To feel bad about requesting ELCS?

[Worriedandabitscared]

Hi all,

I've posted about this before about it and you were all so lovely and helpful so I thought I'd update and ask for some more advice as I can't speak to anyone in RL (yay for mumsnet).

I spoke to a perinatal midwife today and explained I was raped for four years between 14-18 by an ex partner and it's really got me worried for birth, when I first got pregnant I honestly didn't even think about it, I guess 40 weeks is a long time and it seems so far away but then I had an infection in early pregnancy (I say early but it was like 21 weeks) and two lady doctors did an internal and it hurt and I asked them to stop and they didn't so that was very triggering for me and I spent a week crying and having nightmares for the first time in five years and that's when I started to think how birth may affect me with the pain, not being in control, the doctors and nurses being down there when I'm in pain, not being able to stop it etc etc and then I started to think how it could affect my relationship with my little boy, how I might start to blame him or wouldn't bond because of what's happened and I know that sounds silly but it really affected me so I spoke to my midwife who sort of ignored me and talked about something else and then at my next appointment when I brought it up again she said " they don't do c sections routinely, vaginal birth is better for you and baby and you don't want baby getting hurt do you?" Which of course I don't but I'm important too which is when I posted on here and everyone was so lovely and gave me the confidence to contact her manager who was lovely and set an appointment with the perinatal midwife and I've spoken to her today and she is discussing it with a consultant, she said we could just request no vaginal examinations unless absolutely necessary but I think the whole process will be very triggering so she's speaking with the consultant and calling me back with the next steps and I've been thinking about it and I think if I mentioned this at my first midwife appointment and she was like no chance you're having a vaginal birth and that's it then I would have opted for an abortion, that's how strongly I feel and I know a c section isn't the easy way out but I'd genuinely rather go through major surgery and a harder recovery than risk getting re traumatised and not connecting with my son etc I know they can still say no but with everything going on with covid etc do you think it's unreasonable to try and push it for mental health reasons? I feel like I'm self aware enough to know that my fears are silly and of course it isn't my sons fault and he's doing his bit ready for birth like being head down etc but at the same time feelings and trauma aren't always rational and in those moments or after birth I might completely shut down etc and I think I need a bit of a handhold, am I being silly or was I right to ask?

Your feelings are completely valid and you should not feel silly at all, please never think of yourself in that way. You are completely entitled to an elective section and it is absolutely fine to advocate for yourself for this with your medical team. I had an elective section, for different reasons but it was something I had to advocate for myself to access. I thought I would have to fight to justify myself but that couldn't have been further from the truth. The consultant and midwives were nothing but supportive and it was signed off in no time. It is your decision and what's best for mum is best for baby

Your feelings matter enormously, you’re doing exactly the right thing by advocating for yourself, your mental health and your right to choose the birth that is right for you.

That midwife sounds completely unprofessional and a total bitch. How dare she minimise your past experiences, your fears and wishes and try to scare you further by mentioning your son getting hurt. There are risks to all methods of delivery and you deserve a calm, considerate, professional discussion, not a lecture or emotional blackmail.

I wish you and your little boy every good thing and send you strength to continue fighting for what you want and need.

It's your decision entirely. Just tell them that you've thought about it and with your history and how you feel you think it's best that you have a C section so could they book you in please. Dont phrase it as a question or let them try to talk you down. "No I'm certain in my decision, a C section is the safest choice for me and baby."

I had an elective c-section which took one conversation with a consultant to arrange. I had done my research and the consultant confirmed for my circumstances it was marginally safer for the baby to be born by c-section although the risk to me was slightly increased. It was a great experience and my baby latched on in recovery. I had another elective c-section with my second that also went well. Do not feel guilty, you are entitled to request a c-section.

You are absolutely reasonable to request a CS. Keep repeating: I've done the research, I understand the risks and I'm confident that an ELCS is the right choice for me.

Good luck

This really pissed me off, and sadly from my experience too many midwives refuse to discuss CS or at worst tell lies to try and convince you otherwise. I really don't understand why they do it.

When they quote stats for complications, they use both emergency and elective CS together, but they are very different. An elective CS is lower risk than a VB.

I was the same as you, fortunately DD turned breech and I was offered an ELCS at the drop of a hat and it wasn't as scary or painful as is made out. I took nurofen for pain relief and it was fine, and all healed very quickly.

This is your body, and particularly with your history your midwife should be supportive. If not then keep going above her, request a consultant appointment until she realises your body, your choice.

Just to add in I know this is tough but please be honest about it all. For example insuring the catheter for csection after you have gone numb. Stick by your gut. Your baby.

Also my csection was amazing and I personally found examinations quite traumatic too so please do make this clear. It won't help you or your baby in labour and will just make an emergency csection more likely.

I did the exact same with my eldest, ELCS, for similar reasons. I'm planning to do the same again.

You are doing the right thing, stick to your guns, and do not be fobbed off. You don't say how far along you are, but you should have an appointment with a consultant at some point in the 3rd trimester (30 weeks) and another shortly before you reach your due date.

My consultant was lovely and supportive, agreed with me wholeheartedly that it was best for me. Midwives split about 50/50 between supportive and barely concealed disdain for my choice. Family were shitty about it. Fuck that noise, your mental health is vitally important for the wellbeing of the baby. If you want an ELCS for the extremely valid reasons you have explained above, you should have one. You just need to be brave and tell the consultant the truth.

I really hope that you have complained about the midwife you originally spoke to. If she was aware of your history, that is a bloody awful thing to say.

Don't feel bad about requesting
one. You are totally justified. Rehearse saying 'I need to be booked in for an elective section for my mental health' or similar that you feel comfortable with and repeat, repeat, repeat!

I'm so sorry for what you have been through whilst I havent experienced what you have, i lost a baby previously and had a horrific time in hospital with it. So a year later when I was pregnant again all I could think about was the birth and how it would feel like when I lost my baby. I didnt talk to anyone as i felt ridiculous. However at my consultant appointment at 32 weeks i broke down and explained to her how I felt. She was so good and i requested an ELCS. She said she wanted me to be sure, told me to go home, research everything, try talking therapy etc and then to see her 3 weeks later
I went back at 35 weeks and still wanted an ELCS and she gave me a hug and signed the consent form. I was allowed to pick a date for my ELCS, choose music and all sorts. My little rainbow baby was born a few weeks later, 2 days before the ELCS was booked 😬 I went in to labour but they quickly took me in to theatre and didn't try and talk me out of it. Midway through the surgery my consultant came in to say hello, the most surreal thing. The ELCs was actually an amazing experience.
They cannot say no to your request please bear that in mind.
When I had my 2nd child I was given the option of a VBAC or ELCS, I opted for another ELCS ( again another amazing experience) they explained they send you to a VBAC lesson to try and get you to choose VBAC but I had the same consultant as the last time and she said she wouldnt make me go and signed the forms for my ELCS again

Good luck with everything. If you need to chat please message me xx

Get one.
You needn't feel bad or overly justify.
A friend had one for merely being scared of birth.

Your experience and you are valid.

I've heard an ELCS can be a beautiful experience and hopefully the start of a wonderful journey for you xx

No, YANBU. You are entitled to an ELCS for mental health reasons (or any reason). Your fears aren’t silly at all. I had a traumatic vaginal birth and couldn’t bond with my son for months.

I was a midwife for a very long time and it makes me furious to hear that a midwife has told you that you can’t have the birth you want. The reality is that this is a decision that can only be made by your consultant in conjunction with you, after a full and proper conversation.

It sounds as if you are now on the path to that. Do listen carefully to any proposals she may make such as speaking with a counsellor or psychologist first. Do listen to the risks and benefits. That way you are making an informed choice.

Whichever way you decide is completely and totally fine. I’ve seen many women in similar situations who have gone on to have both vaginal and caesarean births.

Good luck.

Hi Worried,

You have every right to request an ELCS given what you have been through. You are not silly. I am so sorry you have not always been treated well by your midwives. Ask for an appointment with the consultant obstetrician, take as much supporting evidence you have (GP/counsellors letters etc). Show you've done your research. Get the plan written in your case notes, not just electronically. Take a photograph of that entry in the notes. All the very best.
Midwife

Omg - you are not silly at all! You have a right to request a ELCS (and the doctors who examined you previously absolutely should have stopped when you asked them to! I'd consider speaking to PALS about that, but I appreciate you might have enough in your plate without doing that). Have a look at the Birthrights website - they should have some advice on how to advocate for yourself. Good luck!

YANBU at ALL

You are not silly, you're having a completely normal reaction to a traumatic event.

They shouldn't say no if you are making it clear you are at significant risk of an incredibly stressful end to your pregnancy, PTSD relapse (sorry if that's not the right word) and PND through a vaginal birth. In your case, a section is the best course of action.
Do you have a counsellor or GP or anyone that could write a statement about the risks of vaginal delivery for you to show them? Also, and please dont take this the wrong way, I'm wondering if the language you are using is contributing to them not taking you seriously? If you are saying things like 'I'm probably just being silly, and I realise you are likely to say no, but I was wondering about a section...' then it sounds like you're not that bothered and can be talked out of it. Can you practice being more assertive? 'I need a section, my mental health is at risk of serious harm with a vaginal delivery' and 'I am unable to have a vaginal delivery due to past trauma and it WILL trigger my PTSD' will be much harder to argue against. They should be listening to you anyway but they clearly aren't.

I am glad you’ve spoken further with health professionals about this.

You are not unreasonable to want an ELCS in your situation.

Last time I recommended reading The Positive Birth Book which contains lots of information on how to have a lovely CS birth, and will help you to advocate for yourself. Please read it.

www.amazon.co.uk/Positive-Birth-Book-Approach-Pregnancy/dp/1780664303?tag=mumsnetforu03-21

Agree with what @OoohTheStatsDontLie days about thinking about the language you use when talking to healthcare providers. You need to use positive language and advocate for yourself.

My situation is different to yours, but I either want to give birth with gas and air/pethidine, or I want a CS under general anaesthetic. I do not, under any circumstances, want an epidural or spinal anaesthetic. I do not want a forceps/assisted delivery.

This is written very clearly in my birth plan as:

“If I am unable to give birth vaginally without assistance, I wish to have a CS”
“If I have a CS I wish to have a general anaesthetic”

Please become more forthright and TELL them what sort of birth you wish to have. Birth isn’t just about making babies, it is about making mothers too. You matter in this.

www.nice.org.uk/guidance/cg132/chapter/1-Guidance#planned-cs

Sorry if you've already seen this

Section 1.2.9 maternal request covers this. They are supposed to establish the reason why (this case is pretty clear) and advise you of the risks.

I it's to do with birth anxiety they are supposed to refer you for help with this but if after this you are still anxious and request again and understand the risks then they are supposed to offer you one.

In your case its unlikely they are going to be able manage your anxiety about it (understandably, as it's not run of the mill anxiety about birth that can be overcome by a bit of deep breathing) .

I'd refer to the NICE guidelines if you get any pushback and also tell them that you understand and accept all the risks of surgery but have weighed up the pros and cons for both and you need a section

I can't improve on what has already been said, all I would like to add is that you do not have to share the details of your trauma with any health professional in order to justify your decisions.

It is adequate to say "due to past trauma" and to state what is difficult for you. They do not need to know the specifics of that and you should not feel pressured to relive your traumas in order to justify yourself. Anybody who tries to find out specifics of what originally happened to you is a voyeur.

You do not have to let anyone invade your privacy like that. IME, any health professional who is an ignorant dickhead about the significance of trauma will continue to be a dickhead to you even if you tell them you were raped or any other detail. They won't be moved by it and it will leave you feeling violated.

It's also unacceptable that they ignored your requests to stop. As soon as they continued to touch you after you withdrew consent they were assaulting you. You haven't overreacted by being affected by that. It's an absolutely unforgivable (and criminal) thing for any HCP to do and I'm sorry it happened to you. They should be punished for it.

Gosh, OP that’s terrible, she was way out of order.

Of course you should have an ELCS if that’s what you want. I believe outcomes are actually better for ELCS than Vbacs.

Please advocate for yourself. I had an ELCS for baby number two and it was a brilliant decision. It was a great birth.

Best of luck.

Hi everyone,

Sorry I disappeared from the thread, DH got a positive covid test so been rearranging all my appointments for the next ten days - I'm 36 weeks pregnant by the way and the midwife has called and said the consultant is more than happy to book the elcs in for me and she'll call in the morning to get the ball rolling so I feel like a weight has been lifted

I know what PPs mean about being more assertive, I'm very soft spoken and don't like to cause upset but I completely appreciate where you're coming from, I need to practice being more assertive but I'm really glad in this situation I didn't have to be and they've not put up too much of a fight.

Thank you so much everyone

Great news OP

I hope your husband is ok x