Requesting a c-section: has anyone done it?

[ScreamIfYouWantToGoFaster]

Hi ladies, first of all please can I ask you all to be gentle with me? I know that elective c-sections are a controversial area which many people have strong opinions on, and I respect that. This thread really REALLY isn't intended to start a debate on the virtues of one method of birth over another, and if you are strongly opposed to elective c-sections I would respectfully ask you to please air your views on a different thread.

I am currently 29 weeks pregnant and have been suffering from sciatica and SPD for some time now. I have very limited (and painful) mobility and have been signed off work for several weeks already. I am concerned with the risks to my long-term mobility if there are any complications with a vb (such as requiring forceps). I understand that a c-section is not the "easy" option, and that there is a recovery period of 6 weeks. In my opinion though I would prefer to spend 6 weeks recovering from a cs rather than spend 6 months unable to walk after having to go into stirrups with SPD.

My question is not about which birth method to go for, that's a personal decision which I am making with the assistance of my physio, and my independent midwife. My question is how do I request a c-section, given the latest NICE guidelines on this issue? The consultant at my hospital has already made it clear that they do not consider having SPD sufficient reason to be offered a c-section, and they will not do a c-section "on demand" as this is not what the NICE guidelines recommend. So what exactly is the process under the NICE guidelines? Who do I contact to initiate this process? How long should the process take? (There is a reference to "counselling" - does this mean a single appointment or several?). Most of all I would love to hear from anyone who has been through the process of requesting a cs when their consultant didn't feel it was medically indicated?

Thanks!

BUMP. Good luck OP. I hope you get a c-section.

Hi, I'm not in the UK bit am in a country which tends to draw its guidelines from the UK (rcog). I had an emcs last time for various reasons and requested one very early on this time for 'medical reasons'.

I was told they'd prefer vbac for a myriad of reasons. Over the course of several appointments I repeated my stance that I felt I would not be a successful candidate and by approx. Week 28 an emcs was agreed. One consultant I saw told me they couldn't 'force' me to vbac if I didn't want to and to keep requesting the elcs. So perhaps worth asking to speak to another consultant.

I was asked to look at the rcog website for information about vbacs, I was able to use this information and information from the hospital to display quite clearly that my chances of ending up in an emcs situation were likely over 50% anyway.

I'm having my elcs on Monday. :) best of luck to you!

Go into meltdown, if you're feeling depressed and anxious about a vb, then let them know you feel like that, tell them you feel very happy and comfortable about a section, you have done your research and that it would damage your mental health to be forced to have a vb against your wishes. Let us know how you get on. X

What thunderboltkid has said, is spot on and exactly my experience about 1 month ago (central London hospital). It is really misleading when people say that you can just have a CS becasue NICE says so. The reality is very different. I could have written your post exactly and went with my independent midwife to request an ELCS at 36 weeks. The consultant absolutely said NO! I was devastated.

This is my third pregnancy and I have two small children that I can't look after already. I have just been desperate to get my life back and minimise future damage (my most debilitating time was post birth!). In my case, I wrote various emails/letters to the hospital trying to re-state my case and they very efficiently got back to me the same day. The senior consultant then phoned me and we discussed why I felt I needed an ELCS. My fears were as follows:

1. Previous 2 babies have been large and both gone overdue (41+). I wanted to minimise the time I had yet another baby in my pelvis. DC2 was fully engaged for 5 weeks!
2. This baby is already being monitored and measured as large for dates. Again, I don't want it sitting in my pelvis for longer than needs be!
3. Both children delivered by vontouse with legs in stirrups - ouch
4. I am physically and emotionally drained from SPD (only something a fellow sufferer can appreciate!!)

But when we went through all, it really came down to the fact that I didn't want to go overdue and I needed a date, psychologically speaking, in order to know when this was all over! So we have agreed that I will be induced at 39 weeks exactly so that all my concerns are addressed. I know that all movements will be controlled (DH and IM there to remind everyone!!) and I also know that if I look after myself post birth, then my pelvis does get better (plus I can have painkillers post birth!).

The biggest relief of NOT having a section, is that I suffered with SPD at its worst after DC2 was born - the biggest problem was the lack of stomach muscles meant the back was overstraining and my pelvis suffered. I am realistic that the same will happen, but this time I need to manage it better and get those stomach muscles re-engaged pronto! If I had a c-section, I would be cutting through the very muscles that I need to support the problems in my pelvis!!! So please think carefully about whether an ELCS is actually going to beneift, rather than a VB.

The downside, is of course, I now have a third labour imminent...but I am genuinely relieved not to be having surgery.

My stomach muscles were pushed apart, not cut, it isn't common these days for surgeons to do that. I have fractured my pelvis at a young age, had Spd on crutches and ended up in a wheelchair, my consultant said that a section would do me less damage and was just as safe got the baby if I had been able to attempt a vb. Op I Would talk to your consultant, and get a second opinion, ask about all possible outcomes with a vb and section, if the risks of a section are more acceptable for you, then you really need to push for one. Good luck.

Shameless bump!

Also, thank you so much to everyone who has responded, I really appreciate all your comments. Especially ChocolateBiscuitCake - you're right about perhaps needing to follow up with letters to make my case.

Any more advice would also be appreciated. Thanks all!

but my reasons were due to a previous traumatic delivery. I think you might need to re-emphasise the mental and physical risks of you enduring a VB. I got my midwife and GP onside and although the first consultant rejected the request the second opinion approved it. My midwife had arranged the 2nd opinion with a consultant she knew was more pro CS than the first. If you're serious, keep making your case and don't let it drop.

Oops! Lost the first few words for some reason should be:

"I have had an ELCS approved"

Yes, I also had an ELCS. In my case I was very phobic of birth. I wrote a letter to the consultant (fairly formal), outlining my reasons for the request, explaining that I had read the NICE guidelines and that I understood the risks involved. I also wrote that if the decision was to be based on cost, I would be willing to pay.

I found that it took a while for the midwife to put me through to the consultant.
Once I saw the consultant, she agreed there and then and was bemused that I had to wait so long to see her, that I could have been spared a lot of stress by seeing her sooner. She was fantastic about it.

The c-section was fine, no problems at all and I don't regret it one bit.

I'm due in September with my second child and I am hoping that it will be agreed to have another ELCS fairly soon in my pregnancy. I hope the same consultant is still working in our area.

Good luck.

Oh and read the NICE guidelines over and over, make sure you know your facts and stats and don't be swayed if this is what you really want.

I had an EMCS with DS1 which was deeply distressing for me and DS ended up in SCBU as a result. I was all fired up to fight tooth and nail for an ELCS with DS2. In an standard appointment with a trainee doctor at the hospital I told him I wanted an ELCS and why and he went, 'OK' and that was that! I don't know that that is normal/standard but I was deeply relieved I can tell you! Oh and the ELCS was fabulous. I actually got to hold DS2 immediately whereas I didn't get to hold DS1 for nearly 12 hours. I cannot tell you how sad that made/still makes me :(

I had a third degree tear with first birth so was anxious about the second.

When I saw the consultant (well I think he was a registra) he was rather dismissive about everything and I ended up crying. In the end DH asked if I wanted a cs could I have it, he said yes. By the way he was speaking to me I honestly didn't know this was a option. So something to be said for asking outright instead of skirting around the issues once the discussion has taken place. Basically I refused to leave his office until I was reassured one of the other, once we were at stalemate he got his senior in.

In the end I had a vaginal birth, but after have being reassuring by the VBAC MW who explained what things in labour I should do and what to avoid, a lovely consultant who acknowledged by fears and actually gave me answers to questions and a referral put in place for physio to happen as soon as I had given birth to address my pf issues. FWIW she is doing wonders

even though I didn't have a cs in the end, I think if I had agreed to vaginal birth straight away I would have gone into labour very anxious (as I felt it wasn't my decision but one being forced upon me) and who knows how things would have gone.