Maternal requests for C sections

[littlepippip]

AIBU to ask for your experiences of a maternal request for C sections? What are your experiences asking your GP/Midwife/consultants through to the birth and after. Very much appreciated thank you

I decided I wanted a CS because of my assessment of the relative risks in a worst case schenario. I live in France, the first doctor I asked about it asked me to stand up, then said I was tall enough to give birth naturally (!). The second said absolutely not, no discussion, it was her decision and her responsibility. The third was sympathetic but told me it was not French policy to allow ELCS. I went to Greece to give birth. My consultant there had seen his wife struggle in labor only for their son to be deprived of oxygen and be born with severe disabilities - he changed his mind about ELCS for his patients from that day onwards.

I live in the north east, with dc1 I had an emergency section. Dc2, I was sent to the consultant because of previous section. He told me I was an ideal candidate for a vbac which I didn't want. I told him I wanted an elective section because of my own fears and asked to be referred to another consultant. After going through my reasons with her (new consultant) she agreed.
Dc3 - automatic c-section.

Despite my first section being an emergency they were all positive experiences and I'd make the same decisions again.

If it's what you want don't be bullied into it. Stand your ground and request to see a new consultant.

Good luck

I had a maternal request elcs for my first birth last year. My new was supportive, even popping into the hospital to be there when I saw the consultant on her day off. I didn't see the consultant on that day as my me said he was "in a mood and wouldn't agree to it." But she told me not to worry and arranged an appointment with a different consultant. I did have to go for an assessment with a perinatal(?) mh person and they agreed that an elcs was in my best interests.

The second consultant agreed immediately. He said that for the baby the risks of a csection were no higher than a natural birth, in fact were slightly lower for a csection.

OP I think as long as your friend is determined she will get her csection. As a pp said, a consultant can refuse but they must refer you on to someone else.

new should read mw. West Midlands btw

Acting as an advocate for women is part of a MW job description.

I am perfectly happy to refer any woman to a consultant so she can make an evidence-informed decision about how she might like to birth her baby. If she has no joy with the consultant (& there is no reason why she shouldn't, given current NICE guidelines), I will find her another one.

As a MW & as a woman i feel it is up to each women what goes into and comes out of her vagina. End of.

Pleased I work in a unit where women's voices are listened to and respected.

I had a birth debrief then CBT for PTSD after DS was born and both midwife and CBT person agreed I would be suitable for an elective c-section if I get pregnant again. The CBT counsellor is the maternal mental health head for our county and as it happens is the person women are sent to if they request a c-section for mental health reasons.

The question is should the NHS fund this ? I have no idea of the costs - but if you are wanting a baby but to scared to have the baby - that's a problem no ????

As a MW & as a woman i feel it is up to each women what goes into and comes out of her vagina. End of.

Totally agree, Couldn't have put it any better

My role as a midwife is to inform and support women, not to infantilise them.

Stop - I assume that's part of the reason those asking for an ELCS have to jump through so many hoops rather than being granted one automatically. And they need to weigh up the risks to mother and baby of saying no, which could then drain NHS funds further post birth I guess.

stop it's a lot more £ to fund a vaginal birth and then CBT/counselling/ treat PTSD/depression etc for endless years than it is to help a woman make an informed choice about the birth she wants (&a needs) - if that birth is an elective section then so be it.

Why is it a problem? Some of us want a children but can't face the birth for various reasons, why should we not have children because of this.. Why should people miss out on such an important, life changing thing? I've been told the costs are not that different when you factor in all the after care a lot of women need after a natural birth- physio, repairs etc. If I had gone through a natural birth I would have cost a lot in mental health dealing with PTSD. I can confidently say having a section made me a far happier parent (just me personally)

I had my second baby by ELCS as my first baby was a section after a failed induction. I felt pressured by the HCPs I saw to have a vbac and I felt my concerns weren't really taken seriously. I had to be very firm to get my section and had to go through several appointments with a Registrar, then a midwife and then a consultant ( felt a bit like hoop jumping) before they would agree to the section and I definitely felt like the negatives and risks were highlighted. I had statistics quoted to me that weren't correct for vbacs ( I read up on the success rates for vbac in women similar to me) but I'm glad I was confident in my choice as it was right for me.

Yes Agatha completely true it is a crap argument, and costs for all birth interventions vary so much by the set-up of services anyway

What a joke that we have choice in everything else (which hospital etc) but apparently we should not have choice during birth ... Those women trying to take up the NHS budget

I don't think "demanding" is the way to go though. It doesn't show that you have valid reasons, and is likely to get medics backs up as you're basically dismissing their expertise and their job.

Speak to them like professionals, show you have thought it through, lay your reasons in front of them backed up with as much of (their own) information as you can.

Like I said, their job is to make sure you are making an informed decision. A demand isn't an informed decision and they wouldn't be doing their job if they didn't walk you through the options. If they are confident you know all the information, they will let you make the decision.

I was terrified of giving birth - first time . Absolutely petrified and surprise surprise i had a fairly shit birth . I would have loved a c section.

I think any women that had a horrendous first birth resulting in major trauma deserves the consideration of an elective CS

I don't however necessarily think that every petrified first time
Mother should get one that's all - sorry not a popular view I expect

I had to have an emergency c section after no pain relief for hours- baby was back to back and wouldn't turn- and wouldn't wish that on anybody. No control, horrible environment and you can't see anything, I couldn't even hold my baby after he was born. I don't have another birth to compare but I'd definitely be trying to have a natural birth next time. Plus you're immobile for days after and the scar is horrible. Yes it fades but after 18 months my tummy still has a little pouch hanging above the scar despite being toned everywhere else.

In my personal experience, I wouldn't be asking for a c section.

I don't disagree with you stop - lots of things need to be considered but the HCPs have a duty to understand that fear and the reasons behind it and support the mother in making an informed decision. I'm sorry your fear led to a shit birth that must have been very hard.

In my case there was tokophobia with the complication of historical sexual abuse so the midwives were genuinely shocked the consultant was weird about it but I don't think it should have to be those kinds of circumstances alone where women choose an ELC.

for you musical

I found not being able to see anything very reassuring personally and my understanding is that EMCs do tend to be much more stressful. I did have some pain overnight but was up and about same day and walking with ease within a day or two. The scar took a while to completely heal but my stomach is the same it was before I had DD. I think everyone has different experiences and that's why it's so important it's the mother's informed choice.

Ah thanks puppy - actually my friend helped me get over the fear factor (God knows how ) and had a fairly pleasant second birth .
I always support elective CS when people are damaged after a birth (emotional or physical)

I wasted that NCT money that's all I can say !

Slight derail - dc2 is 8 months old and the area around my c section scar is still completely numb. Anyone else had this?

After having DD - 54 hour labour, 3 failed attempts at ventouse, rotational forceps and a massive haemorrhage that needed multiple transfusions and a 3 day stay in ICU - I was told by all the medical staff that they would absolutely recommend a c-section if we have another.

Even the most natural-birth centric people I know have said it would be the safest choice and they would advise against another VB.

I do think it's up to the woman.

However I do think they need to give you information that you can make an informed choice. They were obsessed with the possibility of scar rupture, but no dr informed me that my chance of placental problems would be raised if I agreed to another CS for example. I felt their information giving was very poor. It was selective at best.

stop it's a bit odd that you present an argument based on funding when you admit having no idea about the costs! The immediate costs of a CS vs an uncomplicated VB show VBs to be more cost effective but of course this is not always the case when you look at longer term costs and aggregate results. VB costs include costs of complicated VBs and once you add the costs of caring for neurologically damaged and oxygen deprived babies into the equation CSs become extremely cost effective. Which shows the dangers of making cost based decisions in the NHS! If these numbers are correct, and we base decisions in cost, then women should have to run through hoops to have VBs. Clearly this is perverse as birthing methods are a deeply personal and subjective decision, ranging from free births to ELCS.

boo it's very difficult to attribute the problems to one birth. For example placenatal problems are more common in women who have had a previous CS. Their next baby is therefore more at risk. If the next baby suffers with placental detachment and then suffers damage even though it's a normal birth, the problems are created by the previous section. Unfortunately the stats don't tend to count those episodes.

There was a study that looked at the maternal career of a woman rather than looking at each birth in isolation which helps one understand why there is a general push towards vb if you can. That gets into the realms if preventative medicine and lowering the risk of a population for the next birth. Which overall matters, although maybe not to each individual.

Having said that choice is good.

There is an assumption after a traumatic vaginal birth, that an elective caesarean will be less traumatic, which isn't always the case. The birth, immediate aftermath, and long lasting knock effects can also be traumatic.

Faster - the area around my csection scar is numb, but also has moments of being very itchy or painful.....6 years on!