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.

There are health and developmental benefits to your baby of going through labour. Hormones are released that encourage certain brain developments, which is one of the reasons why healthcare professionals encourage women to go into labour.

Having said that, it is entirely your choice to ask for a planned CS but be prepared for the obstetrician to try and encourage you to have a vaginal delivery.

I think it is a valid option. Where would this end if it wasn't - no treatment for smokers or the obese....not a world I want to live in (I am neither btw)> you really don't know until 8 moths or so how you will feel

I had what was called a semi elective c section. As I am diabetic NHS policy is to deliver early (although this is not NICE guidelines) so I spent 4/5 days in hospital while they tried to induce me. As I am high risk I spent this time on the delivery suite gettig no sleep because of the noise (screaming, mostly) and increasingly scared witless by all the medical histories I couldn't help over hearing,

I particularly remember the staff bullying one woman on her third child who was clearly shit scared at vaginal delivery having had traumatic previous experiences.Her consultant had agreed c-section then when she turned up the midwives bullied her into so called "natural".I hope she was OK as she was crying.

The consultants kept changing every shift and therefore changing advice / changing their minds about whether they could break ny waters, After 5 days of people sticking their hands up me I was terrified of the pain - maybe some of the people here think this should be a test you have to pass before you're allowed to get pregnant?

Quite frankly I was terrified of c section too and if had been offered magic chance not to be pregnant I would have taken it.

Finally I gt a consultant - a man btw - who could see I was knackered. My choices were to "rest(ha!) " in hospital for 2 days then startduction again or have a c section. I am so glad i had it, I am convinced further induction would not have worked and by the time it did I would have been too exhausted to do anything let alone push, and my husband would have had used all his pat leave before I left hospital.

Furthermore they completely f*** up my diabetes care before the op and ignored my (expert patient) requests for help - goodness knows what would have happened if they'd been allowed to take charge for duration of natural labour.

Someone posted here they gave birth in 10 minutes on the way to the hospital. this comes across as fairly smug tbh - bully for you, it is not that easy for everyone. Most of my friends have had complications and pain relief has not been available in several instances.

It may be different if midwives were less busy and less stressed and I had more confidence in that but that is another issue....

(BTW how many resources do homebirths take - 2 midwives......)

"Only a woman knows, for example, whether she is likely to cope with the mental trauma from loss of control associated with interventions in VB (or whether she would rather avoid that risk entirely). Or whether, given the lack of midwife support in many hospitals, she would be better off with a CS than trying to labour alone, unsupported."

Which goes back to the point I made earlier, that improving provision at the basic human level, ie providing more MLUs, where a woman can labour in a homely environment,supported by a midwife (ie the specialist in supporting labour) and without doctors rushing in and out every 5 minutes, is highly likely to improve outcomes and probably save money too.

It seems to be forgotten that MOST pregnancies CAN result in natural straightforward deliveries. However, sadly, the culture these days is that many women expect to have horrendous labours, they expect that they will need drugs to get through it, and they are fearful of a non medicalised environment. In some countries, eg the US, the situation is even worse, with women routinely giving birth numbed up with epidural.

If a woman is totally sure that she is happy with a medicalised birth (and if she is happy with the possible side effects of this) then fine - but for all the women who want to have a csection, there seem to be just as many who have had very medicalised births and regret it, and actively seek a different experience second time around.

If there is a medical need for intervention, that's one thing, but so many interventions take place which are avoidable.

'Not your money though is it.
Just waste valuable nhs money because you 'can't be arsed' with the pain. Same as people who 'can't be arsed' to pay for a taxi and call an ambulance instead!'

By that logic, people who are drunk shouldn't be treated by the NHS for free, either. It's totally unecessary for people to get drunk.

Yeah and I bet there isn't many folks who agree that treating drunks at the weekend is an appropriate use of NHS resources either.

No more bariatric surgery, either. There are alternatives to that, too.

Alimat1 My experience was the same - no midwife at elcs with dts. Only saw her for bloods and urine throughout.

Violethill - I'm sure you didn't intend any offence but I don't think it's really fair to refer to people having "very medicalised births and regret[ting] it". I think most people who have a large degree of medical intervention the first time round do so for a medical need. It shouldn't be a case of them regretting it - that really implies that they have done something wrong which they haven't. Most will not have had a choice anyway.

I think it's this culture of implying some sort of blame when a woman has medical intervention that:

a) fuels the sort of comments that I refer to in my original post
b) creates the scenario where women feel guilty or like failures because they haven't had perfect births - many of the posters on this thread have referred to feeling like this.

The cultural movement which glorifies intervention free childbirth ignores historic maternal and infant death rates before progress was made in obstetrics. Let alone the pain that women went through.

expatinscotland Kindof. Except if a fatty needs surgery then there isn't another option. They need surgery. There is another way to give birth. You don't HAVE to have surgery.

Thats not to say that specialist bariatric equipment and surgeries and recovery times and complications don't cost the NHS money it can ill afford, it does, absolutely and life would be a lot simpler if we just banned fat people BUT I don't expect even a Tory government would go for that.

YANBU. I chose to have a c-section for my first birth and have done so for my second due in July. Of my dozen or so closest friends who have had babies they all had terrible births - 2 nearly died as a result - and most ended up with EMCS. When I told my doctor this as the reason for my decision to have ELCS with my DD she just said "fair enough" and put me down for an ELCS. I had even less of a fight this time. I have never regretted my decision and have become evangelical about ELCS - I really really don't understand why any woman would choose to put themselves through the pain of childbirth - but I defend every woman's right to choose how they have their baby.

"There are health and developmental benefits to your baby of going through labour. Hormones are released that encourage certain brain developments, which is one of the reasons why healthcare professionals encourage women to go into labour."

Can I have more information on these hormones which encourage certain brain development?

What hormones?
Specifically, what aspect of brain development?
Are these hormones present in breast milk, and could a section baby not benefit from the breastmilk or do these hormones need to be delivered through the umbilical cord's blood supply?
And what about a woman who has a section after going into labour? Does her baby gain the same benefits as one delivered vaginally?

Oh, the NHS' valuable money??? My fucking arse. That was my money once, and it was just as valuable to me then as it is now. 'tis the NHS who is ungrateful with the money I give them and not the other way around!

Strix - I wondered about that too. I thought it was mum who was rewarded with a release of endorphins. I heard being pushed through the birth canal can aid breathing but not that it can have an effect on development.

Schmee your choice and hopefully your choice with be supported fully by your consultant.

Have you thought about the recovery period with two older children to look after as well? Will you have plenty of help at home afterwards?

Unless it was for overriding medical reasons I'd rather go for VBAC than have another C-section purely for the recovery.

Also I think the 'medicalised birth regret' point that Violethill made, isn't about the intervention itself.

I think highly medicalised births are very traumatic if not planned, my emcs experience resulted in my baby taken away (meningitis)before I had the chance to hold her. I did not see her for four hours afterwards. Out of everything I went through over those two nights and three days, that is the single most painful memory.

I think when women seek an alternative after a traumatic, medicalised birth, they want to ensure it doesn't happen again. It isn't about the process of the birth, it is about the traumatic memories and emotions attached to it.

A friend asked for a C section for her DD2 having received an emcs first time round. She was determined she wanted a c section again, she wanted everything under control. The reason? Her mother died three days after she gave birth to her DD1 and the idea of revisiting that trauma - the two things seemed to have become linked in her mind - was just too much.

There was no medical indication apart from previous c section - but she was granted one.For many on this thread she should have grown up and got on with it. I'm glad she didn't have to.

To the person who pointed out that you have two midwives at a homebirth. You are right. The cost of two midwives (and the second midwife is often there for less than 2 hours) is far, far less, than running a fully staffed hospital ward for the same birth.

FabbyChic have a .

OP, YANBU - stand your ground and demand an ELCS. Good luck with it all.

To the person who pointed out that you have two midwives at a homebirth. You are right. The cost of two midwives (and the second midwife is often there for less than 2 hours) is far, far less, than running a fully staffed hospital ward for the same birth.

Yes but that hospital ward would still need to be there and staffed in the event of the homebirther being transferred in therefore the cost of the two midwives is additional not instead of.

for those who had an EL LSCS, and had NO midwife at all present, can they please tell me who took the baby from the surgeon at delivery?
And who did the paperwork
And who registered the newborn baby to give it its NHS number.

im genuinely interested, because as far as I know, I dont know of any hospitals local to me that do not have a midwife at delivery - they are there for both mum and baby

No idea Alimat1 - funnily enough I was more focussed on my babies than the paperwork! No-one was introduced to me as a midwife though from memory - I think there were nurses there as well as some student doctors.

Then i reckon those 'nurses' were midwives

Thought you'd say that - they weren't introduced as such and I wasn't told there would be a midwife there but may have been, or at least performing the role of one if the midwife's job is to do the paperwork etc. Is it important?

yes its important as higher up someone said midwives only attend emergency sections giving us a false sense of sections. And that they do not attend elective sections.

I said where I work, indeed everywhere i have worked, midwives attend EVERY section.
It is our duty to care for both mum and baby.
Therefore we see all emergencies and all electives.

I dont suppose the scrub nurse introduces herself.
Or the ODP either.
Or all the student doctors.

You must have arrived at the hospital been admitted and prepared for your section by a midwife.
And taken down to theatre by someone.
And taken back from theatre by someone
And recovered by someone.

I Had an emergency section, followed by a planned section. Room full of theatre staff, obs dr doing the section, midwife to take the baby, and a paediatrician.
After the first section, it is common to try to persuade you to have vbac. I had no choice as the baby was transverse. With subsequent pregnancie, the risk of uterine rupture during attempted vaginal deliveries and other such difficulties becomes increased.
In the end it is your choice to decide how your baby is born, and is certainly not the easier option.
Good luck with your delivery x

normantebbit and strix make good points.

Personally I dont; feel great for not having a natural borth but it was best for me at the time and I have to remember that.

Thanks Chynah - that was what I meant re cost. Not sure that shutting the delivery suite for non emergencies and having two midwives for everyone would be cost efficient.... but having the FULL attention of 2 midwives would probably assist anyone.

The whole process seems a bit messed up to be honest, some extra finessing of design features would help - maybe a zip:)

problem is many women attempting vbac are often doing so after a previous bad experience which ended in emcs. With the risks involved and that many Vbacs end in emcs anyway - you need to feel really strong and confident that you can pull it off. Not very nice entering into a possible risky labour that has a quite a high chance of emcs when you can bypass that worry by opting for an elcs. YANBU.

I definitely had a midwife at both my ELCS although baby was given straight to me and the midwife did the stats/monitoring/paperwork etc back in recovery.