c section

[kelslakeishax]

So i had my 16 week midwife appointment today and i brought up the subject of having an elective c section and when i was able to book an appointment to see a consultant she said this wouldn't be further discussed until 36weeks. I think this is wrong however.

I have a genuine anxiety about child birth and I think my pelvic area is too small for childbirth.

So here are some questions i have for mums who have had this done before or an opting for one now!

-What week did you have an appointment to discuss a c section?

-How easy was it to get one?

-Did it all go to plan?

-Can you get one on non medical grounds?

Most women have anxiety about giving birth tbh. . But major surgery isn't an easier option than letting your fanjo do what it was designed to do!! (as someone who has had both deliveries-one an emcs at 35 weeks!)

I had an EMCS first time and have requested an ELCS this time.

My first consultant appointment was at 13 weeks and we discussed it, but my consultant is pro-VBAC. We're meeting again at 30 weeks. I have discussed this with my midwife and if the consultant doesn't agree I will move to a different consultant.

You can request an ELCS and if the consultant doesn't agree they should move you to one who will. The relevant guidance is here:

www.nice.org.uk/guidance/cg132/chapter/1-Guidance

36 weeks sounds very late in the day to begin discussions so I would request a referral at your next midwife appointment. At the very least your consultant may be able to help with your fears.

Both VB and CS carry risk, do your research and weigh up the risks to help your decision-making. Which? also provide a breakdown of births in each hospital so you could look up your hospital and see what percentage were VB or CS, what percentage had interventions, etc.

Birth is very personal, very emotive, and everyone has an opinion based on their own experience or other belief. According to the clinical guidance though, this is your decision.

Can I ask you what reason you gave for an ELCS? Because at the moment my only reasons are my size and anxiety about childbirth but I'm being told those reasons are not good enough x

My reason is previous CS.

If you look through the guidance though, you do not need to give a medical reason. Maternal choice is supposed to be enough. It is worth noting that extreme fear of birth is known as tokophobia and I know of women who have been granted ELCS on these grounds. However, trusts are trying to bring down CS rates which is often what causes resistance to ELCS requests.

Get your stats together, familiarise yourself with the guidance and if you continue to meet resistance contact the supervisor of midwives for assistance.

The relevant paragraphs are:

1.2.9.5 For women requesting a CS, if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS. [new 2011]

1.2.9.6 An obstetrician unwilling to perform a CS should refer the woman to an obstetrician who will carry out the CS. [new 2011]

so when they as me for a reason I can say I have anxiety 'tokophobia' without another medical reason? I'm just really worried they will reject me based on this claim x

What week did you have an appointment to discuss a c section?
I declined a sweep and declined to be booked in for induction at 40 weeks. I had an appointment to discuss a section at 41+2

How easy was it to get one?
I declined sweep / induction again and they agreed to a section as I was already overdue.

Did it all go to plan?
Yep I had my section at 41+5

Can you get one on non medical grounds?
My only medical ground was being overdue, but that doesn't really count as I declined all the usual options.

Good luck

Sorry kels, I'm not suggesting you say you have tokophobia, more that you ask for it to be looked into as you're clearly very anxious.

Also, your reason can be maternal choice because of anxiety and size. It sounds as though you need a midwife or consultant to talk constructively through your concerns and request rather than just dismiss you at the first ask.

They will almost certainly try and steer you towards a VB, hence my suggestion that you get stats together to show you've looked at risk properly.

This process is unfortunately stressful but if you know your ground, write a list if it helps because these discussions can leave you flustered, you are allowed to request this.

dugee hugs I have an appointment now on the 25th of this month and I will be 19weeks + at the hospital for another scan. Do you suggest I ask then for an appointment to discuss my options? because at my 16week appointment my midwife said I couldn't discuss it until 36weeks. Also shall I get a list prepared of my rights and worries to help back me up?

I have a consultant appt at 34 weeks to discuss, the midwife said that whilst I am high risk, it's only for the birth not the pregnancy, so there's no need to see the consultant before then. 6 weeks is still plenty of time to sort out if a c-section is decided upon.

I am not sure if I will request a c-section. I had a very complex forceps delivery resulting in a 3 litre haemorrhage and a difficult recovery including internal tearing. I also developed PND partially relating to this birth. However I know that there is no easy way to give birth and I'm not convinced a c-section is the right answer.

I would advise you to speak to your midwife about your anxiety rather than just push to see the consultant. I have been having flashbacks about the birth and have been referred to a specialist mental health midwife and she is great.

I just don't like my midwife giving me clearly wrong information when I should be entitled to discuss this with a consultant etc. Good luck for your birth!!!x

Perhaps ask to see the consultant for a pelvic exam and go from there. It's impossible to know the size of your pelvic outlet from the outside. A simple vaginal exam should hopefully put your mind at ease.

A pelvic exam won't help you know for sure if you can give birth vaginally.

I would request you see your midwife to discuss your anxiety about birth. Getting proper help will either make you feel better about a VB, or confirm it's not going to get better so you can sort out a csection. Either way, talking therapy needs to be arranged before 36 weeks so please ask your midwife about it. I rather hope the counseling helps because I know cs recovery isn't easy, but even if not, have options.

I'm going to request a csection due to a previous cs following a failed induction (massive baby!). I don't know what the timing will be as I've not yet had my booking in appointment, but I know my rights. If after advice and counseling I still want a cs, then that is what the NHS has to do. Good luck.