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.

Freckley I apologise if it was my post that you were referring to. I am sorry if it was too horrendous, but I suppose in a thread where people are talking about being fully prepared about outcomes of csections etc, I was saying that some of the results are things that it is very difficult to prepare for.

littlePeaPod, earlier I spoke about breathing difficulties as a result of elcs, and you said that at 39 weeks, the differences between vb and elcs were negligible. This is not the case, especially in babies born with more severe respiratory distress. There is a difference between being born at 37 and 39 weeks(risk decreases from 4 fold to 2 fold), but something ds's consultant said wrt these figure is that a scan only has to be a little out wrt to dating to make thisdifficultto assess. Also that some people have a tendency to gestate longer (eg I had dd1 and 2 at 42 weeks, and ds was delivered at 39 weeks, and his lungs were not ready). thiss article talks about the increased risk in babies born by elcs.

I haven't read all the threads on here so I apologise if I repeat anything.
I have been told due to the transverse lie of my baby that I may have to have a C-section and im gutted.
there are so many ladies out there who just want to give birth naturally and to avoid major surgery but that choice is taken out of their hands through no fault of their own.
every case and women is different,obviously,and should be treated as such.
I can totally understand why someone would choose a C-section if they have had a previous traumatic birth or have a genuine,crippling fear of vb but I have never and never will understand ladies who choose C-sections for shallow reasons.
reasons such as deciding what date they would like their babies on,loss of sexual muscle tone or just deciding that they cant be bothered with the hard work of pushing out a baby vaginally.
reading a few facts about the risks of c-csections and coming on here hearing a few stories doesn't prepare you for the real thing.
having major surgery OR giving birth naturally are not something that you can just read about and be prepared.
until you have gone through either of these thing you will NEVER know the reality.

There will never be a happy consensus on this. I make the assumption that all those strongly against have not experienced the devastating effects that can happen for a VB handled ineffectively and inappropriately by surgeons and midwives. If the OP wants a CS and has researched all the benefits and costs associated then fair play to her, she is an adult capable of making informed decisions. My only negative stance is that I don't think an emergency theatre should be taken up purely because the labour starts early. This is a purely selfish view as I have a planned CS but if I go into labour early, would need an EMCS to prevent the damage that has been fixed being permanently destroyed necessitating the need for colostomy bag. Emergency theatres should kept for medical emergencies only.

However, I completely understand the want for an ELCS whether or not the OP has any experience if she feels that is the safest way to deliver her baby then people should respect that. (Sorry to talk about you, it's just the way I started off writing!).

Irrespective of the medical side of things, I think you're risking missing out on a major life experience. Witnessing your body take over in the way it does during labour is an incredible thing.

I honestly didn't experience this at all, I was pushing when instructed by the midwives, have wondered since whether this is why it was so awful.

Flowersnavase I don't believe anyone has said anything regarding ECS taking precedent in financial terms over and above the elderly or helping people with cancer or have they and I missed it? I believe the only thing mention was the NHS is currently also funding other procedures that have resulted from an individuals choice (e.g smoking - cancer and over eating - obesity). My personal view is we don't put enough in the system to support the elderly and I would like to see cuts in certain benefits so these funds can be redirected to the elderly and impoverished children. But that is another different and very emotive thread. I wouldn't even mind seeing an increase in taxes if it was guaranteed that this is were those funds would be redirected.

I don't believe I am / will be missing out on a major life experience. Ultimately the major life experience for me is the birth of my daughter in what I believe is the safety and list stressful environment for her. How that process happens isn't the major part or the miracle in my eyes, its simple a means to an end. So on that basis I really don't see it as missing out on anything.

With regards your IVF question. I don't believe we can compare the two. I don't know the risks to mother and baby if a women gets pregnant via IVF in comparison to sex. i assume very little. I understand though the medication can make you really poorly. I am also assuming the risk of injury to the mother alone is no way near the risks they face via a VB or ECS. Logically I am finding difficult to compare the two. Also I believe the scenario where women get IVF to have a child with no intercourse currently rightfully in my view exists (e.g same sex partners). Are you arguing this should not be allowed too because they are not conceiving by having sex with a man?

iamnotalone thank you and I can understand your concerns regarding EMCS.

URT and Jane please be assured that outside of reading scholarly articles recommended by my MW, the consultants, my GP and others etc. and my own research on VB and CS, I have also consultated with two Consultant Obstetricians and one Consultant in foetal medicine. My views and the stats are not simply things I have taken off google or bought a couple of books on. I have spent a lot of time andmoney understanding what is right for my daughter and I believe I am very well informed to be able to make that decision. Some of my friends all think I am mad to have gone to such lengths but its my nature to want to know exactly what it is I am facing. They also understand why I did it having watched my sister and some of their VB experiences. I am not walking into this blindly. If anything is raised here or by RL people which concerns me or makes me think then I will look into that too. My research was triggered by the utterly inadequate antenatal information on all both options provided by the NHS.

Freckly. I am sorry that this has distressed you. I wish you well and please do hide this thread.

Jane sorry I forgot to say thanks for the link. I will read it my information regarding breathing difficulties came from Risks of Respiratory Morbidity in Terms of Infants Delivered by ECS (Cohort Study) if you are interested.

<a class="break-all" href="http://www.birthchoiceuk.com/Professionals/BirthChoiceUKFrame.htm?www.birthchoiceuk.com/Professionals/statistics.htm" rel="nofollow" target="_blank">www.birthchoiceuk.com/Professionals/BirthChoiceUKFrame.htm?www.birthchoiceuk.com/Professionals/statistics.htm

I have no idea if that link will work, if not will try again!

Yes it does! Click on the Latest Summaries of Statistics section for the country of your choice (I was going with England) and the stats are there. These are the most recent, as 2012-13 will be compiled at the end of this year. Hope that helps.

Pass thanks for the link. I am traveling today but will most certainly have a look at the link in the next few days.

LittlePeaPod, I can see you have done a lot of research, which i think is amazing, and not mad at all. I did too. I had a very difficult decision to make with ds, due to previous damage I was offered a csection, and wanted to make sure it was the right decision.

The things that I was not prepared for were the things that actually you probably can't be prepared for, with any type of birth. But for some reason it was much more of a huge thing with the birth of ds, probably because of the fact that ds was so ill when he was born. I was also unprepared for things like the vomiting (this can be a reaction to some of the drugs), the huge blood loss i suffered, the itching, the phlebitis that developed in my legs and although i had been warned about the pains from gas, i truly did not realise just HOW painful these could be!

The other side was the emotional reaction i had to it all, this feeling that ds had been bought into the world in the wrong way at the wrong time, it really was (and if i am completely honest with myself still is) an awful feeling.

Anyway, I know these are all very personal feelings, but I just want to point out that there can still be unpredictables in a csection.

Sorry for weighing in again with negatives (honestly, LittlePea I am agreeing to disagree with you!) - but it isn't true that any damage such as bladder injuries can always be fixed on the operating table while your cs is being done.

For mine, none of the doctors or surgeons (at a major teaching hospital with a good reputation) knew how to repair the damage, so a consultant had to be brought in from another hospital 40 minutes away. During this time I had to be packed (as my stomach was basically wide open), moved to another theatre at the other side of the hospital and put under GA as the spinal was starting to wear off. Absolutely terrifying and not fun when you've just had a baby who's been whisked off to scbu with a life-threatening infection. My poor DH didn't know if either of us would pull through.

It's highly likely that if I'm able to get pregnant again (which itself is in question because of the injuries), that I'll have a difficult pregnancy due to the scar tissue stretching and organs being in weird places, then won't even be allowed to attempt a vb.

All I'm saying is that I really hope you have thought the risks through. People seem to find it very easy to imagine the worst outcomes of vb but not a cs for some reason. I honestly do wish you well and I hope it does turn out to be the right choice for you - I just don't think you can be sure of this until it's happened.

People seem to find it very easy to imagine the worst outcomes of vb but not a cs for some reason.

Yes to this^^

LittlePea-it has been shown though that a section costs more than a straightforward VB. So the NHS is spending more on you than it probably needs to and that money has to come from somewhere. If everyone behaved like you, OB spending would increase and that surely necessarily means spending elsewhere would need to decrease. And you can't simply say you'd be prepared to pay more taxes to cover it: unfortunately we can't determine how our taxes are spent to that degree.

I'm glad you don't think you're missing out on an experience but I disagree strongly that you are doing the best for your baby. Leaving aside the argument as to which type of birth is better, how about looking at WHEN the birth happens? You do not, and cannot, know when your baby is ready to be born. Sure, 39wks is a good benchmark, but what happens if your dates are off? If your baby isn't 'average' and actually would like another 2/3 weeks of gestation to get to optimum health? You have no idea when your baby would choose to be born.

And the IVF thing was an example of how you're exploiting modern medicine. I'm shocked that medics agreed to give you major surgery with no medical indications and see it as highly unprofessional. They wouldn't remove healthy breasts or ovaries because a patient was afraid of cancer so I cannot understand how you got your own way (other than your dogged persistence). FWIW, no I don't believe same sex couples should have children, but that's adding a whole other unnecessary layer to the argument.

In response to a PP who said she didn't want to push/strain, abdominal surgery is hardly glamorous.. You will have tubes everywhere and a total lack of privacy about all bodily functions. A CS is not a nice, glossy, no-sweat-keep-my-hair-and-make-up-in-place way to get a baby.

Ultimately you've clearly made up your mind but I see your choice as bizarre and somewhat selfish. Whether you still agree with it after your major operation will be very interesting: I hope you do and the operation is very straightforward but you may well feel differently a few weeks after when you're still unable to tend to your baby as much as you'd like. Best wishes.

I don't think saying that you don't smoke, don't drink, don't cost the nhs any money is an argument to saying that therefore the nhs can afford to pay an extra 1k (approx) for your birth.

You never know if in later life you may suddenly be taken ill like my father who has spent the last four years in an nhs hospital!!!!

Four years on an nhs ward, loads of tests, quite a lot of treatment and drugs. His bill must run into hundreds of 1000s of £.

The tax argument is specious anyway - unless you earn six or seven figures for many years you will never be a net contributor. Most of us are still paying for our own birth, childhood education, etc etc.

Oh god, yes. Cs is no more dignified than vb! Having a catheter inserted with about 8 people in the room, the point where they clean you up downstairs afterwards, being manhandled onto the trolley when your legs are numb, being shaved... Yep, definitely not the civilised experience you might expect.

Op, I disagree that cs is a less stressful way to be born. Babies are designed to be born vaginally. Contractions help empty their lungs of fluid and they are exposed to vaginal flora which established their long-term gut health. Have you read the studies which show that infants born by cs are more prone to asthma and allergies in later life?

I think most of the things people are afraid of when it comes to vb ( tearing etc) are risks to the mother, not the baby.

i agree nhs should warn women of the risks of vaginal birth

bitter after fourth degree tear

And giving birth clearly isn't just a 'means to an end' for you. The amount of time, energy and effort you have clearly spent on researching all of this suggests giving birth is much more to you than just getting baby from your uterus to your arms. You ARE concerned about the experience, otherwise you'd just be going with it and seeing what happens.

I focused intently on prepping for my first VB, to the point of not really coming to terms with the fact that I would have a real life baby at the end of it. I totally agree that giving birth is only a step in the whole parenthood journey, but you seem to be contradicting yourself in how important you consider it to be. You cannot control everything when it comes to children and maybe pregnancy and childbirth is a way of getting the mother ready for that.

I'm really going to stop now-my kids are waking up (am abroad) so I have to go.

I think this is a really interesting debate, but I think the OP still hasn't answered the underlying question of why she is choosing a CS. Saying that you have looked at all the risks of both choices and believes that a CS is the best choice for you is not answering the question of why. There must be some reasons, whether it is: not wanting to push; wanting certainty of date, believing it is less risky to her personally, not wanting a stretched fanjo (not at all certain btw as I can vouch); feeling it is a "more educated" choice; wanting to be different - something. It is my choice is not an answer, which given you sound like an intelligent high performing woman, you must be aware of. Now it may be that you prefer not to share your underlying reasons on here, but in my opinion, you have not explained that properly and until that point, I find it hard to really empathise.
FWIW - I absolutely do think it should be a woman's choice and personally I am not bothered which a woman chooses, but I don't think that that choice should be funded by the NHS. As a 50% taxpayer I think I have a moral responsibility to use the NHS as lightly as possible because I can afford to not use it. It is so overburdened already that the selfishness of forcing it to supply an ELCS without a medical cause takes my breath away.

hazey I have similar feelings to you about my C-section. I know it was necessary but I really wish I could have had a calm VB when DS4 was ready.

yy to C-section not being glamorous. I spent the whole day the day before wearing a hospital gown. Went on a tour of NICU wearing said gown. Then when I had the op the anaesthetist lifted up my gown and used it as a screen so I was exposed to the whole room from my boobs down. I'd left home in a massive rush so my legs were furry as well. Then afterwards I had my pads changed by midwives and when I went to see DS4 in NICU it was in a wheelchair with a catheter bag clearly visible.

I find the arguments about cost a tad ridiculous. The figure of £1000 has been quoted. If that's it then I for one don't mind my tax dollars going to the OP who has paid into the system. Where should we draw the line? Maybe to the people who contribute nothing to society of any value, monetary or otherwise and still get the benefit of an overburdened NHS? Or those that deliberatley abuse their bodies & receive a lot of treatment having never paid in? Like the poster earlier, I don't want to add an unnecessary layer to the argument, I just think its a non issue.

I have just read an article in yesterdays Guardian about how the Royal London had to adopt a 'one in one out' policy for 2 whole days last week.

Now I know this is extreme circumstances, but it is a horrifying illustration of just how stretched the NHS is. There was such a shortage of beds that they could not even take emergency patients. People were being discharged earlier than possibly advised to make beds available.

I'm sure OP has chosen a shiny new hospital with more funding etc etc but the fact is, there are very sick people that need beds and operating theatres and anaesthetists and surgeons. I can't see your decision as anything other than selfish while our NHS is in this state.

And well done for paying so much tax - but PPs are right, it means nothing in the bigger picture. We all pay our share, that is our social responsibility.

I am another one who feels the OP has yet to explain her reasons fully. 'My choice' blah blah is simply not an explanation and I find it hard to see how you expect us to understand without providing one.