to think elective repeat caesarian is a valid choice?

[schmee]

I'm currently pregnant with DC3 and would like to have a repeat c-section. I had a planned c-section last time as had twins, one of whom was breach. I haven't seen the consultant yet, so I don't know if I'll be allowed one on the NHS but I hope so.

I remember last time round people saying "oooh I don't blame you if you're having twins" when I said I was booked into for a section. I really don't understand what "blame" has to do with it, particularly as the decision was made to safeguard the health of my twins. This time round if I say my preference is for a repeat c-section the response is even worse, with people from frenemies to strangers feeling able to question my choice and try to get me to reconsider. WHY?

I wondered if people here think repeat c-section is a valid choice. And whether anyone's mind about planned sections had been changed by watching One Born last night which showed what a calm and baby-focussed scenario a scheduled section can be.

This is my last post as this thread turned into a mud slinging match.

OP asked "if people here think repeat c-section is a valid choice." I don't because (as question is asked) it is an unnecessary surgery that sucks resources away from the NHS. This money could have been used for terminally ill child that needs an expensive drug or surgery that is not routinely offered on NHS. Did you guys who are smug about "finally getting my ELCS" think about this? Probably not... it is not YOUR business, YOUR body is YOUR business.

To OP I wish you all the luck with the new baby, it is magical time and enjoy it to the full.

What rinabean said, above. Clytemnestra that is indeed a pretty picture. I can boast a wonderful caesar under local anaesthetic, just as you had, but I can't boast that I looked as glamourous and pretty as you did! :)

Violethill, that's really interesting. Thanks :)

I think control is probably also a big part of how you would feel about a given birth experience, which is why I'm mostly anti-intervention but think anyone who wants a section should get one. I wasn't aware how much of a role support played but it makes sense. The shortage of midwives in this country is appalling.

Okay how about hysterectomy's done for sterilistion purposes only?

Loving Clytaemnestra's pic too.

Having had a crash section at 34wks-nightmare, and a crash section at 37wks following attempt at vbac-how crap is that idea, then had absolutely lovely calm elcs for number 3-home within 36hours lovely lovely lovely! Surgeon said scar so great could have another, but he'd deliver earlier to prevent any risk of rupture-simples! At the end of the day, it's all personal choice and what's best for you, your baby and your situation. What everyone wants at the end of any birth,whatever type, is a lovely healthy happy baby and momma :)

Just the fact you thought c sections were done under general as a rule made me think you hadn't had one, have you?

bemybebe - I'll let the consultant be the decider of whether I've got valid reasons or whether I'm stealing money from a terminally ill child.

Clytaemnestra beautiful picture

Elective sections done under REGIONAL anaesthesia not local - in terms of complexity, risk and resources needed this is a significant difference.

Elective section is indeed a low risk procedure and more so when it is elective. However it is still more risky than uncomplicated vaginal delivery (obv no way of guaranteeing this!). There are higher risks of DVT / PE, PPH, infection etc etc.

As for recovery times from elective section being comparable - they aren't. They are still significantly longer than after vaginal births.

And as for vasectomies, I don't know the cost to the NHS but even done privately they only cost around £330. Compared to the cost of other contraceptives taken over a lifetime they are probably fairly cost effective. So no comparison.

And I speak as someone who has had a section.

I'm not keen tbh on it being offered for non-medical/psychological reasons on the nhs (ie 'I'd like a repeat c section') so perhaps that does mean I don't think it is a valid choice unless it's done privately or is for medical/psychological reasons. Can't say I'm hugely bothered about it but I'd rather the general guidelines stay as they are - vbac the preferred option

Interesting. People normally play the "think about the children!" card with regards to the baby being born when discussing birth choices.

I just wanted to show that planned c-sections are not actually terrifying and awful things, and that they really can be utterly positive experiences.

Am going to take the picture down now cos DH will kill me if he sees I'm showing the world pics of him in scrubs and a hairnet!

Do you have any idea how hard it is to find strait statistics about planned cesarean vs vaginal childbirth? Every article has an agenda. It's worse than when I was looking into America's gun laws vs our crime rate. I shit you not.

Anyway, I managed to find something that has a decent amount of references: e-articles.info/e/a/title/Vaginal-Delivery-versus-Elective-Cesarean-Delivery/

There'll be fodder for both sides here, unfortunately, but for anyone talking about NHS stress, let me point you to the bit above the Conclusion where it gives (USD) prices for each method:
---
Spontaneous vaginal delivery: $1,340 (bear in mind this is the type that could happen in your bedroom, like LadyOfTheManor's. Not indicative of the majority.)
Planned Cesarean without labor: $1,532
Assisted vaginal birth: $1,594 (the most common type in a hostpital.)
Vaginal birth after an induction: $1,715
Cesarean delivery after labor: $2,137
Not taken into consideration was the additional cost for the neonate or mother if they required ICU/NICU admission which could occur after any type of birth. (English: Aftercare for the baby or mother if they required hospitalisation afterwards).
---

So, planned cesareans are cheaper than most vaginal childbirth. Do your part for the NHS, ladies.

Any article you read saying that cesarean has a massively higher risk of infection etc. was probably written with sources from the 80's, as I found out. As we've heard a few times, it's not a huge incision any more.

Actually, I think prev C-section is a valid medical indication for repeat caesarian. Due to increased risk of scar rupture etc. Needs to be individual assessment and choice.

Shewasashowgirl I apologise, it may have been my wording that led you to believe I understood caesarean was a GA only procedure. Poor choice of words led you to that conclusion. I was trying to highlight the differences between a wee jag in the nuts and anaesthetic being injected into the spine, huge differences despite both being 'local anaesthetic'.

Oh sorry Smiley I wasn't comparing Electives with Vaginal delivery. My fault for not making my post clear. I was referring to other procedures done on the NHS that are 'necessary' like hysterectomy's and vasectomy's.

I agree with all your points BTW. I was just badly trying to point out that there are other procedures done on the NHS that could be seen as unnecessary. I'll sign off now because I am not making much sense

mercibucket - my OP might have not been clear there. I expect to be offered one for medical reasons, although I also expect to be offered the choice to attempt VBAC (which has about a 50% chance of success). But I would like one and know which my preference will be. I don't believe VBAC is the preferred option - I think that it's very much a six of one, half a dozen of the other situation according to the guidelines. Unless you know something I don't?

"This money could have been used for terminally ill child that needs an expensive drug or surgery that is not routinely offered on NHS."

Yep, still smug.

And, for the record, your being ridiculous if you think that's how NHS budgets work.

DrMcDreamy - you must think natural birth with epidural is also an invalid choice then - that's a needle to the spine job too.

And yep, to reiterate, I am still SMUG. Smug that I was able to make the organisation that was responsible for fucking up my head, my pelvic floor and my baby first time round deliver my second baby in a calm and trauma free way. Thank you for asking

shewasashowgirl - you're right about there being other procedures / treatments on NHS that are not strictly necessary, and it's really hard to work out what should and shouldn't be funded. Sometimes I wish we had a bit more public debate on this particular issue!

bonzairob - you're great and I would like to thank your DP for introducing you to this thread. So I will actually be saving money for other patients if I have a repeat section. Phwew.

IMHO a woman who has had a previous CS should be able to decide for herself (assisted by her consultant of course) whether to go ELCS or VBAC next time round, bearing in mind all the pros & cons.

just in case it hasn't been posted already this is the RCOG guide which gives good info on the pros & cons.

FWIW I planned a VBAC second time round after an EMCS first time round. Long story, but I eventually ended up with an ELCS at 40+10 when DS showed no sign of making an apprearance (had disengaged his head...) & my BP going up & up... (probably a good thing with hindsight as DS was 10lb 10.5oz & a head measuring off the scale )

Bonzai- you are referring to highly medicalised vaginal births, where a woman has an epidural (anaesthetists don't come cheap!) which may then lead to forceps or ventouse. Most births don't medically NEED to be like that!
A natural birth , supported by a midwife is way cheaper.

I haven't got an issue with anyone else's choice but I am stunned that people choose a CS over a VB for the avoidance of pain. Surely major surgery and inability to move afterwards is more painful?

The thought of a CS terrified me. Not just the surgery but having to stay in hospital afterwards and then bed rest for days or even weeks. DD1 (my middle child) was breech until 38wks. Thankfully she turned but I couldn't eat or sleep for fear of needing a CS. I guess if you feel that way about a VB, then your mental health would suffer.

However, I have to take issue with VB being the 'painful old fashioned way that modern technology allows us to bypass'. I heard this a lot in the States too. I certainly don't think VB should be hidden away under a file headed 'outdated medical practices' just yet.

FWIW, I've had 3 VBs and when people say they had an easy recovery from a CS, they usually mean at least a few days. I was up and home within a couple of hours each time. Driving the following day etc.

As I said at the start, I have no beef with anyone's personal choice but I do struggle to get my head around the concept of CS being an 'easier' choice. An elective following an ECS is a different matter though.

it might depend region by region - last I heard (a few years since I was in labour now!) our area only offered vbac unless you put a bit of pressure on the doctor. I can't imagine they really turned people down if they showed a strong preference for repeat c section but it wasn't offered and I know people who had to have natural births even though they'd wanted repeat c sections. thought it must be uk wide policy but perhaps not.