If you chose an ELCS without medical reason, why?

[Sparksi]

I’m a FTM to be in my 20s, currently very low risk.

I am considering opting for a ELCS. There is no medical suggestion for me to have one but I have been reading up on local stats and month by month, it seems under 40% of women have an unassisted vaginal birth. This seems really low to me. Nearly as many people (circa 30%) had an EMCS.

I want to avoid an emergency situation where possible. I sway between wanting minimal intervention and birthing in the birth centre attached to the hospital, and just wanting a controlled, planned ELCS despite the longer recovery. We only plan for one, possibly two DC.

If I could guarantee a straightforward vaginal then that would be my first choice but it seems that the odds are actually against that, notwithstanding in the 40% who got it that will include women with birth injuries and tears. It just seems like a coin flip situation. I am risk averse and like to plan things, but I know childbirth is probably the most un-plan-able thing in the world!

If you picked a ELCS, why? Did you regret it?

I didn't have an ELCS, but similarly to you I'm a planner and quite risk averse by nature and the idea always appealed to me. The midwifery team were vehement in talking me out of it.

In reality, I had a horrible labour and birth experience where I was basically told I had to use the MLU, which just wasn't the right environment for me at all. I know it works for a lot of people, but I wanted the structure of a more medicalised setting with access to proper pain relief. In the end I laboured for hours, scared and in pain, with very little progress, until I was eventually and begrudgingly 'allowed' to be transferred to the labour ward and was given an epidural. ultimately, this all culminated in an EMCS anyway.

I 100% wish I'd listened to my gut and pushed for the ELCS, as my recovery was otherwise a breeze. I had friends with similarly aged babies who had VBs and suffered far more recovery-wise than I did. One in particular still struggles now, 5 years later.

While I had some mental health reasons that meant I felt an ELCS was best for me, the main driver was just that I wanted one. It was very straightforward and nobody tried to talk me out of it. They have to make sure you're aware of the risks but given I went to the appt with the NICE guidelines, I think they knew I was serious and had read up about it enough to have made an informed decision.

Really appreciate a comment from the other perspective! Sorry you had such a horrible experience, they should have listened to you.

Thank you.

I had one birth that wasn’t great, induction and assisted birth Episiotomy and recovery wasn’t great. I probably could have pushed for a c section with my second but I really wanted a more natural birth which is what I got and I don’t regret it (I always felt a bit cheated after my first birth).

However we have discussed a third and I would potentially opt for a c section to get sterilisation at the same time. I did speak to my friend who is a midwife and she would opt for natural over c section any day and said the recovery from a c section is miles worse. If we decide to have a third and C-section i will come back to update this thread 😂

I had a crap birth first time round and wanted ELCS second time round.
The midwives and consultants fully supported my right to choose

I am going to be having one in August but that's because of previously having an emergency one. I didn't realise you could just ask for one without medical reasons! Just read some research where they said lots of trusts don't give them for non medical reasons, but this is dated back to 2018. So be interesting if they just agree to it! Personally I would try for a natural birth, but then I don't have one of each to compare.

From (I think) 2021? You can just opt for it. Maternal request is what it’s called x

Does tokophobia count as a medical reason?

The thought of giving birth made me delay childbearing for many years.

Like you, I think the stats are not great (90% of first time mums tear, 20% get PTSD, 5% get a grade 4 tear) and I didn't like the attitude that I perceived the medical staff treating me to have (You're a silly first time mum so you don't know anything, you can't possibly be bright enough to read and understand Cochrane reviews for yourself, here, have this poorly evidenced intervention you didn't want and we'll make it sound like you don't have a choice) and a lot of those fears were backed up by the findings in the Ockenden report.

I still came across some snotty attitudes having a section, but at least I got the birth I wanted.

Are you allowed to just ask for one on the nhs or do you have to really push for it? I'd definitely chose one for the reasons op stated but I don't think I'd have the confidence to really push for one if I had lots of push back. I don't know how these things work

I had a phobia of giving birth. Absolutely nothing would have helped me overcome it, so I chose the maternal choice C-section. I had such a great experience and don't regret any bit of it. It was the absolute best choice for me and I'd have another if I was planning a second child.

I'm maybe in a unique position where I literally don't know anyone who had a positive vaginal birth experience, even those whose births didn't sound that bad still opted for a c section for their second (for non-medical reasons). So that probably contributed to the phobia.

I booked in for one with baby number 3 but went into labour a few days before the date. I had her naturally in the birth pool. She was measuring large and I was a bit traumatised from a previous large baby (10lb+). They were very reluctant to let me have one as I had "successfully" given birth 2 x already. I actually found the whole thing more stressful and was glad I didn't need it in the end. With no.4 I went full circle and planned a homebirth. Just quote the NICE guidlines and stay strong but bear in mind things can still change with an ELCS, including it being cancelled on the day/made to wait hours before going down etc.

Didn’t want to push baby out of vagina.

Didn’t like the look of it. Relative left disabled after a prolonged delivery ending in a forceps birth. Didn’t want to risk that.

I also insisted baby delivered at 37 weeks in line with recommendations for a blood clotting condition I have. Baby had umbilical cord wrapped around her neck several times. Who knows what could have happened if I’d gone with the hospital’s original advice of vaginal birth with induction at 41 weeks if I was still pregnant. They agreed probably best not to think about it.

To add some info: the hospital kept trying to talk me out of it, but ultimately supported my choice. I first started stating I wanted a c section at my booking appointment, they kept saying at each appointment we'd discuss it in future and eventually booked it at 36 weeks.

I had to go to a "birth clinic" to discuss my reasons and give them a chance to convince me to change my mind. That was the biggest waste of time- the midwife listened to me in tears essentially saying I was convinced my baby or I would either die or we'd suffer lifelong trauma from birth complications and then went "have you considered a home birth?". Fucking idiot.

I'm older now, and although I'd love a birth like last time, ECS isn't off the cards because I need to have a general anesthetic and I'd rather be prepared for that in advance.

I was in my 20s with my first, the safest way to avoid intervention was to have a home birth. So I had a home waterbirth. It means there is a midwife for you and one for your baby. I felt in control of my environment, so the sense of safety and reassurance it gave me meant that my labour could progress. It also meant I could guarantee a waterbirth, which meant I lounged around in the warm water, avoiding any tears or injuries. My baby was back to back and I have issues with my spine and heart, so it was the best birth I could have.

I'm still at the IVF stage and they often prefer to induce you at 39 weeks with an IVF baby, so because of that I'd probably rather an EMCS. My first choice is another home birth.

I just didn’t want to push a baby out.

I didn’t want to risk a tear, a prolapse, loosened uterine muscles - none of it. This was all many years ago now, around the peak of the “natural is best” mania. Women were refusing gas and air fgs, in case it damaged the baby. I consider(ed) it a far too early start on the sort of martyrdom and guilt that many women impose on motherhood.

C Sections are incredibly safe for both the baby and the mother. I had two. They were both amazing. I healed very well and quickly from both, my scar (one on top of the other) is 2.5” long and under my pubic hair, I have no overhang, and my pelvic floor is entirely intact. I breastfed for 18 months and 20 months respectively. I have had no long term consequences bar the scar. I’d do the same thing all over again.

Having had a traumatic first birth which resulted in an EMCS, I opted for an ELCS with my second. As it was, I needed to have my second child early due to pre-eclampsia so technically had a medical reason for the ELCS in the end. But I was having it regardless.

I totally get the fear of having a traumatic birth and wanting to avoid that. I recovered very quickly from my second birth. It took me much longer to recover from my first, although they were technically the same. I put that down to how traumatic it was.

OP I must admit it’s all bit of a minefield. The fact you’re young and low risk they ‘will allow’ you to go to full term. A lot of C-sections happen after a failed induction- a lot of women are induced at 37/38 weeks due to being ‘high risk’ that fail.

I wanted a home birth, and after it not progressing at home, nor after all the induction drugs too I had an urgent C-section. (FYI a lot of women say they had emergency C-sections but if their partner is in the room it’s either an unplanned/urgent C-section).

When we try again I’m going to choose a midwife led birth and if that’s not possible I’ll request a C-section. I won’t be faffing around with inductions/medicalised birth.

NCT was great for us but I do wish I had did a hypnobirthing course too just for the knowledge around different types of births/options.

As the poster above said, hypnobirthing is really helpful. I thought it was a bit hippy dippy before I looked into it, but because you are calm and in control it lowers your chances of interventions. The big risks of c sections are haemorrhage and infections. Also remember that if you go for a vaginal birth and then things get tricky you can say no to forceps/ventouse which increase the risk of damage to you and opt for a c section at that point. Just make sure it's in your notes in advance so things don't progress too far for that to be an option.

I picked ELCS for DC2 and 3 after having vaginal for my first. I had a very positive pregnancy experience but from the moment my waters broke every health professional I was in contact with dismissed my experience. I was wrong, my waters hadn’t broken/ my contractions weren’t that bad / I wasn’t in active labour / I didn’t need to push.

I had opted for a home birth but I really struggled with contractions. Didn’t realise I was in fast labour so they were more intense. When I was told I was only 1cm dilated (which was not true) I said I would need to go to the hospital for pain relief. I had to get a taxi although I couldn’t walk I was in so much pain. They only let me in the birthing pool because I ‘wasn’t coping’ and they were unusually quiet that evening. I was told I would have to leave the pool when someone who was actually in labour needed it. I told them I felt the need to push and they said I wasn’t at that stage yet so they didn’t support me through it. When I gave birth 1.5 hours later they were pretty sheepish about telling me I was wrong for the previous 3 hours.

I had a third degree tear that I may not have had if I had been taken seriously. I was so lucky not to have any complications with this. I have friends who have had serious complications - renal incontinence / nerve damage.

For me it wasn’t the pain (never did get any pain relief) or even the tear. Those things really pale into insignificance when you have your child in your arms. It was not being respected through the experience, being told I was wrong. That really affected me. I wasn’t going to trust the process again. I found my first ELCS a really positive, healing experience. It was not on medical grounds, the consultant recommended a vaginal birth because I had fully recovered from my tear but I refused. My only regret is not having a ELCS for my first. I laugh/cringe at the old me that thought I was going to do a homebirth 😂

Mine weren't medical reasons as such but related to my mental health- I requested one because I wouldn't have coped with the uncertainty around a natural birth. I also had GD and was anxious about the possibility of things going wrong towards the end with that.
Midwives I saw didn't try to change my mind although they weren't exactly supportive of it either. Mental health midwife I spoke to was supportive.
I was due to attend birth choices clinic which I think is when they would have tried to change my mind. But I never made it as I had an emergency section at 37 weeks for very high blood pressure and a couple of other reasons.
It confirmed to me it would have been the right decision: despite my partner not getting back to the hospital in time I felt very reassured throughout and recovery was straightforward

I don’t yet know if it counts as a medical reason yet until I see the consultant this week, but I’m requesting one as I had a very rare gynae surgery 5 years ago and the one study on this surgery found that women who had it were more likely to have cervical and perineal tears, an EMCS and sexual dysfunction after a vaginal birth. I can’t be sure of the efficacy of the study, but I’d certainly like to avoid tearing if I can really! I could cope with a first or second, but I’m really scared of a third or fourth degree.

I also found an infographic from my local hospital which showed that almost 50% of births there in February were CS. And very few babies were born in the midwife-led centre. The majority of vaginal births were on labour ward. This has made me question the levels of intervention and EMCS that might be happening there. I don’t want an assisted birth or an EMCS after labour.

My first born son ended up being born by emergency c-section after a very long, painful and exhausting labour. The idea and uncertainty of giving birth again terrified me and I really didn’t know when I would come around to the idea of doing it again… Until a friend posed the idea that I could ask for a planned c-section. Totally changed my perspective.

My second son was born by planned c-section and it was the most wonderful and calm experience. I think it healed my trauma from the first time around. From the moment I requested it, no one pushed back at my request. No regrets at all!

I looked at the stats in my local hospital for number of forceps / ventouse deliveries per month, and how many vaginal deliveries ended up being emergency C-sections (one in three).

I then looked at the research for the percentage of new mothers who had bowel and/or urine incontinence one year after delivery (horrifyingly high), and/or any other birth injuries such as prolapse.

I then had a friend left unable to walk for nearly six months after a vaginal birth, and saw the impact of this on her mental health.

I think the idea of tearing/episiotomy is horrific.

Finally, I work with children and families who sadly have experienced acquired brain injury or other conditions due to a lack of oxygen in natural delivery. I've seen the effects.

There was no alternative for me - ELCS all the way.

Thank you for this. Where would you find such detailed stats?