Elective c section

[PontinPlace]

I had a traumatic, horrendous birth with my ds four years ago ending in a crash section and both of us getting sepsis. I am now thinking about a second baby but I 100% do not want a VBAC, I want an elective section. My local hospitals all have a "no Maternal request c section" policy. Does a previous section count as medical reason enough to request an elective, or will that count as Maternal request?

I didn’t think they could refuse you- at least that was what I was told. The midwifes at my hospital said that a consultant could refuse you, but would have to refer you to another who would perform the section. Mine didn’t even try persuade me for a VBAC, just agreed to the section.

My likely hospital is guys and st thomas which I have heard is notoriously anti elective section

I had EMCS last year and am now pregnant with number 2. I have said I want ELCS and have had that accepted without argument, though in my case the fact that the gap between babies is small counts in my favour. The smaller the age gap, the riskier VBAC is, so in my case my recent EMCS is a really solid reason for me to have ELCS this time.

There are risks associated with both options, but FWIW I'd be very surprised if any obstetrician were brave enough to refuse you an elective Caesarean after a previous Caesarean if you were clear that you'd weighed up the risks of each and said you wanted ELCS. If they "make" you attempt VBAC and it goes wrong then they'll be in a tough situation.

The current NICE guidelines are that it is the patients choice, I asked for an ECS and was given one this summer. The consultant tried to put me off but I was adamant so he agreed quite easily

I had a traumatic first birth almost 8 years ago which ended in emcs. I had PTSD from it and health problems DS had. I asked for a elective section for my second DS who was born 6 weeks ago and it wasn't a problem. However, I went into labour on the morning of my elective section and actually gave birth naturally in the end. I don't think you can be refused a section if you request it, I had no objections despite there being no medical reason other than my first traumatic birth.

If you’re happy to look a little further Kingston Hospital are very supportive of ELCS. I had one there with no other reason than it is what I wanted.

I agree with PP. Look at the NICE Guidelines. Also, I imagine if you've had a traumatic birthing past you may be consultant led anyway, and you can discuss c sections.

I am at the other end of the country so no idea about your local provision, but I know in my locality women who have bad previous sections are able to opt for another if they wish. The obstetricians/midwives should discuss the pros and cons of both a planned section and VBAC with you - they wouldn't be doing their jobs properly if they didn't - but ultimately the choice is yours.
As others have suggested, read the relevant NICE Guidelines and maybe print out a copy to take with you to your appointments. That way you can whip them out and query why they are not being followed if you feel you are being pressured into something you aren't happy with.
I actually know far more women who have felt pressured into another section when they wanted to try for a VBAC , but I know it can happen the other way. Hopefully you won't have a problem, but if you meet resistance remember that not only do you have a right to make your own informed decisions, you also have the right to ask for another opinion or for your care to be transferred to someone else.
Wishing you a happy and healthy pregnancy and the birth that you hope for.

had previous sections sorry, not bad ones!

I was told by midwives that they can't/shouldn't actually refuse you a section if that is what you want. I had a normal delivery and was induced but on the induction ward had the surgeon come and speak to me about a section if I wanted one as first pessary's didn't work. I refused and second pessary's worked! Definitely speak to midwives about it from early on

I know the nice guidelines do say that but st thomas actually has its own policy saying they don't do Maternal request sections.

I was wondering more if a section because you had a previous one counts as Maternal request.

I think an earlier section makes you medically far more likely to need a subsequent one. I would start asking for one now, I had mine signed off by consultants and felt far more relaxed when that was done.

I'm not pregnant yet, but I'll be asking from the earliest possible opportunity!!!

Wish I had the ££ to go private to be honest, my experience of nhs maternity provision including postnatal care was the absolute pits and my sister is an NHS midwife so I don't say that lightly.

I think if they won't give you one they need to suggest or find a hospital that will. With your history you might be likely to get it approved. I had an elective for my first and they didn't fight that, they did say I would more than likely need a section for my second as the birth canal had not been opened the first time - I think it's because more likely to cause damage.