Elective c section

[thehappyegg]

I had a horrible birth with my first baby three years ago - back to back labour, failure to progress, which ended in an emergency c section. I'm now thinking of another baby but am terrified of going through labour again. I know I want a planned section to be able to even think about getting pregnant.

I know many hospitals are very reluctant to offer elective sections, but wondered if it is easier to get one if your first birth ended in an emergency section?

I do not want a VBAC.

Any experiences welcome.

don't know about your situation, but my hospital wasn't reluctant to offer it as a possibility. I had a tear with dc1 and was asking about the risks with a second birth and they said ELCS was an option . even though I hadn't considered it at all (I did the ELCS! And was very happy about it). Worth asking.

I had EMCS with DD and although the hospital was keen to let me know they’d support me with a VBAC, I was very firm that I wanted an ELCS, my midwife was supportive but others tried to dissuade me which I was stressful. I got really worked up before seeing the consultant and burst into floods of tears. She was amazing, just held my hand and said “listen, I can tell you right now that I’m going to sign this piece of paper agreeing to it.” I found all the doctors were absolutely on board with me choosing, I just had to be quite adamant with the midwives.

My most likely hospital would be guys and st thomas' who have a "no elective section by Maternal choice" policy, but I wasn't sure if that extended to women who had already had a c section.

Also my labour was like yours, back to back and failure to progress. ELCS was a walk in the park compared to that hell, honestly!

OP I had a similar first birth and trying to decide what to do for my second.

I had such a bad recovery last time that most of my head says VBAC but I absolutely do not want another EMCS.

This thread will be an interesting read for me.

Exactly as Banana said. Midwives kept pushing for a VBAC, any dr I saw said that it was entirely my choice. At one appointment, the consultant turned to the midwife and said ‘the lady has very clearly told us what she wants to do, let’s just leave it shall we?’

My recovery was fine for my emergency, I was up walking about the next morning and totally pain free in a week.

I had an elective C section after a third degree tear with my first. Met no resistance at all from the midwife or the consultant. I went on to have a 10lb 6oz baby so very happy I choose the section. Was a thousand times better than my first birth.

This is on the NHS website.... seem to suggest a woman is entitled to a C section should they choose to.

I think it's common to offer an ELCS if you have had a previous Cs or a previous traumatic birth. I had a bad tear and was offered one. I know friends at other London hospitals who have also been offered one for similar birth stories to you. You should be referred to see a consultant for a birth choices appointment and it is seen very differently to requesting one first time round. I haven't heard of anyone being denied a ELCS in circumstances like yours. Only issue is they often won't discuss it until around 32 weeks when people would prefer to have it agreed earlier.

I think given your previous birth, they would give you it as an option.

I had a 3rd degree tear with my first which resulted in further corrective surgery a year down the line. 5 years later we were thinking about having another but I needed to know for sure what my options would be 2nd time around as j was terrified of it happening again. I had a 'birth reflection meeting' at the hospital where they went through my birth notes from my 1st child. And I was able to ask what my options would be were I to have another baby.
I'm now 26 weeks pregnant and this week I have a 'birth choices' meeting where they will go through my options again but if I want the section they will happily give it to me and I knew that going into this pregnancy which helped my anxiety.

I would contact your hospital to see if they have a service like this where you can talk it through.

I think you’ll probably be fine. I had a terrible first birth. Back to back, rotational forceps delivery with 3rd degree tear. At my check up appointments I asked if I would be able to have a c section for future pregnancies and was told yes. I told my midwife at my booking in appointment with dc2 that I was sure I wanted an elective section. She read my notes and said that was fine. No one ever questioned my decision (just pointed out it was major surgery) but I never waived either. I think if you come across as steadfast in your choice and have your reasons you’ll get the birth you want.

I had emergency section first time and was quite unwell but elective section the second.

I had private antenatal care both times but delivered NHS.

I believe if you have had a EMCS it is generally easier to argue the case for an ELCS because of increased risks involved with a VBAC. But there can be a lot of pressure to have a VBAC.

Technically speaking an ELCS after a EMCS is easier for the hospital to classify as 'medically necessary' than be put into the 'maternal request' classification which ELCS on mental health grounds alone are put into even if your consultant writes Mental Health in capital letters over half your notes (I'm still bitter over that one).

Thus it's easier to get past the NHS beancounters who have no effing idea what they are talking about when they say 'no maternal request'. The classification of your ELCS is what they are petty and ridiculous about. When an Elcs is 'advised' can be open to interpretation and broader scope if you have had an EMCS whereas its a lot more difficult to 'advise' an ELCS if you've had a normal VB or it's your first child because there's a less obvious case on paper. Thus you are therefore theoretically coming from a start point where both you and your consultant have a big more power and leverage to get an ELCS.

Try and talk to your GP if you are concerned. You can do so before getting pregnant if you are very anxious as this counts as a mental health concern regarding pregnancy, if it's affecting you so much you are delaying pregnancy over the issue.

I had a horrific birth at st Thomas, with long lasting complications meaning I won't be having a second. However, when I had my birth debrief, they said they were happy to sign off on an elective c section for a further birth should I choose. Part of my issue about having a second is that I don't really believe them! But I don't know whether that's a product of my feelings about the situation rather than the reality. So yes, it may well be possible, it something to be discussed with them before you get pregnant perhaps.

I had a textbook birth that ended in third degree tear. The postnatal care was so traumatic I too was determined never to give birth vaginally again. There was just no way I could do it for fear of the same happening again.

So when I got pregnant I told the midwife about my crippling PND and how the fear of labour would ruin the pregnancy, if no one could assure me I’d be allowed an elective section. She was really sympathetic and made me a consultant appointment.

Long story short: I got my section without too much of a fight. The consultant allowed it on mental health grounds. I didn’t care how it was justified or what was written on my notes.

It all went amazingly and it really helped lay a few demons to rest.

In exactly your scenario I was very stressed and expecting a fight, but they were like yeah that's fine. Hope you have a similar experience.

Just to say, they never offered it but I brought it up.

At booking in and in early appointments they said things like "looking through your notes I see you had a emcs last time but there's no reason you won't be able to deliver naturally this time". (Like it was a good thing)
From 30 weeks onwards I was well psyched up to tell them:
I have done extensive research and understand the risks
I really struggled to get over what happened last time and was traumatised.
You can't guarantee me that I won't end up with another emcs, I don't think I could cope.

And if necessary I was going to ask for a second opinion/ counselling/ different consultant.

Like I say, none of this was necessary. The consultant looked a tiny bit reluctant and a big bit empathetic and just warned me that any future births would therefore probably HAVE to be sections.

I had a hideous first birth that ended in an emergency section. I told my midwife at my booking appointment that there was no way I could cope emotionally with a repeat of this and that I'd like a planned section. Midwife didn't even try to change my mind, was very understanding and agreed immediately.

I found that the second time round I was a bit braver when dealing with medical professionals and more confident when it came to expressing myself.

I had a horrible first time ending in failed forceps and an emcs. My first consultant appointment was at 24 weeks and I'd driven everyone up the wall making them listen to my prepared speech as to why I should get an elective before hand. Walked in, she asked if I had any thoughts about delivery, I said I wanted an elective...she said okay and that I didn't need to explain myself.

I had a bad first birth ending in forceps - asked to see consultant at about 20 weeks and asked for an elective section and was offered one. Much much more civilized way to have a baby and much easier recovery for me than first time round.