When should the midwife refer me to a consultant for an elective c section?

[BeckyWilson78]

Hi all, I just wondered if anyone could help me. I have my booking appointment today and after a very difficult first birth (six month recovery, private op needed, action successfully brought against trust) I def want a c section. From what I have read midwives try to fob you off and won't refer you, even though it's not their decision to make. Has anyone here been referred at the booking appt or made to wait longer? Can your gp refer you if midwives won't (am lucky to have a brilliant gp). Majorly stressed and it's ruining the pregnancy for me. My hospital this time is st thomas' thanks in advance

I really don't think with that history they will! Go straight to GP if worried & ask directly for consultant care but honestly I know people who have chosen c sections for much lesser traumatic reasons than yours and its been fine. Hope your appointment goes well.

Hi Sunnybobs thanks so much for your message. If it doesn't go my way I will def go back to my gp...

I got told at my 16w mw/consultant appointment that yes I'll have a section, and all going well it will be done around 39 weeks, on 2nd March.

I medically cant give birth vaginally though, I have 5 fistulas so would just burst open.

I cant imagine them telling you no to a c section though. Have a look at the NICE guidelines, and make sure you are prepared for your next appointment, just in case.

Hi Gudgyx
Thanks so much for telling me about your experience. I am fully armed with nice info and prepared to ask the mw to recite it to me if she's getting difficult! I know I sound a bit high maintenance but first time around I believed mws actually cared about patients but now I know you only get the care you need if you kick up a major fuss

I have an appointment with the 'birth options clinic' in a couple of weeks when i will be 18/19 weeks-ish....

my midwive asked me at booking and i said i was 95% certain i wanted a ELCS (had an emergency one with number 1) so she made the appointment for me

I was referred by the midwife at about 16 weeks and so first say the consultant at 20 weeks.

I found him dismissive and impossible to talk to as he was a patronising prat. So at my 24 week midwife appointment she referred me to a different consultant.

Second consultant listened, referred me for a scan at 32 weeks to check babies growth, and then we discussed again. We agreed a section date at that appointment (32 weeks).

I did find the consultants tried to encourage a VBAC, but they also repeatedly said that they were having the discussion because they wanted to be sure I had thought through all the options and was making an informed choice. So be prepared to show you know the risks of an ELCS compared to a VB and be prepared to keep talking until you persuade them! I cried in my last consultant appointment, but not because they were unsympathetic or nasty, just because I found it difficult to explain why I had come to the decision I had and got over emotional because I really wanted an ELCS outcome and worried they would block it. They didn't. They listened and gave me a date once they understood how important is was for me.

I hope it all goes smoothly for you :)

Hi Tiny Tear
That's great to know that you will get seen so quickly, it confirms to me the midwife needs to take action today, if not I will demand to see another mw...

I had my booking appointment last week at 8 weeks. Explained why I wanted a section to the midwife, and she said she'd refer me for a consultant appointment at 16 weeks. She was very understanding and non judgemental, and said if I wanted to, I could get a section booked there and then.

Hi HappyAsASandBoy
Thanks so much for your message, I'm sorry you had a battle but glad you got there. The frustrating thing for me is that no one ever warns you about the dangers of a vb and a doc friend of mine tells me in a healthy pregnancy it's v slightly safer overall to have a c section and that's why nice revised the guidance (the usual figures are skewed by the high risk births). Crying isn't a problem for me, stopping the waterworks is usually tougher! I hate how it all just comes to money and we are bullied into doing the cheapest option...

Divingoffthebalcony, that's amazing, which nhs trust are you in? If you don't want to say specifically just what region?

I was referred by mw at booking in appt and then had a consultant mw appt to talk me through options despite me saying outright I wanted an elcs after a traumatic emcs last time (appt 1 of 2) at 21 weeks. Next appt at 28 weeks and follow up session with consultant to get date at 30 weeks. Lots of hoop jumping which my consultant admitted to but supported the elcs decision at the first appt.

Hi PassTheAnswers
Great to hear you got there in the end, sounds like a battle for you though,

I've just had my booking appointment and I was told that I can definitely have a c-section this time (previous ELCS last year due to breech baby). I was expecting a bit of a fight after reading posts on here but it must depend on area.

Not all hospitals refer for this so early as some posters are suggesting. I have experience of st Thomas's. They are very likely to agree to your request (high Caesarian rate) but I think the trend is to wait later on in pregnancy to give you more time to think/get your head round it. I appreciate you are unlikely to change your mind but some people do and so that is why. I suggest you don't need to kick up a big fuss, rarely constructive, and also you have plenty of time. Ultimately it is the consultant who makes the decision with you but you can ask to see another if the first does not agree.

Hi Cuphat that's great to hear and Playdoughcaterpillar, did you have an Elcs or do you know people who have at st thomas'? I agree it shouldn't be necessary to kick up a fuss but I'm very defensive/ anxious after appalling treatment at lewisham

I'm in South Essex Becky. I can only hope the consultant is as sympathetic as the midwife. But with my history - third degree tear, long recovery, PTSD, PND - I'm hoping it'll be a no brainer.

I'm the same as cuphat, had an ELCS last time as breech baby. Saw GP in order to get referred to midwife for booking appointment. I was asked by GP what I wanted and I said another ELCS and gave my reasons and he said that's fine. I was also surprised as expected a battle. As a PP said make sure you have read the NICE guidelines before your appointment. Good luck.

I had an elective section second time round. There was no need to discuss or book date until consultant appointment at 35 weeks, section was booked for 39 weeks.

Divingoffthebalcony, that sounds horrific, really hope your consultant is supportive.
Monkeroon, that's great that there wasn't a fight, great to hear and a massive relief to you a bet.
Pookbob, that's great it was straight forward, for me I know there is little practical reason for getting it sorted quicker, I'm just so worried about getting let down at the last minute I want some certainty as soon as possible

I have not had a baby there but I used to work there. My babies were born elsewhere. I found the HCPs there, on the whole, absolutely competent and very professional. Please try and strike a balance between standing up for yourself and becoming a trouble maker! Most people respond best when spoken to politely.

The idea of someone who works for a hospital labelling someone fighting for what they need and are entitled to a trouble maker doesn't surprise me after my past experience but it does disappoint me, hopefully I will encounter people with a more positive attitude today. Had I been a, in your words, trouble maker last time my Hv told me afterwards that I would have been admitted to hospital while in established labour instead of sent home, given some pain relief during a 40 hr back to back labour and not had to pay £2k for a private op, thankfully the health ombudsman forced them to refund me and saw through the ridiculous tissue of lies the hospital told.

Becky I think what playdough is trying to say is be assertive but not aggressive - so calmly, clearly state your point and stick to it, know your rights and don't back down but don't shout, become really angry, rude, etc. Its human nature that people respond best to the former rather than the latter.

I really hope that you get a nice sympathetic mw who is understanding of the obviously very traumatic past experience you had.

Hi Whyohwhywouldyou, that's kind of you to say that. The appointment went amazingly well, got a referral to a consultant within the next few weeks, been given the same midwife for each appt and all in a very supportive environment. Such a relief

I'm glad you've got a nice mw this time and your consultant appointment quickly. It must be a relief to feel supported this time. Fingers crossed that this time you get a much better experience all the way through.