Elective c-section vs VBAC - meeting with consultant midwife

[Collienova]

I've got a meeting with consultant midwife on Monday to discuss birth options. Just as a preemptive statement - I already decided I want another c-section instead of VBAC. However, the hospital is VBAC focused and I will have to jump through all kinds of hoops to get this agreed (meetings, workshops etc).

How do I cut through the red tape as I think it would be a waste of everyone's time? I have done my research and have not made this decision lightly. Has anyone got any tips on how to best get that across? TIA

I am wondering if you are at the same hospital I was as I had the consultant midwife and various hoops also.

Insist on seeing a consultant. They are the only ones that can sign off a c section.

I printed the RCOG research on vbac and repeat c section and highlighted why I thought cs was lower risk in my situation.

There were a lot of other things too. Vbac course. Seeing a psychologist. Getting 2 consultants to say yes.
Be adamant at every stage. Take someone with you if you can and it helps you.

All the best

This is the guidance. If you say you've read it. Understand risks etc.
www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg45/

Thanks AbbeyRoad! That's exactly what I thought - I've read all the guidance and I'm pretty confident I've got a strong case. I just loathe having to do the course, see the psychologist etc as it won't achieve anything... I do understand why they do it; I just hope they have enough flexibility to adjust the process if I make a good case. They have to agree eventually anyway as far as I understand!

Yes I got great advice here on mumsnet. There's a thread of me losing my shit about it on here somewhere!
General consensus was they do give in eventually. It's tough when you're pregnant and wanting reassurance and it sorted though.
Seems to massively vary by NHS trust as well.

I'm pretty shocked to hear you have to go on a course and see a psychologist That is often the case for women wanting an elective caesarean for their first baby for no medical reason, because really this option is for women with tocophobia. It's a bit more understandable if those interventions can actually help women deal with a phobia rather than pander to it.

But for VBAC? Ridiculous. Caesarean is a perfectly reasonable option and, depending on the circumstances, previous vaginal births etc, one I'd choose myself. I would absolutely ask to see a consultant and tell them you know the risks and benefits and don't wish to jump through hoops.

Put your desire in writing and hand it to the midwife (and copy to consultant). Be very clear on your choice, and state that a VBAC and its consequences will be a result of their choice NOT YOURS.

I have had three sections. First one emergency/crash. Next two elective. No regrets.

I totally agree DoctorMonty! I think these options can be very useful for mums to be that are unsure which option would be best, but a waste of resources in my case for example.

Everything @DoctorMonty said. I'm horrified at the psychologist in particular. What happened to respecting women's autonomy and choice? What if you refuse? Repeat section is a perfectly valid and often safer choice. What a horrific waste of resources to insist on psychologist for women with obstetric needs. Disgusting.

I'm in the same position - hospital pushing VBAC whilst I know ELCS is far lower risk for me (why would I take the 19% chance of an anal tear with a VBAC?!)

One of the papers listed as a reference on the ELCS 'information' sheet (basically a list of risks) is titled along the lines of 'why maternal choice shouldn't be a factor'. I'll try and find a link. It's making me very very worried

An update! The meeting with the consultant midwife was not what I expected! She was definitely extremely pro-VBAC, but couldn't really argue with the facts in my case. A few tense moments where she didn't seem to agree with/like our risk assessment as it was different to hers. However, had the call today that my c-section is booked it! Thanks for all the support! Now I just need to make I don't go into labour before then!

Great news OP