ELCS - tokophobia. What to write in my letter for consultant?

[sarah13xx]

Hi, I have a consultant appointment (finally) at 29 weeks to discuss my request for a c section. I have mentioned it every time I’ve seen my midwife (6, 16 and 22 weeks). She originally told me she’d refer me to the birth options clinic to discuss my fears before getting to see a consultant but after hearing me at the 22 week appointment, and realising there was no other option for me, she referred me for a consultant appointment straight away. Even waiting a few weeks to hear back about whether an appointment had been arranged or not really affected my every day life with the extreme level of anxiety I was feeling. I ended up phoning her to ask if she knew if they were arranging it because I was actually struggling to sleep and waking up panicking about not getting to speak to someone and it being too late. I got the appointment through the other day for 29 weeks 😊 Due to covid the consultant appointment will be over the phone, which I think works in my favour anyway as I’m really not good at standing up for myself usually!

I am going to write up a letter of my reasons to read out at the appointment and I’m wondering if anyone in the same situation can share what they put on their notes to tell the consultant? My reasons are pretty extreme - do not read if you’re giving birth soon please 🙈 but they are:
Severe anxiety - even talking about birth makes me panic

Waiting on the appointment I’ve been a nervous wreck and barely sleeping worrying about it
My fears of what would happen if I was somehow forced into giving birth vaginally (which I couldn’t be):
I’d lose a huge amount of blood and die
I’d need forceps (over a third of FTMs do)
Tearing/episiotomy- have friends who have taken 4 months to heal
Baby getting stuck - lack of oxygen, dying
PND due to not having the birth I feel I need
Lack of control, emergency buzzers having to be pressed
Before getting pregnant I checked birth rights website/NICE guidelines and would not have got pregnant if it hadn’t been for the fact I’d read all of that information and knew I would be able to have a section if I requested one
Have watched every YouTube video and read every article about risks - years before considering getting pregnant, this has gone on my whole life
Don’t feel breathing techniques or anything could change my mind, it’s the only way I’m willing to give birth
My midwife said I would be so anxious I wouldn’t even dilate or relax enough to be able to progress in labour
Having this decision made will feel like I am able to breathe again and actually enjoy being pregnant, which will be good for both myself and the baby

Basically I’m well aware it’s not the ‘easy option’ and will have a long recovery but it’s the only way I can physically do it.

Anything I should add?

(On a previous post I received loads of comments trying to tell me why I should give birth vaginally - in the nicest way possible please don’t comment if that’s your opinion, I made up my mind a very very long time ago)

Op I was you a couple of weeks ago
I'd already told my midwife I wasn't giving birth at all
They arranged for my midwife to come with me to consultant appointment to advocate for me incase they said no as I was so panicked
However consultant was amazing
Said it would be detrimental to my mental health to refuse so I've got my C section
However before then I spent weeks making lists of the risks of c section and the risk of natural birth so they couldn't say I was being biased
I wanted to prove I understood all the risks
I also had a list of hospitals that accept maternal request c sections and was willing to transfer to there the closest being 1 and a half hours away
They can't refuse remember this and research your rights if they say no they have to refer you to a consultant that will do it
They will try to talk you out of it just remember 'I've considered this and I am happy with my decision'
It's your body your choice

@99redspottedducks thanks, that’s a good line to use, I will get that in! I just know how much better I will feel the second they say yes, even without knowing the date yet. My midwife did reassure me when I phoned her that I shouldn’t worry because my request would be granted. I would just rather know in advance if this one is going to say no and I need to then ask for another consultant etc but I’m hoping he can tell it’s the right choice for me

That line is curtesy of my sister she said the same to me (outs self) luckily this is my pregnancy name change
If you google hospital trusts that accept maternal request c sections there's a good list on birth rights. Org
Mine was under 'partially offer with concerns' however my consultant agreed straight away but my midwife team were amazing they'd already made consultant aware that mentally I couldn't take a no
However as you know, they can't really refuse anyway
I hope your appointment is as easy as mine after all the weeks of worry the relief was amazing
Appointment at 29 weeks is a good sign mine was 36 weeks but they brought it forward to 34
I'm still waiting for my official date but knowing I have one is a fantastic feeling!

@99redspottedducks hope yours all goes smoothly! I found the list on birth rights last year and looked up my hospital, it was a while ago but they had done 30 something that year and were rated ‘amber’. There is one hospital just over an hour for me rated green though that I would be willing to go to but I’m hoping this guy is nice and it doesn’t come to that 🙈 Also hoping I dont go early then need to rush in in a flap telling everyone I need a section. I watched the celebrity bumps programme and on last week’s Kate Lawler (who is the same as us) went early and ended up in tears because some of the midwifes tried to tell her she was to do it naturally and not get her section. That would terrify me! She did get it in the end though. Just going to be very very careful in the lead up to mine not to try and do anything that encourages labour 😂

Hi, jumping on your thread to ask a quick Q about your consultant meeting!

I want an ELCS due to extreme tokophobia & many of the reasons you have set out, like you I mentioned it at my 6 week booking appt, 16 weeks, and 22 weeks and each time the midwife said it was too early to make any birth plan decisions. At the last one I had (28 weeks) she referred me to Birth Choices - is this not the same as the consultant call? I had thought it was...

Just a bit nervous as I don't have the Birth Choices call until 36 weeks, I thought they could book me in for an ELCS but if I have to speak to another consultant I'm scared I could go into labour before they have time to book me one!!!

@kallia hey, so my hospital have started a new thing where people who are either first timers who are just terrified like me or people who had a bad past experience can go and discuss birth options. I think they mainly try and talk you into a vaginal birth and send you off for hypnobirthing so I thought I was going to have to go through all of that before qualifying to then speak to a consultant but the midwife I had the last time obviously just saw the state of me and thought this girl needs an appointment asap 🤦🏼‍♀️😂 Originally my own midwife had said I’d speak to the consultant about 32 weeks or something so I don’t know whether me phoning panicking has also made them book it earlier. At one of my scans they also said my placenta is really low and if it doesn’t move I’d need a section because of that. Obviously I was delighted at that 😂 but I don’t want to rely on that on its own to get me a section in case it changes. They said it was another scan at 32 and 36 weeks then I’d speak to a consultant if I was to have one because of it. I don’t know why they leave everything so late, I feel like once I hit 30 weeks I’ll feel like I’m on the home straight and could go at any time 🙈

There's a lot of helpful stuff on Birth Rights. This one's a PDF link and should give you all the info you might need. Good luck!
birthrights.org.uk/wp-content/uploads/2018/08/Final-Birthrights-MRCS-Report-2108-1.pdf

@RidingMyBike thanks, I had been on their website and found my hospital on it but don’t think I’d came across this!

Thanks so much @sarah13xx and @RidingMyBike, that's super helpful :) hoping I don't get fobbed off with hypnobirthing, I've been fairly adamant from the beginning that I know and understand the risks and that I want a C section anyway. I've stated this from the beginning but I'm quite good at hiding how anxious I feel about the alternatives so I hope I get taken seriously.

@kallia my last appointment was with a different midwife because my midwife was isolating so she didn’t know anything about my phobia and as I started to tell her she said have a look at this.. and started writing down a website for hypnobirthing for me. Usually I’m way too polite and would just along with what they say but with this I just can’t sit there and kid on I’m going to do it so straight away I was like well actually I’ve been asking for a section since 6 weeks 🙈 after I went into it in more depth she was actually really supportive and said I should stick to my guns and not let the consultant put me off if that’s what I really want but I think most people who are maybe just a bit scared get fobbed off with hypnobirthing and maybe go along with that

lol, you may not have a great birth experience with an elective CS. I had one as my dd was breech and I found it terrifying. My BP dropped really low and I was woozy, faint, out of control. My VBAC was much better.

It is better for most people to have a VB; don't expect a CS to be amazing. I was in shock and distraught after mine.

@kallia

Thanks so much *@sarah13xx and @RidingMyBike*, that's super helpful :) hoping I don't get fobbed off with hypnobirthing, I've been fairly adamant from the beginning that I know and understand the risks and that I want a C section anyway. I've stated this from the beginning but I'm quite good at hiding how anxious I feel about the alternatives so I hope I get taken seriously.

I found when I admitted how badly I was coping the midwifes were so supportive I rang my team having a meltdown that I needed help I couldn't give birth in anyway I just wasn't going to do it She calmed me down got to the route cause of my anxiety 'consultant saying no' and set the ball rolling that, that was NOT going to happen I'm not sure I could of coped without their support so don't be afraid to seriously admit how you're feeling If they know they can help You can also asked to be referred to see perinatal mental health team They can also recommend c section to consultant

@tenlittlecygnets 'I was shocked and distraught after mine'
That's exactly how I felt after my first natural birth which took me 6 years to get over before I felt I could try for another baby
Everyone has their reasons for the choices they make

@tenlittlecygnets sorry you didn’t have a good experience. There’s no easy option but that’s the only way I can physically do it, whatever the outcome, so that’s what I’m going for

@tenlittlecygnets sounds like OP has heavily researched the risks and benefits both ways and has decided she’s happier with the risks involved with an ELCS than attempting vaginal birth. Obviously we are all different with different preferences but OP sounds well-informed.

Just wanted to show you that things won't necessarily be great even if you have a CS. You're statistically more like to lose more blood in aCS, for example.

I totally understand why you want a cs. I did for my second. I am very pro cs Just be aware that a cs is still unpredictable and you might not get the birth you planned. I only held ds briefly after he was born as I was shaking so much they gave him to dp instead!
Good luck

@tenlittlecygnets many of these risks are based on c sections in general which includes both elective c sections (the safest of the three types of birth) as well as emergency c sections (which people are entering into already in a life threatening situation a lot of the time). I’m just as prepared for things to go wrong as anyone is when they sign up for a vaginal birth. If I’d presumed it would go terribly from the start I would just not have had a child at all but when he’s already in there I’m of the opinion now they could say they will have to amputate both legs at the end of the operation and I will still go for it 🤷🏼‍♀️ There is just no alternative for me

Fair enough, op. I wish you all the best and hope you have the best birth possible.

@tenlittlecygnets thank you, I hope so

@99redspottedducks I had a bit of a breakdown on the phone to one midwife who was lovely, she calmed me down and said that she'd put it in my notes for the midwife to discuss with me at the next appt, but of course they wouldn't force me to have a vaginal birth if I couldn't take it.

I still had to ask about it at the appt as my midwife forgot to mention it. Don't want to be cynical but I'm a bit concerned they're kicking the can down the road until I go into labour naturally which I would find completely terrifying.

I agree with the line the poster got from her sister above and may use it myself! I’m getting resistance too even though after a really bad birth last time and injury the mental health team recommended a section next time as I was traumatised after for months. I totally get that recovery can be tough with a section but I think it’s dreadful that even in cases like mine and yours where you are well informed and it’s right for you it’s such a battle. I’m at a stage now where it’s actually harming my mental health having to repeat what happened to try justify my reasons. What I got off my consultant was anyone would be nervous after your experience but the odds of having that again are slim, and I’m like well they were apparently slim in the first place and the worry it’s causing me now isn’t actually worth it! I also am fed up of being talked out of it too when I made my choice already. I’m 36 weeks now and literally petrified I’m going to go into Labour!

@Yummymummy2020 oh no! When’s your next appointment and who’s it with? I know how hard it is for me and I’m not even going off a bad experience, I’m just trying to avoid the bad experience before it happens 🙈 so I can only imagine how traumatic it is when you’ve got to relive that to keep telling them the same thing. They obviously make it as difficult as possible so that people (who haven’t considered the options/risks etc) don’t just waltz in and say they fancy one but I’ve had to tell so many different people and only now am I about to get to tell the consultant who is the one who will even make the decision. I really hope he gives me an answer there and then, I obviously won’t get a date til later (which even terrifies me in itself) but I’m hoping I can chill out if he says it’s fine and I can have it. If I was you I’d do what I did the other day and phone up either your community midwife or the number for the midwives you deal with and say you’re not sleeping etc and it’s on your mind all day every day worrying you’re going to go into labour and this isn’t sorted yet! My midwife said the secretary who works for my consultant prioritizes who gets appointments with him in order of urgency. At that point I’d heard nothing from them and thought I might not til 30 odd weeks but not long after I phoned her in a panic (a few days later) his secretary phoned me saying she’d heard I’d spoken to my midwife and was really keen to speak to someone ASAP. So the message obviously got to them that I was getting myself in a state about it all 🙈 Kate Lawler (from celebrity bumps) has the same fear, had her section booked yet went into labour a few days before and was in tears because the staff were trying to tell her to give birth naturally. She did eventually manage to get her section but I really don’t want any delay or hanging around if I’m actively in labour and that happens to me!

I really hope you manage to get it sorted and get a date in as soon as you can! Keep me posted x

@kallia I think that’s what they seem to do in so many cases and even when they give you a section date they make it as late as possible and presume you’ll just go into labour and do it and won’t complain. The thing they don’t realise is if they try that with me I am going to be like the woman I saw on one born every minute the other night who just screamed at the top of her lungs 😂 I’ll scream on the way in, I’ll shout and scream I want a section at anyone who enters the room, I’ll maybe even run around the corridors shouting it until something is done 🤣 So their plan of kicking the can down the road will majorly cause them way more hassle than just booking me in early would 🙈 I told my midwife my whole big story when I was only 6 weeks and even then my heart was racing etc just having to talk about it. When I looked back on my online notes on my phone there is no note of me saying that. It wasn’t like I just said I’m a bit scared of labour, I actually requested a section. The first time she notes that I said it was at the 16 week appointment and her response then was really just, I’ll deal with that at the next appointment. She was then isolating so I got someone else and again went through the whole thing, I think that time is the most definite I’ve been about it though. She could see there was just no possibility it was happening! I think having that different midwife that day is the only reason I’ve ended up with a relatively speedy referral to a consultant and she was actually encouraging! I’m just hoping if I decide to have another child later on getting a second section will be nowhere near as difficult because I’ll be prioritised as being higher risk and maybe won’t need to go through all of this and will potentially even be able to relax and enjoy it slightly!

It really annoys me that for all the talk about "women have the right to make their own birth choices" no-one's really doing that.

I'm super scared of going into labour - like you @sarah13xx I'll be screaming at the hospital staff if it happens - but it shouldn't have to be that only women who are visibly upset at the idea of labour get to have their C-sections booked in. I've worked so so hard in hours of therapy through my pregnancy just to not collapse at the thought of contractions, am I now going to get punished for "not being distressed enough"?

I've done extensive research, I'm well informed, I know the risks and am prepared to accept them. That's all that should be required.

@Yummymummy2020 I really hope you get booked in soon, keep calling and keep insisting.