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.

[sleepcrisis]

I'm a bit baffled by this thread.

I am with KirjavaTheCat - Thank god for c-sections, but seriously, if you want a baby and you are low risk, doesn't that mean you have to give birth? Like most women on the planet?

[mrsvilliers]

KirjavatheCat, I totally agree, if it were not for c sections then either I or my little boy would not be here. So thank goodness they exist!

LittlePea, I hope your section goes well and is what you expect. If it helps with prep, I was lent a bed support for people who had stomach surgery which I found invaluable (about £30 on eBay). Post surgery you can buy silicone gel pads which help reduce the scarring and also pilates is really good for overhang etc, once you've recovered obviously.

Now if anyone could point me in the direction of a thread on how to get baby #2 out when you are terrified of another section yet convinced your body is incapable of natural birth I would forever be grateful...

[Excited2meetmyprincess]

mrsvilliers where do you get the silicone pads from? I am trying to get everything that will help reduce the scarring as I already have a few scars on my stomach from previous surgery x

[hazeyjane]

I think one of the things that I found very hard after having a cesction was the feeling of failure - not because of peoples opinions on electives, but because I thought I was prepared, I had weighed up lots of factors, I had a very good reason for having one, I had read lots of threads where people talked about electives, and the majority of experiences seemed positive.

I was so shocked by the reality, that that is why I just want to post here and say, if things aren't great afterwards, if you do take a long time to recover or suffer any problems afterwards then be gentle on yourself. It has taken me a long time to process my csection, and the feelings I had about it afterwards.

[LittlePeaPod]

kitty thank you. I am a first time mum to be too. Congratulations and wishing you a happy. heathy pregnancy too.

MrsV thanks for that. Please could you share the brand names for those tips. You could email or post on here. Sorry I can't help with your other query.

Sleep all women are giving birth. It's just we now live in a world where women have more choice about what they do with their bodies. If a VB is their chosen birth plan then brilliant and if an ECS is their birth plan then brilliant for them too. I have just never understood why one choice is more worthy compared to the other. After all a VB and CS both carry risks to mum and baby.

One of the other points I have been considering and researching is the difference between EMCS and ECS. Historically when people have discussed EMCS and ECS these two procedures seem to have been bundled into one. I wanted to know if there was a difference and if this impacted the outcome of the birth. Here are some very interesting points which I thought I would share for those considering an ECS (happy to also share the information I found out about risks and benefits of VB and ECS if anyone is interested)

• EMCS are emergency events and as such the medical team have to move very fast. This can leave women feeling chaotic, confused and frightened. Add this to the fact women are all so unprepared for this potential eventuality through the antenatal sessions, no wonder some women are left with such a negative perception of CS. On the other hand a planned ECS is slower and everything is explained to the woman as it occurs thus leaving women feeling much more in control and relaxed
• in an EMCS women get little notice that a CS is required, whereas in an ECS women have weeks/months to prepare for the CS
• EMCS often come after hours of labour so women are likely to be exhausted, frightened and traumatised. With an ECS unless the woman opts to wait for labour to start before going in for the ECS, she should be fresh and alert before going into surgery

Emotionally the circumstances surrounding the birth, understanding of whats happening, why its happening and been able to make quick informed decisions can only benefit all women. In the event of an ECS, women have time to process all this and prepare themselves. Where as in a EMCS women don't have this opportunity unless they are well informed about CS prior to labour. But this can only happen if our NHS have a transparent policy of ensuring women have access to unbiased information. I also read a paper a few weeks back which said that depressed thoughts and negative feelings are quite common after an EMCS and some women feel disappointed they have not succeeded with their planned VB. this didn't surprise me one bit considering women are not properly prepared for this potential eventuality.

Sorry for my continual rants but I a fed up of the current NHS BS policies which constantly push one choice and one choice only.

[Bamboobambino]

Couldn't agree more

[Excited2meetmyprincess]

Totally agree with you. Would rather have a planned c section than have an emergency one!
My cousin has had both and with the emergency first she was out of action for a while and was emotionally drained afterwards and really struggled with what had happened. With the planned one she was up looking after her older DD and the baby within a couple if days and just seemed like a totally different person compared to the first time round.
So I do think they are totally different and would never want to run the risk of having an emergency one x

[FixItUpChappie]

I don't judge you for wanting a elected cs because I think women are very disconnected to birth in this era - we are only exposed to it in the most clinical and limited fashion and I think that approach breeds fear about the pain and process.

I can only add that because cs's constitute major abdominal surgery there is a lot of variety in the individuals pain and recovery. I think there is the sense that a cs is easier with more pain relief. I have had two, both out of medical necessity. The first was ok relatively but the second was very, very painful and hard on my body. I would never chose to go through that over having a natural birth.

Its quite likely that my first cs contributed to my getting a complete placenta previa with my second child too - a very serious complication that is on the rise with the rise in cs's.

[vaticancameo]

Very tricky one. I've had a vb and an elcs. In my case, my vb undoubtedly cost the NHS more than the cs, as I had problems with my stitches and had to go back for further surgery a few months later. The cost of different types of births doesn't take into account complications and follow-ups (although there will be plenty of complications following cs too, of course).

For me personally, cs was a less traumatic experience, but I had complications in my vb. The cs was still very painful to recover from and I obviously have a large scar as a permanent reminder. Even though it was an elcs, dd was still stuck and had to be delivered with forceps, and I know that long-term, she has a higher risk of asthma, allergies etc because of her delivery method. I know that my recovery was longer and more painful than those of my friends who had a straightforward vb.

Your choice op, but personally, I would never opt for cs if a vb was an option. You have an excellent chance of a normal vb without complications, but a cs is a guaranteed longer recovery and a big scar.

[GreatJoanUmber]

After two EMCS, I'm going for an ELCS this time. My first was what I'd class as an avoidable EMCS (long, slow labour with little progress and eventually baby became distressed); my second was a real emergency "crash" section, an attempted VBAC. Both were quite traumatising and the recovery long and hard.
I've thought about it for a long time, but finally decided to go for the elective this time. I'm hoping as it will be a much calmer scenario and I will be well rested, the recovery won't be quite as awful as the times before.
I do think though that a VB is in most cases the better method to deliver a baby - just from my own observations of my friends; even the ones with complicated or assisted VBs had an easier, faster recovery and easier second birth. I just think for me, it's not the way to go as my body doesn't labour well and would most likely end up with a c/s anyway; and of course the logistics (having to arrange childcare for the two little ones).

[hazeyjane]

Please believe me when I say an elective can be just as traumatic and physically hard as an emergency section. And more traumatic than a vaginal virth - and I say that as someone who had to have surgery after my first vaginal birth and had botched stitches after my second.

[4athomeand1cooking]

I have read this thread with such interest. My first impressions were not unlike some on here - how a first time mother can choose major surgery over a VB seemed strange.

However having thought about it, I realised even with my 5th expected child, (I have given birth by VB for all), the one thing that has plagued my pregnancy has been the "how and when" my natural labour will take place.

The fact that my labours are usually quite quick, my consultant is trying to encourage me with an induction. Yet the risks involved with an induction are numerous. On the other hand an induction would eliminate much of my worries about travelling to the hospital in time to give birth etc.

His argument is that I am already at higher risk of a pph - Induction increases this even more risk but at least I am sure to be where they can help. I suppose the same argument goes for a CS.

So why is it that the medical world think nothing of this type of intervention with it's many risks, but a CS should be out of the question? Induction does not seem to raise the same eyebrows.

For someone who does not fear surgery but wants to eliminate this element of CB, a ELCS is surely an attractive idea.

[imnotalone]

I have read this with much interest (although haven't managed to read it all so apologies if my point is repeating another). I had a EMCS following an extremely traumatic birth which resulted in serious long term damage. Despite this, it didn't put me off having another child as I envisaged a calm, planned Caesarian - my pregnancy had been fine. My second pregancy was a dream, I took earlyish maternity leave to prepare for my planned cs but unfortunately, DC2 decided to put in an appearance 3 weeks early. Luckily, they managed to get the CS done in time but I was fully dilated by the time I'd got into theatre.

For those of you that have planned CS's, please be aware that you may go into labour early and will the hospital be prepared to give you a EMCS for non-medical reasons? Would you want that?

I am now pregnant with DC3 now and have also been made aware of possible risks into having an early ELCS compared with VB or EMCS - www.nhs.uk/news/2007/December/Pages/Caesareansection.aspx

There are clearly pros and cons to each perspective but don't put all your hopes on a planned CS as your DC may decide otherwise...

[SaucyJack]

Not knowing the 'how and when' plagued your pregnancies?

Leave it out. It's a minor inconvenience, even when you go overdue. And yes, I've gone overdue myself so I know it doesn't feel minor at the time.

[4athomeand1cooking]

Yes they did actually saucyjack, considering my family live 20 miles away and 3 of my labours were 2 hrs, 15 mins and just under 5 minutes, it is a very real concern for me!

Would I be willing to risk an intervention of a Elcs or induction to give an element of certainty? I am not sure but since a homebirth has been ruled our for health reasons they are going to have to be real considerations.

[KirjavaTheCat]

The thing is, very quick labours are a cause for concern for so many reasons. I can imagine in those circumstances that a c-section would be quite sensible really, especially if a homebirth is ruled out. Giving birth in the passenger seat of a car down the M2 at 2am, not ideal.

For no medical, psychological reason though? None at all other than "I'd prefer it"? You can argue that women who choose c-sections because they're afraid of the thought of giving birth vaginally have anxiety issues. It's an issue that can be solved by a c-section.

Simply preferring not to push a baby out, thank-you-very-much or "I'd like to have my baby on this date, please", aren't 'issues' are they? Major abdominal surgery should be carried out if there's a good, solid reason to, surely?

I think the NHS rightly don't present a c-section as a 'birth option' alongside homebirth and induction, because it's completely separate. It's major surgery. It's a big deal.

[GreatJoanUmber]

immotalone, thanks for the link - I did read the Aarhus University study results before my first consultant appt and based on that requested for my ELCS to be at 40 weeks, not 38 or 39.
My other two were both late (1 week and 1.5 weeks respectively) and my labours are slow and inefficient (got to 5cm dilated in 36hrs), so I think I'm on the safe side - even if I do go into labour before 40w, I'll still have plenty of time to get to the hospital.
But I agree that every woman considering a CS should have read the study of at least be aware of the risks.

[SaucyJack]

Dunno if I'd even agree with that Kirjava, tho obviously you don't know what you're going to get until you get it.

I had my second on the lounge floor so quickly the paramedics did not have time to get there. My mum caught her instead. Pushing stage was six minutes.

But I'm not complaining at all. I have poos most morning that take more time and effort. Quite honestly I wouldn't bother crossing the road to avoid having the same experience with number 3, never mind having major surgery.

[LittlePeaPod]

Morning all. Really want to respond but I have to rush off this morning and I have not had an opportunity to properly digest all your posts. I will do later. However there is something that caught my eye that doesn't require much thought and I feel this should be addressed now.

Livvylongpants I respect, value and actually want to hear other people's opinions on this particularly emotive subject even if those views are opposed to mine. The majority of people on here have stated their argument in an adult, genuinely emotional (due to previous experiences) and thoughtful way. I completely respect them for that even if we will never agree on this particular subject. However with regards your comment If you don't want to go through labour you shouldn't get pregnant. I can't make my mind up whether it makes you sound ignorant or simply stupid. If you wish to join the debate then please do so but try not to do it in a "Jeremy Kyle" ridiculously trashy manor. If you have nothing other than childish playground insults of value to add then best not to say anything at all. God forbid if you are a MW!

[LittlePeaPod]

Livvy your point about having a child is utter childish, stupid and ridiculous. Tell me, since you seem to understand the dangers so well. Why do you think the risks of an ECS are worse than those of a VB. Considering a VB is a traumatic process your body endures and thats not taking account of some of the things that can go. Please note I put ECS. Please could you provide me with some specific examples of the risks associated which mean a VB is safer? I really would like to understand.

Also anyone that flippantly compares a VB to a splinter in the foot having read some of the experiences of the some of tge women on this thread either didn't consider their comment or is just been an arse!

[vaticancameo]

Op, you can want a cs for whatever reason you like, but you cannot argue the stats are in your favour. The risk of complications for you and baby is higher for cs than vb - ranging from bleeding, cutting the bladder, infection etc for you, to a higher chance of breathing problems, risk of injury etc for the baby. You can choose to ignore the stats, but you can't deny they're there (my SIL is an obstetrician and I had many conversations with her about all this before my cs, so I do know what I'm talking about). In my case the benefits outweighed the risks, based on my previous birth. You're not in that position, having never given birth before.

[LittlePeaPod]

Vatican if you read my Op and my previous post you will see that I am fully aware of the risks and benefits of both VB and ECS. Not only have I had the information biased as it may be from my MW etc. I have also had advice from two Consultant Obstetricians and one Consultant that specialises in foetal medicine. I am aware of the risks you mention above and I am also aware of the VB risks - eg injuries to babies (facial/nerve damage to face, eyes, arms, legs), bleeding in the baby's skull, breathing difficulties etc. never mind the risks to me.

I want to hear what people have to say and if anything gives me food for thought or concerns me I can raise this with my Consultant. What I can't abide are ridiculous comments comparing VBs to splinters and CS to chopping feet off. I would like people to engage in this debate but if they engage then do so in an adult fashion.

[Bamboobambino]

We are arguing about the difference between what is the right choice for the individual (the OP in this case) and society as a whole (i.e a utilitarian approach) The OP, and many others in her situation, have decided, based in their own assessment of the risks and benefits that they would prefer an elective section. The fact that many healthcare professionals make this choice too, does not make it irrational. Each woman needs to make choices for her own situation that she won't look back on and regret. For some, this will mean trying for a VB at all costs. For others, the choice will be an elective section. Think for a moment how a woman may feel, if pushed into a VB that she didn't want, only to end up with a traumatic instrumental delivery, or worse a baby damaged by birth hypoxia. Should we all be 'doing our bit' for the NHS by having VBs if that's not our choice? Personally in this day and age, I think not!