They don’t want me to have an elective c section

[Woodlandwitch]

I had an EMCS with baby number 1. All very traumatic and has taken a lot of time to build up to being ready to have number 2 and the only reason I agreed to was because I was told I could have an elective due to last time

I just attended my booking in appointment with midwife and they say they don’t let people choose to have an elective.
They are booking me in for a vbac class and birth reflections sessions and said if that doesn’t change my mind they will then have a discussion with me but that it’s not a given.
I don’t want to go through with this now and am panicking.

What can I do?

Are you not consultant led? I had a c section with my first that was an emergency very traumatic with my second child I had a vbac and also with my third but every time I had the choice off my consultant I'm currently 10 week pregnant with my 4th and will be opting for a c section this time.
My only advice is stand your ground ask to see a consultant and be adamant about what you want

Stand your ground OP. If they won't offer you a section they should refer you to someone who will. It may mean giving birth in a different hospital than you planned.

Don't be bullied, it's your body and you cannot be forced into something you're not comfortable with.

Meant to add, for your next appointment write down all your reasoning so you don't forget anything you want to say. Take your DP if you can. Kick up a fuss and don't panic. Your body is not an afterthought and you will not be dictated to after what you went through the first time. Be calm but keep repeating yourself. To several different people if necessary.

God this stuff makes me angry.

Contact PALS and tell them. they will help you get in front of a consultant so they can help you make that decision.

They’ll obviously try and deter you from an unnecessary c section if they can. But they’ve said they’d like you to attend birth reflection sessions and discuss a caesarean after. If may just be beneficial attending the sessions and then seeing how you feel

Your body, your decision. Informed consent means you understand and choose. That goes for vaginal birth too. Hospitals try to protect their c section rates - makes me angry. I was "talked to" very rudely in my first pregnancy and my birth went tits up for the very reason I wanted a planned section. Didn't leave them any room for negotiation the second time when they tried to push me into a vaginal birth the second time after trying to tell me I had a "natural birth" the first (forceps after being told i wasn't in labour, no pain relief despite back to back labour which they didn't know because they discovered I was in labour when they examined me at 10cm).

I had a similar issue with my booking appointment following a horrendous experience with my first. Saw the consultant later on who said it was nonsense and they would support me with whatever I wanted.

I also refused the vbac class because I didn't see the point.

They should support you in your choice. You may find the RCOG leaflet and NICE guidance helpful.

www.nice.org.uk/guidance/cg132/chapter/1-Guidance#planned-cs

See point 1.2.9.5 in the guidance. Its not specific to previous CS but covers 'maternal request'.

www.rcog.org.uk/en/patients/patient-leaflets/birth-after-previous-caesarean/

Ultimately you do have a choice but you may need to push a bit. It is probably worth going to the sessions they have recommended just so you know you have explored all of your options. Read up on guidance, ask to see the unit policies and if your hospital has one ask to see the Consultant Midwife.

Thank you all. These responses has really helped me.
I’m looking at the leaflet now

I know in the area that i live women can ask for an elective based purely on psychological grounds, ie of their last birth was traumatic. I'd stand your ground as I think that midwife is wrong, hope your ok xx

I have a couple of friends who had emergency c sections with their first and were therefore allowed to opt for a planned c section for their second, it doesn't make sense that some areas allow this and others don't. Definitely stand your ground

I think what she’s saying is she can’t put you down as elective caesarean without the agreement of a consultant. They will make you jump through a thousand hoops and you will have to argue your case with probably two senior people. However I suspect it will work out in your favour in the end.

Personally I fought tooth and nail for an elective and then changed my mind six months in and decided I wanted a vaginal delivery. Don’t even ask me what that was all about!!

They cannot refuse. They can certainly ask you attend a VBAC session etc but again, you don’t have to. In my second pregnancy I was very clear at every single appointment I would be having an ELCS with my second (first was EMCS and traumatic as hell for me) and the consultants in particular were very supportive. They said they wouldn’t book at date til I was approx 36weeks for 39weeks by as it happens my ELCS ended up having to be booked quite last minute for 37 weeks. Anyway, it’s early days OP, please do not stress. At your first consultant appointment make it very clear you want an ELCS and talk a bit about the risks and your research etc to show you’re making an informed choice. Thereafter at every single appointment ask ‘when will my ELCS be booked?’ Be strong and assertive and factual. You’ll be fine.

I'm gonna go against the grain here. I had a traumatic birth first time around. So glad I had normal vaginal deliveries for 2, 3 and 4. Its massive surgery and as a nurse I appreciate the risks. The amount of people coming in afterwards with post op complications is huge!

I Had an elective section for number two, after they almost killed me having number one.
The consultant was very clear to never attempt a natural birth again.

Then the registrar decided to tell me that it would be better to try a natural birth and he would need me to attend a class.

I totally bollocked him, asking had he even read my notes? Did he understand how complicated my last birth was, does he know how it feels to haemorrhage half his blood, let along have a third degree tear, and a mountain of complications!
The midwife was crying laughing in the corner.

I got my c section and it was lovely. Stick to your guns.

I had 2 elective sections. On DS2 midwife really nasty about elective No1, long debate about having elective No2 and eventually she said OK but essentially told me I was stupid. Then she put a massive red VBAC sticker on my notes without telling me what that meant. I only found out when I saw consultant far later and he was surprised I wanted section No 2 given what midwife had put in my notes. Got it again though. Have to put up with a lot of awful midwives and judgemental people to do it but was more than worthwhile in my view.

Stand your ground, first app registrar tried to pressure me into a vbac- I just kept repeating I would like a c section please. Saw the consultant for the second time half expecting a battle - he took one look at notes and said I was thinking xx date does that suit? Job done. And also my elective was brilliant - recovered so well and was out of hospital within 24 hours

It doesn't matter whether other people are glad they had VBACs. OP doesn't want it. She asked what she could do, not whether we think she should try a vaginal delivery.

OP remind them of the NICE guidance and ask them to justify any departure from it, what are the clinical reasons in your case. Also cite the case law Montgomery v Lanarkshire. Perhaps take a copy with you. If you think they're not presenting a full picture of the risks and benefits of each option, ask how they are complying with the law on risk disclosure. That case s specifically about failure to disclose all risks of VB to a woman.

Remind the midwife that she should be your advocate and remind her of the NMC code about prioritising patients.

My midwife told me that too but when I saw the consultant (automatic appt because of first emcs) he signed off on an elcs without a second thought.

Don’t panic until you’ve seen a consultant. MWs don’t actually decide these things.

My VBAC appointment lasted about 30 seconds , the consultant said , hi and do you want a second csection, it’s safer for you, I said yes please, we picked the date and that was that. I think the midwives have to refer you to the clinic as a matter of policy , try not to worry too much I’m sure you can work something out at the clinic x

Make sure you are referred to a consultant. I had a 3rd degree tear and pph during my first birth and was referred to a consultant at my booking in appt. Consultant said I could either go vaginal again or have a c section. I opted c section and am booked in the week after next! I didn't have to fight and the consultant said she would support either choice. I haven't discussed it with the midwife at all, other than to say I'm having one and they saw the date in my notes.

It’s against nice guidelines and your basic human rights to make you have a VBAC. Please join the cesarian by choice awareness network group on Facebook. You can get lots more advice and support there!

You are entitled to one. I've screenshotted the nice guidelines, this section is the maternal request.
X

I want an ELCS as I've had a fear of giving birth ever since I can remember. It's even put me off the idea of getting pregnant at all.

Here I am at 42, nearly 20 weeks with my first baby - a family history of pre-eclampsia, a really, really bad back and major, MAJOR, anxiety about a natural birth.

My hospital didn't bat an eyelid about booking me in for a c-sect - I didn't have to fight my corner at all which was a huge relief. I genuinely think they would have suggested I have one anyway, but we haven't even got that far in the process. They just knew I was anxious and stepped up to help.

Today however, a colleague who bangs on about her amazing natural birth experience with no intervention or pain relief (do you get a bloody medal for this or something) made me feel so small about wanting a c-sect that I'm genuinely now doubting my decision. What the actual hell?!

None of us are volunteering for a fucking spa day as an alternative to natural birth, and it's outrageous that anyone would try and minimise whatever we might be feeling or thinking about the process.

I don't care how my baby gets here, I just want him to get here alive, calm, un-traumatised and in one piece.

Stand your ground OP - you are absolutely allowed to ask for this - but remember - it won't just be the hospital who might give you a shitty time, it's preachy other women who somehow feel they have right to judge you!