The case for ELCS.... Other than breech, previous CS, etc...

[atrcts]

I had a consultation with an OBS registrar about having an ELCS.

Previously I had an induction with forceps delivery, which left me with injuries taking 2 years to resolve. I started motherhood EXHAUSTED, faecally incontinent (admittedly only once but was touch and go for many months after), with added exhaustion due to the extreme pelvic bone pain (day and night) caused by forceps.

I already have severe fatigue issues as I have Multiple Sclerosis, and it was suggested to me by my GP that it might be a better recovery to have a 6 week CS surgical recovery, with no 13 hour labour, rather than a VB.

The registrar was pretty patronising and said I could "try" to "convince" the consultant to book me for an ELCS, but that she very much doubted I'd get anywhere.

Her argument was that second birth "might" be easier and that a lot of people with multiple sclerosis don't have much fatigue and so can cope perfectly fine like everyone else. Basically, poo-pooing my concerns.

So I wondered if anyone has ever had to "fight" for an ELCS and if so, how did you present your case to the consultant?

P.s....This isn't intended to be a debate about whether ELCS is hard to recover from - I've had abdominal surgery myself before and recovers fine from it so I know a bit about what I'm risking. I also know that not every birth is the same and that some people will want to argue that forceps might not be necessary again, but I don't want to risk it, as studies show forceps are much more likely in someone with MS than someone without it (due to muscle weakness and messages not always firing to the brain adequately).

I didn't have to fight. I asked very politely if we could discuss the options and we agreed. I had been seeing him for antenatal care as I was a novelty way old for the local demographic. (NHS and not IVF)

I would smile and nod at junior doctors and midwives and go straight to the horse's mouth. Have your facts to hand and be calm but assertive. Your GP is already on side remember. You can always go back to your GP and ask for a referral to a sympathetic consultant.

I didn't really have to fight much. I was expecting a large baby and had a family history of traumatic birth of large babies and I just wasn't going to have VB. The consultant agreed to the ELCS and actually I knew he secretly approved anyway. Like you, OP, the more junior dr gave me a hard time about it but I kept repeating my story.

DD would have been over 10lb at birth had she made it that far - in the end she was born really quite prematurely so a perfectly ordinary size but because I had booked ELCS that was still available to me as an option and that's what I got.

atrcts I can't believe the registrar's attitude. You've got all sorts of reasons to have an elcs - not least the faecal incontinence and injury you suffered last time. You must have had quite a severe tear for that to happen and a further vaginal birth could put you at risk of permanent problems. That's without the psychological impact of the last birth and the MS.

I can't understand why there is any resistance - you are making a perfectly rational decision AND your GP backs you up.

Please let us know how you get on.

In the most polite way possible, bugger the registrar. Ask to speak to the consultant and don't let them fob you off with anyone else.

Thanks for the helpful responses. I see the consultant next week and will definitely let you know how it went :)

Hi - just to update you as promised! My consultant was accepting that I have a good case for an elective if I want that; and will discuss it in more detail later on but said not to worry about it. sweet relief!

Good news atrcts. Hope all goes well.

Glad to hear you had a considerate response. Good luck !

Well done. Enjoy your pregnancy :)