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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

Emergency c section delayed due to electives?

156 replies

JenS16 · 07/12/2022 10:42

I was admitted yesterday for an emergency (category 3) c section and they can’t fit me in today as the list is full of electives! Hopefully tomorrow but they can’t say for sure.

I am fully in support of women having a choice when it’s comes to childbirth but AIBU to think that emergencies should be prioritised over electives as there is a risk to the baby of waiting??

(I know I don’t know the situ of the women but waiting for electives but as they are not classed as emergent I would assume there is lower risk or they’d be re-classified…)

OP posts:
LydiaBennetsUglyBonnet · 07/12/2022 10:43

surely yours is also classed as an elective? EMCSs are not planned or scheduled the decision happens quickly and iIRC it has to be 15 minutes from the decision to the birth

ElephantInTheKitchen · 07/12/2022 10:45

Elective doesn't mean "purely by choice" it just means scheduled and planned in advance. The way the NHS works, they'll all have a clinical need for their c section.

mylion · 07/12/2022 10:47

I'd imagine your section is not deemed as 'emergency' anymore as emergencies are taken in & done within a very short timescale and always take priority over planned. After review they have maybe decided it doesn't need action as quickly as thought. If you're concerned about it 100% question it so you can get an understanding of what's going on, it'll maybe give you some peace of mind until the section is done.

Cinnabomb · 07/12/2022 10:48

They will likely be in a similar risk category to you. Some maybe cat 4, some 3. By definition cat 3 means there will be no harm in delaying.

NameIsBryceQuinlan · 07/12/2022 10:50

I had an elective for many reasons but I was told that mine may be bumped back if there were more emergency cases that came in. They wouldn't prioritise a non medical necessity over someone in an emergency.

JenniferBarkley · 07/12/2022 10:51

Elective just means planned. If your baby was more at risk you would be prioritised (women going in for an elective c section will be told they can be bumped for emergencies).

My emergency section was because of a failed induction, I was put second on the morning list as one of the elective women had diabetes and was fasting so her case was much more urgent than mine. I was then almost bumped further by a more urgent emergency but that woman managed a natural delivery - the tension of the staff on the ward made it clear things were touch and go in that room.

My elective was because of a transverse baby and so she was only ever coming out via section and it wasn't straightforward. It wasn't urgent but there was zero choice in the matter.

CTR1000 · 07/12/2022 10:52

ElephantInTheKitchen · 07/12/2022 10:45

Elective doesn't mean "purely by choice" it just means scheduled and planned in advance. The way the NHS works, they'll all have a clinical need for their c section.

Not quite true - women are allowed to request a section on the NHS without a medical need for one.

That being said, I agree that because a section is elective doesn’t mean it’s by choice. I had an elective section for a placenta praevia. It was planned, I knew the date well in advance. The obstetricians wouldn’t have advocated a vaginal birth due to risk of bleeding. But my section was still elective.

Numbat2022 · 07/12/2022 10:52

When I had an elective it was made very clear we could be postponed indefinitely if enough emergencies came in. Mine was as planned, but I know a few people who were bumped to the next day or were suddenly told they were being done in the middle of the night due to emergencies needing to be done first.

I would imagine yours is now an elective as they're not operating immediately? An emergency section is to save the mother or baby's life, they can't be delayed.

Original poster
JenS16 · 07/12/2022 10:53

LydiaBennetsUglyBonnet · 07/12/2022 10:43

surely yours is also classed as an elective? EMCSs are not planned or scheduled the decision happens quickly and iIRC it has to be 15 minutes from the decision to the birth

As it was explained to me yesterday by the consultant, there are 3 different classes of emergency c section (class 1 is right now, within minutes; class 2 is within a few hours and class 3 is within 12-24 hours). Class 4 is an elective where there is no risk to the baby or mother.

They are not giving me a set time as they said emergency c sections can’t be scheduled so they’ll just fit me in when they can.

I am a class 3 so they said would have to be within 12-24h of admission, which isn’t happening. They are still classing me as a class 3 though and still saying there is a risk to the baby and she is compromised.

I know all/most c sections on the nhs are for a clinical reason but not usually an emergency….

I’m just very anxious about it all, and after being told that baby is compromised and needs to come out within 12-24 hours and too risky for an induction, I can’t understand the wait…

OP posts:
Numbat2022 · 07/12/2022 10:54

Ah - I hadn't thought of the scenario with a failed induction as per pp above. Of course... but in that case it may be that the staff know you're ok to wait as nothing is happening anyway.

JenniferBarkley · 07/12/2022 10:55

LydiaBennetsUglyBonnet · 07/12/2022 10:43

surely yours is also classed as an elective? EMCSs are not planned or scheduled the decision happens quickly and iIRC it has to be 15 minutes from the decision to the birth

EMCS just means unplanned. My EMCS was several hours after the decision was made, and probably at least 8 hours from it becoming clear that that's the way things were going.

LydiaBennetsUglyBonnet · 07/12/2022 10:56

The 12-24 hours will be a target not a “Oh my god if it isn’t done in this time the baby won’t be ok”. Definition of class 3 is that they are needed due to a risk factor but can wait. Yours isn’t an emergency, it’s an elective.

Original poster
JenS16 · 07/12/2022 10:57

LydiaBennetsUglyBonnet · 07/12/2022 10:56

The 12-24 hours will be a target not a “Oh my god if it isn’t done in this time the baby won’t be ok”. Definition of class 3 is that they are needed due to a risk factor but can wait. Yours isn’t an emergency, it’s an elective.

This is not what I have been told by 3 different consultants in the past 24h.

OP posts:
ancientgran · 07/12/2022 10:58

If the baby is compromised they need to get on with it. I'd be looking at how to escalate this.

I hope they sort it for you, I had a category1 and I suppose the only good thing was I didn't have time to worry about it, they just grabbed the bed and ran leaving DH standing alone in the room.

Thedogscollar · 07/12/2022 10:58

A cat 3 section is not life threatening to mother or baby therfore not classed as an emergency.
You will have been put on the list with the other elective sections and it is usually thd surgeon who decides on the running order.

JenniferBarkley · 07/12/2022 10:58

Gah. This is the problem with the elective vs emergency terminology - emergency doesn't mean urgent or immediately life threatening as it might imply, and elective doesn't mean by choice.

AgathaMystery · 07/12/2022 10:59

I agree with all the above. A placenta acreata or placenta praevia would be classed as a planned (elective) section. Planned so the woman can survive the birth… but hardly a choice is it?

OP if you are worried why don’t you ask to discuss transfer to another Trust? It’s done all the time.

Original poster
JenS16 · 07/12/2022 11:00

JenniferBarkley · 07/12/2022 10:58

Gah. This is the problem with the elective vs emergency terminology - emergency doesn't mean urgent or immediately life threatening as it might imply, and elective doesn't mean by choice.

I think you’re probably right but this needs to be explained to the patient if it’s the case…

OP posts:
Ripasso · 07/12/2022 11:00

Can you ask if any other hospitals in the area have availability today? I would be contacting PALS and asking to be prioritised if they said you should get a section in 12-24 hours and that is being missed. I was advised when given a time for my elective section I would be bumped for emergencies understandably. At least ask to speak to your consultant to confirm with them what is happening.

CTR1000 · 07/12/2022 11:01

Are you and baby being monitored if there’s concern about baby? It’s not unreasonable to ask the question as to why it hasn’t happened yet if you were told within 24 hours…

PlantDoctor · 07/12/2022 11:01

I had a medically necessary elective and on the day we got there and waited like seven hours in operation gown (obviously with no food or drink) and unfortunately got sent home due to many emergency sections rightly taking priority. I don't think emergency cases would be turned away in place of elective.

JenniferBarkley · 07/12/2022 11:03

JenS16 · 07/12/2022 11:00

I think you’re probably right but this needs to be explained to the patient if it’s the case…

Show quote history

I would have a chat with a midwife (probably easier to track down than a surgeon) to get reassurance all is ok.

Sorry, think I was probably a bit brisk in my replies forgetting you're sitting in a hospital waiting for surgery! Honestly both of my sections were great experience and I had good recoveries, it'll be grand.

While we're here do you have any questions or would you like to chat as distraction? Do you know if the baby is a boy or a girl?

Badbadbunny · 07/12/2022 11:03

YABU because not all "electives" are simply lifestyle choices. My C-section wasn't an "emergency" as such but it was essential is I had pre-eclampsia and had my c-section after 5 days on a maternity ward. I remember seeing the cover of my file where they'd marked it "elective" as there were only two "tick-boxes" either emergency or elective. It's likely your's wasn't really an "emergency" either, just necessary and it's been decided that there are people ahead of you in the queue, maybe those who've been on the ward waiting longer than you. A genuine, life threatening "emergency" will always be prioritised over "electives".

MRSDoos · 07/12/2022 11:04

I’m not clued up on the terminology so I won’t comment on that but just wanted to say I can completely understand why you are worried especially as you have been told by 3 different consultants that baby needs to come out. I can’t imagine how anxious you are and would definitely push this further today if possible with doctor / midwife x

Nosleepforthismum · 07/12/2022 11:06

Mine was elective but not by choice as PP’s have said. Mine was done 5 weeks early as the risk of me going into a natural labour would have been very dangerous. If it’s been pushed back it doesn’t sound as though it’s a typical emergency c-section and more similar to mine which was classed as an elective. I knew I would have to have a c-section relatively early but was only given the date the day before and that was pushed back on the day for an emergency section that was more urgent than mine on the day.