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)

I’m in next week and it will be with the consultant again! She said last time I would find it hard to get someone to agree to do a section but I’m not sure that’s fully true and I think it was a fob off really! I would love nothing more than having a happy relaxed birth but I think after last time the fear will prevent that even if everything went well anyway, I will still be terrified which will cause trouble in itself!

@kallia I know and it’s not even the hospital staff’s fault that you’ve been left to get into that position but they’re the ones who would have to deal with it! The woman on one born every minute the other night was requesting an epidural and really shouting and screaming for ages about it. The anesthetist arrived on the ward to do someone else’s epidural but the midwife in charge said actually can you go to her first because she is most in distress so it clearly is based on how much you shout and scream or how much you just sit quietly and take it 🙈 We usually go to my parent’s holiday home (over an hour away by boat) every summer. This year I’m not willing to go anytime after 34 weeks because I’m just petrified beyond belief that I’d go into labour and I’d have to wait on the boat back and everything. I’m going to be sitting by the door with my bags packed ready to just race straight in there the second I even feel a flinch 😂

@Yummymummy2020 do you have a typed letter of your reasons/past experience? I would take that with you and as quoted in the NICE guidelines, if she is not willing to do your section ask her to refer you to someone who will. She will maybe realise this week you are being really persistent and just give in!

I had an ELCS for my second due to tokophobia. I had a traumatic birth with my first, forceps delivery with a major haemorrhage and internal tearing. I went on to develop PND and the delivery and subsequent difficult recovery was a part of that. I was not able to even countenance the thought of going into labour again without genuine panic.

I was very nervous to speak to the consultant about it (I was high risk so under consultant care anyway) but I found I was listened to and respected. The consultant was at pains to make sure I understood that an ELCS is a major surgical procedure and the risks involved. I was given lots of information and then two weeks to consider before making my final decision. No one tried to convince me to try a natural birth again, although I was informed of the statistics of needing another assisted delivery and having another haemorrhage.

At the second appointment I said I had decided to go with an ELCS and that was that. Not made to feel guilty or under pressure at all. My ELCS was a positive experience and I have no regrets, in fact I found it incredibly healing.

I hope you are supported in the same way by your consultant OP.

It’s so appalling that women dont have a choice on the NHS. I gave birth privately in the UK; at my 12-week appt the obstetrician asked me what kind of birth I wanted. I said a c-section, he wrote it down and that was it. I had a c-section. In the end I had to have one anyway as I had placenta praevia. But it was 100% my choice anyway.

Now I’m in Switzerland and it was exactly the same here. I was asked and I decided.
It is barbaric not to give women a choice about what happens to their own bodies. Barbaric.

@Useruseruserusee wow, glad you had a good experience and a straightforward discussion about it after such a bad experience first time round. Hopefully my consultant is as understanding 😊

@LapinR0se it totally is in this day and age! Ever since I was a child I was almost fascinated by it because it seemed so barbaric that I couldn’t quite believe people just strolled into it like it was fine. My opinion of it seems to have got stronger rather than just becoming an ‘adult’ and suddenly thinking it was fine. If both men and women went through it I’m sure it wouldn’t be the same rules! That’s the thing that gets me, if my consultant is a man and starts to be awkward about it. At no point in his life has he ever had to contemplate experiencing any of it. Going privately is my last resort, only if I’ve been referred elsewhere and they say no. I have a low lying placenta so they’ve said I’ll need more scans and would potentially need a c section because of that anyway so that might end up working in my favour

My distress was so evident that it was granted at 12w by the consultant. I would write what you've put here.

For what it's worth, I've had two babies by section now and although my Toko will never be 'cured' the births were so good that I actually managed to enjoy them. Recovery was a doddle (certainly faster than most friends that had vaginal births) and I had zero regrets. I had minimal blood loss, was able to have cuddles within 2 minutes if birth and didn't even feel mildly queasy (to the extent I was scoffing chocolate 2 hours later).

You can do this. To allow yourself to become pregnant feeling as you do means you are STRONG even if you don't feel it. You've made it so far and you can come through this with the best prize ever.

@Babyboomtastic aww what a great comment 😊 Glad you’ve had such a positive experience. Everyone seems to make out recovery from a vaginal birth is completely fine but I have so many friends who have been unable to sit down for 2 months or unable to lift their leg to get in the bath weeks later due to having forceps/tearing/episiotomy etc. So I feel like I’ve geared myself up for a tough recovery from a section because you’re told how bad it is but that’s great you had a straightforward recovery too! Anything better than agony will be a bonus 😂 It does feel surreal that it’s my number one fear and yet I’ve let myself get a baby inside me without freaking out too much yet! 🙈 I actually don’t mind being pregnant at all and have had such an easy time to the point I wouldn’t even know I was pregnant most days! Hopefully the birth will be just as good ☺️

Keep checking when you meet with MW that she records what you actually requested/said. I'm concerned by the accounts above where someone asks early on for a CS with reasons and that isn't even documented.

I found they were very lax about recording what actually happened and what I wanted - missed off request for MH support so I didn't get any antenatally - to making assumptions/outright lying - saying I was 'well supported' but didn't actually ask. If she'd asked she'd have discovered my Mum was about to leave not to return for several months and there was no other support! We had concerns our baby was showing signs of dehydration, MW didn't document and dismissed our concerns, baby readmitted following day seriously ill with dehydration.

If I was having another baby I'd stand over them and supervise what they're writing!