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AIBU?

To ask what the truth is about elective C Sections?

179 replies

Moomin8 · 04/12/2019 19:13

I'm not thinking of asking for one myself but I wondered what people's rights actually are because certainly it is not clear (perhaps intentionally)

My friend has a 6 month old ds and she had quite severe tokophobia. It's so bad for her that she can't even cope with smears or internal exams and needs medication to cope with these. So she had requested a section from quite early on, she told me. Apparently her midwives were in support of this but when she got to see the consultant at 36 weeks, her attitude was very unpleasant. She told my friend that tokophobia doesn't actually exist and got really shirty about my friend wanting a section.

My friend stood her ground and the section went ahead fine but she was upset about the consultant's approach. Her midwife told her that the doctor may have been trying to put her off because of cost of a section.

Does anyone know what the facts about this are?

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whatswithtodaytoday · 04/12/2019 20:41

I requested an elective c section due to tokophobia (related to a traumatic experience and a gynaecological condition). I didn't experience any problems getting it - I told my midwife I intended to have one at my booking in appointment and she was supportive all the way through. My consultant listened to my reasons and immediately agreed, no pressure or any kind of judgement. Booked my section date at around 25 weeks I think, because they agreed it was more stressful for me not to know. I had some extra support during and after the operation and everyone was fantastic.

I was under the care of the mental health team and they were amazing - in fact I credit them with my mental health now being better than it has in years.

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Moomin8 · 04/12/2019 20:53

My understanding was that the NICE guidelines changed in 2011 where the NHS now cannot refuse.

Everything I've read says that c sections are 3 times as likely to result in the death of the mother than a vaginal birth (even though risks are small)

Personally, I have had 3 vaginal deliveries and I was very scared to have a natural delivery after my first baby because I'd had botched episiotomy stitches. It actually wrecked my marriage and I couldn't have sex. In the end I tried to have as little intervention as possible and somehow, baby #2 came naturally and helped heal the horrible stitches!

I feel bad for my friend tho - she was made to feel like a bad mum.

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Piglet89 · 04/12/2019 21:02

Yes but that’s the risk of death of mother; as you say, that risk is probably small either way. What about risks of permanent damage to either mother or baby? Wonder how those stack up?

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RunningAwaywiththeCircus · 04/12/2019 21:05

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RunningAwaywiththeCircus · 04/12/2019 21:06

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mynameiscalypso · 04/12/2019 21:07

It's impossible to get any good stats on the risks of c sections because they almost always conflate ELCS and EMCS which are very very different. My understanding is that an ELCS is slightly less risky for the baby but it's a relatively small difference.

I had no issues having an ELCS for MH reasons. I said I wasn't prepared to have a vagjnal birth and that was 100% accepted by everyone. Nobody tried to change my mind - obviously they had to run through the risks as part of the consent process but I already knew them.

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Teachermaths · 04/12/2019 21:10

I think there's no right or wrong decision, only what suits the mother best.

I had and EMCS with an awful recovery (5 months) and really want a VBAC this time. However some women recover quickly from a section and are up and about in days.

They are at maternal request and women should be fully informed about their decisions.

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123Dancewithme · 04/12/2019 21:11

I had a c section on request (I had severe health anxiety during pregnancy) and had no problems getting one.

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ivfbabymomma1 · 04/12/2019 21:15

I requested one and was given one. The consultant said she likes to promote women's rights to decide. I had a c section because it was an ivf pregnancy and they didn't want me to go beyond 39 weeks so they wanted to do an induction. This may have made them go lighter on me?

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Fithles · 04/12/2019 21:22

I had an horrendous first VB ending in Keillands forceps (no-one tells you how bad they are) butchered both me and baby, lifelong damage for us both, bf was a nightmare (no milk until day 6, assume body thought baby was dead).

I got a CS with my 2nd (2012) but the first consultant was shitty and refused. I was granted at my 2nd appointment. ELCS was wonderful calm and much easier to recover from and bf after.

The same consultant that was shitty with me also refused a friend of a friend. She unfortunately didn't pursue it further, had the VB with her 2nd, her fears of massive damage were realised and resulted in double incontinence and hefty bills for nurses to care for her and the baby for months after (into years for her as they tried to put her back together). There's quite a legal dispute on the cards for that one.... Incidentally if you take the cost of settling claims for botched VBs into account (because many such claims are about life-long brain damage to kids and their care requirements) a CS is actually cheaper to the NHS than a VB.

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Moomin8 · 04/12/2019 21:26

That's awful @Fithles Sad I'm sorry you and your child had to go through that.

Personally forceps is the one thing that I really fear. Can you refuse use of forceps?

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thetideishigh · 04/12/2019 21:26

One fact that get's glossed over by midwives/consultants is the breakdown of statistics regarding the likelihood of any delivery ending in a C-section. Older mums are more likely to end up having a C-section.

I was quoted the statistics for all mothers and having researched the matter quoted back the rate for over 35's (into which category I fell). This was not well received but it was accepted that I had fully researched the matter so I was given a date for a C-Section.

They tied to deny me the C-section on the day, offering to induce me instead ! (Clearly they hadn't read my notes at all regarding induction being something I wanted to avoid).

If I had more confidence in the local NHS maternity care I might not have been so adamant that C-section was my informed choice.

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Moomin8 · 04/12/2019 21:27

Older mums are more likely to end up having a C-section.

Interesting. Is this regardless of whether it's your first baby or not?

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eyesbiggerthanstomach · 04/12/2019 21:28

I had one due to tokophobia (I can only have smears under general anaesthetic). They did have to refer me to a psychiatrist first before they agreed and it was fairly late on in the pregnancy. Until they confirmed I could have a c section, my anxiety was through the roof. I did read somewhere that if your consultant won't agree they have to point you in the direction of one that does. I think it varies from trust to trust as well.

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Snowpaw · 04/12/2019 21:35

I asked for a section on day 3 of induction that wasn’t progressing. They wanted to break my waters at 1cm dilated and then start the drip etc but I said no, I didn’t feel my body was at all ready to give birth: I wasn’t even in labour. I just didn’t feel it would have gone well. They had a discussion and agreed to it, I had to wait for a couple of emergencies to go in front of me but they did a section and it was very calm and positive. I really felt that they listened to me and I was very grateful to the doctor and whole team. An IVF pregnancy so don’t know if that made them more willing.

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cukooboo · 04/12/2019 21:39

I think it varies by trust, I had a straightforward VB with DC1 with no intervention. I had a bad pregnancy with DC2 & there were potential problems. I was offered a CS but I wasn't that keen so we agreed to early induction however baby didn't want to come so CS it was. Personally I was take a VB over a CS any day.

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Fithles · 04/12/2019 21:47

@Moomin8
Theoretically yes you can refuse any procedure. There will be people along in a minute to describe all of the times when it's safer to use forceps as the baby is so low down.

What is very poorly described is the different types of forceps, reasons for using - the positioning of the baby and risks of permanent damage. I was exhausted and in dire pain and had no idea baby was high and mal-positioned, requiring rotation.

I had written in my birth plan that in the event of needing forceps I wanted the option of going straight to CS. I was persuaded out of this by a team of people saying 'Consultant is confident he'll get baby out with them'. I was not prepared for the consequential damage though. I still can't shit without manually holding back my perinium and I'm slightly faecally incontinent - 10 years later. For the first few years I'd regularly shit myself walking down the street. DD has two scars on her face.

People/midwives often dismiss Keillands forceps 'oh they aren't used much anymore' - well I suggest you find out whether they are. There's at least one consultant at St Thomas's London priding himself on keeping their CS rates down by butchering women and babies with them.

And as an interesting anecdote to the Dr PP saying she'd go VB every time, I know two female Drs (a GP and anaesthetist) and a wife of a urologist. All had all their babies by CS, two each, elected to do so and were glad they did.

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Fithles · 04/12/2019 21:50

@Cuckooboo do you mean you'd take any VB over a CS? Or only the straightforward VB that you had? Would you prefer CS if you knew you'd be permanently damaged by VB like I am?

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gonewiththerain · 04/12/2019 21:50

Yes you can refuse forceps, that was all my birth plan said.
I would have agreed during labour if baby was very close to the exit but was not going to say this before hand.
I ended up with a c section, I think if forceps had been attempted we’d both be seriously damaged

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SunnyCoco · 04/12/2019 21:55

I've had a positive experience

Requested it, no problems whatsoever getting it agreed.

I'd opt for elcs over a VB any day of the week.

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belleandbete · 04/12/2019 22:00

Don't know anything about the politics of it, but from experience, I had a vaginal birth first then two elective c-sections, I know everyone is different but i would advise anyone to go for the c-section (based on my experience)- totally different from an emergency c-section. They were brilliant experiences and the recoveries were way quicker and easier than from my vaginal birth (2 week recovery from c-sections versus nearly a year from vaginal)

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wouldthatbeworse · 04/12/2019 22:02

I had two ELCS in 2016 and 2019. Requested it at booking in, had to be quite firm at consultants appt and they gave me lots of quite scary reading. Ultimately the NHS respected my preference. My recovery was a lot better/faster than most of my friends who attempted vaginal delivery (although some of them have had very easy births with their second kids)

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sirstheword · 04/12/2019 22:05

I had severe complications in labour resulting in an EMCS and intensive care with DC1 that gave me PTSD. When I was pregnant with DC2, the midwife immediately said ‘I assume it’ll be an elective this time’ I had it in my head the whole time it would be fine, then I had a visit with the consultant who tried telling me I must try vaginally and not have a section. After a good half an hour of begging, I went into full on panic attack mode, asked her to abort the baby then as I simply could not go through that again. She still refused and said its not best, eventually the big consultant came in and he immediately agreed a section.

Completely hideous and unnecessary experience and I will never forget the absolute fear I had. Whatever the guidelines are, some of the heartlessness in the process is hideous.

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Moomin8 · 04/12/2019 22:11

@Fithles that is shocking. Did you get any compensation?

I can't understand why forceps are still used. They seem very dangerous to me.

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PlutoAjder · 04/12/2019 22:11

I've known several to have an elective under NHS guidelines, no pushback.

Including one (god I hate the "just a bit scared" bullshit) after years of trauma therapy after a childhood surgery went wrong, fully awake terrified child who had nightmares about being back in the hospital for a good 16+ years after, CBT, Various phobia therapists etc to help her consider getting pregnant... But yeah, she was "just a bit scared" Hmm

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