Elective CS for First DC

[onebyoneNOTfourbyfour]

Maybe I'm being a bit thick or niave here, but can you elect to have a CS for your first baby and if so has anyone here had any experience of how to go about asking for it and how yours went?

I realise I'm opening myself up to a lot of tut-tutting from the natural-birth brigade but frankly am strong enough willed and intelligent to know what I'm doing. There are not medals/awards for having a long, painful, medical intervention free birth. My goal is to have my baby delivered healthily and without any trauma.

Thanks in advance for your input.

Some people want a section as they think a vaginal birth will spoil their sex life.

onebyone If you want a c/section you can have one. It isn't easy, but with a bit of research and coaching it is possible.

However, I would advise that you find out a LOT about it, and watch videos etc.

Some women prefer to have c/sections for control reasons. Is this yours?

Stripeyknickers - that's not quite true. C-sections carry higher risks of certain complications, but there are other risks that are much higher with vaginal birth. And these risks can be serious. So, as I said above, it should be up to every woman to decide which different set of risks she 'prefers' to take.

And I have to say it really upsets me when I see people claiming that women want c-sections so as not to ruin their sex lives because a. what is so terrible about that? If men gave birth, you can bet they'd get c-sections on the NHS for this reason and b. I think it trivialises the incredibly serious issue of pelvic floor damage, which can cause problems a lot more frightening than a crap sex life.

'Stripeyknickers - that's not quite true. C-sections carry higher risks of certain complications, but there are other risks that are much higher with vaginal birth. And these risks can be serious. So, as I said above, it should be up to every woman to decide which different set of risks she 'prefers' to take.'

jo I'm afraid Stripeyknickers is right if we are talking about properly managed VBs!

And I meant to add:

There isn't much convincing evidence that vaginal birth is safer and easier than elective c-sections performed on healthy women/babies after 39 weeks. I looked into this a lot and read a lot of research before I made my decision.

A lot of the 'risk' stats include emergency sections, and also cases where sections were performed where a problem was already evident in the pregnancy.

And I take your point NinkyNonk but sadly VBs in this country at the moment are not always well-managed.

'A lot of the 'risk' stats include emergency sections, and also cases where sections were performed where a problem was already evident in the pregnancy.'

This is true of the complications that arise in VBs too.

joanne No they are not, but there are things you can do to ensure they are i.e. homebirth, doula etc.

"Both natural birth and c-sections have risks and benefits but for this reason, it should be up to each individual woman how she gives birth. It's an absolute disgrace that women have to 'beg' for c-sections in this country."

Of course it is perfectly reasonable for anyone with a medical need (and by this I would include phobias etc) to be able to have a section without argument. However, I disagree with the notion that a woman should have the "right" to choose a section for mere preference alone. Most of the people who talk positively about their elective sections have had horrible VBs to which they compare them. But most women do not have horrible experiences or consequences from their VBs.

OP you could have your baby delivered healthily and without any trauma, at home, within a matter of hours, without a stitch. Or you could have a uncomplicated c/s and be in less than great nick for weeks, with pretty much the certainty of further c/s for future children.

"There isn't much convincing evidence that vaginal birth is safer and easier than elective c-sections performed on healthy women/babies after 39 weeks. I looked into this a lot and read a lot of research before I made my decision.

A lot of the 'risk' stats include emergency sections, and also cases where sections were performed where a problem was already evident in the pregnancy."

And I've written a 15,000 word dissertation on the subject.

A lot of the risks aren't just for that pregnancy/birth/baby but for future pregnancies and babies and I think that needs to be understood.

I have to say I'm on the fence still wheter women should be allowed to choose a section. Part of me thinks that yes they should be able to make an informed choice but then part of me thinks it would place too big a burden on already overstretched maternity services. There is the argument that you can't choose an "unnecessary" proceedure in other areas of medicine. I would love to have a disc replacement to sort my back out and think it would be a better option, but I bet the NHS consultant when I see him next motnh will only offer me a discectomy. I don't like it, but unless I pay and go private I don't have a choice.

Some consultants may if you kick up enough say yes to a section for no medical reason. Others won't.

Mazzy - most people on this thread who have talked positively about their c-sections are talking about c-sections for first babies, so have nothing to compare them to.

You're right, many women also talk positively about VBs, but most of these concede that there was a certain amount of pain (usually extreme pain) involved. I had literally no serious pain at all with my c-section. I realise I was very lucky, but I don't think I'm that unusual.

You're right of course about risks for future children, but some women know that they only want one child, or at the very most two.

And it's not as clear cut as 'phobia' or not. I wouldn't class my state of mind as a 'phobia'. I was just convinced I did not want a vaginal birth and, had I not been able to have a CS, I wouldn't have had children. That's how strongly I felt about it. I think to force women who feel like this to go through vaginal birth just because it's 'natural' and/or cheaper to the NHS is pretty barbaric.

And what exactly counts as 'necessary' in terms of a medical procedure? Is IVF 'necessary'? It's available (in some cases) on the NHS. So is viagra.

I can't tell you what should and shouldn't count as necessary. NICE and ethics committees for that. "Choice" is wildly overrated, imo. And unrealistic, given how overstretched NHS maternity services are - and any visit to a postnatal ward in most cities will attest to that.

Anyway, we are digressing from the OP somewhat.

The NHS are never going to say that sections are necessary when research shows that vaginal birth has less overall risks and is cheaper.

Hit send too early on last post.

Wheras for some people IVF is the only way of conceiving and viagra is the only way of having a sex life.

A section is not the only way of giving birth.

That's the difference.

"My goal is to have my baby delivered healthily and without any trauma."

And major abdominal surgery is not trauma?

At least after a "long, painful, medical intervention free birth" () you can get up, walk to the shower, have a shower, hold and feed your baby whenever you like, not to mention drive anywhere as soon as you like.

Oh yes, and not have the risk of adhesions and uterine scarring that will increase the risk of having a retained placenta with the next birth.

CS for valid medical reasons. It should not be a matter of personal choice unless there is a good reason to consider doing it.

fwiw OP, natural birth is SAFEST for mother and baby.
there is no reason why you wouldn't deliver a baby healthily and without trauma by having a vaginal delivery.

you are more likely to die during a c-section than during a natural birth.

c-sections can also cause issues for baby post-birth, particularly with breastfeeding.

Where is the OP

'I think to force women who feel like this to go through vaginal birth just because it's 'natural' and/or cheaper to the NHS is pretty barbaric.'

Joanne I happen to agree with you on this. However, the 'system' is not able to cope with either providing c/s for everyone who 'wants' one, or set up to ensure that there is the support necessary for women to make a 'true' informed choice. Hell, the system doesn't even ensure that every woman gets their basic tests on time or that no woman has to deal with 25 midwives during their pregnancy and birth. We are a looooong way from the ideal and there are more important 'essential' services that need funding way before unnecessary c/sections.

FabIs, it annoys me because it's unnecessary scaremongering. People love to make out it's the worse thing ever with very long recovery times/problems breastfeeding, picking up your baby etc when that's simply not the case. And what's the point of your commnet about some women not wanting to ruin their sex lives? Is that any of your business? I coudldn't really care less how other women give birth. I also don't believe that the NHS is unundated with requests for elective c-sections on non-medical grounds - most people seem to want a vaginal delivery - so going on about costs and strain on the NHS is a moot point. If we must look at that then surely we should look at the numnber of births a woman is allowed on the NHS - is it fair that you can have as many babies as you want on the NHS with the taxpayer footing the bill? Not really.

My best friend wanted a CS for non medical reasons and whilst her local hospital refused her on these grounds they did refer her to a neighbouring one that did. She was clear and consistent in her reasons and would have been prepared to pay.

for anyone who has tokophobia or compelling psychological reasons to hvae a c.section, they will get one on the NHS.

I understood the hospital's reluctance to perform caesareans is related to the WHO guidelines, rather than cost alone.

They recommend that the rate of Caesarean sections should not exceed 15% in any country.

One of the reasons I was able to have a cs was that my hospital (UCH) already exceeded this target, as they are a specialist centre for complicated births; they did not have to worry about meeting it. Many other hospitals do, and the NHS is under great pressure to ensure that the WHO target is met.

Thank you very much for your responses ladies. I seem to have opened up a hornets nest of differing opinions, but that's a good thing. I haven't posted since simply because I don't spend my whole days and evenings glued to t'internet!

There are several reasons why I want an elective CS for this my first and ONLY child. Firstly, yes I am petrified of the pain. Ten years ago I went through the trauma of a termination and required pethadine for the labour like pain - it was horrendous and I don't want to go through that again. I also do not want to go through hours and hours of agonising labour to end up having an emergency CS when I could have one from the beginning. An epidural may not be possible either due to my scoliosis and fused spine. And I also have no desire to have my nether regions destroyed and ripped apart by a large baby, forceps and ventouse, and then stitched and the future incontinence. That truely is horrendous. I have had major surgery several times in my life and it really hasn't been as awful as some would have you believe.

Thanks again for your contributions.