Elective c section on medical grounds on nhs

[henryhsmum]

Hi

I had a horrendous birth experience with DS1. He was transverse and very big 9lb 9oz. To put his size into perspective I am 5ft 2 and weighed about 8 stone before I got pregnant. By 6 months people were asking when I was due.

I went into labour 10 days late and it lasted 55 hours! After 4 hours of pushing they eventually did an emergency forceps procedure. It was terrible and poor DS was so shocked that he stopped breathing for 2 mins when he cane out. Not sure why but given he was so big and healthy I'm sure that him being yanked out in 3 pulls from forceps had something to do with it.

Then 3 months after the birth I had 2 unexplained black out seizures inspire of no epilepsy history. Still a mystery but they councided with first period after birth and I think it was due to hormone changes after birth as there us a type of epilepsy linked to hormones nd I know from testa before the birth that my progesterone level was over 3 times the average- good for pregnancy but may have caused the seizures.

AnywY, 5 years on I am now keen to have another bAby but I am petrified because of the birth experience and the seizures. I really don't feel I could go through such a long labour and traumatic delivery of a big baby again. I was told by a midwife afterwards that next time I should have an elective c section. What do you think my chances of getting one on the NHS would be given the birth/post birth history? I did also have PND after birth, which was a bit atypical as it was straight after rather than a few months after and it went by 3 months. It stopping coincided with the seizures which makes me think it was linked to falling hormone levels. In fact I think the birth, PND and seizures were all interlinked but I think the PND was also due partly to birth trauma.

Sorry that's so long, just thought I should give the background. I appreciate a lot of women have bad births and elective c sections on those grounds. Given the severity/ length of my delivery and the post birth problems do you think I have strong enough grounds for an elective c section NHS. Without it I honestly don't think I would have another baby!

Yes, I would have said you have good grounds (and I'm really sorry for what you went through)

When you get pregnant again, ask for a consultant referral at your booking in appointment, if you're not given one automatically. I would say three things:

1. Make sure you have your "argument" for a section clear in your head before you meet the consultant. Write it down if that helps you remember it all or if you think you will, like me, burst into tears whilst retelling it. Convey to them that you have read up and are aware of the risks, the recovery factors, etc. But equally, don't feel bad though for showing how much it affects - sentences like your last one about not feeling you could have another baby otherwise are important. They show the depth of trauma you feel. So don't feel you have to put a brave face on it.

1. Be prepared that they may give you a vague yes in principle but not officially sign off on it until quite near the end - mine eventually gave my notes the magic inkstamp at about 32 weeks I think,

1. If your consultant isn't sympathetic, find another one who is.

I've just had an elective, 2 weeks ago. Well, sort of, anyway - it ended up being classed as an emergency cos I went into labour early, but it was always agreed that it would be a section. My first birth was traumatic though for me it ended up in an emergency section, so I'm a bit different to you. But I found that as long as I could show the consultant that I had read up on the risks, recovery, etc, knew what I was getting myself into and still showed a firm and consistent preference for it, in the end he agreed.

HTH.

Good advice above. If your consultant won't give you one, go to your GP and get them yo recommend another consultant.

But I am sure you will be fine

Hi

Thanks it is really helpful advice. My slight concern is that I had my DS in a different part of the country to where I live now so I hope they can find my records - does nayone know how far back they keep records?

I think I am going to see an obstretician privately before even getting pregnant so I can get their view on if I could have an elective c section.

My gp sent me to see a consultant in October to discuss cs - this was before dh and I began trying (got pg in December) and was all on nhs. We didn't have a problem convincing them. Turns out I'm pg with twins so they've advised cs anyway, but consultant wrote to gp saying he felt cs was fine due to history of dd's birth (this was before twins were conceived).

If you are going to go private for the delivery then you will able to opt to have a CS if you want one.

There might be other things to consider given your history - for example would you want to have the option of trialling labour for a certain length of time, and then a CS if you werent progressing? Or growth scans to estimate the size of the baby?

stealthcat- I honestly don't think I would want to try natural delivery not because of pain (I managed last time on just gas and air, only had epidural at last minute when they did forceps). They pretty much thrust the consent form for the forceps at me and the obstretician said I had to deliver vaginally as he had an emergency c section. It was Xmas eve and I think from what he implied that they were understaffed and I should really have had a section, the community midwife said as much afterwards.

A large part of me wanting a c section is the mental trauma after DS - PND, seizures and the birth which I had nightmares of for 6 months afterwards. My DS now has autism too and there is some evidence that forceps births are a contributing factor. To me, the fact that a 9lb 9oz full term stopped breathing immediately birth although he had no problems is an indication that he was very traumatised by it and in shock basically.

I didn't have growth scans with DS they measured the bump and said he was normal but midwife admitted afterwards she had realised he was transverse and big when he was 7 days overdue. To me she should have told me and I should have had a c section offered then or at least be induced. The size does worry me as I don't want more pelvic floor damage (I am weak at moment but no problems as such) but I know c section doesn't entirely avoid that.

I couldn't really afford a c section privately so I guess I would want a reassurance before being pregnant that I would get one on NHS. I just hope I have good enough grounds.

Just have to cross my fingers I guess.

Seeing a private obstetrician probably wont add much then - if you are sure that you want a CS on the NHS, then the only thing that really matters is whether the NHS consultant will do one.
Have you asked your GP if they could refer you to see an obstetrician on the NHS at your local hospital - if you see the person who would look after you in pregnancy and they say that they think a CS would be apropriate then that should carry more weight.

I also don't think seeing a private ob would help - the thing is going to be whether or not your consultant, and your NHS trust, will approve one.

I would have said you'd have to wait until pregnant but Princess's story makes me think perhaps not - if I were you, I'd write up a list of all the reasons you've said here, then spend some time researching NICE guidelines on elective c/secs, google your PCT and see what policies you can find, any good practice guidelines etc - compile a big document and then try what she did - go to your GP and ask for a referral to someone. I'd also request your maternity notes from last time from your previous PCT - they will charge you but I think it would probably be a useful tool in your arsenal, as it were.

Sounds like you had a horrendous first time of it, you poor love.

Ditto casserole's point about getting your old notes. Send the request for them recorded delivery, and state that you'd like to recieve them by [date] (e.g. 3 weeks after the date of your letter).

Ask your GP if there's a birth choices clinic at your hospital to talk through your options (they may have a specialist midwife who can champion your case with the consultant).

Prepare, prepare, prepare for your meeting with the consultant. If you can put together a pack with your old notes, a list of points why you feel an elcs would be beneficial to you (eg reducing birth trauma/not starting your relationship with your newborn shattered after a 55 hour labour/etc etc), a copy of the NICE guidelines re CS with any key points highlighted then the consultant will be able to see you've done your homework and be more inclined to give you what you want. Although you may find that the sign off doesn't come until it becomes apparent in 3rd trimester that you're defiinitely having another large baby proportionate to your petite frame... so much antenatal care is "wait and see"!

I met a girl though antenatal classes who'd had a very similar experience to yours and had also waited 5 years to even contemplate a sibling, such was the trauma. She'd found counselling quite helpful so that may be something to consider too?

Hi

my first baby was 10lb 10oz which was a bit of a shock, I was having contractions for 3 days at home before eventually being accepted to hospital, I couldn't get the baby out & was completely exhausted, eventually had a ventouse birth & was rushed straight into theatre as had a 3rd degree tear, all in all it was hideous, afterwards I was told that if they had any idea of the size I would have automatically had a c-section. Was so out of it I didn't bond with baby for the first 24 hours. I am now 7 months pregnant & really want to have a elective c-section, i saw my consultant a few months ago & I found her really really tough, she was completely unsympathetic & said that I needed to wait till my 36 week scan to check the size of the baby before they agree to a c-section. This is really stressing me out & I really want to get this sorted ASAP, I don't care what size baby is I still want a c-section - anyone got any advice as to what I should do - I am already dreading the next meeting with consultant & would really like an answer before 36 weeks.....

thanks

reacher - phone up the hospital and change consultants. You should not have added stress whilst pregnant. It is highly unlikely the consultant will actually deliver your baby so all you need is for them to sign it off.

I had elective section, maternal request with no.1, had to go into battle with horrid consultant with no.2 so I phoned unit and changed my consultant and with no.3 no battle at all!

Yes - change consultant. And then go the appt with the new one armed with all the document mentioned about - including an honest account of how it's affected you.

They may still not sign you off until a bit later - they wouldn't formally sign me off till 32 weeks and I'd had a previous emcs and had gestational diabetes 2nd time round, with a baby showing big for dates - but eventually they did sign me off at 32 weeks. But they should at least be able to give you an indication of their thinking. But GO PREPARED, and be able to argue your case.

Maybe you should speak to stangirl on the other thread about CS. Apparently she asked if she could have a CS for no medical reason other then not wanting to go through the pain, and she got one. if they can do that i dont see why you cant !!

I had one for no medical reason too. Was hard work getting it and I had to change consultants before I got one who agreed. Go armed with as much information as you can to back up your reasons etc and if you don't think you can argue your case that well take DH/DP to do it for you.

Hiya! inbetweener has mentioned my ELCS experience. I was indeed given an ELCS on the NHS for no medical reason. My hospital was Kings College in London. I am so terrified at the thought of childbirth I had already worked out that I could afford to go private to have an ELCS if necessary but in the end that was not required. My consultant just asked me twice and then signed me up. If anything - because I am thrombophilic - they should have tried to avoid a c-section but it was fine.

Hi

just to let you know I got my elective c-section. was feeling so stressed about seeing consultant again, luckily on the day she was so busy that I saw another consultant who just asked me if I still wanted one & asked my reasons why, then went out to the corridor where she had a chat with my main consultant who signed it off - phew, big relief (just wish the prior meeting hadn't made me soooo stressed)

cheers all