too why you would choose major surgery with no medical reason. If you think a c section is an easy option you are very foolish.

noblegiraffe Wed 11-Sep-13 11:23:49

I think that hurdles should be put in the way of a woman choosing an ELCS for no medical reason, if only to give them pause for thought.
Natural childbirth is a scary prospect, and I think many women who if they were offered an easy-sounding opt-out would rip off the mid wife's arm to accept.

But I've had an EMCS and I had an ELCS the second time around. I thought long and hard about the ELCS, knowing full well how awful the recovery was the first time. My NCT friends had bad tears and so on, but none were so weak that they couldn't hold their baby for longer than half an hour, for weeks.

My ELCS recovery was a breeze in comparison, but it still involved being bedridden, a bladder infection, struggling to get out of bed, copious painkillers and being very tired for a couple of weeks. When I tell people my recovery was great and easy, I mean for major abdominal surgery, not for childbirth.

It's not like the too posh to push easy option that it sometimes it can be seen as.

Excited2meetmyprincess Wed 11-Sep-13 11:24:10

I have also chosen to have a c section but it has been really hard convincing my consultant as she really pushes for natural birth. Even though I have the agreement of 3 other doctors!!
Mine is sort if for medical reasons though. I have hemiplegic migraine and it puts me at high risk for pre eclampsia and for having an attack in labour because boosts in hormones are what trigger them. So rather than take the chance of being out of it for days afterwards I would prefer a c section and be able to spend time with my baby afterwards and know what is going on around me.
But even with this I am still struggling with my consultant and have to go back again at 35 weeks to get her final decision, because she is saying its a risk not a guarantee and I might be able to have natural without it happening. However my neurologist disagrees and is pushing for c section. So I am keeping my fingers crossed and waiting for her answer!
But I do know that its not going to be easy and have really looked into everything and the risks from both for me personally and the fact that the baby could get stuck if I have an attack half way through labour and put her at risk just sealed it for me!! Xx

Kelly1814 Wed 11-Sep-13 11:25:00

I don't know of any friends who have regretted their ELCS.

I know a great deal of freinds who regretted their vaginal birth and are still traumatised by it.

morningsarepants Wed 11-Sep-13 11:37:48

Agree with Kelly. I've had both VB (went horribly wrong - and yes, still traumatised, and with physical problems too) and ELCS. ELCS wins hands down. I always wish I'd had the choice back then for ELCS first time around.

thecakeisalie Wed 11-Sep-13 11:38:04

I know a lot of friends who have had fantastic vaginal births including myself. Even my first labour where I experienced medical intervention that slowed everything down it was still a very good experience. I was discharged with both babies within 6hrs of delivery and able to resume normal activities.

Kelly1814 - does that mean we should all opt for an ELCS to avoid any trauma during labour and regrets afterwards?

I have zero regrets about my vaginal births and will be hopefully having another one this time - hopefully a home birth too.

thecakeisalie Wed 11-Sep-13 11:40:23

morningsarepants - but first time round you can't know its going to go wrong so we can't all opt for a cs just in case can we?!

morningsarepants Wed 11-Sep-13 11:53:51

I was told by an obstetrician that guidelines have changed since I had my first child and although not strictly medically necessary I had enough "at risk" characteristics to be offered an LSCS if I wanted one had those guidelines been in place at the time. So yes - I would have gone for it - just in case. I wish I had thought about it more and argued for it back then.
Though I agree you have a point. Many friends have been fine with VB.

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