Any tips on what to say if consultant refuses me a ELCS?

[whatwasIthinkingof]

I am 32 weeks pregnant with DC2, had a traumatic birth 18 months ago and long recovery and would prefer a c-sec this time (although I realise a c-sec will not be a walk in the park!).

Anyone else had conversations with consultants/midwives and they?ve tried to put you off having a ELCS? If so what did you say? And did you get the ELCS in the end, despite ?no medical need??

The reason I ask about the consultants is that the GP worried me today. I asked what are the chances of me being granted a ELCS at St Georges Hospital, Tooting. I explained I had already been told at 20 week appt with consultant that there was no medical need as such.

GP basically said that the hospital can refuse me a ELCS and I have no legal right to insist on one. She also was quite frank about the fact that one of the reasons was that recovery for C-section in hospital takes much longer so patients need a bed for several nights and with a VB they can be out the same day so a CS is more costly in terms of both actual expense of the op and taking up a bed. She also mentioned the risk aspect, ie a c-sec considered more risky than a VB so surgeon and anaesthetist are more reluctant if they consider you don?t technically need one. I felt very worried and frightened when she said this, at the thought of having to go through what I went through last time.

I completely understand your worries as I was the same. I went along to my consultant appointment ready to fight my corner and totally stressed that I would be refused. I was actually 'granted permission' on two counts. One was my traumatic first birth and the fact that I suffered a third degree tear. Did you suffer any tears?

When they asked me whether I was happy to try for VB this time, I stated that I was not. That after a very traumatic first birth and my tear, I had been told that CS would be an option open to me if I decided to have any more children. I told them that had that not been the case, I would not be pregnant again. I didn't have to fight or be persuaded otherwise. It was clear they would prefer that I didn't have a CS but I think they understood that the tear meant I had a good case and that trying to persuade me otherwise would be difficult. Yes, they could have refused but I was so adamant that I would have taken it to the highest level possible, even gone to another hospital, until someone said yes!

Actually what is on your side (and I would have used had I needed to), is that in 2011, the NICE guidelines on elective CS were revised. They now say that if a woman insists on a CS, she should be referred to counselling and if she cannot be persuaded otherwise, that permission for a CS should be granted. I think they thought this would lower the overall c-section rate by gently talking women out of it. Women who have already had a traumatic first birth are unlikely to be convinced, however, and should be granted one if they still want one.

I fully intended to use the NICE guidelines to get my way. I didn't need to , but it may be something you should be armed with before you go. The fact that you suffered mental and physical trauma, and have tried to give birth naturally once and it didn't go well, should be reason enough to insist they consider it medically necessary.