Can you request a C Section and are you likely to get one, especially for your first pregnancy?

[Unsure96]

I’m in my mid 20’s, never thought I wanted children until I recently started thinking about the other side of things and realised one of my biggest reasons is being absolutely terrified of pregnancy and giving birth.
If I was ever to get pregnant then I don’t think I could mentally do a natural birth, not so much because of a fear of the pain but all the ways it can cause damage, such as incontinence, tearing your clitoris etc. I understand that a C Section seems to usually come with a much harder recovery afterwards, but would this be a realistic request for the NHS?
I have also thought about surrogacy and adoption, also if I did have a child then it wouldn’t be for around 10 years anyway, but I’m not sure how affordable those would be as options

Well regardless of what you say and what you will do, it doesn't actually change the risk profile.

You might not change your mind with that information. But others might.

For women to have the ability to make informed decisions it relies on hcp being able to spell out how this might not be the most appropriate course of action and to present alternatives. And then for women to make decisions from that.

And a basic minimum level of care should go without saying for whatever you choose and tbh I don't think thats happening for a lot of women and that's backed up by a couple of public inquiries saying the same thing.

If women are seeking ELCS because of poor standards of care which are not optimal and are causing harm, we should be tackling that head on, not just giving a privileged few who can navigate the system and be pushy to get better care by having an ELCS.

I'd prefer if we had honest and frank conversations rather than ones which just suit the agenda and wants of a minority rather than the basic needs of everyone...

... You crack on there.

@RedToothBrush I never said you were talking 'bollocks' but I fundamentally disagree with the assumption that every maternal request is the result of mental health difficulties or past trauma. No!

I am 'scared' of giving birth vaginally because:

• it can last for days and be extremely traumatic in and of itself with no history of trauma.
• when you're in the hospital, you are at the mercy of the healthcare professionals who may or may not respect your requests for intervention or lack thereof.
• there are so many variables and things that can go wrong. 1/3 of FTM require instruments or EMCS to get baby out.
• only 50% vaginal births are uncomplicated.
• forceps can cause substantial tearing.
• tearing being normalised is ridiculous to me. It is not ok that our nether regions tear and have to be stitched up.
• one can end up with a dodgy stitch job and may even have someone give them a husband stitch - this is a complete violation.
• tearing can cause incontinence (front and back) and this can last a lifetime.
• pushing a baby out weakens pelvic floor muscles more than just being pregnant. This increases the risk of pelvic organ prolapse. Although, I recognise that the weight of a pregnant uterus does a number of them, research has shown that pushing out a baby does more damage. It's common sense really - I mean once a body has changed enough to push a baby out of the vagina, it makes sense that it opens a pathway for other things to fall out.
• The NHS isn't interested in fixing incontinence or prolapse, according to many testimonies of women. Like tearing, it's normalised as 'that's what happens when a woman gives birth.'
• babies can get stuck and end up in fetal distress.
• personally, I find yanking a baby out by its head, or sucking it out by its head, extremely barbaric.
• babies can be starved of oxygen during vaginal births and can end up with permanent brain damage as a result. Contrast this with 'may have breathing difficulties' but can be taken immediately to NICU after being removed via ELCS.
• babies can need to have their bones broken to get them out.

Now, I look at my list and I don't think any of that is irrational fear. It's not tokophobia - although it's been labelled as such by our health system because it's so hellbent on vaginal being default and 'normal' despite the above, so anything that deviates from a mother's wish to go through that experience is pathologised.

I'm not denying that some women do have previous trauma or mental health difficulties that make giving birth an unacceptable option. However, it's important to recognise that it's not every woman. Personally, I thank my lucky stars that I am fortunate enough to have all this information at my fingertips and be well-versed in my reasons why vaginal is unacceptable and also the risks of c-sections (which for some reason lumps the risks of EMCS and ELCS together sigh).

I'm glad you got your c-section. I'm sorry to hear you had to fight harder for it. Thank you for helping women on here in the same position. That is all I am trying to do too. If someone wants a c-section currently, my experience is they will be told the risks of c-section over and over again which is why I am highlighting the risks of vb. Just to reiterate, I know that c-sections come with more serious risks to me as a mother. However, the percentage risk of those things happening is far smaller than the risks of vb I outlined, which are commonplace.

I don't think we should be talking younger women out of sections. However, it is important to highlight that it increases the risk of future pregnancies and that a woman who wants many children will need to weigh up her options differently.

@Labyrinth86 👏🏼 All this and more! Exact same reasons to me. The ‘phobia’ aspect of it was more around the whole decision making process for me because I’ve never been more sure of anything in my life than the fact I would be having a c-section. I was told a completely skewed version of the c-section risks and none of the risks of a vaginal birth. I will still have to listen to those risks again next Monday when I go in for my section because I haven’t signed the form yet. No one about to push a baby out of their vagina has to listen to all the awful things that might happen just as they’re about to do it 🙈 It’s certainly not any easy road out and it’s not even easy to get there in the first place so I don’t think anyone enters into it lightly!

[quote sarah13xx]@RedToothBrush I’m not sucked into my own personal position. You were referring to younger women (me) therefore I’ve justified why ive made the decision I have. Forming a relationship with healthcare professionals may have helped you in your own personal situation but would do nothing for me if the end goal was for me to give birth vaginally, as my fear isn’t around the staff or what they might do.

I think anyone who dares to get pregnant while experiencing tokophobia (whatever that looks like to them) is extremely brave and should be fully supported and encouraged to have whatever birth they choose to have rather than made to feel worse about a situation they’re already highly anxious about[/quote]
Yeah, I don't agree with moving goal posts based on age either. It can be traumatic and result in life-long injuries regardless of age.

Also, according to healthcare professionals 35 isn't an 'older mum' these days (and I wouldn't class it as late 30s either ) I've always felt this way, which is why I didn't have kids when I was younger. I only entertained the idea of being pregnant after reading women could request c-sections. My family did have kids in their 20s and some still ended up with horrific injuries and mental health difficulties post-birth where there were none before. It's not the case that younger equals less trauma. It might be statistically less likely, which is all research can tell us, but there are countless women in threads on here who have traumatic injuries and were younger mums.

@Labyrinth86 out of my group of friend’s (in their 20s) not one person has had a ‘good’ vaginal birth. One couldn’t sit down at all for 2 months because it hurt so much, she then had to get help because it wasn’t healing the way it should. My other friend (only 26) lost a huge amount of blood and ended up in theatre nearly having her womb removed. The others have all had either tears/episiotomy/forceps 😳 I think every single one has been told they can have a c-section next time!

You honestly don't think this was part of my issues?

Seriously. I can't be arsed.

Go read my posting history on rational v irrational.

This still doesn't change risk profiles and how they stack up in particular groups disportionately.

You obviously think that we shouldnt be told this and we should ignore data because you are fixated on what you want.

Thats fine but seriously don't tell me i havent done this or dont know the arguments.

Ive done them to death. I just also believe in properly informed consent and transparency and that an ELCS isnt a magic bullet.

Im also not speaking from a position where im looking from afar on it.

@RedToothBrush you have a strange attitude for someone claiming to help support women in these really vulnerable situations 🤔 In my experience (and everyone I’ve seen on here) consultants very thoroughly go over the risks of a c-section. What they don’t do is give you the risks of the alternatives to compare. If you’re dead set on having a c-section from the off, chances are you’ve researched for hundreds of hours on it, like me, so the risks don’t come as any surprise to you. No ones saying you shouldn’t be told the risks, you should just be able to make an informed choice looking at the true risks of all of your options

My attitude is that things should still be ethical and still be safe and still be informed

I have problems with people who ignore the importance of this and that its not all about what you want.

I've fought this from the front and now it feels like people are frankly missing the point about why it was important in the first place which harms other people in the process.

@RedToothBrush

You honestly don't think this was part of my issues?

Seriously. I can't be arsed.

Go read my posting history on rational v irrational.

This still doesn't change risk profiles and how they stack up in particular groups disportionately.

You obviously think that we shouldnt be told this and we should ignore data because you are fixated on what you want.

Thats fine but seriously don't tell me i havent done this or dont know the arguments.

Ive done them to death. I just also believe in properly informed consent and transparency and that an ELCS isnt a magic bullet.

Im also not speaking from a position where im looking from afar on it.

I assume this was to me? If so:

• I don't have the time to read your posting history. Also, why should I do that? I have an issue with your current assumption that all women who want a c-section are in some way unwell. I reject that notion and provided evidence-based reasons why. I stated that I recognised that older women may be statistically more likely to have issues (physical) with vaginal birth. I'm not denying the existence different risk profiles. However, I do not* believe that these should be the be all and end all. If a woman is likely to suffer from PTSD or PND following a vaginal, why should she be forced to do that just because she's considered low risk physically? Incidentally, in my 'late 30s' I'm considered low risk anyway.
• I didn't say ignore the data. What I said is the data can only tell you statistically how likely or unlikely complications will be. They do not provide a guarantee that things will be fine based on age or anything else. That's the thing about vaginal birth - not even medics who examine you throughout pregnancy or even on the day can predict how it goes.
• I haven't told you that you don't know this or that?! I just disagree with what you're saying and I'm entitled to do that. I tried to provide reasoning for it too. I'm not just being difficult for the sake of it. lol. I'm a qualified psychologist. Informed consent is drilled into me. I would never argue that all women should have a c-section nor that it's a magic bullet. It comes with increased risks to women, including increased risk of death. However, I'm confused by your line of argument because there is no way* any woman, especially maternal request, has an ELCS without being told the risks and signing the consent form.
• Finally, how on earth did we even get here? The OP asked a simple question and I was trying to offer support. In your opinion, I'm not at liberty to do so because I'm geriatric and ready to pop whereas she is not pregnant and young. I merely offered to share my experience as I am currently going through the maternal request process. I'm sorry that offended you so much.

[quote sarah13xx]@RedToothBrush you have a strange attitude for someone claiming to help support women in these really vulnerable situations 🤔 In my experience (and everyone I’ve seen on here) consultants very thoroughly go over the risks of a c-section. What they don’t do is give you the risks of the alternatives to compare. If you’re dead set on having a c-section from the off, chances are you’ve researched for hundreds of hours on it, like me, so the risks don’t come as any surprise to you. No ones saying you shouldn’t be told the risks, you should just be able to make an informed choice looking at the true risks of all of your options[/quote]
My thoughts exactly @Sarah13xx

I always wanted a c section and had one granted on grounds of maternal request at first (but would have got one anyway as baby ended up being breech)

I bitterly regret it

Adhesions and scar tissue destroyed my tubes. I nearly died twice and risked leaving my child motherless due to 2 ruptured ectopics. I was infertile by age 36. It cost us £35k to get pregnant again

I appreciate I represent the worst case scenario but it's a risk nonetheless that I really don't think is discussed appropriately when you sign the consent forms. I know a lot of women in my ectopic support group Who had ectopics due to c section scarring and also those that suffered secondary infertility and miscarriages as a result of having a c section

@twinningatlife how did you nearly die? I'm terrified of brith

I'm late to this thread- only pop on this section occasionally these days.

Same as @RedToothBrush, I first found Mumsnet due to my fear of childbirth. This was 9 years ago now. I can definitely confirm that Red has a great deal of knowledge on the subject and has indeed helped many women with her advice. I also agree completely that a c-section isn't a magic bullet and that it's not going to be the right choice for every woman who has fears around birth. However I strongly believe in a woman's right to access all of the facts on risks and benefits and make an informed choice on how she wants to give birth, whatever her reasons. If there is no huge medical risk involved in her choice she should be allowed to make it.

I think the reasons why women may have tokophobia (although now I'm thinking about it- I don't think it's an irrational fear at all really, is it!) can be complex. There probably are often factors like past abuse or mental health issues at play. But not all the time at all. I've had anxiety in the past, maybe this was just another part of it. I was genuinely terrified of the loss of control, what I also perceived to be a frightening, humiliating experience, with risks of horrendous birth injuries, to myself and baby, and the risk of incontinence. But anyway...

I was incredibly frightened when I was pregnant. It wasn't long after the NICE guidelines were changed in 2011. I think that gave me the confidence to go ahead and have a baby but looking back I don't know how I did it. Had a lovely midwife, was referred to an understanding consultant, who booked me for a section when I was only 16 weeks. He said I had the worst case of tokophobia he had seen in 30 years of practice.

It was a relief. Although the rest of the pregnancy was still incredibly difficult. I was terrified of going into labour ahead of the planned section date. I got to 39 weeks and it all went smoothly. I was even allowed to have a general anaesthetic as even the thought of being awake during the op was terrifying. I made an excellent recovery. I actually had a second elective section just over two years later with my second child, again very difficult experience but I wanted two children and luckily again, all went very well and I made great recoveries with no ongoing issues.

Red has given some great advice over the years but I also disagree on discouraging women in their 20s or treating them differently. Age may change risk profiles (correct me if I'm wrong but I would have thought a woman in her mid 20s, no relevant health conditions with a healthy BMI is pretty much in the best position for any mode of delivery and the subsequent recovery) but the risk of trauma to and poor outcomes related to tokophobia doesn't change. I was mid 20s when I had my children. I am so so glad I was allowed to have my sections. The potential for trauma and PND afterwards if I hadn't was massive. It was the right choice for me.

I think it's a bit patronising too to say that someone in their 20s will definitely want a large family. Women, generally speaking, choose not to have large families these days. Of course some do and good luck to them, but with modern contraception, it's not an inevitability. And honestly, I think most women with a horrendous fear of birth are not going to continually want to put themselves through multiples pregnancies and c sections. I had two- I can only speak for myself but don't want to go through it al again. I'm nearing mid 30s now- I'm sure my body wouldn't cope as well and the risks are higher. I'm glad I have my two and that's it- for many reasons I'm done having babies.

I do think that women should be able to make informed choices. And also think that the NHS is very good at highlighting all risks of c-sections whilst trying to minimise the risks of vaginal birth. I also think that the NHS and medical profession is inherently misogynistic and women are held to higher account to justify perfectly reasonable decisions about their healthcare - especially in maternity- but that is probably another thread.

I could have gone into more detail with lots of this stuff but don't have time or energy frankly but I have a reasonable amount of knowledge on this too, I've been through it twice and thought it might be helpful to those in a similar position at the moment.