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.

It does worry me that the predominating viewpoint in our society is that vaginal birth is a destructive and painful experience.

In my view, this has been caused by centuries of male-dominated birthing where women were made to lay on their backs with their legs in the air, unable to naturally move around to allow the pelvis to open. No wonder damage results.

This accumulated fear means it is almost inevitable that today's new mother approaches the (vaginal) birthing process with trepidation, when it should be seen as a calm, natural and joyful experience, where complications and extreme damage to the perineum are the exception, not the norm.

Yes, it's an intense experience but so much of how it is experienced will depend on the woman's attitude and state of mind. A fearful woman who expects a painful and traumatic birth experience, will get just that.

A lot of women seem to choose elective cs out of fear and lack of education about how birth can and should be. It's a shame and puts birth straight back into the hands of the male-dominated medical profession.

You know your own mind, onebyone. Ask to speak to a consultant. Good luck, and I hope you get your CS.

onebyone, i am sorry you had such a trauma when you had your termination

had your put that information in your OP, i think respinses would have been very different

IMO, you will be given your c.s on the NHS with no problem

your OP was a bit 'sod off your hippy earth mothers, i want a surgical delivery', whereas your reasons for needing,m not just wanting a c.s are compelling enough, without putting people's backs up

all the best with your birth

illuminasam- Do you believe that a woman can choose the type of labour; and consequently, the type of birth she has?

Genuine question.

OP - Lulumama is right that you will have absolutely no problem getting a c-section on the NHS - just be clear about your reasons and that you know all the risks.

And Illuminasam - nothing upsets me more than women employing supposedly 'feminist' arguments to justify forcing women to go through 'natural' births. You're right of course that some births go wrong because of the way they are managed, but I also know a lot of women who have approached labour prepared, not fearful, and have laboured the way they wanted with supportive midwives etc. who still had an absolutely horrific time. Some people find it 'intense' others find it complete agony. Let's be honest about that.

Both vb and cs carry serious risks and the stakes are too high to force women to go through the type of birth they don't want. I agree with NinkyNonk's point about limited resources but in my opinion women should be out on the streets campaigning for the right of every woman to give birth how she wants, and not sniping at others' choices on mumsnet. How feminist is that?

I begged and pleaded shamelessly for a cs from NHS for my first and only dc and they refused me. I had a private doctor write a letter for me saying that I should have a cs as well. The consultant that read it and met with me said no NHS don't do that.

I had good reasons and psychologically it would have definitely be the right thing to do. It took ages to heal, ventouse and episiotomy. I was terrified of all of the internal exams, still have nightmares about the birth now and am in counseling for it. DS is 14 months .

Some people will tell you that you're missing out on a life changing experience if you don't give birth vaginally. I'm probably going to get flamed for saying it, but I don't think you'll be missing out especially if you're not yearning for that "experience" anyway. Even now, I feel that I wish I could turn back time and have a cs instead.

The magical moment is when you see your baby for the first time. It doesn't matter what has happened just before that, whether the baby come from an incision or from your vagina. It's still the most beautiful moment in the world.
In my case, I would have probably enjoyed my baby even more in those first hours had I not just felt like I had been assaulted for 36 hours!

I have no idea how you get a cs on the NHS. We couldn't afford the 2000 pounds we were quoted to have it done privately, either.

Best of luck and my advice is just do what you can to get it if you really feel strongly about it.

Sorry if I've offended anyone who loved their vaginal birth or thinks every woman should experience it.
For me, the experience is about meeting your lovely baby. And that is the most amazing moment in the world. I can't wait for you to experience that. You don't know how deep love can be until you have a child. Enjoy

Some trusts will offer counselling rather than a section to people with tokophobia.

It really does depend on the consultant. I have seen people refused one even though they've been hysterical. Other times women have been able to get one fairly easily.

tjb and joanne - yes I definitely believe in women's choice. And no-one's forcing anyone to do anything.

A family friend just had an elective CS two days ago because she's terrified of birth and there's no way I would condemn her for it.

I do reserve the right to think it a shame however, that women are fearful of natural birth in the first place.

I had to be induced to give birth to my first baby, he died half an hour after birth. Yes it hurt but what made it hurt especially was that I was saying goodbye to my baby and the unnatural 0-60 contractions. And the big point for me was that when the contractions ended, so did the pain.

At the time, the doctors pressed me to have a cs - "we'll have that baby out of you within the hour, it will all be over". I had to be strong and fight to give birth to my dying baby the way I wanted to - naturally. I was made to feel like a freak in the hospital for doing it without drugs.

I think there are genuine issues of control here and being a control freak, I want to be the one in control, I don't want to hand that over to doctors and aneathetists and post-operative care nurses.

With this pregnancy, I could end up with a CS, ventouse, etc etc, I could crack under the pain and go for an epidural but being a mind-body experimentalist, I want to at least see how far I get.

Where is the OP??????????????

Whoops sorry missed later post.

Gangle You are really leaving in a dream world if you think c sections come without problems. Lots of people might sail through the operation but a lot don't. Of course anyone elses sex life is none of my business but haven't had to have an emergency section and being left with life long consequences i do think to have a section so you can still shag as before is bonkers.

Hi OP. Just wanted to add my two pennies worth.

Please do your research and talk this through as much as possible before you make your decision. A c-section is not a walk in the park. I have had two - both fine, no complications etc. However, with the exception of the minority of my friends who suffered very bad birth injuries, the vast majority of my friends who had vaginal births recovered far quicker than me. It is a major operation. Do not underestimate the seriousness and weirdness of it! You will have to be shaved, catheterised, have an epidural, probably be on very strong painkillers and bed bound for a while afterwards on a drip. It isn't as simple as some would lead you to believe.

Good luck whatever you decide, though. Birth is scary the first time around.

I had an elective CS on my first and only baby, so far. I asked for an appointment with the consultant, from my midwife who was really supportive.
As for the consultant, it wasn't easy by any means. He quizzed me throughly and made me feel quite small aboout why I wanted a CS, even though I took in a folder type thing of the arguments why I wanted them but he still wanted to know why. I needed better reasons than a big baby or even a heart condition that was picked up on me.However, he did agree, I think because of in the end, it was what I wanted, and he said I would go to someone else to ask so he agreed.
In the run up to the CS, I did think I was mad, but I'm happy to say it was brilliant. I really enjoyed my son's birth. It was a really beautiful day and no trauma at all.
The recovery was Ok too, not as bad as I thought it would be either.
If you are set on a CS, then make sure your arguments are sound and you are sur it's what you want. Good luck!

happywheezer. I did that. I had a gp that I sometimes see privately (when my insurance from my job covers it) write a letter to the consultant at the hospital to say that he recommended that I have a cs due to psychological reasons. I had been petrified of childbirth since I can remember... I still am, in fact!
When I got my positive test it was all I could think about and I just cried and cried for weeks.
MWs and consultants kept saying no unless I wanted to go privately no cs.

When my waters broke I was terrified. I kept asking again for a cs and waited 29 hours for an epidural which they finally only agreed to because the mw that came on duty at that time couldn't do the internal exams anymore because I was in such a state.
I do think women should be able to choose how they give birth. I would have even paid for it if there was a payment plan over a year or something (and no, credit card not an option).

I always think of these as crystal ball threads. Fact is that unless there are medical reasons one way or another, you can't predict how things are going to go. For some women CS brilliant, others terrible, ditto vaginal.

I wish they would invent some way of working out what would actually be best for each woman, not just in terms of mother and baby surviving, but taking into account damage, psychological effects, recovery and so on...

In the absence of that crystal ball, I can only speak for myself, have had a great emcs and a great elcs, and suspect that with the OPs history they will let her have a CS if that is what she wants.

I had 2 elec CSs for maternal choice. Fab, v quick recovery.

You were very lucky then Highlander and I am pleased for you.

OP, I just want you to consider, as others have said that birth is quite out of our control. I nearly gave birth naturally both times, even though I was quite unprepared for that, because all the way through both my pregnancies, they had told me that it was highly likely with my diabetes etc I would end up cs. So I was not entirely mentally prepared for vbac.
One cs was calm, elective, the other was calm GA.
But i was pushing in both, prior to cs.
Please please be aware of this. Just give it some thought. That you don't know what will happen and sometimes it is not even possible to cs, even with the best laid plans.
That is all I wanted to make clear to you.
Merry Christmas. I hope it all goes smoothly for you.

Onebyone - there is a big difference between wanting CS for emotional or 'vanity' reasons, and for medical reasons. I don't know much about scoliosis and about fused spines, but I would imagine that they could labour and vaginal birth. They would - in my limited knowledge - seem to me to be good reasons to consider CS.

But bear in mind that not all labours are as traumatic and damaging as you think. The best way to have a relatively easy labour and undamaging birth is to have good consistent care. Unfortunately the only way you can guarantee getting this is to have a private midwife and/or a doula. If you labour with the constant support of an empathic and knowledgeable person, you are likely to have a good experience of labour and birth.

You have a terrible memory to contend with. Have you considered a debrief with a midwife who would go through the notes of that experience with you? I had a very distressing first birth experience, thought I had dealt with it, but it came back to bite me when I was preparing for dc2's birth. A midwife spotted this at about 35w and I had a fantastic debrief with her, which cleared much of my anger over the first birhting, and put to rest my fears for the next. Dc2's birth was a vastly better experience than dc1's, and it totally changed my feelings about my labours.

With your history, I think only you know what you will feel more comfortable with.

I was very worried about giving birth naturally and requested a section. Was turned down, and induced, and ended up with an emergency section, so i got my wish. Recovery was very painful for me, even moving really hurt, which painkillers didnt touch. Personally I would never chose a section again because of the recovery, it took me 10 months to feel back to normal. All of my friends had vaginal births with no problems, and were home a day later enjoying their new baby, while I struggled with just basic tasks like breastfeeding, and had to move back to my mothers for a few weeks.

People have much easier recoveries than I did, my twin included. But I hate the way c section is portrayed as an easy option as it is an operation, and giving birth is a natural life event, but can understand with your past if you would like the whole thing over and done with instead of going through labour. Have a long talk with a midwife about it before you make your decision. Best of luck.

"bear in mind that not all labours are as traumatic and damaging as you think".

Absolutely true. But you have no way, going in, of knowing how your labour will be. Most of my friends had 'okay' childbirths (don't know anyone who says it was particularly enjoyable). A significant minority had terrible experiences, and some have had on-going difficulties and private operations for such things as incontinence. A c section is indeed major surgery. It is also, as described above, 'weird' (good description!) and a little bit scary until it actually starts and you realise it feels odd but not painful. You will definitely be sore when they downgrade the painkillers to 'paracetamol ordinaire' about 48 hours afterwards - just as the baby really perks up and demands to be fed - cue slightly crablike moves off bed. But - I've had two - for the vast majority of folk having an elective you get what it says on the tin.The risks are way smaller than for an emergency section and compare very favorably to recent studies on home births.
This last sentence will no doubt unleash hot debate here - not to mention endless boring quoting of whichever research study backs up the poster's stance - for the simple reason that those most opposed to denying women the choice of a section, those who argue most vehemently that it's simply not possible (resources, risks etc) to allow for all choices in childbirth, are frequently those who argue most forcefully that women should have a choice of home birth, no matter the costs (resources, risks etc). In other words the 'I'll support your choice so long as I approve' brigade. Funnily enough those of us who opt for sections don't generally judge other's chosen childbirth methods at all - nor question whether they have 'phobias' or 'control issues' (no I don't - and nor do I have urinary issues, PTSD issues, tear issues or sexual health issues - not that it's anyone's business!) so whatever your ultimate decision, OP, good luck and have a great birth.

Bell

I'm afraid I don't agree with the tone of your post and that it is directed at pro-VBers, but I nevertheless think you have a good point.

I had a fantastic and enjoyable birth to my dc2, to the extent that I am considering surragocy as the only way to do the birth bit again without the following 18 years. I know there are others in my position.

However, the reason my birth was so wonderful is because it was a VB in it's purest and naturalist form with amazing facilities on hand and amazing support. I made absolutely certain that this was all set up for me, after a horrendous time giving birth to DC1, where all of the above was implied but not delivered.

'The risks are way smaller than for an emergency section and compare very favorably to recent studies on home births.
This last sentence will no doubt unleash hot debate here'

Not really possible unless you post links to the research. However, intuition tells me you could possibly be right when it comes to birth satisfaction. There is no way on this earth I would have given birth in a hospital unless it was for a c/s, after no.1.

'those most opposed to denying women the choice of a section, those who argue most vehemently that it's simply not possible (resources, risks etc) to allow for all choices in childbirth, are frequently those who argue most forcefully that women should have a choice of home birth, no matter the costs (resources, risks etc).'

This is the bit I have issues with. It's simply not that simple. Again I would have to ask you to point to some research that suggests that homebirths are anything like the cost or risks of a c/section.

'I'll support your choice so long as I approve' brigade.'

I have absolutely NO issues with this bit and happen to agree. Also the pretence that no-one can make you do anything you don't want to do, when actually they CAN make you VB. I wouldn't say there was a brigade though. Perhaps within the NHS there is, because they have targets and policies, but outside of that, generally the pro-VBers simply know what I do about the way a VB is supposed to be and know that properly done is a walk in the park compared to a c/s. Sadly very few women have births like mine and rarely is it because they couldn't have done.

'Funnily enough those of us who opt for sections don't generally judge other's chosen childbirth methods at all'

Neither do pro-VBers. The reason they may come across as strongly opinioned is because it is only those ones that can be heard above the noise of general unnecessary intervention that women only need because they are interfered with in the first place.
The 'thank god I was in hospital because my baby needed help getting out' brigade, when in fact the only reason the baby got stuck was because they weren't 'allowed' to labour in the position they wanted.

Star - not getting at pro-Vbers just anti -Cbers! If you told me you wanted a VB there is no way that I would try and persuade you otherwise. It's none of my business and in no way do I think that 'my way' is at all 'superior'. But sorry, quite a few pro-VBers, and particularly pro-home-Bers do come across as judging other people's choices whilst being voluble about their right to their own.

On the research re risks of elective section v home birth - groan - you put me in danger of being the very bore I warned against!

But, briefly, one of the latest studies on elective sections was a Canadian one - 2007 - which took as it's very stance the notion that lots of women were choosing sections and possibly weren't aware of the risks. Herewith a summary of the results (without hiding the bad bits) :-

"Women in the C-section group were nearly five times more likely to suffer a heart attack than those who planned a vaginal birth. But the actual difference was tiny: 1.9 per 1,000 women in the C-section group compared to 0.4 per 1,000 births in the vaginal birth group. Overall, the study found 2.7 per cent of women who had "planned" C-sections suffered some type of severe complication, such as a bacterial infection, hemorrhage or hysterectomy. That compares to just 0.9 per cent of those who planned a vaginal birth, including some who ended up having an emergency C-section.
Dr. Robert Liston, head of obstetrics at UBC and one of the study's authors, said women should know about the increased risk for C-sections, but "the bad outcomes are rare, so it doesn't affect a lot of people... For most women, it's not an issue."

The most recent study (I'm fairly sure) on (UK) home births showed that, whilst for most mothers and babies there was no bad outcome, for those (a significant proportion) having to be transferred to hospital the risk of death for both mother and baby was significantly higher than hospital births (both hospital Vbirth and Cbirths). A leading London teaching hospital recently stopped funding a midwife team specialising in home births because they had discovered that the risk of damage to the baby was higher than in hospital births (including Cbirths).

NB I reiterate, this wouldn't stop me from supporting any woman's right to choose a home birth.

PS - as to the costs of a home birth - quite simply the major constraint in the NHS at the moment is the shortage of midwives, not surgeons, and if you have a home birth you grab two. Indeed I have seen a home birth recommended to someone on MN on the grounds that you get two MWs to yourself whereas in the maternity ward you'll probably end up sharing one with several other labouring women.

PPS - sorry and I will end with this - the Canadian study showed that the risk of infant mortality was actually lower with a planned c section. cesareandebate.blogspot.com/2009/12/life-threatening-infant-morbidity-is.html