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.

They are absolutely not allowed to refuse you a caesarean. If they don't agree they have to refer you to someone who will.

Please don't back down. I have been through this, and luckily my husband is very assertive and helped me get my choice of caesarean.

They simply CANNOT refuse.

As shit and ridiculous as it is I think the best way to get your result is to jump through their hoops, nod and still say "I'm 100% sure that a c-section is still the right choice for me and my baby". Although you probably already know that. If they try to convince you otherwise after listening to all their information I'd just say "I understand that, I have listened to your info, I am still choosing a c-section"
It's an absolute joke that we're told we have a choice yet you wouldn't have to go through all of this to have a vaginal birth. It really infuriates me. And I think you're brave for choosing a c-section too, the thought honestly terrifies me

I am firmly in the ‘my body, my choice camp.

If you feel the need to quote statistics the following links may help but keep in mind that few studies separate statistics from emergency and elective c sections so may b3 less reliable.

I would love to see any links to studies regarding birth injuries in elective c sections, if anyone has any info on that?

OP, in your shoes, I would be tempted to quite bluntly compare their process to pre abortion counselling. I would also ask if NICE guidelines require you to meet a certain number of doctors or midwives before agreeing to a c-section . (No, they don’t).

journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002494

www.researchgate.net/publication/51564060_Cesarean_versus_Vaginal_Delivery_Whose_Risks_Whose_Benefits

www.newscientist.com/article/dn27929-stop-glossing-over-the-risks-of-natural-birth-to-cut-caesareans/

pqcnc-documents.s3.amazonaws.com/sivbdoc/sivbeb/8ChildbirthConnectionVaginalBirthandCesareanBirthRiskComparison.pdf

www.theguardian.com/politics/reality-check-with-polly-curtis/2011/nov/23/health

That’s brilliant, thank you uncreative.

I am peed off at how they just accepted my decision to have surgical management last year following my second MMC without any hesitation whatsoever, the consultant actually said it was a sensible idea. Yet when I am speaking to two separate consultants here explaining that the surgical route is safer, they’re insisting it isn’t. Oh but it is.

It’s become a bit of a tit for tat argument. I’m going to stonewall them next time and be abrupt and blunt. There’ll be a lot of nods and yep, yep I understand that but I still want one thank you. Eventually they should agree...

Out, if you can, try to avoid being abrupt and blunt. It's likely to make HCPs (in particular, the consultants who could sign off in an ELCS) think you're being "difficult" and that you're doing the equivalent of sticking your fingers in your ears and going "lalalalala" every time someone tries to dissuade you. The net effect is that a reluctant consultant will remain reluctant to offer an ELCS because they won't believe you've properly considered the alternatives.

What you need to do is convince them that you have genuinely understood and evaluated all the evidence, and that you're making an informed decision that a VB is an unacceptable option and that you therefore want an ELCS. Calm and measured, an oasis of rational serenity... but firm in your request. A reluctant consultant might disagree with you, but is more likely to offer an ELCS if they believe your decision is truly informed.

Yes, Geeka is right. I said ‘bluntly’ but you will catch more flies with honey than vinegar.

Just wanted to give an update re today’s growth scan.

He weighs a pound more than average and head circumference and abdominal circumference are on the higher end of the scale. No excess amniotic fluid so I’m measuring ahead because he is large. No surprises there... They’re not concerned though and haven’t advised further growth scans. Says all looks well, he’s just going to be on the bigger side.

He is breech which I gathered as his kicks have mostly been low down for a few days now. At this stage they are hopeful he will turn. I’m kinda hoping he doesn’t because it gives me even more reason to have an ELCS .

Next step is the consultant midwife... no idea when that appointment will be. I’ve been told not to expect a final decision until I’m 36 weeks.

@OutPinked great news re: scan
Just wanted to reassure you that I had a similar uphill struggle - until I met with the Consultant Midwife. He was amazing! He also held a great deal of sway with the actual medics. Once he's 'ticked my boxes' it was plain sailing and I was finally free to enjoy the rest of my pregnancy.
I then developed pre eclampsia and was taken straight in for an earlier ELCS anyway

As others have said, grey rock with the negative people, nod and smile vacantly. This is your informed choice.

He is breech which I gathered as his kicks have mostly been low down for a few days now. At this stage they are hopeful he will turn. I’m kinda hoping he doesn’t because it gives me even more reason to have an ELCS

Careful with this one. They can turn, especially in multiparous women. If they scan you on the day and the baby is head down, if the only indication is breech, they'll potentially say there wasn't another indication.

So definitely get a section agreed for maternal request, irrespective of the presentation of the baby.

I had some great coaching from AIMS.org.uk - Association for Improvements in the Maternity Services - in respect of my rights and what to say exactly for the consultant to follow NICE guidelines and organise an ELCS. I cannot recommend them enough and urge you to call their helpline to have a chat about it. like the pp I would still do this irrespective of the presentation of the baby and get agreed sooner than later.

Stick to your guns and wishing you all the best.my elective was a really chilled relaxed affair and I hope yours is too

Thank you so much nancy, have made a note of that and I’m definitely going to contact them.

Glad to hear that turquoise, that is exactly what I’m hoping for too.

I was ready to say you don’t want to put yourself through surgery if you don’t need to and the recovery isn’t great in a C section but after reading what your other traumatic births were like it sounds like you requesting a c section is in your best interest and I’d do the same , I’ve had a vaginal birth and emergency section and an elective section and the elective section was the best birth by far .

Just tell your consultant you have consulted NHS England and they have confirmed it's your right even if you don't need one to have one. I was told the same constantly and was crippled after a natural birth which could have been avoided with a caesarean. My sister who has a similar condition to me was also pressured but towards the end of pregnancy she was so panicked the same would happen and she would end up in a wheelchair she phoned NHS England and they advised her that she had a legal right to chose the method of birth and she just need dto say calmly that she had decided and if they can't book in a caesaeran you will raise a complaint. Tell them it's your legal right and direct them to the following page. In particular the section about asking for a cesarean.
www.nhs.uk/conditions/caesarean-section/

I agree. Stand firm. Also if you have time read ‘ This Is Going To Hurt’ by Adam Kay. He used to deliver babies and provides a v interesting view of what goes on behind closed doors in hospitals. Best of luck x

Wow! Friends who have had form like yourself OP we’re all offered electives as a matter of being sensible. However, I’ve had the opposite experience where 12 years after having an EMCS I had to fight for a VBAC as 3 different consultants tried to bully, blackmail and trick me into having an elective with DS2. Its outrageous and I feel bad for you. So long as we all understand the risks, why can we not be treated like the sensible people we generally are. YADNBU

My husbands finest hour whilst I was being bullied in a ‘birth options clinic’ was to hard stare the consultant (or actually registrar it think) and she said,

‘This is a meeting so we can all talk together and decide what is best for you’
And he pointed at the three of us in turn and said who’s decision is it? The three of us or the two of us (pointing at me and him).

The DR looked actually momentarily shocked and than said ‘well the two of you of course’

‘She’ll be having the CS then’. Said DH.

I must confirm this conversation happened at the end of a very long road of appts etc... I was bullied horrendously by a consultant who I had gone to ask about my options and wanted a sensible discussion with before I’d made my mind up. Sensible discussion wasn’t possible with this women who said, and I quote ‘you owe it to your husband to have a vaginal birth, it will improve your sex life’

After baby four i was up putting my washing on within 30 mins..

Haha bet you weren't. And if you were - you have very weird priorities.

I’ve not read all the thread, but from experiences of friends, I think consultants only consider physical aspect, not the mental. That is just as important.

After 3 hard births you d think they d be suggesting a c - section- rather than you go through another traumatic birth. This is nt the same but it is the stubbornness of consultations who think they know you better than you know yourself - at 44 I had my 4 th child - luckily never suffering any real problems at all - but the consultant insisted I be induced early because off being 44 - I was healthy - not over weight - no blood pressure problems - I refused - she said - ok i ll give you an extra week ! I laughed - and said - no I ll see you when I m in labour!
Next consultant during last child’s birth - was trying to insist I push another hour - I d been pushing for ages and as my other children popped out I know something was nt quite right - I refused and asked him to give me a c section !! He said how about an assisted birth to start .. and I had an assisted birth - turns out she had her head tilted and she has a wide head ! She was never coming out with help.
So after that ramble lol !! The up shot is - you KNOW you !! Stick to your guns. Smile and refuse anything but a c section - good luck x

I've had 4 babies, 2 vaginal and sections. First 2 vaginal, the second of which was the least traumatic, I still wasn't up and about for about 36 hours. Baby 3 was a crash section, we could have both died if it had not been done, it was noisy (me mostly to be fair) and distressing (for DH more than me but still) and I had to have GA rather than spinal block (long story) but I had an excellent recovery and was up and about less than 24 hours later and fully discharged from the hospital 48 hours post section and I healed well.
Pregnant with baby 4 less than 2 years later (my consultant was not impressed but it wasn't planned and she was a contraception failure) and I stated that whilst I would like to go with a vbac if I went into labour without induction, there was no way on earth I was having an induction this time (I found it very distressing for 1 and 3) and I wanted an elective section. My consultant was brilliant, agreed with my assessment and entirely understood my reasoning behind it. I had a growth scan at 38 weeks because I was measuring a little small and her growth had slowed. My consultant stuck with the plan and booked me in for 4 days before my due date (only decent date he didn't want me to go over, too risky) for a section in case I didn't go in to labour on my own. I didn't so I got my section. It was calm, relaxed (still a bit complicated - they couldn't get a spinal block in so I had to have GA so no DH) and I had another fantastic recovery and I was doing the school run 2 weeks later. I was (apparently) lucky to have a consultant that listened to me, treated me like the intelligent human being I am and respected the fact that it's my body, it's my choice.
@OutPinked I really hope you are listened to and you get what you want and need to make the rest of your pregnancy as relaxing as possible and your delivery as safe and chilled as it should be.
Ignore PPs that think because it was a certain way for them it's that way for all and that sections are done for vanity (it's rare) and that you're a burden on the NHS; your body your choice! Oh and frankly you'd be considerably more of a burden to the NHS if they ignore your wishes, it all goes wrong and you require long term intervention, physio or worse and you sue the buggers for medical malpractice .
Sorry that's long

My first birth was similar with the episiotomy, stitches, stitches coming out etc, plus retained placenta. Second easier and third flew out. By the sounds of it, it seems as though each birth gets slightly easier for you. As you many have mentioned a c section carries more risks and is also pricey on the NHS. I do agree sometimes a woman needs to be listened to more when it comes to their bodies, but in the other hand we are discussing this with trained professionals who do this on a daily basis.
I’m not saying you’re wrong but I honestly believe that if you want an elective c section you should go privately.

@AppleKatie you owe it to your husband to have a vaginal birth, it will improve your sex life
seriously?

@Londonerlove really? ELCS=private? ODFOD Here have my very first and I've been on MN a long time!