Elective c-section for first child, no medical need-experiences please?

[j200]

Hi, I have had a tough time getting pregnant and had to go through fertility treatment which finally worked but i found quite a traumatic journey which has taken a real toll on my self confidence.

Am now 20 weeks but have been suffering anxiety the whole pregnancy so far, made worse by bleeding at 14 weeks.

I am thinking about requesting a c-section having read the pros and cons of both, based on the majority of my friends having horrendous birth experiences and me not being able to take anymore trauma. I just wondered if anyone has done this too and were pleased with their choice/didn't find too much resistence from NHS

Thankyou :)

Hi
Sounds a bit similar to my own circumstances - Read my thread 'first time birth & having an elective c-section' further down this page - I got lots of advice.
I'm booked in for Monday so will try to update end of next wk.

Thanks Sas x

Why would you put yourself through more intervention? CS is not necessarily the easy option. Vaginal birth does not have to be traumatic or damaging. Most are not. Surely it would be better to deal with the existing problem - your fear and anxiety - rather than run away from it and into major abdominal surgery?

You can get therapy to help you get past this, and prepare you for whichever form your birthing finally takes. CBT and hypnosis are both very effective. Please consider them before you commit yourself to medically unnecessary surgery.

I had a planned CS after ivf. For me, it was absolutely the last thing I wanted, but the baby wasn't growing properly and the drs wanted to get her out several weeks early and didn't think she would survive induction. I found it absolutely awful. The surgery itself was horrible. It is a very brutal thing. I've heard it described like someone doing the washing up in your belly. For me it was more like some wild animals having a fight in me. The spinal wore off before the end of the surgery so I could feel them stitching me up at the end. I was shaking uncontrollably throughout (a fairly common side effect) and felt pretty out of it. The drugs made me throw up in recovery, which was the most painful thing ever because of the stitches. I can't understand why anyone would do that to themselves by choice!

I did this. I told my midwife I was terrified and she referred me to the pregnancy psychologist at the hospital. The sessions were not massively helpful if I'm honest, but the psychologist came with me to my consultants appointment and I got the section for mental health reasons.
I am a bit of a control freak so I was happier with the idea of a set date, a set thing happening to me, and knowing when it would be over.
I actually went into labour early so it wasn't as planned as I would have liked but that's nature for us I guess.

I think to be totally honest having a baby is always a bit of a trauma, its such a massive thing to happen to you whichever way it happens so anxiety is inevitable if you're an anxious type. As with all anxiety though it really doesn't help, try to enjoy being pregnant, it doesn't last long and I find it hard to remember because I was so worried. Easier said than done though. Best of luck.

Also-your friends "horrendous birth" may not have been.

Not downplaying, but people have different viewpoints, approaches, expectations, and things tend to get exaggerated in the retelling.

For example I have a friend who recently gave birth. She was traumatised, had been told she wasn't built for giving birth, it was a horrible, long process, she thought she'd have to have a CS for failure to progress at one point.

Turns out she'd had an absolutely textbook, 1cm per hour, epidural, no intervention birth. 10 hours from first contraction to birth. It was just she hadn't done any research, and had been expecting to pop the baby out in about an hour or so. Didn't know about transition, dilation rates, stages of labour, so every hour the baby didn't arrive she was panicking more and more.

Apparently she thought I'd had a section for failure to progress too, when I'd been admitted to the labour ward at 9 am in very early labour and had a section at 11 am! (severe foetal distress on a routine trace = emergency section). We're close enough she knew I was going in that morning, and got the birth news about 12 noon...

However, it is your choice. One thing I found useful was to write a plan (mine was for vbac). I wrote a specific list of circumstances- basically I wanted to be able to request a section at any point if I felt I wasn't psychologically coping.

Have you thought about other options? Early epidural? hypno birthing? Look into it all first, as Six said a section is a big surgical deal, so make sure you've done your research.

Have NC for this.

I was in a very similar situation. I was late 30s and finality got pregnant after years of infertility, 3 IUIs and 3 IVFs, the last one being an immune cycle at a distant clinic with a huge amount of travelling and extra drugs/ input. The pregnabcy was so, so precious, and very likely to be our one and only one.

When we saw our obstetrician, they actually asked if I had thought about an elective CS. In her experience, IVF patients sometimes found the lack of control in a "normal" VB particularly difficult. I bit her hand off. For me, for us, it felt like the best way to try and guarantee a safe delivery. But I'm unusual in that I'm also medical, and extremely practical. Machines and medicalisation reassure me rather than scare me, and I've also seen too many complications in my training and working life (admittedly probably rare, but disproportionately magnified to me).

My ELCS was a calm, planned, fantastic experience. No problems bonding with the baby or breastfeeding.

I would strongly agree with previous posters that you need to find out as much as possible about both VB and CS though. You may find there are things about CS that worry you as much or more than VB.

If you decide to go for CS, the key thing is going to be finding a sympathetic consultant. That is going to be the tricky part, especially these days where there is a huge push to reduce the number of sections.

Good luck, happy to answer any other questions x

j200, I have mixed views about this despite being booked in for an ELCS for anxiety myself.

The current climate is to automatically go for an ELCS if you are suffering from anxiety during pregnancy. My beef with this, is it often neglects to actually look at the problem itself which is the anxiety and I do think that there is something of a bias towards an ELCS which actually might not be right for everyone. The trouble is everyone's anxiety is different and there are lots of different ways to tackle this which women are not fully aware of when they start going down this route. It really depends on what your anxiety actually is and what your priorities are. You do need to spend time and actually break down your anxiety - instead of saying my friends had traumatic births think about what in their birth is it that makes you anxious for example - from there you can look at different options and decide whats right for you. What other people have done is largely irrelevant tbh.

Counselling, is an option, but may or may not work in the timescale you are given.

Another is getting extra support through the pregnancy or by getting a more individualised birth plan which makes the midwives aware of particular issues. Its about building up trust with who is caring for you.

Rather than post it all again, I discussed it all in more detail on this thread a couple of days ago:
www.mumsnet.com/Talk/am_i_being_unreasonable/2157053-to-be-worried-about-seeing-consultant-about-elective-c-section-tomorrow?

FWIW, I am aware that IVF patients are significantly more likely to suffer from anxiety / request an ELCS for a number of reasons (more likely to be older, suffered loses in the past, less likely to have more children, need more reassurance amongst others) so midwives and consultants will probably be more favourable to a first time mother in these circumstances if they are up to date with the latest research.

I've booked an ELCS for no medical reason for my first child at the end of November. I'm not unduly anxious about labour - if I go into labour before my ELCS date I'll probably just continue with a vaginal birth - but having looked at the stats and the research for VB vs ELCS, and speaking to people who've been through each, I decided I preferred the risks associated with ELCS suited me better than the risks associated with VB. I have had pelvic floor weakness and for me, doing everything possible to mitigate aggravating that was a priority.

Although I've always been fit & healthy, I've been through major surgery many times with no problems so it holds no fears for me. I'm under no illusion that it's the "easy option" but it's the preferable one for me. I'm afraid I can't comment on the NHS as I'm not in the UK and am with a private obstetrician but it's not been an issue at all. The only issue has been with people who seem to take it personally that I've opted out of having a VB! My vagina, my choice. Bugger them.

I'm afraid I can't comment on the NHS as I'm not in the UK and am with a private obstetrician but it's not been an issue at all.

You are choosing to pay for intervention, the OP is not paying but is considering asking the NHS to fund an ELCS, so different discussion.

Not really a different discussion BuskersDog, the OP asked if anyone else had chosen an ELCS and whether they were pleased with their choice, so I have relayed my experience as it is relevant to that part of the post.

Who elected you the thread police?

I think a long discussion with your midwife/obs and possibly counselling. I had a very traumatic first labour and a very long recovery (over 6 weeks) and this was a vaginal birth but then for all the negative stories you hear, some woman have absolutely wonderful vaginal births which are completely textbook and the same can be said about c sections. Generally I noticed during my time working at the hospital elcs seemed to have more of a positive feedback than emcs. You'll hear plenty of negative stories about infected wounds, not being able to walk for weeks and again you'll hear about the women who had a c section and gush about how great it was and they were up and about as normal within a week. It's important to balance out that both births can go either way really and a c section isn't always the easy alternative.

Having said that, after my first labour I couldn't overcome the anxiety and I am having a c section 29th of august this year. The first thing I am noticing is I am not worrying anymore about going into labour and feel relaxed and a bit more "in control" if you see what i mean having a date. With my first DS I did expect some discomfort but because the birth was so bad it was so much worse than I thought and I hadn't prepared myself. With this I know it's surgery, I've planned well in advance help, DP has lots of time off work, I've stocked up well on things etc.

Whatever you decide don't make anyone feel bad about your choice, it's your body, you do what is best for you and your baby. :)

I just wondered if anyone has done this too and were pleased with their choice/didn't find too much resistence from NHS

Fair enough you are happy with your choice so far, but it not being an issue is far more likely if you are stumping up a few grand to pay for it. The OP also asked about meeting resistance from the NHS, cost is a consideration for the NHS, not just the balance of medical need/risk.

Which is why I addressed that part of he question in the last sentence of my 2 paragraph post. Thanks for the pointers on NHS priorities though.

Funny, I always thought, given the revised NICE guidelines, that maternal choice was quite an important factor as well.

Not chosen in the end as ds was breach but had considered it for similar reasons - years of infertility - mc-stats so bad wasn't even eligible for Nhs ivf. So v anxious about baby making it as ' only' chance. As I was over 40 was referred to a consultant anyway who basically was so amazed I'd got pregnant he was were getting this baby out safely whatever
Ask to speak to someone explain the situation.
The consultant and I basically agreed that on a certain day v close to due date I would be induced ( depending how that proceeded at any point I would be able to opt for cs. This was all on Nhs too.
My experience and belief - natural birth is better for baby BUT because of the small small risk of birth complications cord accidents, placenta failings at end of pregnancy etc cs is the minorly safer way of getting baby out
After cs was fine healed quicker than people with tears etc
But elcs I think caused huge breast feeding issues.
But I have a safe miracle baby!

TheBuskersDog Sat 16-Aug-14 09:54:51
You are choosing to pay for intervention, the OP is not paying but is considering asking the NHS to fund an ELCS, so different discussion.

You might want to read the NICE guidelines and their assessment of the cost effectiveness of an ELCS then.

Its actually value for money, especially if you consider possible costs for women with additional mental health needs....

Mental health is health and a medical reason.

You can't always just have some CBT and be cured and able to have a normal pregnancy. Or indeed life. Some are lucky and can, some have more persistent cases. Clinical anxiety isn't just an off day.

It is entirely reasonable to have treatments on the NHS related to anxiety.
Whether of course those treatments will throw up other physical issues that are worse than the anxiety (e.g. slow recovery from surgery ) should be seriously considered. But not that there is no reason.

My CBT andplanned MLU birth are probably quite costly to the NHS ... But people are very pleased. Sadly I think its because it makes me more "normal" and less awkward (as my can be) so they make pretend I'm saving the NHS money. Probably not in the long run, I put my hands up and say I pay my taxes so I demanded the healthcare that worked for me. End of story. In my case, NHS approval for MLU reminds me I'm physically "normal" in combination with my CBT. I'm fully aware I might end up on the ward - and very grateful the NHS has such facilities in my area. But if I had different triggers an elc might have been suggested.

Hello Gennz
I'm pleased it's all working out for you.
There is no easy way to give birth & for some the risks of Elective CS are more acceptable than the uncertainty of VB.
If you are under 35 & have a healthy BMI the risks are quite minimal anyway.

Too right squizita.

My consultation went to lengths to point out that while I had made a request, he deemed my request to be clinical need due to the severity of my anxiety.

Yeh I had one. Subsequently had to have another operation then got an infection and in total was inhospital for a month. Was attached to a machine for 2 weeks of that. When hot home district nurse came every day for a couple months. None of that put me off sections but it was an ordeal. Its not an easy option