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Childbirth

Share experiences and get support around labour, birth and recovery.

Facing Uphill Battle & Hoop Jumping - ELCS

31 replies

WaitingForNormality · 23/02/2021 15:10

After a bit of advice as to whether this is normal NHS burocracy and box ticking, or if this is unusual and unreasonable...

Pregnant with #2 and from 1st appointment (booking with midwife) expressed request for elective section for birth. Following 1st birth (2016) I suffered from an anal fissure (basically a tear in the bum - it's even less fun that it sounds!) which I still suffer with now, but manage well with daily stool softeners and diet. I requested a section in order to avoid risks to any further potential damage/trauma to that area which could arise from pushing during labour (which triggered the original fissure) or, worse case, a significant 3rd/4th degree tear which would result in another tear in that area.

Had consultant appointment at 19wks (following midwife referal after my booking app) and he originally listened and agreed straight away. I was so overcome with relief that I cried. Only, he then called back 10mins later to say that it needed to be considered by a multidisciplinary panel first and he would let me know in 2 weeks what the outcome was. 4 weeks later I had another appointment, where a different consultant said the panel had met but didn't make a decision as they want evidence from a colorectal surgeon that c section would be beneficial - this, they said, would take a further 4 weeks and booked my follow up consultation.

Just had that follow up and now it turns out they're requiring me to have a separate consultation with the colorectal surgeon who has been unable to say if it would help or not. This is scheduled for another 5 weeks away.

I've explained that regardless of what the colorectal surgeon says (i.e. that a section would not make the fissure worse or better), I am requesting a section as its my view that no one can promise me I won't suffer additional tears/trauma from a vaginal birth and its a risk I'm unwilling to take. I've researched extensively and medical studies show that tears in the area are the single biggest factor leading to anal incontinence, so you can see why I'm cautious about any further harm in that area!

No one has mapped out the route to a decision for me (despite asking) and I feel I've got no idea when or if they will agree to a section. I will be 32 weeks by the time of the colorectal appointment and with each passing week my anxiety is rising. I honestly feel trapped, and that I have no say or autonomy over my own body.

Is there anyone I can complain to or help to push this process along? Does anyone have any experience with this and hints to help me navigate through this?

Terrified it will drag on indefinitely without a decision and I'll end up being forced to labour 'naturally'.

OP posts:
Screwcorona · 05/03/2021 13:23

I think I would get the elective booked, heal after birth and then make a complaint about the process to PALS.

Or

If this next appointment doesnt result in the csection being booked immediately call them to intervene.

PALS involvement shouldn't affect your treatment negatively at all. They are there to step in during and after treatment.

WaitingForNormality · 16/03/2021 09:17

I just wanted to come back and update the thread, as I know how annoying it is when you're looking for similar problems on MN and cannot find out what the eventual outcome was!

I had another consultant appointment yesterday with the obstetrics team at my NHS trust to discuss my request for ELCS. My last appointment was bloody awful so I was quite anxious. This time I saw a different consultant (rules in my trust require 2 separate consultants to sign-off on maternal request) and it was absolutely fine! The consultant said they'd reviewed my notes, and were happy to sign-off straight away. They said that they were happy to discuss risks etc. once again but given that I'd already been required to speak with 3 registrars, 1 senior consultant, plus themselves (a consultant) and that my case had already been through a formal multi-disciplinary panel review they were convinced that I was informed and understood my decision. Essentially, he said it would be a waste of everyone's time to continue to make me attend more appointments. He even booked my C-Section date there and then for 39+1!

So... I managed it in the end! If you're in a similar situation, keep at it and make sure you keep consistently saying what you want and remain firm. The NICE guidelines are in your favour.

Thanks to everyone for their comments on this thread - you were super helpful :-)

OP posts:
Excitablemuch · 16/03/2021 13:49

Ah great news I had been wondering about it. Good luck and enjoy the rest of your pregnancy. My c section is Friday and I can’t wait!!

Screwcorona · 16/03/2021 14:17

That's fantastic! Glad you've got this booked and sorted and can enjoy the rest of your pregnancy 🥳

EarlGreywithLemon · 16/03/2021 15:14

So pleased for you OP! So sorry you were put through all this though. So wrong and so unnecessary!
Hope you can now relax a bit and look forward to meeting your little one in not very long.

WaitingForNormality · 16/03/2021 15:16

@Excitablemuch

Ah great news I had been wondering about it. Good luck and enjoy the rest of your pregnancy. My c section is Friday and I can’t wait!!
Thanks! And best of luck for Friday... how exciting!!
OP posts:
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