Elective C section

[suziequeue1]

10 weeks pregnant at the moment and mentioned to a midwife in passing that I plan to have an elective C-Section and she looked at me a bit strange. Now I am worried about pushing for this. Also wondering when I actually tell the hospital that this is what I want- would it be at my 12 week scan? Or is that too early?
I am 1000% sure this is what I want for many reasons. There is 0% chance I will change my mind. Having a vaginal birth is not ideal for me because of certain medical issues related to my spine which makes it difficult for me to push.

If an elective c-secion is what you need to do that's totally up to you! I don't think there is any particular time you need to tell the midwives by, perhaps just the next time you see them after the 12 week scan, and then you'll need to repeat that you want a c section a few times as they will ask you questions to try to make sure you are sure and that you know the risks etc. But it's no big deal, people do this all the time. Congratulations on your pregnancy!

I heard a lot about them being against them and trying to discourage you etc. I had no push back from anybody at all with my section and I've never heard from anyone personally who did although I think it's a well known "thing" so I'm sure there may be some truth in it. I wouldn't worry for a long while yet so much can change in pregnancy for example i was told early on id probably have to have a section then it all changed then changed again as baby was breech then she turned! I confirmed i wanted a section at 36 weeks and they booked it in, was very simple.

have you had advice from your spinal surgeon re mode of delivery? There isn't always masses of advantage of having a c-section over a vaginal delivery for all back problems, and if you do stick with the section plan they may need to discuss whatever the problem is with the anaesthetist so they can plan things properly... so deffo worth getting their advice if you haven't had chance yet.

Maybe just a bit early - they usually start discussing birth plans with you a little later on but if you tell them that’s what you want then they shouldn’t have a problem with it!

I don’t think anything was mentioned until after at least 24wks. I had no issue in requesting one. Just be firm.

Yes spinal surgeon thinks c-section is safer for me.

Your surgeon will need to be involved in your pre-natal care / birth plan. The sort of anaesthetic used etc might be effected by your spinal issues. Surgeon needs to talk to midwife (or vice versa)

It’s a bit early to discuss birth plans. I didn’t like being asked at my 10 week appointment, it’s too early, and I’d previously had a late miscarriage so was very stressed. The 12 week scan will be done by a sonographer so that’s not the place to discuss it.

I sustained a serious spine injury in a car accident. When I had my DS it had to be an elective C section because a) he was nearly 9lbs (I'm just a little bit under 5') and b) he was anterior. Due to my spinal injury an epidural wasn't an option.

C sections are not the easy option. It involves major surgery on your stomach and the recovery period is protracted. For one thing I wasn't able to drive for at least 6 weeks.

I said at my booking appointment around 9 or 10 weeks that I wanted ELCS, it was noted at my 12 week scan and the date agreed and posted out to me by the time I was around 18 weeks.

I had no push back from any of the midwives I saw (7 or 8). 2 of them said things along the lines of 'can't blame you'.

Yes in your case @suziequeue1 there should be some dialogue between your spinal team and the midwives/consultant but you should not have to 'fight' to get a C-section.

Not sure how this would be possible? The last time I spoke to him was at my 10 week check-up after my spinal injection, and I was speaking about how we have been TTC and I was worried about my back during pregnancy & labour due to the injection making things worse etc. What he said about labour was that C section would probably be my best shout for the future as I struggle to even go number 2 on bad days due to inability to push... he is my surgeon through the NHS and he is not easily contactable and obviously very busy as the NHS is, so not sure how I would get him involved in my pregnancy care?

fair enough. In that case when it does come to birth planning (probs a bit early still) make sure you ask for an anaesthetic referral so they can think about which mode of anaesthesia might be safer/ the impact that either will have on your back (they and your obstetrician will probably want your surgeon's input to find out exactly what the back lesion is/what they're worried about with pushing, but can contact them themselves).

That will be all you need to show, then. The surgeon’s advice should overrule any midwife’s comments.

I’ve had both forms of delivery and found recovery from cs was very straightforward. Over the long term (mine are 25 and 17) I’ve had more of an issue with the results of DS25’s delivery the traditional way due to the second degree tear.

It’s your midwife that needs to make the referral to an obstetrician for them to sign off the c section so ask for that the next time you see her. Don’t get fobbed off about it being left to the last minute in case you go into labour early.

I'm not sure you need your spinal surgeon specifically to be involved, but it sounds like you should have consultant led maternity care. I have rheumatoid arthritis so I had consultant led care, it basically meant I saw the consultant or a registrar for most of my appointments instead of a midwife.

The consultant obstetrician has expertise in pregnancies that are "high risk" for whatever reason. My maternity care was at a different hospital from my rheumatology, so it was probably at my booking in appointment that I was assigned the consultant led care based on my answers to the questions. I don't really remember though.

Also, a lot of medical staff won't say the perfect thing in all situations, so please don't focus too much on one midwife's response. You can have a c section if you just feel like it, or if you have a great reason to like you do. You may get a few medical staff giving you the pros and cons, as they feel they need to give you a balanced view, even if you've told them your mind is made up, so don't let it bother you or sway you.

For what it's worth, I've had two elective c sections, and would highly recommend.

I think the earlier you inform them of why you want the ELCS the better. Something like on the advise of my spinal surgeon, I was informed that the safest method of delivery should I get pregnant in the future, was a c section. I would be unable to push due to spinal issues.

That means you will then go down the consultant-led pathway. I had EMCS with my first child and ELCS with my second due to medical issues. I told them of my ELCS request at my booking appointment. When I had my 20 week scan I saw a consultant immediately afterward and they just talked through all the risks and it was agreed there and then.

I think it was then booked in at my 34 week appointment and was scheduled for when I was 39 week pregnant.

You say she looked at you a bit strange, did you tell her it was on advice of the spinal surgeon? If you have no context then I wouldn’t worry about her strange look, she doesn’t have any of the facts. I can’t see why you’d struggle to get a c section

It’s not the midwives who decide the kind of birth you get anyway, they won’t really have anything to do with it other than you ask them to refer you to the consultant for a birth options chat - this usually happens in my trust about 17-20 weeks. I had an elective due to previous birth issues, no push back at all. It wasn’t booked until 36 weeks though so no panic yet!

Ignore op unfortuntly there is a cult like element to some midwifery
Luckily mine were amazing.

The hospital would contact him - you just give the name.

I have had consultants from different departments involved in my maternity care, and it is easily sorted.

You’re a long way off having to make a plan, so don’t worry about mentioning it to midwives - when you get to birthing choices that’s when you need to talk about it.

I started telling them from my booking appointment! They made me go to a birth choices clinic to try and convince me out of it, but ultimately they should sign it off if you insist (under NICE guidelines). I was 34 weeks before they’d actually book me an appointment though, and even at that point I had to push them to do it, they never brought it up.

One of the best decisions I’ve ever made, incidentally. The birth couldn’t have been a better experience in any way. My recovery was smoother than many of the vaginal births I know of.

It will be hard

I needed a c section for medical reasons, vaginal was never an option for me. When I mentioned that at my booking appointment the midwife was really dismissive. After she asked all the questions my medical history raised some red flags and so ended up referring me to have a consultant led pregnancy.

Did you explain your history with her or just tell her you want a c section? If after telling her your issues she was still dismissive, then suggest you contact them and try and get yourself under consultant care as with your spine issues, you may need to be under their care generally.

Maternal request c-section is an absolute right and should not be refused. You may receive some questions about this from health professionals but state it is your birthing choice and right.

In that case ask him or her to give you a supportive letter to give to your obstetric consultant. Ask ASAP, these things can take time.