When do they typically book ELCSs?

[YouMeandtheSpew]

Sorry in advance for the long post.

I’m 22 weeks. I’m pretty sure I want an ELCS due to a previous third degree tear which required follow-up surgery when it didn’t heal properly. I had a fast labour and a large baby. I’ve subsequently recovered well, fortunately.

The consultant gynaecologist who repaired me at the time told me she wouldn’t recommend any more vaginal births. She sent a letter to that effect to my GP, saying I should be seen antenatally to discuss it in any subsequent pregnancies. I still have a copy of that letter and it’s in my hospital notes.

I had an appointment in antenatal clinic earlier this week and saw the registrar. It really wasn’t what I was expecting. The registrar told me there was ‘no reason at all’ I couldn’t have a vaginal birth and was very strongly pushing me towards it. I pointed her towards my notes and what the gynaecologist had said in the letter. She read it but said ‘I have no idea why she’s said that, she’s not written anything in your notes about why she thinks you should have a c-section.’ I asked if I could speak to her (the gynae) about it but the registrar said she’d left the hospital.

Eventually the registrar said she’d book me in for a further appointment at 34 weeks for a scan to check the size of the baby and a further discussion (with her) about delivery options.

I was hoping to have it all agreed and done and dusted at this appointment. I feel I didn’t advocate for myself very well (I was so blindsided by her approach - I really didn’t expect to have a fight about it.)

I feel anxious that 34 weeks is too late and they’ll decline my request for a section saying there’s no space or it’s too late or something. So I was just wondering when other people had theirs booked in?

Thank you!

I think it’s far too early for any C-section now - or at least that’s what I was told; and what all my research points to!

I was told the request would be officially considered around 34/35 weeks, then I’d get an idea of the date around 36/37 weeks, and the section itself would likely be 38/39.

It’s always right at the end… I might need further surgery alongside the c-section if that’s the route we take, and even then, they won’t book it until later on.

Go back to your midwife and ask for a referral to someone else.

My journey has been, noted at 10 week booking in, referred to consultant midwife to discuss who agreed to support at 22 weeks, had obstetric consultant at 24 weeks who agreed it although date won’t be given until 32-34 weeks.

I've been told about 39 weeks but i haven't confirmed i wanted it but been told it would be approved if i did due to medical issues

I started my c-section discussions with consultant at 32 weeks, had to go back at 36 weeks after they said I needed to think it over for a month. Flagged it up to MW around 28 weeks to make sure had enough time to see consultant. ELCS booked in for 39 weeks and only got date confirmed this week at 38 weeks.

Mine was initially a maternal request due to anxiety, now a medical one due to Kate diagnosed GD but they shouldn't refuse you whatever the reason. Consultant themselves can refuse to perform surgery but they need to find you someone who will..check out the NICE guidelines on it and also Birth Rights website

They only book you in about a week before. Don't worry, they won't run out of slots. If it gets pushed back for whatever reason and you go into labour, there are always emergency slots held each day too so you'd just take one of those instead.

@YouMeandtheSpew get your midwife onboard tell her it's causing you unnecessary stress she should help advocate for you and get you under a new consultant perhaps . I know that 2 consultants had to sign mine off

I know what you mean when you’re out on the spot and feel you don’t put your point across strongly enough, it’s so hard, we’re raised to be polite etc! I’m pretty bolshy but I was glad my husband was there because the consultant was similar in trying to say I could have a vaginal birth instead.. like yes, I know I could but it’s not really advisable 🤦🏼‍♀️
Anyway! It was in my notes from my booking appointment that I was opting for a c section because of my health, I had the meeting with the consultant the same day as my 20 week scan and was given the date there and then. I’m now 33 weeks and, if nothing drastic happens, the date and plan etc is still the same.
Reading this, it seems this isn’t really the norm?

Mine were booked at 36 weeks for 39 weeks

Hi, thank you all so much for your replies. It sounds like 34 weeks won’t be too late to get it agreed and booked which is very reassuring. I just really felt she was trying to fob me off. She initially said I should come back at 36 weeks and I pushed back on that.

However I think I will speak to the midwife about getting a referral to a different person. She just didn’t make me feel very comfortable and I don’t want to worry about seeing her again until I’m 34 weeks.

@Ughmaybenot - exactly, and when you’re taken by surprise as well! I really did have a pretty traumatic time during my first birth and the gynae was so clear that she didn’t advise me to have any more vaginal births - so I was really expecting the doctor to recommend a caesarean there and then, or at least ask me about my preference. So I was just so blindsided by her approach and didn’t know what to say!

Ask to speak to someone else anyway as that consultant doesn't sound supportive.

I mentioned it at my booking appointment and actually had a consultant appointment and the ELCS date just before the 20 week scan (which I know is unusually early but they said might as well get the slot booked now and if I go into labour sooner to come to the hospital straight away).

I was worried about it as my hospital website makes out that they are against maternal request ELCS. It is rated Amber with Birthrights.

My consultant appointment was 33 weeks and the date was agreed there and then.

If you feel you didn't advocate for yourself well enough, put all your thoughts into an email and send to your consultant. Although i had no issues getting my c section agreed due to a previous traumatic birth, I felt the section date was too late so I did this and they moved my section date to a week earlier than previously agreed. I feel it is easier to explain how you feel in writing sometimes!!

Totally feel your anxiety on this one. I just had a c-section last month for no reason other than sheer terror (huge phobia my whole life) long story but it was a c-section or the baby was staying in there in my mind 😂 You have a letter backing you up so you shouldn’t have to justify yourself and your reasons but consultants and midwives seem to try to put you off a section at all costs. The midwife pushed the conversation about mine further and further down the line and kept saying she’d refer me to a consultant at the next appointment. It wasn’t until it got to 22 weeks that I’d worked myself up into a frenzy about it and asked to speak to someone as soon as possible. She saw the state I’d got myself into over it and referred me. A few weeks passed and I hadn’t heard anything about the appointment. By this point I was waking up during the night panicking they were going to say no then I’d be heavily pregnant and under no circumstances was I attempting labour 🙈 it just wasn’t happening! I phoned my midwife saying I couldn’t go on not knowing what was happening because it was affecting my every day life. She chased it up and I got an appointment through for 29 weeks. It was a telephone appointment and I got hit with all the risks etc (some very dramatic ones that really only apply to an emergency section but I just agreed to them all). Overall the consultant was actually nice and I had prepared pages of notes with my reasons, information from the birth rights website on how many maternal request c-sections my hospital had carried out and the nice guidelines but I didn’t need any of it, she said she wasn’t going to tell me no and I seemed well educated and I’d obviously done my own research (only the 10+ years of constant googling 🤣). She said we’d need to have another appointment at 34 weeks to get my date booked. When it came to the 34 week appointment it was with another doctor who said my consultant had actually booked it at the first appointment. I got my date and went in at 39+4 for what was the best day of my life 😊 no dramas, no emergency buzzers, no being unable to sit down for months, no pain (or almost none)! Everyone I’d ever spoken to after they’ve had a baby has a big dramatic story to tell but mine couldn’t have been more straightforward and calm. It was lovely 😊

If they aren’t accepting that letter as a medical reason I would go with the anxiety angle on it. Contact your midwife and say you can’t wait til 34 weeks not knowing what’s going to happen. Say you’re struggling to sleep, eat etc for worrying about it and you’d really like to speak to someone sooner. Have the nice guidelines handy and find your hospital on birth rights maternal request page to see what the chances are they’ll say no. They shouldn’t! but if there’s going to be any hassle you obviously want to know asap so you can get it sorted.

Good luck, hope it’s as positive as mine and you get it all booked soon

My first was arranged at 38+3 for 5 days later after an unsuccessful ECV
My second could have been booked at my 20 week appointment but the consultant put me down for vbac despite me saying I didn't want one. Then my midwife arranged me another appointment with a new consultant who booked me in, I was around 25 weeks at this point.