Emergency c section delayed due to electives?

[JenS16]

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…)

That's incorrect. Elective is just anything that is planned. Doesn't mean there is no risk to the mother. I have to have an 'elective' by a certain date because I have twins and health conditions that could cause still birth if I go beyond a certain date. So, I wasn't given the choice at all. They just use this term.
They have obviously over simplified it to you when explaining it xx

Yes I’m being monitored frequently and had several worrying CTGs, consultants have confirmed CTG is abnormal/compromised but not immediately dangerous. I was sent to labour ward last night for the section but then a worse emergency came in and I was sent back to the pre natal ward….

I asked this morning when I saw the consultant and they said it was because the elective list is full so they have to fit me in the emergency list, but as there’s no immediate concern within the next few hours I’m low on the emergency list.

It feels like they’re just waiting for the CTG to get worse and then I’ll have to have a crash section… I’m just so worried.

I think this is just the state of maternity services at the minute.
I was told on the Tuesday that I needed to be induced that night or the next day. There were no 'slots' available until the Friday and at a different hospital.
There's too many patients and not enough staff.
I can understand how worried you must feel, I was the same and wondering if my baby would be OK until the Friday.
I hope you get a safe delivery ASAP

Emergency and crash sections do take priority, so presumably yours isn’t as urgent as you seem to suggest? If you or baby were in danger they wouldn’t make you wait.

I had a medically advised section planned for just under 38 weeks, but my waters broke just before 37 weeks. I went in but they were booked solid (no idea if planned or emergency sections). The midwife said I was not in active labour so could wait, though if I did become active they would get me in straight away. As it happened I was able to get my section done about ten hours later.
I'm sure they want the best possible outcome for all, but have to prioritise.

My section was technically elective, but I’d been under feotal medicine since 20 weeks and baby needed to be born to prevent their feotal anaemia getting worse.

Just read your update. It's likely just that the team doing sections is busy with someone else with a more urgent need. However, I would definitely contact PALS and get the ball rolling to find out what's going on - I can completely understand you being anxious.

At my hospital they book in three elective sections per day, and then the emergencies take place around them (or bump them out of the way). There are usually two teams available but not always.

I'm sorry this is happening to you. I was kept waiting with my cat 3 emergency section too but that was due to cat 1 and cat 2 sections needing to be done. I had my section the next day. I remember how scary it was though, I always hate it when they put the fear of God into you saying it's an emergency and baby is at risk, then make you wait because your emergency is less urgent than other people's.

I do think you have a point about the number of electives these days but do support womens right to choose however in my experience many hospitals are also to blame by refusing electives as a birth plan of choice so pushing all electives to a smaller and smaller pool of hospitals - in my local area 3 of the 5 hospitals were emergency c sections only ie if something went wrong mid labour. if you wanted planned c section you had to go to the remaining 2 which also happened to be the only places you could go if you were high risk or having multiples.

At some point with cat 3 and 4 electives they've got to be done so can't be bumped down the list forever

You’re being monitored so I’m sure the baby is safe and there is no additional risk. However, it’s completely natural to worry and be upset by this delay. Is there someone with you that can go and talk to the staff to get an idea of what’s happening without getting you involved and stressing you out.

Similarly to others, I had an elective c section planned as my baby was breech. It then turned into an emergency as I went into early (and fast) labour.

I am sure that they are not dealing with c sections which are deemed less of an emergency than yours, but I totally understand how worried you must be, especially after being told CTG is compromised. Do you have someone there who can advocate strongly on your behalf and try and find out when you will be seen. I know it’s so difficult to do so yourself when you are scared and vulnerable. Hope everything goes ok.

I had two emergency c sections

they literally ran with me from room to theatre and no word of a lie they were born within 10 mins? I mean it was a rush. One was such a rush they put me to sleep because they couldn’t get the spinal in

Cat 3 is no immediate risk. There may well be cat 4s that are deemed more necessary. I know it sucks to have to wait, but I'm sure they'll be doing them by clinical need.

Just wanted to say that I didn’t mean to imply that electives are all by choice, I know many are for medical reasons, and even if they are for maternal choice I completely support women having that choice, and hospitals should be offering these as standard. It just seems that the system isn’t very well set up for this….

I think the messages I’ve been getting from the staff have just been very mixed in terms of urgency… being admitted and told it’s an emergency and then just being left to wait is very anxiety inducing when I’m worried my baby could be at risk.

I’m also a bit upset because I was really hoping to have a vaginal birth and just found out yesterday I no longer have that option (or at least they would STRONGLY advise against this option - I know they can’t force me either way) so just generally having a hard time sitting here waiting with nothing happening…

Of course class 3 should become before class 4, etc! YANBU.

Just been looking at the guidelines

Cat 1 = immediate threat to the life of mother or baby

Cat 2= there are problems affecting the health of the mother and/or baby but they are not immediately life threatening

Cat 3 = the baby needs to be born early but there is no immediate risk to mother or baby

Cat 4= the opeartion will take place at a time that suits the woman and the caesarean section team.

when several women need caesareans at the same time, they will be prioritised according to level of risk.

It does sound like they are taking a risk based approach, and the electives that are booked in are deemed a higher priority (agree with what others have said - most electives are due to medical need, not just because of the mothers choice).

I had a Cat 2 emergency C-section with DD, and there was no delay. I wasn’t wheeled through the corridors in a massive rush (so not a Cat 1), but there was no mucking about and as soon as the decision was made to do a c section, I was prepped straight away. DD was born within the hour.

I hope that you don’t have to wait too much longer OP, I can understand how anxious you must be - but you are in the right place and being monitored and it won’t be much longer.

There is a complex arranging around theatre spaces according to need/neonatal bed availability/likelihood of mum need HDU/ITU after. These are all juggling acts and what the schedule gets arranged around.

Mine was semi elective and I was already in labour. I was told they were quiet and I ended up waiting 12 hours overnight as I kept getting bumped. They did eventually give me a room and gas and air though.

Elective just means scheduled, most likely due to risk to mother or baby. If your emergency section was more high-risk you'd be prioritised over those.

Bless you op. You've been getting mixed messages and of course you'll be listening to every word they tell you.

I'm sure you'll meet your baby soon

Try and rest xxx

I think I was CAT 2. Got bumped 3 times.

This happens all the time. Women are told the baby needs to come out but it’s in fact safe to wait for 24 or more hours. I ended up going for a full 48 hours after my baby “needed to be delivered”. It’s a pain in the arse, especially if you’ve started nil by mouth. But it is what it is. You’re not an emergency c section. And yes women with a lower category may be bumped ahead of you if they’ve already spent two days waiting and long periods without fluids.

I wish you well with the birth
youve been triaged and assessed as cat 3-not immediate
women have cs for multiple reasons eg mental health, previous birth trauma, underlying heath issue that put physiological strain on labouring woman. Like you they all have needs and are triaged accordingly. If a crash section were required that’s the immediate need and the list would be amended

The class 4s do have to happen at some stage though. I imagine in some busy hospitals it's a delicate balancing act.

The maternity unit where I had my DC has two operating theatres. When I went in for my ELCS, it seemed like the normal procedure is that one theatre does electives and the other remains open for emergencies. I think there were five of us for electives that day and they told the woman who was fourth on the list that there were no guarantees as typically they can do four in a morning in the elective theatre.

Then they decided to alternate us across both theatres, so one theatre would be cleaned while the other was in use to reduce the gap between electives - presumably because they assessed everyone who was labouring and the risk of them needing the emergency theatre was low. This allowed them to fit all of us in.

Presumably something similar going on for OP - one theatre running through the electives as scheduled and another doing the emergencies in order of need.

I work in maternity and if we say 12-24 hours we do everything possible even if means a middle of the night section. If they’ve documented cat 3 and don’t get it done in the timescale and there’s a poor outcome shit would hit the fan. I’ve known women be transferred to other hospitals as well. We organise it.