Elective Ceserean

[rosepetal1]

Anybody had an elective, I am still suffering from having my DS1 who is now 3.5 as I tore so badly. Would love to have another but not sure if they will let me have a ceserean, how do you go about it, will they just give me one because I request it??

maternal request is not in itself an indicator for c.s , the NICE guidelines do say that..some consults will do elective for previous bad tearing, some won't

how bad was your tear?

It really depends on your consultant. I had a bad 3rd degree tear with DS1 and was refered to the consultant at about 16 weeks (I asked my GP to do this).

For the first two appointments I saw two different registrars (who work for thr consultant) who had very different opinions on what should be done. The first was all for a c section and said I shouldn't risk another tear whilst the second said don't be so stupid get on with a natural birth (lovely lady!)

I was in tears after number two and asked to see the consultant who said it was totally my decision. She went through my options and explained the pros and cons of both.

Ultimately I decided on a section but it was totally my decision and the consultant said she would support me either way.

If you really want an elective section could you ask your GP off the record to be referred to a sympathetic consultant (some are anti sections after a tear/others are pro).

I had a 3rd degree tear and now beacuse of it have an anul fissure which is agony at times. Trying to get it to heal is a nightmare, have been suffering for over a year now. My consultant for that won't do the operation for it because he thinks it's too risky to have two cuts in the muscle. Don't know if I can get him to advise on a cs and for it to be on record for when the time comes.

that sounds horrible......you can ask him re birth, and maybe ask for a second opinion re no repair?

rosepetal1 - I have had 2 electives both maternal request, you should prepare yourself for a lot of resistance. I changed consultants as my original one wouldn't consent....but we got there in the end...I think they knew I wouldn't accept what they said! I knew my own mind. Best of luck and stand up for what you want it is your body and birth experience. Happy mothers = happy babies!

I agree with him about not repairing the problem I have now as he thinks in 15-20 years I may lose control of my bowels if I have too much scar tissue in the muscle, which is why I don't want to risk tearing again.

Thanks smurfs, luckily it's not even an issue at the moment because I'm not even pg but something that would definitely be a factor as to whether I want another or not.

agreed smurfs..but c.s is not without risks and is not a decision to be taken lightly IMHO, and it is worth carefully weighing up your options if you potentially have a choice

Rosepetal

you poor thing- that sounds like a really nasty tear.

I would be amazed if anyone thought you weren't a good candidate for a c/s- in fact I would have thought a consultant would insist on one.

Don't be afraid to be assertive. My consultant is fairly anti c/s (he talked me out of my last one and has a reputation for doing this) however he has been absolutely brilliant with me this time round because I had a difficult labour 3 years ago with a second degree tear (unlike you, however, it healed really well and I still don't want to risk another vaginal birth which is why I'm booked in for a c/s in a few weeks time).

In my experience, GPs and consultants will want to do what is best for you and I think you have a really good case for wanting to go ahead with a c/s.

There have been some pretty horrifying posts on MN from women who have suffered long term damage from third and fourth degree tears so I would be really cautious about a vaginal birth.

rosepetal, check out this URL which explains your rights re. requesting a C-section.

www.csections.org/rights.php

It's actually quite postitive and gives you the impression that it can be done if you push hard enough. Before I got pregnant this time, I wrote to my consultant begging for an elective C-section for pyschological reasons and he agreed. Admittedly, this may have been because of my previous section (as a repeat c/s is more 'allowed') but he did acknowledge my fears and worries and said that because of this he would be happy to give me a section. I wouldn't have considered having another child without being promised an elec c/s and I told my consultant this in my letter - he replied saying "far be it from me to be responsible for you curtailing your family to one". Ok, other consultants might have said "that's your problem - I'm still not giving you a section" but it certainly worked in my case. Yes, secitons aren't done without a valid medical reason - but what a lot of people forget is that psychological problems are a valid medical reason. Write to your consultant, telling him/her all your worries and fears and fingers crossed you get the answer you want

rosepetal-i asked my consultant for a cs with my last pregnancy,as the one before was an emergency cs.she said point blankly no.

when it came to going into labour,i was in agony,not with contractions but with scar pain from my previous cs.

im now pg again,and asked my gp about a cs,she said she didnt think consultant would agree.saw consultant,explained to her about how much pain i was in when having dd,and that i was terrified my scar was going to rupture.she offered me a cs.(i went in there prepared to beg for one!)i know in myself that should i have to give birth naturally,that i wouldnt be able to cope with the pain of when the baby goes under the scar.it gives me nightmares just thinking about it!

im sure if you were to get pg again,and if you explained your worries,then,hopefully,they would agree to a cs.especially as you have otehr probs down there aswell.

Just to echo what Tinkjon said about psychological reasons- this is definitely a valid reason for having a c/s.

In fact, I think that's the official reason my consultant has given the go-ahead for me ie "previous traumatic experience", whereas I think it's for sound physical reasons.

I'm sure you'll have no problems with having a c/s if and when you do become pregnant, however may be a good idea to talk to your GP now.

see your GP and say that you're having a section - you'll very likely get referred to a sympathetic consultant, rather that a pro-vag bully.. Don't ask permission, it's actually your decision. It's you that has to live for the rest of your life with any physical/emotional trauma from a vag birth, not your consultant/midwife etc.

I had a C section with DD, and was planning with my consultant to have a VBAC this time, but looks like it might end in a planned section after all. Good luck but please be very aware that the pain after a section is pretty bad to, and soo sore for a while after, but I have no tear to compare to so could be same level of pain
Do what you think is best.
Lisa

Depends on the consultant. I am having an elective after an emegrency section with dd. I had to have counselling after the birth and again just to get pregnant so at my first consultant appointment I just said "I want a section." and then outlined the reasons why.
i.e. the PTSD after my dd's birth
needing counselling
the fact that I was already stressed and depressed about the idea of labour and possible complications and I was only just 12 weeks pregnant... etc
He told me all the risks of a section and I said that I didn't care and had been told by counsellor that I would be able to have a repeat section otherwise I would never have allowed myself to become pregnant again. He said "Fine"

Thank-you all for your help. I think when I go back to see my consultant about the problems I'm having now I will ask his opinion. Failing that will have a word with my doctor and see what happens.

Just to add a slightly successful story for you: I got an elective section booked (in 9 days!), on "maternal request." I got it because of psychological distress - my previous labour was vaginal, no tears, no intervention, but DS ended up in SCBU and I didn't know for 12 hours if he would live

I'd say your GP is defo your first stop. If they know you and you tell them what you want and why, they should support you through the whole pg, starting by helping you to find a sympathetic consultant. Be prepared for a long process. It can be mental torture to have to explain, repeatedly, throughout the pg, to different people (MWs, registrars, and consultant) why you want a section. Ultimately you will need your consultant to agree, nobody else really matters, but you have to endure the process till you get a meeting with them and they put it on their books. I was misled early on, thinking I'd have my section, when in fact I learned at 34 weeks upon meeting the consultant (finally) face-to-face that I'd not been officially "approved" yet. Don't stop till your consulant tells you it's approved.

You should also prepare to hear a lot of negatives about CS from everyone in the NHS. Each person I spoke to in the system told me something different and negative about the risks, and nobody explained the benefits to me. Some of the things I was told were plainly wrong (e.g. my risk of infection was higher because I'd previously delivered naturally. Utter crap).

Besides endurance, you'll need as much research as possible so that you have a complete, balanced & realistic view of all your options. Everyone else will probably have an agenda, not the whole story. That way you can make up your mind and stick to whatever you decide is best, for you. Good luck!

(my NCT teacher had a good, short, balanced book on CS - worth checking your local group for resources if you don't have anywhere else to start)

HI rosepetal. I also had a third degree tear and it took a long time to heal. I also agreed not to have the surgery for the same reasons.

I want a homebirth and certainly the opportunity of another vaginal birth, (I'm 17weeks). They are very reluctant and want me to have an ecs. I'm surprised that for you it is the other way round. the 'bottom doctor' I saw said they always recommend a cs - sorry I don't know their official name but perhaps you could get them on your case...

The 3rd degree tear that I had when I gave birth to my son healed very well, but since then because the muscle doesn't stretch so much because of the original tear I now have a fissure which is a cut. Seperate problem but caused through giving birth. It is agonising at times and I have been on laxatives for the past year and a bit trying to get it to heal.

Fingers crossed I am finally healing but don't want to risk tearing again into the muscle as for me it could cause incontience in later life.

I haven't actually spoken to anybody about it yet, but thought I would get some advise and opinions on here. I am due to see my consultant in a few months so will ask his opinion. Although as he is in a different department not sure whether it will make any difference.

Then I think they will give you a cs. Our mw showed me her tick list and if you have had a 3rd deg in our borough and are pg again they refer you to the specialist hospital and discuss a cs. They also send you to a consultant at 34 weeks who discusses the sort of birth you want/is wise.

I'm surprised is not the same everywhere.

I have a gap in my outer sphincter and have been told I have a 50% chance of another 3 degree. I am still deciding but think if baby is in a good position for a natural birth I can control the labour but if posterior or other bad position may go for cs. I'm going to get an epi-no to help test the stretch and prepare for labour.