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 agree that there is no point in questioning the decision to have an ELCS, but the reasons for it are very relevant. They massively influence how to approach getting a csection agreed (and how long this could take), so asking for said reasons is important if relevant advice is wanted. No judgement here, though, I've been there.

It's one thing to ask about reasoning, quite another to contribute nothing more than an anecdote about one's own recovery from a different type of CS!

How tediously predictable that people would pile into a thread like this and lambast the OP for wanting a C section.

At absolute best, such queries are tremendously naive. There are undoubted pros to a straightforward vaginal birth, but so too are there undoubted pros to an elective section. I come from a family of surgeons, one of whom has spent decades doing reconstructive work on the vaginas, rectums and pelvic floors of postnatal women and in all those decades, virtually none of his patients have been women who have had Caesarian sections.

If you're lucky, a vaginal birth can be an uncomplicated experience - even a wonderful one, for that matter. The difficulty is that a really very significant proportion of women are NOT lucky. Like, significant as in one can barely get away with describing it in medical literature as uncommon. And while who will be lucky and who not can be guessed at, it can never really be accurately ascertained in advance. I have dealt in a professional capacity with women who were relentlessly pressured during their pregnancies to pursue vaginal deliveries and are still physically paying the price 20 years down the line.

So please would people stop lecturing and sneering at women who would prefer to opt for a birth method that - whilst not eliminating all risk by any means - provides a more controlled situation with far fewer variables. We are not "designed" to be able to give birth vaginally with ease when doing so au naturelle prior to the development of modern medicine and obstetrics left VAST swathes of the female and infant population dead. Nature is not a sentient entity with a plan.

My friend had an EMCS and was shocked at an acquaintance getting an elective cs. My DS birth was vaginal, and traumatic and agonizing and awful. On paper it looks great - quick, baby fine, no major damage except an episiotomy and ventouse. But three weeks later I had a horrendous injury and genuinely thought I was disabled. I also suffer from urinary incontinence and have only started having sex again after 8 months, and even now it hurts.

OP, I'm sorry I can't help but am outraged on your behalf!

Very well said, Mouse! After my disaster of a vaginal birth (resulting in an EMCS) I can't wait for my ELCS for DC2.

Great post, Mouse!

Mama I had to have a C-section as I had placenta previa across my cervix and one of my twins was breech.

Because it was scheduled and I was not in labor the Ob/Gyn was able to do a bikini cut low down on my abdomen. I had Vicodin for pain but not nearly as much as the nurses expected me to need, I came off it within two days and just had a mild burning sensation for half an hour the third day. Apart from some itching along the scar and an abdomen that sags over it, I had no further problems with it.

I think an emergency section is very different with a much more invasive incision that probably cuts through more muscle and nerves than I needed.

I'm pretty sure previous posters are correct in saying Bournemouth is midwife-led only now - you'll need to go to Poole for a CS.

Have you had any luck with the Obstetrician OP?

@Kirstnz

Please, please come back and let us know how you've got on. A number of us would benefit from your experience. Thanks

I had a vaginal birth with dc1 then an emergency with dc2. When pregnant with dc3 at 20 week appointment the consultant told me I wouldn't be able to have an elcs and 'if I insisted' they would 'buy me a box of chocolates but the answer would still be no'. I worried incessantly (emergency call due to size of baby and dc3 seemed to be big too). I had next appointment at 36 weeks following a scan that showed baby - and in particular baby's head- was measuring well ahead of dates and a different consultant asked how I'd like to deliver and immediately agreed to an elcs. Dc3 was well over 10lb (im really petite) so it was the best choice for me but it seems to depend upon who you ask.
Maybe a change of consultant might help?

Thank you all so much for your posts I really appreciate the time you have taken to reply and in sharing your experiences and knowledge. I contacted the Dorset CCG to find out what the Trust's policy actually is on elective c-sections, and as a result they offered to contact the antenatal department at Bournemouth on my behalf to find out why they won't perform the operation, and what they will do to support me with my choice. I now have an appointment with the Antenatal Quality Care Commissioner on Thursday to discuss my issue. I feel nervous but it's a start, and I will keep you all updated as to how this progresses. X

PS: I know that they only perform c-sections at Poole but I am still under Bournemouth's care for now.

Applause for mouse

Hi Everyone just to give you an update - I had a positive meeting. I prepared for it by writing a letter explaining my reasons and also containing policy information and the NICE guidelines. They have agreed to send me to Poole for the next stage meeting - so I have everything crossed! The charity Birthrights have also been extremely helpful and supportive and if there are any women out there going through a similar situation I would highly recommend contacting them. I will post again after the next step in this journey is completed,

Kirstie

Sound like things are moving in a positive direction and you have some good support. Good luck with the next stage meeting!

An update: I have had 2 meetings now, one with a consultant midwife and then one with an obstetrician. Can I just say that the consultant midwife was absolutely amazing and so supportive! She then contacted the obstetrician to give my background, and the obstetrician was also incredibly understanding and supportive. Not only have they agreed to support my section but have also check me at 37 weeks to see if I am going to go into spontaneous labour - and we have a plan for that too (not section but a plan that I think I can cope with.) It's been a strange and emotional journey but I am eternally grateful that I now have a positive outcome. Thanks to you all for your support and I hope if anyone else goes through a similar experience that they find some positive tips here!
Kirstie

That's great news! I hope the rest of your pregnancy goes smoothly and wish you luck with the birth and new baby

Aw thanks and thanks for your support Xxx

PS: forgot to mention that I have been told by people I met with at the Trust that the NICE guidelines don't mean that they need to be followed and lots of trust do not follow the NICE guidelines with regards to elective c-sections. Some trusts do not even entertain the notion of elective c-sections anymore. You are better of arming yourself with the CCG's policy and using that when you put your case across.

It is your choice, it is your body. You need to write to the GP and the hospital team outlining your decision, the reasons and demonstrate that you have an understanding of the risks. Finally quote the NICE guidelines.

Ask for a response by X date and take that response forward.

Good luck OP

I love your post Mouse. I wish i could record it play it in real life to a group of mums I heard talking the other day. The way people always dive in to try to persuade someone not to have a cs and assume their reasons for choosing cs are invalid just shows how little the word 'choice' means when it comes to Pregnancy and birth.

I had a forceps delivery and then cs by request for my second pregnancy. The cs was by far the easier recovery for both me and baby. I only wish I'd insisted on cs the first time round.