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.

NICE guidelines:

1.2.9 Maternal request for CS
1.2.9.1 When a woman requests a CS explore, discuss and record the specific reasons for the request. [new 2011]

1.2.9.2 If a woman requests a CS when there is no other indication, discuss the overall risks and benefits of CS compared with vaginal birth and record that this discussion has taken place (see box A). Include a discussion with other members of the obstetric team (including the obstetrician, midwife and anaesthetist) if necessary to explore the reasons for the request, and ensure the woman has accurate information. [new 2011]

1.2.9.3 When a woman requests a CS because she has anxiety about childbirth, offer referral to a healthcare professional with expertise in providing perinatal mental health support to help her address her anxiety in a supportive manner. [new 2011]

1.2.9.4 Ensure the healthcare professional providing perinatal mental health support has access to the planned place of birth during the antenatal period in order to provide care. [new 2011]

1.2.9.5 For women requesting a CS, if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS. [new 2011]

1.2.9.6 An obstetrician unwilling to perform a CS should refer the woman to an obstetrician who will carry out the CS. [new 2011]

I would suggest you quote these at them - particularly 1.2.9.5 and then ask for them to enact the final one.

Normally im totally all for natural birth if at all possible but when the stakes are so high, i think in this case they should just agree and stop making life difficult for you.
I dont like the idea that women can just demand c sections with no actual medical reasoning to it...those who dont want to ruin there bits downstairs make me angry. Theres people who would love to be able to have babies at all and theres no place for vanity in childbirth.
I think in all cases where it is necessary due to previous births or medically more safe for mom and baby, it should absolutely be your choice!!

Obviously for most women, a natural delivery is the safest and most efficient option. For most women it goes spendidly and is a positive experience. But there are attached risks to a vaginal delivery and it can and does go very wrong. I wish those risks were more readily discussed than they currently are. I also wish the consultants would give a fair argument and state the risks of both types of birth instead of purely drumming in the risks of a CS.

It’s a shame women aren’t better trusted to make vital decisions about their own bodies. I don’t think many people (if any) flippantly decide to have major surgery. For most, there will be a viable reason. I’d LOVE a natural delivery to go well and to be able to trust my body to handle it the way it’s designed to. As it stands, I have very little trust in my worn out uterus .

Mines defo worn out and i do not plan on having anymore children..thank goodness i dont have to make these decisions.
Whiskeyjar, i wish you all the best and a happy and safe arrival of your last baby, hope the consultant sees sense

@BITCAT
I struggle to understand your view although it seems to be a relatively common one. Studies have established that on balance a vaginal birth isn't necessarily the safest way to give birth and that the difference in cost to the NHS is negligible when looked at from a long term perspective, so what exactly is your objection to women opting for the delivery method that best suits them?

Sadly I think there are lots of women that view giving birth naturally as a rite of passage and often those with bad experiences seem to be the most keen that other women don't get to opt out of the process. Really depressing

BITCAT have a read about what “ruined bits” actually mean for some women and then call it vanity
I found it easy getting a c section, I’m sorry it’s so hard for you OP.

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 had a huge haemmorage during an elective section. I don't understand why -given your history- you would get pregnant for a fourth time and then think you can dictate your care. I bet you were advised that further pregnancies would be a huge risk and I bet you carried on regardless.

I dont like the idea that women can just demand c sections with no actual medical reasoning to it...those who dont want to ruin there bits downstairs make me angry. Theres people who would love to be able to have babies at all and theres no place for vanity in childbirth.

Surely women should have the right to choose how they give birth?

Also what does women wanting babies have to do with this? Isn’t that a pro life argument rather than a vaginal birth argument?

@Blair

Vanity? Do you even understand what birth injury is?

Op small sample of my friends ds and wider acquaintances for both pregnancies, two one was me had good deliveries but although mine was so called text book amazing no stitches, small tear fast labour I do still have a few issues v small 11 years on.

All of friends have had huge trauma through natural delivery. From placenta pravia, pre eclampsia, to a huge range of other stuff happening during labour.

Several wouldn't be here now if they had that birth 100 years ago.

So many nearly died
I take it the smaller clearer risks of elc over the the totally unpredictable nature of birth any day. And I will be encouraging my dc to have elc too.

Everything that goes wrong in natural birth is hidden for all sorts of reasons.

Nope, never been warned not to get pregnant again. Should I have been? . I was never told why I haemorrhaged either. The only time I have been given a reason was actually while discussing a caesarean with the consultant during this pregnancy.

Sorry Blair. Totally quoted the wrong person and then realised I hadn’t read the post of the person who did write that properly.

Ignore me people, I’m sorry I’m shattered (backs out slowly)

No worries Goat!

I don’t get why other women have such strong feelings on what other women choose to do with their vags. I chose an ELCS, my reasons are mine and valid, and no less valid than a woman choosing a natural birth.

I don’t feel offended when someone chooses a natural birth so I’ve no idea why some women are offended by women choosing cesarean!

Women demanding c sections 😂😂😂😂

It's the last hoop really that we really need to tackle.

Women should be able to choose.
We should also be able to choose when we want to die if we are terminally ill.

Society needs to work urgently on these two issues.

Agreed completely rayne. If people have an issue with it being on the NHS, perhaps we should get rid of the NHS and adopt a private system where everyone pays insurance and if you can’t afford it, you die.

More control needs to be given to the individual. It is, after all, their body. Interestingly, it was never questioned when I elected to have an ERPC after my second MMC. Despite surgery ‘carrying more risks than medical management’, they understood that for me medical management was actually riskier so my choice was a total no-brainer. This should be too.

Blair... Maybe psychologists would know. Must be deeper need to sadistic torture women?

Eventually we will back away from the archaic Victorian approach to birth we currently have and all types of birth will be readily offered with pro’s and con’s listed for all.

But what about costs to maternity from botched labour's. Should the mum pay for those too? What about incontinence etc, prolapse and all the other birth injuries. Why should woman choosing to avoid all that risk have to pay for it?

Yy balance is needed.

But at present one feels budget's and personal feelings come into it rather than individual need and proper information.

Blair... Maybe psychologists would know. Must be deeper need to sadistic torture women

I think it’s internalised sexism.

Seriously, see the consultant midwife. They're there to advocate for you and go through things in lots of detail with more time than a standard antenatal clinic appt. Going to another Trust at this stage will require the same hoop-jumping.

I know your circumstances are individual to yourself and it's frustrating, but most obstetricians - who deal with the complications and consequences of those - wouldn't say yes to a section immediately, because they'd be failing in their duty of care to you if they did.

Having an elective section doesn't mean you won't have people piling into theatre; if there's a major haemorrhage and it still might be traumatic for your OH, for instance if you need to be put under a general and he'll be asked to leave theatre for that. The Cons MW will go through those scenarios with you and get you seen again in the ANC.

those who dont want to ruin there bits downstairs make me angry. Theres people who would love to be able to have babies at all and theres no place for vanity in childbirth

Ah yes, these "vain" women who are anxious about being cut, torn (possibly so badly that they require repairing in theatre with GA), sufferiy prolapse, incontinence, years of painful (or even impossible) sexual intercourse. Who do they think they are?
I am staggered that anyone could be so lacking in empathy or compassion that they would feel "angry" with anyone for not wanting part of their body "ruined"?
What hope is there when women are so keen to tear one another down. Struggling to think of a scenario where anyone would judge a man for not being cool with his genitals being "ruined".

@BITCAT

Vanity... Oh bitcat. So funny I've pissed myself laughing.

And I do mean that literally.

Because of my bladder prolapse.

One of two prolapses by the way, and still not the total sum of my birth injuries.

What I don’t understand is, if op is highly likely to have complications, be rushed to surgery or possibly have an emergency c then surely the cheapest thing to do is an elective c. It’s like they’re just crossing their fingers nothing bad will happen.
And all those women ( a lot I know) who’ve had emergency c. 100 times more stressful and traumatic.
If it’s elective. Everyone’s prepared. Everyone’s there
If I was you I would ask what your total care costs per births were for the last three and what a cost would be for an elective. I bet they wouldn’t know the fucking answer. Is lasts years budget so who gives a fuck about how you feel now

Also how many emergency c’s go wrong? Because of the fact they’re a fucking emergency!