Maternal Request C-Section and Anxiety

[CountryGirl189]

Just after some advice please :)

I initially spoke to my midwife during my booking appointment about my anxiety around childbirth and how I wasn’t enjoying my pregnancy because I was so terrified. She suspected I had Tokophobia and when I brought up the subject of a Maternal Request C-Section, she was very, very supportive and referred me to a consultant straight away and the Perinatal Mental Health Team.

Roll forward a few weeks and I’m anxious about the call with the consultant in case they dismiss my fears. Amazingly, the lady that called me was one of the mental health midwives who works with the consultants and listened to all I had to say and explained that no one can stop me choosing an ELCS if that is what I feel is best for me and my mental health, but that they have to make sure you’re making an informed choice. We spoke about different risks etc and she agreed that ELCS are much calmer and will be much better for me to deal with. She booked me in for 4 weeks later (currently 2 to go), to speak to the Consultant directly and book in the ELCS.

Today I had my mental health assessment and what a disappointment. The woman was completely dismissive of my fears and suggested they could prescribe me a sedative to calm me down for when I went into labour?!

Needless to say, I had a panic attack once she left and now I am terrified that my wishes will be denied and I’ll be declined the ELCS. I’ve tried to contact the lady at the hospital, but the receptionist claimed not to know who she was and suggested I speak to my midwife in the meantime whilst waiting for the appointment call.

Will I still be able to request and insist on the ELCS as a maternal request?

(I understand a c-section is not for everyone and I have my own reasons for wanting one and I am well, well aware of the risks involved, but also well aware of the risks involved with ‘natural’ birth too)

Any advice from those who have been through this is much appreciated!

I'm sorry they were dismissive of you, was that the mental health professional? They won't have any sway in whether you have a C section, if you had a good experience with the MH midwife i'd be reassured by that. As far as I know they cannot actually refuse a maternal request for a c section. Do you have someone to go with you for support? Maybe the MH midwife?

Its entirely your choice

This was me too. My midwife referred me to a consultant/obstetrician at the hospital who made the decision. They have the right to refuse your request but are required to refer you to another one to consider your case. Mine gave me a real hard time but ultimately agreed once she realised my mind was made up. Had to sign some kind of waiver that I'd chosen it against their advice. Wishing you the very best of luck.

You saw a bad apple.

You can request the section. It is major surgery so the consultant will have to explain all the risks to you so you can give informed consent. They aren't trying to scare you out of the choice, they just need to be sure you understand what you're electing to do.

Be aware that they might not give you a date at this point or even a week. As it's a maternal request you'll be at the bottom of the list as if were and they'll have to see what their medical list is like at the time. Likely it will be 39 weeks but that might change.

My DiL had her baby v recently and had an elective C Section- due to her anxiety / fear.
I was a bit but kept quiet (I am a good MiL!)
All was fine - made a fantastic recovery!
She wasn't dismissed at all throughout her pregnancy.

Thank you everyone for your lovely comments 🥰

Thankfully my lovely midwife has just called me and said to completely ignore the mental health practitioner from today and said she was really disappointed with how they dealt with everything!

She said if I’ve spoken to the mental health midwife at the hospital and she’s said that it’s absolutely my choice, then that’s what it is and that she and the mental midwife will support me all the way!

She did obviously say that the consultant will make it sound scary, but it’s just because they have a duty of care to let you know what risks are involved - I just wish they’d start sharing the risks of vaginal birth too!

It sounds as though the maternity people are supportive so I'd ignore the mental health lady. It's your right so tell them that you will be having a c section. I've had two maternal requests c sections and both were positive experiences.

Yes, the shout about the c section risks and totally minimise the vaginal birth risks.

@CountryGirl189

Thank you everyone for your lovely comments 🥰

Thankfully my lovely midwife has just called me and said to completely ignore the mental health practitioner from today and said she was really disappointed with how they dealt with everything!

She said if I’ve spoken to the mental health midwife at the hospital and she’s said that it’s absolutely my choice, then that’s what it is and that she and the mental midwife will support me all the way!

She did obviously say that the consultant will make it sound scary, but it’s just because they have a duty of care to let you know what risks are involved - I just wish they’d start sharing the risks of vaginal birth too!

Yes this! 100%! Why don’t they tell us the risks of vaginal birth trauma?

Some countries have moved to c section as standard now, for all women.

Also, I don’t accept that a vaginal birth is cheaper than a c section (unless of course, they’re comparing a 2 hour midwife led vaginal birth, with a complicated 24 hour consultant led vaginal birth with a quick life-saving 30 minute c section at the end - and costing that up as an average c-section).

£9 out of every £10 claimed for birth negligence is for vaginal births, the other £1 is for so called ‘c sections’.

I say so-called because those ‘c-section’ negligence claims include all of the unnecessary injuries endured in a long vaginal birth… which ended in an emergency c! Hardly accurate to include those vaginal injuries and errors as a stat for c-section negligence.

The stats are so inaccurate, the information is one-sided, and women are suffering as a result.

Also; maternity is the biggest department for paying out negligence claims, out of ALL hospital departments.

There’s not a chance I’m giving birth vaginally!

Remember the NHS don't separate the statistics for emergency CS and elective CS (to make it sound scarier). Don't be put off - be firm with what you want.

I was just about to say that Tempus!

The statistics are so, so misleading in that really do lump together all the ELCS and EMCS risks!

And when they talk about vaginal births being less risky, it’s because they’re taking stats from births that had no issues and no interventions - mind control, I swear! 😂

But seriously, they need to start giving full info on both choices - I said to the midwife in no way do I think it’s easier and I know it’ll be very, very sore afterwards, but for me it is more controlled and I’m able to prep myself mentally much better for it. The mental health midwife I spoke to at the hospital said she’ll even do a little c-section birth plan for me with music etc if I want and if she can (covid permitting), she’ll show me around and talk me through exactly what’ll happen on the day!

I decided YEARS ago I would be going c section route. Never once considered the natural option.

I've now had two with the same consultant however the booking process was like two different doctors. The difference being my first section was maternal request and my second was medically necessary.

His attitude at the appointments where i had to sign the consent forms was night and day.

First time round (maternal request) it was all scare stories of worst case scenarios and emphasis on risk. Second time round (medically necessary) he was very blasé and pointed out to me that all risks mentioned were for both emergency and elective and that in his 25+ year career he had never witnessed serious bladder or bowel damage during an elcs.

I laughed and told him he forgot to mention that in the maternal request script. He didn't look amused but I knew that all those years before anyway, I just feel sorry for anyone that didn't know this and was put off by the statistics which club elective and emergency together.

Good luck, stand your ground, they can't actually refuse you especially if you demonstrate that you are making an informed decision and emphasise that you know the risks and are willing to accept them over the risks of a "natural" birth.

So sorry you’re worrying! I had an elective c-section in August and it was the best day of my life but like you I was SO SO anxious about getting the decision approved. I actually had a really easy pregnancy and didn’t find any of it painful, even the birth 🥳 but I felt it was almost ruined by this constant sense of doom of thinking (even after the decision had been made) that somehow I’d get to the hospital in early labour or something and be refused my section. I’ll copy an old comment from me I found on someone else’s post to save typing it all again! This was before I got mine…

Haven’t had one so can’t help there but have requested one and had my consultant appointment! This is my first baby and it’s purely for fear of all those things happening that I’ve opted for one, always had a really strong feeling all my life that I’d die giving birth and I shouldn’t do it and there’s no way of anyone telling me otherwise 🙈 I was warned that my consultant can be quite dismissive and will try to talk you out of it. It was just a telephone appointment due to covid but I had 5 pages of typed notes ready for her with the NICE guidelines, quotes from birth rights etc 😂 I was shaking on the phone telling her all my reasons why I wanted one but she was actually really nice. She said she can’t tell me I’m not allowed one, said she’d get it booked in at our next appointment. Felt like a huge weight had been lifted from me! I would go on the nhs website and write down the risks. That’s what I did and quoted them back to her as she tried to scare me off it. I just said yes to everything and she was trying to make it sound like all these risks were 100% definitely going to happen to me. It was all very one-sided when no one reads you out all the awful things that can (and very often do) happen during a natural birth. I didn’t bother arguing that these risks are actually the risks of everyone who’s ever had a section so all the already high-risk women who need an elective plus all the women who end up in life-threatening situations trying to give birth naturally and are then rushed to theatre for an emergency section. I just said ‘yip, fine’ to everything to get it over with. I’ve been sent a booklet with the risks (just to scare me some more) and a booklet about the two options for anaethestic during it (spinal or general). I’m meeting with her in person to give her the completed forms back and to get the date booked in. The other thing I asked was what happens if your c-section list ends up full that week and the other people take priority because they have a greater medical need? I was asking because that’s exactly what happened to my friend and she was told very late on that they were too busy to fit her in 🤦🏼‍♀️ She reassured me that wouldn’t happen and she will be able to give me a date for definite at the next appointment. I would just say go in prepared for who you might get. I had really built mine up to be much worse than it was!

I had a first consultant appointment for my third pregnancy. She said 'I would prefer you to have a VBAC'. I just thought 'Oh, really?!' and took her leaflets (knowing full well I definitely wasn't going to risk it). Luckily my body decided for me with a complete placenta previa, so that was the last discussion on that!

@sarah13xx oh god, I didn’t realise they could just cancel it if they were mega busy! I definitely don’t want this to happen 😭

Will be sure to ask when I speak to the consultant!

@mumofEandE

My DiL had her baby v recently and had an elective C Section- due to her anxiety / fear. I was a bit but kept quiet (I am a good MiL!) All was fine - made a fantastic recovery! She wasn't dismissed at all throughout her pregnancy.

You still judged her by the sounds of that post

OP, it's weird how anxiety is different for all of us. I was the total opposite and was scared of having to have a c section. I have anxiety and went to a group for pregnant mums for it.

Didn't have that the first time around so was nice to have it for the second.

[quote CountryGirl189]@sarah13xx oh god, I didn’t realise they could just cancel it if they were mega busy! I definitely don’t want this to happen 😭

Will be sure to ask when I speak to the consultant![/quote]
They won’t cancel outright, but you might be moved. So you could be put on the list for the 8th but closer to the time moved to the 9th or 10th or (depending how your area handles overflow) you might be asked to go to a different local hospital. You’ll still be on the list. Just the day might change slightly.

@Raindancer411 - it is really strange! I think I almost find some sort of de-stressing in actual medical procedures, bizarrely!

Needles and all that just don’t faze me and if I know something is supposed to happen, I.e. going numb from the spinal, I find it really relaxing and easy to deal with, especially if I can think about it in advance!

The midwife at the hospital was absolutely amazing and said she’d do a c-section birth plan of sorts with me and she’ll try and get me in (covid-dependent) to show me exactly what will happen on the day, where I’ll be going etc! So I feel very reassured in this!

I asked her about potentially just having an epidural instead and she said that unfortunately there’s no way they can guarantee it and she said the ELCS will be very calm and probably much better for someone like me who doesn’t do well with the unknown! 😅

@TyrannosaurusRights oh thank goodness! This is fine, just as long as they turn around the day before and say no completely 😬

Although thankfully, the midwife at the hospital said if I was to go into labour at any point before or after my date (if it was to be moved), they’d just do the ELCS as soon as I came in - phew!

I had an ELCS due to tokophobia and anxiety (this was before I was diagnosed with autism and my panic about the lack of control of labour makes a lot more sense to me now. It was very calm and went exactly according to the script which was just what I needed. Recovery was difficult but ok in the end.

Years later when I was nect pg I was in a much better place emotionally and had a better understanding of my anxiety, and I decided to go for a VBAC which also went pretty well, but whilst that does make me wonder whether maybe I didn't need the ELCS first time around, tge thibg is I had to make the decision on the basis of what I needed then, without the benefit of hindsight, and so it was the right decision at the time.

It sounds like you have supportive people around you and will be fine. Maternal choice is allowed to override everything-you just need to stand your ground if there are any further objections. Good luck.

The consultant makes the decision, don't worry. Mine just opened up a big diary, flipped to week 39 and asked which day I'd like. I was booked in at around 30 weeks as my anxiety was so bad, but usually it's much closer to the end.

I was terrified I'd go into labour early, but they do have a plan if that happens. You just call to let them know and they start the process to get you an 'emergency' section (not really emergency but obvs not planned like an elective). You'd be very unlucky to get all the way through labour before they were able to fit you in. Electives are done at certain times (my hospital does three per day) but emergencies can be done at any time, so if the surgeries set up for sections are busy the electives might get pushed back until they're less busy.

I had been through maternal mental health services and had made it clear I would be having an elective based on NICE guidelines, and I never really experienced any resistance.

@CountryGirl189 Yes I had an epidural on my first so it was calm, but I did have to wait for an anaesthetise Dr to be free.

Also, just to say - it was so calm. I was absolutely terrified and panicky, and they gave me some lovely drugs to calm me down and had someone talk to me the whole way through. The drugs meant it's all a bit of a haze, but tbh I'd rather that than be fully awake for surgery 😂

Everyone in the room was so chill, nice and quiet, just rustling around doing their thing and quietly chatting. It was very bright and all over very quickly.

£9 out of every £10 claimed for birth negligence is for vaginal births, the other £1 is for so called ‘c sections’.

Have you taken into account the sheer numbers in considering the relative risks this statistic suggests? Given that there are far more vaginal births than planned sections, you'd expect more payouts with vaginal births.