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.

Hoping to get some advice or support. I saw the consultant for first time on Monday, I'm 17 weeks pg with second child and after an exhausting 3 day labour with 2 failed inductions that ended up in emergency c section last time I desperately want to cut to the chase and have an elective. My lovely midwife told me that as I'd already had one, the consultant would easily agree to an elective this time.

However, when I saw the consultant, she seemed to have already made up her mind after flicking through my notes that I would be having a vbac :( She quoted how low risk the scar rupturing would be (which wasn't really even a concern of mine), and twice she said how 10 years ago there wouldn't have been any option but to have a vbac?? Why talk about 10 years ago if things have changed and there is the option now?!

I'm embarrassed to admit that I got quite emotional and tearful, I hadn't expected her to be so anti csection especially with my history, I went on about my failed inductions, 3 nights of no sleep due to contractions and the impact it had on my poor bonding with my daughter due to how exhausted and even a bit traumatised I was. She did seem a bit more human when I got upset, and said that we can decide at my 34 week appointment what the definite plan of action will be.

I'm upset again just writing this, what can I do next time to ensure I persuade her? I will try to take my husband or mum to back me up and maybe take a few notes with me.

LittlePeaPod
This thread has been so informative...I saw my GP the other day & she wrote a referral letter to one of the consultants at my local hospital re my VB fears & wanting to discuss an ELCS.

I need to chase it up early next week if I don't hear anything- I'm almost 35 weeks so time is if the essence.
Pretty sure that even if the first consultant says NO then I'm within my rights to ask to be seen by another, is that correct?

Not certain what the CS policy is at my local hospital (some posters have said that CS policy was plastered over maternity notes i.e. We do not do ELCS in this trust.)
Not seen anything like that written down.

Trying not to get my hopes up but felt 100% better after speaking with my GP. Decided to cut out midwives as I won't be seeing one til late next week- tried to bring up & discuss topic last week but they were v dismissive, I asked about episiotomy leading to 3rd or 4th degree tears, they simply saying over & over that the "doctors will do whatever is needed to get baby out"
Utterly fills me with dread!!!

Why are you embarrassed to admit you got emotional and tearful? You are talking about something that obviously was quite traumatic to you and has made you take it seriously enough to consider this option. Add to this that you feel like your fears aren't being taken seriously.

I think you are being way to hard on yourself saying that. You are ALLOWED to feel like this. It is not a sign of weakness; its a sign of being human. The number of women who seem to think that they are somehow less of a woman for this, is surprising and there is a need to simply say, that however you feel and however you act is actually pretty normal, all things considered.

First thing. From every thread of seen on the subject taking someone for support at appointments seems to really help, as it does seem to make you get taken more seriously. I'm not quite sure why this is - perhaps it shows you've discussed this with someone - or perhaps it helps you articulate an argument if you are upset. Or just a united front evens up the balance of power between doctor and patient and its just harder for them to say no to you.

Second thing. Politics. I would personally find out whats going on at the hospital and what their current rates for CS are and whether there is a mission statement of some description about method of birth eg "we are proud to have raised our CS rate" as it gives you a clue as to whether there is politics going on which may be working against you and you might need to challenge. If there is pressure on staff to increase VBACs then you can use this in your argument about how you do not think your needs are being addressed and that you feel railroaded into this. Use policy to your advantage.

As you said yourself, what happened 10 years ago is irrelevant. Progress is behaving differently from 10 years ago and in medicine this is almost universally regarded a good thing. You know that, be confident in your thinking and logic. Don't suddenly question yourself over that. See it for what it is.

On the plus side, if your lovely midwife is being supportive, speak to her and maybe ask her advice. Maybe ask to be referred to someone else if necessary. It is not acceptable for you to feel like you are being dismissed and sent away. Regardless of whether you have an ELCS or a VBAC if you are feeling like this and are getting distressed about this YOU NEED SUPPORT of some kind and they have a duty to provide you with this, rather than just telling you that you can talk about it in 17 weeks time. Keep this in your mind no matter what. Don't get caught in the trap of thinking or being told, "well other women cope". Do they? Or do they suffer in silence too because there is a massive taboo over the subject or because they feel bullied into not seeking support? You don't have a right to an ELCS but you do have a right to get access to appropriate care for your circumstances. Anxiety can be a serious problem and should be treated if it is affecting your life and consuming your daily life.

And lastly as simple as it sounds I do think its worthwhile thinking about exactly the reasons why you want an ELCS and writing it all down beforehand; both to clarify whats going on in your head properly and to make sure you can actually talk about it in someway and make it very clear you have anxieties that need to be addressed. My mind goes blank with these things and I find it very intimidating in front of qualified professionals who are trying to get you to change your mind about something.

Oh and good luck.

amandine07, thats great news!

Pretty sure that even if the first consultant says NO then I'm within my rights to ask to be seen by another, is that correct?

NICE say: An obstetrician unwilling to perform a CS should refer the woman to an obstetrician who will carry out the CS.

However two catches with that. They don't have to follow NiCE guidelines and you actually don't have an absolute legal right in the NHS as a patient to get a second opinion if your doctor or consultant does not feel you need one. It is completely at their discretion. (Though rare for them to refuse).

If you were in the situation you might need to go back to your GP to get referred again, to someone else, which is not ideal if you have a ticking baby bomb.

Perhaps not the answer you want to hear, but thats the situation.

Only advice to offer is simply be persistent if thats what you want and don't give up. I've seen a couple of threads where someone has gone right to the wire challenging a negative initial decision but they did manage to get an ELCS in the end.

Thanks redtoothbrush, lots of good ideas there.

I had just imagined the appointment going very differently, thought it would be more of a discussion rather than her telling me what she had already decided on, and I lost control of myself so probably didn't explain myself very well. I'd wanted to explain things clearly but ended up more as an emotional outburst.

I definitely need to be more prepared for next time and will research the hospital as you suggest.

RedToothBrush
Thanks a lot for the heads up... Yes I realise that there is a ticking time bomb, so to speak.

Really good explanation and ideas- I just want the consultant to hear me out, rather than give their pre-determined decision before we have even had the conversation & explored all the reasons for the request.

Summergarden
Really sorry to hear you're having troubles- I think you're only second trimester? I'd say keep going, try to meet with another consultant and write things down before you go in or practice saying things out loud at home so you can help yourself come over as confident & assertive.

It's such an awful thing, at a time when emotions are running high, hormones all over the place- all you want us for your fears to be addressed & taken seriously. But not many people do really listen to what is being said.

My GP was v sympathetic & straight away did the referral letter while I was there, listened to my reasons & trot out the VB is always best like all midwives seem to do, like they've got selective hearing and barely even acknowledge your fears let alone try to start exploring them.
Good luck!

*GP didn't trot out the line that VB is always best, without addressing any of the potential risks or long term damage that could be sustained.

I think women just need to know that this is a lot more common than they think and when they look at the reasons why is really understandable.

Healthcare professionals have GOT to start realising this. I actually find comments like "doctors will do whatever is needed to get baby out" appalling as they neglect the importance of the mental and physical well being of the woman in addition to the baby. It is not unreasonable to expect good care for both and to expect that the needs of both are considered as the well being of both is so intertwined. Those type of comments take away the feeling of control and the real idea of consent from women. This is hugely important.

Women need to be taken seriously and given support from each other and from those treating them. Just talking about it on forums like this, I do think makes a real difference to that.

1944 so lovely to hear from you again. Your experience always highlights how lucky we are now even if we have to fight for our choices. Regardless of whether women chose a VB or CS they should remember that things weren't always this safe/supportive (ELCS/home births/MLU /water births etc.). I hope you are keeping well.

Summer my SIL has a very similar story to you. She has a three year old son that was delivered via an EMCS and she has a 5 / 6 week old baby who she wanted delivered via ELCS because of her traumatic experience attempting a VB first time. She had exactly the same challenges and responses you had from the MW and Consultant when she broached the subject of having an ELCS. She too thought that it would be an easier discussion because of her previous experience so hadn't done the preparation and research I did prior to her appointment. She too thought a second CS would be more a formality because of her previous experience.

Speaking to women that have been through this the first response when a maternal CS is requested is the same. Basically no, you can have a VB.

My SIL did eventually have her ELCS approved at 34 weeks and I spoke to her last night to see how she approached the initial negative response. Basically its seems that her consultant also assumed that her biggest concerns were related to a rupture etc. however like you, she did not want to go through the trauma of a VB only to end up with an EMCS. When discussing her choice with the consultant she focused on the emotional trauma and how this was affecting her now and also how this affected her following the birth of her DC1. She advised that moving the conversation towards the phycological (then and now) impact of her previous birth and continually highlighting her concerns this would occur again etc. made the difference. At one point she actually asked the consultant if she would be able to guarantee that her previous VB complications/trauma would not happen again. Consultant couldn't answer that and SIL said she did not want to risk it happening again. She also made it clear from the onset that if her consultant was not willing to support her request she would request a second opinion from someone else.

If I were you, I would focus on the emotional/phycological impact (bonding with your baby, trauma etc.) your previous traumatic attempted VB had. From reading your note you have genuine fear of going through that again. Also it really does help to go in there with some understanding the risks attached to VBs and CSs so you can demonstrate you have done your research and understand the risks. I have posted these before but below are some points I researched.

Mums

• medical intervention - ventouse, forceps, episiotomy, induction and the need to an EMCS who's is the worst result for any woman/baby.

-injuries - cuts,tears, potential broken pelvis, pelvic organ prolapse (uterine,bladder, vagina etc.)

Baby

• instrumental injury -facial and sever brushing
• injury - nerve damage to baby's eyes, arms, and shoulders.
• injury - bleeding / haemorrhage in baby's skull
• potential breathing difficulties due to baby getting distressed (eg meconium on baby's lungs)

Before going I would also recommend you

• try and understand your reasons for wanting an ELCS
• research VB and also try to understand the difference between an EMCS and a ELCS
• read up on how a CS could impact any future pregnancies and make sure you are happy with those risks
• is your DH/DP going to the meeting? It helps to have them there and to have them vocally supporting your decision
• think about what is important to you about the birth
• question the consultant. Eg. How often (percentage) do VB end in EMCS in their hospital? How often (percentage) of VB end in some form of medical intervention? How often (percentage) are forceps/ventouse used? Etc
• try and get a hold of the hospital stats. The stats should be available from your hospital itself as well as national surveys (CS rates, other forms of intervention etc.). Ask them for a copy if their childbirth policy so you can understand what you may be up against.

Just in case the consultant should start discussing scar ruptures etc. here is a bit of information on them. if i were you i would do a bit more research on this so you can show that you understand this but your reasons for wanting a CS are not just based on this.

Scar Rupture - the likelihood of a previous CS scar rupture is higher during a VBAC (35 in 10,000) than a repeat CS and some consultants automatically recommend a repeat CS on this bases (unfortunately not your consultant). The risk of fetal death as a result of scare rupture is very low (45 in 100,00) but again higher than an ELCS. Also external scars are not necessarily the orientation of your internal scar. Rupture rates have been shown to increase when inductions are required( 80 per 10,000 if non-prostaglandins are used, 240 per 10,000 if prostaglandins are used). So bearing in mind you had failed inductions last time, I would raise this as a concern. There is no guarantee that they may not need to induce you again.

The other thing to remember is the consultant/hospital's Duty of Care responsibilities. The UK General Medical Council states that it is the duty of clinicians "to recognise" that even when active treatment is not indicated, the duty to provide care to alleviate distress remains. in other words, in cases of fear of VBs for example it may be possible to justify a CS on the grounds of extreme emotional distress.

Also, I honestly believe it will help to have your DH at the next appointment. Especially if he is vocally supportive and can reiterate how traumatic the previous attempted VB was for you. Good luck.

Amandine. Glad to hear your GP agreed to the referral. I too would be chasing this up if I were you. Do you know which consultant you have been referred to? If so, most consultants will have an Obstetrics Secretary. I would be calling her to check she has received the referral and requesting an appointment there and then. It's true that you don't have a legal right to a second opinion however in the UK you can request a second opinion on any matter relating to your maternity care. So if your consultant should refuse your request they are actually obliged to agree to a referral. Referrals may be to a colleague within the same hospital, another NHs hospital or a privately funded hospital. With regards the hospitals birth policy, the hospital should have a patient support group and they should be able to point you in the right direction to get this information. Again, good luck and keep us posted.

Thanks so much for your support and advice littlepeapod, your sisters situation does indeed sound very similar to mine.

Thank goodness we have Internet forums as a means of support.

You are welcome Summer and indeed its great we can all share experiences, information and advice. I even appreciate the thoughts from those that don't always agree with our choice.

you only need to look to the nhs website to see the bias towards natural births. they call them normal. Go and try and find out info on c sections and its buried..

What gets me about the promotion of the 'normalisation' of birth is that it neglects this aspect of psychological impact.

If you look at it, then it could be surprisingly 'normal' to experience psychological distress giving birth. If this is the case, 'normalisation' of birth would surely also include acknowledging this minor fact and recognising that there are a lot of women out there, who are acting in a completely normal way when they request an ELCS!

There mentality in a small number of other countries is to actually recognise that a request for an ELCS is a red flag and to treat a woman accordingly, by realising that her requirements are more complex and needy than other women.

To me the term 'normal' is anything that occurs in a high enough frequency for it to be termed common. Given that the research coming out suggests that 1 in 6 to 1 in 10 women have a level of anxiety about childbirth which is affecting them, then why all this loaded terminology?

Not all of those women will want an ELCS; a load will alleviate their fears by wanting access to medical interventions such as access to pain relief, which is also something they are trying to encourage women to move away from.

They need to look at the reasons behind what is going on, rather than trying to force 'normalisation' which is what is happening.

3.5 years ago, I posted something similar on this thread (under another name) and got attacked by all people who are pro Vag birth and against ELCS. They tried to push down my throat THEIR idea of what is good for me. I am happy to report that I got my ELCS and had absolutely no reason to regret. I am really upset to see that some ladies here are trying to do the same to you. I am against the idea of home birth but I don't push down my ideas, which are really valid in MY view, down your throats so leave it and accept that ELCS is a very good option for some people.

Oh by the way, I have two friends from my pre-natal class, who had natural births and opted for ELCS after dealing with urine leaking (for years) and 3-4 degree tears. When we were all pregnant, they tried to convince me that a "major surgery" is not a good idea. I had absolutely no issues with my ELCS but was sad to see that they had horrible experiences.

AND, we need to remember that natural is not always good. 100 years ago, when birth was completely natural, the most common reason for female death was child birth and a lot of babies wouldn't survive! We have come a long way from that NATURAL situation and have managed to actually reduce the birth death rates significantly.

RedToothBrush
I totally agree with your comments in your post yesterday morning...also I get a vibe from midwives that if you are not prepared to go as 'naturel' as possible eg VB, breast feeding etc you're somehow letting your baby down.
This is not healthy, in my opinion.

Also, I'm quite worried now as my OH doesn't seem to be too keen on CS- he thinks childbirth is completely natural, women have been doing it forever & all our female friends who have done it have been ok (despite not really knowing any 'details' of their births.

He was a bit shocked when I told him about the 3rd degree tear resulting from episiotomy & forceps that our friend's wife had.

He thinks I need to just chill out, relax & everything will be fine. The problem is, he has never seen a baby being born for real (films do not count!). I have seen a fair few through my work & it has obviously left it's mark on me.

Tried to explain to him that sometimes it is a matter of luck, especially with the baby's position. It doesn't matter how much ante-natal yoga, pilates & positive thinking I do, it's not necessarily going to guarantee an instrumental or trauma minimal birth.

Forceps (to a lesser extent ventouse) & episiotomy are my biggest fear- I've seen the huge amounts of damage that they can do.

I feel that I have to do whatever I need to protect myself- and obviously our baby- it saddens me that it's perceived that is you're not "prepared to do anything, at all costs" you're somehow not embracing the whole childbirth thing.

Hope that me and the OH don't actually start arguing about all this now- it sounds harsh, but what he needs to see is a video of actual childbirth up close, to actually appreciate what goes on rather than just dismissing my fears.

It's made me start to worry that I won't be able to rely on him to advocate for me during birth- I fear that he'll completely side with what the midwives/doctors say & I won't have somebody to back me up, allowing me to make some choices.

Frightening stuff, I feel like women don't actually get very much choice in all this- you're expected to do as you're told & not complain.
Honestly, if men has to give birth...I guarantee it would all be so different.

Had to get all that off my chest!!

I'm fortune that my DH supports me completely.

The biggest thing for him was looking at the statistics about my chances of having a VB without instruments. He was very shocked. Given the risks associated with an ELCS vs a planned VB for all age groups an ELCS came out pretty favourably. But factor in the chances of a planned VB ended up as an EMCS or an instrumental delivery then, for us, the scales definitely tip in favour of an ELCS based on the fact I'm over 35 and have not had children (and there are other reasons which might decrease my chances in my case).

However hysterical and irrational I do get abput this, he can't argue too much with what he can see in black and white. It ultimately comes down to what appears to be safest for both me and baby. He's by nature very much the scientist so it plays to what he trusts and believes in.

Also helps that my very tactful and younger SIL made a big song and dance about having her first child before she was 30 to avoid complications. She's a doctor.

Luck does come into it, but luck comes second to other factors tbh. If you fall into a group where your risk factors are particularly high, then thats your lever to get your OH on board imho.

you only need to look to the nhs website to see the bias towards natural births. they call them normal. Go and try and find out info on c sections and its buried

Very true. Without meaning to go over old ground as this has been discussed in depth on the thread, it is extremely biased. With VBs been referred to as normal or natural and CS been associated with phrases like too posh to push, you don't trust your body, you think a CS is easier and on and so forth, its no wonder there is so much stigma associated with CS. We have read some of this on this thread alone!

Basically anyone requesting a CS is stigmatised and with that as a starting point it makes it difficult to have a rational, balanced discussion about CS in general. Peeapod your note regarding Information on CS been difficult to find is true and not just on the NHS website. In most birthing books/sources CS are relegated to a couple of pages and/or very basic information is provided (normally limited to anaesthetics or number of people in theatre).

Amandine I too am lucky my DH is totally supportive of my decision. Firstly he doesn't want to see me distressed and secondly he has seen how wrong things can go with VBs. I have talked about this before but close friends of ours nearly lost their DD at birth and she has only just come off oxygen three months later. This could have all been avoided had a CS been performed early on in the labour process. The MW and hospital are currently under investigation in relation to their case.

So, I am sorry your DH has bought into the prevailing cultural hegemony on CS. Personally I would never allow forceps or ventouse to come anywhere near me if I did choose to have a VB. Its a shame your DH doesn't understand that a VB is a preference just like CS and it cant be guaranteed that all will go according to plan. When you consider some form of medical intervention is used jn VBs in over 50% of UK hospitals it makes you realise how unrealistic it is to think all women will achieve the perfect "natural" VB. Maybe share the following with him:

VB instrumental birth risks to baby:

• facial injuries and sever bruising following instrumental delivery
• nerve damage to face, eyes, arms and shoulder. In severe cases surgery is required to improve baby's outcomes. And according to one of he consultant obstetricianss I consulted with, incidents are 24 in 1000 (forceps), 32 in 1000 (ventouse) and of these 1 in 100 babies suffer permanent damage.
• bleeding/haemorrhage inside baby's skull

VB instrumental risks to mother

• ventouse and/or forceps. Rates are significant although its very unclear what the actual rates are because of the way different sources report them. Again based on the information I got from the consultant above between 12 in 100 (ventouse) and 23 in 100 (forceps) VBs end in a ventouse or forcep delivery. IMO these instruments are very invasive and can physically damage mother and baby. As well as increasing the need for repairs to a woman's vaginal area instrumental deliveries are associated with increased risk of bowl problems, urinary/anal incontinence, haemorrhoids, pain during sex and sever emotional reactions.

We have read on this thread experiences from women that required major surgery months after to rectify damage following difficult instrumental deliveries. According to my Consultant (who also consultants on gynaecological problems) ventouse seem to cause less damage and pain than forceps with forceps particularly linked to increased incidence of pelvic floor issues. If my consultant could choose his preference would be for women to be counselled to have a CS rather than forceps intervention. He should know, he has to it fix the damage caused when its too late.

• Episiotomy - another procedure I would not knowingly allow of I choose a VB. This procedure will in no doubt result in stitching after delivery and it can make sitting/walking difficult for several weeks. And the impact on sex life may last even longer. A friend used to have to run a bath and sit in it to pee because it was so painful going to the loo. About 13 in 100 women have an episiotomy and having an episiotomy does not reduce the chances of third and forth degree tears.

Its a shame you can't get a hold of a instrumental delivery video so your DH Can see just how invasive these procedures are.

I haven't read all of this thread yet but will do and am pleased to have found it- thanks for starting it Summer. I am only 8 wks with my second, but am keen to request an ELCS at my booking appt next week so need some tips on how to give myself the best chance.

My history is that I went 11 days overdue with DD (now 3.6) and had a straight forward labour with no intervention (I wanted it as natural as possible- hollow laugh!) or even G & A until I was almost fully dilated. But when I started pushing nothing happened- she was completely wedged and her heart rate immediately plummeted at each attempt. So she ended up being delivered in theatre under spinal anaesthetic with ventouse and forceps and I had a massive episiotomy. I bled a fair bit after but just avoided a transfusion. The reason for the difficulty was most likely the size of DD's head- she was 7lbs 12oz and on the 50th percentile for weight and height but her head circumference was on the 95th (DP and I both have large heads so probably genetic).

Effects on me: massively upset at how it had all gone wrong so quickly and that DD had nearly died. Could not stop crying for 48 hrs, did not want to touch DD during this time, totally failed to breast feed (although not that bothered but maybe NHS staff will be more?). Leaked urine for several weeks. Episiotomy stitched quite tightly so sex was painful for around a year afterwards.

Effects on DD: she was very sleepy for the first 48 hrs which contributed to the failure to breast feed. Midwives thought this may be due to traumatic delivery. Massive forceps bruising for several days. Left side of head slightly flattened for first year of life resulting in slightly asymmetric eyes- no longer noticeable but a source of much worry for some time.

Not sure how relevant but one of the midwives on the post- natal ward advised me that I should definitely have an ELCS next time.

So my questions for those that have done lots of research- which of the above effects are likely to have the most impact on whoever I have to convince? My main rational argument would be that the chances are this baby will have a massive head too so intervention will probably be needed and I am not willing to go through the mental and physical trauma again - but is there a better approach?

Oops, just saw that you started the thread Littlepeapod so I have you to thank- sorry!

Missmdden welcome to the thread and sorry to hear of your previous experience. You have literally just highlighted some of the concerns I have raised since starting the thread about instrumental deliveries. In answer to your question. All of the experiences you had from the injury to the baby, you and the emotional trauma you suffered are very important and you should raise allif these when requesting a CS. On the previous page is a post showing some of the research I did prior to requesting my CS.

What I will recommend is that you speak to your GP as soon as possible. Raise your concerns and ask for a referral to a consultant obstetrician. The sooner you see a consultant the quicker a decision can be made. Unfortunately the MW will not be able to make a decision on a CS and IMO going through them just delays the process.

Missmidden no need to appologise or thank me. I may have started the thread but its everyone's thread and we have had some great contributions (for and against).

Thanks Littlepeapod, I will have a thorough read up. Interesting about needing a GP's referral- I never saw a GP once in my last pregnancy and it hadn't occurred to me they would have any clout, but if they are a better bet for getting a referral than the midwife I'll certainly give it a go. I see the midwife next Fri though and no chance of seeing a GP before that so will try both routes.