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.

I have been wondering how you are doing Littlepeapod. I hope everything is OK and you are just frantically busy with your new daughter.

writer hope you are doing well. I remember you from the conception threads. I work in medical negligence and as you can imagine, only know of horrible VBs . I know most of them are no problem, but the imagine in my mind is painted red. I wouldn't be able to do it.

I'd mention your job to the Obstetrician - my guess is they'll be too scared to say no to your request

www.theguardian.com/society/2008/jul/11/nhs.health1?guni=Article:in%20body%20link

interesting article from 6 years ago citing how many female doctors and surgeons opt for an elcs.
the doctor i saw when overdue with my youngest told me she had never considered a vb - i ended up with a vb and no pain relief - nada - and it was the worst decision ever...i have a bad cough right now and have had to wear junior nappies as my pelvic floor is so buggered and yes i am doing kegels but after 3 vb my fanjo is broken.

Thanks for starting this Littlepeapod and congratulations on your DD!

I want to ask for an ELCS. I am absolutely terrified of giving birth naturally. I've put off having a baby till now because of my fears, but after speaking to friends and being told yes you can ask for a CS now, decided to go for it. I'm 16 weeks now. My MW referred me to the Consultant MW to talk about my fears, but I know I want a CS. MW has put in my notes I want a CS. I'm scared of everything to do with natural birth, I keep having nightmares and waking up in the night in a panic, worrying about if they refuse it.

Can anyone help me with the info I need to convince MW it is what I want, I have my appointment on Friday. Will she be able to decide or do I need to see the obstetrician?

I have friends that have had CS and I know it is a long recovery, I know there are risks, but for me the risks of a natural birth are far worse.

Is anyone still around on this thread?

MrsB I was on it a few wks ago as I went through getting my ELCs approved (second time round after god awful instrumental delivery last time- so it wasn't too hard). However I think you will get all the info you need by reading the whole thread- not the argumentative stuff, but the useful info on statistical risks associated with both options.

You need to be really well informed to lobby your midwife (who most likely can't make the decision, but will refer you to a sympathetic consultant, hopefully) and show that it is a rational decision you have taken. Some people also recommended taking your DH/DP to show that they are supportive of your position and to help ensure nothing gets forgotten.

Good luck- it is not likely to be easy but I hope you get what you want- after my first time experience I fully support anyone making the choice for an ELCS, regardless of previous experience of vaginal birth.

VJ and writer it might be too late, but I have had 2 inductions and both have resulted in natural births - albeit very very long labours. I had an epidural with the first and nothing with the second. I am now pregnant again and will be induced a 3rd time (I too am diabetic). I know lots of people who have been induced and not had EMCs.

I fully support anyone's right to choose the birth they want, but unless they have done it both ways think they are wrong to say that an ELCS is as much of an achievement as labouring and giving birth to one's baby oneself as opposed to someone else doing that for you. That does not mean it is fulfilling to do it both ways, but it is definitely very different and there is more achievement in putting the effort in.

I frankly would be absolutely gutted and would feel totally cheated if I had to have a EMCS especially having managed to have two naturally already.

Equally if an ELCS is what you want go for it - there is no right or wrong, but they are not the same.

Sorry what I meant to say is it is fulfilling to do it both ways as you have a baby at the end of it, but it is definitively not the same amount of effort

Thanks for your post madasabox - can I ask how long your induced labours were?

My consultant said that if I do go down the Induction route there will be a time limit on my labour and that if I haven't given birth in 12 hours they will take me round for a CS anyway...

Is 12 hours realistic???

My induced labour took 8 hours. This time I want a section. It's not the Olympics- you don't get a medal for having 'achieved' vaginal birth. The goal is a safe delivery and a good experience for the mum. that will be different for everyone but I resent the people who congratulate me when i say I had only gas and air the last time. In many ways it wasn't a great experience and this time I was a more controlled environment. Just a personal choice.

(I don't mean I resent the people who say it, I mean I resent being told how wonderful I am because of it. It implies that people who have drugs or a section aren't also wonderful)

Seriously Madasabox, you'd feel cheated if you needed an emcs? Even if it meant the difference between having a healthy baby or the unthinkable alternative?

"unless they have done it both ways think they are wrong to say that an ELCS is as much of an achievement as labouring and giving birth to one's baby oneself"

I did both and do say that ElCS was as much an "achievement" as labouring and VB. I achieved a baby at each birth.

12 hours of torture while I bled everywhere and screamed in agony was no achievement. Neither was your birth, I'm sorry to point out. Your body was doing what it was designed to do, with very little conscious input from you. You couldn't have stopped the process if you wanted to, so I honestly can't see how it is supposed to have been an "achievement".

The real achievement is bringing up your baby.

I will have put the effort in, i will have achieved. so the3-4 days in hospital, 6 week recovery and the scar aren't "that much effort" give me a break..

You couldn't have stopped the birth if you wanted to, therefore it isn't something you "achieved" imho.

Since when is going with the flow of a completely natural process which the vast majority of women in the history of the world have also gone through an "achievement"?

I have my consultant midwife appointment tomorrow, hoping this is the first step towards having an ELCS.

After reading this thread and various websites, I know this is the right choice for me, I want my baby to arrive safely in a controlled environment.

Good luck at your appointment today MrsB

Hi all, just a quick question.

I went to see my consultant last week who has referred me to the widwife to discuss my elecs further with her. However there isnt an appointment with her avaliable until the 24/02 and then i have to see my consultant again after if all goes well on the 03/03.

Im due on the 01/04/13.... does this leave me with enough time to get booked in?

It should be fine - I'm pretty sure they can book a woman in at pretty late notice if needed. My Obstetrician told me that technically they aren't supposed to book them until the woman is at least 36 weeks pregnant anyway. Don't worry

My Obstetrician booked my ELCS/bed on the ward when I was 28 weeks pregnant - I heard the midwife on the other end of the phone laughing at her for being so 'proactive'

Lol oh phew thats good to know, i was getting a little bit worried it was all being left conveniently late so they could tell me that at my last consultation there wouldnt be time

Just fingers crossed now that my midwife agree's with me and lets me have my ELECs. Theres a 50/50 that i would have to have an emergency section anyway and i've read on NICE that these are more risky then a planned section. So i think it would be silly of me to take a greater risk when i dont have to.

Oh & thanks for your response writer, that puts my mind at ease

Just discovered this thread and thought I would add my thoughts. I had an ECS with my dc2 after an emergency CS for dc1. Always felt guilty with my choice even though I had a very supportive consultant who let me make my own decision and never questioned my reasons.

I recently heard of a recently retired midwife who stated she felt so frustrated at mothers insisting on natural births and refusing intervention and pain relief until so late in the labour that real damage to either mother, child or both occurred. Damage that would otherwise be preventable. She stated that medics and midwives had striven for years to provide pain-free, safe births, but that insistence on natural birth, and rejection of good medical intervention was slowing the development of this. In no other area of medical/health care do people routinely eschew pain relief and medical procedures in this way. If you had broken a bone, she said, you would not insist on nature taking it's course and refuse all that modern healthcare can offer. Even a headache is treated without second thought. We do not just wait for it to go away, so why do we do that with childbirth?

She really made me feel like I had nothing to be ashamed of. I did make the right choice, and for the right reasons. My baby was born and put straight onto my chest without complication. My recovery was quick, my general health good. I breastfed well. I was driving within 3 weeks.

When I compare the whole experience to that of my first dc, I wouldn't hesitate to choose ECS again.

Childbirth is not a competition.

Congratulations OP - enjoy your little girl.

Guideline = "a general rule, principle, or piece of advice". To me that doesn't sound like any degree of entitlement to ECS. I can imagine some areas will be stalwart of that.

Having had an EMCS (despite 55 hours of labour) I can't fathom why somebody would actively chose a CS when there is no need. I suffered an infection afterwards and was in hospital for five days, hated being unable to pick my son up without assistance for the first few days and and long winded recovery and search for my abdominal muscles again. Not to mention the pain of movement and not being able to drive or pick up things for quite a while!

However I do appreciate it is a matter of choice but don't agree that it should be the burden of the NHS to pick up the cost. For that reason I can imagine the NHS is reticent to offer the advice you were after because it would not wish to condone that course of action as routine. Its stretched and considering the demands and needs of other areas I would agree with its approach.

Good luck regardless. Hugging a pillow comes in handy when somebody/thing makes you laugh.

snobbie that's not too late to book in an ELCS. I had an ELCS with DC2 (after an EMCS with DC1) and even though it was agreed at 20 weeks, the actual section date wasn't confirmed until about week 35/36.