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 ♥️

The idea of tearing absolutely terrifies me - far more than a c section! But this is my last chance for a vaginal birth so trying to go for it.

Yeah mine was fab with no complications, went home very quickly and absolutely no pain or anything down below! Completely normal.

I had an EMCS with DC1 and was 'strongly encouraged' to plan for a VBAC with DC2. It all went tits up and I ended up with another EMCS. The recovery from an elective is better than from an emergency, is my understanding - your body hasn't exhausted itself with labour before undergoing what it absolutely major abdominal surgery and not to be sniffed at. But my recovery from my deliveries was much better than that of a friend, who 6 years down the lines still has issues because of the trauma her body went through during 'natural' childbirth. Your body, your choice.

No you aren't unreasonable, but I'd also question whether it was the best thing for you too.

The issue is that its youd third baby and part of your reasoning is that you didn't make it to the hospital on time and your labour was so fast.

The problem is that this doesn't eliminate the same possibility. Hospitals won't do an elective cs before a certain gestation and even then they can't guarentee an elective even if you have solid reasoning if you go into labour before your planned date unless you have a physical medical emergency and its essentially a 'crash section'. Which might be a realistic possibility given your daughter's position.

I had a planned CS and the system is they couldn't guarentee what time you'd go in on the day you were scheduled. You'd be booked in, with an order slot, but you could be bumped if there was someone who was a medical emergency ahead of you. So you had to turn up and wait until they were ready and had a free theatre place.

The information I found when I was researching my options was that there were two fairly different cohorts for planned CS. The first were mothers who hadn't previously had a baby and the second who were mothers who had suffered from birth trauma from a previous experience. And generally speaking there was a difference in how they should be treated.

In mothers who were suffering from birth trauma it seemed to be the case, that they responded well to greater psychological intervention. What they needed was their fears being listened to and a more detailed birth plan needed which was better tailored to their individual fears and needs.

In your case, you need to talk to your midwife and push for this - you need your trauma to be taken seriously and ANY birth plan you have (be it a VB or a CS) needs to take into account your fast labour. You need to be reassured you will be admitted immediately if you do go into labour with your previous history - simply because if you do, your chances of getting to theatre quickly enough are probably limited. At that point, given the other risk factors, you may be better looking more generally at managing your fears because physically a VB will still remain less risky for you. Again this needs you to be talking this through with your midwife and getting them to acknowledge there is a mental health as well as physical issue with regards to your birth plan.

Above all else, you NEED to be discussing what would happen if you went into labour with a footling breech given your fast labours and how this would be managed.

You aren't making a fuss, please ask for what you want.

The nhs helps to incentivise obs to steer mums away from c sections, but you are able to request one and this should be respected. It is good to ask doctors about the risks associated with both vaginal delivery and section - often you will only be told about risks for sections. It is then a case of which risks are more acceptable to you. I have had two electives and they were very calm, good experiences.

If you want any help asking for a section, birthrights have a good website and there is also a Facebook group for maternal request sections that can support you.

Don’t worry as I said in my previous posts I had an elective.

All booked and ready.

Then he started coming early!

I got straight to the hospital as waters had broken- I got a taxi as soon as I realised my waters were broken (first time mum and it’s wasn’t a large gush like you see on tv! At least not for me!)

I was having pains I forget what they’re called now, I think they’re called “quickenings” and that was agony I thought it was the contractions but they hadn’t even started yet!

So luckily, I was seen to with painkillers and they immediately began the process as they were getting the room ready for surgery.

Two hours or so later my son was born by elective ceasarian, as planned just earlier and luckily for me it was so fast that I didn’t even experience a single contraction!

So if your hospital is as good as mine is, or just generally decent, you’ll still get your elective. Just do what I did and get straight to the hospital as soon as your waters break 😊

(Disclaimer; this was just my experience. Some others may have different experiences but mine was wonderful so I thought I would add to try to relieve some of your anxiety!)

Appreciate everyone who has taken the time to reply. I understand if baby says in a footling breech position I will likely be offered an elective section anyway. I have another growth scan next week so they will be able to tell me for sure, but I’m still feeling all my kicks very low. Regarding the very fast labour, with both my previous I have gone over my due date and then into labour naturally so I am assuming this will be the case again but I have been told any issues at-all I am to head straight to delivery suite.

No, yanbu. And you have medical reasons as well as very understandable anxiety.

And would like to add that although a c section is classed as major surgery, the recovery can vary massively. I had no problem with mine (fortunately) and apart from some numbness in belly and having to do a commando style roll to get up and out of bed, I was back to normal really quickly.

Thank you @NikKai that does really help xx

I think it's perfectly reasonable op. But then I think it should be your choice regardless of the reasoning!

I had an elcs with ds as was likely to need intervention and they couldn't agree on what size he was but mainly I was just extremely anxious about the idea of giving birth.

Was really glad I went for it, it was all very smooth and I was still able to make a birth plan and they honoured a lot of my requests. For me it was a lovely experience.

I would advise you to have good support lined up for the first 3 weeks after you have baby. Dh was back at work after 2 weeks and I ended up pulling stitches on the 3rd week trying to lift ds in his car seat getting to a midwife appointment. I would also plan to limit your visitors initially (depending on how you feel of course). I found that my pain relief didn't cover the whole day well enough and while it was nice to have visits, in the evenings I just felt very weak and vulnerable and needed to go to bed and it was uncomfortable having to delay that because people weren't wanting to leave yet. Next time round I'd give myself 2 weeks grace and then have visits. I'd also say that even when you start to feel really good again, do not push yourself or start doing more, you'll know all about it the next day! Better to take it really easy the first couple of weeks and heal well the first time. Oh and air your wound as much as you can, multiple times a day for a few minutes, really helps with the healing depending on your body shape!

A lot of hospitals are under pressure to reduce the number of sections so you might get a little push back but you're entitled to your choice.