To want to know who will be performing my elective section?

[alicet]

I had an emergency section with ds1 and have just booked in to have an elective section for ds2 on 2nd Oct.

When I went to the clinic this week to arrange this the consultant wasn't available so I saw a registrar instead who was perfectly pleasant but simply unable to answer the questions I had. Including who was the consultant who would be doing the sections on the day they had booked me in for. Having phoned the secretary of the consultant I have been under until now to ask this I was told that they do not know until the end of this month when the rota is published.

Now I know that if this all happened as an emergency then I wouldn't have the luxury of going to talk to my consultant before hand but it's not and I do! And while I can't understand how they can run a service where the consultants do not know what their commitments are from one week to the next, if this is the case then I accept I won't be able to know who will be performing my section until the end of the month.

But I am a surgical registrar myself so I have some very specific requests and questions that I want answered before this goes ahead and I am not happy to leave it to the morning of the section to do this. Moreover as I have signed the consent form in clinic there is no reason why they would even come and see me before I have the section.

I think I am probably being a bit precious but I don't think being able to talk to someone who will be both performing major surgery on me AND delivering my son is too much to ask? What do you think?

alicet - bump as I'll be interested to see the responses to this thread. I'm going to have an elective c-s in October too - Are you able to give me an idea of any requests someone having an elective c-s should think about making and questions to raise?

YANBU. I had a CS with my DD as she was breech and was in hospital for 2 days before the operation as they kept putting it off due to emergencies.
I signed consent for one surgeon but they kept changing it as the surgeons went home/became busy.
Eventually I had my section and didn't even meet the surgeon until afterwards. I actually asked him who the f*ck he was walking up to me after he had finished as no-one had bothered to explain. I would have loved to have met him before, not just for questions, but for politeness sake as well!

MrsFogi - The main reasons I want to see the consultant perfomring it is that I want to ask them to excise (remove) my old scar rather than cutting straight through it (looks better in the end and doesn't take much longer) and to close the wound with stitches rather than staples. Small things really but important to me. the other big thing that probably won't be allowed is that if I needed a general anaesthetic my dh really wants to be allowed to stay in. We would be very disappointed if this was not allowed therefore would like a bit of time to get over it rather than letting it add to what will probably be a bit of a stressful couple of hours before the section. So I am being a bit precious!

I also think that the problem is I feel a bit let down by all this. I agonised to an almost OCD level about whether to go for a section or VBAC and when I eventually decided a section was right for me I felt really relieved. Now it feels that everything is up in the air again (even though I appreciate it isn't) and that apart from knowing the date I don't feel that anything has been resolved as I would have liked. I'm actually not this much of a control freak most of the time honest!

If you CAT me or post your email address I would very happily send you my birth plan and some other stuff that I have found helpful to read as well as links to sites that have been helpful. Good luck to you!!!

Have to say I hope I never treat my patients like this! I make a big point of going to meet people I will be operating on - like you say Chirpygirl it's polite rather than anything else! Maybe I shouldjust look on it as something that will make me a better doc!!!

I don't think that is precious at all, if you were having planned surgery for something else you would be able to ask lots of questions so why should a birth be any different!

{I think he was quite embarrassed actually, and DH said I was really rude to him as he came over as they were removing screen and starting touching DD, when I hadn't touched her myself yet. I believe my exact words were
'Who the fuck are you? Get your hands off my baby'
cue smothered giggles from the anaesthetist and nurses)
I bet he introduces himself now

Chirpy I love your style!!! I think thats hilarious!!!

Sue I certainly won't be letting them do ANYTHING to me without speaking to the surgeon concerned - I'd just like to do this a couple of days before away from all the emotions I'm sure I will be feeling that morning thats all. I don't have any major issues with consenting to the procedure itself - I know and accept the risks and the registrar was very thorough about all of that. Just want to be able to know whether or not my other requests will be possible really and have the reassurance that I know the person who will be cutting me open!!!!

alicet, good on you. I just accepted everything that was dished out to me on that day, for my elective.

I did get told the name of the consultant who was doing my elective at 36 weeks when I booked in the date, but I never met him beforehand. He was not the same consultant as the one who saw me during my pregnancy. The risks were explained to me by a different doctor (houseman?). On the day itself, the named consultant was there, but he was not performing the surgery. It was another more junior doctor who would be supervised by him. Throughout the elective, he was whispering instructions to her.

haha, I had the same issue about excising the old scar. And was told to just mention it to the surgeon on the day itself! Which I did, and they said yes, they will try but if there is too much scarring or is risky, they won't. In the end, they did. And the junior doctor stitched things up neatly and it healed better this time.

On stitches, I think that is hospital procedure. So you can ask now (midwife?). In my hospital, it is non-dissolvable stitches, not staples.

Ditto for dh's presence during GA. I know for a crash section under GA, my dh was not allowed. But if it is an elective and GA is used because the spinal does not work, they might let him to stay. It is again probably hospital policy - feel free to ask now.

My hospital did not allow dimming of lights. The anesthetist was not keen to take photos of baby from the business end as he was lifted out (not gory bits of course). Baby was given a quick check and put on my chest to breastfeed. They were not interested in his cord blood, though I offered to donate it. I don't think dh was asked to cut the cord. And the list goes on ...

Thanks alicet that would be wonderful - my contact is mrsfogi at mac dot com. I know what you mean about feeling that everything is up in the air - I agonised for ages too about vbac v. elective c-s (after abruption of the placenta) and now that I have taken the decision I just want everything to be organised and well-planned given that that is one of the up-sides of a c.s. I don't think you are being precious at all - all of your points are extremely reasonable and in relation to knowing who the surgeon is of course you should be able to find out a good while in advance who will be performing major surgery on you.
Btw I'd withdraw consent until all the points you raise have been dealt with to your satisfaction - I'm a great one for annotating consent forms.

Alicet if you are in an NHS hospital I don't think a consultant would normally do the elective C sections. Certainly weren't any consultants in attendance when I was in the queue. Though to be honest, that's not usually what consultants are good at. The two 12 year olds doing the cutting and stapling when I went through were brilliant though. I did ask if I was their first and they both laughed heartily and told me that C sections was all they had done for the last three months - day and night. So no wonder they were bloody good at it. I think you get whoever's rostered on. Though maybe you're not NHS, so ignore all that!

I'm having an elective CS in two weeks' time. What's this about excising the old scar, please? I had another elective CS 2.5 years ago. I had stiches last time and it healed beautifully. I only met the surgeon on the morning. I had a couple of questions (one relating to the layers of sutures - I have completely forgotten meanwhile but it was very important at the time). Now I'm on the list for the 2 consultants who I've been seeing through this pg, I assumed they (or one of them at least) would be performing the op on the day. She booked me for a Thursday when they were both in.

Well thanks for all your support ladies. Good to know I'm not making a mountain out of a molehill!

MrsFogi I'll mail you the stuff as promised...

Jan I am NHS - apparently though there is a consultant for each operating list and its them I would need to clear any preferences I have with as it will be up to them.

Cristina - maybe if I had seen the consultant I had been under he would have put me down for a day he was in. To be honest I was expecting that it would be him that would do it.

Anyway I'm away for the weekend, then will see how I feel on Monday and probably try and get hold of my consultant either by mail or try and get another appointment to see him in clinic. I'll let you know how I get on!

Oh and excising the scar just means rather than just cutting through the old scar you actually cut it out. Shouldn't add more than 30 secs / 1 min to the length of the operation. Would be happy for them not to do this if its a genuine emergency / crash section but they should routinely do this for elective / urgent procedures. People don't though in my experience!

Don't get me wrong there are more important things in life but if they can do something simple that will make the scar look nicer then I want that please! Basically it looks better in the end as you are suturing fresh skin together rather than old scarred skin.

im not an expert on this but my thoughts:

1. i didnt ask for the type of cut you are thinking of in my elective (following emergency) but i got it anyway - he must have cut through and joined fresh skin - i had stiches not staples and the scar is now invisible mostly. so you may have nothing to worry about - it could be a routine thing now?

2. i wonder if one reason they dont tell you who is that an emergency c-section may take priority on the day and your surgeon may change?

im just trying to alleviate some of your worries x

Feel free to tell me to sod off but thought you might be interested in this!

www.guardian.co.uk/family/story/0,,1656246,00.html

I had 3 caesareans before having a VBAC last year and if I'd known then what I know now, there's no way I'd have had the shitty experiences that I did, mostly because I didn't realise I had any choices.

sorry, am new - didn't realise the link wouldn't automatically appear for people to click on. Is this better?
www.guardian.co.uk/family/story/0,,1656246,00.html

Alicet - I've had 3 sections and I've never met the surgeon for any of them until literally just before.

My 1st section (elective) I got a registrar, never thought to ask who was doing it till I got to theatre . However, she still asked me at the end how I would like to be closed up? Didn't actually give 2 **s as baby had just been taken off me to special care but that's another story! So I still got a choice.

My 2nd section was an emergency one happening out-of-hours so again got a registrar I'd never met before. I was upset about the scar from my 1st section so dh stood over the surgeon to make sure she excised it!

3rd section my consultant changed the date of it a week before and hence she was on holiday! So that morning I got a registrar (who was in a foul mood because one of the other registrars had called in sick). Yet was a wonderful experience.

So, hopefully, even if you can't meet your surgeon before, it should be possible to get what you want!

I have had 3 sections - first planned due to breech, met the surgeon at pre-op the day before.

Second crash under GA, met surgeon afterwards!

Third one was done by consultant who came to see me the day before and answered all my questions. He revised my scar but was unable to do the lipo to my thighs that I wanted

IME it's quite unusual to meet the surgeon much in advance.

Fascinating article, wish I thought that these ideas would catch on in other hospitals. I didn't have a caesarian but was induced and had a long labour, and if I have another baby I suspect I'll probably be induced again and I now know that a very high proportion of inductions lead to emergency CS.

Newgirl ? thanks for trying to put my mind at rest. I have stopped being so neurotic about it at least but will still try and speak to them in advance. I am fully prepared that things could change on the day with regards to who is operating and if that was the case I wouldn?t be silly about it. Just would like the opportunity to discuss it with the person who is most likely to be there that?s all.

Vbacqueen ? thanks for that link! I had seen it before and think its really interesting. Thought about a lot of the things they did and about whether to ask for this for me but at the end of the day decided that I didn?t have a problem with how my emergency section was done. Needless to say it would probably have been a bit of a battle and I thought I would save my energy!!!! Will ask them to lower the curtain and for immediate skin to skin though ? this didn?t seem like it would be a problem to the registrar I saw. I have just stupidly now got fixated on the things she wasn?t able to say would be ok!!!!

Thanks for everyone elses helpful comments. I still want to meet the surgeon before hand but will probably chill about it until after the weekend and then decide whether I will get in touch with my consultant or not. It may well be sensible to just wait until the day. However I know that its unlikely I?ll see them beforehand then as I have already signed the consent form! And although not seeing them beforehand doesn?t mean I won?t get what I want ? obviously most of you did ? I am not happy with that really.

Thanks though ? you?ve all made me feel a lot calmer!

youre not neurotic - i think you are probably better informed than most of us so you know what to ask - i would imagine that women in ten years will all be having meetings and discussing options!

If I had known previously what I know now, my caesareans would have been very different experiences. The first was a crash section under general anaesthetic and I didn't give a toss what happened as long as my baby and I were still alive after.
When I had my 2nd baby I was talked into having an elective (for no good reason as it turned out) and the only thing I was bothered about was being awake for it. They managed to knock me out by mistake half way through.
For my third CS I was determined that I should be awake throughout and I wanted them to drop the screen so that I could see my baby being born. I hadn't discussed this prior to the event and as I was lying, strapped to the table, I blithely assumed that it wouldn't be a problem so when I politely asked the question and the surgeon told me no, I was too shocked to say anything much. Was my request unreasonable? I don't believe so!
When I had my 4th baby I did it all completely on MY terms and gave birth naturally, with just about every aspect of my birth plan followed to the letter.

I think the moral of the story is, if you really want things to happen in a certain way (and after all, it's YOUR birth, YOUR body and YOUR baby so why wouldn't you?) you need to plan for it, and make sure that everyone involved is fully aware of your wishes. Alicet, if you want to meet your surgeon beforehand, then do so!

VBACqueen Thank you SO much for that link. I am having a planned c-section after 2 wonderful hippy-dippy homebirths and have been in the depths of despair about the inhumanity of it all. Now I have a point of reference that it doesn't have to be like that.

I have decided to 'chuck cash at it' in the hope of maintaining some degree of choice and control and am going private. I have met my consultant and will be discussing this article with him at our next meeting next month.

THANK YOU THANK YOU THANKYOU

No problem Rapunzelle! Even if you were having your baby on the NHS, it's still possible to have control over the way things are done, but to be honest it can be a bit of a battle sometimes. At least by going private you can dictate how every single aspect is played out, what music you have on, whether the lights are dimmed, immediate skin-to-skin, slow delivery, the lot! Have a wonderful wonderful birth and let me know how you get on - I'd be interested to hear what it's like at a private hospital. Bet the bloody food is better too LOL
Good luck!

Just to let you know I wrote an email to my consultant and he has arranged to see me the day before my section to answer my questions! So glad I made a fuss afterall and any of you who were in similar situations shouldn't feel bad bout asking either!