Elective Csection

[FrostyPopThePenguinLord]

Hi all,
Fairly new to this posting business but have been lurking for a while so please excuse me if I make any horrendous whoopsies or offend anyone, I can assure you it's not intentional.
Fiancé and I are in the process of trying to get me knocked up, so I thought it was high time I asked others about their experiences.
In the bluntest possible terms I do not want to give birth naturally, it's not a case of 'too posh to push' (good grief I hate that expression), but equally I would not say I'm deeply anxious about childbirth as a process or have huge fears over it to feel that I need psychological help.
However my decision to procreate has largely depended on wether I would be allowed an elective section or not, I've even emailed the maternity department at my local hospital to ask their stance on maternal requests.
My conclusion has been reached by what I hope is my (as far as possible) rational evaluation of the pros and cons of each method of delivery and my overall feelings.
Without going into the nitty gritty of stats and source material etc, which I have looked at fairly extensively, my overwhelming feeling is that I would much rather be cut open under controlled circumstances with highly trained medical professionals in the actual room they could save my life in if it all went tits up, whilst already being numb below the waist!
I know it doesn't always progress smoothly like that and there is always the possibility of complications, but so does vaginal birth and if asked to choose between the two sets of circumstances where I might be in danger I would much rather be already in there and ready to go.
The complications I've heard of with vaginal birth fill me with horror and quite frankly make me want to join a convent.
I've been quite careful to look at a balance of positive and negative experiences on both sides, but I have read things and heard things (I'm at that ages where all my friends are having babies) that sound pretty shit if I'm honest.
Episiotomy...my mum said she didn't even notice them cutting her with me.....I never want to be in so much pain that I can't feel my whatsit being cut with no local....nope not going to happen...
same goes for tearing...id rather a million people gave me shit for being 'too posh to push' than facing even the possibility that I could rip from stem to stern....that sounds like a nightmare.
Forceps...no...just no.
And after all that effort like 1 in 4 women to be told I might need a section anyway....sod that.
Why would I want to push my body and my baby to the point where they have to potentially operate so fast I can't even be conscious because we are in so much danger, I'd rather already be in there.
My mum tells me there is no need to be quite so aggressive about what I want and I'll only get people's backs up. I genuinely don't want to be pushy and awful about it but from what I've read over several years now it seems to be a massive battle from start to finish to get what I deem to be a perfectly valid choice which I have reasoned through in a balanced and adult manner, not a last minute panic.
The majority I've read seem to either think you need to be phobic in some way, have had awful previous experiences or medical reasons.
Medical science has come such a way that I think that c section should be as valid a choice as a water birth or home birth (sorry guys you lost me there, you want to be miles away from the big clean building with the people who save lives and the medicine that makes it not hurt??).
I can't understand why there has to seemingly be something wrong with me in order to justify a choice I want to make about my medical care.
Also all the judgement is completely insane, I have nothing but respect for people who can give birth totally naturally with no pain relief etc....One of my best friends did with both her babies and they were huge and she had a wonderful experience, another friend had 52 hours of labour and forceps as well as more stitches than she wanted to think about, my mother gives birth as easily as a dairy cow and loves being pregnant.... I think you are totally nuts and incredibly brave, those things are not mutually exclusive!! But I would never look down on them or belittle them for their choice in childbirth just because they don't fit my worldview.
I would love to hear from people who had a truly elective section with no medical need and their reasons if they don't mind sharing, I know I'm not alone but it seems to be quite difficult to find people who have decided it is the best choice for them, not because they have had previous trauma or medical issues but just for the simple fact that they think traditional birth is not for them for whatever reason
Thanks guys
X

[totallyrandom]

I second what hazeyjane has said.
I have had 3 vaginal births, 1 completely natural, 1 induced, 1 waters broken and had "only" gas and air as pain relief in all 3. I did have stitches for first or second degree tears with all 3 which healed quickly. I then had a c-section for malpositioning (breech). I found the c-section more painful than any of my vaginal births. I would choose the pain of vaginal birth over 3 days of post abdominal surgery pain any day! Our bodies are meant to deliver naturally in most circumstances and most people do recover quickly. The risks in a c-section are actually much higher for the mother (or so I was told by the doctor) and about equal for the baby.

Like hazeyjane, I went into a c-section quite uninformed and was shocked by not being able to move/turn/get in and out of bed. I had an uncomplicated c-section and any doctor would tell you I recovered very well and after 2 weeks was able to do most things.
I realised afterwards that I had some underlying false presumptions about c-sections such as 1) the NHS doesn't want to allow elective c-sections due to cost cutting- actually most doctors want what is best for their patients which includes the mother so will typically advise a natural delivery 2) most midwives are a bit hippy so want you to try natural first - again, the medical evidence and research shows that in most circumstances natural is better for mother and baby 3) many celebrities are having c-sections so it can't be that bad/might be the better option - still not sure why that is the case, but perhaps to do with age of many celebrities.

Having said all of the above, I believe in a mother's choice so if that really is what you want, go for it (as long as you do your research carefully, including impact on future pregnancies such as risk of attachment to old c-section scar, low lying placenta etc).

[Cuppaqueen]

The NICE guidelines are definitely worth a read in full, and include a comparison of the risks of planned VB versus planned C-section for women without previous CS. See Appendix C - www.nice.org.uk/guidance/cg132/chapter/Appendix-C-Planned-CS-compared-with-planned-vaginal-birth

It's not right to say one is more risky than the other: the risks are different and vary with each person. With CS you have a lower risk of injury to vagina and perineum, obviously, and of pp haemorrhage, but slightly higher risk of any haemorrhage being so severe as to lead to hysterectomy. You also 'risk' a longer hospital stay, although I personally think that's a benefit so you and baby can be monitored. With VB, you have a 1 in 4 chance of EMCS which carries the most risk of all. With CS, main risk for the baby is slightly higher chance of NICU admission but set against that, no chance of the cord being round the neck/ getting stuck and distressed etc.

In addition, research suggests the older you are, the more chance of intervention (induction/ epidural/ forceps etc) and therefore of painful complications. In my opinion, if you've read and understand the risks, you should be able to make an informed choice and most NHS trusts will facilitate that. Saying it costs more money is a generalisation: planned CS costs less than emergency CS, and in any case since when are we saying access to NHS facilities is purely about cost? That risks going down the 'you smoke/drink therefore cost the NHS more and shouldn't have this operation' route. Women shouldn't have to endure the pain and potential trauma of vaginal birth unless they want to. It's 2017 FGS.

I am having a planned CS for my first baby, OP, for many of the same reasons as you. I feel based on my age, size of babies in my/ DH family, and my attitude to risk and pain, that it is the best choice for me and our son. Luckily I am abroad so no fighting the NHS but if I were here, I would be the most determined advocate of maternal right to choose you can find. You go for it, OP!

(And those ladies who want a vaginal birth, hey, no judgment here. Each to their own.)

[Blueskyrain]

I'm having a planned CS for very similar reasons to yours.
With me, I have a lot of anxiety and fear around pregnancy, so they are fine with it from a MH perspective, rather than it being just because I have a preference, but the guidance does say that it is up to you which method you go for. If you want a CS, then you need to say this at the beggining, and may have to jump through a few hoops, but I believe that you should get it in the end.

Should is about as good as you are going to get though. You could go into labour suddenly and not have time for a CS, there could be other reasons why you can't have one last minute, or you could find the NHS stamps its feet.

I'd say you'd need to accept that there is the possiblity it wouldn't happen - even if you went private.

[Soontobenewmummy]

Hi OP, sorry in advance for long post!I'm 6 days post a complex emergency c section.

You've obviously done lots of research. But I thought I'd offer my thoughts on what the experience meant for my baby.

My baby had a huge amount of mucous in her body which didn't get cleared out like it would if she had come vaginally. It meant she needed help to get breathing which was terrifying to hear listening as I lay on the operating table. (Just because it's performed as an emergency doesn't necessarily mean you get put to sleep - I didn't).

She was traumatised by the delivery and wouldn't latch for 3 days . The SCBU doctors gave her formula at about 14 hours without my knowledge as I was separated from her as they removed the bakri balloon, catheter and drain from my body. I lost 2.8l of blood and needed a transfusion immediately after surgery - I didn't get to hold my baby for around 3 hours and I'm confident this is one reason she struggled to latch.

Because she struggled to feed they decided to put her on antibiotics just in case it was a sign of infection - this meant nine attempts to get a cannula in her little body and the antibiotics made her very sleepy, making it harder again to establish feeding. Watching her in SCBU intubated and with her cannula in was very hard even though she was only in a few hours.

She failed her first two hearing tests, almost certainly because of the method of delivery and that added to the stress and worry of the difficult first few days. I found being in hospital for 4 days extremely stressful, despite the fantastic midwives.

Ultimately my baby would not have arrived naturally as she engaged in the wrong position. The NHS team were incredible . But this is not the start to life I would have hoped for my baby. If you'd told me at the start that it would have ended in a section, I would still have gone through the long induction process and 13 hour active labour if there was even a small chance I could have delivered naturally.

Sorry for the essay - it's all still very raw for me but I hope my experience can be useful in some way. All the very best in whatever way forward you decide is right for you.

[welshweasel]

An emergency and elective section are two completely different beasts. I'm sorry you had a rough time but I don't think it's particularly useful to compare the two situations.

[habibihabibi]

I elected CS for both of my deliveries .
Like you OP I wouldn't have had any children if I'd had to give birth naturally .
We paid though, I wouldn't have expect the NHS to have funded my operations which essentially not necessary.
It doesn't have to cost an extortionate amount if you only go privately a few consultations in the last trimester and for the delivery .

[TurquoiseDress]

Hi OP

I can completely relate to some of the things that you wrote in your first post. For me, I had my first child via ELCS and got it for maternal request.
There was no medical indication for me to need an ELCS.
For as long as I could remember, I always felt that a CS would be the right thing for me.

I was surprised at how fairly quick and easy the process was (at a London teaching hospital) and I had gone into it expecting to have to battle for what I wanted. I was 36 weeks by the time I met with the first consultant- after talking through my reasons etc, the diary was opened and I was booked in for 39 weeks.

Then I had to see a second consultant, more as a formality. Also, I had to agree to been seen by a consultant psychiatrist- they seemed slightly apologetic when they told me this, perhaps expecting me to question it/not be happy about it. But I just wanted to sort out the ELCS.

Meeting with the psychiatrist was about 10mins, they asked about family/friends' birth experiences, risks/benefits to CS and that was about it. Such a relief when it was all signed off.

Had an ELCS at 39 weeks, all went well & we were home less than 48 hours earlier. It was the right birth for me and my baby.
Never had to justify my decision to anyone else as I never told anyone else (apart from husband), just told people I'd had a CS due to breech baby. They mostly just looked at me with sympathy.

You need to do whatever feels right for you and your baby, after all you will be the one who has to live with whatever consequences may arise after the birth.

I had no regrets.
Good luck with everything.

[hazeyjane]

An emergency and elective section are two completely different beasts. I'm sorry you had a rough time but I don't think it's particularly useful to compare the two situations.

With regards to an emergency section v elective section, and breathing difficulties - actually an elective has risks of breathing difficulties due to the fact that a) the baby is born slightly earlier than term, and b) that the baby has not benefitted from labour starting. Obviously the added element of a baby not having been squeezed through vaginal birth, thus helping the lung clearing procedure, is the same in both electives and emergency.

My ds was an elective, and yet was born grunting unable to breathe properly or suckle, and spent 2 days in NICU and a further 6 in SCBU, on cpap, being tube fed. This was, in part, due to the nature of his delivery.