Want a C section, but cant convince doctors, what do i do?

[Jessi28]

Can anyone give me advice? i'm desperately scared of natural birth. My granmother was permanently disabeld by birth. My Aunt and sister both died in childbirth. And my own mother had such a horrific experience she rejected me completely.After a 5 day labour, massive blood loss and literally dying in the delivery room and having to be resusitated. And my whole life has been blighted by it, as 28 years later she still hates me for it. I always wanted to be a mother, but always thought i'd adopt till i found myself pregnant. The problem in my family is the size of head. We all have babies with larg heads and we seem to have narrow pelvises. I'm only 28 weeks but my baies head is huge measuring nearly 35 weeks already. Meaning to me its inherited to same characteristics that have caused so many problems to my family. The doctor told me today they wont do a c section till it becomes medically necessary. As childbirth problems are'nt genetic. Meaning i'm traumatised as i feel like i'm on death row i cant enjoy my pregnancy or form a bond with my baby.As i believe i'll never know her. I genuinely believe it is medically necessary. But they wont even address that. Preffering to lecture me, rather than offer reasurance that what i'm concerned about is not an issue. I think they think i'm jsut hysterical, and need mental help. But would'nt anyone with the history i have feel the same way. And instinctively want a c section. Or at least to be reasurred, and have their medical concerns addressed. I asked to referred to someone who'l listen. But got no respone what do i do?

Keep on at them! It is your body and it should be your choice of which method you give birth!! Can you afford to go private?

NICE guidelines state that maternal request is now enough. I'm sure you'll have to fight for it, but they can't refuse you. Google the NICE info and take it with you to an appointment. Do not give up. Keep on at them until they give in.

Ask to speak to a supervisor of midwives or the head of midwifery asap. Remind them that they're there to be an advocate for you.

Tell them that you're aware of the risks of c-sections, the risks for future pregnancies, etc. That you're aware that childbirth problems aren't genetic but that you still want a section.

Tell them that its not a case of been too posh to push but that you're genuinely scared and its affecting your mental health.

NICE guidelines do state that consideration should be given to a woman's wishes on this matter - unfortunately firstly they're only guidelines, secondly some Drs will say well I've given consideration but I still won't agree to it.

But if you can get a senior m/w on side to fight your corner with the Obs consultant then that would be good.

"NICE guidelines state that maternal request is now enough"

No they don't

"but they can't refuse you"

Yes they can.

Cripes that sounds like more than sufficient grounds for me but are you in the UK?

I unfortunately cant afford to go private, though after todays experience. I'll be applying for a bank loan. Though it feels wrong, as it feels like i'd be staking my life on it. Doctors are supposed to do no harm, but in my case it feels like they are doing more harm than good. I'm not too posh to push, i'm not mental or hysterical. I have what i think is a genuine problem. And how traumatising me helps is beyond me. Surely it puts me and my baby at more risk.They could spare me this agony. And let me enjoy my pregnancy and look forward to meeting my baby. The irony is, they'l almost certainly have to do an emergency section on me. So why not spare me, the trauma of awaiting a horrific and possibly life threatening labour. How can it not be genetic? families share traits. This is my family trait.

Yes, i'm in the uk.

hi there, maternal request in itself is not enough but as viva has pointed out, you should be able to push for it. tokophobia is a reason for a c.s..

if your midwife or obs is not sympathetic ask for a referral to another

do you KNOW that your pelvis is too small? has anyone actually said that, or are you presuming?

how many scans have you had? one scan on it's own is not really a clear indication, a series of growth scans are better and even then there is room for error

but your fear and psychological issues should be enough to get a c.s

Certain HA are worse than others for maternal requests.
The way I understand it is like Beaver says.
You can ask and but they can still refuse.This puts them on tough ground legally, if something goes wrong.
Have you seen a consultant yet? Don't let MW fob you off either.

You are also allowed a second opinion if one refuses.
Write all your reasons down and take it to your appointment. Keep asking.
BTW, I had a csection request, in Solihull accepted.
We moved to Bristol and was told that I wouldn't have got one if it was my first baby. I was very affronted, that women can have different levels of care in different parts of the country.
But money is tight in the NHS now.
Ask for a different consultant, if your one doesn't work out.

Viva - very helpful, thanks for the clarification...

www.bbc.co.uk/news/health-15840743

So this article is lying is it? It clearly says counselling should be offered but ultimately the decision lies with the mother.

A close friend of mine has just gone through this and is having a section so it can be done.

I'd arm yourself with the knowledge of the risks of LSCS, the potential short and long term effects, the recovery and so on - so you can attend a meeting with a supervisor or midwifery manager and say that you know them, understand them and are prepared to take them. That you understand the service is concerned you do not understand these risks but you do and are 100% accepting of the implications of your decision.

Good luck and congrats on your pregnancy.

I mentioned the NICE guidelines, i was dismissed. Thats why i asked to be reffered to someone who'l listen. I got no responce. Thats why i feel so stuck and afraid. I'll certainly take the advice of talking to a midwife and trying to get her onside. I feel like my family history, at least desrves considering. I was told i'm not a doctor and tey know better. But they dont know what its like when every woman in your family has been killed or maimed by childbirth. The doctor today actually laughed at me and said "this is not Africa". They've obviously pegged me as a mental health case.

Thankyou to all of you for answering my post, i'm so upset right now. Hearing advice from level headed people is really helping

Jessi, the research would say otherwise. That women don't labour like their mothers/sisters/aunts, big babies don't run in families, narrow pelvises might but they don't rule out a vaginal birth. The research shows that babies grow to an appropriate size for the woman and that's what Drs will quote back at you till the cows come home. There are plenty of very, very slim women who birth average to large size babies with no problems.

However it is reasonable for someone to say that although you understand that the stats/research may indicate you're not high risk you are still so anxious that its affecting your mental health. I think they might listen more if you acknowledge that from a medical point of view they are correct in saying you're not at an increased risk of these things happening to you. Otherwise they will just spend any appointments trying to convince you of this. If you tell them that you are convinced but even so can't stop the anxious thoughts, etc then that might be better.

If it is any reassurance I'd like to say that obstetrics has come on in leaps and bounds since you were born. Nobody would be allowed to be in established labour for 5 days as that would put you at a massive risk of a heavy bleed afterwards. If women do start bleeding after giving birth there are much better drugs and protocols/emergency drills to ensure that the bleeding is stopped quickly.

The issue around if a woman can 'demand' a section is almost a redherring.

Of course you can - but you have to find a surgeon who is prepared to do it. SO you can say your having one as you have free will. The surgeon, the consultant obstetrician, can refuse as s/he has the same free will and most also act in his/her best judgement.

So in reality a person may occasionally need to move on from one Dr to another to get their operation. A consultant is the only person who actually matters in all this - they are the ones putting their name to your surgery.

you're

ANd yy to Viva - I agree with all she says.

I really do advise you meet with a midwifery manager or supervisor. Take it from there but certainly see a consultant to finalise your choice for section if that is indeed the choice you make.

The title of the article is completly incorrect, women can't choose a section.

The problem with NICE is that they're guidelines, a Dr does not have to adhere to them, nor can they be made to adhere to them. A hospital doesn't have to follow them. Infact in some areas hospitals may have protocols that conflict NICE guidelines.

Some Drs are more agreeable to women saying they want one and will agree to it. I saw a woman telling a consultant xyz a while ago, inc family members who had nearly died, etc in order to try and get a section. He rolled his eyes, said somethign to ger along the lines of that it doesn't increase her risk so he won't consider that. Then went on to say lets not beat abut the bush, if you want a section just say uou want a section and you can have one - but the reason will be maternal request, not family medical history.

Other consultants wouldn't have agreed to it.

I know some trusts in the country the Drs, even consultants, are banned from allowing sections apart from if the reason falls into a set list. The PCT (or whoever it is now) will not pay for a section unless it comes one of the reasons on the list. So the Drs can't use their discretion. I imagine this is cost saving.

NICE guidelines do state that if a consultant won't agree to a section then they should refer you to another consultant. So you could ask to see a different one. I'd suggest bypassing your comm m/w and ringing the hospital tomorrow and ask to speak to a supervisor/head of midwifery, antenatal clinic sister.

Dear Jess

You poor poor thing, I am gearing myself up for a battle to have an ELC as I am scared of labour and all that can go wrong. I am only in ealry days and yet it worries me every single day, my first labour was OK, but it was the mental trauma that got me, it affects me today!

As far as I can tell from NICE guidelines if they wont do it they must refer you to somoene who will.

I would personally ask to speak to another consultant and if not - is there another hospital you can use?

I understand they dont want to give an ELC to everyone who asks for it -but to me, to leave a heavily pregnant woman in such a state of distress is beyond disgusting, they should be supporting and reassuring you.

I would say that they are not listening to you - you cannot speak to that person, you are suspicous about thier cocnern for your over all health as OBVIOULSY, you are in mental distress!!!! And you think its about numbers and money rather than patient health.

And if anyone else you speak to is equally as un helpful threaten to go to papers?

"ANd yy to Viva - I agree with all she says"

I may print that off and frame it!

I'm afraid that for many of us in the service it is about patient health. Many of us have seen 1st hand that LSCS is not 'the easy way out' and some of us have - very very sadly - seen families who believed it was in real distress at being the unlucky one all the side effects and risks happened.

The trick is to make sure everyone knows what they are agreeing too. The good and the bad

BTW - I do NOT mean to imply that any one on the thread thinks LSCS is the eay way out. I just mean that we have seen people who do get the shock of their lives and wouldn't want this for anyone.

Know your choices, accept your risks, make your prefrences clear.

When are you due to have your baby by the wa?

Viva -

What evil, evil 'care' you are getting. elizaregina is right - NICE does say if they will not offer c/s they must refer you to someone who will.

But don't leave it there Jessi I would write to your MP and really stir it up for them - post on www.patientopinion.co.uk and contact one of the organisations that support maternal request like www.electivecaesarean.com

The Birth Trauma Association also supports women with fear of childbirth www.birthtraumaassociation.org.uk

There needs to be a blacklist of these vile medical professionals. To put you through such suffering with your history is appalling.

Good luck, take care and don't give up

Ive had a series of growth scans becuase i'm hypothyroid. And since 15 weeks my babies measurements have been jumping way above the average line. I had one today, and the measurements for the head were 34 weeks +6.I'm 28 +2 (given the history can you imagine how thats played to my worst fears) And i know about my pelvis after x rays, following bad fall several years ago. So i dont think my concerns are ungrounded. That plus the family history, surely means i should at least be heard. Yes i ended up in floods of tears and yes by the time this is over i probably will need mental help. But they've pegged me in that box and are not taking me seriously on the medical point of view. But surely by addressing my concerns they could prevent a lot of that. I'm not too posh to push, i have genuine reasons to feel the way i do. I wish i did'nt know any of it. And my family history was different. I'm sure under those circumstances i'd be happy to look towards a natural birth. But i cant cahnge what i know. The only thing i'm sure of, is that i need to make history does'nt repeat itself with my baby. I want her to have a mother, and not hate herself for being born like i sometimes do. A mum is something ive never had, even though my mother survived. We all love our mothers, no matter how they treat us. And its so hard when you see them suffer cause of you. I dont want my baby girl to feel the way i did as i grew up.

Those are all valid and painful reasons and you nede to go see the midwifery manager who deals with this side of things and secure your choice.

You also need to have awareness of the downside of your choices so they know you are signing with informed consent.

And don't feel you need to justify it to us - you don't. No one thinks you are too posh to push.
If this is what you want then read about your choices, their implications, know your risks and be prepared to accept them. Reasure your care givers that you get their point and have considered their points and believe your decision is right for you.

You have some very painful thoughts though, and I wonder if one day a period of healing and reflection would help you with all of them.It is sad to carry such heavyness.

treedelivery "I'm afraid that for many of us in the service it is about patient health. Many of us have seen 1st hand that LSCS is not 'the easy way out' and some of us have - very very sadly - seen families who believed it was in real distress at being the unlucky one all the side effects and risks happened."

The problem is those within the service only see the short term problems - they don't see women left with incontinence, fistula, sex problems and post traumatic stress disorder which are ALL higher with vaginal birth.

There are risks both ways but they are certainly not all related to caesareans.