pushing for an elective cesaerean....... can they point blank refuse me? I will be 34weeks when i next see my consultant

[sianilovesbeingamummy]

I am due to see my consultant next week, i will be 34 + 5......... i last saw him when i was around 24 weeks pregnant to discuss c-section..... he said he would give me chance to think about things!!!!! however, he didnt seem too keen on me having a section......

I ended up having an emergency section with my first as his heart rate dropped dangerously low and wasn't rising again..... i was 40 + 14 and had also been in hospital for 4days while they tried to induce me, unsuccessfully i might add!!!

I don't want this experience again and i also have to arrange childcare for my son so the thought of having a date for section is less stressful and allows me to plan as much as i can.... obviously i know there is always a possibility of going into labour early but at least i know i have planned as much as possible......

Has anyone else been successful in getting a section date after thinking they wouldnt?

There's no 'right' to a CS, but if your consultant doesn't agree with you wanting one, then really under NICE guidelines he should refer you to a consultant who will carry it out.

But then, the guidelines aren't mandatory, so there's no guarantee that that would happen.

I'll be interested to hear how you get on. You had same birth as me and no way am I going for that again if I get pregnant. I assumed as some people have to push for a vbac they'd be happy to section for a second time? I'm maybe mistaken though as I'd only idly thought about it.

I requested a c section after a similar experience to you. I was told I'd have a huge battle on my hands as all labours are different and there was no medical reason for me to have one.

Our dc2 heart rate dropped and was prepped for c section but as dc was v low they tried vent rouse and got dc out quickly.

Think you'll need a good case for c section. It's an operation at the end of the day with huge risks.

If you've already had a section you have a good case for having a second and I do think the childcare/planning issue is one that is taken seriously by some doctors too.Success rate of VBAC is 75% therefore 25% have EMCS.If there is a 25% chance you are going to end up with one anyway why not have a planned one?Much safer.One point of view to put to the consultant.There is a drive within the nhs to offer all women who have had 1 section a choice about their next delivery.I have just been part of a focus group to develop an online tool to help women decide about whether to try for a VBAC next time or an ELCS,but it is in thexearly stages and may not have filtered through to all trusts.There are lots of women who prefer to try VBAC anyway but if you really want an ELCS and are aware of the risks you should be allowed.I never had any problem getting the consultant to agree to the second one(or 3rd! ) but my 1st one was elective so had never even been in labour,and I am aware and grateful that I am in a very pro-section nhs trust(outside London).Once you have the appointment though I am fairly optimistic if you are clear about what you want,and why,they will let you have the final decision.Good luck

You are me in 20 weeks time - 4 day induction, the lot.

I've just been sent an appointment with the VBAC consultant at the hospital, but just like you I've been thinking about it and have all but decided to push for CS again instead, the stats that I found (and now can't find again) suggested that I'm only 40% likely to succeed with a VBAC (normally 70-80% I think, but I have a couple of complications). I will not be induced again.

I would ask some questions about their VBAC success rates for similar circumstances, what their post-op infection rates are like etc. So the consultant can see that you're really considering all risks.

My consultant was all ready with his diary open to book me in until I said I wanted to try for VBAC. So it's not necessarily the case that you will have to fight. I had placenta previa the first time so nothing indicating that I would need a CS next time (I did have one as it happens but the second had nothing to do with the first! :o)
He said to think about it - well you have and you are still keen. I suspect he will book you in.

I successfully argued to have an ELCS on non-medical grounds, but it was a battle. Very stressful, right at a time when you're very vulnerable.

I had a long labour and ventouse delivery with DD1 in 2009. I developed coccydynia as a direct result. When I became pg with DD2 (born April 2012), I didn't want to risk damaging my tailbone again. There is a lot to my story and my decision-making process but essentially, I met with the consultant at 20 weeks and he frightened the bejesus out of DH and I regarding what can go wrong with CS. What I didn't know them was that EMCS and ELCS statistics get thrown together and, although things can go wrong, ELCS is much safer, with far more predictable odds (especially for me then - 29yo, fit, healthy, first-time CS). I was told to 'think about it' and go back to meet with a consultant midwife at 26 weeks to discuss my natural birth options.

Met the midwife, wasn't convinced by the 'if your back gets hurt, we'll deal with it as it happens'. Met with an independent physio and chiropractor, read Leigh East's book (Cesarean Birth: a positive approach to preparation and recovery) and decided an ELCS was the best option for me. Booked another meeting with the consultant at 34 weeks. He tried to convince me again not to have it and isai 'Look, I've made an informed decision. If you won't do it, please refer me to a consultant who will'. I was near tears at this point.

What Fliss said is right: the Nov 11 NICE guidelines aren't in place fe every trust and my consultant told me this. But, despite rubbishing my reason why I was requesting te CS, he did then relent and say that he wouldn't want me complaining to him after a natural birth having damaged my spine.

Contradictory? Yup. I think there is a huge drive to lower CS birth rates and therefore undermine women's reasos why they want one. But do insist if that's what you've decided. I loved my ELCS, hands-down more preferable to my labour. Take an advocate with you (DH/DP/DM/friend) to prompt ad support you and dig your heels in.

Molotov Good post

If you are refused a repeat c/s you should do a formal complaint. VBAC is no cheaper than repeat C/S and carries higher risk for the baby so you have an absolute right to insist on repeat c/s in your case.

I would put it in writing to the obstetrician firmly stating your position and declining VBAC. Take it up it up with the patient liaison service at the hospital if you get no luck.

C/S is the most common operation carried out on the NHS and it is very safe. (Not risk free but then neither is vaginal birth).

Stick to what feels right and good luck.

Thanks, Ushy :) And I second the 'vaginal birth is natural, therefore less risky' argument that tends to be used to sway pregnant mothers. There are risks to both modes of delivery and the key is to understand what those risks are, what risks are likely to apply to you (unpredictable to know with some things); what risks you prefer over others.

thanks guys, will definately keep you update..... bubs is currently breech @33weeks, still plenty of time to turn i know but hopefully she will stay this way and c/s will be a defo then xx

Do bear in mind that even if baby is breech, that does not guarantee you a CS. My last baby was breech, the abdomen measured over 20cm two months before birth (he had major kidney problems) and I was still being told I would have a natural birth think my consultant was evil, tbh.

IME everything depends on your consultant. However, if they refuse, you can ask to be referred to another consultant. I was told that no other consultant at the Hospital would agree, but thankfully on actually being referred the second consultant was both helpful and sympathetic (wish I'd been referred sooner). However, I really had to fight for that referral.

Good luck.

I had my vbac app yesterday (25 weeks) and they were completely open to it being my choice as to vbac or Elcs.

Similar to you I was failed induction for 5 days with dc born 40+15.

I have said that I categorically will not be induce - they were fine with that.

Got another appointment on 36 for final decision.

Had DS2 in July by CS. I too had a failed induction with DS1, was in delivery suite for 2 days and when I eventually go to 10 cm's and was told to push discovered DS1 was stuck and pushing would damage my bladder so had an EMCS.

This time round the consultant would not confirm ELCS at 22 week apt but I made clear my request, at my 34 week appt they were happy to book me in for CS after I showed I had looked at both VBAC and CS options. In the end I went into labour at 36 weeks but again I said I wanted a CS so that is what I got in the end.

I honestly don't think they can point blank refuse when you've already had a CS. Whilst the risks are low there are more risks to the baby associated with a VBAC and on those grounds if you state you are not willing to take those risks and if they force you to VBAC against your will and something goes wrong they are fully liable then they will soon get the diary out. Personally I was prepared to fight for my ELCS following my EMCS last time but found no resistance at all when I pitched up with a printed and highlighted copy of the RCOG paper on delivery following a CS. I got the impression they also thought I should have a CS! In your position though I would not budge and just keep repeating you are not willing to take on the additional risk of x y and z. RCOG paper here to help: www.rcog.org.uk/files/rcog-corp/GTG4511022011.pdf Hope it all goes to plan for you.

well i got my section, i didnt have to push very hard as baby is small and they are worried about her at the moment so i have a section currently booked for 7th May however this could be brought froward at anytime should they feel bubs will grow better once delivered....... will be finding out the final verdict next week when i have my 3rd growth scan..... doc at hospital will either make a decision or my consultant will in 2weeks time....... either way, she will definitely be here by 7th May which is only 3weeks away on Tuesday so not long at all now.......just scared yself realising how close it actually is now,lol xxx