I had an ELCS 7 weeks ago or DD2 and it was a hard-fought battle but I'm so glad that DH and I pushed for it. Essentially, after a long labour and long pushing phase with DD1 in 2009, I knackered my tailbone. You would never know how painful it is and how much force you exert upon it in day-to-day life until you injure it.
I won't bore you with the extraneous detail so here are the essentials:
?Met consultant at 20 weeks. Told him about my problem. He said that mode of delivery wouldn't make any difference bollocks and froglets the bejesus out of us with the worst possible outcomes of CS vs an ideal VB. He said he would support me if i wanted CS, but first wanted me to meet with a consultant midwife at 28 weeks and in the meantime, field opinions from others.
?Met with consultant midwife at 28 weeks. We talked about various birth positions thy would take the strain off my back and various pain relief. Bottom line was that VB might make my tailbone pain worse and if it did, I'd be drugged-up enough to get through te birth and then we'd deal withte pain later - not a viable option for me.
?Met with an independent chiropractor at 32 weeks who explained the snarky of my birth injury and that i stood a very high chance of hurting it and/or making it worse.
?Meanwhile, I read Cesarean Birth: a positive approach to preparation and recovery by Leigh East which contextualised te pros and cons of CS and VB (great VBAC section in there, too). Also looked at November 2011 NICE guidelines. The initial doomy CS outcomes had been overplayed.
?Met with consultant again at 35 weeks. It was a battle royale; him poo-pooing all of the research I'd done, saying I could still birth vaginally ... But my mind was made up and I held firm with DH's support. I knew the risks of CS and was prepared to take those risks. CS date booked for 39+3, given consent form to sign.
My CS went as 'Maternal Request' in the end, as it was against medical advice. My feeling is that not enough is known about my back condition for coccydynia to be a recognised reason for CS request.
Anyway, I had to jump through hoops and literally say that I knew the risks of CS and would take those risks over the risks of VB. You have to be polite but VERY FIRM, or you will be walked over. You might have an easier time of it than me, but bear in mind that VBAC is encouraged to bring CS rates down. If though, you know that you want a repeat CS, show that you know the risks and are willing to take those risks over VBAC. If you aren't beig listened to, ask to be referred to another OB, due to NICE guidelines. They might tell you they haven't taken those guidelines on yet, but I doubt you'll be denied this, lest you feel you were pushed into VBAC an something went wrong.
Best of luck!