ELCS

[seoladair]

I'm booked for ELCS on the NHS in a few weeks, just 3 days before my due date. The ELCS is not medically indicated - what happens if baby decides to comes early? Will I have to go through VB?

Hi - can't give you a definitive answer - but didn't want your post to go unanswered. I was told that I would still get a cs - but mine is medically indicated... What has your mw said?

I was in this same situation. When I asked what would happen if I went into labour early, I was told that I would be given the option of a VB, but that I could still have the ELCS if I wanted, since it had already been agreed. I was worried about being pressured into a VB, since the ELCS wasn't medically indicated.

I asked them to make it clear in my notes that an ELCS had been agreed, and they did write that if I went into labour early I was to have the operation.

(It was booked for my due date, I didn't go into labour early, and DS was born by a lovely and calm ELCS from which I recovered very quickly and easily.)

Oh good, I am relieved! I haven't asked midwives as they are generally a bit disapproving of ELCS. I will phone hospital and request that they confirm in my notes that I can have the op in the event of early labour.

Same situation here - it was a big fear of mine that I would go into labour before ELCS date, and lack of communication/unsympathetic mws would force me to go through VB.

I talked to the consultant MW and consultant, and they were very happy to put in my notes, very clearly, that if I jumped the gun, I was to be given a CS, NOT a 'trial of labour'.

My fab MW also told me that if I thought I was going into labour, not to hang around but to get into hospital asap (ring to tell them you are on your way and why). There was a very small chance that if I was one of those women who has very very quick labours that things could be too far gone by the time I turned up at hospital. Normal advice to labouring women is to stay at home, have a bath, make sure it's not a false alarm, etc etc. You should do the opposite!

As it turned out, my waters did break 10 days before my ELCS date - I went in as instructed, was given a CS the next day (I had PROM, I never experienced contractions). CS was fab, btw - brilliant experience, great recovery, very healthy baby boy!

Explain your fears to the most sympathetic authoratative person you have dealt with, and ask for that plan to be written prominently in your notes.

When my ELCS date was booked, this was actually discussed, and put into my notes - at my trust they use bright yellow stickers on which the birth mode is noted down, as well as whether the mother is willing to try VBAC if going into labour before date.

My consultant and I discussed the options and he made it very clear in the notes that I'm getting a CS whatever happens. I thought it was normal that it would be discussed when setting the date, and am surprised that your consultant didn't.

Thanks everyone. I will ask them to specify that there will be no trial of labour. I've never actually met my consultant - when I was booked to meet him, he sent a lovely registrar, who talked through everything with me. She then went to talk privately with him, then returned and confirmed that he had given the thumbs-up for a CS. I was so pleased that it went out of my head to ask what would happen if baby comes early.

Then the senior mw came in, and phoned to book me in for ELCS 4 days after my due date! She changed it when I pointed it out to her, thank heavens...

I asked about this at an appointment and was told, while they will do everything they can it might not be possible to promise a CS. I was told it depends how far advanced the labour is and if there is a theatre free. I have since decided to try for a VBAC myself. As my previous labours progressed quickly and my son was 4 weeks early, so even if I did get a date the odds of making it to theatre are stacked against me.

Might be different hospital policies etc, think they are all very different. They seem to differ alot on their policies for management of VBAC anyway.

Try not to worry.

Yes....I just have to hope baby stays put until her date! I wonder whether it's time to slow down. I've been very busy up until now, but I'm 36 weeks pregnant, so maybe if I take it easy, there's more chance that baby will take her time! I was to have been making a 6 hour train journey next week, spending 3 days away, then another 6 hour journey home again, but I'm thinking it might be sensible just to relax at this stage.

I am frightened of the same and am due to see them for mrsa tom so will discuss again and get it highlighted on my notes, i cant go through a vb again!

hi sarahbeth2. Good luck for tomorrow - let us know what they say!

Do be aware that even if it's on your notes, it might not be possible if there are too many actual EMCS that day. I had an EMCS after failed induction and even though it was an EMCS, because there was no major rush as DD wasn't in distress, I got bumped and bumped because of more rushed EMCS and crash EMCS that needed doing. I had to wait 30 hours for my CS after going nil-by-mouth and expecting to go in, so if I'd been in active labour and progressing (my problem was that I wasn't progressing and my ctx had become intermittent) DD would've likely arrived before there was a theatre available.

Really? Depends on how many CS your hospital can cope with, but I can't see a hospital prioritising an elective for non-medical reasons over a crash CS any day.

Hospitals prioritise CS's all the time, according to need - a CS where the baby is in acute distress will be given priority over one for maternal distress, for example, no matter how distresssed the mother.

CS's are quick operations, usually 45 minutes or less in theatre. As QTPie says, the list is monitored and assessed all of the time - very few women who go in for a planned CS FOR ANY REASON, including breech, have their op at the scheduled time precisely because emergencies come in and are dealt with first.

This is NORMAL, it is the way hospitals work. There will be enough down time for an elective CS somewhere along the way in 24 hours. Yes, it might mean a wait. But that's fine.

If you have been told you are having a CS, the consultant has signed this off, then you will get your CS.

If you are in the tiny, tiny, minority of women who have a very rapid labour, and things progress too quickly to get you to theatre, then those are the only circumstances where you might not 'make it'. But that's not so much an issue of scheduling theatre slots, those women can give birth in a car/ambulance/kitchen floor.

Don't worry about it. Get it agreed you don't want a trial of labour under any circumstances, and they will make sure there is no unreasonable delay. And don't listen to scaremongers. They should have better things to do with their time.

"And don't listen to scaremongers. They should have better things to do with their time"

If this was aimed at me then I will in my defence say I only ever referred to my circumstances in my post.
Due to previous surgery on my cervix I have a very very short 1st satge of labour so a delay of 24 hours for me would mean a vaginal birth. Hence the reason I have decided I will opt for a VBAC.

I was in no way telling the OP that this is what she should do and that her labour will be the same as mine. I can only offer advice on my own circumstances, which is what the Consultant based her advice on to me.

I'm supposed to have an ELCS because of my scar type but it will be a planned crash (everyone is accepting that there's no chance of an ELCS) because I won't last long enough as an impatient mummy (I have never gone to term) so they will leave me until I'm past the point of no return then crash her out.

As yours isn't medically indicated it would depend on why. It could be that they push you up the queue or that they aren't able to fit you in, but I should imagine that you'd go up the queue in front of people who are ELCS as you'd now be ECS.

No nunnie it wasn't aimed at you.

Be aware that the NHS doesn't in fact offer Csections for 'non medical' reasons. NHS info says this quite clearly. However, sometimes when a woman has a C section because of birth trauma, or primary tokophobia, then this is referred to colloquially as 'non medical reasons', medical being defined here as 'physical'.

Which is of course very stupid. We don't refer to someone with severe depression as having 'no medical problems', for example.

I don't want to put words into seolodair's mouth - she doesn't have to offer personal information to strangers on the internet if she doesn't have to. I suspect what she means is 'no physical reason.'

I had an ELCS for primary tokophobia. Of course mothers and babies in dire physical need were given priority over me. So they should. But there was no question of me not having one - they just warned me I'd have to wait, and I did.

Ohh sorry fruity, it's obviously pregnancy paranoia if there is such a thing.

I don't think you were being paranoid nunnie, sorry - (although I bet pregnancy paranoia exists, pregnancy 'everything else' seems to!)

I just get frustrated when women who are obviously worried about not getting a very much wanted Csection are made to feel more anxious when it's really just people venting their own negative opinions about ELCsections in general.

(which I don't think you were doing either btw, in case it sounds that way).

Pregnancy and birth does bring the judgmental types out of the woodwork, so everyone gets a bit nervous and paranoid that they are being judged!

DD1 came in 2 hours so having ELCS with twins this time - they'd better not make me wait too long!

If you have already had a c section prior to this one and consultant has agreed to no trial of labour then really I can't see there will be a problem. I was always told that they just get in you in as soon as they can