Elective c section in London on NHS

[Ceramic272]

Hi
After some months of trying, it seems I may be pregnant (yay) and I’m trying to wrap my head around the practical steps up until childbirth. (I don’t have any close friends really who’ve had kids and also don’t want to tell people at this stage anyway, so trying to figure it all out online!)

I know I need to register for antenatal care and was planning to just self refer to Kings, as it seems we are in their South London catchment.

When it comes to birth planning.. for various reasons I’ve always wanted to go for an elective C. I have horrible anxiety at the thought of a vaginal birth and being out of control/having forceps used etc etc, not helped by various stories from family members working in the NHS and other reasons I won’t go into. Also, and I don’t want to start a debate here, I fundamentally believe it is my right to feel in control and choose how I give birth..
However, it seems (based on some of the threads here) the NHS generally pushes back on elective c sections and you’d need to somehow “prove” your trauma/anxiety etc to be offered one (which again honestly seems somewhat offensive to me).

Has anyone had a good experience of requesting a c section on the NHS at Kings or elsewhere in south London? I looked up private maternity but the costs made my stomach drop..had anyone tried NHS up until 32/36 weeks and then private for the delivery? (I don’t know if that’s even a sensible option.. but Kings private seemed to let you start at 36 weeks so presumably some people do that.)
We could afford private birth but we’ll already need to budget an enormous amount for childcare, adding on a private birth too (especially given our taxes go to the NHS and I’ve generally otherwise had decent experiences with it) just seems insane..

PS - please don’t start a debate on c section ethics or merits etc, I just want to hear from others who’ve been in a similar boat in London and what they did!

Recently gave birth by ELCS at Kings. Requested it in my first midwife appointment, she was supportive, referred me for an appointment with the consultant around 24 weeks and it was booked on the spot. No issues at all, no one questioned it.

I cannot speak for London but as per the NICE guideline you do have the right to request an elective caesarean and this can be purely on maternal choice.

I would suggest you ask for an early appointment with an obstetrician, they often want you to attend a ‘birth options clinic’ but ultimately this is a choice you, as the patient are allowed to request.

I had a little push back from one obstetric registrar but no issues with anyone else and despite an early labour I had a section and it was the best thing I ever did for me, my baby and my mental health.

I’ve had two c sections at Kings. Neither pregnancy was totally straightforward, but you basically just need to ask for a c section. It’s entirely your right to have one, and I’ve never encountered any push-back.

Not in London, but just wanted to reassure you that things have changed now. The guidelines have changed - you can have your C sec, no questions asked. I didn’t get any push back when I requested ELCS. Huge congratulations on your BFP.

You shouldn't have to prove anything, just be calm and consistent that you want a section.

Some midwives do try and steer women towards vaginal births as they are statistically safer and I guess it's their job to make sure parents are informed about the pros and cons of any choices they are making.

They can advise but they can't refuse you a section.

https://www.nhs.uk/conditions/caesarean-section/

Also - Kings is a great hospital. Congratulations and good luck!

Yes also to add kings was excellent. I really can't fault the experience

Oh also re: fully private. A full private c section at a private hospital like the portland will be £15 - £20k.

Tommy's have private rooms you can pay for (think £800 a night, so pricy) so you can do the birth on the NHS and then stay in one of the private rooms after which is cheaper than a full private procedure.

I can’t believe how quickly so many people have responded and how helpful and kind the messages are! This is so reassuring, thank you everyone

Congratulations! I’m not in London but I also requested an elective section due to anxiety and had no issues at all. I had to discuss my reasoning with a consultant but it was agreed the same day. Needed a section in the end anyways as my son was breech but it took away a lot of anxiety for me knowing it was booked.

They’ve changed NICE guidelines in the last couple of years, any woman has a right to ask (and get) a c section

My eldest niece had a terrible birthing experience with an 11lb 2oz baby. She had third degree tears and it got infected too. She shared with her younger sister perhaps too much. When Dniece 2 got pregnant she worked herself up in a terrible state because she was told her baby was large. She requested an elective C section and was granted it without any issue. Her baby was 9 lb. She recovered a lot quicker than eldest niece too.

My hospital trust was under Kings for my most recent birth. You get enhanced scans at the Harris Birthright Centre which is fab as you get extra scans and they’re super detailed (and I found very accurate) but you can feel like a bit of a lab rat! As a result of the scans they realised DC2 was measuring big, no gestational diabetes or maternal factors but I was subsequently offered an induction or section. I took the c-section option and they were more than happy with this. They really just wanted baby out! I know my situation is a bit different but i did find them very respectful of my choices. They did offer induction a couple of times before that discussion and I declined. I’d previously had a vaginal birth and I did find second time around I was more confident to advocate for myself.

I would say though that it would be worth not getting too hung up on birth choices much before baby arrives. Make it clear at your first antenatal appointment that your wishes would be for a c-section but try and enjoy the pregnancy and take it for it is before you hit the third trimester. They generally wouldn’t give you a c-section date before then anyway as they need to see how you and baby are doing in the months preceding it. It might be worth exploring options for you anxiety too, not because you want to change your mind on natural birth but it will help you throughout the pregnancy. I did hypnobirthing for my first birth and I actually found the techniques really helpful in the build him to my section.

Thanks OP this thread is really helpful. I’ll definitely be doing an elective C section at Kings if possible! Please update on how you go and any tips xx

Also a c section Mum for purely the reason of wanting one I have vaginismus and PCOS and the thought of natural literally petrified me if I was to have another roll me back into theater as that's the only way for me.

I had zero push back i did need to see two consultants as a formality.

In terms of private not sure when @KingsHeath53 had her but portland lindo etc were north of 35k (prob more like 50k all in) when i looked in 22 for a straightforward elcs.
The cheapest private option is the private wing at st thomas' westmister suite which "becomes" nhs
This was 20-25k

I had an emergency c section, so can't answer your question directly, but just wanted to say what a positive experience I had.

It was quick, very calm and recovery wasn't too bad at all. A couple of weeks of wound pain/tiredness, but then I was surprised at how quick I was able to walk for 15 mins/half an hour/over an hour. I was back cycling by 6 weeks and running by 8 weeks.

Wishing you all the best with your pregnancy x

I had a private ELCS at Chelsea and Westminster. It cost 20k 😱 but don’t regret it for a second.

I had an elective c section at kings back in 2018 due to tokophobia and it was pretty straightforward. I spoke to a midwife at my first appointment and it was confirmed by a consultant later on. It was a very positive experience.

Ok.

so basically if you want an elective section it’s not about “proving” your need, but that you’re aware of the risks vs benefits and are making an informed decision.

m/w and dr’s have a duty of care to make sure you are aware of all the risks. If you go in demanding a section they are obliged to point out everything that can go wrong. It’s not talking you out of it, it’s making sure you know you could end up with a bowel or bladder nick, infection risk is higher etc.

so go in with an open mind, listen to the hcp’s, and make your decision based on medical information available. They do tend to leave it til later on so you are also fully informed with regard to how your pregnancy is progressing.

I gave birth in a S London hospital and was referred to a Vbac clinic. Not to talk me into a vbac, but to meet with a specialist m/w and talk through my specific medical history. I was sent away for a week with some excellent literature, went back and said I’d chosen elcs, as was booked in 5 days later.

if you listen and can show you’ve made the decision on medical information it’s unlikely you’ll get much of an argument.

one last thing- if you’re in London consider traffic, parking etc. not only for the birth, but for every scan, appt, post natal visit etc. often nearest is best- kings for me despite being near was an utter pita to get to, and no direct public transport. I considered tommys but would have had to get the train as driving would take hours at most times of the day, and then no parking…