How to access ELCS

[bestguess23]

For many reasons I am seriously considering whether a c section would be the best birthing method for me. I have complex medical issues and I am growing increasingly anxious about the birth. I have ME, an immunological condition and fibromyalgia. Despite all this, I am low risk and being cared for by midwives. How do I go about getting an appointment with an obstetrician to talk this through? Is it via the midwife or my GP? My midwife did not think a c section would be needed and went so far as to say the hospital trust wouldn't allow it. My consultant for my other medical issues believes it is possible I will need a c section. I feel a bit lost so just want to get some clarity from an obstetrician. I am only 13 weeks now but I don't want to leave things too late, particularly if I am likely to meet resistance. My next appointment with a midwife will be at 15+2 which is as close as we could get to 16 weeks. Has anyone been through this grey area and have any advice to offer? Thanks

The midwife should refer you but this might not be till 24/28 weeks.

Ask the midwife to refer you. I did, and she mad ethe appointment there and then (when I was still under 20w). They saw me at 32 weeks, not before, but it was good to know I had the chance to meet a consultant to discuss it.

I would seriously consider a natural birth as there are also risks to a section (having said that I had a natural birth first time and not yet had my second 36+6). I've got fibro, cardiac issues etc and I'm classed as higher risk but still had a natural birth. Basically I was referred to a consultant who then came up with a plan to minimise risk (and not to mention exhaustion on my body). The plan allowed me to know exactly what would happen if I couldn't handle birthing and when I would be moved to a section. That way it shouldn't turn into an emergency section as such. Actually my first was so fast it didn't all quite happen but I didn't have any real trouble. Honestly there is so much going on the normal fibro stuff kind of faded into the background. This time we're not even waiting for established labour, I go in for an epidural at the first twinge. This both allows a more gentle labour for me and should I require a section (and I've got lots of details about when they will do it) I'll already have the pipe in as it were! Definitely ask to speak to a consultant but don't be too worried. I know a few people with my condition, or others like it and all have laboured fine. It's just about being prepared.

One final thing, my symptoms have got much worse as pregnancy progresses so be prepared to seriously pull back on pacing. I'd also recommend early leave if you work. Hope this helps!

Thanks for your advice so far. I haven't decided on an ELCS I just want to discuss it with a consultant who is in full command of the facts. My midwife was entirely dismissive but my immunology consultant said he would be very surprised if I didn't have to have a c section. One of my conditions is very rare so I have never named it on MN but it does have a direct impact of my ability to have a vaginal birth. I will raise it with the midwife at my next appointment and see if I can get the ball rolling. I really just want to be informed as my case is sadly far from straightforward.

Then definitely insist on seeing a consultant. I don't understand why your midwife doesn't want to refer you anyway. Mine was keen to ensure she got the best advice on a specialist situation.

The only justification she gave was that the Trust are working actively to reduce Caesarian rates. She admitted she hadn't heard of the condition but based on my description and my other conditions she said I was still low risk. My consultant, thankfully, was a bit more informed but he did say I need to speak to an obs before making my decision.