To be annoyed I’m having to fight so hard to have an elective caesarean?

[OutPinked]

Basically, after three 10lb babies, my uterus has understandably lost its tone. I am 28 weeks with my fourth and final baby but measuring 32 weeks. I’ve been referred for a growth scan which will be utterly pointless as they always are. They’ll confirm he’s a big baby then do nothing with that information because there’s not really much they can do. Passed GTT with flying colours and I’m not obese, it’s just genetics.

First delivery was shoulder dystocia with emergency forceps and an extended episiotomy. Stitches burst open and became infected, I was in agony for weeks. Second delivery was retained placenta and huge PPH, again I was rushed down to theatre then later given two blood transfusions. It still took me weeks to recover and feel human again. Third delivery went ok but I needed an injection to stem the bleed.

Last year I had medical management for a missed miscarriage. Had a massive haemmorhage, went into shock, fell unconscious and needed emergency surgery+ a blood transfusion. Again, it took me weeks to feel human and I was on iron tablets for months.

DP can’t face the trauma of seeing me nearly die again and I can’t face the trauma of doctors piling in from all angles, jumping on top of me and being rushed down to theatre either. We’ve both decided an elective caesarean is safest. There’s no risk to future pregnancies because there won’t be any. If I do start to haemorrhage again, at least I’m already in theatre surrounded by medics who will immediately be on top of it.
It just seems far more calm and controlled and to me, is an absolute no brainer.

However, I have now seen two consultants who have tried their upmost to deter me. I’ve had almost pointless risk factors thrown in my face (pointless because there’s more chance of dying in a car accident but that won’t stop me driving). I’ve been told that I may bleed more after a CS and when I’ve explained the fact its still safer than risking that blood loss after a ‘natural’ delivery they shoot me down by saying they will still be on hand if it happens after a natural delivery. They don’t seem to grasp that I don’t want them to have to rush in from all angles, I want them to just be there from the off. They also try to deter me by mentioning recovery time forgetting how long it took me to recover after my first and second deliveries as well as the MMC last year.

After yesterday’s consultant appointment, I now have to see an ‘expert midwife’ to ‘discuss birth options’ . Seems ridiculously patronising because my mind is evidently made up but it’s just another hoop to jump through... then I will have to see the consultant again if it’s still what I want (it will be). Argh! To me, it’s just another example of women not being trusted to make the right decision for their own body and I’m tired of it. It’s irritating they reserve so much energy to warn women of risk factors during a caesarean but never ever warn them of what can go wrong during a ‘natural delivery’ too.

Definalty see the consultant mw.

Mine was brain washed she totally ignored my feelings and emotions about birth one and was fixated on my amazing birthing hips .

I told her I'm more than a pair of hips and I really got insight into how narrow minded some of them can be. It was shocking.

Presumably you are not averse to a hysterectomy should that become necessary as you want no further children, so that risk factor is not a concern for you.

I think that you have grounds to ask for an ELCS. The advice you are getting seems rather out of date. It was certainly true when I had my children that a CS was a dangerous procedure - now it no longer is to the same degree.

Have you thought of/could you afford to go privately? A bit of money might oil the wheels.

And yes - I do know that the NHS consultants should be helping without all this hassle.

I remember watching a programme about a private maternity hospital and they all seemed to be lining up for electives with no quibble. Can't be right.

Have you got your GP involved? I spoke to my GP, who dictated a letter there and then to the consultant, I then also wrote to the consultant explaining why I wanted ELCS, quick meeting with the consultant and it was booked in there and then. Try your GP (again?) for support. Good luck.

Op insist on it.

I have had 3 natural births followed by two elective sections, all babies were 9 and 10pounders.

The natural births have left me with bowel incontinece and I also almost died from a Post partum haemorrhage after one of the natural births.

Without a shadow of a doubt there is a wall of silence when it comes to the long term damage caused by natural births. There is a stark contrast in the level of info given to women on naturals births v c sections.

So much so that the law has now moved to allow women to sue their trust if they suffer any ill effects of a birth whether it be natural or c section if they were not warned in advance of all the potential dangers and hazards of the procedure.

Research this online and you will see that Consultants will leave themselves open to lawsuits if they do not fully appraise the patient of the dangers of a natural birth.

If they do and then you insist you do not consent to a natural birth but will consent to a section then surely it follows they have to section you.

You have sound reasons. I would draft a letter outlining all your reasons for wanting a section and if you really wanted to put the cat amongst the pigeons cc the letter to your solicitor. But even putting your concerns and requests in writing means it is on the record and they will not want that to come back and bite them if anything goes wrong.

@Cheby nonsense, you can't make a sweeping statement like that, electives can be done for medical reasons like placenta previa where attempting a vaginal delivery would be very dangerous.

Elective just means planned as opposed to emergency.

And OP yanbu. Stick to your guns and insist on a cs.

The consultant I saw yesterday actually trotted out a line I can fully imagine he says to every woman requesting an ELCS. He said “people watch One Born Every Minute and think an ELCS is a straight forward process, they never show what can go wrong.” . I found it really condescending, as if to say I’ve watched OBEM (I haven’t watched it for years) and decided I want one flippantly. It was quite bizarre actually.

I agree with all of your points. A hysterectomy would have been beyond devastating had it happened during the two ERPC’s I needed last year for MMC’s because I desperately wanted this fourth child. Now I have him though, not so much. Our family is complete. I did say that to the consultant yesterday actually and he dismissed it again because it’s ‘serious surgery’. Of course it is but it’s a small risk I’m really, truly willing to live with.

They merge EMCS and ELCS into one big lump. I saw him gulp when I stated that EMCS’s are twice as risky and that the stats are wrongly merged together. He took a big gulp realising I am pretty clued up.

I will see the ‘expert midwife’ of course but I’m merely treating it as another hurdle rather than anything useful, it won’t sway me. This is undoubtedly the safest option for me.

Completely agree with you OP. My first delivery was a shoulder dystocia which was terrifying. It was immediately stated by my GP that any subsequent deliveries would be by Caesarean section, which my second and last was. It wasn't called into question until literally in the delivery room where some dickhead started asking me why I was being such a princess (not in those words obviously but that was the inference.). Couldn't believe it. The c section went ahead obviously as it was planned but it left a very unpleasant taste in my mouth.

I will try the GP if needs must. So far I have informed the midwife at the booking appointment who then referred me to a consultant, saw her at 20 weeks. That consultant really pushed against a c-section so when I next saw my MW last week I insisted again. She referred me to a different consultant who I saw yesterday and now he’s pushing me to what he called an ‘expert midwife’.

The letter is a really good idea, I will get working on that.

I really do think more information needs to be put out there about the risks of a vaginal delivery as they do before any surgery. It isn’t a straight forward process and there’s always risks attached.

Oh and I didn’t say I wasn’t worried about the risks to the consultant, I just said I accept them and also stated the risks of a natural delivery since he wasn’t about to do that. I find the risks of a natural delivery more worrying and actually more of a reality than those attached to an ELCS.

I wish you well op,

Just don’t think the issue is “not trusting women to make decisions about their own bodies”, they would’ve done same with a man..

They’re doctors and they’re responsible so they’re the ones that should be trusted to make a decision- with your consent.

I think we neee to give doctors more credit

This is so dependant on trust. Mine was agreed with no problem. I am so sorry you are having to fight for this. It’s sexist in my opinion, and manipulative.

Is there any scope to change consultants/hospital?

I was going to ask this as well.

I had opposite wanted a second HB - no risk factors against it and had history of rapid labour.

Got sent to a consultant who really wanted me to have a C-section - got told all possible VB risks pretty much got told despite two straight forward births this one would get stuck and likely kill us both - and despite no growth scans insisted this one would be even bigger than second 10 lber - it wasn't – he didn’t even want me trying in VB in hospital - nothing we said made any difference.

They badly let us down in the end - though I suppose not even trying to turn up in time is impossible with elective C-section .

Keep fighting your corner! YANBU.

Can you go private and pay the huge costs for an elective c section yourself?

I think it does depend on which health board you’re under.
Stick to your guns and keep repeating your very justified reasons, you’ll get there in the end.
I does seem to be a running theme of not listening to us though. My hospital was the opposite, I had quick straightforward V births with ds1,2 & 3, and an EMC with ds4. With ds5 I said from booking appt. I wanted VBAC (this was 11 years after my emc) was transferred over to CLC and was asked at every bloody appt was I sure I wanted vbac? They went on constantly about it! Annoyed the hell out of me, in the end I told them that the only way I was going into the operating theatre was if it was an emergency, that finally shut them up! Had another straightforward quick birth in the end which I am extremely thankful for.

A pp said they can't refuse you one. They absolutely can. In our county at your first midwife appointment they hand you a leaflet explaining that they will not do csections at request, only if they are medically necessary. The argument is whether it is medically necessary. With previous traumatic births and the higher risks though, I really can't see why you don't qualify! Write it all down before you go to see the midwife. Good luck!

I’ve had two PPHs and would want a CS next time. Except there won’t be a next time because I can’t bear the thought of going through it again. The risk increases every time. I don’t blame you for wanting one OP.

YANBU

I have a friend who had an ELCS because the midwife suggested it. Why? Because she seemed a bit tense when talking about the birth. True story.

You should stand your ground but no, you shouldn't have to.

I’m a teacher so can I afford a private c-section? Probably not . Do I work for (and therefore contribute towards) the public sector and pay taxes though? Yep.

It may well be worth switching trusts if they continue to make it this difficult, that’s a good point although no guarantees a new trust would be any easier.

New legislation means they can’t refuse it even if a woman wants one without medical reasons but I definitely have strong medical reasons...

I have an enormous respect for doctors, that’s indisputable and maybe they are just following protocol but if that’s the case, protocol needs to change. It shouldn’t be this difficult to obtain a safer birth and it is safer for me without a shadow of a doubt.

Also worth noting that my previous births (and miscarriages) won’t have been cheap, possibly more expensive than an ELCS. It’s a big risk I will need all of that extra care again following a natural delivery so if it’s a cost issue, an ELCS is probably cheaper.

You will need to kick up a stink.

At my birth debrief I was told that the reason I didn't get a c section - despite discussing what I wanted three times (once before labour and twice during) - was because technically, TECHNICALLY, I didn't demand that I wanted one whilst absolutely declining all other interventions during labour.

Basically all my birth injuries are because after 50hrs of labour and being high as a kite after 20hrs on gas and air, and the threat of my baby's heart beat dropping, I was too polite and tried to work with the professionals instead of kicking off and refusing the interventions they told me were necessary.

Not bitter at all 😬

I had an unplanned pregnancy, discovered when I was 20 weeks pregnant. I was totally traumatised and absolutely terrified of giving birth again after a previous precipitous labour with birth injury that hadn’t healed when I discovered I was having DD3.

I requested a female consultant as I felt deeply uncomfortable discussing intimate injuries with a man. On the day only a male consultant was available so I pulled my big girl pants up and went in. He looked at my notes and in a really condescending tone said, “It says here you want a C section but obviously that’s an error” I asked why he thought it had been written in error and he said, “because that would be ridiculous you’ve had normal births before with no problems” so I said, “How do you know if I’ve had problems when you haven’t spoken to me yet and assumed it’s all a mistake?” He FLICKED his hand at me, waved me off like I was an idiot. There was no way I was going to discuss my intimate issues after that. I told him he was condescending and walked out.

I tried again with a different consultant. They told me a C section was too dangerous. I was refused.

The actual birth ended up with an adherent placenta that needed to be removed under a general and I have such awful damage to my body I haven’t been able to resume any sort of intimate relationship since.

Nobody gives a single shit and I feel like a big part of my life is over. They don’t care about women.

I think it’s about cost so the NHS makes it difficult in every way.
Carry on fighting; I completely agree with women not being trusted to make decisions; from the minute I became pregnant it felt like that.

I'm from Glasgow and I just had to see a consultant who advised me of risks then booked me in - it was so simple and I felt really supported. I'm sorry you haven't had a similar experience- it's a shame it varies so much across the country