First Time Birth // Elective C-Section ???

[LDN1]

Hi, I wonder if anyone can help.

We are having our first baby, first week in July. We are both 40 and perfectly fit; but age and general anxiety led us to want an elective C-Section.

We thought we were on track to have an elective CS at Macclesfield hospital... but they quietly (with no word) shut down their maternity and labour ward due to staff / Corona issues / placements. Bit shocked we had no word from them... it seems that the assumption would be that they’d possibly be back open (not likely) - or that we’d just, last minute, be told to go to another hospital. Pretty pathetic in my opinion and just adds to the anxiety.

And so, we are now starting the transfer to St Mary’s in Manchester. But nobody can give us an answer as to whether we will be able to have an elective C-Section or not.

As a result; I’m also looking at options for private hospitals / wards. Can anyone help me!!? I’d like a definitive list of all of the private hospitals and wings that are currently open. I’ll then have to call around and ask what the state of play is.

Any help much appreciated. We just want to know we can have an elective CS; with little to no risk of plans being changed or cancelled...

You have a right to choose an NHS elective c section. It’s likely all chaos at the moment so just keep chasing up and asking when you will get your consultant appointment/ date. Don’t ask if, ask when.

Interesting; thanks Feeling99.. I’ve noted what you’ve said... it’s just that, so far - even PRE virus; the lack of contact / info from the hospital is a little alarming. We’re thinking of just going private now; neither of us have needed to use the NHS in 30 years - and we don’t even get a told that the whole labour ward has been shut, where we were supposed to give birth.

Just can’t believe the way it’s all panned out; virus now on top of it. Time we take control and just forget the NHS, I think. Not what we wanted to do but need to be in control and fed up of being told different things / or in fact not being told anything at all!

It sounds like you're already quite set on going privately, but I'd just ensure what happens if you go into labour before your planned c section date - will you still get your elective c section? (Although how long is a piece of string atm) From what I gather trusts are unwilling to book you in before 39 weeks yet you're classed as full term from 37+0 and many women (myself included) give birth quickly and early even when it's their first time so there may actually be no time for that c section in a worst case scenario. Likewise, you'll presumably also want to clarify if birth partners can be at the birth - again, I believe some trusts have said no for c sections and given you'll be using the exact same facilities for the actual surgery as the NHS patients, I wouldn't be confident they'd make exceptions just because you were paying for it.

You say age and general anxiety have led you to want a c section which is fine but I'd consider looking at hypno birthing if you're anxious about giving birth. It's quite a hippy name tbh and we were quite dubious (scientists & engineers here!) but it's more about the facts of what your body does and how it does it which we found reassuring and answered a lot of our questions as first time parents.

Thanks for your reply!

As for the facilities; don’t the Lindo Wing (and similar) have their own facilities, separate from the main labour wards?

I don’t assume for a second that the equipment / facilities is any better in private wards; but I thought the fact that the ward was private meant more options on us both being allowed to be there... or are you saying that despite being on a private ward; the same actual rooms and facilities are used ??

Lindo Wing has its own theatre and patient rooms. So if you went there for example you wouldn’t be staying on the NHS postnatal ward. However for a place like that, if your baby needed the NICU afterwards then they’d be moved across to neonatal in NHS whilst you recover in Lindo.

I would assume the rules are the same regarding birth partners with regards to Coronavirus. If you can afford thousands on a private section then that’s great.

I am 36 weeks gone and was insistent on wanting a section at the start of pregnancy due to bad anxiety. However my mind has since changed as I’ve had more time to look into it and a section isn’t the easy way out, the risks for me outweigh the benefits especially for someone healthy like myself and the way the world is now the less time in hospital you spend, the better imo. NHS will try to talk you out of it, with good reasons if no medical issues. They’re not after your money. But each to their own!

Thanks for the reply. Yes; regard elective CS. We have many relatives and loved ones who ended up in a panicked, emergency, CS - and given some advice off of our midwife; it seems that for us, it's the safest most predictable route to go.

I used to work at St Mary's in Manchester it's a fantastic hospital. Lots of facilities. Dedicated elective section list all day every day, separate to the emergency list.

Your problem will be, even with private, is that due to massive nhs staff shortages due to the virus many private staff have been pulled into NHS trusts, or private hospitals have been told to take NHS patients to accommodate everyone safely.
I don't think anyone will "guarantee" you a section as the demand for the services is so high. Though if you had real need (you seem to have done your research and have your reasons) rather than just "convenience" your wishes will be respected as far as possible. NHS or private.

What is more likely is that due to staffing shortages/closure of units/stopping of home births, is that your elective "date" and time is more likely to be changed than it ever previously would have been.

I'd ring St Mary's up and discuss your options with them, as well as the private hospital.

As for your partner attending, each trust/unit seems to be varying slightly, though most (from my experience and anecdotes on here) are saying partner from active labour/section only, and limited time post birth. Though this is subject to change - especially by the time you are due to give birth in July! Hopefully for the better

Yes, the Lindo has a set up as has been described above (one of my mum friends gave birth there last year, bizarrely her work health insurance would pay for her to have baby privately but in the event of a medically necessary c section they'd have to pay an excess) but I assumed you wouldn't be having your baby there given you mentioned Northern cities. I have no idea what the facilities are like at all of the private hospitals other than I know for sure that some private ones share their operating theatres with the NHS hospital they're attached to, hence saying it'd be worth getting clarity if this is of importance to you before you spend your money.

Sounds like you've got some good advice from the poster above - you're completely entitled to have a c section but you may be up for a fight, especially in the current climate, but that sounds like something you're happy to do so good luck with it! And enjoy your baby :)

Thanks again for the replies!

The fight for an elective CS is avoided by going private; that - and the knowledge of date and who’s doing what is a great comfort.

I’ve heard recent accounts of NHS deliveries and people being swapped about last minute; organised chaos perhaps. To be honest; we’d happily use the NHS... especially as, as a family; none of us have been anywhere near a hospital in over 25 years!! So the one time, we’d like to have used the NHS - we feel we can’t... we were booked with Macclesfield hospital; they closed their labour ward a few weeks ago and didn’t say a word to anyone... no letter, phone call... nothing. We then looked at Manchester St Mary’s; but again, communication / info / details are just not forthcoming. The chances also, of being able to have an elective CS there given the current situ’ isn’t great and so we feel we have to take back control.

We are thinking Lindo wing, but still looking at the others. Really, we just want a date, to know who will be doing the CS, and to know we can both be in the room. So far, the only option that ticks all of the above, is the private route.

If we could have gone NHS and had all of outbreaks boxes ticked, we certainly would have done. The food menu and supposed luxury of the private route isn’t even a factor for us; it’s purely to take control of the situation.

If the money isn’t an issue for you then going private makes sense. My advice assumes it would be prohibitively expensive. If not, problem solved.

You may get more clarity over the date if you go private but for it to be "guaranteed" you'd essentially need to camp out in London from 35/36+ weeks and just hope it doesn't come any earlier than that! I appreciate you've got time given you aren't due until July, but I'm not sure how that would work if you can't get a hotel/air b&b etc? I delivered my first baby completely spontaneously within a few hours at 36 weeks and lots of others do the same so if you definitely want a c section then you'd have to be near enough to come in quickly if you went into labour naturally before your c section date. Having done a couple of miles car journey whilst having heavy contractions, I don't advise anything longer than that! I'm also not sure they'd be able to tell you who were doing the delivery given the pandemic at the moment (they may be isolating etc) but I appreciate that it might help you feel more in control than using the NHS if you feel like they've let you down.

It's glad to hear that your family has been no where near a hospital within 25 years. I was like that, then one day my life turned upside down in my late 20s, and now I'm forever thankful for the NHS and everything they continue to do for me :) we also have private medical cover but haven't bothered to use it yet. I'm sorry to hear your experience hasn't been the same.

@ldn1 could you travel to Leighton? I had a choice to birth at Macc but Leighton is closer to my home, they're fully open (check their Facebook page, they're active daily and have just done tour videos)

I'm sorry but I think in the current climate event paying private you won't get an iron clad guarantee a time and date and clinician to do the procedure.
as I've previously said, may private midwives and obstetricians are being drafted/pulled into support the NHS trusts, or NHS patients are being treated in the private hospitals due to lack of capacity and staff at the trusts. I wouldn't assume/bank on a specified guaranteed date.
Ring all the trusts local and the private hospital you're considering to ask about arrangements though and inform yourself from the horses mouth.
Also not sure travelling all the way from Manchester to London would be a good idea in late pregnancy, nor in lockdown would it be considered an essential journey.

I'm sure you're nervous and scared, we all are! (I'm 32 weeks today) better to inform yourself and perhaps look into hypnobirthing and positive birthing to help?

All the best, hope you are able to have the outcome you want

Thanks to you all for your messages; we have taken everything on board. We are going to push for St Mary's Manchester - and see how we get on in the next week or so.

Thanks again.

Hi, @LDN1

I wanted to check how was your experience in St Marys or private for the c-section. I am now in a similar situation, currently having may antenatal care in St Marys but considering going private to be 100% my request for an elective c-section will be approved.

I hope everything is going well with you and baby :)

@MariG300

Hi, *@LDN1*

I wanted to check how was your experience in St Marys or private for the c-section. I am now in a similar situation, currently having may antenatal care in St Marys but considering going private to be 100% my request for an elective c-section will be approved.

I hope everything is going well with you and baby :)

Hi MariG,

We ended up going to Wythenshawe and managed to get a date booked in with one of the very best C-Section doctors. He’s called Andrew Pickersgill and he was pro choice on C-Sections years before it became a thing. His record on C-Sections and all related work is amazing and it was our private midwife who had heard of him and suggested trying to go that route.

Macclesfield: it seemed that they would do an elective CS but only after a bit of a battle, and then of course, closed - St Marys, they were basically telling us no’ to an elective CS - even though it was our right to have that... and so our private midwife came up with some names for top doctors that are fine with elective CS’s and that work in or around Manchester / Cheshire.

London / private was still on our radar but we were starting to get more and more worried about the virus and having to be stuck down in London (lived there 10 years and now avoid the place if we can!)

And so a couple of names came up: one I think worked at St Mary’s but we couldn’t get ahold of him easily and the other was Andrew who works out of Wythenshawe.

Once we’d got transferred to Wythenshawe and knew that we had Andrew on the day set for our elective - we managed to calm down and our only anxiety was if we’d make it to the day (the baby seemed to be ready to pop out at any minute!)

Long story short: after a horrid rollercoaster of events, being given the runaround by different hospitals, and little communication: Wythenshawe were brilliant; Andrew was brilliant; The anaesthetist was brilliant; The staff were all brilliant. There was one strange nurse the day after, who had some comments for us - but it was not nearly enough to taint the whole experience. We managed to get a private room for the night and we were home the next day.

Andrew made all the difference: it felt as though we had the A-Team with us throughout the birth. It reminded me that there are very special people working within the NHS. The nurses and staff were equally great.

Having said all of the above, one of my best friends has had two births at St Mary’s and had great experiences. Another friend had one at St Marys and one at Wythenshawe and she preferred Wyhtneshawe, but not by a lot.

I’ll finish by saying, do not worry. These places are all good and you will be fine. As for the elective CS specifically: just fight your corner and don’t let up. If it’s feeling like St Mary’s won’t etch in stone that your request will be honoured, maybe consider a transfer.

The amount of anxiety that can build up is horrid and all you’ll want, as we wanted, is to know that you’re having a CS, the day it’s happening and preferably who is doing it. We honestly thought that that wouldn’t be too much to ask but it seemed impossible.

It all worked out in the end and we have a healthy baby. Truly wishing you the best and I’d like to say, don’t worry too much, you will be fine.

Thank you so much for sharing your experience and all the details @LDN1! It is really helpful :D

I will try to get a consultation with Dr Andrew Pickersgill, do you know if it is ok to have a private consultation with him (I read online he also works privately for pregnancy consultations) to get more advice about how to go about it? Or should we contact the Wythenshawe hospital directly?

Also, may I ask about the private midwife you worked with? Could you recommend her and tell us your experience of having a private midwife and what difference does it makes?

About St Marys, so far they seem somewhat receptive to my elective c-section request. The first booking midwife was great, very supportive of my concerns and request, and booked an appointment with a consultant to talk about on day one, she also told me in general St Mary do listen to women's choice as much as possible. But I met the consultant last week and she barely said anything back to my concerns, just that is dangerous and riskier (I said I understood the risk, and still prefer it), and that she is not the one making that decision so it would be decided later. I insisted I needed a clear answer before it was too late in the pregnancy, to be able to change hospitals if necessary, because having VB was not an option, so she made another appointment with another consultant at 20 weeks. If that one says not, I'm going somewhere else for sure.

Besides that, I have to say all staff of St Mary has been great and if I did not have the c-section request issue, I would be more than happy to stay with them.

Hi sorry for the late reply, just saw this. He used to do private consultations and still might but I know with Covid, things were always changing!!!

The private midwife was great but we experienced and heard of others that weren’t so great. I will try and get the agency name for you.

Thank so much for the tips @LDN1!

Update: Today I got my c-section approved and the CS date booked in Manchester, UK! Thank you so much for the tips, the support, and the information in here and other Mumsnet groups was very helpful :D

Details for anyone in the North West looking to have an Elective CS:
It was at St Mary's Hospital, from the Manchester University Trust (that also has Wythenshawe hospital), that I had heard was a proCS-choice friendly NSH Trust in general. I asked on all my initial appointments with midwives to have an appointment with the OB consultant that made the CS decision and got it at 20 weeks (today), mentioning I needed to be able to get approval for my elective CS as soon as possible to stop stressing about it, or to have time to transfer if denied.

I brought a letter (stating my official request, reasons, and that I was informed and understood the risk but still felt it was best for my baby & my health) to the consultant. The consultant was Dr. Sorin Juverdeanu, he was empathetic, professional, and respectful and did not try to persuade me against it, he gave me the required consent form and explained the risks mentioned there, but was not trying to push me to change my decision or making feel bad about it, so I highly recommended him. He booked for 39 weeks and reassured me that in case of unexpected early labor the hospital will do an emergency C-section (unless is one of those miracle speedy cases when the baby head is almost out when you arrive at the hospital of course).

The midwives before that were also friendly and receptive, so far I am very happy with St Marys :)

That’s great news!! Apologies for not responding sooner I’ve been moving house and forgot. Congrats and you can rest easy now. Best wishes with everything!