Elective Caesarean - Advice

[Discomonkfish]

Hi all, I had an emergency c-section with my first baby and was told by a friend that you can ask for an elective c-section if you want one. Just out of interest I asked a midwife at The Baby Show if this was possible and she said no, they would persuade you to try for a normal birth. Back home in Leeds the Doctor who saw me at the hospital following my scan asked me what I wanted and I said I'd prefer the elective. Not sure I'm doing the right thing but has anyone else chosen to have an elective? Sounds selfish but it means I can plan my time off work, organise my parents to come up and look after dd while I spend time with the new baby and generally take the easy way out! Although yes I understand this is an operation at the end of the day so recovery will be longer / risks associated etc. The fact that they offered it to me though just makes it too easy I think. Plus it must cost the NHS extra. Shouldn't all hospitals encourage you to have a normal birth first and have any of you opted for an elective. btw there's no reason medically why I should have an elective.

Hi Littlemadam, I'm due on 16 October by the scan dates but 22 October by my dates. I think they go by the scan dates so if I'm booked in for 39 wks which I think I will be, that should be the w/c 9 October. I've got my appointment to get booked in on 11 September so will get my date then. From my notes my consultant is Sparey. Can't remember who my emergency c-section was with last time was out of it a bit. Mason rings a bell though...

I had an elective CS with my DD and will be having one next time.
It was a lovely experience and one I don't regret for a second. Knowing the date, time and place is certainly handy but for us it was mostly the calm, organised, relaxed environment that made it a wonderful experience.
I was lucky and had a great recovery ( better than a lot of my friends who had vaginal births) and was driving within 2 weeks.
Good luck.

hi
i had em cs with ds1 and then vbac with dd2, i recovered very quickly after cs and was also driving soon afterwards (have since been told by HV that insurance companies will tell you on phone you are covered but unless you get it in writing youre not covered), i wanted to try for a vbac purely due to MRSA and other HAI and it was a lovely experience but recovery "down below" was longer than i expected, this is your body, your baby and ultimately your (informed)decision - as someone on this thread has already said, so long as you get your lovely healthy child does it really matter how they arrive?

I had elective CS with dd as she was breech and I found the whole experience fine, H & I went in together in the morning & apart from the waiting around to go to theatre it was finr (we were last on the list!!) I am 21wks preg with no2 an really want another CS consultant has been trying to persuade me to go for VBAC but I have scan next week and they have said if I am adament then theyll give me the date for CS. Recovery time was great had DD on tues came home fri and was coping fine that weekend (in fct my milk coming in was the most painful thing!) by the following friday everything felt fine was out and about havin lunch with a friend in town etc etc. Hope it all works out for you.

Just catching up on this thread. If you would like to have a c-section out of choice and not for medical reasons can your midwife say no? What do you say to convince her to let you have one?

Hiya, I think that it depends on your hospital because I had an emergency c-section with dd in 2004 and the doctor I saw at my scan asked me what I wanted. I was a bit shocked because I'd just come back from the baby show in Birmingham and while I was there I asked one of the midwives on one of the stands if I could opt for an elective and she said no, they would push you towards a VBAC so I just think it depends on your area....God knows why they don't just keep these things the same across the country....it would make it a lot easier. I live in Bradford but wanted to have my baby in Leeds because I'd had a bad experience with an op my dh had at BRI plus Leeds is easier for me to get to but you'd think my surgery were trying to organise a delivery on the moon, it's only 10 miles away......they don't know their arse from their elbow....

Was told today that the elective would probably be carried out by a registrar not a consultant but that the consultant would be available if needed....bit worried now...what's the difference between the 2 and is this normal??

My section was carried out by a Registrar - dont know the difference to be honest but Im here to tell the tale put it that way.

a registrar is junior to consultant.... i share your worries, i'm having same discussions with my hospital and am trying to insist on a consultant... i have complications which mean i'm not keen for a registrar to do my section... they wont guarentee anythinng but are taking me more seriously since i outlined all my concerns in a letter to them. Put your concerns in writing, it does make them take notice

Discomonkfish, have you considered VBAC. I had an elective C with my first DS as he was breech. Was automatically offered another with my second DS although no medical reason. Despite being rather scared I did go for the VBAC and was so glad I did. I had no complications a relatively quick labour and experienced a sense of achievement when he was born that I just did not get with the C section. Best of luck whatever you choose. xxx

Haven't time to read the whole thread but just to say that a registrar is not automatically a bad thing! There are a finite no of consultant posts, you need to publish a certain amount of research etc etc so there are many more well qualified registrars than there are posts available. My advice would be to talk your concens through with the registrar beforehand. They will have done many many sections, planned and em, and will be able to handle every problem. They are also used to anxious patients and would not be offended by a polite inquiry as it will reassure you and give them a happier patient! Don't worry!

I am a clinical neg lawyer and was v nervous about underqualified staff coming near me in labour. As it turned out, my em CS was done by an SHO under the supervision of a reg as it was the first one he'd done! It was brilliant and I'd let him do it again. Agree totally with your concerns about letting a less experienced person operate, but I personally would have no qualms about a reg without a consultant present.

HTH>

Why does it seem as if anyone who wants an elective CS for their second delivery is pushed towards VBAC?

I had a horrendous time with DS1 (10 pounds!) and ended up with an emergency CS after failed ventouse and two tries with the forceps (which they left sticking out of me for twenty minutes while the SHO tried to figure out what to do because there was no one more senior around to make decisions - bit of a low point in the experience). The little guy's heartbeat never wavered from 140, so there was no reason for them not to keep tuggy on the tongs with their feet on the edge of the bed for leverage. I kid you not. After 24 hours, they finally admitted he was stuck and spent another hour shoving him back up the canal. In the end, a student cut me open and my scar is horrible and jagged.

This time, I asked for consultant-led care and an elective section, and he tried to persuade me for over 10 minutes that I should try for a VBAC. I'm ashamed to say I almost hit him.

I am so tired of all the text-book responses we pregnant women get from M/Ws and doctors. They never seem to listen to the subtlety of the question you are trying to get answered. Sorry for the rant. I am really NOT looking forward to the second time.

DH and I were stopped in the street by a couple with 2 kids when I was 40 weeks preggers with DS1. They told us to be assertive and bitchy to get what we wanted, threatening to sue if necessary. On the day (no, days) in hospital, we just didn't have the courage or energy to push for what we wanted. The M/W and doctors totally and utterly ignored my birthplan. I am still emotinally scarred by the whole experience. Consultant for DB2 hadn't even read my file when I met with him! Grrrrrrrr....

So, my dear, do what you want. You've paid your dues! Insist on a consultant if that puts you at ease. I agree with you totally about planning for the delivery, e.g. childcare management. An elective CS is highly civilised. In the days before CS, DS and I would have been dead 100 years ago. I understand that there are women out there who have a driving need for the natural birth experience. But that is their priority, so don't let them make you feel guilty!

I'm a little bit surprised that no-one has mentioned that recent research has shown that babies born by c-section are three times more likely to die- Times Article .

And yes, the research eliminated all mothers and babies with ill health, complications and emergency sections for medical reasons.

Why would you risk the life of your baby just so you can organise your life more efficiently?

think that it is a hard decision to make if you had emergency c/s first time as normal delivery is unknown territory - sometimes it's better the devil you know.

babies born by caesarean 3 times more likely to die? well, who knows if this research might be discredited 6 months down the line....

if you are desperate for vaginal birth - go for it - if not, then get as much helpful advice as you can - you can request a VBAC and then change your mind surely? if no medical reason for c/s, why not give it a go - you might love it!!

understand that easier to organise things if have c/s - but spontaneous natural labour is really quite exciting!!

sounds like you haven't really made up your mind - so keep an open mind!! and good luck with the birth whatever you decide.

BTW, i had emergency c/s first and VBAC second time...

Bit of a side track from OP, but ugh what a depressing article...for those of us who are being advised to have a section for medical reasons
Obviously, if the reason in question is something life-threatening, its a no-brainer - but there are a whole host of grey areas. At least there are for me.
Moan over, sorry to hijack!

Don't forget though that many babies have to be born by C section as they are very poorly to start with, and would have no chance if they were born vaginally.

Each to her own I say. Read about the risks, read about the benefits of C section vs VBAC and make an informed choice which works for you. Don't get bullied by other people (even if they have got a consultant's badge on!)

Dolly P...those Baby';s were taken out of the equasion of that research, though...!
Anywya, I had to natural Births and my last one was an Emergency C-section, which I hated, if I would have another child...EVER...I would opt for HBAC...I was very anti Sections to begin with and the Emergency one didn't put me in favour of them, tbh!
Saying that,I have heard a lot of different views about this, and know plenty of women who had, after an initial emergency Section a elective one the next time and who found those wonderful expeeriences...I really think it depends on what YOU want to get out of it...for me giving Birth is important, and I felt with ys we missed out as , in my own eyes, I did not give Birth to him, he was extracted from me in an unatural way....but if the Birth is not important to you in itself...then...go with what you feel is right for you!
But there are more risk to a C-section than there are to VBAC ( in general now), not just to you but to your Baby....it also seems to be better for the Baby if you go into labour first, even if you decide on C-section...something to do with the hormones making them ready for the outside world!

Thanks for the advice guys...I'm booked in for the op on 10 October so fingers crossed...

Just a catch up to let you know how it went. ds was born by elective on 10 october. experience was weird! It was strange to go into hospital and next minute you have your baby. Had a rough time afterwards. My temp dropped and had to have a heat blanket on for 3 hours and so couldn't have skin to skin which was awful. Was really out of it for a good while and afterwards my wound got infected (nice! [wink} not that I want to put anyone off or anything!) Care in LGI was absolutely awful in the ward afterwards (can't fault the midwife who delivered the baby and took me down to the ward) To give you an idea I had to empty my own catheter. Staff were sat in a room chatting all night not checking on patients and it was too intimidating to go to the door to ask them for anything....I know they say they're busy but I got the impression they just couldn't be arsed and were desperately in need of a matron to kick some butt...these people wouldn't last 5 minutes in the private sector....rant over All in all I wish I'd had the patience to wait and try for a natural birth.....

Glad everything went erm well okay. At least you have beautiful DS - can we see a pic on member profiles soon. . You have scared the bejaysus out of me though as I cant deliver so I'll be well looking forward to my next section.

Sorry Liesel, didn't mean to freak you out....the actual op wasn't bad and the first c section went really well even tho it was an emergency one...I think I just got unlucky and to be honest the reason I got an infection was because I was moving house 2 weeks after the birth so was lifting when I shouldn't have been so don't worry. Hope it goes well for you....

delighted to hear of the safe arrival of your LO!

sorry you had a difficult time...sounds horrendous........emptying your own catheter!?!?!? you can complain about the care you received..or lack thereof...

hope you are enjoying being a mum of two!!! xx

thanks lulumama...ds is lovely....I was more pee'd off with the care afterwards tbh....i felt quite sorry for the other ladies who were there too. There were 2 women who were in a bad way and they weren't checked on all night...Fair do's if they're busy you can understand but they were just sat around doing jack in a little room off the ward....I think I will put in some feedback. Don't want to seem ungrateful as the people who operated and delivered ds were fabulous but they really were awful on the ward.

aftercare is vitally important...! glad that you are not feeling too bad about the experience! xxxx

With regard to the three times more likely to die, it's a startling statistic, but the numbers from the article are:

1.77 deaths per 1,000 live births. The comparable rate among vaginal births was 0.62.

Also, babies are often born by section because there are delivery problems. I'm not sure why there's such c-section distrust on these boards - some people seem (not the person who quoted the Times article) especially keen on making women more anxious about having sections, and I don't think women who 'choose' to have them are going into it lightly, therefore are already anxious about giving birth, and being frightened more isn't constructive. I have to have a c-section, but don't want to tell people why, or that it isn't a choice. My very pro natural birth friends have been telling me that I won't experience birth properly, that it's an incredibly important experience that I should go through, etc, and I really think this kind of talk - can it really be just because they care about NHS funding? It seems rather more emotional than that, and I am not, anyway, using the NHS. Are they saying that women who adopt can't bond with their children in the same way, or that carrying the baby for 9 months isn't bonding? Why are women being allowed to feel guilty about this? Few of us would deny a woman's right to abort a baby for whatever psychological reasons, but to have it cut out of her seems to really get people's heckles up. It just always seems to me to be anti-woman, anti-mother, rather than really all about concern for the baby or the NHS.