There seem to be a few comments on this thread suggesting that the team availability is a convenience measure for staff rather than a patient safety measure so I just wanted to reassure the OP that that’s highly unlikely to be the case.
As the OP is clearly aware this isn’t your usual straightforward c-section that could be done by anyone at any point (eg many of your ‘standard’ EMCS that can and are safely performed by an obs registrar and an anaesthetic reg at 3am) it’s much more equivalent to a very high risk c-section plus a major cancer-style operation to managed the intersection between the placenta and bowel, bladder etc. Both of these operations are very serious and you really want the best possible team around.
To have the best possible outcome you want a very experienced obstetrician, a colorectal surgeon, an experienced obstetric anaesthetist, potentially a urologist, potentially an interventional radiologist. You want haematology and blood bank to know so they’re prepared for a haemorrhage and have enough of the right blood in stock (or potentially specialist equipment for blood salvage). You also want all the other associated theatre staff (the ODPs etc). From the baby point of view you want a paediatrician in the room (potentially a team including nursing support if needed). You want to know there are beds available on ITU/HDU post-op for you and that there’s a bed available for baby (ideally one that doesn’t mean they’d end up transferring to a different hospital). It’s possible that some of these surgeons etc may not be needed or only needed for a small window but you want them there ready to step in asap rather than having to call them in from home/clinic/ward round/another list etc. There are a huge amount of moving parts to get into place to organise this sort of procedure.
I believe an anaesthetist has already commented up thread about how scary it is to try and manage this sort of surgery out of hours without all this set up to go (you’d probably have an obs consultant but not necessarily one with any experience in your condition (and they’d also be covering the rest of the ward whereas in a planned operation you’d be their only patient)), the paediatrics team might only be a registrar and SHO, the general surgeon may only be a registrar (and also in theatre for emergency cases overnight already), paediatric consultants and surgical consultants may will be on call from home but you don’t really want the delay. I’m not saying this to be dismissive of registrars (I am one and I’m married to an obs reg) but this is a case where you want somebody experienced in hand who is not distracted by having to take another emergency to theatre asap or the patient they’ve just had to leave on the ward/A&E etc to come to emergency theatre. No obstetrician wants the first time they’ve performed such a delicate and high stakes operation to be at 2am with limited support unless they absolutely have to.
There may be an element of schedule planning but nobody wants to deliver babies early if they don’t have to so it’s much more likely to be a ‘let’s do Monday afternoon rather than Tuesday morning as Dr X has his cancer list on Tuesdays’ rather than a matter of weeks early for the sake of it.
You’ve mentioned that it feels strange as the intervention of for you not baby but it truly is for both of you. It’s not my area of expertise so I won’t give too much comment but I’d be interested to know what the difference is in outcome between 34, 35 and 36 weeks (as that’s your realistic delivery timeframe - comparing with term isn’t going to be helpful for you). You also need to know and understand the risk of haemorrhage and how that increases in the same time frame and the risk to yourself/baby in that scenario (I have a hunch that the risk to baby from a major haemorrhage at 34-36 weeks is much higher than the risk of delivery but as I say I’m not an expert so this is something to ask your team).
I completely get how scary and overwhelming it is. It’s very common not to be able to take everything in or feel like you’ve made the wrong decision. We’re doctors but we’re also humans and have likely been there to some degree themselves. I certainly have! I’ve walked out of consultations about fertility treatment, miscarriage etc and had no idea of what was said or why I’d agreed to something or realised I’d forgotten to ask something and then felt daft. When I lost a baby I had literally no idea as to the risks/benefits of surgical or medical management etc. I know that they were explained to me but I just couldn’t engage, I couldn’t even remember my medical training. It’s a very human response to a high stress situation. It doesn’t necessarily mean that your consultant is wrong, has bulldozed you as somebody said upthread or that they’ve not communicated well but communication is a two way thing. I don’t mean this as an insult, as I say I’ve been there myself, but it’s difficult to have that conversation when your brain has just received a lot of new information and gone into panic mode. It doesn’t necessarily mean things weren’t discussed - I’ve had patients swear I did/didn’t tell them things when I know I had, it’s just the brain’s failure to absorb when stressed.
It’s really important that you have faith in your team so I’d really encourage you to ask for another appointment and take somebody with you. I’d be very surprised if they weren’t able and happy to facilitate this. It seems like you have two main concerns - the choice of timing and the choice re sterilisation so focus there. I find it helpful to draft questions - the acronym people have been posting is really helpful. I’d also see what support is available, it varies by hospital/region but people have mentioned psychologists etc so see if that’s an option where you are. When I’ve worked in neonatal units we’ve had women come to look around ahead of planned early gestation deliveries which if possible removed some of the mystery of NICU and allowed them to ask questions of the staff - perhaps that is an option?
I wouldn’t jump straight to getting a second opinion, certainly not from a private provider (I’d have serious reservations about any private surgeon who would perform this surgery without being able to replicate the level of multidisciplinary input this case clearly requires - just being near an NHS ITU/NICU isn’t going to cut it) before you’ve given your team chance to explain and hopefully put your mind at ease. If after you’ve spoken to them again you’re still uncomfortable then certainly see what the local process is for seeking a second opinion (you’re well within your rights) but I’d start with the team who knows you first.