Help! Obstetrician says no to elective c-section at Bournemouth

[Kirstnz]

Can anyone help me please?! This is my 3rd baby and I have decided after my last 2 vaginal birth experiences that a c-section is right for me (I know the risks involved) but at my first appointment with the obstetrician at Bournemouth last week I was told absolutely not! I am devastated! I have since read the NICE guidelines so now I know I can ask them to refer me to an obstetrician that will carry out this procedure but does anyone have any further advice or even know exactly what the Bournemouth/Pooles Trust policy is on elective c-sections? I am being seen by an obstetrician as high risk (over 40 etc) - any help and advice gratefully received!

I don't know what happened to you but I had an emergency section with my first, and it was the worst thing that ever happened to me. I felt like I'd been crippled

I'm no expert but does it not depend on your reasons for wanting a c section?

Why do you think it's right for you? After two vaginal births what are you concerns? Usually you need have to have had to have a very traumatic birth before

I'm sorry you are going through this. I would write to your hospital's PALs department and set out all of your concerns. Then ask to be transferred to another consultant who will agree an ELCS. NICE guidelines seem to be taken as guidance by some hospitals and rules by others.

I would also recommend taking somebody else in with you to the appointment with your consultant and get them to fight your corner for you. Good luck and I hope you get your section.

OP didn't come on here to be questioned about her decision, she wants to know policies and rights.

I don't know about your area specifically, but in cases of requested csection, nice guidelines say while advice and counseling should be first offered (if anxiety related for example), if the mother is still requesting a csection, then maternal request should be the final deciding factor. I've heard stories of consultants trying to put women off or schedule it as late as possible, but you still have a right to a csection.

I would request a different consultant if I were you. Have your reasons clearly written down, and bring back up research if possible. Shows them you've thought it through.

I've got my birth options app next week after an emcs with my first. Csection recovery is hard, and I wouldn't recommend it, but I'll still be opting for a elcs. So I understand if you feel it's best for you. Good luck!

The charity birthrights are looking at this issue, and have some good guidance on their website.

It's not quite as easy to say the OP has a right to an el lscs. Nice guidelines say what they say but they are guidelines. They are not law, the NHS do not have to abide by them. And not all hospitals do. Some hospitals have local guidelines which differ.

The OP has a right to transfer care to another hospital if no consultant at first hospital will agree. Her best bet is to ring and ask to speak to the head of midwifery on Tuesday morning. Remember there are no Supervisors of Midwives anymore so I would go straight to the top.

I went through similar with my second pregnancy but at a different hospital. They had a natural birth policy and said the NICE guidelines were just that - guidelines not rules.

How far along are you? Mine was signed off very late into the pregnancy and past the gestation I'd had DC1 so all very stressful but they did give in eventually.
Stick to your reasons and do not waver. They might want you to see a psychologist and other things (vbac course in my case).
I also printed the research off the RCOG website to show I'd understood the risks involved.
All the best.

Possom is correct, they are only guidelines so you don't have a right to a cs, it's a matter of persuading them and is very variable due to area. Yes you can ask to be transferred to a different obstetrician but they can also say no, you can transfer to a different hospital and they can also say no. So while they say if a particular obstetrician won't agree they must refer you to one who will, this process can go on and on until you're out of time. If you have anxieties due to previous traumatic births they should take this much more seriously- mental health reasons are considered medical grounds for cs by most trusts- you may have to go through counselling etc first. If you have a supportive gp it is worth talking to them as they can also write to your consultant to recommend a cs and support your reasons.

Thank you all so much for your input, experience and advice, it's given me a much clearer picture of what I can do to try and get this elective section. Will keep you posted incase this thread can be of use to other Mums in the same predicament.

I can't really help as my consultant was happy to oblige my request after a traumatic vb last time.

I hope it works out.

For what it's worth, ELC recovery was a total doddle in comparison to my vb recovery! So don't assume the OP will have a worse time. It really depends what you are comparing it against.

Bournemouth won't do a c-section as they're a midwife led unit, I have my DS in Poole

I really hope you get your ELCS, good luck Kirst! I'm a bit miffed by people questioning your decision and getting confused between an emergency and and an elective CS. I think each hospital has a different policy, but you're right to take things further.

I had a terrible first labour resulting in an emergency CS and I've been very clear with the hospital (Kingston, SW London) that I'd like an elective section with my second. The consultant has told me that it's absolutely my decision and my body and so I'll be booked in at 39 weeks for one. Four people in my NCT are currently pregnant and three of us will be having an elective at the same hospital after terrible first labour experiences.

Just to add, the CS part of my first labour was the best part of it. I'm only a sample of one but recovery was quick and relatively easy.

I had an emergency section with my first and was in favour of having an elective with my second but when I got booked in the midwife basically told me that wasn't likely to be granted as no reason to say I wouldn't be able to have baby by vbac..... I was basically persuaded to vbac and remember her sayinb ' well we have to treat you as if you are going for a vaginal birth' I requested an app to talk about it and didn't get it till much later - subsequently I ended up with a horrendous vbac, emergency forceps delivery which left me in way worse state than my Emcs. C section recovery was like a spa day in comparison and I'm annoyed at myself for allowing my decision to change and ignoring my gut which was to have an elective section! Stand your ground and go with ur gut about what's best for you..... and don't stress about section recovery but buy big ( high) pants! Good luck 😉

Im sorry but i dont understand why anyone would want a cs??? i had an emcs and recovery was horrendous, plus if youve had 2 vaginal births before what is the reason you would want one? Really curious

I'd push back and give your reasons and ask for a second hospital if possible. At 40 years old you should really deliver before or by 40 weeks as there is more risk of still born - don't fret it's small !! My consultant said she wouldn't insist at 40 weeks but if I was a couple of years older she would insist!

I had a section with both as they didn't engage so induction futile

mamma there are lots of reasons why some women want a CS, e.g., they feel more in control with a CS, they've suffered physical and/or psychological damage during a VB which makes a CS feel like the better option, etc. In my case I've looked at the risks in relation to my personal circumstances and a second CS is by far the safest option for me. Under no circumstances will I attempt a VB, but that doesn't mean I can't understand why other women want them

Bournemouth is only a midwife unit these days, you'll need to go to Poole I think?

They may very well be a busy time ? When i had my section I was put in late (I was meant to have it at 37 weeks because of complications but couldn't have it until I was 39+6) because they couldn't fit me in and they could only have five (or three can't remember) a day booked in. I was also told they may send you home on the day if they don't have space for you. Your due date may well be a busy time and you're not considered high enough risk?
You always have the right to speak to someone else though, did you manage to explain why?

You can't compare an emergency CS to an elective!

mamma firstly, emcs and electives are two different animals. Secondly, some women, such as myself have absolutely horrific recoveries from vaginal births - I have the kangaroo flap people with sections talk about, I have a loss of sensation down my left side and I'm doubly incontinent, something which is only getting back to normal 18 months on, and I'll never get full sensation or bladder control back. Sex is agony and my body is fucked. I'll never have another child (partially as I can't do the required act to get pregnant, but also due to the possibility of permanent incontinence, further loss of feeling and my PTSD). If I found myself miraculously accidentally pregnant and couldn't persuade DH to agree to an abortion I'd be begging for a section.

I think you can ask to see a different obstetrician- you may have more luck.

I went to the vbac clinic the other day to discuss options and was really shocked that they weren't remotely resistant to me having another section despite the fact that, although I think I have very good personal reasons for wanting one, there isn't a real medical need.

It's a shame it's so inconsistent - you really should have a right to make a choice.

I had an EMCS with my first and now have an agreed date for an ELCS with my second (5 years on). It's tough to hear, but the other posters are right - do not have the right to a csection. However, you do have the right to explain your reasons and to keep looking for an obstetrician who will agree, or another hospital who will agree.
I saw the consultant midwife at Princess Anne hospital in Southampton. They have a VBAC policy, but both my husband and I focused on the facts and statistics in the NICE and RCOG guidelines as well as my medical risk factors. If you can make a strong medical case, you've got a better chance. Hope that helps and good luck!

Perhaps people could take their failure to understand why people would want a CS to another thread? Since OP didn't ask for your opinions, let alone your incredulity, there's no reason to offer either. In particular when she's talking about an ELCS and you've only had an EMCS!

(fwiw I've had a VB and a Cat 1 EMCS OP and I get it, so it's possible to have had the roughest of sections and still see why someone might want a section. But even if I didn't, your wishes would still be valid).

Practicalities- how far along are you? Have you had any discussion with the supervisor of midwives if there is one, PALS? Put anything in writing? Most MNers who kick up enough of a fuss seem to manage to get an ELCS, especially if they've one or more risk factors.