Elective section , first baby, maternal request

[FTMRLH]

For several reasons I would like to ask for an elective section even though I am pregnant for the first time and considered low risk.

A few are:
Severe anxiety surrounding the thought of birth even before being pregnant, this has prevented me trying for a baby
Anxiety about lack of control during birth and the trauma which may ensue if my labour doesn’t go to plan
Prevention of an emergency caesarean
Anxiety of not being able to bond with my baby if the birth is traumatic, family history of PND

I’m not afraid of the pain, it’s the lack of control, the unknown, the panic if an emergency happens and the responsibility I have to birth my baby without causing any stress or birth defects.

I have educated myself on all the guidelines, the risks, the recovery etc and feel this is something I 100% want but don’t feel like I am able to discuss it at my appointments.

I mentioned my anxiety in my booking appointment but the midwife was then more encouraging of a home birth which pushes my anxieties and worries through the ceiling.

I’m 13 weeks now and can’t talk about my pregnancy to anyone including my partner because it triggers severe stress and worry which often leads to nausea and migraines

Any advice from anyone who’s been in a similar position would be greatly appreciated

thanks in advance

That's great, OP! Well done and good luck. I've had elective c sections and they were all lovely experiences, calm and free from anxiety. I was able to have plenty of skin to skin and to breastfeed my baby very shortly afterwards too. I don't regret anything.

@FTMRLH

I went to my scan today and saw a midwife afterwards. I told her my concerns and that I wanted a csection. She was amazing and got a doctor in to speak to me right away. I explained what was causing my anxieties and the research I’d done on my own. I’m booked to see a consultant when I’m 24 weeks to discuss further.

She said everything is my choice and as long as Iv spoke to the consultants and been given the information to make an informed decision it is up to me. And I can even change my mind on the day of the op if I decide against it.

Just wanted you all to know how I got on.

Fantastic news! That's really reassuring! I've got my first MW appointment on 16/03/2021 and I'll be raising it too.

All the best with the consultants - it sounds promising!

You sound exactly like me! I had decided I wasn’t going to have any children because I just couldn’t go through the birth part. To me it sounds like complete and utter HELL no matter how much people say ‘oh it worth it’ or whatever. I just could not go through it all. Petrified is not even the word. Last year I looked into all the birth rights stuff, found my local hospital and realised if I asked for a section it should be granted so decided to try for a baby. I was wondering at what point to raise this with the midwife but in our booking phone call she said ‘so you’ll be green pathway birth centre’ and I had to jump in and tell her it all and say I really wanted/needed a section. She did a slightly patronising ‘aw why? There’s so many nice stories too’ but I made it clear I had spent years researching this and just couldn’t do it any other way. She reassured me that I will be able to get a section and will be referred to a consultant further down the line who won’t put me off it and I will still have the choice at the end of our discussion. So that was fine then at the 12 week appointment it was just really a scan then a blood test and the birth wasn’t mentioned. It wasn’t with my own midwife who I’d shared all my concerns with either so I didn’t really feel comfortable realing all that off to a random midwife who wasn’t asking about the birth. My midwife phoned me again at 16 weeks and I asked her again about it. She said at 22 weeks when she comes to visit me at my house she will refer me to a discussion thing at the hospital for dealing with anxiety around birth and after I’ve completed it il be able to get referred to the consultant to make the final decision. I am trying not to even think about it and just tell myself I’m getting a section at 39 weeks. Even have the date in my mind that it’s happening. I’m now 21 weeks so about to be referred next week. Even the thought of having to go to this to discuss it makes me anxious but I’m going to take all my reasons typed out in bullet points so I can’t forget what I want to say. Just hoping it’s all straightforward and it’s granted quickly. Even other people mentioning things about the birth is making me anxious because every time I say to them about my views they do the patronising thing of ‘awk I thought that but it was fine’. Then try to start a discussion with me as if they’re going to change my mind 🙈 I don’t think there can be a video or piece of research on the internet I haven’t seen on child birth at this point so just trying to block it all out and tell myself it’s sorted!

@sarah13xx yes we do sound exactly the same. Please let me know how you get on? It’d be great to hear another similar experience? Which trust is your hospital part of? Xx

Take a look at Mummy Concierge on Instagram. She had similar worries and talks about her two elective sections. For first, second and now third baby due July.

[quote FTMRLH]@sarah13xx yes we do sound exactly the same. Please let me know how you get on? It’d be great to hear another similar experience? Which trust is your hospital part of? Xx[/quote]
When I have searched before it’s often hard to find anyone else who feels the same and I don’t know anyone in person who feels like this! Ever since I was a child I’ve always thought I just could not do that and expected at some point when you become an ‘adult’ that goes away but it’s just got 10 times worse 🙈 I’m in Scotland so it’s Ayrshire maternity unit. Have you checked your hospital on the map on birth rights? Mine was rated ‘Amber’ as to how well they follow the NICE guidelines but they have granted 30 something requests in the year they asked them so people obviously do ask and get them. There’s only one hospital in Scotland rated ‘Green’ but luckily it’s only about an hour away from me so if they start to be really difficult about it near the end I will ask to be moved there! I feel so strongly I’d take out a bank loan and pay to go privately if no one would do it 🤣 Also hoping I’m booked in for no later than 39 weeks and I don’t go early! Would be so scared they’d say they can’t do the section and leave me in labour til it’s too late xx

Hope you get the birth you want.
However I just wanted to say I have loved my natural births and good hormones you get after. I get the unknown is scary.
How about if you had a epidural.
Getting over a c section is very hard.

I hope I've understood your original post properly, if so, I hope this is helpful.
Fell pregnant (completely unexpected, mid-30s) end of 2019. So petrified I cried until I threw up. For exactly the same reasons as you. However, my mistake was bottling it all up, and I got perinatal depression and psychiatric referral. Prescribed meds, but wouldn't take them, and spiralled. I became obsessed with the idea my baby would get stuck and have something happen if forceps required.
Ultimately, I had suspected PROMs at 36weeks, and had a complete loss of control, panicking and sobbing whilst being checked. I had a phobia of being touched/looked at in such a private area. A Dr came to see me and a midwife kind of said, have you considered c-section, as if this is how you react now, you may struggle with labour.
So I got a section booked at 38 weeks(!). But went into labour spontaneously 2 days beforehand!
Now, I can promise you, obviously painful, I felt like I was floating in a bubble, pethadine is a hell of a drug. And I had no fear whatsoever, 3cm dilated when I went in, I felt really calm and was laughing to myself in-between contractions! But the c-section was still available, and I ultimately opted to go through with it, mostly because I had no-one there like a mum or sister to advocate for me (Covid). Not sure how many cm I ultimately got to, but my baby was a bit head squished, but sitting upright with the pethadine I felt fine. There was no panic whatsoever, I just knew if I had the section I could just get it done and not be alone again.
My point, I think, is god, if I could do it all again...I wasted 9months of wonderful complication free pregnancy vomiting and shaking with fear. The moment I got the section booked, I felt like the weight of the world had been lifted off my shoulders. I think if you explain your feelings to the midwife, and push for yourself, be strong, they will accommodate you. If it's worth it for you to relax and enjoy this pregnancy, which you absolutely must try to, you should ask. It doesn't mean you have to have one, and trust me, from what was the most scared mother, I would go back and do labour in a heartbeat.

@FTMRLH
I too have tokophobia and pushed for an elective at my booking appointment.

Met with the consultant and burst into tears, could barely read/go through the notes I'd made. He was understanding and made the call to the hospital to book a c section date there and then. I believe this was back in September and baby wasn't due until March 2021. It was a massive weight lifted and I found I could then enjoy my pregnancy.

As it happened my waters broke early but I was still able to have the section. I was petrified but it was perfect and amazingly positive experience.

Baby born 13.30, we were out lunchtime the next day. Even with covid procedures etc my partner was with me from entering mat ward until the evening in recovery. He was asked to leave once we had to go to the ward.

Was out of bed and walking later in the evening and kept on top of pain relief so didn't feel anything. Ate and drank loads and got the catheter removed.

At home recovery was fine, again kept on top of pain relief. Only had to take it slow getting out of bed and the car for the first few days. Certainly didn't feel like major surgery and wasn't bed bound like some stories people tried to scare me with.

Baby is now 6 weeks old. It was amazing and would do it again tomorrow.

Do your research and if an elective is what you want don't be afraid to fight for it. X

@Humpf07
Thank you so much for your positive story.
It’s really reassuring to hear from other people who feel the same and have had the support they need.

Iv been really lucky so far and all the midwives I have spoke to have completely understood my worries and haven’t even suggested trying to talk me out of it.

Iv done my research and know what I want.
Hopefully the consultant also supports me, I believe their a perineal mental health specialist too.

Slightly stupid question but do you just attend the maternity/new born centre like you do for scans for the consultant? Iv never been given any information and it’s approaching quickly.
I need to make notes. Iv managed to talk about it without crying at my last appointment but I think the consultant appointment might be a different story

Xx

That's great news that the midwives are taking you seriously! I was the same as you, I found I had to keep mentioning it at all my midwife appointments, they kept saying well let's see how you feel at the next appointment and we can book you in to speak to the consultant. Eventually I went to an appointment around 25ish weeks and it was actually not my usual midwife, I had everything typed out and she read it and said we will get you booked in to see the consultant asap! I think writing down your reasons for the consultant is a good idea, it shows you've done your research and it helps in case you become emotional (which I did!). I remember asking the consultant to just read my notes but she said just talk through it if you can, and I just burst into tears.. managed a few sentences and she was very sympathetic actually.
Once she saw how serious I was, the consultant read through a few of the c section risks (which they have to do) and then I had one more appointment to sign the consent forms. These appointments were all at the same hospital where I had my baby (Barnet, which is part of Royal Free London). But it might be different depending on your hospital. Good luck, I remember the relief when it was all finally booked in!

You will have no control whatsoever during a c-section. If you give birth vaginally you will have some control, or lots of control depending on the circumstances.

@Caneloalvarez glad you got one in the end! This is like me just now too. I am almost 24 weeks and I’m kind of in limbo waiting to see if a consultant is going to phone me or if il receive details of an appointment. I’ve mentioned it at every appointment and they’re always supportive but just kind of push it further down the road and say we will deal with it then. I, like you, had a different midwife at my last appointment and had to start from the beginning again with explaining all my reasons but she could see there was just no way I would consider any other birth. She said she would pass it on to my own midwife to have a consultant discussion arranged but I’m now not clear if that means she’ll note that down and when I see my midwife at 28 weeks again she will then arrange it. I just feel like I can’t wait any longer 🙈 I’m really not a cryer and I feel like I feel so strongly about this it doesn’t really upset me as such but I started silently crying the other morning and my partner was asking what was wrong. I was like I’m just so worried about all of this 😭 This was after I’d had a dream about the consultant appointment and woke up then couldn’t get back to sleep for worrying about it so started my frantic googling 🤦🏼‍♀️ I’m going to wait til 25 weeks then contact my midwife and basically say I can’t go through another 3 weeks of not knowing what’s happening because it’s having such an impact on my every day life.

I will be SO glad when I have spoken to the consultant and he/she agrees hopefully 👏🏼 Don’t think I will ever have been so relieved! X

First off don't be afraid to let it all out in that room. They need to see tokophobia is very real and the impact on women's lives and pregnancies.

My consultant was fab, reassured me and asked me why I wanted a section... through tears I reeled off.. fear of Birth and all that goes with it - pain, loss of control, the unknown, interventions, inductions, examinations, forceps, tears, availability of staff, pain relief, haemorrhage, ending up with a section anyway. Plus all the potential long term problems... incontinence, prolapse, further surgery, PSTD, PND.

Anyway, he had a frank conversation with me and pretty much agreed with my "case" he explained there are still risks involved but was happy I had done my research and called the hospital to get it booked.

At the end he asked whether I wanted to remain consultant led or midwife led.

I explained how relieved I was that he agreed to the c section, a date booked and it being recorded in my notes and basically said I didn't want to take up any more of his time. I was informed and knew what I was "signing up for" so essentially there was nothing more to do until the c section date arrived. All further appointments were with the midwifery team. I was given a booklet with a c section "pathway" explaining what would happen and birth plan template (look up gentle c section)

I won't lie I felt like a different woman leaving that room and had a bit of faith in humanity restored.

Let us know how you get on. X

@Frogartist an elective c section is most definitely a more controlled process and more predictable, for a start you know the exact date and time of the birth which eases an anxious persons mind immediately (well in my case it did!)

@sarah13xx oh gosh I'm sorry to hear you're worried about it, they do try and sneakily push you further down the process I think! But ultimately it's your right to request a c section. I think I'm my notes I actually wrote down "if this hospital will not perform my c section I will find one that will" to show how serious I was!

At your next appointment, be really forceful and say you want to be referred to the consultant and you would like a date in the diary for this asap. I think the process is actually meant to be sending you to the "birth options clinic" first of all, which is basically midwives talking to you about c sections and also natural birth, to make sure you have all the info. However, I think I was too far along for this to happen so I got referred to the consultant and they then booked in my c section, it was about a month in advance which felt quite late to me but I was just happy it was booked in! So if they mention the birth options thing, just reiterate that you want to see the consultant.

I was really happy with my choice, it was a very calm and also magical experience, I was still quite anxious on the day but it I now wish I'd just relaxed and tried to enjoy it more! The recovery is a bit painful but the hard part for me was done in a week or so.

@Caneloalvarez yes this is exactly how I feel and I would be willing to go anywhere that will do it! I think mine will agree to it, both midwives that I’ve told have said they will but it’s just how casual they are about it as if I can just wait about not knowing til 30 odd weeks 🙈 It was the birth options clinic my own midwife said she’d refer me to after my 22 week appointment but then it wasn’t her who ended up doing the appointment so everything we discussed has been added to my notes for her to act on. I think I will send her a text just to see if I can chase it up before my next appointment or it might seem like I’ve been at home chilled out about the whole thing when I’ve been the complete opposite 🤦🏼‍♀️

That’s exactly what I’m hoping for. My view on it is so extreme that I feel like no matter what it’s like it’s got to be better than what I have in my mind about what my natural birth would be 😑 glad you had a good experience x

@Frogartist

You will have no control whatsoever during a c-section. If you give birth vaginally you will have some control, or lots of control depending on the circumstances.

Physically while surgery is under way then I agree - no you can't jump up off that table however could you while experiencing pain while giving birth in the latter stages vaginally?

With an elective once the screen goes up you are at the final hurdle and guaranteed your baby will be out in 15 mins tops unlike vaginal birth where you could be suffering for days.

With an elective you walk in to that room fully in the moment... fully informed and the plan explained to you throughly before. There are limited options and probably better mental health outcomes unlike vaginal birth.

With an elective I would argue that you do have control - A date, a time, a full team of professionals... paediatricians, consultant, midwife, partner, anesthesiologist and many more ready to assist and support.
Blood is on stand by. Nothing starts until you confirm you cannot feel anything.

My issue with vaginal birth is there are too many things that can go wrong too many factors.

As you said @Frogartist "depending on the circumstances" I wouldnt want to gamble on whether I could get an epidural in the moment while experiencing quite possibly the worst pain of my life.

Personally I found vaginal birth less stressful and I was more in control than the c section , you definitely need professional specialist therapy not counselling as you have severe anxiety and must get help
life does not have to be this miserable and stressful

:10Caneloalvarez

@Frogartistan elective c section is most definitely a more controlled process and more predictable, for a start you know the exact date and time of the birth which eases an anxious persons mind immediately (well in my case it did!)
Yes,,of course. The c-section process is more controlled in that way. I meant that the woman giving birth is more in control of a vaginal delivery than a c-section during the actual process. Of course things might happen during a vaginal delivery that means that you have to "give up" some of that control.

As you said@Frogartist"depending on the circumstances" I wouldnt want to gamble on whether I could get an epidural in the moment while experiencing quite possibly the worst pain of my life.

Well, no, I agree with your concern. However, it is not exactly a "gamble", most of the time most women get the care and pain relief they need during a vaginal delivery. Having c-section does not guarantee that you won't feel any pain or that things will be easy.

OP I hope you get the birth you want.

@RosesAndHellebores

As a 60 year old mother who had straightforward vaginal births with no stitches, I’d have an ecs every time and shall advise Dd to have them. I have had a weak bladder for 26 years and a weak sphincter muscle for 6 or 7. It’s all manageable but frankly I’d rather not have to.

Just tell the midwife what you want and expect and brook no argument. If you get an argument write to the director of midwives.

This We need more @RosesAndHellebores

Women need to stop "glossing" over birth and say it how it is.

@Frogartist

As you said@Frogartist"depending on the circumstances" I wouldnt want to gamble on whether I could get an epidural in the moment while experiencing quite possibly the worst pain of my life.

Well, no, I agree with your concern. However, it is not exactly a "gamble", most of the time most women get the care and pain relief they need during a vaginal delivery. Having c-section does not guarantee that you won't feel any pain or that things will be easy.

OP I hope you get the birth you want.

I have heard of this happening a lot and it happened to my friend just last year who was told she couldn’t have the epidural she had been asking for for a long time. She said she would never go through it again and was so traumatized after it that they have told her she could have an elective section in future because of how many things went wrong. There are just so many factors involved which might all go great or, like hers, all go horrifically wrong 😕 It certainly feels like a gamble when there are so many different outcomes