Request for honest advice.

[lauralouise8]

Ladies, I am a newbie here and I apologise in advance if this has been asked before. I am ten weeks pregnant with a surprise (but wanted) first baby. I had always imagined that I would pay for a private elective c-section, as I have a fear of childbirth and am worried about not receiving the level and amount of care that I would ideally like. I could afford it, but obviously it would be money that could be spent towards something else (I'm not rolling in cash, but I have savings). I was very set on the idea of a c-section, but every medical professional I have mentioned this to has pulled a face. In addition, I had my booking appointment the day before yesterday with a very lovely and very competent NHS midwife. We ran through the very long 80 question (or so it felt) health questionnaire where you get a point for every condition/ailment/allergy you have ever had, and I came out with a risk score of zero, which obviously means that I am lucky to be very low risk. This, combined with the much higher than anticipated standard of the initial NHS care I have received, has made me question whether I really need to spend that sort of money for a private elective c-section, when there is medically no obvious need for it. I am now questioning something that I thought I had clear in my mind. Any genuine advice or thoughts would be appreciated.

Here's my take on it. I'm British and live in the US. One DC born in London, vaginal birth, 3rd degree tear, lots of physio after, some unresolved issues. DC2 born here by c-section, mine was an emergency but I'd have requested one anyway. Care second to none, signed off to drive after two weeks, home after four nights, looking after a toddler and a newborn alone after two weeks. Yes, it was hard, but perfectly doable.

You will get any number of people going on and on and on at you about the major surgery angle and yes it is. But - it is the most commonly performed kind of major surgery. Women here work until the day before, have a c-section and are back at work within two weeks often. I think the NHS doesn't like c-sections due to the cost angle and so vaginal birth is the 'norm'. Here, you're an oddity if you have a regular birth.

I think that's a little unfair on the NHS, Wibbly. Vaginal births aren't actually cheaper in the long run, as I'm sure they well know.

The other side of the coin is that in the US, they push all women to have CS because the more medicalised the birth is and the more time you spend in hospital, the more money everyone makes. So it's not all about the well-being of the women, either.

I have worked in maternity for 20 years and given birth 3 times and I would not choose to have a caesarean. As others have said, it is early days and you have lots of time to source some good information and educate yourself. I second Ina May Gaskin's 'Guide to Childbirth' ( although this is American) and also Kate Evans' 'Bump' to start with.

Chachah - a straightforward vaginal birth, with no complications, is cheaper. Agree re the medical insurance side though - everyone's a pawn in the great big health insurance game. I'd still go for a c-section again if I had a third though!

I def think it's too early for you to make a final decision so just ask around. Speak to people, do some reading and look at when you would need to decide.
I was never worried about labour, just whether I would be able to cope with the pain as I am a wimp.
I was lucky and was at low risk so could choose anywhere to give birth. I did a lot of reading to decide that and spoke to people so in some respects went through a similar process to what you should (albeit for much different scenario)
My birth went well in the end and I coped far better than I ever thought I could. 3rd degree tear which sucked and meant a stay in hospital which I wanted to avoid but it was only a few weeks until I started to feel a lot better. To be honest the thing that I felt worst about was the postnatal bleeding.
I guess what I am trying to say is keep an open mind and keep talking it through with your mw and family and friends etc. It's right that you might be able to have one on the NHS so investigate that option. Just make sure it's the birth experience that you want regardless of money as at the end of it all it will be those memories that will mean more than what's in your bank account.

If it's pain relief you're worried about have you thought about a private vaginal birth? That way you are guaranteed access to epidural when you want it. I don't know how available that kind of thing is outside London though. Good luck.

I started my pregnancy convinced I wanted a cesarean due to a terror of childbirth.

Now I'm 36 weeks and have had so many people (medical staff, women that have had c-sections) tell me that cesareans are not as easy as you'd think (although can be great) and learning about the realities of childbirth that I now feel prepared to attempt a vaginal birth.
I now don't know if I'm genuinely happy to have a vaginal birth, or if my instincts are still for a c-section, but I have been cowed by other people.

So, what I'm trying to say is, learn more about both options and you will hopefully feel more comfortable about making a decision. I started this thread asking for people's experiences and found it really really helpful.: www.mumsnet.com/Talk/childbirth/2028797-Cesareans-advice-and-experiences-wanted-please

Don't let anyone tell you that your decisions are wrong, and talk through the options in depth with your midwife. A good midwife won't belittle you or make you feel wrong for wanting a cesarean. Good luck.

This may have already been said (don't have time to read all the responses right now) but it is normal to be apprehensive of labour. There are things that can help which I am sure the others have mentioned already.

You mentioned going private for an elective c section. I would look in to this properly before making any decisions. Private hospitals do have good customer service (nice food, rooms etc) but I don't think I would have cared during labour. However they usually don't have emergency facilities on site so if anything went wrong (chances are everything will be fine so not trying by worry you) then you would be taken to your local nhs hospital anyway. In addition my understanding is you pay as you go so to speak so if you need to spend a few days in hospital it could cost you thousands more than planned. I personally would not want to be making the decision to discharge myself from hospital based on financial rather than medical reasons. I think you may be should consider pros and cons compared to elective c section through nhs or natural birth. Really I think do the research, talk to friends and your midwife and then do whatever feels right for you! And congratulations!

I think it is difficult to advise because each person has their own experience of childbirth or if they haven't given birth their own thoughts of how they want to give birth. Personally, I would have hated the thought of a c-section. First birth I had was fairly easy considering second not so great but still wouldn't opt for a section. You just have to speak to the midwives and come to a decision that is best for you.

I didn't have my dd in a private hospital, or in London even though I went privately. And there was a back up dr in case the one I was actually seeing was on holiday or poorly etc.

Someone did make a valid point though (sorry, can't remember who and I'm on my phone) about the extra costs adding up for any unforeseen visits necessary and/or overnight stays. I had to have two overnight stays whilst pregnant (separate occasions) and they cost nearly £2000 each.

On the plus side though my DH got to stay with me for both nights after having dd, there were no strict visiting hours, had my own room and bathroom, had tea making facilities and a fridge in the room and a calm environment around me, food wasn't good though.

I'd have had all if that if I had a vaginal delivery too though.

I had a vaginal delivery post induction. I got an epidural which was amazing. Pain free until it wore off, but they got the anestestist back up to top it up. Didn't even feel pain at the pushing phase, but could feel pressure so I knew when to push and was only pushing for 15 mins.

If its pain that you are worried about, maybe enquire about the availability of an epidural? I hope worrying about the labour doesn't reduce your enjoyment of your pregnancy, its a very special time.

I'm afraid no-one has a right to a CS on the NHS. They are only decided on the health interests of mother and baby. For many trusts, their policy is not to automatically give them to those with a fear of childbirth but instead to refer them for counselling. A CS is major surgery and not to be undertaken lightly.

I've not given birth before and am currently 22 weeks pregnant.

Just for the OP really - before I was pregnant I was scared of the thought of childbirth (who wouldn't be really? it hurts a lot!), but as the pregnancy has gone on, I've got less scared - slightly oddly. I've gone from thinking I'll just pay for a CS, to now being worried that the baby is currently breech, and if it stays there I might not get a choice of having a VB.

I recommend the Ina May book, and reading lots of birth experiences. It seems that most people are very keen to share (overshare) scare stories, bad experiences etc, but there are thousands of people we don't hear from who have a perfectly acceptable VB.

I'm not saying the perfect VB, but a reasonable one - maybe low level tear or cut, maybe hauled out of a pool and stuck on their backs, maybe all a bit tight on time/carpark panic, or feeling like it went on forever, or feeling there were too many people in the room, or having a partner who went to pieces, etc etc. Those seem to me to be very quickly overshadowed by the actual joy of a baby being in your life bit (and also the exhaustion of a baby being in your life!). In my close family I have some women whose stories make me as a naive non-mother pull a bit of a face, but they are FINE with how it went. One friend who has a 3 month old told me very soon after the birth (like a week) that 'oh yeah, it's not a walk in a park, it's not a load of fun.. it's called labour because it's fucking hard work, but also it's not THAT shit... and you get a baby' - she had back to back baby, epidural that didn't work, and ended up in theatre with a episiotomy and forceps. It 'wasn't that shit'... apparently. I was crossing my legs and wincing.

Just my two cents, sorry if anyone is offended by it!

Hi Op

I was in a similar situation as you. I wanted an ELCS (which I got 5 months ago) and had a very positive birth experience with none of the scary stories you hear. I set up a thread some time ago which has lots of information about what you need to do. Considerations with regards CS risks and VB risks. Antedotal information/experiences/stories from woman that have experienced everything from crash / emergency and ELCS. The thread also tells you what you need to do if you want your ELCS to be approved.

www.mumsnet.com/Talk/pregnancy/1849354-Elective-C-Section-medical-non-medical-reasons

Good luck Op and hope you get the birth you want.