Elective C - section

[firstbabyloading]

Hi everyone I'm currently 6 months pregnant and I have known for a long time that i want a c section.
By no means do i think this is an 'easy option' or im too posh to push but i have my reasons as to why i want one.
I know soon i will start talking birth plans with my midwife and i just wanted to hear of peoples experiences of asking for an elective as I've heard alot of negativity from professionals who try to put off or have even refused to let them have one.
Do I have the right to ask for one as there isn't alot of info I can find online.
I know my reasons but I feel I'm not going to be able to get my point across when I speak to my midwife as I find it hard to put into words how I'm feeling.

Hi, choosing an elecrive c section is a big deal, can u explain why u want one. With my first boy i had to have an emergency section and 8 weeks ago i had an elective but i wish i could have had a natural birth.
I was in so much pain with the elective and 8 weeks on im still having issues.

You have the right to ask but it may not be granted. Even if it is agreed, depending upon your reasons, prepare yourself that you may go into labour beforehand and end up being unable to have one anyway.

I’ve had four c sections and had different recoveries from them. By no means are they pain free but they do tend to be much more predictable in terms of recovery than a vaginal delivery.

Good luck and I hope your consultant is agreeable.

Apart from being a higher risk than vaginal birth, C-sections are expensive - it involves a lot more staff (think 7 or 8 medical professionals rather than 1 midwife) and equipment, so as much as I think choice is important it’s a big strain on NHS resources to have one for no significant medical reason. For this reason alone they may discourage it.

I would try to get the reasons why you want one written down on paper, partly to get them straight in your mind and partly so you can refer back to the list during the appointment if you are finding it hard to get your point across.

You do have the right to request a caesarean, but equally the health professionals are required to explore your reasons with you and make sure that a caesarean is the best option for you, and that you fully understand the risks and potential complications, including the impact on future pregnancies.

I’ve had two electives. I had absolutely no problems getting them - I did have a reason. Both times I saw a consultant but for them it seemed a bit of a formality, just to sign the paperwork that it was ok. I suppose it depends on which trust you are in but I never had that experiences of having to argue for it - good luck!

Hi OP, you need to check out the NICE guidelines - they're online. You have every right to have an elective section but some trusts are more obstructive than others - it's possible to find out - there was a list published somewhere in the last year but I can't remember where.

You should also look up www.birthrights.org.uk
For information (and will be less biased than posters on here!). Elective sections are more expensive than a straightforward VB and that's what people usually quote, but if you have complications, injuries and trauma that needs rectifying afterwards they aren't! Good luck OP!

You absolutely have the right to request one and, if they follow NICE guidelines, your trust should offer you one. I'm a strong believer in allowing women to chose what is best for them. I'm having an elective section in two weeks for a variety of reasons. I first mentioned it to my midwife at 16 weeks, had an appt with a consultant at 20 weeks where the date was agreed and another follow up a couple of weeks ago to confirm it's what I still want. I didn't have to fight at all, I just explained why a section would be better (physically and mentally) for me and they agreed. There's an organisation called Birth Rights who have a lot of useful information too.

HI op, I was told during my hospital stay by a midwife that you can have the birth you request and to ask for a different consultant if declined. However, due to complications I ended up with a c section, one year on and I've only just healed both physically and mentally. I practised hypno birthing, yoga and relaxation prior to birth and it actually made me excited to go into labour. Even if you do decide on a section and get the green light for it, these techniques will come in handy whilst your waiting or in theatre.
Best of luck.

Consultants will be the gatekeepers. If you can show you've looked into it and really understand the risks/benefits of either side I think you're more likely to have an easy ride.

I've heard of women having to jump through hoops like meeting mental health staff to establish anxiety but not sure if that happens any more.

Looking into it might be useful for you anyway, both to make an informed decision and to make choices about the procedure. CS can make breastfeeding harder so it might help to understand what you can do to make it easier if you plan to breastfeed.

It's a postcode lottery. A PP mentioned Birthrights and their site has loads of resources. Here's a report they did with a map showing how likely you are to get your request: www.birthrights.org.uk/wordpress/wp-content/uploads/2018/08/Final-Birthrights-MRCS-Report-2108.pdf

Also about the cost: I got given the maternity "charges" list as I'd been abroad for 2 years and didn't what my chargeable status was anymore (it's on a printed page but ask your hospital for one if you're curious). ELCS is actually ONLY cheaper than straightforward vaginal birth. Even an uncomplicated birth with epidural is more expensive. EMCS is VERY expensive though.

I met with my midwife for the first time today and told her immediately that I want an elective section (traumatic first both). She was completely relaxed about it and said that should be no problem, I’ll meet with the consultant to discuss my reasons then we’ll meet again at 36 weeks to confirm that’s what I went then I’ll be given a date. I asked if I was likely to face challenge and she said no, the hospital I have chosen is very supportive of women’s choices. This may be individual to my area though (north east)

I wanted a c section but got talked out of it. I ended up having a false labour two weeks before due date then going into real labour a week before I was due. Hours,days weeks of pain and on the day I ended up needing an emergency c section as I wasn’t progressing. I wish I’d Chosen one in the first place!!!

Look up the latest version of the NICE guidelines and quote them. Sounding informed and assertive is important.
I had a ELCS easily agreed (literally- "what day do you want it?") for reasons of maternal choice (first birth). I'd say these were the reasons it was so easy in my case:
Being over 40 helped as they were aware my odds of an EMCS were high anyway, and they had already suggested induction at 39 weeks due to placenta being less reliable at my age so I could then argue against induction and add in my worries about risk to baby plus instrumental delivery, which is a simpler argument.
I had consultant care anyway so it was a fast track to a consultant who has more authority and often is more pro- CS than midwives.
I got them to write it on my notes in my blue book at every appointment as evidence of my consistent view.
Oh and felt I should point out that breastfeeding is not harder after a c-section. Pretty sure that's a myth usually stated by women who've never had one. Reading this repeatedly before my c-section got me worried unnecessarily, which is a shame.

You absolutely have the right to ask for one. As PP have said, look at the NICE guidelines and the Birthrights website.

I was like you. All my instincts told me to ask for a section. I wasn’t assertive enough and I let myself be fobbed off and bullied into having a VB. I now regret that. The outcome I’ve been left with has all the drawbacks of a CS (long recovery time, infection risk, blood clot risk, etc) plus a whole lot of drawbacks of its own.

My advice is:

• Do your research. Show them that you’re well informed of the risks and benefits of each option. Write down your reasons and what you plan to say.
• Ask now. Ask repeatedly. Make them note the requests. Don’t leave it too late as some trusts have a strategy of fobbing you off until it’s too late.
• Trust your instincts and stick to your guns. If a CS is what you want, it’s what you want. It’s very difficult because VB is always presented as the ‘morally right’ option. But there are many, many good reasons to opt for a section. Look closely at any statistics quoted to you because many of them conflate ELCS and EMCS when obviously they are two very different procedures. I wish I’d listened to my instincts.
• don’t listen to any bullshit about it being more expensive for the health service. Firstly, the NHS’ financial woes are not yours to fix. Secondly, it’s just not true.

Oh and felt I should point out that breastfeeding is not harder after a c-section. Pretty sure that's a myth usually stated by women who've never had one. Reading this repeatedly before my c-section got me worried unnecessarily, which is a shame.

I think this is a good example of how risks associated with EMCS and ELCS are conflated. I asked my consultant about this and he said CSs are most likely to interfere with breastfeeding when the woman has undergone a long traumatic labour and then an EMCS - because her body is exhausted and traumatised. But we get told that CSs (all CSs) can interfere with breastfeeding.

OP are you planning on using the NHS?

I just asked and then was invited in to see the consultant who double checked, they did go through all the risk factors in details about how much higher the risk of x,y,z was for CS v vaginal birth but were happy for me to have one, they did say if I labour before 39.1 when the section was booked for I may need to go vaginal if I have started dilating or if they are busy, this was in Manchester

I have had 2 sections now one being 5 weeks ago and both out within 24 hours and mega quick recovery, I had a great experience myself with them luckily, I do know that's not the case for everyone though

I hope you get what you want OP. If you are worried you won't get your point across when speaking to the midwife or consultant, how about writing down a few points and taking it with you. Just the main reasons why you feel it's best for you, and the benefits and risks as you understand them.

Thank you all so much for your informative replies, a lot of them have put me at ease a little. i have always known I want a cs and I have read up alot on them its not just a spur of the moment decision I have made.
I have my next appointment in a week and I need to start stating my wishes I'm worried that because I haven't mentioned it yet they won't take me seriously but with all your help I feel a little more confident and am going to write things down on my reasonings.
Like I say I have always knew i wanted a cs me and my partner have been together for 10 years this is our first child and I have always been scared of the thought of childbirth and thats one reason we have waited so long to conceive.
Now i know every woman has fears about childbirth and I've had people say oh everyone gets nervous, but I know deep down its more than that. I also have a massive fear of the loss of control that comes with natural childbirth. I hate anything being out of my control there are so many things that can change or go wrong with natural (dont get me wrong i know a cs is not always straightforward either) but I've read alot that you can go through hours of labour and still need an emergency cs anyway. Also I am overweight which I've also read goes towards needing a c section, however I'm very lucky this has been a straightforward pregnancy upto now and i am healthy otherwise (blood pressure always normal, no gestational diabetes)
Thanks again for the advice and sorry for rambling again but I don't have anyone I can talk to about this and am glad to read the positive stories x

Oh also yes I am using the NHS and I am in the north east as someone asked.

PixieLumos actually c-sections work out a fair bit cheaper over all than ‘natural births’.

OP i would attend classes to tackle your anxiety surrounding childbirth.
C sections are very dangerous and expensive for the NHS.

firstbabyloading I think women should be able to have the birth they want so absolutely ask for the section if it’s what you want. But I would advise looking into to get yourself into a positive mindset. The positive birth company do a brilliant downloadable course xxx