Probably a silly question about elective c sections

[Ahorsecalledseptember]

When and who do I tell I want an elective section?

I am now 35 weeks and nothing about childbirth has been mentioned!

It is causing me some worry. People keep saying I need to tell them but I don’t know who ‘they’ are - the midwives?

The midwife should be able to arrange an appointment with the consultant who might well want to refer you to a birth options clinic before seeing him/her again for a decision. Hopefully it will all be straightforward for you but at 35 weeks, I’d be contacting the midwife tomorrow.

Hi, I told my midwife at our first appointment (over the phone because of Covid) that I wanted an elective. She arranged an appointment with a consultant which I had at about 16 weeks. They've now made another appt for about 32 weeks where they will give me my CS date. It's not too late but I'd get on the phone to your midwife asap in case you go into labour any sooner

Yes, tell your midwife as soon as possible! Electives are normally scheduled from around 37 weeks

I don't think they ever actually ask what type of birth you want- they presume you're going for vaginal unless you say otherwise (or there's a medical reason that would make C-section safer).

Thanks sparkly I did see the consultant but the birth was barely mentioned! My next midwife appointment is at 36 weeks, it just seems awfully late?

I see kiri - it explains why they are assuming it’s a vaginal birth, then! (Sounds obvious, but I honestly expected some consultation about it!)

Give your midwife a ring. Theatre space can be at a premium (my hospital only books 2 ELCS a day in case they get a rush on emergencies in any day), so "book early to avoid disappointment."

Oh blimey, thank you.

Yep they won't ask you and in a lot of hospitals they will make it really difficult for you to get a c-section. Where I live you would need to be chasing it up very forcefully from about 20 weeks as you need many appointments all of which have a long delay. I think you need to contact your midwife right away if this is what you want and expect to be fobbed off.

Well, I have been asking about it since 20 weeks but I just keep being told that all gets discussed closer to the time, but given I could give birth in 2 weeks and not be early, surely the time is now! I mean I like laid back, but really!

So... a lot of hospitals have a policy of trying to minimise c-section rates and one way of doing this is simply not referring you for the necessary appointments unless you chase it up relentlessly (you normally need an appointment at a birth choices clinic to discuss the decision, an appointment with a consultant to book the section or, in some hospitals, a referral to mental health because wanting a section is considered a mental health issue (yes this is actually true)).

Your hospital might just be laid back but it's more likely they have no intention of referring you unless you push very hard for it. I'm not saying this to tell you off or anything, but I think at this stage you need to either make it your absolute mission to get a section booked, or accept you are goign for a vaginal birth. It is very likely that your midwife is assuming you will just end up giving birth vaginally. Definitely don't expect them to take the lead.

Have a look at this website for more information

www.birthrights.org.uk/campaigns-research/maternal-request-caesarean/

Thanks very much - that does explain things as I’ve been waiting for them to ask me what I want!

Why do you want an elective c section?

I’m concerned about exacerbating an old injury. And it will hurt

@Ahorsecalledseptember

I’m concerned about exacerbating an old injury. And it will hurt

Vaginal births do hurt, but c sections should not be thought of as a pain free option. I'm in a new mums group for October babies and it's been a huge surprise to listen to all the c section mums discussing the healing process- honestly sounds so grim.

I know, but I really have given this a lot of thought and consideration, and I do feel I know my body well.

Hi OP, I had an elective CS 3 weeks ago for similar reasons and I'm very happy with the decision I made. I was clear from the outset that this was my intention. The procedure at the first hospital I was due to give birth at was to schedule an appt. with a consultant at 32 weeks to decide mode of delivery, I ended up transferring to a different hospital halfway through my pregnancy as I wasn't happy and the second hospitals policy was to do the same at 36 weeks. Understandably I was left feeling really anxious about this and the chance of going into early labour, so I asked for this to be bought forward which it was to 34 weeks. It's your right to have an elective csection, if the hospital aren't accommodating do stand your ground. All the best for the remainder of your pregnancy x

Depends where you are - I had no resistance at Princess Alexandra in Harlow. I was v clear though from the start with the community midwives that given last birth I wanted an ELCS. I met the consultant at 36 weeks and booked in for 39+1.

Bit odd though that to date no one has asked you home birth, birthing unit, labour ward, ELCS or what your birth plan is (my DD2 was born in July so a lockdown baby and all the normal questions were go through if only by phone).

I had an elective c sec after a forceps delivery with 3rd degree tear with my first. Best thing I ever did and the recovery was much easier and less painful after my c sec. that’s just me though ...

Yes, you must tell your midwife now. Lots of midwives are very reluctant to ask and/or refer for a first birth, if they are in a trust that wants to keep the rate down. I had an EMCS and have just booked an ELCS for my second and my midwife really dislikes me for not wanting to be persuaded into a VBAC, but hey ho!

They definitely should be talking to you about it - to be honest, I am surprised that if you had a previous injury this wasn't something you disclosed around booking in to start the discussion- I can't remember what they ask the first time around!

Birth plan

No, I was asked by my GP’s receptionist where I wanted to give birth, and that’s been the only time it’s been mentioned!

I will give the community midwives a call tomorrow. I probably need to be a bit pushier. I understand things are difficult at the moment but it’s been a little lackadaisical.

I disclosed it at the start whole and I’ve tried to discuss it on, oh, at least five different occasions now.

PS even my EMCS was was totally fine - take it easy initially. People who haven't had them often talk them down a lot more than those who have and those who have had both often compare a vaginal birth vs a crash section, which is totally different to an elective.

Right, sorry if I missed that.

In which case, you need to start mentioning your right to have one under NiCE guidance and probably that you will have to contact PALS and/or make a formal complaint if they don't at least tell you what the process for getting one is. I mean, at 37 weeks your baby is pretty much cooked and could arrive early. It's a bummer to have to be so pushy for something that really should be discussed freely with you, but there it is.

Ps my midwives have been pretty reluctant and the system has been pretty clunky this time around (could be Covid plus second baby), but I mentioned at EVERY appointment that I won't be considering a vaginal birth and need a consultant referral for a section until the damn referral came through. Probably why my midwife hates me, but she just wouldn't listen and kept trying to direct me to the birth choices clinic (which is all very well, but if she had spent any time with the file from my first birth, or even my booking in notes and looked at it dispassionately and objectively she would know a vaginal birth really isn't the best option for me!).