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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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Mummyme87 · 04/12/2019 22:13

Ithinkwerealonenowtiffany
Placenta Accreta and percreta are incredibly rare although on the rise due to our rising section rate. and a huge problem in China now due to the one child policy being dropped.
In think in view of its rarity it’s not used frequently in the risk discussion. At my that it is as we are a national referral centre for this. See women regularly with this. It’s life threatening and the cost to the trust is astronomical due to the input required from various departments of the hospital etc

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Moomin8 · 04/12/2019 22:15

Whatever the guidelines are, some of the heartlessness in the process is hideous.

This really annoys me because it's a vulnerable time for a pregnant mother. And ultimately what we all want is a safe experience that we recover from quickly for us and for the baby.

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Dinosauratemydaffodils · 04/12/2019 22:18

No one mentions accreta when they talk on sections but they are a life threatening condition. If it had gone unnoticed she wouldn’t be here today.

Im angry that its not mentioned. She’s even been on the local news talking about it and women just aren’t being told


My midwife brought it up when she was trying to talk me into attempting another vaginal birth. I was already aware of it however.
The only person I know in "real life" who had it, had it with her first baby. No history of uterine surgery or IVF.

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WhentheRabbitsWentWild · 04/12/2019 22:25

My 1st C Section was an emergency due to my sons distress .. DS was 17 days late and I was induced

2nd I was in lower backache labour for some hours but they found a medical issue so I had C Section 2 . DD was 2 weeks late.

3rd and 4th were planned and I had my tubes tied (I think) whilst I was numb from the waist down .

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Stephminx · 04/12/2019 22:26

@Booboostwo

That’s like comparing apples and oranges.

What about the cost comparison of a VB versus a section where that section really goes wrong ? Or where both procedures where both go right ?

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hazeyjane · 04/12/2019 22:27

I had an elective after 2 vaginal births. It was not a huge battle, but there was still wariness from hcps despite difficult previous births.

After my c section I can understand the wariness more, as it was a far more difficult and traumatic procedure, post birth experience for ds and recovery for myself than I had prepared myself for (and I had done a lot of reading up beforehand).

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cukooboo · 04/12/2019 22:29

@Fithles If I had another dc I would go for a VBAC & obviously one cant predict the outcome. Physically my body suffered more from the CS then the VB. My cousin nearly died from her elective CS & needed a blood transfusion, luckily she was still in the hospital. One of my close friends who had quite a few stitches & got an infection with her first VB had to have a CS due to breech position & started to feel it so had to be put under. She preferred her VB, everyone is different.

I never understand why people can say their CS was fantastic etc but it's somehow wrong to say you preferred a VB. I've had a fair few operations & I just don't like the whole process. CS are still major surgery. I actually was very upset after my CS because even though it was textbook I found it more painful than expected initially & you tend to hear only the positives & I felt ungrateful that I hated the entire experience & was physically shaking & incredible anxious throughout. I hated the spinal block, been strapped to the table, the catheter, the lying there whilst I was been cut open, not feeling my legs, the injections after etc, I just didn't feel in control. Baby needed a ventouse with my CS so it was absolutely the right thing to do but that doesn't mean I can't prefer it to have been a VB.

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cukooboo · 04/12/2019 22:37

One thing that did surprise me with the CS was being packed on my way the next day with some paracetamol. Most of my other operations involved stays of at least 5 days & morphine.

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Moomin8 · 04/12/2019 22:37

@cukooboo one thing my friend did say was that she had hated the catheter and had panicked when it had to be taken out.

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SheOfManyNames · 04/12/2019 22:39

I don't think it's to do with cost. It's a major abdominal surgery with quite a few risks. Most doctors would try to discourage it if it wasn't necessary.

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cukooboo · 04/12/2019 22:42

Yes @Moomin8 I didn't like it & I remember drinking loads of water & panicking I wouldn't be able to wee in the 2 hour (or whatever it is) window.

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neonglow · 04/12/2019 22:45

Has anyone read ‘this is going to hurt’ by Adam Kay a former obstetrician/gynaecologist?
There’s a bit in there where a woman is requesting a non-medical c-section. He comments that he feels it isn’t fair that women in this situation are often heavily discouraged with unbalanced information before adding that 60% of female obstetricians choose to have their babies via planned c-section.

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Fithles · 04/12/2019 22:49

@Cuckooboo thanks for that additional explanation but you didn't answer my question. I think you said you'd be happy to take the risk of faecal incontinence? Try shitting yourself in public just once, then reconsider your options. I really struggle to understand the 'it probably won't happen to me' approach - though it's easy to see why.

@Moomin8 I didn't sue, so no compensation for us. I'm a lawyer - the Bolan principle means medics can just close ranks and get someone else to say they'd have taken the same action and therefore no compensation. It's a long and costly legal process, just couldn't face going through with it. My notes also didn't reflect my or my DH'd recollection of events.

The acquaintence with the exploded perenium and double incontinence is suing. She'll get a settlement. All a bit late though I'd rather have a fully functioning lower body and normal life.

Give women proper information and proper choice - whether the choice is VB/instrumental VB/ELCS or whatever. It's their body and they need to live with the consequences.

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Moomin8 · 04/12/2019 22:54

I couldn't agree more @Fithles

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Fithles · 04/12/2019 22:58

BTW @Cuckooboo and @Moomin8 it is possible to need catheterising for a VB - I did. You can also lose so much blood you need a transfusion, my SIL did after her VBAC, was in high dependency for 48 hrs after.

I think info about VB needs to cover all types of VB, not just minor tears and stitches. Nor focus on coping and/or pain relief during labour. The exiting of the baby itself can wreck a woman's body, permanently.

Stats on damage 2nd/3rd/4th degree tears, incontinence, prolapse, fistula, instrumental intervention etc need to be separated by 1st and subsequent VBs. Subsequent births are statistically easier and reduce the overall rates of such damage - but if you're giving birth for the first time you need to know your actual risk.

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NamechangeProtectIdentity · 04/12/2019 22:59

I was pre 2011, and requested, requested a CS at each appointment and was breezily told how do I know, its your first, will be fine. Somehow I knew it was never going to happen that way, so went along with it, went 2 weeks over, had a sweep, induced, 30 hours, barely a couple of inches diallated and no where like labour. I literally just had to lie there waiting. 33 hours later they finally agreed nothing was happening so offered a CS, just to get the baby out.
I am annoyed I was brushed off and hope it's easier for women now. My CS, although classed as ECS, was calm, recovery was very easy and I was never in any pain afterwards.

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Comradesally · 04/12/2019 23:04

' you will try vaginally' '


Arnt these words astonishing? Spoken to grown women.

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IaIa3 · 04/12/2019 23:04

I saw a flow chart in my hospital recently, basically all paths lead to a c section if that is what is wanted. However if the consultant that you happened to be seeing wouldn't sign of on a section they can refer you on to someone else to sign off on it. I think cost of the surgery plays a huge roll as that's why they try to talk people who are entitled to one out of it.

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cukooboo · 04/12/2019 23:05

Well @Fithles I potentially would be risking faecal incontinence if I decide on a VBAC though wouldn't I? The midwives & consultants can assess risk but there are no guarantees. Obviously I'd prefer not to shit my pants in public but the possibility of it wouldn't automatically make me rule out a VB.

really struggle to understand the 'it probably won't happen to me' approach - though it's easy to see why.

I don't understand this, why does preferring my VB to my CS mean I'm not aware of certain risks & have assumed it wouldn't happen to me.

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cukooboo · 04/12/2019 23:17

I think i'm pretty clued up on the risks related to VB, VBACs, ECS, EMCS. I have GPs & surgeons in my family & friendship group. I actually had a 2nd degree tear with DC1 but not all tears are equal & it didn't cause me any issues. Pregnancy & the weight of baby alone causes issues with incontinence & prolapse which people don't often realise. Carrying a baby & birthing it is hard. I'm pro choice & think women should give birth based on what's right for them.

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Thehagonthehill · 04/12/2019 23:27

Most consultants have 1 day of theatre a week, that's 5-6 ELSCs, that's why they can offer everyone a CS.
Our hospital has 2 dedicated theatres,one for electives and one for emergencies.
Bigger hospitals may have more Theatres for obstetrics but will serve bigger populations.
The real issue is capacity,consultants are not worried about cost.

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Thehagonthehill · 04/12/2019 23:28

Can't offer not can.

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cukooboo · 04/12/2019 23:42

That's a good point @Thehagonthehill
I remember discussing my options with friends & the one who is a London surgeon told me to not risk an emergency CS & stop when still at the elective stage as otherwise the surgeons would most likely be a locum team & the emergency ops tend to be a lot more rushed in general. I think I was originally scheduled for 10am but got pushed back a few hours due to other priorities as limited theatres & staff available.

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Moomin8 · 04/12/2019 23:49

I had a catheter for my first Labour because I'd requested an epidural. It didn't bother me too much - I didn't feel it and wasn't aware of it but I did end up with a near forceps delivery because the epidural stopped my contractions. And then I had all the problems with the badly stitched episiotomy. With my next two babies I didn't have much time for pain relief and I had decided to Labour on my feet as much as possible. It was all very different.

I think I'm lucky that I haven't had a worse experience and ended up badly torn or incontinent. Also examinations don't bother me.

I just think it's awful that doctors can tell you that you are imagining a fear of something. I have noticed in this pregnancy that I'm rushed through appointments and don't have time to discuss what I want or don't want. I'm also gestational diabetic this time so will be induced at 37+ weeks. I will have to make sure my dp speaks up for me if a forceps delivery gets mentioned.

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JaceLancs · 04/12/2019 23:54

I had an elective CS with DC1 due to breech and small pelvis
With DC2 was offered another section early on if I wanted but then due to pregnancy complications was told it was my only option (performed at 33 weeks)
No real issues with either they are now 26 and 28!

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