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Childbirth

Share experiences and get support around labour, birth and recovery.

Original poster

elective c section - how do I get myself first on the list?

37 replies

xenabelly · 13/01/2007 17:02

I'm booked in for an elective c'section on Monday morning (eek!! am dead nervous and dead excited and just counting the hours...)

Anyway, when I went for pre op on Friday, the midwife told me 3 women are booked in for an elective section at 9am on Monday (me being one of them). The midwife said that the surgeon just 'looks at the list and decides which order he's doing them in'. However, this means one of us will end up having baby in afternoon and I just can't bear the thought of sitting around all day on pins and an empty stomach waiting all that time.

Does anyone know how the surgeon will make a decision and any tips to get myself at top of list. Am going to arrive mega early just in case it does end up being first come, first served...

Thanks

OP posts:
tissy · 13/01/2007 17:36

Elective sections don't take that long.

I was first on the list (but I am a member of staff, don't know if that made any difference), was wheeled into theatre at 9 am, spinal sited and dd delivered at 9 20 am. Sewing up took another 20 mins or so. No more than an hour in total. They would have to clean the theatre, but would expect that all 3 of you would be done in the morning.

TBH, I wouldn't push it at all- priority will be decided on things like clinical need, expected difficulty of surgery/ anaesthetic, need for more than one paediatrician (twins or multiples).... you can't really influence it, so don't try.

If you turn up early and all your paperwork is completed, and you're ready to go, you stand a better chance than someone who rolls through the door with 5 mins to go, but only if all other things are equal.

DaisyMOO · 13/01/2007 17:42

It does depend on emergencies though tissy, so if you have a few unplanned cs the third elective cesarean could conceivably end up in the afternoon.

xenabelly, I really wouldn't try and push it. I guess saying you think you're having contractions might get you further up, but I suspect if they think you're trying it on you're more likely to end up last

Ladymuck · 13/01/2007 17:49

Emergencies will have a far greater impact ime. When ds2 was born by elective I was in for 8am, and ds2 was born at 7:15pm. They had a total of 9 c/s that day as well as some 3rd degree tear repairs.

I think that in our case the surgeon did the simplest first (I had to have a cervical stitch removed and ended up last of the 3 electives). They are more likely to prioritise you if you are close to due date though as there is a greater risk that you end up an emergency. I was only 39w, and the others were closer or even over 40w.

Original poster
xenabelly · 13/01/2007 18:11

ladymuck

thanks for replying - can I ask were you allowed to eat anything if you didn't have your op until 7pm?

I get really faint and sick if I don't eat breakfast and it's the having an empty stomach all day that's bothering me a bit (i'd be useless at fasting!)

OP posts:
tissy · 13/01/2007 18:42

but some places will have a separate theatre for emergencies, so they may not have any impact- there's no harm in asking the MW when you arrive!

If they know for certain that you will wait longer than 4 hours, then they will let you have at least a drink, but if someone else in front of you gets cancelled, and you're moved up the queue, then the drink may push you down the queue again!

Aloha · 13/01/2007 18:53

I hate this about the NHS...booking X number of people for the same appointment. I think it is appalling.

expatinscotland · 13/01/2007 18:55

Sorry, but that's the most ridiculous thing I've ever heard.

Do they book another three at 10AM?

tissy · 13/01/2007 19:04

aloha, you can't just book one person for a theatre list that lasts 3-4 hours, when each operation only takes an hour! And,if you booked each person at a different time, then if one of the earlier people is cancelled, the next wouldn't be ready, and a lot of time would be wasted.

Many places have separate lists for elective and emergency operations, to try and make the elctive lists more predictable, but in the places that don't have enough staff to run two theatres, the emergencies have to take priority, what's wrong with that?

tissy · 13/01/2007 19:05

no, expat, the three will be booked for a list that starts at 9 am. That will be all, but if there are emergencies (and there is no second theatre) the emergencies would be given priority.

Aloha · 13/01/2007 19:10

But they don't book like that because the theatre session is 2-4 hours. They book like that because we, the patients are mere cattle to be processed and it doesn't matter how long we wait, hungry and scared for an appointment there was never the remotest chance of being kept by the great god of a consultant. Yes, there will be another three at 10am and so on. The same happens with all appointments IME. I used to have to go regularly when I had problems with cysts on my ovaries. There were several booked for 9am, several for 9.30, several for 10am etc etc. The backlog was horrendous. Everyone waited for hours on hard chairs, even if you were ill or in pain. Yet if you tried to beat the system by arriving late (ie still an hour or so before you would have been seen) you would be penalised by being put at the bottom of the list, ensuring they got their four hour wait out of you. I tried complaining but obviously got nowhere.

Toothyboy · 13/01/2007 19:10

I went in at 8.30am for mine. Ds2 was delivered at 4.25pm. I had been in gown, canula in place (bleurgh) since about 1pm. There was a shift change due, so the morning shift didn't want to start, then they thought an emergency might need to go ahead of me. I was a nervous wreck by then - physically shaking. I was on the verge of walking out at about 3pm.

I know this doesn't help you Xenabelly, just wanted to share my experience. Maybe tell them straight away that you're really nervous and are desperate to get it over with! Good luck .

Aloha · 13/01/2007 19:13

I was told to arrive at (I think) 8am and had the operation at nearly 6pm. It was appalling.
Sorry Xenabelly, you may be lucky. YOu may well be picked out the hat first and with any luck there won't be any emergencies. YOu have an early appointment so hopefully you will be seen relatively early.

Toothyboy · 13/01/2007 19:16

Blimey Aloha - I thought my wait was long - I don't think I could have waited that long. Did they allow you to have anything to eat or drink? I assume, like me, you hadn't eaten since 8ish the previous evening?

Aloha · 13/01/2007 19:21

No, it was only the fact that I was so angry and anxious that kept my hunger at bay tbh. I was pretty desperate. When dh went to have lunch I had to make him go away as it was so miserable. They kept saying, no, don't have anything as it will be soon and being really unsympathetic and all round horrible, actually. Aaargh.

tissy · 13/01/2007 19:23

NO! Aloha! There won't be another three at 10 am! The system for operations is different to the system for clinic appointments. The three arriving at 9 am will be the three elective sections planned for that day. Yes, they will be given a lower priority if there are emergencies, but if you were the one with the emergency, you'd be pissed off if someone having an elective section went first. The NHS does not have enough staff to eliminate waiting altogether, and even in the private sector, all the aptients for a planned list will be asked to turn up at the start of the list, so that if there are changes to the order, the list still runs smoothly.

The only exception to this is in day surgery units, where there is a high through-put, and they need to clear beds before the next patients arrive.

Aloha · 13/01/2007 19:23

xenabelly - don't want to frighten you too much! The operation went brilliantly and wonderfully both times when I actually got in there! No pain, all gain!

Aloha · 13/01/2007 19:25

Sorry Tissy, I'm really sceptical. I cannot see how my 9am appointment turned into a 6pm appointment otherwise. The clinic appointments system is an utter disgrace throughout the NHS.

tissy · 13/01/2007 19:26

I was (obviously) very lucky on the day of my section; there were two of us planned, and no emergencies, but in the same theatre on a different day there might be 4 planned, two emergency sections and some tears to repair. It's the luck of the draw. In the private sector, there won't be so many emergencies (due to a lower volume of patients), but it could still happen.

iota · 13/01/2007 19:32

casting my mind back 5 yrs to my second so called elective, I was clearly told that I had to come in in the morning, but that I might have to wait all day depending on emergencies. I think I went in mid-morning

my first c-sectin was not planned, but was the result of a failed induction and was performed at 7.45pm on a Sunday - poor surgeons.
This was because I'd eaten a hearty lunch in the expectation of a natural, albeit induced birth

At the end of the day, I was glad to be safely delivered of a healthy baby

tissy · 13/01/2007 19:32

I think the problem is calling it an "appointment" ! In our department,people get told, " the plan is to do your operation this morning, but as we only have one emergency theatre available for the whole hospital, we can't guarantee the time. The doctors will get together shortly, and decide on priorities, and will let the ward know. If your op is DEFINITELY going to be more than 4 hours away, you will be given something to eat/ drink, but this could affect your place in the queue, if the order should change..." I sound like a cracked record some days!

Aloha · 13/01/2007 19:36

Well, I just got starved and snapped at my surly midwives. God, Kings is a cesspit really. Good surgeons but I wouldn't want any of the other staff to trim my hair let alone have any serious responsibility.

Toothyboy · 13/01/2007 19:39

I actually asked the midwife at the time the "appointment" was booked what time the section would take place and she said "Oh yes, 8.30".

Aloha · 13/01/2007 19:41

I'm in a really grumpy mood this evening...but really, don't get me started on the horrors of Kings' midwives...

spudballoo · 13/01/2007 19:41

Poor you, I'm booked for a private elective section at 11am, arriving at 9am. The hospital have 2 theatres for electives, and 2 for emergencies, with electives of course being bumped should more emergencies arise.

I know it's awful not being able to eat or drink, but equally I had to have a GA a few hours after my last birth and I'd had tea and toast. So as they were putting me under they had to press down VERY hard on my windpipe. Believe me, you don't want to eat something if there's even a remote chance that you might end up with a GA! It was the single most unpleasant and terrifying moment of my life, I can still remember the feeling of sheer terror even now...and of course it was the last thing I remember before going under. URgh.

I would just get there when you're asked, be nice, say you're very nervous and hope for the best.

Good Luck!

x

tissy · 13/01/2007 19:51

ah, well, aloha, that's London for you. Ayrshire MW are lovely!

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