Insisting on C/S rather than induction!? What happens?

[StarlightWithAsteroid]

Has anyone done this?

It's just that my birth plan stated this and it caused a bit of a circus when I went overdue (completely ignored until then), with insisting on my seeing a consultant to 'agree' blah blah blah. I refused the consultant btw.

No idea how it would have panned out as I did go into labour spontaneously close to the 42 week mark according to scan. But am wondering about it.

I wouldn't expect them to agree elective major surgery without an assessment appointment beforehand, they will want an opportunity to make sure that they have all the info they need, and that you have all the info you need.

They had all the info they needed for 40 blimmin weeks.

Surely if the baby is in danger it needs to come out. Although, should it come to that I would have met with a consultant. I just wasn't prepared to meet one at 41 weeks with a perfectly healthy baby, especially as they had had 41 weeks to set it up.

Would they have agreed to induction without an assessment?

I'm just wondering why the circus really, and what would have happened in the end if I hadn't gone into labour.

Why do you think it was a circus? It seems totally reasonable that before agreeing to perform elective surgery that the consultant would want to ensure that both you and them knew as much as you both needed to.

Not sure it's elective if the baby is in danger is it?

Woukd have been happy to see the consultant before the surgery btw, but not 'just in case'. How many other people have to see a consultant 'just in case' they have a c/s?

Was the baby in danger? the impression from the OP was that there was a bit of a gap between them trying to get you to see the consultant and you going into labour. Have you thought about a birth debrief with a midwife - that would give you an opportunity to ask about this with someone who has your notes in front of them.

A cs is major surgery, with the associated risks. If the surgeon has the luxury of discussing it in advance it is safer all round. The surgeon also has a duty to personally warn of risks an alternatives, so a "just in case" discussion makes good sense. Also, an ELCS has to be agreed by a consultant I think. A more junior doctor can only make that decision in an emergency.

I've read my notes. All eight lines of them .

The baby wasn't in danger at 41 weeks any more than at 36 weeks and no consultant appt was made then. I suppose I'm just wondering what woukd have ACTUALLY happened and why the birth plan was acceptable and uneventful up until the due date, and then became the trigger for copious amounts of phone calls and apparently internal emails.

If the baby wasnt in danger then there would have been time to have had a discussion about the procedure in advance. The surgeon has a duty to inform you about the risks of the procedure, give you an opportunity to ask questions and check your medical history.

Well why woukd I agree to a c/s at all if the baby wasn't in danger?

They read loads of birth plans, its probably not an issue until you hit 40 weeks and what to do if you do go over 42 weeks becomes an issue, so didn't bother with it until then.

I think, shaky memory and not medically trained, that after 42 weeks there is a concern that the baby is not going to receive enough nutrients through the placenta as it isn't working as efficiently. At that point they need to get the baby out, the usual method is induction, I assume that this is the preferred method for reasons of safety, and more cynically, cost also.

The consultant either has to persuade you not to have ES, if not medically required or sign it off as bonzo said. Not sure about the last bit, just guessing, maybe someone else has an idea.

Why did you want a CS rather than an induction?

I refuse to labour in hospital.

Why didn't you just agree to speak to the consultant? Surely it's just standard for anyone requesting an ELCS to see a doctor so it would just have been a step you would have to go through to enable your request.

I wasn't requesting an ELCS though. I was refusing an induction. I was having a homebirth. But I wasn't overdue yet, so I wasn't even at the point of induction refusal, and the baby wasn't in danger, so there were no plans for a c/s.

I didn't want to raise my stress hormones and agree to a meeting that might have the effect if making me even more overdue. If these things have to be done, they should be done earlier, not at the last minute when they might feck things up for the woman.

Anyway, still not clear what WOULD have happened.

Why did you say in your title 'insisting on CS rather than induction'?

Because if they want to get the baby out I woukd insist on c/s rather than induction.

There is no argument that coukd ever persuade me to have an induction, so if baby had needed to come out I woukd have insisted on c/s.

Clearly this IS a circus, bu I don't understand why. Has no-one else done this? It sounds fairly simple to me.

Totally with you op. I'm two weeks away from due date and getting a bit twitchy! Everyone I have heard of being induced has ended up with emcs after days of painful labour, I rather just cut out the shitty middle bit and get straight to the inevitable thanks! No way will I agree to induction.

It isn't a circus. No-one can force you to have a procedure that you don't want. If you had gone to meet with the consultant then you could have discussed all the things that are concerning you, and found out what the facts were at that point.

I wasn't even refusing to meet with the consultant though, just at 41 weeks when I was neither overdue nor risking the health of my baby. What I WAS refusing to do was willingly attend a potentially stressful meeting at a sensitive time in the pregnancy that could impact on the likeliness of spontaneous labour.

Thats your choice, but it does mean that you didn't get a chance to discuss your concerns with them and fix a plan.

I do see your point to an extent but equally you could have explained your request and your reasons for it to a doctor, they could have said ok then at an agreed point of overdue ness you will get an ELCS rather than pressure for an induction. You could have gone away happy and been facing even less stress having resolved the situation. The timing may not have been ideal but other than writing this in you birth plan did you explicitly talk to a midwife about this earlier in your pregnancy?

Maternal choice in childbirth is important, but sometimes you have to help people help you, and I don't think referring you to a consultant when you are requesting surgery is particularly unreasonable of them TBH.

there isnt the time for the consultants to see all mothers before the due date

You are arguing that if women put in their birthplan that they could at some point possibly want a CS, then they should see a consultant at some point in their pregnancy, to avoid a possibly stressful meeting later on.

Lots of women will give birth naturally anyway, so lots of meetings that didn't need to happen? How do you want consultants to spend their time?

There isn't time for this.