How is a c section determined?

[K8eee]

Exactly that! Just want to prepare myself for all procedures (if I can!!!)

Sorry I might be being a bit thick here, but in what circumstances do you mean?
Do you mean a planned in advance section or a convert to section if labour is not going well or both?

Both please!

I'm having one because of two health conditions I have. The decision was made when I was 20 weeks pregnant.

Well I think if you mean during labour, it is when baby is in distress, swallowed meconium or labour isnt progressing fast enough. I think it is up to the consultant.

Oh right, what about a planned c section?

Ok, planned in advance happens for two reasons. Maternal request (but it's not as straight forward as just asking for one and you'll get it. ) and Medical need. Medical need cesareans are only booked if the risk of natural birth outweigh the risk of CS. This could be because the baby needs to be born early or because anatomical abnormality with the mother for eg.

Unplanned CS happens when it becomes apparent that the baby is becoming distressed or there is serious threat to the mother. This can be because the baby is stuck inside the birth canal for example.

There are lots of individual reasons why women have CS. It might be more helpful to talk about any specific concerns you have.

Are you going to do NCT or similar? Our group covered this and it was quite helpful (half the group ended up having EMCS including me).

Baby's position can mean they recommend c section too, my first was an emergency c section as she surprised everyone by presenting foot first and it looks like this one is likely to be planned section as head firmly in ribs for last 6 wks now and am 34wks so not a lot of room left to turn. They will take a decision at 37 wk scan and then double check baby still breech (bottom/feet first) if I go in for planned section.

I've not had any reason to be scanned again, or complications. How and when would my mw look at the delivery options?

Do you want a c-section??

They wouldnt K8eee, its natural unless theres a complication - either identified in advance or at the time.

You can talk to your midwife at any time about this, but yes, green tshirt is right, it's assumed natural unless something is flagged up.

The midwife will generally discuss birth plan at 36 weeks.

But if you think you want a lscs for maternal request you really need to bring it up before then. You'll have to see your consultant and it could take a week or two to get an appt.

K8eee your midwife won't look at the delivery options at all if you have a straightforward pregnancy. You will just see the midwife every 2 weeks (then every week in later pregnancy) and they will check your blood pressure, urine, fetal movements and bump size and if all is well they will wait for you to go into labour naturally up until 2 weeks after your due date. If there is nothing wrong they will always have you going for a normal delivery because if everything progresses normally and this is achieved it is the lowest risk birth option for mother and baby.

If you get through your pregnancy with no complications until the end then the main reason for an elective section to be offered would be for a malpresentation such as the baby being breech or in a transverse lie (sideways).

Emergency caesareans can happen for many reasons during labour but can be divided into risks to the life of baby and risks to the life of mum. Baby risks are usually distress (picked up by changes in their heart rate on the monitoring during labour) or malposition which is when they get themselves into a position such as a brow presentation where they cannot be born naturally although this is very rare. Risks to Mum are prolonged labour (if a baby isn't coming down the birth canal quickly enough it increases the mums risk of having a post partum haemorrhage), bleeding, problems with blood pressure.

All of this makes it sound like there is lots of awful things that can happen but the serious ones are very rare and the vast majority of mums and babies are absolutely fine. The most important thing is to keep an open mind, listen to what your midwives and doctors are saying but don't be afraid to ask them questions about their advice before you decide on what to do. You'll be fine!

Thanks Betty, that's really reassuring. I don't want a c section as recovery is longer and there are more risks from what I have read and heard. The more natural the better I feel. Admittedly I am absolutely petrified!