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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Consultant midwife appointment cause I've requested a c-section .. What will happen?

16 replies

Firstpregnancy2014 · 08/10/2014 11:59

My community midwife told me last week to expect a big fat no.

Basically-

I was under consultant care due to previous fainting and low blood pressure. At my last consultant appointment at 28 weeks I told them I want a c-section. Purely for personal reasons rather than health. I explained my reasons and the consultant didn't even try and talk me out of it she just told me she would book me an appointment with head of midwives/ consultant midwife

I'm terrified of childbirth, my mum took me to counselling and took me round the birthing rooms at the hospital a few weeks ago. She then committed suicide 18 hours after my grandma died. I can't go back in those rooms. I don't want to step foot near those rooms. My mum was my birthing partner and although I have my partner - it's not the same

I started seeing a private counsellor who suggested a section in order to completely change my birth experience. Thus is now what I really really want... How can I make sure I get it?

I'm 33 weeks now so really need to push for an answer. The element of surprise is something I can't deal with at the moment.

Also I have done ind empty reading surrounding csections
This isn't a decision I have taken lightly

OP posts:
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JustGotMyBabyOnBoardBadge · 08/10/2014 12:21

Arm yourself with the NICE guidelines - you have every right and say to the midwife that you are not leaving her office until she agrees.

You HAVE the choice, it's your body and your baby - remember that they care givers around you for the experience are only there for your care...not to make your choices!!

With your history of trauma throughout this pregnancy they SHOULD be much more understanding, you've gone thru SO MUCH!!! However if they are not taking this into account during your meeting then make sure you slap them with the NICE guidelines. If you can get your Councillor to write a note stating why you want the C-section too that might be helpful, other than that you can always give the midwife the Councillors details to call them directly.

Firstpregnancy2014 · 08/10/2014 13:18

Thankyou! I'm really hoping I don't need to fight but my midwife was so dismissive of me and said they don't hand out sections to everyone that asks for them!
I just want to be able to enjoy the end of this pregnancy rather than dreading going back there

OP posts:
PicandMinx · 08/10/2014 18:59

The community MW doesn't make decisions about c-sections. They do not have the authority. As said up thread, arm yourself with the NICE guidelines and do not accept no for an answer. MWs that dismiss a woman's concerns with such an attitude should consider a new career.

BeginnerSAHM · 08/10/2014 19:52

Indeed - I agree. You can have a c-section if you want. You might have to go through the process of seeing counsellors etc but I'd be very pushy in your position. Really sorry for what you've been through.

Mariacbw · 08/10/2014 20:38

So sorry for your loss, it must be awful what you're going through. It won't ever be the same havibg your partner as your birthing partner & not your mum but try & stay positive & use the supports that's available.

As for the midwife - she is so wrong to be dismissive of you saying c sections arebt given to anyone who asks. You aren't anyone, you are an individual with exceptional circumstances and she should be doing everything she can.

I hope it works out for you

hugefatso · 08/10/2014 21:03

Flowers You are suffering from very valid post traumatic stress.

Firstpregnancy2014 · 08/10/2014 21:09

Thankyou all. I'll update after my appointment. I have just wrote a list of reasons why I want the section
Hopefully I'll get to the end of it without becoming a crying mess. It upsets me to talk about what's happened

OP posts:
SilverStars · 08/10/2014 22:43

Crying may help them see how you are and convince them it is right so no need to be brave.

you can also ask to be referred th their specialist mental health midwife - most areas have them who can help.

eastmidswarwicknightnanny · 09/10/2014 06:43

For my first I struggled a little to get my elcs as little was known by the junior doctors about my medical condition however I was adamant n said I would seek care elsewhere as I was having a c section n suggested they either learnt v quickly about the condition or get the consultant n I got a new app with consultant who said no way can u have normal delivery n booked section

This time saw specialist midwife who was fab and got consultant who agreed to c section v quickly.

I think you seeing a senior midwife is a positive they will listen to you and you should get what you want they want to make sure you are making an informed decision really

Jersey37 · 09/10/2014 11:13

I'm so sorry - you must be going through an awful time. I do think you should have a choice - psychological issues are just as important as physical medical issues. If you are stressed, then it will be a difficult birth. I do think however you should fully investigate what is involved in a C-Section. It isn't exactly nice either... longer recovery and a lot of pain over a longer period. My sister in law also had some nerve damage that affected her diaphragm after a C-section. But at the end of the day - it should be a decision made by you and all your doctors (including counsellor). I was really anxious about delivery - and forced myself to do a hypno birthing course to ease my anxiety and it has helped a huge amount (they don't put you under hypnosis - just teach you techniques for relaxing and breathing so that you don't fight the delivery - which is what is likely to cause more pain and tears and emergency C-sections etc....) I still feel anxious about going into hospital (which consultants recommend because of my BMI and BP) - but I do feel a lot more prepared - even if it doesn't end up being a sneeze birth :)

Do post to say how you are doing....

babykonitsway · 09/10/2014 13:33

They can't say no.

Go in prepared and have your reasons for it. Explain how distressed and anxious you are regarding a vaginal birth.

If cons says no, ask for a second opinion.

Good luck

DayLillie · 09/10/2014 13:45

I am not sure a community midwife can speak for the consultant midwife - she may have her own ideas, and you might not find they are the same.

Still, arm yourself with your reasons and read the NICE guidlines, and as above, there is also the second opinion. My sil had to ask for a cs for her second and it was fine. Best of luck.

RedToothBrush · 09/10/2014 17:01

At my last consultant appointment at 28 weeks I told them I want a c-section. Purely for personal reasons rather than health.

I need to correct you here as this is a fundamental part of your case for an ELCS.

From what you have posted, you are requesting a CS because a) you are terrified of childbirth to the point that you toured the ward with your mum before she died b) in addition to your fear you now associate the labour ward to your mum's death. This makes a strong case that your request is NOT for 'personal reasons' as you put it, but for mental health reasons.

Let me be clear here; mental health is a reason to justify a medical need for an ELCS. Just because you are requesting it does NOT make it for social convenience.

With this in mind, I'd like to ask what support your community midwife is offering you to cope. The fact that she has said you are unlikely to get an ELCS rings alarm bells and it seems she hasn't conveyed the fact that your mental health might be an issue that is compelling you to make this request. She should have identified that you need support here and she should be aware that mental health is a valid reason to have an ELCS rather than being somewhat unhelpful in just saying you are unlikely to get one. Has she suggested other alternatives or actions that may help you to cope better; for example, has another visit to the hospital been proposed? Your circumstances are extremely unusual, and they should be making some sort of effort to go out of their way to support you, if they are caring for you properly and have your welfare at the centre of their priorities.

To my mind, from the limited amount you have said, it strikes me that she might simply be unaware that mental health is a valid reason for an ELCS and that she should be supporting you more rather than letting you believe that you are making this for 'personal' reasons. This is not uncommon at all. There is a huge amount of ignorance on the part of HCP on the subject, perhaps particularly with those that are not as up to date with the latest information and research on the subject.

I hope that you do have a consultant midwife who is more educated on the subject. I had an excellent one who sadly has now left his post, but he agreed to my ELCS without issue (my first pregnancy) due to my mental health issues, which are somewhat unusual and the result of certain events in my past. He stressed this exact point about mental health being a health issue. I would take heart from the fact that your consultant didn't try and talk you out of it, but instead took you seriously and made the referral, as you requested - he clearly thought that it was a valid reason to be referred. Don't forget he is more senior than your community midwife.

That said, it does depend on where you are in the country, as some hospitals are pushing policies that are not consistent with the NICE guidelines and the fact that mental health is a health issue unfortunately. Its pot luck, and about reducing CS rates and meeting targets rather than giving a shit about women having individual needs which are sometimes unusual.

I hope your appointment has gone well. If you cried don't worry it can help. If you get a refusal, then ask for a second opinion. Its rare that they will deny you in the end but you might have a battle on your hands first. (FWIW I've only seen two requests ultimately go unheard on MN in over 3 years). One of the ways you should approach it is if you do get a negative response is to ask how they are going to deal with your unusual circumstances and current mental health needs during labour if they won't give you an ELCS as whilst you don't have a right to an ELCS you do have a right to appropriate care; this means they can't sweep the fact that you have these issues under the carpet - they have to do something.

Firstpregnancy2014 · 09/10/2014 21:14

Thankyou so much for your kind and supportive worlds
I had my appointment today
The consultant midwife was amazing and had a mental health midwife in there too. they did try and talk me out of it quite alor.
They offered me hypnobirthing, an induction so I feel more 'in control', a doula etc etc
I said no to all of these and I now have to go back to my consultant at 36 weeks to book the csection. I feel so much more confident. I probably still won't believe it untill it's booked but the consultant midwife today said they arnt telling me no they just wanted to make sure I was making an informed decision and that the consultant would then book it in 3 weeks... So I'm guessing it's just a yes ! I feel like I can now start to look forwRd to this birth and hopefully won't face any problems at the 36 week appointment

OP posts:
DayLillie · 10/10/2014 16:18

That sounds good. I hope it goes well.

StrangeGlue · 10/10/2014 16:35

Op this is for health reasons - your mental health! You may well have to see the psychiatrist (not half as bad as it sounds) but if you lead off with explaining about your mum and the obviously huge impact on your mental health you have a v strong case IMHO.

My hospital has a person who you speak to who does liaison/advocacy between you and the consultants - does yours?

Good luck!!

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