Elective C Section / depression / vaginismus

[Lady929]

Hi everyone

I’m FTM and 24 weeks pregnant. I have my midwife appointment tomorrow and wondering if it is the right time to bring up my options of maybe having an elective c section.

I have anxiety and depression (no medication for a year as I’ve been trying to manage it myself). In the last month or so my depression has got to a really bad point. I’ve been so anxious all the way through my pregnancy due to so many friends having losses and things go wrong in their pregnancies. My mental health is not in a great place and I am just getting by.

I also have vaginismus. Well my doctor said I probably had it and referred me to the Gynae department a few years ago but I never went as I didn’t want to go through the trauma of internal examinations. Ive only ever had one successful smear test and have always had painful sex. The thought of maybe ending up having an induction or a natural birth that doesn’t go to plan is filling me with dread and I’m worried about my mental state if things don’t go to plan once the baby is here.

I know this all sounds really pathetic but do I have a reason to try and push for an elective c section or should I just try and get on with everything? I feel like I’ll not be able to stand up for myself if midwife tells me I’m not suitable for a c section anyway.

Thank you if anyone listens to my long rambling post.

@Lady929 - My other half isn’t best pleased at the attitude she had, to say the least!

Because he can see how much it is affecting me, he’s said he’ll fight anyone he has to to make sure I don’t have the stress anymore - he’s so, so worried it’ll affect the baby!

We’re so disappointed with how we were treated - if we’d been confrontational and a bit sh*tty with her, I’d understand, but we couldn’t have been more polite.

Once the baby is born, we will absolutely be pursuing formal complaints and we’re not afraid to take it further, because in the 21st century, patients, male or female, should NOT be being treated like this.

I absolutely understand that as medical professionals, they need to cover their own backs if the worst happened, but equally, have a bit of empathy and think about what is coming out of your mouth and the way you’re saying it!

I honestly don’t think I’ll have another one either at this point! We wanted two, but this has been scarring enough!

I really don't recommend a c/section unless you need one medically, the pain and recovery is horrendous.

With an epidural you won't feel a thing.

Hopefully doctor will be more understanding and can take you through the full range of options, but be open to other solutions as c-sections really aren't the "easier way out" that people think they are!

I pushed for a c/section for medical reasons. Midwives we're against it totally almost telling me to just face it naturally. I prepped loads for my consultant appt and in the end the dr didn't even fight me. Agreed to it, said it's mad the midwives tried to put me off.
I felt so much more relaxed knowing the risk of further damage was minimised, really improved my pregnancy.
Btw, C/S went really smoothly and I felt fine after a couple of days. Only ibuprofen was needed afterwards! It is a major op but as it's planned you can also plan for being out of action for a while. Good luck, I hope your obstetrician is as practical as mine was!

I was up and walking 3 hours after my CS, took no painkillers after a week, and drove myself home from hospital. Some CS can be traumatic, some vaginal births can be. Never assume.

My pain and recovery with a C section wasn't horrendous at all. It was less painful than getting a wisdom tooth out and much less painful than toothache.

I feel you have given them something to fix by mentioning the vaginismus. They're almost obligated to take the cheaper, possibly 'safer' option and try to address that. The real problem is your mental health and how much distress you're in. Under those circumstances you certainly can insist on a section but do not take no for an answer and show you've read up on the risks and carefully considered but still feel it's the right choice.

@carmenitapink - that is absolutely your point of view and that is fine to have. However every single woman is their own person and every single c-section and recovery is different. Unfortunately you can only speak for yourself and not every woman.

All midwives I have met are fully supportive of my decision (I can’t speak for other womens’ experiences), and they fully understand that it is entirely the woman’s choice to choose how and where she births her baby.

An epidural is a fantastic source of pain relief if:

A) It is able to be guaranteed (it isn’t and this has been confirmed by midwives involved in my care)
B) It is guaranteed to work effectively (again, it isn’t)

I am sorry that the recovery was horrendous for you an I hope you can heal from that. However I will personally choose what I believe to be the best option for me, my baby, my body and my mental health.

You have to look at the whole picture not just the physical to each of the women on here who are thinking of a section. Some suffer with a mostly incurable fear of something penetrating them, some suffer with muscle spasms that effect their ability to control how their vagina reacts to things. When you suffer with either/both of those for years it isn’t as simple as saying ‘don’t rush to pick that because it hurts’.

My C-Section was an ‘emergency’ in the end and I bled more than I should of so had to stay in theatre a bit longer and off my baby went with his dad. That being said, it was calm, peaceful, no serious issues. I was up and about really quickly afterwards, like PP only had ibuprofen for pain relief. Of course it’s a major surgery but it’s not black and white enough to say it’s horrendous.

Mine was fine, lots of others were fine. As long as you are well informed of all the risks of child birth and c-sections then you should be free to choose.

Omg I’m having another absolute meltdown ☹️ So I have a 32 week growth scan next week (low lying placenta) was actually hoping it would be low lying so I could have a section without fighting for one however I know 90% of them move to a normal position so would have been very unlikely.

However the scan to check it is an internal one and I’m absolutely terrified. I know they are supposed to be a lot better than smear tests but just putting anything inside me is making me want to hyperventilate 😢 I feel like the sonographer won’t have a clue what vaginismus is and will look at me like I’m stupid. I get severe anxiety just going to normal scans as I’m always worried they are going to tell me something is wrong with the baby so I’m going to be in an absolute state 😢

How are you getting on OP?

@Lady929 did you know that just very recently the NHS axed targets pushing out only vaginal births onstead of c sections. Hospitals have a KPI where they can only allow 20% of elective c sections etc but now they have said its up to the mother to decide whats the best course for her and for hospitals to stop pursuing targets instead of planning a care plan suited for the individual needs of a mother following neglectful actions.

Fight for it they cant deny you. Your midwife is no expert on vaginismus! It can take as much as 4yrs plus to continue physical therapy and even once slide your back to square one. Tell her to read about it.
See below:
“In a letter sent to maternity units across England, NHS England chief midwife Jacqueline Dunkley-Bent and clinical director for women's health Dr Matthew Joly expressed concern over the target’s trusts were trying to hit.

In the letter they added: "We therefore ask all maternity services to stop using total Caesarean section rates as a means of performance management, as we are concerned by the potential for services to pursue targets that may be clinically inappropriate and unsafe in individual cases,"

@neptuneandcoke thank you for asking 😃

I’m doing ok! Suffering very badly with my depression and anxiety so just trying to get through each day. I had a scan to see if my placenta had moved and unfortunately for me it had so I couldn’t use that as a reason to have a c section.

I’ve had to end up having another scan for reduced growth, thankfully all ok. The midwife at that scan said you are booked in for a c section. Now the senior midwife I’d spoken to did say she would provisionally book me a c section but I assumed she was just saying it to shut me up as I was crying down the phone and got a bit mardy with her. I have my consultant appointment next week so will see what happens then.

The midwife I saw at my recent scan was so lovely and said to me if you want a c section they do have to give it you. She said it’s your body, they have to explain the risks to you but ultimately your need to do what’s best for me. She explained that she had had two sections (not sure whether planned or emergency) so maybe that what why she was more understanding? I wish she was my community midwife lol.

Hi @Nerdy123 I had read that about the targets yes which is a good outcome for women who want a c section.

I have got a few notes and wrote down my points I want to get across to the consultant. For the last couple of weeks I’ve been more open to a vaginal birth and just hoping that I won’t have too much intervention. I just don’t think I will cope mentally if it all goes wrong how though and I end up with ventouse/forceps or end up having an emergency section. I know induction and internal checks early on are definitely out of the question for me though.

I’m struggling with a lot of guilt now though about having a c sec, I will be lying to most people about the reason why (including mum who I’m close to) because I do feel a bit ashamed and almost like I’m taking the easy way out with a c section. But if I had a C section I know it’s no walk in the park and I’ll still be scared to death Plus the long recovery etc. I feel like I’m torturing myself with all the worry.

I’m not judging anyone in a similar situation who wants a c section either, I think I’m just feeling the guilt from people like my usual midwife who seem to think having a planned c section is the worst thing somebody could possibly do.

@lady929 i suffer from vaginisum have done since i found out and been in physical therapy for many years. I do my own smear tests, i insert the vaginal wand myself. While im not scared about vaginal birth because the consultant told me they will give me epidural straight away which should allow for examinations and reading other vaginisum sufferers storys who said it was fine, i am still thinking about c section. Yes i too got a whole “re think it its a big deal bla bla” even had to see a second consultant to get their “opinion” but at the end of the day my husband figured out what was going on and challenged head on if they were trying to force their opinion and method on me and as soon as that was said, the consultant panicked. Its our choice and its your choice so like alot of people have said dont worry because tbh they cant force you eitherways. Im sure it will go fine. I hope you do keep us looped!

That should say *vaginismus

@Lady929 ps dont worry about what the midwife thinks or anyone thinks on it being easy way out etc most of them dont know what vaginismus feels like, what it can do and how massive a deal it is. Do whats best for you.

I ended up having to go for a reduced growth scan last week (everything thankfully ok) and the midwife who did that brought up the subject of C section saying it was booked in on my notes. I know the senior midwife on the phone said it was booked provisionally but if it’s on my notes then I’m not really sure what’s going on. She was so lovely and asked me if I was ok about my consultant appointment. She said they have to let me have a C section. She said she’d had two C secs (not sure why) and her actual words were the worst thing about it all was not being able to drive for a few weeks. She was so nice to me I could have hugged her.

So I’m feeling a bit more positive about the consultant appointment next week and I do think I’d be so much happier with a section but I’m still battling with feelings of guilt/shame of having a C section which I know is ridiculous. I feel like things keep coming up in the news/social media etc about bad vaginal births and it really triggers me so I’m really not sure I could do it.

When are you due? Have you decided to have the C section?

Hi @Lady929,
I've asked for an elective c-section because I don't want to give birth vaginally - various reasons but not any specific to your case.

I had a Consultant appointment at 30 weeks - I told them I wanted an ELCS. She fought me on it - gave me a lot of reading to do and talked for a good 20 minutes about the benefits of a "natural birth".

I went back in for another Consultant appointment last week (35 weeks), and at the front of my notes, I'd added my birth plan which said at the top 'I requested an ELCS on 16th February 2022'. The Consultant read my birth plan, asked if I'd read the additional information and understood the risks, then went and got the consent form without another question asked. I didn't have to explain, fight or anything, but I was an absolute anxious mess for weeks before thinking that it was going to go the other way and that I'd be forced into something I didn't want.

I got the date for my section 3 days later.

I honestly think if you go in and tell them exactly what you want and that you understand the risks, they will accept it. If not, you are allowed to request another consultant.

For reference, this is what they told me to read...
www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/choosing-to-have-a-caesarean-section/

Just an update from me - saw the consultant at 20 weeks last Wednesday and got my c-section approved very easily thank god!

After the stress she gave me in my first appointment, it’s a relief!

I’ll get my date at 36 weeks 🥰

@Motherl0de thank you for the advice! I have read up on the information you’ve linked and will tell them I’ve read it and understand it all :)

I’m glad you got your section date! I’m a bit worried as I’ll be 35 weeks by the time I have my consultant appointment and worried they are going to make me wait another couple of weeks to let me know if they will finalise it or not. It would just be nice to know in my head what’s happening now so I can be prepared.

@CountryGirl189 so glad you got your C section approved :) Out of interest have you told family/friends the reason you’re having a C section or are you just going to say you’ve been advised to have one for medical reasons. I’m going to lie and say mine is for medical reasons if it gets approved as I don’t want everyone knowing I’ve chosen to have it myself. I don’t know why I care what other people think but stills feel like a bit of a taboo subject if you don’t want to have a “natural birth”

@Lady929 - I’m completely open about and specifically tell people why I’m having it and that it’s because it’s my choice!

Whether they like that or not is totally up to them and they can ‘judge’ me all they want! All that matters is that my family are supportive and they really are! My mum said she wouldn’t wish labour on anyone at all!

It’s time we break the taboo! As long as they baby is born healthy and you’re confident and happy in your choice, that’s all that matters!

This is so true! I really need to wrap my head around the fact that I’ve done nothing wrong by choosing to have a C section. It is definitely the best option for me and gives me the best start as a new mum and looking after my baby. I don’t think anybody else has the right to judge anyone for how they give birth.

Just to update everyone, I’ve got my elective section date booked in. I am so relieved! I actually had a positive experience, must have had a consultant that wasn’t anti C section.

She asked me what I wanted and I said an elective section. That was it, no trying to dissuade me or anything. Quickly went through the risks but was just stating facts, not trying to scare me.

I’m still very scared, a C section is definitely not the easy way out and I know I will be so nervous but it was definitely the right decision for me. I now can’t think of anything worse than trying to get through a vaginal birth that would only distress me. We don’t win any medals for how we give birth and a healthy baby is all that matters.

If anyone needs any advice / has questions please feel free to ask. My hope now is that all women will start to be treated as well as I was when I have made an informed decision about how I would like to deliver my baby.

This is amazing! And OWN that c-section! You’ll honestly feel so much better for the rest of your pregnancy and afterwards knowing that you made the choice for you and your baby! It’s literally no one else’s business what you choose!

See if there’s a midwife you can make a c-section birth plan with - I have a lovely one at the hospital who is going to go through everything with me, I.e. music etc to keep me calm and she’s also suggested hypnobirthing just for being able to not have a last minute panic on surgery day! 💕

@Lady929 happy for you. Do you mind when your able to, messaging us back letting us know how it went please? Ofcourse i pray all will be fine but ut be good to hear from yourself too to just complete the thread from you on the planned c section.

Thank you @CountryGirl189 I will look into making a birth plan. I’m so unorganised I need to get on with actually sorting my hospital bag lol! I definitely feel much calmer knowing I’m having a c section although it’s starting to feel so real now!

@Nerdy123 Of course I will update and let everyone know. Hopefully I will be letting everyone know what a positive experience it was ! :)