Should I request a c section? FTM

[Riverrushing21]

Currently 30 weeks pregnant and v anxious about childbirth, to the point where I’m wishing I had just requested a c section- is it too late now??

I’m not actually worried about labour itself or about being in pain. One big fear is of tearing and having a horrendous recovery, incontinence, sex issues etc afterwards. I’ve read many horror stories about the recovery (or lack of) after 3rd or 4th degree tears and I don’t want to be in such a bad state after birth that I struggle to look after baby.

Another fear is of going overdue, (I know this is very common for FTMs) as I know someone who went overdue and had a stillborn, after no other issues throughout the whole pregnancy. If I had a c section, going overdue wouldn’t happen, and labour wouldn’t be able to develop into any emergency situations.

I know it may not even happen to me and I could have a textbook labour- is it crazy to even consider ELCS for first birth? Will I just get told no straight away? If it’s too late for me to request it now, any tips on how to approach a vaginal birth without all this anxiety?

@SweetBabyCheeses99

I think that’s a really good point. I needed a surgical revision after my first birth (pre-Covid). I didn’t have to wait long for it at all - 6 weeks I think - but now I’d have to wait 1-2 years. I’m much more inclined to opt for a section for my second birth because I think if I need the follow-up care I needed with my first then accessing it will be seriously difficult.

[quote Aggy35]@HangingChads really? So we want the baby but don't want to push and that's OK as goverment will lift it out?
Whats next i don't want to carry it?
Its already going that way with let's just do what easier for me thinking all around.Who needs birthing or breastfeeding etc.[/quote]
Why are you so angry about how other people chose to birth or feed their babies? Why make another woman feel bad about it? C-sections or bottle feeding aren't the 'easy' route but for some people they are a better choice. Why's that such a problem?

@sarah13xx thank you for this! where can I find the NICE section on the Birth Rights website?

@PineapplePanda the link to the maternal request c-section page is

www.birthrights.org.uk/campaigns-research/maternal-request-caesarean/

The NICE guidelines I’ll just copy below:

Maternal request for caesarean birth

1.2.25 When a woman with no medical indication for a caesarean birth requests a caesarean birth, explore, discuss and record the specific reasons for the request. [2011, amended 2021]

1.2.26 If a woman requests a caesarean birth, discuss the overall benefits and risks of caesarean birth compared with vaginal birth (see the section on planning mode of birth) and record that this discussion has taken place. [2011]

1.2.27 If a woman requests a caesarean birth, offer discussions with the woman, a senior midwife and/or obstetrician and other members of the team if necessary, for example an anaesthetist, to explore the reasons for the request, and ensure the woman has accurate information. [2011, amended 2021]

1.2.28 If a woman requests a caesarean birth because she has tokophobia or other severe anxiety about childbirth (for example, following abuse or a previous traumatic event), offer referral to a healthcare professional with expertise in providing perinatal mental health support to help with her anxiety. See the NICE guideline on antenatal and postnatal mental health for more detailed advice on providing mental health services for pregnant women. [2011, amended 2021]

1.2.29 Ensure healthcare professionals providing perinatal mental health support to women requesting a caesarean birth have access to the planned place of birth during the antenatal period in order to provide care. [2011, amended 2021]

1.2.30 If a vaginal birth is still not an acceptable option after discussion of the benefits and risks and offer of support (including perinatal mental health support if appropriate; see recommendation 1.2.28), offer a planned caesarean birth for women requesting a caesarean birth. [2011, amended 2021]

1.2.31 If a woman requests a caesarean birth but her current healthcare team are unwilling to offer this, refer the woman to an obstetrician willing to perform a caesarean birth. [2011, amended 2021]

If all women requested c - sections for the reasons you've stated, no one would have a natural birth again.

@Aggy35

I'm a first time mother to be and I think c sections should be reserved for when medically necessary unless done privately. Harsh as it sounds those possible problems are a part of having a child.Should we all get c sections because we want everything down there to be as before?

Don’t be so sanctimonious

@sarah13xx

This was me! Although I was absolutely one million per cent sure I wasn’t having a vaginal birth, it just wasn’t happening! I’ve had a lifelong fear of it so the second I was pregnant I was desperate to speak to someone to request a c-section. I commented this on someone else’s post earlier. Have just copied it to save me writing it out again but good luck!

Just had an elective section 2 weeks ago. It was maternal request, purely because I didn’t want to experience any of the awful things any of my friends have. I’ve had a lifelong fear of giving birth and always knew if I got pregnant there was only one way that baby was coming out!

I did A LOT of research before getting pregnant and also during pregnancy to prepare for my consultant appointment to try to ‘convince’ her to approve my section. It was a telephone appointment in the end up and I had 5 pages of printed notes ready to read her 😂 It turned out I didn’t need a single bit of it. She could hear how anxious I was and quoted the NICE guidelines (that I had written down) to me before I got the chance. She said it wasn’t her job to tell me no and I could have a c-section if I wanted! She did then try to put me off by telling me all the risks, many of which related to an emergency c-section or high-risk elective rather than a straightforward one on a healthy person. I had researched all the risks myself and knew what the true risks that would relate to me were so just said yes to everything. She booked it in there and then but didn’t tell me the date until our next appointment at 34 weeks. My section couldn’t have been more straightforward or painless, it was brilliant! Honestly the best day of my whole life 😊 2 weeks on I feel almost completely recovered (although I know inside I’m probably not so going to take it easy-ish for another month).

I’d say go on birth rights website (maternal request c-section part) and look up your hospital to find out whether they’re rated red, amber or green on following the NICE guidelines. My hospital was amber and it was still really quite simple to have it approved so it’s not the end of the world if it’s red. It will also tell you on there how many they’ve carried out. Look up the risks on the NHS page so when they tell you them you know what the odds are (most are uncommon or rare). Have the NICE guidelines written down and if they say no ask to be referred to someone who will perform it. Due to my fear I found I really played on the anxiety aspect of it. The main anxiety inducing thing was trying to get it approved and waiting for the actual appointment itself! So definitely mention mental health and the benefits a c-section will have for you.

They shouldn’t say no!

You come across very smug.

& don't you think we are all scared of birth... Ffssss

@Imnewhere1991 I am 😊 after worrying my entire life about giving birth (and never stepping foot in a hospital once or costing the nhs a penny) I made the decision that I would be controlling how I gave birth. Tokophobia is not a general fear of birth, it’s a phobia. Had I not had my c-section approved I would most likely be traumatized, struggling to bond with my baby and possibly suffering post natal depression right now among many physical injuries that I’ve managed to avoid.

You sound like a very bitter person. So sorry you feel that way.

@Imnewhere1991

You could have requested a c-section on the basis of your PTSD and past trauma and sexual abuse. Other women’s birth choices aren’t to blame for your experiences.

Imnewhere1991 Hi, you might be better off taking this up with me if you like. I didn't have a phobia of giving birth or concerns beyond the usual; I just considered the medical research and concluded that an ELCS (with no underlying medical condition) was the correct option for me on the basis of the balance of risks for mother and child and which I was most comfortable with.

That decision is perfectly within the NICE guidelines - and the specific policy of the hospital I attended - and was agreed on that basis by my consultant and his juniors after a very civil and pleasant risks conversation at which they were happy that I was perfectly well informed and therefore competent to make the decision. No pretence, no abuse of the system.

As you'll see, the average cost of a c-section is barely any greater than a vaginal birth when only consequential incontinence is factored in. So I don't consider that I am costing the NHS more money (and would be perfectly happy to pay the small supplement charge if it were demonstrated and if that were really the issue).

Approx. 75% of hospitals refuse ELCS or treat it as a lucky dip. I think that is wrong on the basis of both financial and medical care considerations and will happily campaign for other hospitals to follow the sensible approach of the hospital I attended.

What is this about for you? Your understanding that it's more expensive? Your understanding that it's more risky? Or something else?

'It was maternal request, purely because I didn’t want to experience any of the awful things any of my friends have. '

Your quote no?

I am not bitter, I am a traumatised new mum. The money the NHS have had to spend supporting me after the birth could have been saved if they'd even allowed me to discuss a c - section.

I suffered pre and post natal anxiety and depression, I was induced due to diabetes, my son got stuck, needed forceps, Vontouse cup, was in NICU, low blood sugars, tongue tie, temperature issues. I had to be cut, got a 2nd degree tear, my son got jaundice and I couldn't hold him apart from feeding and changing while he screamed under a blue light for 48 hours, I needed a blood transfusion that was missed, I was so traumatised I didn't recognise myself or my son, I was then given anti depressants, a year of therapy, weekly cpn visits, offered admission to a psychiatric unit. The traumatic birth tipped me over the edge. I had lost my mum as a child, was neglected and abused, had 7 years TTC, lost my baby and fallopian tube due to a misdiagnosed ectopic pregnancy and had two miscarriages.

I am not bitter, just very jelous

@NoNoThankYou

Imnewhere1991 Hi, you might be better off taking this up with me if you like. I didn't have a phobia of giving birth or concerns beyond the usual; I just considered the medical research and concluded that an ELCS (with no underlying medical condition) was the correct option for me on the basis of the balance of risks for mother and child and which I was most comfortable with.

That decision is perfectly within the NICE guidelines - and the specific policy of the hospital I attended - and was agreed on that basis by my consultant and his juniors after a very civil and pleasant risks conversation at which they were happy that I was perfectly well informed and therefore competent to make the decision. No pretence, no abuse of the system.

As you'll see, the average cost of a c-section is barely any greater than a vaginal birth when only consequential incontinence is factored in. So I don't consider that I am costing the NHS more money (and would be perfectly happy to pay the small supplement charge if it were demonstrated and if that were really the issue).

Approx. 75% of hospitals refuse ELCS or treat it as a lucky dip. I think that is wrong on the basis of both financial and medical care considerations and will happily campaign for other hospitals to follow the sensible approach of the hospital I attended.

What is this about for you? Your understanding that it's more expensive? Your understanding that it's more risky? Or something else?

Money is not the issue for me. The amount the NHS have had to spend on me after the birth would outweigh any additional costs. Plus, I pay my taxes so no guilt.

@sarah13xx so yeah I hope you get some comfort from knowing you didn't suffer what I have.

@Imnewhere1991

I’m really sorry you went through that, it sounds very traumatic. I also went through a traumatic vaginal birth and I really relate. It’s very difficult and I was hugely jealous of women who’d had sections or positive birth experiences for a long time. I found time was a massive healer.

But it isn’t the fault of other women and their birth choices.

[quote YouMeandtheSpew]@Imnewhere1991

I’m really sorry you went through that, it sounds very traumatic. I also went through a traumatic vaginal birth and I really relate. It’s very difficult and I was hugely jealous of women who’d had sections or positive birth experiences for a long time. I found time was a massive healer.

But it isn’t the fault of other women and their birth choices.[/quote]
I know and it is still raw for me, so I'm going to avoid these threads from now on. Sorry to anyone I've offended.

I think the wording 'it was maternal request, purely because I didn’t want to experience any of the awful things any of my friends have.' made me feel resentful .

I'm sorry you had a traumatic birth also. 🌸🌸

@NoNoThankYou thank you Ive read similar studies & did bf but my understanding was not all the bacteria "came back" but further studies are needed & the impact of that. The whole gut health is very interesting in general to me.

www.nature.com/articles/d41586-019-02807-x

I also went through a traumatic vaginal birth and I really relate. It’s very difficult and I was hugely jealous of women who’d had sections or positive birth experiences for a long time. I found time was a massive healer.

It's so difficult as birth is so personal. I had pnd post CS which wasn't helped by feeling so constricted physically & I felt very guilty as I much preferred my VB & found the CS recovery initially hard but I felt I couldn't complain as it was definitely the best option for baby & many women want a CS but don't get one so who was I to be upset about it.

Thanks @sarah13xx

Great to know that my trust is Red...

Imnewhere1991 I'm so sorry to hear that. I'm furious on your behalf, both for your past, and that women like you go through traumatic births and substandard obstetric care in general in this country.

It really is a national scandal that few seem to care about unless babies die in the process and the NHS is actually investigated or sued. But if women are seriously injured and traumatised in the process? Well, it's just women, isn't it? It's what they're for - breeding and that. They've been suffering since the dawn of time. It's 'natural'. Who cares? They've got a baby, what more do they want? They want their health too? Selfish! It's expensive! It's vain! You're not worthy of the resources! Sacrifice your well-being for the sake of your baby and everyone else in the country like a good woman and mother should! (You get the picture).

I honestly think that's the insidious, half sub-conscious attitude underlying a lot of the attitudes around birth in all sorts of ways (not just the availability of c sections) and it sickens me.

I really wish you a full recovery and a happy life.

bananamushy Ah yes, I remember this one I think! Thanks for reminding me. It's really, really interesting, not least in that if there is shown to be an issue(s) we'd be one step closer to working out how to address it for c section babies which would be helpful.

I may quit the day job and go into medical research...!

Exactly. I agree with the sexism in childbirth & women's healthcare in general. Pisses me off!

@NoNoThankYou

Imnewhere1991 I'm so sorry to hear that. I'm furious on your behalf, both for your past, and that women like you go through traumatic births and substandard obstetric care in general in this country.

It really is a national scandal that few seem to care about unless babies die in the process and the NHS is actually investigated or sued. But if women are seriously injured and traumatised in the process? Well, it's just women, isn't it? It's what they're for - breeding and that. They've been suffering since the dawn of time. It's 'natural'. Who cares? They've got a baby, what more do they want? They want their health too? Selfish! It's expensive! It's vain! You're not worthy of the resources! Sacrifice your well-being for the sake of your baby and everyone else in the country like a good woman and mother should! (You get the picture).

I honestly think that's the insidious, half sub-conscious attitude underlying a lot of the attitudes around birth in all sorts of ways (not just the availability of c sections) and it sickens me.

I really wish you a full recovery and a happy life.

@NoNoThankYou thank you so much. Your well wishes are gratefully received 🌸

Everything you've said is spot on. Couldn't be worded any better.

The midwives were so rude to me too, I kept thinking what did I do so wrong 🥺

It makes me so cross, even know, after EMDR therapy on it and nearly two years later. Some days it makes me so angry at the world, when I was already angry at the world for many years, and it hurts that bit more when you read other mums were treated so well and it was the best day of their lives etc.

My son's birth will forever be etched in my memory but it was not the happiest day of my life and it'll forever pain me to feel like that.

Thank you for your understanding and kindness 🌸