Is it unreasonable to ask for an elective c section?

[MJH27]

I am now 32+2 and starting to feel very anxious about birth this time. This is my third baby, my last birth was quite traumatic as we didn’t make it to the hospital in time, baby was born in an ambulance on the way to hospital and I had quite a large PPH recorded as 800ml but I’m not sure how accurate that is as I was bleeding heavily for around half an hour in the ambulance and when we finally arrived at the delivery suite there was a big rush to stop the bleeding.

Anyway my reasons for wanting an elective c section are..

• Severe SPD, I am unable to walk to the bathroom without holding onto furniture or somebody helping me. I’m not sleeping due to pain when laying down and turning over in bed causing extreme pain which usually leaves me sitting on the edge of the bed crying.
• During this pregnancy from around 20 weeks I have been suffering with heart palpitations and fast heart rate as soon as I am on my feet. This goes away when resting but feels like standing is too much for my body right now. I’ve seen doctors and had an ECG but apart from giving me iron tablets I’ve been given no idea why this keeps happening. My heart rate is 130 as soon as I stand and can go up to 170 if I’m walking around doing simple household bits.
• Baby is currently in a footling breech position, though I feel she is trying to move.
• Previous VERY fast labour (less than 2 hours) and PPH

Sorry for the long post but I’m just looking for some advice really, I plan to speak to my consultant about all of this when I have an appointment in 2 weeks but don’t want to seem like I’m causing a fuss. I understand it’s major surgery and comes with risks but I’m now seriously worrying about my risks with a vaginal birth also.

Thank you if you’ve made it to the end of this ♥️

You are absolutely not being unreasonable to ask and discuss this with the consultant. I had a very fast birth with my second (accidental home birth) and it affected me for several years.

Thank you so much for your reply! I have a nearly 9 year age gap since my last birth and I’m sure this is due to being absolutely terrified of what could have happened.

Of course its not unreasonable and you have very clear reasons! The NICE guidelines also state that any woman can ask for a section for any reason...
However do consider that having a section may not protect you from these issues you have listed and a section is a serious operation that can have side effects/go wrong etc etc.
I begged for a section after a traumatic 1st birth but was told it was not a good idea. Which I was very angry about. However when I actually gave birth I realised the doctor had been right. Having a section would have been far harder on my body whereas my second vaginal birth was only a few hours long and I was out of the hospital, home and walking around fine within the same day. Very different from my first birth. Had I had a section I would have faced harder physical consequences.
Id just talk it through with the doctors and see what they say to you, what their opinions and arguments are.
Sections arent always the answer but you should weigh up all the information from your consultant and decide if its right for you or not based on that.

Thank you 🙏🏼

As @SheilaFentiman says - you're absolutely not unreasonable to ask for this in the circumstances. Go to the discussion prepared with all your symptoms and worries written down - as some HCPs will try and sway you into natural birth. You have every right to ask for this. Good luck.

YANBU. You are completely reasonable to ask for whatever type of birth you want. I’d definitely advise listening to the medical professionals, but it’s your choice and never ‘making a fuss’. Good luck.

I had one (for other reasons couldn't have vaginal birth), best decision I ever made. I'm a lone parent babies dad not around and I have a very small support network (couple of friends), so very alone after and still managed just fine

Lost one "friend" who was meant to be my birth partner so I gave birth alone as she felt her opinion on my choice was relevant and would / should override my own bodily autonomy. She made several vile comments including how I won't get by figure back "with a massive scar across your belly" (not true, I look fab for 5 months pp but have a stone maybe to lose- scar tiny). She also claimed to be having night terrors that were so bad she "didn't dare tell me they were too graphic" (fear mongering). Told me it was "unnatural and dragging the baby out too early" (medically inaccurate) and that I was triggering her memories of self harm with the idea of surgery. So it was all about her.

Its still my best decision 😍

YANBU. I had an emergency one but if I had known, I'd have gone for an elective all day long. And still would if we have a second.

Footling breech is generally a good enough reason for a csection, as is your pph. Talk to your midwife asap.

Definitely entitled to one. They’ve changed the rules now so they don’t even have to keep c sections below a certain number for funding and even when they did, it’s still your right. You know what birth’s about and you know your history. Go for it!

WOW what a friend!! Thank goodness you didn’t go through labour with her at your side. Can you imagine!

I’m glad this all worked out with you but I’m really not impressed with your doctor’s response considering the trauma you went through! This would never happen to a man.

My c section was wonderful btw, electives are very different to emergencies. And my recovery was so quick!

It’s not unreasonable to ask for an elective c-section for any reason at all! I chose to have one as I was very anxious about the birth and what could go wrong, and was also on my own and quite far from hospital. Also I have doctors in the family and they thoroughly recommend c-sections. As it turned I probably would have ended up having an emergency one anyway as the cord got wrapped around baby’s neck, but I’m very happy with my decision. Your birth, your body, your choice.

Sympathies on the SPD, I had it too and could barely walk from about 3 months, it’s awful.

@Ididivfama yeah I wasnt best pleased. The doctor i first spoke to was awful. Even if they did prove to be right. I do have complaints about the way I was spoken to. However the medical advice was right. And im currently pregnant with my 3rd and planning a homebirth which is how much I've u turned on sections based on my 2nd birth experience.
The general argument was that sections are a serious operation and can lead to escalations in medical intervention.. for me I really really hate hospitals and altho having an elective section would have alleviated my fears about some of the things that went wrong with my first birth it would have had the massive downside of me definitely needing a hospital stay and some ongoing care with healing from the operation. In the end having the vaginal birth meant I got to go home very quickly.

I mean it just all depends on your personal feelings regarding why things went wrong. I actually think a lot of things went wrong with my first birth due to too much medical intervention. My thinking was for the second that a planned section would be safer than just constantly trying to stabilise me and the baby with intervention after intervention like they did during the first birth.
But I have now actually been won over by the idea of attempting a completely natural birth..
However every woman should make their own choices based on all info given to them and their own individual needs which may be very different. My baby also isn't breech and wasnt during the other births either... I do think breech babies are a strong case for elective sections.
But as I said I just wanted to offer a differing perspective as I had thought a section was the answer for me but it turned out not to be.

Thank you all so much for your kind and helpful messages! You’re all making me much more confident to ask for what I want.. Obviously I will listen to what the doctors feel is best but if they are happy to go ahead I feel this would be a huge weight off my shoulders x

There are actually a lot less side effects and birth injuries from c-sections than vaginal births statistically. This is the reason the Royal College of Midwives has recently apologised for its pro vaginal birth policy, because it has led to many injuries and deaths. Long term side effects are also much higher with vaginal birth (that’s what has led to reassessment of the cost to the NHS also). I was up and about very quickly after my c-section. I’m really glad it all worked out for you but it also could have gone differently, I’d argue that was more your doctor being lucky than right! Most of the people I know who had very difficult first births were advised to have c-sections for safety second time around.

Sorry to add. I knew it was the best thing for me despite pushback and losing a friend and it was worth it. I was alone after and no issues parenting with the pain. You adapt.
If you feel in your instinct then I would have it. Good luck 👍

I know, it would have been a nightmare. It was something about the idea of cutting into me triggered her trauma from when she used to self harm. Selfish much ffs 🙄 you just don't look down! I did it without a birth partner then and was glad she wasn't there! But the staff were amazing and they found a student midwife to hold my hand and take pics.

Op, in my case it was the best decision I could have made but also- the aftercare was amazing. They really take care of you so don't be worried about that.

As for my "friend" she took umbrage that I was no longer interested in her friendship (no drama I just quietly went away and blocked etc cos was sick of it: my figure was the last thing on my mind!). She then used an old Facebook account to berate me for losing a friendship over "my life choices". This was after she had put a public passive aggressive post about me re "my life choices" - I saw that and got rid. It occurred to me that has she been accurate and said "my friends bodily autonomy during childbirth", she would have got ripped to shreds rather than the many "oh hunz" she got by using misleading language.

Anyway op that friend issue was the worst part and I really didn't care 🙃 it was my best choice and i would do the same again.

If you're worried about having to justify an elective to the doctors please don't be- my choice was simply that I had past sexual trauma and did not want pain in that area all associated with my child being born, the best thing in my life. That was fine for them as it was a mental health/ trauma related issue. You don't need a massive list, just be honest and they should work with you

I had an elective c section due to anxiety (IVF pregnancy, previous miscarriages, tested positive for group B strep). I had no push back at all. Everyone was very supportive and agreed it was the best decision. I did find it all quite scary and stressful, especially as I had PPH after and was severely anaemic. I wasn't one of those women who was absolutely fine immediately afterwards. However, within a few weeks I was up and about, plus I had no issues breastfeeding. I still feel it was the right decision, as any kind of instrumental birth would have completely traumatised me after everything we went through prior.

You've already written a really concise list of reasons why, which is great.

A few thoughts… being footling breech is a clear indication for an elective section. You probably need to have a robust plan for what will happen if you were to labour with that presentation given your history of precipitous labour. The PPH risk may not be lower having a section - depends what caused it. A section is not necessarily less cardiovascularly challenging than a vaginal birth.

Thank you! Everyone keeps telling me I have ages for her to turn but equally seem to be surprised when they scan and see her head high up. I believe the PPH was caused because I need medication to deliver the placenta as soon as possible, when that has been delivered the bleeding has stopped both times. I’ve been told in a vaginal birth I would definitely need an assisted 3rd stage but still terrified that if I don’t get to hospital in time the same could happen again or worse. That is another worry with the heart rate issues how my body would deal with the major surgery, I’m hoping my consultant may look further into this issue as I’ve seen 2 doctors, one told me to stop looking at my Apple Watch 🙄 and the other said ECG was all fine and I would benefit from iron tablets.

Your baby being footling breach is a very good reason to ask for an elective c section, please don't be fobbed off. And given the baby's position, if you feel you are starting labour go straight into hospital even if you are just feeling twinges. If I were you I would be asking to be monitored more closely to be on the safe side.

I'm due a c section in 3 weeks, requested by me for previous traumatic birth and anxiety. They agreed it fairly easily. Just hoping I make it that long (will be 39+1) as baby has been engaged for a while!

It isn’t a question of being reasonable or unreasonable. Both vaginal birth and caesarean birth have risks, the question is, with your medical history, which type of birth is lowest risk for you personally?

I was obsessed with avoiding a caesarean and made a lot of decisions around that. Had a third degree tear that was very nearly fourth degree, and now have stress incontinence, I do wonder if I’d be in better shape if I’d had a caesarean.

Ask doctors and midwives and keep asking until you have a decision you’re happy with.

I’d be very interested to hear your doctor family members views on why c sections are better! I’m going for a vbac but if I need to be induced I wonder if I should go for another C-section.