Help me to plan what to say to consultant- ELCS

[CouldBeAGreatMum]

Following on from a previous post about requesting an ELCS. Just looking for advice on my next steps. I have now had my first midwife appt. I said that I was going to request an ELCS and she booked an appointment with a consultant in January. I am wondering what I need to prepare for this appointment and if anyone has been there and can let me know about your experience?

Background is I have had weekly therapy for a number of years due to childhood neglect / attachment disorder resulting in anxiety, depression and other MH stuff. I'm extremely anxious about pregnancy and birth and strongly feel an ELCS would go some way to supporting me to feel that little bit more in control and able to cope better with managing my pregnancy (even though I know you are never in control and there are risks). I have severe anxiety about birth and I am worried I will be met with barriers to ELCS.

Any tips about this consultant appointment and what I should say would be so helpful. Hospital is St Thomas, Westminster. Thank you

Cant help with that specific hospital, but saying exactly what you wrote above and explaining you understand the risks but you feel that you will panic in labour which you know will do the baby no good (potentially putting them into distress) and know labour needs you to relax to progress should be enough.

I got an ELCS with less justified reasons than you but elsewhere in the UK
Good luck!!

Very interesting, and hopeful- thank you @Bibbidybobbitysplated

They might offer you counselling too, which might be important. Anyone can go into preterm labour and in that scenario you will have to deal with that, so having coping strategies will be empowering

No advice about speaking to the consultant but hope they listen to you.

I'd recommend hypnobirthing to help with general anxiety around pregnancy and birth- can be really helpful even for an ELCS.

Remember that it is the consultants jobs to warn you about the risks of an ELCS. This is not them saying don’t do it. It’s just them giving you the information so they know you can give an informed consent.

Just be yourself and explain everything like you've done on here, if it helps write it down and go off that. You will most likely only sort having a section towards the end of the pregnancy. I told every midwife I saw until 28 weeks I wanted a section, they couldn't have cared less and I didn't see my consultant despite being consultant led until half way through and only saw her twice. It is my second baby so maybe that's why

You go in there and you request it with confidence, 'I would like to be booked in for a c section, this is why ... I understand the risks'. I had a consultant say to me 'I assume you'll be having a vaginal delivery' my response 'no'. I was booked in.

Thanks everyone, good to know. I forgot to say in my OP that the midwife referred me to the mental health midwife also, so that seems to be happening @JoanieCash. Plus I already have therapy every week anyway.

I will do my best to be clear that I understand the risks and firm that this is what I need.

I was in the same position a few weeks ago (same hospital). I had notes with me and had prepared a speech (don't ask..), but in the end the midwife was really nice about it. All you have to do is listen to the risks around c-section, clearly state that you understand the risks involved, however you still want to proceed with the C-section. She will try to talk you out of if gently, by suggesting a birth plan where they perform a C-section if anything goes wrong, but as long as you ensure her that you have made your decision, it will be fine.

I was told numerous times that it is our choice to have a C-section and they only want to know that you understand the risks, that's all.

The process was much easier than expected and I was booked for a C-section there and then.

I’ve just had an ELCS agreed by consultant due to previous traumatic birth and birth anxiety and it was far easier than I expected. Due to being 42 I had consultant appt booked at 36 weeks but that felt far too late in the pregnancy as I know that the NICE guidelines say that a maternal choice ELCS request may require referral to perinatal services and possible treatment. Once I quoted NICE to the admin at antenatal they booked me in for an appointment at 25 weeks! I went prepared with a written list of all my reasons plus evidence I had weighed up the pros and cons of ELCS. I didn’t need any of it- the consultant asked why I was there and I explained I’d had a difficult previous birth which left me with trauma symptoms and that I was concerned that my mental health (anxiety about the birth) could be detrimental to this birth and lead to complications (worried that I’d be tense and anxious which could prevent my body doing its job in labour). He then basically said I should consider a ELCS which I happily agreed to! It’s made a massive difference to how I feel now about the pregnancy. Although I didn’t need to argue my case, I would recommend doing your research, being assertive and requesting to see another consultant if one refuses. Good luck.

Just to add that the book 'why caesarian matters' would be worth a read OP 👍