How can I ask for a Csection?

[squashie34]

I am due to see my consultant next week at 36 weeks and I am Just looking for some advice on how I can ask to opt for an elective csection on the basis of anxiety/MH rather than a vaginal birth.

I've always had a fear of giving birth vaginally but thought when I got pregnant I can deal with it when it happens- however as my pregnancy has gone on my anxiety has gotten worse and worse. My friend unfortunately gave birth to a sleeping baby a few weeks ago and this has just rocked me to the core, so much so my thoughts are consumed with it. I now have nightmares most nights that when I give birth the baby won't come out alive I can't get excited for my baby to arrive as I'm convinced we won't be taking her home from the hospital.

The midwife referred my to IAPS mental health and have been diagnosed with tokophobia - I am having some cbt sessions and have been put on sertraline but I still come close to having a panic attack every time I think about a vaginal delivery and can't see anything except the worst outcome. I know that there's no way my labour will progress as it should with such fear as from the positive birth course I did to try and ease this anxiety, I know adrenaline is the devil and it's more likely I'll need intervention which then results in more panic etc.

I know a csection is a longer recovery and carries risks but I'm willing to take that for the fear I have. I'm worried that the consultant will just say 'no' as there isn't really a medical reason for the csection, but just wondered if anyone had any advice for how I can approach the subject?

I would suggest you say just what you have said here. Write it down in advance if you think it will be hard to say.
I can understand how much your friend's awful experience of loss will be playing on your mind.
I am quite surprised that if your midwife referred you to IAPS and you are on sertraline that no-one has actually discussed birth and your fears with you until now. Tokophobia is considered justification for c/section by many people, but it is very important to have a balanced discussion about the risks and benefits of both vaginal delivery and c/section.

Good luck

OP I've had two ELCS due to Tokophobia- both within the last ten years. It absolutely is a medical reason- it might not be a physical health problem but mental health is medical too.

My tokophobia was very severe. I was so scared of having to say out loud all of my fears so I actually wrote down every single reason why I wanted to have an ELCS, explaining all my reasons- also showing I had a thorough understanding of the risks and the benefits. The consultant just read through everything I had written, didn't question anything more and actually went to get the diary to book my ELCS (I was only about 16 weeks pregnant).

I appreciate I was lucky to have someone do understanding but many women are granted ELCS for tokophobia. Remember the NICE guidelines too- they're guidelines and not set in stone but they may help.

Writing everything down coherently really helped me- I was so anxious at the appointment that I couldn't have possibly said everything I wanted to.

Good luck!

Take someone with you and write down your fears.

My sister had NO health implications -none. But she worked herself into a frenzy about a V Birth. She was given an EC. No issues.

Please make sure you tell your GP, midwife etc this is what you want and why. They may push back CS takes longer to recover etc -but providing you know the risk I'm sure they will support you.

But you do have a medical reason -anxiety and mental health implications.

I friend of mine had in her youth an operation on her outer private parts after an accident -and it didn't heal and was traumatic and suffered from repeat infections etc. Again . Fully heal and 20 years later -asked for and was given a c section. Take someone 100% on your side and ask.

Unfortunately in my area it's just me that can go to the appointments - my consultant isn't very warming and last time I saw him I just felt I was an inconvenience and was wasting his time, hence why I think my request would just be shot down 😕

great idea about writing it all down, I can sound quite articulate on paper and I have done so much research but my anxiety about this is so bad I know as soon as I talk about it out loud to him I will burst into tears especially as he doesn't make me feel comfortable. @AlexTurnersCigarette can I ask how you gave them the letter, did you just hand it to them at the beginning and sat this is my birth preference?

My lovely midwife had specifically referred me to the consultant she thought would be most understanding.

At the appointment I didn't want the student present in the room, he hadn't read my notes and made a flippant comment about having to get used to having different people around when giving birth.

I proceeded to cry, and hand over what I'd written down, I probably blubbed something about having written it all down.

He read it all and apologised profusely for not having read my notes 😂 he was actually lovely. Agreed immediately, booked it in the diary and scribbled 'ELCS agreed' all over my maternity notes.

That's how it happened for me anyway 😂

Just got back from the consultant and she read my letter and agreed to the Csection! She talked me through all the risks but was actually so lovely about it and it's totally my choice and that she can see I've read up a lot on the benefits vs risk with vaginal birth. Got my date there and then.

Thank you so much for all your advice and support - I never would have had the confidence to advocate for myself like that otherwise ❤️

Glad to hear this OP.

Hope you can enjoy the rest of your pregnancy more now and look forward to meeting your little one 😊

@squashie34 oh that's fantastic, I'm delighted for you. I hope you're feeling better about things now and can relax a bit 💐