Requesting an ELCS

[MrsN1984]

Hi
My Papp-a results were lower than average & I'm having regular check ups & growth scans. At my last consultant appointment, I was told that I will more than likely be induced. I've had a terrible pregnancy so far with a few other issues.
After lots of reading & discussions, I 100% do not want to be induced & no foreceps to be used.
I also have IBS. I am terrified of tearing & ending up incontient.
I am seeing my consultant tomorrow & I'm worried I will have to fight to have an ELCS. Surely this is a far better route than a possible scenario of a failed induction & EMCS? I understand an CS will not be a walk in the park but recovery from a vaginal birth can be traumatic too. Am I going to be listened to?

I'd like advice on getting my point across to the consultant, not the pros and cons of CS. Thank you x

Look up nice guidelines on c section and go armed with that information. Show that you've read up and its something you are certain is best for you in your individual circumstances and that you understand things like a longer recovery.

Try not to worry.you might not have to fight. With all the facts to hand as the previous post says you should be able to fight your corner. I was in your situation and had 2 consultants with different opinions so I ended up compromising by booking an elcs as close to my due date as possible. They ended up doing an emcs when I went in for my pre-op assessment.

One of the consultants told me damage was inevitable with a natural birth in my case but still tried to talk me out of it. When I saw him afterwards I really wanted to tell I was right. Trust your instincts op.

Good luck!

Thank you both I've geared myself up for a fight just in case lol. Have read the NICE guidelines and a few other things, written down my points and feel like I am making the right decision x

Don't assume you will have to fight. However, if the consultant you speak to refuses a c-sec ask him / her to refer you to another consultant.

I'm hoping not to have to fight but want to be prepared seeing her tomorrow. Fingers crossed!

Just convincing them you understand the procedure etc should be half the battle. The consultant that was trying to get me to go naturally had come from a hospital where he felt too much intervention was used so he just had a bit of a bee in his bonnet about it. I'm sure at first he thought that my opinion of a cs was that it was the easy option.

I did have complications with it and even though it was emcs in the end I don't have any regrets.

You might find arguments to support your case in this book
www.amazon.co.uk/Choosing-Cesarean-Natural-Birth-Plan/dp/1616145110
DecaffTastesWeird suggests getting another consultant's opinion in case of refusal. I think it's a very good advice.

How did you get on?

Ha, I love how I was all ready for battle, came to the room and my consultant just opening my notes and says: Okay, let's book you in for cesarean. And I'm like:
And I didn't really have massive reasons to not try VBAC. I had mild birth trauma which was mainly caused by not having anyone with me in the hospital. So yeah, wasn't much of a fight.

I think you were lucky, I am having to fight!

Saw first junior consultant who said she couldn't recommend a c sec for me as I was low risk and should go for a vb. The reasons I want a section are for MH reasons though as I have had extreme anxiety and panic attacks all through pregnancy, probably a result of having to go through fertility treatment and fearing that I might never be a mum. Just want this baby out as quickly and safely as possible even if it will take me longer to recover.

Next appt on Friday with senior consultant and I guess I will have to put my foot down then, just don't need this extra stress and feeling like I have to justify my decision to a million people.

I am really surprised that anyone has to push - I had an appointment at which the consultant pretty much said, your options are VBAC or ELCS, we suggest that you try a VBAC but its up to you, and I said no thanks, I will have the ELCS, they said ok and booked me in for an ELCS at that appointment. They said that they thought that was a reasonable decision for me to make and that "it is all about patient choice".
At the end of the day it is your choice, so just say that you are aware of the risks and benefits of both options (assuming you are aware - if not you better do some reading to make sure you are happy with your choice) but you have decided you would like a csection, end of discussion. they might make it seem difficult but if you stand your ground they can't actually make you vbac - its up to you at the end of the day.

Thanks Muffin, that gives me hope. She implied last time that if I still wanted a section I would have to see a different consultant as she and the senior consultant didn't support it.

I guess I will have to show them that it is truly what I want despite the risks (that I am fully aware of) and if I need to take further action to get it I will...

Put a lot of your requests/reasons in writing. Harder to ignore blatant evidence and sincere begging. Too much to bear for them if something subsequently went wrong due to their refusal.

Good luck. The consultant I saw was honest enough to admit that the overall VBAC "success" rates for their hospital didn't correlate with my own likelihood of success because of my own circumstances- previous very big baby, this baby also measuring 3 weeks ahead, and I didn't dilate at all last time.
She also agreed that 65% of the women in my hospital have a successful VBAC - all that means is that the baby comes out of the vagina and not the sunroof! Of that 65% there will be a significant proportion who had forceps/ventouse/serious tearing etc, and who probably wish they had had an ELCS even though they are classed as part of the success story of VBACS.
Obviously if the choice is ELCS or straightforward uncomplicated vaginal delivery with no damage to you or DC then I think most people would choose vaginal delivery, but that is not the choice - if you go for a VBAC it is very difficult to predict what will happen.

Update: so, my consultant said no and is referring me to another one.
She was adamant that vaginal are much safer than a C section & came across very patronising

What is the consultant doing to address your fears if she is refusing your request? Its all very well saying no, but she's not addressing why you are asking and giving you reassurance that you need to feel happy with which is actually the most important thing here, not how you eventually give birth. By referring you to another consultant and just saying no, without any other support she just washed her hands of you whilst creating more stress and anxiety.

Basically she's spectacularly missing the point and giving you poor care.

Just wanted to offer my sympathies and support. I was told I was being a 'poor mother' to consider ELCS, and the Consultant was so patronising and nasty I left in floods of tears. Now at a different hospital and complaining about my previous experience.

Just kept telling me about the risks then looked at me blankly when I said there are plenty of risks with a vaginal delivery too!
Told me to go away & think about it , even though I went fully prepared, and then see what the next consultant says.

Update : after numerous appointments , sleepless nights and anxiety , I have finally had an ELCS signed off and booked in