Elective C Section

[Heatherous]

Wondering if anyone can help me as I can only find info on EMCS not elective. I've just found out I'm pregnant with my 2nd (only about 6ish weeks). With my first I had to have an elective section as my son was breech. Is it likely I will have the choice to have another section or will I be pushed to have a VBAC?
Thanks!

They do quite like you to have a VBAC but they can't force you to have one, especially if you've already had a c-section.

Thanks, I just have no idea what to expect

I had an emergency csection with dc1 and I'm 32 weeks now with my 2nd and booked in for an elective c section on the 15/10 they gave me the pros and cons of both and were very understanding.

I'm glad about that LBNM19!
I had an EMCS with DC1 due to placenta abruption and a host of other issues and I have been invited to a VBAC clinic to talk with 'one of three midwives who are all keen on VBACs' and I am panicking that they will make me have a VBAC.
I really don't want one and prefer to have a ELCS. I have read up on the pros and cons of both and ELCS works best for me and my family.

Because you had an EMCS first time though LBNM19 does that mean your more likely to have a section than somebody who has had an elective?

Depends on where you are really. There is a drive to promote VBACs. However if you would prefer an ELCS then the NICE guidelines are in your favour and there are few hospitals that would ultimate refuse to give one.

The NICE guidelines on CS are probably your best port of call to compare the two - there is a chapter on the subject.

I would stress you should read but also keep your own personal circumstances in mind - there is no right and wrong to go - and your situation and preferences may be very different to someone else's.

To be honest I'm not sure, the consultant mentioned there was a 25% chance that I would have to have another section, chance of the scar opening etc.

My first child had an undiagnosed condition, he was born small and my waters were mconuoim stained. This baby has been tested as does not have the same condition and is being treated as a normal pregnancy. X

I had an emergency section with my first. When I was pg with number 2 they invited me to a VBAC clinic to discuss which would be best. Most midwives & the consultant were keen to encourage a VBAC but I wanted an elective section as I didn't want the trauma of my first. They were all fab and made sure I was sure and then booked me in. There was no pressure at all which I expected there to be so I was pleasantly surprised.
If you know all the facts and make an informed choice, they should respect that and my hospital did.

I'll probably be heavily flamed for this and chased out of mums net town but here goes anyway.
Why would you ELECT to have a c-section? They are horrid! I had one with first, he had a shoulder dystocia and his heart rate dropped so they went in for him in an emergency style. I lost loads of blood and almost warranted a transfusion, thankfully I avoided that but still didn't meet my beautiful little man until the next day when I woke up from the general. I managed a VBAC with my second and he also had a shoulder dystocia and required a forceps delivery but we got there... He weighed in at 10lb 4oz by the way so it was no mean feat (my first was 9lb 5oz) and my husband jokes now that there is a draught when I walk now but come on, your prize at the end is worth everything your body might go through!
I don't want to judge anyone but I really don't understand a major operation as a choice! The risks of a section are huge compared to a vaginal birth and for goodness sake a vaginal birth is what our bodies are designed for.

North, I would never tell you that your opinion is wrong however your comments regarding vbac being safer however are totally wrong. It is not safer to have a vbac. There are risks involved for whichever you go for that the individual must way up. I also hate the 'it's what we are designed for' argument it's very weak. Women die in childbirth doing what we are 'designed for', in this country we are lucky that should our bodies not comply (or indeed if the mother mentally can't go through a vaginal birth) that we have access to services that in the majority of cases save mother and babies lives. I hope that there aren't any poor guilt ridden women reading your drivel.

OP I had an emsec first, very poorly baby all good now but it was a horrific experience. Second I was planning a vbac but waters went and nothing happened, offered induction but having previously weighed up the facts I went for a section. Entirely different experience, highly recommend it.

north I'm so sorry you had to experience an emcs for your first birth. You had possibly the most traumatic experience a women can have during birth - having your baby be pushed back in when the head is delivered, a general anaesthetic....it's my worst nightmare. But your emcs is as far away as you can get from a planned elcs which are usually very civilised and even bordering on pleasant affairs. VBAC has it's own risks - it's up to the individual to decide which risks they are happier to face

I shall not get into an argument for sharing my feelings about this and please don't try to twist my words as I didn't say anything about safety. I said risks because there are risks with any surgery and especially major abdominal surgery.
Why should any counter opinion be deemed drivel? Also I don't think it's fair to canal my statement weak, why weak. What do you use your uterus and birth (there's a clue) canal for?

North it sounds like you had an EMCS not an ELCS and in either case you are disregarding the possibility of complications with VBs which make them the riskiest type of birth.

OP if you go on Google scholar you can find studies on the relative risks of various birth options. Look for studies with large numbers of CS cases and also studies that differentiate between EMCS and ELCS . Risks vary, some options carry more risks for the mother while others carry more risks for the baby and risks always have to be applied to individual circumstances, but having said all that the ranking from least to most risky goes like this
VB with no complications
ELCS
EMCS
VB with complications

The main risks of ELCS are bleeding and infection of the wound. While a VB with complications may risk brain hypoxia and neurological damage to the baby, this sis a worst case scenario.

i don't want to judge anyone but I will before finding out why women choose

A sizeable number of women choose for mental health reasons following a previous traumatic delivery. This is classed as medical need in many cases. Hth

north I think that the wording ELECTive is really misleading as it gives the impression that those that had an ELCS somehow chose to be in that situation when the reality is often that they had no choice given the risks they were faced with but to consent to an op.

I 'chose' an ELCS..... it was pretty much that or die so I went with the easy option. There was absolutely nothing horrid about the operation or the recovery in spite of the horror stories people like to peddle.
Having ELCS no 3 very soon.....my poor redundant birth canal will just have to lump it.

North, I actually commend you on your advocacy for vaginal birth considering you twice had shoulder dystocia which is a truly terrifying experience if you have it to the degree you had.

I'm choosing an elcs to protect my health long term - I still have issues from my last birth

Hope you don't mind me butting in with a question.....

Do the NICE guidelines only apply to Britain?

I'm in Ireland, and have had a previous cs and would like another one this time so would like to go in to fight my corner armed!!

Watching this thread with interest. I've seen a number of doctors throughout my pregnancy and all of them mentioned I might need a section yet until last week none of them committed to it and wrote it in my notes.

My baby has had the cord around her neck, she's been transverse and now she's breech. I also have cpd, scar tissue from 2 pregnancies I didn't carry to term and damaged stomach mussels from a botched laparotomy.

When the last doctor I saw said he thinks it's the only option for me I've agreed straight away. I think he was surprised I didn't argue. It went over my head when he said age was a factor too though.

I haven't had the pros and cons explained to me though but from what I've seen online I'm sure it'll be the right choice for me. It's not really bothering me that I may never give birth naturally. The thought of struggling and then them converting to an emcs I find terrifying so I'd rather be prepared.

I think it might depend on your consultant....

I have seen two different consultants - the first was very positive about Vbac and felt as I have delivered both normally and by c-section then I should be fine- the second was quite negative and promoting a caesarian again.

I would say be firm about what you want and there should be someone within the hospital who agrees with you !

I am going to Booking In tomorrow and will be asking for an ELCS after a traumatic EMCS.

This is due to mental health reasons primarily along with some physical ones, and I am about to go into CBT sessions for this.

Why is this not reason enough to ask for an ELCS where I will be in more control of the situation and outcome north?

I chose a CS. When the consultant asked me why I said it was because I would rather run the risks of an ELCS than take the risk of a VB going wrong. My consultant agreed with me but then again his first child was born brain damaged because of a VB gone wrong.

As it turned out DD remained transverse which would have indicated a CS but I had mine booked anyway. DC is due tomorrow by ELCS with no medical indications.

It's called informed choice and it is there for a reason.

What are the risks you are weighing up if not safety risks? So ok North you didn't use the word safety but I'm unsure what else you could mean?

What you said was- 'The risks of a section are huge compared to a vaginal birth'. Which is wrong. So I stand by everything I said.

The argument is weak because you are using a 'one size fits all' approach. You are ignoring that women and babies die during natural childbirth- doing what we are designed for (I think this should cover your birth canal comments sufficiently, although it's the same route that is taken to get the baby in, so there is more than one use). It is weak because you have not taken into account any other circumstance e.g. Mental health, babies health, damage to the mother (frankly I would be devastated if my DH made comments about a draft when I walk having birthed two of his babies in a horrific sounding way).

As others have pointed out an emergency section and an elective section are normally entirely different experiences.

If you are lucky 'the prize' that you take home will be perfectly healthy whether you have a vbac or a elcsec. It is not wise, clever or indeed safe to give ill informed judgy (and you do come across as judgy intended or not) opinions on subjects such as these.

Hi Op

No one can make you have a VB if you don't want one. Although they will try everything including trying to scare you to talk you into have a VB. if you don't want one just keep saying no. They can't force you!

I had an ELCS and it was a brilliant experience. None of the scared stories you hear came true. Below is a quick bullet point of my experience. I would recommend an ELCS to anyone. Happy to answer any questions.

• DD born NYE via ELCS. I have no regreats. I will be having another ELCS if all goes to plan with the second one, hopefully next year.
• CS was not scary, traumatic or painful as people said it would be
• I was able to breast feed, carry my DD, change her nappy and do everything as soon as spinal wore off
• I spent 1 night in hospital
• I was driving after 2 weeks. Yes that is legal and insurers are happy for you to drive as long as your GP or consultant signs you off
• I was back at the gym (spinning, weight training etc.) after 4 weeks with full GP and consultant approval
• I have no ugly CS over hang
• DD had no breathing difficulties or any form of injury following CS

So all in all I didn't experience any of the scary things people said may/could happen. For those wanting/having a CS, take it from me. It's not scary and we (DH & I) have some amazing memories following DD birth.

NICE guidelines apply to England & wales only and are still only guidelines rather than rules. Each hospital has the freedom to make their own decision which also allowed them to take personal circumstances into account. NICE guidelines do not apply to Scotland or NI however they are still respected and can be used as a point of reference to argued a case

Nice on balance say elcs are a safe option cavet being as long as you don't have too many

North, birth is natural and we are evolved for it and it is high risk. If you look at countries where women have births as nature intended with no access to medical staff or care, maternal death rates are very high, between one in thirty and one in fifty in the documentary I saw, depending on the country.
My ds was born by emcs due to placental abruption, if I had a vaginal birth he would have died or at best been brain damaged.
It is fine to share your experience and views, but incredulous and judges sounding comments, like why would anyone choose a cs?! Are not helpful to those of us weighing up whether to choose a cs this time.
My cs was a positive experience.