Elective C section

the anaesthetist would decide that (because they are the ones who can weigh up the relative risks vs benefits of both techniques), but that is why a referral to the anaesthetist is important so they can get advice from the spinal team if needed.

It's never to early.

I had mine agreed before getting pregnant...

Date booked at 16 weeks (I've never heard of being booked in earlier though).

Quote the NICE guidelines at them. Don’t let them talk you out of it if it’s what you really want. They will absolutely try. Develop tokophobia if you need to 😉
An elective c-section is an absolute dream, from my own personal experience. So civilised.
Congratulations on your pregnancy. Exciting times ahead.

Will you still be able to have the spinal anaesthetic or would you need a general anaesthetic for your section? Did the spinal consultant say that you are safe to have a spinal or epidural?

Oh absolutely, you're right. I meant more that she may get the same information repeated by several members of staff, which could be frustrating, but is likely well intentioned. They probably don't know what conversations have already been had.

I was asked at my booking in appointment (for DD2, I can’t remember about DD1). I said I wanted an ELCS and that was that, I was in the system and got a date at about 20 weeks (which changed because of the baby, but I think would otherwise have been fairly fixed).

Id had one for DD1 as well which might have changed things, but there was zero resistance. Which was great!

Congratulations on your pregnancy OP.

You may get a few medical staff giving you the pros and cons, as they feel they need to give you a balanced view, even if you've told them your mind is made up

every patient absolutely should be given the pros and cons because it's a really important part of the consent process and the patient needs to knows they are making a properly informed decision. Even when a section is the the best way to deliver for spinal/orthopaedic reasons, or if it just remains the patient's preference, they still absolutely need to know what the effects of the procedure might be for a chronic back problem and know what they're looking out for post-op in terms of back problems as well as all the usual obstetric stuff.

? Wheesht.

what nonsense

In that case ask him or her to give you a supportive letter to give to your obstetric consultant. Ask ASAP, these things can take time.

Maternal request c-section is an absolute right and should not be refused. You may receive some questions about this from health professionals but state it is your birthing choice and right.

I needed a c section for medical reasons, vaginal was never an option for me. When I mentioned that at my booking appointment the midwife was really dismissive. After she asked all the questions my medical history raised some red flags and so ended up referring me to have a consultant led pregnancy.

Did you explain your history with her or just tell her you want a c section? If after telling her your issues she was still dismissive, then suggest you contact them and try and get yourself under consultant care as with your spine issues, you may need to be under their care generally.

It will be hard

I started telling them from my booking appointment! They made me go to a birth choices clinic to try and convince me out of it, but ultimately they should sign it off if you insist (under NICE guidelines). I was 34 weeks before they’d actually book me an appointment though, and even at that point I had to push them to do it, they never brought it up.

One of the best decisions I’ve ever made, incidentally. The birth couldn’t have been a better experience in any way. My recovery was smoother than many of the vaginal births I know of.

The hospital would contact him - you just give the name.

I have had consultants from different departments involved in my maternity care, and it is easily sorted.

You’re a long way off having to make a plan, so don’t worry about mentioning it to midwives - when you get to birthing choices that’s when you need to talk about it.

Ignore op unfortuntly there is a cult like element to some midwifery
Luckily mine were amazing.

It’s not the midwives who decide the kind of birth you get anyway, they won’t really have anything to do with it other than you ask them to refer you to the consultant for a birth options chat - this usually happens in my trust about 17-20 weeks. I had an elective due to previous birth issues, no push back at all. It wasn’t booked until 36 weeks though so no panic yet!

You say she looked at you a bit strange, did you tell her it was on advice of the spinal surgeon? If you have no context then I wouldn’t worry about her strange look, she doesn’t have any of the facts. I can’t see why you’d struggle to get a c section

I think the earlier you inform them of why you want the ELCS the better. Something like on the advise of my spinal surgeon, I was informed that the safest method of delivery should I get pregnant in the future, was a c section. I would be unable to push due to spinal issues.

That means you will then go down the consultant-led pathway. I had EMCS with my first child and ELCS with my second due to medical issues. I told them of my ELCS request at my booking appointment. When I had my 20 week scan I saw a consultant immediately afterward and they just talked through all the risks and it was agreed there and then.

I think it was then booked in at my 34 week appointment and was scheduled for when I was 39 week pregnant.

I'm not sure you need your spinal surgeon specifically to be involved, but it sounds like you should have consultant led maternity care. I have rheumatoid arthritis so I had consultant led care, it basically meant I saw the consultant or a registrar for most of my appointments instead of a midwife.

The consultant obstetrician has expertise in pregnancies that are "high risk" for whatever reason. My maternity care was at a different hospital from my rheumatology, so it was probably at my booking in appointment that I was assigned the consultant led care based on my answers to the questions. I don't really remember though.

Also, a lot of medical staff won't say the perfect thing in all situations, so please don't focus too much on one midwife's response. You can have a c section if you just feel like it, or if you have a great reason to like you do. You may get a few medical staff giving you the pros and cons, as they feel they need to give you a balanced view, even if you've told them your mind is made up, so don't let it bother you or sway you.

For what it's worth, I've had two elective c sections, and would highly recommend.

It’s your midwife that needs to make the referral to an obstetrician for them to sign off the c section so ask for that the next time you see her. Don’t get fobbed off about it being left to the last minute in case you go into labour early.

That will be all you need to show, then. The surgeon’s advice should overrule any midwife’s comments.

I’ve had both forms of delivery and found recovery from cs was very straightforward. Over the long term (mine are 25 and 17) I’ve had more of an issue with the results of DS25’s delivery the traditional way due to the second degree tear.

fair enough. In that case when it does come to birth planning (probs a bit early still) make sure you ask for an anaesthetic referral so they can think about which mode of anaesthesia might be safer/ the impact that either will have on your back (they and your obstetrician will probably want your surgeon's input to find out exactly what the back lesion is/what they're worried about with pushing, but can contact them themselves).