How do you call a section that is not planned but also not real _emergency_ section?

[bansku]

Word Emergency section to me sounds like a real emergency where baby has to come out immediately ie. quick general anesthetics, no time to clean tummy and vertical scar.

My friend said she had emergency section because not dilating. The procedure sounded more like planned section. Is this called a semi-emergency or have I missed something?

I think anything not planned well in advance is often called an emergency section. I've heard the kind you mention in your first paragraph called a crash section, I think.

Any c section where labour has already commenced is an emergency section.
You are describing a crash section.

CS are categorised 1, 2 and 3.

Basically 3 is a slow walk. Electives, inductions that don't work and the like.

2 is a fast walk - things like breech discovered in labour. Not dilating but baby quite happy or baby a bit unhappy.

1 is a run. Do it NOW!

They do call it an emergency because a vaginal birth was planned and labour underway. Don't you believe your friend or something?

The "baby must be born within 5 minutes" section is a crash-section (I had one) and those are performed only in extreme circumstances because of the huge risk of having an unplanned general anaesthetic.

A emergency c section I believe is where labour isn't progressing etc. a crash c section-which is what i had- is where they have literally 4/5 minutes to get the baby out only performed in very critical circumstances and they slash u open any which way etc

Thanks! From where I come from we have own word for these semi-emergencies.

I don't think she had an real emergency because they asked her if she wants section now or if she would like to wait another six hours to see if she dilates.

Well maybe it is just me and my conception of what a word emergency means.

You are just being pedantic about it aren't you op?

There are actually 4 categories of cesarean section. See here

Your friend's was probably a category 3 - so no immediate danger but baby does need to be delivered.

Category 4 is scheduled or elective - ie done at a time convenient to staff and mother.

LoveAndOtherIndoorSports
Thanks for explanation.

I have wondered about this, I had to have a CS but I wasn't in labour and it wasn't desperately urgent so in my notes it was 'elective'. I know it doesn't really matter but it bugged me, I prefer to think of it as a 'planned' one. Who the fuck would 'elect' to have a CS at 27 weeks??

It's an odd use of the word 'emergency', yes. Ditto 'elective' for any planned ones even if the 'choice' is life or death!

Never understood why they don't just call them planned and unplanned which would have the advantage of not beginning with the same letter so make writing notes easier, as well as not scaring women who haven't had babies into thinking 1 in 3or 4 of their friends had been in a life-threatening situation which is what most people think emergency means.
I remember my antenatal class were hugely relieved to find that emergency was much less scary than we'd all imagined, in most cases.

I agree that 'emergency' and 'elective' are bad words for sections.

Elective - well, maybe that's an ok phrase where it is maternal choice, but it does sound a bit wrong to say someone has 'elected' for a section where, say, there is a transverse lie. It's not like there was a choice!

Emergency - even worse. I don't think it can be particularly helpful to women to feel that they were part of an 'emergency' when in many cases it was nothing of the sort. An emergency medical procedure sounds scary and traumatic. An unplanned section for slow dilation sounds, well, far more run of the mill.

I think you have to assume that the terminology is from the doctor's point of view not the patient's - i.e. for an 'emergency' section they get buzzed without advance warning.

When I rule the world, I will rename many things related to women and medical procures. I shall start with sections and ERPC, but I may include others!

The terminology we use in the UK is that any section that happens after spontaneous onset of labour is an emergency (cat 1-3), even if it happens 4 hours after the decision is made, even if you were planning an elective section, then went into labour early, it would still be emcs.
It's a bit confusing, and it might not sound accurate to you, but that isn't your friend's fault, she had an emergency section, why bother doubting her and making your own definition?

Needs overhauling. Like all birth terminology.

How does 'Failure to progress' make you feel? Or that someone 'Delivered' your baby (like you were just there as a bystander). Or having a 'Home Confinement'? Or you have an 'Incompetent Cervix'.

Words invented by medical men to make women feel like shit.

A crash section is still an emergency section, just a fast one!

My birth notes state that I had a 'semi-elective' caesarian.

It was a medical emergency due to severe pre-eclampsia, but I wasn't in labour, so maybe that's why they decided to call it that. I didn't exactly have a choice about it though!

I actually asked this whilst being stitched after my DD2 was born.

I was told it was still an EMCS - she was cat 2 on that link. My first EMCS was cat 1, but not so crash as to require general anaesthetic as theatre was prepped and ready next door.

The terminology is not just used for obstetric activity - its used across all hospital procedures. Hospital activity falls into two categories, 'elective' and 'non-elective'.

For example, if you are admitted to hospital via A&E you are a 'non-elective' admission. If you are booked in to have treatment, you are an 'elective' admission. So it's not really fair to say that the use of the term 'elective caesarean' is some sort of stick to beat women with - 'elective' used in this sense does not denote 'chosen', though the tabloids may interpret it as such in their 'too posh to push' stories.

My cs was probably a cat 2 then. Fully dilated, two hours pushing, baby far too high for instruments (-2 station) but completely undistressed with good heartbeat.

That kind of backs up my earlier point though frustratedMod - it is terminology for the convenience of medical staff, not the benefit of patients. I really don't understand why more appropriate language cannot be used with patients.

youll you're right, the distinction is there for the benefit of clinicians, managers etc, but it would be much too confusing and potentially risky to change it because it might be misunderstood by patients. However it's not helpful for doctors to use words like 'elective' in consultations with patients, unfortunately sometimes they need a bit of training to 'de-medicalise' their language!

In terms of the difference between an 'elective' and an 'emergency' section, an emergency section is one where the patient has not been booked in for a section prior to admission, as far as I understand it.

It must skew the stats though. I had a Planned CS booked in, but my waters went over a week before that date. I didn't go into labour, but they had to do something, so just did the CS the next day. I waited (a long while) for an energency free gap in theatre - strolled into theatre, had the op.

It was called an emergency CS on my notes. It never felt like an emergency to me and doesn't seem in any way comparable to my friends' experiences of EMCS. I understand there was a timescale at meant the baby had to come out, but I never saw any '1,2,3,4' categorisation. It seemed a very odd way of recording it to me.

That said, my cs was booked for primary tokophobia, on the recommendation of a psychiatrist on the perinatal mental health team, my community MW and consultant MW. What did it say on my notes? 'CS for maternal request'.

It would be difficult to gauge exactly the sense of emergency from a number though. I suppose ds and I were category 2- his heartbeat dropped, so definitely urgent, but still quite a relaxed experience from my pov: I was awake, there was time to keep me informed etc, and because it happened early on in labour I was not exhausted. I am sure there are times when it feels far more like an emergency for some poor woman in category 3 who was worn herself out labouring for days.

Frustrated - I totally agree. I am a lawyer by training. We have a fair number of seemingly nonsensical technical terms. However, I had it drummed into me during training that I do not use these with clients. I either use them, but explain the background and why the terminology is used (as you just did re elective), or I use non technical language. Sadly I think that is rarely the case with sections.