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.

I see you mentioned you are in the North East OP.

I've had babies in both the Rvi and the QE. Both hospitals wanted me to be induced for different reasons. I refused and opted for a section. RVI were immediately fine. QE I had to press my point a bit more.

@PatricksRum They're really really not. An ELCS is a similar risk to a (simple) vaginal delivery and not that much more expensive. As soon as you start to have any complications with a vagjnal birth, the price (and risk) will also sky rocket. A lot of the stats conflate ELCS and EMCS which are very different both in terms of how dangerous they are and how much the procedure costs.

@mynameiscalypso
Can you point out how an elective c section has the same risks to mother and baby as a vagina delivery please

Calypso speaks the truth. Also, the right decision for you is what you're most comfortable with. You may be asked to speak to the perinatal mental health team to discuss any fears of childbirth before you can book the CS but they aren't there to prevent you from having the CS - but to support you.

FFS CS are not 'very dangerous and expensive'! Actually, risk to the baby is slightly lower in ELCS than in a vaginal birth.

Of course it doesn't have the same risks but overall, when comparing an ELCS (not an EMCS), the level of risk is similar. There is substantial guidance/analysis available online particular from when the NICE guidelines changed in 2011 but there are, as ever, statistics that will back up whatever argument you want. For example, one study found that there are 1.8 fewer deaths per 10,000 women who have c sections than those who have vaginal births. Other studies have found no difference. EMCS are a whole different kettle of fish and will have a high risk generally - to both mother and baby - because of the circumstances in which they are performed and therefore data which shows, for example, the c section babies will more often end up in NICU often ignores the fact that a proportion of c sections are done because a baby is sick and needs to come out immediately. It also depends on what you view as an acceptable risk - I'd rather the known risks of a c section than the possibility of tearing / instrumental delivery / incontinence (in fact, one consultant said to me she'd always go for c section because of the risk of incontinence).

Don’t keep saying how expensive they are! VB can have its own massively expensive outcomes.

Op please go for it, I never even asked. I was talked out of it by similar people to the posters here, but in real life. My own mother said not to do it. It does have a long recovery and we live in a rural area so it was tricky not being able to drive, and you are in some pain and struggle to bend and move for two/three weeks all of that was nothing compared to the pain of active labour. shudder I don’t think I was scared or prepared enough.

I’d read all about breathing through the pain, and mad woman who needed no pain relief. Seems to be loads out there! So I put lot of pressure on myself, then on the day id was so tough. Theres a reason a lot of woman poo themselves and are very sick. The pain is out of this world. Don’t stat that as a reason, but that was the reason I wanted a c section. By the time I got one i’d Been in pain just over two weeks and properly active labour 48 hours :( so by then I was massively fed up I’d gone through it all to end up with a section anyway.

Oh btw I breast fed, came with its own challenges but nothing related to the c section.

OP just be confident about what you want and go into your appointments with really clear about your reasons (I'd definitely write them down as others have suggested) I've had an ELCS agreed and found my appointments with the consultant were far less stressful than the ones with the midwife and in my experience, the consultants were much more impartial and patient led (not that I had any issues with the midwives though, I think everyone just has their own agenda and opinions)... as others have said, a real issue I found is that when trying to persuade you to have a VB, the info they give is very biased and gives worst case c section (including emergencies) and best case VB (especially regarding cost!), which just isn't realistic as they will try to claim that you have nothing to worry about and that you'll have a straightforward VB, which I think most know isn't the norm for a lot of women. Happy mother, happy baby. Good luck🍀

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

Even if this were true (it’s not) it wouldn’t be a helpful contribution.

Hi @firstbabyloading I had an elective and like you knew I always wanted one. I asked at my very first appointment and I had to be 'counselled' by two different people to make sure I knew what I was asking for, risks etc. I wanted one for my own personal reasons too but predominantly because I have ibs and didn't want to risk any tearing. My hospital was great, they told me they wouldn't refuse someone one, you just have to be counselled first as it is major surgery. I think some hospitals can though so best to check to ensure you don't need to change at a late stage.
I recovered fine after mine, babies are more mucusy though, my little boy needed a few hours in special care for his breathing but was out in 18 hours and he's doing great now. If I have another I will have another elective. The worst part for me was the spinal!

Should have added only scared because had to keep still and I wriggle! I did colostrum harvesting too in case milk didn't arrive as I had mine at 39 weeks, I bottle fed but did manage to get a bit for him.
Go with your gut, everyone thought I was mad wanting a section but I knew me and my own body and it's a very personal choice which nobody should judge you for. Best of luck x

Hi OP
I had an elective section for my first. I am similar to you, always wanted one and was prepared to go private if NHS consultant said no. However NICE guidelines do indicate you are able to select a section - if the consultant you see refuses to take it on then they have to refer you to another consultant.
I had to meet with consultant to discuss my reasons and demonstrate that I understood the risks. I ended up having a very interesting friendly debate with the consultant. He was giving me a lot of statistics on the risks (which I knew already from my research) but confirmed my suspicions that the % were amalgamating elective and emergency CS, very different circumstances. He couldn't provide me with the statistics on elective as a stand alone and did agree that these being widely available would help women make more informed decisions about the birth they chose for themselves and their child. He also confirmed elective CS is actually a safer birth for the baby which was one of my reasons initially.

Pleas be very prepared with the NICE guidelines read, show that you fully understand the risks and that you have an appreciation for recovery etc

Good luck!

I've had one VB and one elective section. Section was much better but things I have learned:

• c section pushes the pain of labour in to the recovery period (though you may get unlucky with a VB and get pain of birth AND horrifically painful recovery!)
• c section is not higher risk. Some things are higher risk with a c section, somethings lower. On balance, the level of risk is broadly similar but more quantifiable with a c section.
• you can have good or bad deliveries regardless of delivery method. What matters is feeling listened to and in control.

PatricksRum where have you got your information from? Because it is just plain wrong. The risks of a c section are DIFFERENT to the risks of vaginal birth, but they are not greater. Risks of elective and emergency sections are also different. The risks of post operative infection are the similar in cases of emergency section, elective section, manual placenta remoal (vaginal birth) and episiotomy/ 3rd and 4th degree tear (vaginal birth). Risk of nerve damage - to stomach in a c section, (more so in emergency), perimneum, vagina and anus in vaginal birth (increase with episiotomy or 3/4th degree tear). Risk of infant death is reduced in elective section, highest in emergency section but NOT due to the section but because emergency sections often involve the most distressed/ unwell babies. Risk of urinary incontinence is increased with vaginal birth.

Cost wise, emergency sections are highest, with straightforward vaginal birth without epidural and planned sections very similar in cost. Some studies suggest that the overall cost of vaginal birth is highest when long term associated costs (incontinence and prolapses) are included.

My consultant said it was basically a case of which risks were you more comfortable with.

Hi op. I had an elective section in Jan. (It was fantastic and I was very pleased with my decision). I was dreading asking for one and did research etc (nice guidelines / NHS website etc) around associated risks etc. Before my consultant appointment, I made some notes around why I wanted one etc and when I came to it, the consultant was amazing. She totally listened to me about it all and it was purely my decision. Nobody tried to talk me out of anything, everyone was very supportive.

I hope you get what you want. I wouldn't worry about costs etc, only what is best for you and your baby. Good luck x

I was 100% set on c section and had an appointment due for it. I had therapy because I was so scared of labour...nothing helped. I decided to be brave and go for natural, I'm really happy with my decision and I'm looking forward to my next baby! Please try natural, you won't regret it.

saralola how do you know she won't regret it? I regret it. I was like you, set on a c section but changed my mind. I now have permanent birth related injuries from going natural. I should have stuck to the section. My section with my second was wonderful, nothing like the car crash VB.

Saralola how can you say that? If it went well for you it doesn't mean it will went well for her too. Never think that you can tell someone what to do.
Maternal request CS is as safe as UNCOMPLICATED, STRAIGHTFORWARD vaginal birth. That no one can guarantee that you'll have.
The same goes for the cost. And if you're having an epidural there is additional cost; since you need anesthesiologist to give it to you and a doctor that has to monitor you if by any chance sth goes wrong.
I am so over that "natural is the best", "you were made for this" crap. Evolution doesn't care for the dammage to female/baby, as long as the female is still fertile, she can procreate. If she dies the male can find another fertile female and make another baby. Nature is cruel. We have too narrow pelvises unlike the other mammal species. And we're having babies way older than our ancestors were so there is bigger risks.
So OP I really hope you'll get your CS with the first consultant. If not they have to refere you to one that will give it to you. Don't let them scare you with sky high EMCS risks cause they are not the same as maternal request CS. Write down reasons you want one and stick with your guns :)
I'm not from the UK and where I live you basically can't get CS. I will have one tho, cause I'm willing to argue with the doctors, I know the risks I'm willing to take and the risks I'm willing to put my baby trough. The severe pannic attack I had when I was just discussing birth with my OBGYN helped with her reasuring me she'll do everything for me to get one :) my friends don't get it tho, I always get the "natural is the best, you were made for it" argument. Oh one of them doesn't use tampons cause it's unnatural to have sth in your vag. The only one who gets me, has worked in the field and knows how safe is maternal request CS, wasn't so lucky. They wouldnt give her one. She had dammage from 2 complicated vaginal births, but they said(literally); oh you had 2 babies vaginally, the 3rd will just pop out, you're all streched out down there anyways. She never ever wants to get pregnant again, cause it was traumatic again.
So; your body, your choice, you have to live with the consequences. No one can tell you what's best for you!

I am not anti c-section. Everyone in my family has had a c-section and they were happy they done it. Don't get me wrong! Anything you do has pros and cons. My baby's umbilical cord was wrapped around his neck and I had doctors run into my room twice, at that point I regretted my choice but they were so professional and knew exactly what to do to make sure my baby was born safely.
If it's fear that is stopping you then I say it's just best to overcome your fear as you may want more children. Natural birth is always recommended however it's YOUR CHOICE.

I really don’t understand how it’s allowed that EMCS and ELCS risks are conflated.

Having an ELCS eliminates the risk of having an EMCS fgs, just HOW can you be told risks of something you’re AVOIDING to try and put you off doing it??

Anyway, back to the actual point, the guidelines state your consultant either has to agree or point you in the direction of another consultant. Birthrights is probably the best resource for info, go and check their website, they have tons of stuff on there to help women.

Little update I finally met with my consultant and my elective section date has been confirmed :)
Thank you to everyone for their advice and information and all I can say is as long as you sound informed on what you want and that you are making the best decision for yourself then I can't see anyone putting obstacles in your way.
I can honestly say not one health professional has tried to discourage me, obviously they have to inform me of the risks (which whereas compared to the risks of a vaginal birth, I don't think they go into detail half as much but nevermind thats another discussion) but like I say as long as you put across how much you understand and why you have made the decision you should get to have the birth you want.

@firstbabyloading so glad for you. You can finally relax and enjoy your pregnancy. One thing of your mind!