ELCS at NHS Hospital-impossible??

[boots28]

Hello,

I am new to mumsnet and am due to give birth in September. I would really like to have an elective c-section, but have heard this is very hard/near impossible to get in an NHS hospital.

Has anybody been successful in getting one on the NHS? At what stage should I bring this up and who do I ask? Would it be my midwife?

Any advice would be greatly appreciated.

Ask your midwife for local info. If it's going to be considered, you would then see a consultant. I haven't heard of anyone getting an ELCS on the NHS for non-medical reasons.

Hello boots28 -

This thread might be useful for you - www.mumsnet.com/Talk/childbirth/954334-Anyone-asked-for-ELCS-for-first-baby

And the (full and rather long) NICE guidelines, which are what NHS practice is supposed to be based on, are here if you want them - guidance.nice.org.uk/CG13/Guidance/pdf/English. I only say 'supposed' because like so much of the NHS, policy and people's experiences of it seems to vary very widely from place to place.

Sorry this is a 'linky' reply - I don't think I can be much more help because I don't know why you want to ask for an ELCS. It is true that a C-section isn't something you can just tick a preference box for on the NHS (I have no idea what the situation is in private healthcare) - however, women have asked for them and got them - it really depends why, and experiences seem to vary. The MN thread link I've pasted here is a good illustration of this, and that's why I think it might be helpful.

Hi boots28,
If one of your reasons for wanting a c-section on the NHS is because of the cost of going private, it might be worth you knowing that some trusts will also let you have NHS care up until delivery, and then just pay for private c-section. This is what I am planning, and it works out about half the price as going private throughout.

A friend had 3 ELCS's at an NHS hospital and another had 1. The one who had 3 is an anaethetist though so was probably able to argue more persuasively...

I had an ELCS with my first for no medical reason on the NHS (18 months ago). I would ask your midwife to get you referred to a consultant to discuss it as soon as possible altough you may have to wait ti 30+ weeks for a decision. Have you reasons worked out and read up all you can on the pros and cons. Read the NCE guidelines and take hubby/partner to back you up. Stick to your guns and don't let them fob you off. It wont be easy but remeber you are entitled to a second opinion so use it if you have to (I did). My ELCS was a lovey experiemce and I have had another since (easier to get second time round ) Good luck.

I know two women who were allowed elcs with first baby due to stress/trauma (both had been sexually abused as kids and couldn't face labour) so it is possible.

I am electing this time, but only cos I had an emergency last time and it was properly messed up. Mw was really snotty when I suggested it, but consultant reviewed my notes and agreed there wasn't really another option (surgeon from last time put 'NO VBAC!!' underlined on my notes.

What I'm trying to say is that midwives don't seem very supportive, but if you can get past them to a consultant, they will reason with you about it.

You could argue that your fear of a natural birth qualifies as a 'medical' reason. You might have to see a counsellor or psychologist first, though.

Why don't you ask your mw to refer you to a cpn or social worker?

They should be able to provide support/counselling now (as opposed to putting you on a waiting list for a counsellor!)

my social worker is lovely (like I said, I was pretty traumatised by previous section!) and helps me with CBT, even drives me to hospital appointments and is working with me through exposure therapy (I get to look at and handle the equipment that will be involved in the surgery and get used to the idea of being in hospitals again). She really has been very helpful.

You might find after some treatment that you don't have the panic attacks any more and that the section doesn't seem quite so necessary.

It's certainly not the easier option, but I understand that phobias don't have to be rational.

I had ELCS with my first in December - it was a wonderful experience. So it is possible.

Arm yourself with as much knowledge about the procedure, the benefits, and the risks, so that you come across as someone who has thought this all through, understands the risks, but on balance wants a CS.

Approach your midwife first, if she won't help ask to see another midwife. The decision has to be made at consultant level (so I was told), so you will have a consultant's appointment as well. The midwife cannot sign it off, iyswim. Good luck!

Kiki84,
You need to talk this through with your consultant as the first step. It may be that you will qualify for an NHS c-section because of your psychological problems.
If you don't, the next step is to ask for a second opinion, which you are entitled to.
If they still refuse you and you need to go down the private route, you need to phone up the secretaries of the consultants you are considering and ask them for their prices and whether you can combine NHS care with private delivery.
Good luck and let us know how you get on x

If you have a really extreme fear of birth then you should be able to get an elcs on the NHS. You will probably have to discuss with several doctors/midwives and may be asked to do some counselling first, but if at the end of that you still have your phobia the elcs will almost certainly be approved. Psychological issues are a perfectly valid medical reason for an elcs.

If you just want an elcs for no medical reason (physical or psychological) then it gets more tricky (and also your thread is not likely to end well, as that topic tends to degenerate into flame wars quite rapidly). I have anecdotally heard of its being agreed in some cases, where the mother was firm but polite, but I don't know how Kingston feel about it although I've had two children there.

(oops, conflated two posts -- it's PixieCake, who has the phobia of childbirth, who is going to Kingston. Which hospital are you registered with, OP?)

(not PixieCake, Kiki84. I really shouldn't be allowed to post today )

My NHS ELCS was maternal request and I didn't need to say I had a fear of childbirth or have any counselling. I never discussed my wishes with a midwife only with consultants - however I did have my husband with me who backed up my request Very firmly (but politey). My ELCS was a lovely experience.