Elective C-Section (medical/non medical reasons)

[LittlePeaPod]

I understand this subject has been done before. I also know that ECS particularly as personal choice rather than as a medical need is an emotive subject and the debate about CS birth can be particularly contentious.

Considering 1 in 4 women in the UK experience a CS birth I have been disappointed to see how inadequate access to CS antenatal information is, so women can make a truly informed decision. Personally I think it's short-sighted to focus solely on VB and continually emphasise managing pain relief. The NHS is so focused on their target to reduce the 1 in 4 CS due to cost that they are neglecting their responsibilities to those women that choose or want a CS birth regardless of medical need.

I am currently 23+6 and I have chosen to opt for an ECS. There is no medical reason for a CS but this is a birth choice that I want. I understand that CS and VB both carry real but different risks but I believe these risks should be explained to women so we can make informed decisions about which birth risks we wish to take. Unfortunately this is not the case and the push for VB is so endemic in the NHS that women are not receiving the true facts on CS.

For those women like me that want an ECS birth. I just wanted you to know that due to the new NISA guidelines if you want/choose a CS the NHS now have to give you one. They will do everything they can to try and change your mind to the point of trying to scare you and make you feel guilty about your choice. But, regardless of medical need if you insist that a CS is the right choice for you the NHS have to honour your wishes and give you a CS. I am fortunate to have been able to privately pay for independent advice on VB and CS from three different very well respected professionals in the UK (two consultant obstetricians and one consultant in fetal medicine) and also received advice from a close family friend who is a consultant anaesthetist. I was shocked to hear how target driven VBs are in the NGS and how in fact this is what's driving the push for women been made to think they should have a VB and not the safety issue.

Ladies it is your choice how you have your babies and what you do with your body. If you want a CS you can have a CS regardless of medical need on the NHS. My DF and I have just spent a lot of money finding that out. I am 23+6 and the NHS have now confirmed I will be having an ECS and there is no medical or psychological need. I am having it because its my choice. I wanted to share this because prior to spending a fortune getting non biased information I was under the impression that I had to prove a VB was medically necessary, would psychologically affect me or that I had a fear of VB before a CS would be authorised by the NHS. Well that's not the case, its about personal choice. VB or CS you have a right to choose and the NHS have to honour your choice. It's just a shame and has royally pissed me the fuck off that if your choice is an ECS for non medical reasons the NHS are making it so difficult for you to opt for that choice in an informed way.

LittlePeaPod

Thank you so much for starting this thread and sharing all your thoughts, experiences & interactions with doctors and midwives.

I'm currently 25 weeks- I didn't find out I was expecting until I was 20 weeks! Now things have sunk in and myself & OH have adjusted to the situation my thoughts are turning more & more towards the birth which is obviously a massive, necessary hurdle to get through before we can meet our baby.

I was so freaked out at first when midwives asked if I wanted to be signed up for the local birth centre- I could barely cope with the fact that I was pregnant, let alone thinking about where/how to give birth.

From my experiences of working in the NHS it's what I've seen on labour ward that makes me shit scared. On my obs & gynae placement as a medical student I remember every woman who I witnessed give birth.

Nobody can reassure me by saying "it won't be so bad" or "don't worry, a healthy baby is all that matters in the end"
In a way, I've seen too much much & nobody can pull the wool over my eyes.

Currently I bounce between the birth centre hoping for an uncomplicated VB & minimal/no tearing to wanting to try and organise an ELCS. It's not the pain that worries me so much as the potential long term damage to my body.

I've seen ventouse & forceps used up close and seen the perineum tear as the baby emerges (sorry maybe TMI!)

Also, a vivid memory is seeing women being stitched up afterwards with obviously inadequate pain relief- one had her epidural button moved out of her reach during the later stage of labour, but it hadn't been given back to her once the repair of her 3rd degree tear following ventouse had started.
Initially I thought she'd been lucky as the doctor had the scissors in place to do an episiotomy but the rest of the baby shot out once the head had been born.
Would slowing this part down & protecting the perineum have prevented the tear?

The midwife/doctor couldn't work out why she was complaining so much and the poor women was do out of it she could barely verbalise her pain

Phew this is turning into a long post! I seem to have let out a lot of my fears & worries and where these have come from.
It's all these things and more that make me want to have a CS.
Yes it's surgery but it feels way more controlled than a cascade of intervention ended up in an instrumental delivery with significant perineal damage.

Once again, thank you very much LittlePeaPod

I have been lurking following this thread with interest. I had a third degree tear with DS and now 32 weeks pregnant I have the decision to make whether to opt for a natural birth or c section. I'm pretty sure I will opt for a natural birth again over having a c section as that is what feels right for me and nothing in this thread has really convinced me otherwise

A few previous posters said there is no right or wrong choice and I think that is really the crux of the matter here. Everyone is different and no one can fully predict the birth outcome for mother or baby and either option has its risks so it is up to the mother to decide what she feels the most comfortable with.

Thanks Littlepeapod for bringing this thought provoking discussion to the table. I may not agree with all your views or your choice to opt for an ELCS however I do feel you absolutely have the right to make that decision for yourself.

Good luck.

Hello again.
For risk of offending some, I'm delighted to say that I got my date for my ELCS.
So I am proof that if you fight hard enough you'll get one. Many may not agree with how I went about it, but it was the only way I could ultimately have what I believe should be my birth choice.

I've read this thread with interest and have come to the conclusion that most of those opposing those a woman's right to choose ELCS on the NHS, feel that fundamentally it's unfair that they are using more NHS funds (for an ELCS) than those that choose Vaginal Birth. Or perhaps, that they consider it wasting valuable and finite NHS funds.
I suppose my question is to those that oppose ELCS, if everyone that wanted one went private and paid themselves, would you still have an issue with it?

And yet life is full of things that are unfair. For example, no one likes funding workless households for whom social welfare is a lifestyle choice, for example. Or those same families who choose to raise four, five, six children on "benefits" while the rest of us act responsibly and generally wait til we can afford to have them, and usually just have the amount of children we can afford to have.
I don't like funding that. But it's just the way it is.

If that isn't the reason ie it isn't the money or cost to the NHS, and I have got it all wrong, then why would anyone care how someone else chooses to give birth? I genuinely am interested..

Jojo, I think it's the culture, both within the NHS and society, that women are able to, and therefore should, give birth vaginaly and preferably without much pain relief. That is why when that is not the preferred choice for some women, such as you, the op and myself, we come up against misinformation, judgemental views and have to fight to get what we want. It is seen as 'not normal.' when I first requested a section I was told repeatedly about the risks of caesarean, but despite requesting a balanced discussion about the pros and cons of both vaginal and caesarean, have been sent to 'normal birth' (their words, not mine) specialists, told lies about the risks of various pain relief and interventions and have come away thinking that my decision must be mine alone, based on my own research. I could not put my body in the hands of medical professionals so hell bent on presenting a biased view of an experience that has so many unknowns anyway. I research, know the risks, and I stand by my decision.

P.s: sorry for the rant, but my experience has made me question the wisdom of such a biased view. For example, if you scare a woman who wanted a caesarean into having a vaginal birth by only stressing how bad a caesarean can be, what if something happens and she needs one anyway? She goes into the operation terrified! That is helpful to no one.

jojomanon you certainly haven't offended me! I brought up your points in a previous post.

I am proud to live in a country with a welfare system and socialised medicine. I don't mind the benefits thing - I just hope people don't abuse it. But it can't be all one sided!

If my choice is to have an ELCS then why should I not be entitled to it? If I feel that strong about this birthing choice (which I'm not sure about yet) then who's to tell me that it's in my interest to be petrified and subjected to something I don't want.

I have an appointment with the midwife on Saturday and will let you all know what I choose.

This thread has been hugely interesting and it is great to see so many people support the idea that ELCS should be an option open to everyone.

Having had one traumatic natural birth on the NHS (barbaric comes to mind) I simply could not face another one. It was 'thanks' to my 3rd degree tear that I was able to persuade them to let me have ELCS now I am pregnant with my second. They wanted me to go for VB though - agreement for CS from them was reluctant. My mistrust is so strong that I am still going armed to the booking appointment with my arguments and stats clearly laid out in case they change their mind or try to get me to change mine.

I am due on 13th December. If I went overdue to the same extent I did first time round (41+5) I would be giving birth on Christmas day or thereabouts. I blame many of the things that went wrong for me first time round on the fact that I went into labour overnight and they were short staffed with NO resources. No theatre, nothing. Horrible and i refuse to go through that again over Christmas. I live near my hospital and the car park is packed every week day, quiet on a Saturday and dead on a Sunday, as well as overnight. How many of those missing cars are the surgeons, anaesthetists and consultants for when things go wrong?

The ill-considered idea that women now are supposed to give birth without intervention to be proper mums really annoys me. My own mother thinks the fact I had an epidural harmed my first baby at birth when in fact he was transverse/sunny side up and they didn't realise. His bruising was down to the forceps they used to try and turn him :-( Her opinions on CS are equally ignorant - to the point I have little respect for her opinions.

Do people forget that, whilst yes, the female body is designed to make, carry and deliver babies, that childbirth has never been straightforward and has been responsible for many millions of women dying young, with or without their babies. It is only thanks to modern interventions that maternal and infant death in childbirth has been reduced. It is fair to consider natural childbirth still a scary and potentially fatal activity.

And until the NHS can put care of women before cost, I would encourage all women to do what they need to to get the safe and fulfiling birth they want. We do pay for it many times over, many of us never taking a penny out whilst watching others bleed the system dry.

I have my ELECS in two weeks time and even now after its all been agreed a midwife I have never met today questioned me today as to why I was having one and another obstetrician who I have never met two weeks ago also questioned why and how I got a ELECS agreed and booked at 28 weeks as if she didnt trust her colleagues judgment. it has p! ssed me off that even tho it was agreed a long time ago and since very first getting pregnant i have always mentioned my choice of wanting an ELECS that I still have to keep justifying and explain myself to different people even tho its all booked and agreed. ..I bet I wouldn't have to keep justifying a natural birth choice or be questioned on it !! ...its extremely distressing so close to my due date.

. so an update as promised.

I had my beautiful baby daughter today via an elcs.

I was asked to be at the hospital for 7am and was second on the list to go in. Due to other emergencies and another elcs that was a higher risk than me I didnt go down to the operating theatre until 11:50.

There were about 8 to 10 medical staff in the operating theater and every single one of them were absolutely lovely.

They explained everything at every single step.

It turned out I had a very high placenta which wasnt discovered till they cut me.open and they had to use a sort of horseshoe instrument to get my baby out. Even the obstetrician said to me it was a goos idea I hadnt gone natural.

The procedure itself wasnt awful, I felt no pain but felt every tug and pull. and because of the high placenta they were a little more rough with me to get her out safely than usual. The aestheticaoligist was lovely during this time and held my hand along with my partner.

I had skin to skin contact almost straight away and so did my partner

sorry if this is all a bit bitty but I am still on an emotional high.

all in all I have in no way regretted my c section. I am lying in bed now in minimal pain. yes I am sore but no pain as of yet.

so far a very positive experience for me and I am even more sure that a natural birth was just not for me.

Congratulations! Glad your c sec went well. I see the consultant in 28th I think over all I am to be opting for a c sec after all, this thread has been one of the most interesting threads hope more people post there birth outcomes. I will be updating mine in Jan and weather my choice was right or wrong for me x

MunchinJess. Congratulations. I am so delighted for you and thank you so much for sharing your experience. I fully intend on sharing my experience. I think it's good for women to hear how Csection turn ou. I have my appointment with my obstetrician on the 25th November to agree my Csection date.

Congratulations again

Congratulations, what lovely news and great to hear your ELCS went as planned. Mine is booked in for the 24th Dec and like the other posters i plan to share my experience. Enjoy your lovely new baby xxx

Fraggle my Csection is liely to be 28th December....

Hmmm, strange thread. I don't agree that everyone should be able to choose what they'd like re birth. VB is natural & usually best for baby. I've had 2 elcs & both were gat experiences though. Cs babies miss out on 'friendly bacterua' that help their digestive systems when going through the birth canal.

Also OP brought breastfeeding into the equation. Again, it's best for baby. So much so that I defo think everyone should be encouraged to do it for as long as possible even though it's a hard thing to do. At least for the first few days when colostrum present as it has huge benefits for baby, (also helps CS recovery fow womb to contract). I was able to breastfeed my dd now 12 weeks for the first 4 weeks, then expressed for 2 more before moving to formula. I wouldn't judge people who couldn't manage it but would certainly judge someone who didn't try breastfeeding at all if they were medically able to do so as I can't understand why you wouldn't want to give a baby the best start possible, even the first feed makes a difference so am interested in the reason for choice here as there are no risks to weigh up apart from sore nipples! (alright thrush, mastitis, sleepless days and nights....)

I think thats quite a judgemental view Evelyn, some could just as easily judge you for not continuing beyond 6 weeks. Both breastfeeding and birth choices are very emotive topics and this thread (as stated at the beginning) isnt for judging on either.

LittlePeaPod - that is close. 11 Wks and counting. I can't wait. I looking forward to your post CS feedback

Hi ladies.

I have drifted in and out of this thread but I now have my final appointment with consultant on Wednesday to decide if I can have my c section and just wondered if anyone could give me any advice on what I can do to help it along as my consultant is very pro natural birth.

I have quite a few reasons for wanting the c section and will give these below, but consultant is still trying to push me into a natural birth.

Reason are:

1. I suffer from hemiplegic migraine which means I lose complete use of my left hand side (similar to a stroke) and things that kick it off are stress and hormone increases so labour is a high risk for causing one.
2. I have been told by a few doctors that I have a small pelvis (I am only 5ft) and when I have been for scans etc the baby is showing as large for dates and always two weeks ahead on the size charts. So natural delivery would be difficult because of small pelvis
3. my baby is back to back with me and refusing to turn. The midwife managed to turn her and within two days she had turned back! Obviously prefers this position. But my sister was born back to back via forceps because my mum struggled due to small pelvis and it ended up breaking her nose and putting her in great distress and at 24 you can still see where this happened.

So personally I feel that I have enough reasons to want a c section but as I say I am struggling to convince my consultant of this. So wondered if any if you ladies who managed to get your c sections had any advice on what I can do or say to get it.

I am currently 34 weeks and the section would be done at 38 weeks if allowed so I don't have long to convince her.

Thanks in advance xx

I think the problem is that medical experts rarely know how the birth will progress until it's in full force. I have heard many horror stories of friends being encouraged to labour for too long in a natural birth because they are reluctant to offer a c section unless absolutely unavoidable. In all cases, intervention took place anyway, and many friends have long term damage as a result. In my case, I had a difficult labour and have been left with a severely prolapsed uterus due to the long labour (30 hours) and a large baby (not foreseen). I will need surgery in future.

I am very happy that two consultants have agreed a csection for this pregnancy. They agreed it was less risky for me. When I was 15 weeks pregnant, we agreed a date for it and I am booked in. I am so relieved not to have months of anxiety and fear, worrying it will be the same as last time. I know a c section has its risks, but I am prepared to take my chances. My recovery was slow last time as my hip was pulled out in stirrups and I couldn't walk properly for two weeks.

This is an interesting debate as emotions on both sides of the argument are so strong. I haven't had time to read more than the first four or five pages of the thread as yet, so forgive me if I go over ground that has already been discussed!

Personally, I think the 'right' to an ELCS for non medical reasons is only part of the larger jigsaw of maternity care and won't be resolved until maternity care in the UK is rebuilt from the ground (patient) upwards.

I had my first baby around 16 months ago. Pregnancy was fine with no issues and only black mark against me, as far as the NHS was concerned, was my BMI (I am either obese or morbidly obese - I forget which is the current favoured term for someone of my exceedingly large dimensions). I desperately wanted a homebirth and read up on all the reasearch for and against home vs hospital. I battled through midwives and consultants and had the homebirth agreed. However, baby was breech and wouldn't turn even with an ECV (now there's a procedure I wouldn't recommend anyone trying - ouchie) so I was booked for an ELCS. I would still have tried a VB, at home ideally, in hospital if I had to, but no-one would hear of it. Essentially the skillset to deliver a breech baby vaginally is just not in the NHS anymore as they never get to experience it due to the medicalisation of breech birth, and I couldn't afford an independent midwife. After the battle to agree a homebirth and the failed ECV I didn't have the strength to fight for VB so meekly agreed as I was emotionally exhausted. The section itself was fine, quite enjoyable actually. The three nights on the postnatal ward were the worst of my life and I still get very, very angry when I talk about them. I had a wound infection that took four weeks to heal (not unexpected, given my size). It took three weeks to establish breastfeeding and it took me many months to bond with my son. Whether the feeding or bonding issues were related to the section or the stay in hospital or just serendipity, I'll never know and to be honest don't really care as it's in the past now and I would like it to stay there!

Baby number two is due in February. This time, from my booking in appointment I have made it absolutely clear I intend to have an ELCS. I have done this as I don't want to spend my whole pregnancy battling for the birth I want again, I just want it settled and I'll accept the hellish stay in hospital again and the risk of infection just to get it booked and settled. Ironically, the midwife is trying to persuade me to have a VBAC instead although I feel I have medical justification for an ELCS (previous CS and due to my experiences when on the postnatal ward I fear I will be far to anxious and stressed in a hospital environment to relax enough to labour successfully). I have my first consultant appointment after my 20 week scan on Monday and intend to push to get my ELCS booked. I suspect this will be in vain and I will once again have to spend my entire pregnancy anxiously fighting for what I feel is the best route for both myself and my baby.

The point I think I'm trying to make, in a rather rambling fashion, is that while there must be people that have a smooth journey through pregnancy and birth (regardless of type of birth), my personal experience of maternity care is one of constant battle, resulting in a stressful pregnancy that can't be the best for either myself or my babies. While there are no doubt good midwives and good consultants, I have experienced both the good and the bad. The good listen and talk with you, the bad will nod, quote guidelines and talk at you.

Regardless of the situation and particular circumstances and choices, maternity services need to put treating the patient as an individual and really seeing and listening to that person at the centre of their work ethic. I believe that this would help optimise the care received (and the cost of care) as people would be more likely to get the care that was right for them without having needless referrals up and down the chain of command while battling for a given outcome. This doesn't mean just agreeing to any and all requests of course, but listening to those requests, understanding the root of them and working with the individual to explore the options and best way forward. Of course, financial pressures make this impossible. And so those of us that don't / won't / can't follow the smooth path through maternity care battle on and I see no end to this.

Gawd, that turned into a miserable rant. Apologies

Evelynj as I have stated throughout the thread I am keen for everyone to get involved in this debate. Whether people agree with me or not, I believe this is a discussion that must be had so women become more aware of how biased our current maternity care is and how poorly informed women are in terms of risks associated with VB and ELCS. Not sure if you have read through the thread but you will have seen that we have discussed the benefits and risks attached to VBs as well as ELCS. With this in mind the ladies that are choosing to have an ELCS believe that they would rather take the ELCS risks than the VB risks. I won't go over these arguments again because this would just be going round in circles. However please feel free to read through the thread and give us your views on the risks/benefits argument. With regards your note Also OP brought breastfeeding into the equation. I believe you are mistaken in this comment. I have not raised the issue of breastfeeding and certainly I have not said that women should not breast feed. Again I would appreciate it if you read through the thread as you will see that this has been raised by others. My personal opinion on breastfeeding is the same as VBs and ELCS. Women should choose how they wish to bring their children up without the fear of stigmatisation by other judgemental parents that feel some sort of superioty because their choice is different and therefore making them feel guilty in any way. As I do not judge the parents that choose to have a VB, breastfeed or not breastfeed, I expect them not to judge my choice. What I do judge are the small minded people that feel they can force other grown adults into following a path that is not right for them. I judge their small mindedness!

Fraggle I know it's so exciting. We are about to start decorating the baby's room. Picked the wall paper and colour scheme yesterday… Eeeeeekkkkkk I fully intend on giving an honest and non biased blow by blow account of my ECLS and process up to it.

Excited2meetmyprincess I am happy to share how I preped for my meetings however just rushing out now so I will post a bit later on.

sorry I have had an opportunity to read the rest of the posts but I will do later.

Little PP - where are you located? I'm in Nottingham. We are moving 4 Wks after the birth so no decorating/nesting for me as yet x

Fraggle how do you know roughly when the date your c sec will be? Or is this something you get to choose. Iv got app with consultant on 28th, I think I read it's usually a week before due date which would put me at 4th Jan but I don't know if it actually works like that.

terilou mine was booked at 38 weeks and 6 days.

can I just add that midwife aftercare really hasnt been great and my partner and I have already said if we have another baby we will be going private.

munchkin sorry you've had a bad experience(nothing worse than bad after care), i had emcs with my first dc I was put to sleep so have no recollection of procedure ect but at our hospital the after care was brilliant but that was in 2007, my sil also works as a trainee midwife at the hospital I will be going to so I'm hoping it will be ok.
I am nervous about the epidural( I hate needles) how did that go was it fast/ painful