To ask for an maternal choice elective C-section?

[Miphy]

I am 20 weeks with first baby- name changed for this thread.

Prior to pregnancy I was already leaning towards requesting a section. I am a doctor, not working in anything related to it now but obviously spent time in obs & gynae placements.
In my obstetric placement we had to spend a week with the midwifery team so that we had a chance to see ‘normal’ birth. Without exception every single birth I attended went ‘wrong’ and either ended with assisted delivery- forceps, episiotomy, in one case horrendous tearing, or emergency section and massive postpartum haemorrhage.
In contrast elective section list was lovely- but wham bam baby out, happy well rested mums.
Then later in gynaecology saw clinic lists full of women with birth injuries and PTSD.
This massively influenced my perception of birth.

I had thought more more about water births, hypo birthing etc and thought I may as well give it a go vaginally.

However the more reading I do now about birth the more I read about horrendous birth injuries, and of my friends the ones who had sections all fully recommend it whereas some of my friends who have had a vaginal birth have told me some pretty horrendous stories. One still can’t have sex two years later. I know there’s a recovery after section but somehow surgical recovery seems more straightforward and I’m not short of hands on help and support- both our mums are retired, husband works from home, all very keen to provide hands on help.

It feels to me like an elective section involves known small risks, I know what I’m getting. Whereas with a vaginal birth I can have some lovely water birth, minimal tearing, quick recovery, or I can end up exhausted from a prolonged labour maybe with a wrecked undercarriage, maybe a distressed baby and then even potentially a high chance of needing an emergency section with even higher risks. And it seems I won’t know which way it will go until it literally happens. It really feels like the injuries by women after vaginal birth are minimised and you’re just supposed to deal- so they aren’t treated as ‘risks’ in the same way.

I find myself hoping the baby is breech so my decision is made for me. I’m thinking Of asking about maternal choice section at my antenatal clinic appointment. I wondered if anyone had any experiences or any advice?

YANBU! But I had an ELCS and lost half my blood so it’s not necessarily flawless. But definitely more controlled.

(My first birth was induction,forceps, epis, 3c tear, and small haemorrage. C section recovery was a walk in the park despite the blood transfusion!)

I did it. They didn’t quibble. And it was perfect for me, just what I wanted. Planned, controlled, calm.

Yanbu! I had elective c section (not going to justify this to anyone) and it was very relaxed and straightforward. After I was able to stand and get moving about , The pain afterwards wasn’t as bad as monthly period pain

My friend is a doctor and she also had an elective CS. I guess doctors will always see/hear about the births that go wrong, because that is where they are needed. They don’t really experience the lovely homebirths/water births/ midwife led experiences. So really it is no wonder you have the feelings you do. I would never have chosen major surgery over a natural birth, but my own experiences are very different to yours.

YANBU! Your body and birth, your choice! I'm still TTC but I have always said I'll have an elective C section for similar reasons as yourself

Your colleagues better equipped to advise?

Quite honestly ever since joining MN and hearing the horrific injuries caused by child birth, I am considering asking for an elective CS.
It’s not something I ever gave thought to and I don’t think the possible injuries from childbirth are publicised enough, as I had no idea.

I've had a emergency c section followed by 2 virginal births, emergency csection was before I was in full labour and I didn't need any form of intervention on either of my natural deliveries but I found all 3 traumatic for different reasons. Basically I don't think either way is without downsides both mentally and physically

I had two planned sections for pretty well the same reasons you’re citing. Recovery was a breeze compared to friends with tears etc or those who had emergency sections. It took away all the uncertainty and anxiety, I wasn’t exhausted when baby arrived, breastfeeding was fine. In my experience I honestly can’t see how the recovery is any harder than what the body goes through with a natural birth let alone one with interventions or ending up with an emergency section. I say ask and insist. I know it’s not the preferred route for everyone but it’s your right to have one if you want one x

The ones that go well aren’t the ones that need doctors. You can check the actual statistics, not just go by your own limited and biased experience.

YANBU op. My first birth was awful, i was induced due to cholestasis, and I had to have ventouse and forceps and ended up with a 3rd degree tear, blood loss and anaemia plus a shit ton of stitches inside and out. It took me months to recover and still not 100% right really (16 years later!) It put me off trying for another dc for years. Second dc I pushed for elective c section, consultant really tried to push me towards a vaginal birth again but I was having none of it. C section was a dream compared to my first birth. It was so much more calming and recovery time was much quicker. Knowing what I know now, I'd only ever choose c section!! I am also aware that not everyone has horrendous vaginal births like i did.

YANBU to request whatever kind of birth you want. It is your body and your choice. However, do not forget that people are unlikely to tell you about their straight forward and quick vaginal births. At best it would be boring, and at worst it can seem smug when everyone else seems to be recounting horrific stories.

I felt incredibly lucky to be able to have both of my babies vaginally. I am quite short and had 90th centile babies. My second baby was born with no pain relief, help or intervention from the midwife. Avoiding major abdominal surgery seems like a huge plus to me.

Your birth, your choice.

For what it’s worth however, at 32 weeks pregnant and about to go for a natural birth (hopefully) myself, I do find some of the things you’ve said scaremongering- and coming from quite a biased perspective.

YANBU - your body, your baby, your choice.

Having been through both - traumatic vaginal birth & semi-emergency CS - I'd go for the CS every time! It was so much better than the vaginal delivery for me.

YANBU, should be completely your choice, but I think you've been unlucky in terms of what you've seen and heard. I really enjoyed my last labour. The first one was induced and that was not good, but the last one was really lovely and I was out for a walk a day after. I can't wait to do it for the last time. I felt so powerful and alive. Neither myself nor any friends had any lasting birth injuries.

My aunt is a consultant obstetrician and birthed at home, so it doesn't seem to put everyone off birth, but I can understand why your experiences would!! Her mum, my grandma, had 11 live intervention free births at home with only friends/family helping as they had no choice. I wonder if growing up around birth in that way influenced her. I saw my first birth aged 10 and it was pretty wonderful.

That said, I think if you can have an easy, controlled birth it should be an option and you shouldn't have to justify yourself. I do have one friend who has always had a phobia of birth and had an elected CS with no ideas. She is very happy with her choice (and is a bit of a hippy and into woo in most other respects so I'd sort of expected her to birth in a woodland clearing and do a ritual with her placenta...)

I think your view is very skewed from what you’ve seen at work (understandably). FWIW I have a doctor friend who had an ELCS. Her baby ended up with RDS (in hospital for a while) which is likely caused by having a section and she feels hugely guilty and developed PND. You can’t win. I had two natural births and wouldn’t want any surgery I could avoid but I’m sure if I’d had some of the traumatic births you read about on here I would feel differently.

Your birth, your choice. FWIW didn’t have the birth I expected but felt euphoric afterwards. I had expected I’d have the water birth, just using gas and air, hypnobirthing etc. I had a 30 hour stop-start labour after my waters broke, pitocin and an epidural, second degree tear (no time for an episiotomy) and postpartum haemorrhage. I feel like I had a straightforward birth with no complications and I felt great before, during and after.

Having had 2 emergency C sections (def not through choice) I've had 20 years of chronic pain from surgical adhesions.

It makes me really angry when people discuss major abdominal surgery as though it's a breeze.

@Miphy YANBU but I just wanted to tell you about my birth as a positive experience for you.

I'm a very anxious person; always think the worst case scenario, catastrophise everything and my heart rate is usually 120/130+ (ECG has ruled out anything abnormal!).

However, I never once worried about birth. My thinking towards birth was 'What will be, will be' and the only plan I had was a water birth but even if that didn't happen, I'd have been okay.

I was a week over due and had two days of contractions that were very irregular so I couldn't go into hospital but managed at home with codeine. My waters broke on the night, I went straight to hospital and into the birthing pool with gas and air. 4 and a half hours later, my daughter was born.

I was up and walking within the hour, I went home the following day (could have gone home the same day but I needed help breastfeeding) and my recovery was absolutely amazing.

I'm not saying its easy either way and I'm in no way slating anybody who's had a C Section but I wanted to give you a positive story

And I also don’t think the answer to women experiencing substandard birth experiences is to just to encourage them to opt for major abdominal surgery instead!

I am at the very early stages of pregnancy (6 weeks), a doctor also and wouldn't have gotten pregnant if I wasn't as certain as I can be that I will get a c-section (even if I need to pay).

I think a lot of people go into the idea of vaginal childbirth (as I would have done, pre-obstetrics placement, and pre-Mumsnet!) that episiotomies, tears, traumatic births and long term side effects such as incontinence are 'horror stories' rather than actually a very real possibility of happening. What I observed were also midwife led 'normal vaginal deliveries' rather than shadowing an obstetrician, for example.

What I like about a c-section is the greatest likelihood that what I envisage about birth will happen. Yes, recovery might be tough, but I know as a person what sort of pain/situation I will find manageable, and I would prefer this versus the acute pain of vaginal delivery.

I also think of the mothers experiences I witnessed as a student- how horrific vaginal birth looked from their perspective, versus the c-sections I observed where regardless of the surgery going on, the mothers were calmer, more relaxed, happy to be distracted by me in chat, talking away about unrelated topics.

All the best with whatever you decide. I think a maternal choice elective c section is a very valid choice.

I had an Emergancy cat1 CS after failed induction and fetal distress with my first and elected CS for the 2nd birth due to the traumatic induction the first time around.

Both were fine, I did have a large 2l pph with my elective one, so it’s not always so straight forward, but after the shock I was fine.

I’d elect again, didn’t put me off. Both have loads of positives and negatives.

Official statistic despite what we are told gave a very clear view-between 20 and 25% of birth end up being either instrumental delivery or emergency csection in this country. It is generally considered a slightly safer option for a baby to be born via csection. It is also likely the mother would have complications from instrumental delivery. Midwives don't consider having 'minor incontinence' or nerve damage in the area as a good enough reason to be concerned.
I requested elective C-Section and it was 100% right decision for me. It was calm, smooth, controlled procedure performed by a highly qualified doctor.
It is a personal choice. Some women want the experience to be as natural as possible, some want doctors.