When to have an elective c-section

[Kizza2]

To anyone who has had an elective c-section-

1. how did u go about choosing the date?
2. when does the OBGYN start discussing it?
3. is the date chosen by the parents, the doctor or a compromise of both- e.g. does the doctor say- "right, i have these days available, choose one"??

We are due December 28th, but the baby will be taken out before that but we are conflicted about the date-

we want it to be as far away from December 14th- thats my dads birthday and for the rest of the babies life he/she will have my dad crowbar himself into any celebrations which we dont want

We dont want- December 4th, 9th or 15th or 18th (family birthdays) and not the 8th- 8 is considered very unlikely and we are not keen on 7th (know some not so nice people born on that day).

we were told by the midwife that they can take baby out any time after 36 weeks which leaves 30th Nov and first week of December available- which is great but if the baby is doing ok, then is it better to wait till 37 weeks?

we are very conflicted, as wonderful as December is, it is very popular.

Make sure it's at the start of the month as some of the best pre preps offer guaranteed places to those born early in the month!

Seriously, do what your doctor advises is best! Sharing a birthday (particularly working round family issues) is really not what it's about. And "we know some not so nice people born on this day"... this is really very strange, how is that relevant in the slightest.

DS was born by ELCS on my birthday - that was the date that we were given and we didn't think to question it. It does mean that my birthday is a bit of an afterthought but that's not really the end of the world. It hopefully means that he won't forget mine when he is a grown up though!

I was told that they normally do elcs at 30 weeks. When I asked if they would consider it earlier as I'm worried about going into labour before the date (seriously anxious about it) they said they wouldn't do it before 38.5 weeks.
They'll give me a date at 36 weeks.

Your reasons are mostly petty and you could go into labour anytime and your baby could be born on any one of those days naturally.

Sorry 39 weeks, not 30!

I was just given a date, I'll be 39 weeks exactly, the registrar just calculated when I'll be 39 weeks and booked me in.

There are risks to the baby if delivered by cs before 39 weeks, presumably your first baby was in scbu, why would you risk your second going there too? Obviously if your consultant feels that the baby is safer out then that's different, or if you go into labour naturally before then, but surely your baby's health is the most important consideration?

I was just given a date which was 39 weeks exactly. It wouldn't have occurred to me to try to avoid days such as other peoples' birthdays. It's the birth of your baby, not a business meeting... Put your diary down and chill a bit!

The same as the other posters, shocked really at how you are choosing dates. The clinician will look at medical need and theatre / ward schedules. Keep him /her in as long as possible unless there are medical risks.

I had a ELCS booked, due date was 2nd Jan, ELCS booked straight after Christmas for 27th Dec, clinicians choice only, book laid across me on the bed to book it in.

I doubt you will get a date close to Christmas, they try to reduce no of electives as staffing levels are down over Christmas holiday. From a personal point of view I'd hate to be in over Christmas, the meals were awful, paper hats and crackers around a hospital bed. Ough

My ELCS was booked for 37+3 - on Christmas Eve.

Consultant was going skiing in my 38th and 39th weeks so was offered 24 or 27 December, I chose the earlier date as I just wanted the pregnancy to end, I had had lots of problems.

Christmas Day in hospital was pretty shit. So maybe avoid that if you can.

The OP here I think is American or with experience of the US health services. She may have a very different experience of health services where patients do have more choice than the NHS permits. I also find some of her reasonsing for dates a bit trivial but in cultures where there is a large degree of patient choice, this may not be so unusual as it is for us with NHS experience!

I don't know whether she is in the UK or US but in either case there is a clear push to not deliver by ELCS before 39 weeks any more due to breathing problems, unless there is a clear medical need. Even previous early pre-eclampsia wouldn't be sufficient to trigger an early delivery unless there are problems in the next pregnancy (and I really hope there are not). I had an ELCS at 38+2 after previous severe, and early PE with a horrible outcome (it was 26 weeks and my DD1 died). No-one wanted to do it any earlier, and if I hadn't been starting to develop minor problems would have waited until post 39 weeks. I had great ante-natal care but I wasn't really offered choice -- and wasn't expecting that either!

I would expect your obstetrician to start talking about whether you want a repeat c section or a VBAC relatively early on though - certainly by 20 weeks or so. They probably won't want to discuss dates till a lot later as that will depend on how the pregnancy progresses.

Are you in the uk?

My consultant said how about xxx date for your elective section. In our hospital each consultant had 'a day' that they booked in for his was a Friday. I actually asked if I could have the Friday a week later as it was a very special date for us and he agreed. However I have not known anyone to ever be offered a choice here. I got my date at about 30 weeks.

OP I've seen many babies born at 36/37 weeks suffering from respiratory distress syndrome, so I'd be leaving it as close to the 38/39 weeks if you can.

I've also had 2 premature babies, and this time will be having a elcs but we've agreed 38weeks to avoid RDS, and if baby tries to escape before then as per last 2, then hopefully it'll be able to be stopped as I don't want a ill baby again, I just want to have my baby next to me of at all possible.

I've actually had this very conversation this afternoon with my consultant - (I'm 37+5 today). After a repeat section was agreed, he went to get the diaries, and saw that there were no free elective slots at all for the next three weeks! Of course, this wasn't helped by it being booked so late, but I know lots of people who have only been booked in at 36 weeks+). He decided to squeeze me in as an extra on the 31st (no choice there) even though he'd 'get shot in the neck for it'. When I got in half an hour later I had a voicemail saying we've changed your section to the 26th. So you may well find you have no choice whatsoever like me.

I was told it was 39 weeks as an earlier increased the risk of baby being admitted to SCBU. Apparently the risk plummetted at 39 weeks. I also wanted it sooner as my first baby had arrived at 37 weeks but was told tough, they would do a semi-emergency one if I went into labour before 39 weeks.

They might let you do it a day or so either side but IME they won't mess about when it comes to the babies health.

I'd love to know how your consultant agreed to an elective CS - I asked for one (being 42 and scared ) but was told I would just have to 'get on with it' & have a VB - fortunately for me, but obviously hugely traumatic and a lot more expensive for the NHS I ended up with an EMCS .

To be honest, the date would be the least of my concerns.

OP I've got to be honest I find some of your 'reasons' for avoiding various dates pretty extraordinary, especially the one about 'some not so nice people being born on the 8th' I'd imagine some nice and not so nice people can be found to have ANY date as their birthday.

Agreeing with all the others who have said that 39weeks + is best for baby - I am having an ELCS and my consultant aims for 39+2 wherever possible although I may get taken at 38+6 due to his AL and my hefty baby! I understand that you have previous medical issues that make it unlikely you'll go to term but 36 weeks seems ridiculously early and I'm genuinely amazed that a midwife would say 'any time after that' unless there was a genuine medical emergency.

I can't work out if you're from another country or culture where this is more common place but I do find it a bit odd to be honest.

at the OP!

Please try to relax your expectations a little and your perfectionism. Taint good for a family with a newborn.

I'm in the UK and if I was lucky to have another baby (unlikely) then I know that the latest I would have it, would be 37 weeks, to be honest I don't think I could go beyond 36 weeks. The risks to the baby would be far less than my peace of mind.

DD1 was born by EMCS at 38 weeks, and she did have respiratory distress (not beacuse she was early, but they said it was due to the mucus not being cleared, as it would have via a vaginal birth). She was fine though.

At the time, seeing DD1 being wheeled out in a trolley, with a flashing light, was the scariest thing ever. Now I'd risk it all in a heartbeat. Therefore, at the end of 35 weeks, I'd be begging/screaming for a section.

For others though I agree that the later the better. For me, the anxiety would be far worse.

I am giggling at this thread.

Honestly, unless you are paying to go private the consultant will just tell you when it's going to happen or you may get a choice of 2 dates. As long as you avoid Christmas Day, consider yourself lucky.

Bonkers.

What are you going to do sweetie if you go in to labour on the 8th? Cross your legs?

My elective was done on the first weekday after 39 weeks.
I wouldnt have wanted one earlier than 39 weeks without good medical reason.

Even if you go private they TELL you when you're having the section and that's it! They're there to provide you with excellent obstetric care, not fit in with your diary!!! Private doctors still have an ethical code!

First time mine was booked for a Saturday, then he rang and said he'd do the day before as that was when his anaesthetist was free. No choice. Second time I begged and pleaded but was delivered no earlier than the consultant's recommendation. He gave me a later slot so I could miss the traffic on the way in.
All ELCS, all with same doc, all private.

Bag of Holly - my elcs was very much a matter of asking me when I wanted to do it ( post 38 weeks) and we arranged the date between us, him and the Portland. We had the final say in choosing my son's birthday so I do think it's possible if you go private to choose.

Yes but sunshinecurl that's after 38 weeks and before 40 so it makes no difference really, just down to theatre/cons schedules. The OP is on about picking a date not based on medical reasoning for the most part.

Good point - Bag of Holly :-).

My EDD is 21/09/12, we scheduled the ELCS for 17/09/2012 to make it's the beginning of the week. I asked my obgyn about possible date at 29wks+5. he suggested the date, I accepted. He called someone in my presence to schedule my ELCS first thing in the morning (it's private care) so hopefully my baby waits for the agreed date and time.