I want an Elective C-section- AIBU?

[MellaY]

Hi all, I'm wanting to know if you all think I'm a bit cracked and if anyone has advice on how to pursue this.

I will be a relatively young (21) first-time mum and also only 9 weeks pregnant. I have always had an unhappy relationship with parenthood and childbirth, which I have come to realise is much more about childbirth than the parenthood part and childbirth being a barrier to parenthood for me.

I have no desire to have a VB and the thought of it both terrifies and repulses me. This is for a variety of reasons:

When I was about 14 my cousin had a horrible experience of VB the first time where both she and her little boy nearly died, she also experienced a lot of tearing and has experienced discomfort ever since due to how she stitched up (there was some debate at the time whether she was stitched too tight and given the 'husband stitch'). The thought of this happening to me truly scares me.

When my mum had her first pregnancy and VB she needed emergency surgery during childbirth due to having a previously unknown vaginal septum.

I have a complicated medical history. I was very ill at the ages of 16/17 with a rare immune disorder known as adult-onset stills disease. This affected me profoundly partially due to the disease and partially due to the side effects of the medication I was on. I was in therapy throughout my illness and for a year after due its effects on me, I felt completely out of control of my body and what it was doing and how it looked (long term steroids). It was a very traumatic time for me. Despite me being well and unmedicated at this time I am being placed under consultant lead care and considered a high-risk pregnancy as there is little knowledge regarding how my illness may affect me and my pregnancy or whether pregnancy may cause it to flare up again. These complications may well lead to me needing a c-section anyway.

I struggle with an overactive bladder and have done for many years which I also fear will be worsened by childbirth to the point of negatively impacting my quality of life.

I cannot handle one more out of control thing happening to my body, I know I can't. I am fearful of what may happen during childbirth to both me and my child. I have had surgery in the past and have witnessed many surgeries (albeit on animals, not people) thanks to a job I had when I was younger. Surgery is a known factor to me, I know a c-section is not any easier than a VB but it is something I have already experienced and know I can cope with.
I am afraid of tearing which may sound vain or selfish to some but I know I wouldn't be able to cope with damage or scarring in that area of my body. It would destroy my self-esteem where I feel a scar from a c-section would not, it's a scar I have 'chosen' and not that I want it on my body that is simply more okay to me than tearing.

AIBU for wanting to pursue a C-section as the method by which I want to give birth considering all the reasons above? I feel like some will attribute it to my age without looking too much further past that. Also if anyone has any advice on how to broach this with practitioners or how they have dealt with similar issues your advice is welcome.

Also thanks for reading this mammoth word vomit

You have the right to request a c section. Tell your midwife and then speak to your consultant about it at your future appointments.
I always felt very similar to you. Nothing in particular that triggered me but I just couldn't bare the thought of a vaginal delivery. I worried throughout and luckily for me my son was breech so I was able to have a section and then request a section for my 2nd child also.
Having an elective section for me made the whole experience calm and like you say I had some control. I knew what would be happening and when. The recovery is painful but I was happy to accept that. Good luck with your pregnancy

I had an ELCS when having my second due to a difficult birth with my first. When I asked the midwife about it she didn't bat an eyelid and was supportive- it's your body and it's your decision!

You don't need to justify it at all although it sounds like you have a number of good reasons. I won't lie, I am healthy and had an equal chance of no problems second time around as of having all the problems I had before (including a severe tear). I felt a bit of a failure for not going ahead with VB and recovering from the CS was harder than I expected. But guess what? I got over it because I recognised those feelings were nonsensical.

Admittedly not long after I had my little one the subject came up with a random tradesman I was chatting with at the house and when he described CS as 'the easy option' I nearly ripped his head off

I’ve had both. I had an emergency crash one with first after a botched induction so I was insistent I wanted elective with 2nd over induction etc.
All hospitals are different but I did have to push extremely hard to get an elective booked in. I read up about nice/rcog guidelines and wrote a letter bullet pointed with factual reasons why I felt an elective section was the most appropriate option.
They did agree but I had to go to a few appointments as it’s important you know the risks etc, and it wasn’t something they agreed until the 3rd trimester.
In the end I did end up going into labour naturally 2 weeks early. they was going to do the section but I decided to try naturally as it was progressing and it went well!
If you feel a section is the best option for you then definitely discuss this with your midwife and request one

I feel very strongly that every woman should have the right to an elective c-section if she so chooses.

I think the most important thing for you to do is to read up about the risks of both, so that when you have that conversation you are prepared and do not let yourself be bullied into having a VB. Be very firm.

I had an ELCS with my second after a difficult first VB. For me it was about control too as the biggest issue I had with my first birth was lack of control of the situation which as a HCP who could see what was going wrong and no one would listen was something I really struggled with. My ELCS was a wonderful empowering experience. My hospital were happy to accept my request and there was no trying to push me into a VB but they do have to read out the risks etc as part of the consent process. Have a read of the NICE guidance anyone can request a section and if the consultant you have refuses your request the guideline suggest they refer you to a different consultant for a second opinion.

Hi OP

Look up the elective/ planned c section guidelines, it covers mental health scenarios which this would come under. They will likely try and reassure you about your fears and maybe try and get you some help to cope with them but after this if you understand all the risks and pros and cons and still want a section they have to give you one

The only thing I would say though if one of your reasons is tearing/scarring, is my c section scar is 100% worse than the tearing I had with the natural birth. The section wasn’t sewn up well, I picked up an infection from the hospital which caused it to open. I have the classic c section over hang now and I’m extremely self conscious about it.
I did tear with 2nd which required stitching, the stitching healed very quickly and it looks pretty much the same.

From a vanity point of view, you may not have a flat stomach again. But for all the other reasons you've mentioned, YANBU.

There is a maximum they are happy to do though so don't do it if you're planning on having lots of children (doesn't sound like you are).

I'm having a ELCS in 3 days. I'm a FTM too.
Consultants didn't even ask me why I wanted one. They said it was my right and as long as I knew the risks then it would be fine.
I'm really nervous but I feel far more in control then I would if I had to be induced or have forceps or tearing etc.
Just tell your midwife you want a section and go from there. Good luck!

I requested an ELCS for mental health reasons due to previous trauma - it was granted without any problems at all. I mentioned it to my midwife at 16 weeks and got a date agreed shortly after my 20 week scan. They have to go through the risks with you (which some people interpret as them trying to talk you out of it) but if it's what you want, just stick to your guns. It's absolutely your right - check out the birthrights website which has more detail.

Congratulations on your pregnancy!

YANBU at all, I had one and I didn't have a list of very good reasons like you do! I was simply terrified of VB after hearing horror stories, and I have a history of anxiety. I asked at each appointment and was told a few times "ok well let's see how you feel at the next appointment". Then I got a bit more forceful, typed up my reasons, brought them them to an appointment and asked the midwife to read it. She was like okayyyy I can't see why they would refuse you, I'll book you in to speak to the consultant. The consultant was very nice, she had to run through the risks of c-sections which was momentarily scary but I was still sure and signed the consent forms.

I think in these covid times, just make sure you type up your reasons, print them off, repeat yourself at each and every appointment and ask when you can see the consultant. Just FYI they tend to leave it to quite late in the day to refer you for the consultant appt.

I have no regrets, the actual experience was magical, I just wish I'd relaxed a bit more and not been so scared about the spinal anaesthetic, it wasn't bad at all! Recovery is painful but zero regrets!

Well scaring on your belly is more obviouse then down below so that is unreasnable. But other reasons are not. You can request. It may also be a good idea to look into some form of counselling. I think a C section puts you in less control to be honest. You have to hand that over to someone else. It,s not an easy option by any means. Def look inot proes and cons. Do discuss this with your midwive but yes you would not be ureasonable to request a c section.

Also, they might refer you for councelling to make sure there is nothing they can do to persuade you to have a VB and to calm your fears. I didn't have this as it was too late in the day so I just got signed off quickly towards the end. Seems like it very much depends on your hospital as they all have different approaches.

I was denied one but looking back my mistake was not asking soon enough. Bring it up at every midwife appointment until you are taken seriously and its on record that you're having one. Good luck!

Everyone's different. I had an emergency CS with my third and was offered an elective with my fourth. I said I didn't want it, it was a difficult birth and ended up with forceps and came close to CS but I was so happy I didn't need one in the end. I have no issues with problems after a vaginal delivery, my CS scar drives me mad, I have a numb area but it itches, scratching a numb area does nothing and feels weird and the itching is a torment so for me it was a no brainer to try and avoid a CS. Having said that I had a hysterectomy so the CS scar was reopened, tidied up and the itching did reduce a bit so maybe another CS would have done the same.

Good luck with whatever you decide.

YANBU. you might have to push for one, but just keep stating your position until you do.

You are not being unreasonable and it’s understandable the way you feel however I do really think it’s worth a discussion with your midwife and drs, so you can make a fully informed decision. Cs is a risky procedure and there are health benefits for baby by having a VB. if you have all the info and still decide on a cs that’s your prerogative. Good luck!

@MellaY Absolutely not being unreasonable. Not sure if you will get the elective C-section. (On the NHS) But I hope you do.

Have you thought about seeing how much it would cost to go private? (Just in case.)

As far as I am aware, you have the right to ask for one, but your Doctor / Consultant also has the right to refuse it unless there are valid medical grounds. In which case they have to direct you to someone who is willing to perform the C-section. Definitely discuss with Midwife from the very beginning so they have time to help and support you with it.

I absolutely 100% do not believe you are being unreasonable, and at the end of the day, the ultimate goal is a safe delivery and healthy Mama & Baba - whether It be VB or CS. Good luck x

I had an elective CS after a traumatic birth. I did have to fight quite hard for it, every professional I spoke to until 37 weeks tried to persuade me out of it. I had a lovely birth, very calm and controlled I know I made the right decision. If it’s what you want you have a right to go for it.

However I will say regarding scarring after tearing, I had an episiotomy during my first birth leaving a noticeable scar and to be totally honest it doesn’t bother me at all. There’s nothing disgusting about it, it’s just. Small line or scar tissue and much less noticeable than my CS scar.

Just do whatever is right for you.

Your body, your choice. I do recommend you do as much research as poss about the pros and cons of c-sec and VB and I also heartily recommend you follow the positivebirthmovement on instagram and read the books written by Milli Hill to help you feel empowered and positive about your birth, whichever route you choose! Best of luck with your pregnancy and birth

YANBU for wanting a c-section.

But: I had an emergency c-section with my first. It was traumatic and scary and the recovery was painful and long. My second was a vaginal birth that was an absolute walk in the park. I had a second degree year, but honestly, it wasn’t a patch on a csection recovery! The vaginal birth was a wonderful experience. The section was not. But I have been told by those who have had electives and emergency sections, that the two are very different.

I had an ELCS which was absolutely lovely. I had no desire to have a VB. I personally know of too many people who had horrific experiences and that put me off alot. The recovery from a CS wasn't as bad as you would think and I healed well. I also couldn't bear to deal with all the other issues that come with a VB. Apart from my CS scar I still have my body as I wish.
You have every right to request one given the traumatic experiences you had.

Ive had an emcs and a vbac. My episiotomy healed faster than my cs scar. I was doubly incontinent after in my first pregnancy and afterwards for awhile. I had no issues with after my VBAC. I definitely preferred the VBAC although it should have been an elcs as thats what I'd booked. But she arrived early and I changed my mind.
I wouldn't want an induction or the drip again and would choose a cs over that.
It wasn't difficult to book a cs as I'd already had one.