No available slots for elective c section

[eastlondonmummyE13]

Hi all!
Hoping for some reassurance/advice here please!
36 weeks with first baby and we don't have a date for our planned c section as the consultant told us all slots for our "due week" are taken.

Has this happened to anyone? What happened in your case?
Nobody told us we needed to book it in sooner and assumed we would book it at our 36 week consultant appointment...
I mean... the baby is due when it's due, and they'll have to squeeze me in somewhere, I just don't feel as happy knowing I don't have a "slot"
But I guess if I was going for a vaginal birth, I wouldn't have a slot either... dunno how to feel! Feeling a bit let down by our midwife as we have been talking about a planned c section since December and we weren't advised to book a slot
I also imagine that some of the planned c sections that week may not happen so it might open up a slot for me?

Any advice would be lovely
Thank you!

I was told that I’d be informed of the date for my ELCS in week 38, with the plan to perform it sometime in week 39. My hospital don’t give dates earlier than that, even though I’d first requested it at my booking in appointment and mentioned at every appointment since, so it wasn’t a last-minute thing. Week 38 rolled around and I was told they couldn’t fit me in for the following week as I’d been told was the plan. Was given a date for Week 40. They were simply so busy and my place in the priority list was low. In the end I was called last minute as some slots opened up in Week 39.

I would suggest that you keep checking in with whoever manages the scheduling/theatre list about a possible date - if they can’t fit you in on the week you’re due, what is the plan after that? Are you a high priority for the following week? That was the case for me for example. If you’d be prepared to accept a last-minute date (we were called the day before!) then make that clear too.

Good luck!

Thanks so much!
Will be calling them for updates for sure

It’s not usually anything to do with the midwife when you have your consultant appointment to discuss mode of birth so why would it be their fault? The consultant is usually the one who decides when the next appointment is with them and usual to have the mode of birth discussion and final decision with them at 36 weeks in most trusts so it wouldn’t have necessarily have been attempted to have been booked any further in advance. The midwife cannot authorise a caesarean booking as it requires a detailed discussion about risks and benefits with an obstetrician and they have to be the one to go through the consent forms with you, nothing can be booked until that is done

Thanks
Not blaming anyone, just saying how I feel :)
I'm also just saying that the consultant told us we should have booked it in already but nobody has told us this before... so I just feel misinformed. Overall, I love my midwife and I'm not blaming her or anyone really, would have just preferred a different outcome with my appointment and just looking for some similar stories from other elective c section mums.

If it's an nhs birth, I've never heard of the patient booking in! They manage that for you.

Sorry don't have any real advice, just to say that I was booked for an elective section due to a breech baby last year, but then two days before at my pre op appointment they discovered that she'd turned so my section was cancelled. So I guess slots do open up. Best of luck with it all!

Doesn’t there have to be a medical reason for a c-section? In which case they will have that taken into account.

@DontLeanOnTheKeyboard no you no longer have to have a medical reason , everyone now has the right to request a c-section.

I would raise this with your midwife again as the consultant telling you that you should have ‘booked it in earlier’ is highly irregular for NHS births. Midwives have no power to book them in.

If there is genuinely no space then I imagine they will depend on cancellations, which there will definitely be. Ask your midwife for a clear process on how you will be updated about this.

When exactly is the plan for you to have your section? Week 39 or 40?

I had this, as did a friend a couple of years before me. We both got cancellation slots within a week or so. I got mine when I asked if there’s been any while I was there for my final growth scan. There will always be women who go into labour before their date, or who no longer need the c section like a PP.

Hope you get sorted soon. My ELCS was amazing

I got my appointment for first section through the post by week 36-37 and the second time I was booked in at my 34 week appointment with the consultant.
I went into spontaneous labour both times so I'm sure you will get your slot op, so keep ringing for updates ! Good luck with everything btw

When I was due it was fully booked too. At week 38 they had arranged another elective day, gave me the date the end of 38 weeks - which was 40 weeks on the nose. They might tell you in a week or so.

I am having a NHS birth and I booked my slot at 21 weeks. During my telephone app with the obstetrician to discuss my elective C-section, I asked what the process was as my last was emergency csection, do I just wait to be told a date or can I book provisionally now? He said there's no reason you can't and said he'd get someone to call be back which they did, I didn't choose the date but they booked it one week before due date so I have some peace of mind it's done!
I totally get your frustration! If I hadn't asked then maybe I would be in the same position later.

Thanks everyone for your answers! good to know some of you have been in the same boat and it's all worked out well in the end
Hopefully I will get my slot confirmed soon!

I was given a slot at 39 weeks + 5 days as it was the first available date past week 39 (I'm 35 weeks + 5 days today when I had my consultant appt). I thought it was a bit late, they said it's provisional and they can bump me up the list if slots free up (and reading other comments above, it sounds like it does happen!). Be reassured that if you were to start labour before your date (or before knowing your date!), you can go in as soon as the early signs of labour show up, and you can still have the c-section you asked for (they'll call it an emergency c-section even though it's not an emergency but your decision). Good luck xx

It shouldn’t be a case if you knowing when to book it in either as it’s the doctor doing the booking, sounds like a problem with the system there, unless it is was just an unusually busy time for them. The only time I can imagine a community midwife getting involved is for a woman booked under midwife only care who then requests a caesarean. The midwife would then refer the lady to the consultant obstetrician for the woman and consultant to then discuss.
In most trusts if a caesarean is likely to be on the cards e.g previous caesarean or twins or any other risk factors then you would be having consultant appointments through your pregnancy and they have usually documented a plan that the plan for the birth will be finalised at 36 weeks or whenever is normal for that trust. The initial consultant appointment is usually booked for long before 36 weeks and then at the end of each appointment they decide when to see you next and that next appointment is booked as you leave.
Can understand must be frustrating for you as is a big event, you need to plan for your recovery, and one of the up sides of planned caesareans is that you at least usually get to know the date in advance.

Completely agree with women being expected to ‘book’ in themselves being very irregular, the usual process is woman attends booking appointment 8-10 weeks with community midwife who then sends off referral to consultant obstetrician (unless absolutely no risks factors or request for caesarean and so can be booked under midwife led care, minority of women these days) A first appointment is then made by the hospital for woman to see consultant at some stage of pregnancy, if caesarean is clearly on the cards (e.g previous CS) then consultant will bring up subject at that first appointment or if women just wishes a caesarean without recommendation then would assume the woman would bring this up at this appointment. The consultant then makes a plan e.g see 4 weekly or maybe if only risk factor is previous CS they may make a plan for next appointment to be at 34-36 weeks to finalise/do consents for caesarean booking. Woman asking to book a slot for their caesareans is not usual practice. As for the process and updating, that wouldn’t usually have anything to do with the community midwife, she doesn’t have anything to do with that process beyond the initial referral at booking or new referral if she picks up complications in pregnancy or a new request from a woman for a caesarean. It would be either the consultant team/hospital antenatal clinic team would say speak to about that.

Patients don’t book in c sections so nothing has gone wrong. I’ve had two planned c sections in two different trusts and for both of them, the consultant is the one who books you in and does it at the 36 week appointment. As it happens, both times it was booked much sooner as I asked for a date and they were happy to book it in because I needed a c section for medical reasons.

But there is no expectation on the patient to book it. That’s the doctor’s / hospital’s job.

If you do need a c section and don’t have a date in week 39, they’ll usually give a date for week 40. If you go into labour before your date, you simply call in and they’ll put you in the urgent but not emergency category. My waters broke at week 38, even though I had a c section booked for week 39, and I had the op that day. Which then meant my slot that was booked became free. So, I wouldn’t worry about not having a date at week 39 - it will happen in one way or another.

Thank you! That sounds more like it, I just couldn't understand how I was supposed to have known to book it in sooner, when nobody had said I needed to and I had been discussing my elective C-section for 3 months. I also had my 36 week appointment booked in from about 20 weeks. I conceive vía ivf and the consultant told me early on that if I went past due date I would likely need to be induced, which I didn't want. So after a few weeks of research I decided to go for the CS, hence the consultant not knowing as I wasn't seeing him again until 36 weeks.
I'll call them at 37 and 38 weeks and hopefully will get a slot, but even if I don't get a slot before I go into labour, they will need to fit me in.
Thanks so much :)

Thank you! Very reassuring to know :)

They’ll be cancellations so it’s likely you’ll be given a date, but there will also be emergencies which are higher priority than an elective c section. Have you asked what happens if there are no slots available and you go into labour? Would you need to give birth naturally instead?

Yes that was my first question haha the Consultant didn't seem to think there would be an issue... however I guess we would need to asses on the day.

I can see what has happened, I assume your trust is one where they tend to need to book women in before 36 weeks due to how busy they get. However when they made your next consultant appointment not until 36 weeks they didn’t know you wanted a caesarean. When you mentioned to your community midwife about a caesarean she wouldn’t have thought a consultant referral necessary as you had already seen the consultant plus had another appointment at 36 weeks (which is when caesarean bookings are done in most hospitals) she doesn’t work in that department so wouldn’t necessarily know that they tend to be done earlier there or even know that you hadn’t already discussed it with the consultant unless you explicitly said you hadn’t had any contact with them since you decided on a Caesarean. For yourself, again, you knew you had a consultant appointment at 36 weeks and assumed could discuss it and get it booked then. It’s no one’s fault really, they’ll always be women who end up having to have them booked in a bit later, breech, growth problems detected late on etc, they’ll either do it when you go into labour or find a slot before then for you

@Tany43 that's not quite how it's happened, and actually I haven't been with the community midwife, I have been with the midwife in the same department as the consultant. You're making quite a few assumptions which aren't quite what has happened in my case. Thank you for replying to my post, but please don't feel like you need to continue commenting, your posts aren't really helping me.

I was booked for an planned c-section with my twins, after I had an emergency one with my first dd.

They had other ideas and came early so I ended up with a second emergency c-section... so slots can get freed up as babies frequently ignore schedules!