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.

Private - its also possible to have stitches done on just a few whiffs of gas and air - so that's pretty cheap too!

And DrMcDreamy, I think you're being extremely disingeneous in your suggestion that the default option is surgery, with VB as the afterthought.

No one ever advised me of the risks of VB or offered me an alternative during my antenatal care in my first pregnancy. It's assumed you'll go for a VB, no going through the risks or signing of consent forms required!

DrMc-the other way to have a baby is often dangerous, so a CS may be the safest option.

I had an EmCS with DD1.
I then had to really fight for the second CS, at 39 weeks they reviewed my notes and told me to come in the next day for a CS, as they had grave concerns about me going into labour naturally.

I used to get upset when people felt they could make judgemental comments about my 2 CSs. Now I politely tell them they don't know what they are talking about.

Csections save numerous lives. Yes they might have more risks than a vaginal birth but that isn't the case for every birth. I and many other women and babies wouldn't be alive today if we had no csections.

Ooh that is a good question DrMcDreamy. How are we all defining 'better'?

My ElCS went like a dream with no health problems for myself or baby. I knew that the position of the placenta, despite being dangerous for VB, was in a nice safe place for CS. So in that case it was 'better' because I know that we would both be dead if we'd gone for vaginal.

But next time I would like a VBAC. Why? I have to be honest and it's only for my own personal reasons, nothing to do with a baby and its needs. I felt a bit 'cheated' because I never experienced a contraction. However if I was advised against a VB then I would follow that advice. I don't necessarily think it's 'better' because I'm not sure how I'm defining 'better' when there are no other medical indications.

And on that note, Is anyone medically advised not to have a CS? Why/why not? Does that mean CS is the safer way out (not necessarily the more comfortable)?

Iknowyouarebutwhatami You seem to be confused over what I am saying. I am not saying normal vaginal delivery no matter the cost. I am advocating normal vaginal delivery as the default starting point for every 'low risk' pregnancy, previous sections and those whose MH would be affected by normal vaginal birth do not fall into that category. I am saying ELCS just because you don't want to give birth (with no other mitigating circumstances) is not a good idea.

I would be advised not to have a cs due to a blood disorder.

Panzee "Is anyone medically advised not to have a CS? Why/why not? Does that mean CS is the safer way out (not necessarily the more comfortable)?"

That's a really good point.

"I am advocating normal vaginal delivery as the default starting point for every 'low risk' pregnancy, previous sections and those whose MH would be affected by normal vaginal birth do not fall into that category. I am saying ELCS just because you don't want to give birth (with no other mitigating circumstances) is not a good idea."

But the OP HAS had a previous section, and DOES have mitigating circumstances

That's why the op should find out the least risky method for THIS pregnancy. A previous cs doesn't necessarily mean a cs next time is the safest option- each preganancy needs to be considered on its own merits

I KNOW!! I'm off on a tangent answering someone elses question about whether or not sections should be available 'just because'. I have never argued that women with mitigating circumstances should be denied sections.

I don't think anyone has mentioned the increased risk of secondary infertility after a CS.

Wiggly- the whole thread is about risks, weighing them up and choosing the method which poses the least risk for each baby

What a strange tangent.

Seriously, HOW many women do you think there are out there who have c-sections 'just because'? And how many of them do you think there are on this thread?

As if ELCS are given out like sweeties on the NHS!

Ironically, it turns out it's nigh-impossible to find any statistics on assisted vs spontaneous childbirth thanks to pregnancy sites and blogs about "natural childbirth" muddying the waters.Could be a subject for mumsnet to do a survey on, I suppose.

DrMcDreamy: my definition of "better" in that post was "least traumatic physically and mentally for mother and child, and costing less to boot".

"I am saying ELCS just because you don't want to give birth (with no other mitigating circumstances) is not a good idea." - why? I've proved the costs of ELCS and assisted vaginal are similar, ELCS being slightly cheaper. If everything went perfectly with a natural childbirth this wouldn't be a discussion.

Regarding your argument with Rianbean:
a) Cost

• nope

b) Staffing levels are nowhere near high enough

• same issue as cost, nothing to do with the mother.

c) Space, current maternity units are designed for the reasonably quick turnover that vaginal delivery generates.

• Elective, planned cesareans can be done on quiet days, two posters here have said they were out in a day or two

d) Why would you give someone surgery that didn't need it, "First do no harm...."

• rinabean covered this

e) The risk of post surgery infections/difficulty in mobility following section.

• In the 80's, yes, not any more.

f) We already have a perfectly good way to get babies out (for most women).

• Not perfectly good at all; I concede that "most" is impossible (for an internet argument) to prove but that negates the issue for both sides.

privategodfrey: I had to ask my partner what an episiotomy is. Thanks for that. Did you only put that in because I said about going weak at the knees? :P

iknowyouarebutwhatami Agreed. It just doesn't happen. When I was booked in for my CS I told everyone I was too posh to push. Nobody wants to know the real reason and it's none of their business anyway. I'm sure I'm not the only one who just didn't go into the gory details, which can give the impression that we all just walk up and ask for one.

iknow exactly. The woman who is "too posh to push" is a myth IMHO. Reasons for opting for surgery are likely to be far more complex.

And even if she wasn'ta myth, absent budgetary contraints and assuming the woman is fully informed, who on earth cares? Why would it grate on one woman that another elected to have a surgical birth? It doesn't make anyone else's decision to opt for vaginal delivery less "good" somehow, so why the problem? I really really don't get it.

"I personally think that the NHS should not fund a C-Section, repeat or otherwise, unless there is a proven medical or emotional (ie lose of baby during natural birth) need."

The thing is that it isn't as black and white as that. My consultant actually guaranteed that I would not tear if I gave birth to ds 'naturally', now I am not a medical expert, but I know that is bollocks. I tore badly with dd1 (despite a very active labour in a mlu), and dd2, so as I far as I could see the only way she could guarantee no further damage was by a c-section, which was agreed to by another consultant, who was a little more sympathetic to my fears re a lifetime of double incontinence.

Oh and can I apologise for the shitloads of money that I have cost everyone with my extensive use of the nhs - fertility treatment, a molar pregnancy, chemotherapy, surgery after 3rd degree tear, a c- section and a baby in scbu!

iknowyouarebutwhatami and DrDreamy - I suppose there was a bit of that tangent in my original thread. There is an underlying opposition amongst many people to c-sections which I just don't get. I think it's bonkers and rude that people in RL question my c-section(s) which have valid medical reasons, but I also happen to believe that elective c-section is a very valid, baby-focussed way to give birth.

Cost to me would be the only reason why we shouldn't all be free to choose c-sections - and it seems there is some debate about that.

It's crazy that we are so opposed to c-section as a method of delivery that people look down on it as inferior. Even crazier that they look down on it when it is medically indicated, as in the majority of cases.

found it....

this is the site I found very helpful when weighing up the pros & cons myself whether to go VBAC/ELCS second time round, just in case it is useful to anyone.

Totally your choice.
I had a crash section with my DD and her birth was so traumatic I had an elective section with my second child. I did briefly consider a vbac but the list of constraints that were to be imposed made me decide against it. So check your hospital's policy if you are considering it.
My hospital said I had a maximum of 6 hours to labour in, had to be continually monitored (so on my back again) there were others but it is years ago now and I've forgotten.
My decision was a calm elective section. It was the best choice for me and my baby.

Those who are considering a Csection have probably had horrendous if not life threatening experiences already.

Their wishes should be paramount. As others have said there is no evidence an elective Csection is worse than a trial labour, therefore the woman should be allowed to choose how she gives birth to her child.

Wading in here. So far one ELCS and one EMCS after trying for VBAC.

Who wants to be cut open seriously?

Me. If I have a 3rd DC then I'm damn sure having an elective. No way on earth would I consider labouring again. The labour pains weren't so bad it was the SPD that was horrific for me and the failure to progress.

Whats wrong with giving birth naturally?

Nothing for those who want to do it. But see above. I was in sheer agone for 19 hours and nothing would take the pain away and I didn't dilate past 2cms at all!

Or is it can't be arsed with the labour pains?

Labour pains were bearable, it was the pain shattering through my hips and back that was so horrendous.

you go for your ELCS and bloody well enjoy it.

Iknowyouarebutwhatami have you followed the thread? At least 2 posters stated they had sections because they did not want to labour and another asserted they thought sections should be available to all 'just because'. I have also repeatedly stated throughout that I do not think sections should be denied to women who have mitigating circumstances. Ok so it is a deviation from the main question but I did answer that towards the beginning where I stated that it sounded as though a repeat section was a valid choice.

bonzairob in response to your most recent post.

Cost - Yes, cost is increased when comparing normal vaginal deliveries to caesarean sections. It is. I don't care what piece of American hogwash you have unearthed to refute this suggestion I respectfully reply that it is a load of bollocks.
Staffing levels - It has everything to do wih the mother. You ask the mother who was left to labour on her own because there was no one to look after her.
Quiet days? Really? In the unit on which I work we are currently working on 5 elective sections per week day. Thats 25 a week. Thats in addition to the normal workload of the unit. We deliver upward of 8000 babies per year. There are no quiet days. Incidentally we are staffed to cope with around 5000 deliveries.
I can't remember what Rinabean said so I can't answer that one.
Risk of infection/mobility issues. In the 80's? Have you ever looked at the sheet that we give to post section women? The list of 'can't do's' is immense - rightly so, it's major surgery. And there is always going to be risk of infection to a fresh wound.
And I think I have already answered F) further upthread.

Caesarean section is brilliant if you need it. Lifesaving even. If you don't it's just unnecessary surgery.

I am booked in for an elcs on monday after an emcs last time, although i just found out the baby is breech so no doubt it would have happened anyway, op it is entirely your choice

I dislike the argument about money and NHS resources. Follow that to it's natural conclusion and you could say we're all selfish for having children in the first place. Think of all the money we are costing the taxpayer by breeding!
I had an EMCS after two days of labour when I had been fully dilated for many hours and the baby became distressed. My scar was/is huge (a specialty of this surgeon I gather) and the pain and recovery was long. BF was hard too, though I did manage to. It was six months before I felt physically well again. That made me very keen on VB. However, in my second pregnancy (which I had to be talked into!) I was sent for endless scans and tests because they suspected brain damage. I also had a low-lying placenta and due to the massive scar my consultant said an elective was safest. The point she made was that going through labour and having another EMCS would be much worse than planning the birth. Of course the placenta moved up in the final week and just before I went into theatre the doctors appeared to tell me that they had decided that the baby was within the normal range and not brain damaged so I felt a bit cheated out of a natural birth. But the ELCS went brilliantly, and I BF more easily and recovered more easily than the first time.
I actually felt terrible guilt after both births, like I wasn't a proper woman. That is bollocks. Reading this thread has helped me realise that and I thank you all.
OP. Have the ELective and don't feel bad. Best of luck!