Do "they" always have to accept your request for a c section?

[alotoftutus]

Hi,
I have had four vaginal natural and really quite lovely births - 3 at home.
I am expecting number 5 early next year and am thinking of opting for a c section - mainly due to the speed I Labour and organising childcare for my other children. I don't feel comfortable having a home birth this time - can't put my finger on why, intuition perhaps - I don't know but something is making me feel it's not the right choice.

Anyway my question is can your healthcare team refuse a section of there is no medical grounds for you to have one?

It's the mother's right to choose per NICE guidelines, for any reason. If your consultant is being difficult and refusing to comply with the guidelines then request to see a different consultant.

If that's what you want then go for it! I don't think they can refuse it. Push for the birth you want- always.

However be prepared for a much harder and longer recovery which could be difficult with 5 children!

No; they cannot refuse. If they try to, demand to speak to someone else.

Good luck! I’ve had 4 electives, they’ve all been absolutely incredible births. Loved every one of them.

Not always the case at all

I had twins and was told if I was able to give birth naturally and avoid a c section. It would be a natural birth. Ended up having a c section anyway but consultant adamant it would be Natural unless necessary.

Why not request a due date induction (or earlier if that's when you naturally labour)? It's what my mum did with her 5th so she could arrange childcare for us older 4. Admittedly it was 20+ years ago now, so things have undoubtedly changed since then, but might be a reasonable alternative to an elective.

Otherwise yes, they shouldn't deny you.

From what I understand they cannot deny you one but if you and the baby are both medically ok you may have to fight for it a bit (not saying that is right but I’ve seen this happen with friends). As someone who has had an ELCS due to concerns of baby’s size I can confirm that recovery is quite hard with other kids in the picture! Some women bounce back quickly but you really have to not push yourself for a few weeks and it took me a solid 6-8 weeks before I could comfortably carry and pick up baby. I also couldn’t do much for my 4 year old during this time too. Agree that induction may be a better option if you want to feel more in control timing wise.

I've had two ELCS, and my eldest was two when I had the second one.

I didn't find it particularly difficult to look after my eldest immediately after the section. I couldn't pick her up but I could cuddle her on the sofa, read books with her etc etc. it was totally fine.

I had ELCS both times because I couldn't actually cope with the idea of a vaginal delivery (I have tokophobia). So that was just how it was going to be- it never really entered my mind that it would be a problem to look after my toddler. And it wasn't really an issue. Plus I had very quick recoveries both times. My view on it was I had to make the best decision for my own health anyway- other children were cope perfectly fine with mum not being able to do everything as normal for a bit.

Also, I was in my mid 20s, fit, healthy etc, so probably the best candidate for trying for a vaginal delivery. The NHS were still excellent in enabling me to have ELCS both times. But I appreciate that this is in part the wonderful individuals I encountered, it can be very patchy.

I’ve had an emcs and an unplanned vbac. The vbac was so much easier to recover from and it wasn’t a quick labour and I had an episiotomy.
So in the unlikely event I had a third I would try for another vbac, short term pain. CS equals longer pain ime.

A c section is a difficult choice, it is major surgery op, there is nine layers of stitching inside you and the recovery period can be tough. For the first few days you can be walking on tip toes as the act of putting your heel down sends waves of pain through your incision. It did me.

I think I’d talk to your consultant about your fears. If you’ve already had four vaginal births then it is hugely possible your recovery period will be much quicker with a vaginal delivery . A c section might not even be faster, as you could be hanging around all day waiting, depending on what else happens that day. Any emergencies can bump electives down the list. You may also go into labour before it occurs.

a c section can be very far from the speedy choice as you need to look at everything from entry to hospital to the recovery period

If you’ve already had four vaginal births then it is hugely possible your recovery period will be much quicker with a vaginal delivery

I think this is a really good point actually- and I re-read your OP where you say you have had four lovely vaginal births. If you really want a c-section then absolutely, go ahead and choose one, I think every woman should be able to choose the mode of delivery that is best for them. It's just that it sounds like you've had really good vaginal deliveries in the past and going on that, you have a better chance than most I would imagine of the same happening again!

I have no comparisons to go on, found the idea of vaginal deliveries absolutely disgusting (because of my phobia), and I was much happier having c-sections. And I did have great recoveries and it was all good etc! But I don't know how my excellent recoveries from c-sections compares to your recovered from what you have described as your lovely vaginal births. If you felt the births were good and you made good recoveries I'd perhaps stick with it! But ultimately do what's best for you.

As others have said, you can also for a planned caesarean without any particular medical reason. A first consultant can refuse but they'll have to direct yoy to one who agrees. Midwives might also offer all sorts of things until you get to the consultant. You just need to decline.

There are circumstances where doctors refuse to do a caesarean. Some justified, others not.
At full dilation it might be safer for the baby to be delivered with instruments and so they'll decline doing a caesarean but they should explain this. So iffy but probably not a bad decision.
If you go into labour before your caesarean date, they might also decline. Iffy as well, you might have to argue but they might not be able to accommodate (with free theatres)
Finally, there are cases of stillbirths where they decline to deliver by caesarean. This is unjustified.

Be persistent and you should be a le to plan your caesarean birth. Good luck!

The doctor CAN actually refuse any request.

You may have to push for it, no pun intended. Be aware of NICE guidance and also of the relevant case law on discussion of risks and consent, Montgomery v Lanarkshire.

en.wikipedia.org/wiki/Montgomery_v_Lanarkshire_Health_Board

If you encounter barriers, ask why they're failing to follow NICE guidance.

You are definitely allowed to request one but they can be a bit sniffy in some places.

How old are your kids? I'd consider the total amount of time you're out of action, childcare to cover labour might be easier to arrange than help with childcare for several weeks of c-section recovery. If your other kids are small enough to need lifting/likely to jump on you/run away and need nabbing then vaginal delivery probably makes more sense from a practical perspective.

Speaking as someone who has had one of each. I found recovery from vaginal birth miles easier but I know experiences vary! After four straightforward deliveries, your fifth is likely to be straightforward and quick too, I should think.