Under what circumstances can I have an elective cesarean?

[Pinkflipflop]

Just wondered about this? It's very hard to find info about!

If you had an elective cesarean, did you find it hard to convince your doctor?

I'm not pregnant (yet) though if I ever managed to get pregnant, I really feel that a cesarean birth would be for me.

I'm in N Ireland - so interested if there are any experiences from here too!

can i ask why? A cesarean is major sugery so i dont think a dr would agree to one just because you fancied one (unless you went private). I've already got one ds through a normal birth and am 36 weeks with my 2nd and the of a cesarean terrifyes me. Not being able to pick my own baby up for a couple of weeks, having to hold a pillow on my stitches if i need to cough so they dont bust, being stuck in hospital longer, longer recovery time, big scar across my tummy.If needed i would have one obvioulsy just wondered what your resons were for wanting one?

I think 'elective' can be a misleading word. It makes it sound like a choice. | had to have an elective c-section because the placenta was in the way of the baby coming out.
I think I've heard of people on here having one when they've been extremely scared of natural childbirth if that's what you're thinking of.

If a vaginal birth would be significantly likely to place your child's or your own medical welfare at risk then an elective cs would be the usual route. If you and your unborn child are both healthy then an elective cs is highly unlikely on the NHS. This major surgery is much more expensive than a "normal" delivery and carries more risk than a vaginal birth.

I've had 2 CS, the first an emergency and the second elective.
It's by no means an easy option and much of what pinkyp says is true, longer in hosp, longer recovery time, physically limited in what you can do for weeks after. However you can pick baby up! With my 2nd CS, baby was born at 9.14 am and by mid afternoon I was in the shower washing hair, though feeling fragile! I was holding the baby from there on in and certainly doing the picking up.
What makes you think it's the right decision?

Sorry tobermory (regarding the picking up) i obviously dont speak from any experience myself just through friends experiences etc

S'ok.

You're right about it not being a walk in the park though and different women I'm sure have v different experiences.

pinkyp, I've had an elective section - I was able to hold my baby and pick him up within an hour of the operation. He was breastfeeding happily within 20 mins of being born (and continues to do so). You also do not have to hold a pillow against your stitches when you cough 'so they don't bust'. With all due respect, I think that's not a very responsible description.

pinkflipflop, I think you've posted here before about this? (I think - apologies if I've got that wrong). I'm sorry if you didn't get any useful responses. This thread here - www.mumsnet.com/Talk/childbirth/954334-Anyone-asked-for-ELCS-for-first-baby - should help, it's asking the same questions. I've posted my experience of having an elective NHS CS on there, as have others, so there are several different 'paths' and experiences there.

Pinkyp, whoever told you that about CS has had a very bad experience! If stitches bust when you cough, they're not in right! In any case it's more common now to close with little staples. The scar is nowhere near your tummy, it's way low down inside the pubic hair line, just above the pubic bone. Mine is invisible now. And I was able to hold my baby seconds after he was born, breastfeeding shortly after and back in my room having soup and sandwiches within the hour. The recovery was straightforward - I was told to lift nothing heavier than the baby for the first couple of weeks, and no driving till I could do an emergency stop. The whole experience was lovely, calm, pain free and the best day of my life. ELCS isn't for everyone but it's certainly a perfectly valid choice, and it's as irresponsible to portray it as a terrible, last-resort experience as it would be to suggest that every vaginal birth ends up with high forceps, cuts and tears and busted downstairsy!

I have just had an emergency section, after my little man moved into brow presentation during pushing. My previous birth was vaginal but ended up in theatre as I had a retained placenta.
My section was done under general because the spinal didn't work for me (not picked up till they started to slice).
I was holding my baby within 10 minutes of coming round.
Was advised to hold pillow over scar (which was stithed internally and glued outside, very neat and very low down), was told that this was told to do this to put pressure on and ease the pain, wasn't told they could burst).
My recovery hasn't been easy, and because I was already pushing when they decided to do it, I wouldn't say it was pain free and enjoyable for me. But saying that nor was my third stage with vaginal. With an elective all being well you won't be at the pushing syage and the spinal will work (it did for me with first time with DD), if all goes well I can see why this option would be good for some women.
I don't know your reasons for wanting an elective section, but speak to a consultant, they are the ones that make the decision and will advise you on the best choice for your circumstances. Don't let this choice confusion put you off getting pregnant.

Good luck.

Sorry about spelling and strange bracket use, far too early for me.

You haven't said why you feel its the best option for you?
Lots of people on here know my birth story, if you want to read just how bad a c section can be you can search in the childbirth threads from dec 2009.

I've had two vaginal deliveries and a section. I would always prefer a vaginal delivery. Just remember that c sections are always major surgery, vaginal deliveries are not always traumatic. My section has left me with numerous problems, its certainly not the easy option.

If u can find an understanding consultant then u should be able to get a cs

You haven't said why you feel its the best option for you?
Lots of people on here know my birth story, if you want to read just how bad a c section can be you can search in the childbirth threads from dec 2009.

I've had two vaginal deliveries and a section. I would always prefer a vaginal delivery. Just remember that c sections are always major surgery, vaginal deliveries are not always traumatic. My section has left me with numerous problems, its certainly not the easy option.

If u can find an understanding consultant then u should be able to get a cs

Pinkflipflop - if you feel a cs is right for you do your research and request one from your consultant. I had both mine by ELCS on maternal request as I had no wish for a VB and they were both great experiences.
It wont be easy to get a consultant to agree but you can request a second opinion if refused.

Pinkyp - I could pick up my baby straight away there is no reason why you can't your arms aren't paralysed by it! Also you wont burst your stitches my coughing. I think that often people recover faster from an ELCS than from a non straightforward VB I know I recovered far faster than some of my friends who had VBs.

chynah, i've already corrected that earlier in the thread if you read all the posts? I also pointed out these were people i know experiences and not my own, i do know a lady at my toddler group that stiches did burts by coughing so its not something i have made up.

mine burst without coughing

It is also worth bearing in mind that babies born by elective cesarean are 4 times more likely to develop breathing problems at birth.

FWIW I was a wreck after my elective cesarean, and was shaking so much I was unable to have skin to skin, and certainly wouldn't have been able to pick up ds for at least a day or two.

I worked with someone who convinced the consultant that giving birth vaginally woud cause her psychologic trauma and got her own way, but I thik this was the second consultant and about third midwife she had.

Hazeyjane, can you post the reference to that statistic in your post? That's v interesting.

It's ok hazeyjane, I think I've found it. It was the big Danish study in the BMJ, and it's important to look at when the deliveries took place, as "four fold" doesn't hold true by the time you get to 39 weeks which is the earliest the NHS will generally do a CS in a non emergency situation.

Hansen and her colleagues based their research, which was published in the British Medical Journal, on a study of more than 34,000 births taking place in Denmark. The study revealed a nearly four-fold increased risk of breathing difficulties in those babies delivered via caesarean section procedure at 37 weeks. Babies delivered via caesarean section procedure at 38 weeks experienced a three-fold increase. Babies delivered via a caesarean section procedure at 39 weeks experience a doubled risk. As a result, 10 percent of babies delivered via caesarean section procedure experienced respiratory problems when delivered at 37 weeks, compared to 2.8 percent of infants intended for vaginal delivery. By 39 weeks, the proportion was 2.1 percent compared to 1.1 percent.

This is an article about the study that that figure came from.

Sorry, crossposted!

Ds's consultant (he was born with severe respiratory distress at 39 weeks), said that she believed that if you take into account that gestational periods vary from woman to woman and baby to baby and add into that the fact that dates and scans can be inaccurate, then this can increase the risk.

In my case, dd1 and 2 were both 2 weeks over, so it may be that ds should have had extra time for his lungs to fully develop.

There is also the added theory that labour helps with the functioning of the lungs, "It is plausible that hormonal and physiological changes associated with labour are necessary for lung maturation in neonates and that these changes may not occur in infants delivered by elective Caesarean sections".

Cheers, it's interesting the way the BBC reported on the study. As I said, the NHS don't routinely do any cs before 39 weeks for singletons and 38 for twins. I had mine privately and both times my private hospital stuck v closely to these guidelines too, for exactly these reasons.

The mechanics of the birth help to expel the amniotic fluid from the lungs, and prepare the baby for life outside the womb. Csections are beneficial for some, necessary for others and life-saving for others still. But they are major surgery, and that fact is misunderstood by a proportion of people.

As long as you have considered your reasons carefully, understand the risks and are prepared to take that risk both for yourself and your baby, then most Consultants would agree if you are determined. They wouldn't agree lightly though, and would warn you of the risks strongly.

Before having ds, when the risks of elcs were talked bout with the consultant, the issue of breathing difficulties were very downplayed, and I remember one saying, 'well you'll be 39 weeks, so that won't be an issue'.

Since having ds and talking to his consultant, suddenly the idea that 39 weeks is set in stone, does seem quite bizarre, as we are always told not to set too much store by our due date. She does think there must have been some inaccuracies with the dates, but she also said that she sees quite a few elective section babies in scbu with RDS, with fluid on their lungs, and with lungs that (in her words) just aren't ready.