Requesting an ELCS

[Icklepickle101]

I know this can be controversial and am willing to hear other peoples experiences but please don't flame me.

I'm 32 weeks with DC1 and have SPD which has resulted in me being on crutches since 16 weeks and high amounts of codeine for the pain. I've being seeing an osteopath and physio weekly and both believe the pain is mainly from a sacroiliac joint injury from a horse riding fall 2 years ago, which will need further investigation/surgery after the baby is born. After lengthy discussions with a midwife (not my usual) and the phsyio i would like to request an ELCS to prevent further damage to my pelvis as I have been told if my legs were put in to stirrups in an emergency I could suffer from a fractured pelvis.

How would I go about requesting this? I'm not due to see my midwife until 35 weeks (christmas week!) and don't have a number for her, I am seeing my GP tomorrow for a BP check, would he be able to refer me to a consultant?

As 2 medical professionals have expressed it is in my best interests for my to have an ELCS will it be easy to arrange or will I still have to fight my corner?

Sounds like good reasons to me. Your midwife will need to refer you - call your surgery for her teams or the number on your notes for the hospital midwife team and they'll get it started.

Thanks, was hoping GP would be able to do it!!

Will ask if he has a number for her when I see him tomorrow.

Do I really just need to say "I'd like to be referred to a consultant to discuss an ELCS please"?

Pretty much! They HAVE to consider you. Stand firm if they try to talk you out of it, but obviously listen to their reasonings, you clearly have medical reasons for requesting one.

Im so upset, saw my GP this morning who flat out refused to refer me as he is on the board of the trait to reduce the number of non emergency c sections. He kept telling all these scenarios which included me and the baby dying a fair few times. I just sat and cried the whole appointment.

Where do I go from here? I've been medically advised to have a section but I can't get referred because of his position?!

Trust not trait!!

It is absolutely YOUR choice how you give birth and you CANNOT be reused a Csection.

Speak to your midwife and she will be able to put you in touch with a consultant. Do it sooner rather than later though as you will want to book in a date for 39 weeks to avoid going in to labour.

You may come across some resistance, but just make very clear that this is what you want and they won't deny you your choice.

Good luck!

p.s. absolutely no idea why you thought you would be flamed for this - nothing wrong with having a CS

Please get into contact with your midwife, I'm sure new nice guidelines state they can not refuse you for a c section.
It seems you have pretty good enough reasons as to why you would want one.
I can understand them trying to put you off as yes the recovery time can be more difficult.
But that is for you to weigh up and decide yourself.
Good luck and stand firm.

Your GP is being an arse. It is not his position to make that decision or obstruct it, it's up to you and a obstetrics consultant.
Phone your local hospital or women's health centre they should be able give you the community MW teams number, it may even be on their website. Speak to your MW directly, she should be able to refer you.
I am having a c-section as I have hip problems (RA & previous injury) and a previous protracted birth. My GPs are rather useless but I've had little contact with them, my MW and consultant have been fab. My consultant said it was my choice but she was relieved when I chose a section as the potential for problems with hips is high.

Our GPs don't get involved in pregnancy around here and I suggest you don't go back - he sounds a dick!
In your position, I too would want a section (I had an elcs last year and it was great btw). To reduce the chance of needing assistance, you are best off having an active birth - this you are unable to do as you have severely reduced mobility, so I would argue that you are more likely to require your legs to be in stirrups as you can't have an active birth- and the prospect of a fractured pelvis is extremely worrying - if you had to give birth, you would be worrying all the way through labour, and these hormones could inhibit birth, increasing the likelihood of intervention.

Ring antenatal clinic and tell them you want a consultant appointment or to speak to a MW who can refer you to a consultant.

I too have pgp (not as severe as yours) and know how painful it is. I really hope that the consultant you see is sympathetic and you get the birth you want. Remember, the GP doesn't have much of a say, it's the obstetrician x

In my area our appointments alternate between midwife and GP, something to do with funding I beleive.

I came home and was sick I'd got myself so worked up about.

I called the maternity u to to try and get a number for midwife but she is on annual leave until the 16th do called hospital back to see if they can help but they can't do anything without a midwife or GP referral - catch 22!!

I've also read through my notes and GP has written baby is still transverse and that my codeine prescription will be stopped at 36 weeks. I thought transverse babies had to be CS?

All this stress can't be good for my blood pressure but nothing has been simple so far :(

Try seeing if you can see a different GP at your surgery so that you can have a second opinion and hopefully you can get someone more sympathetic to your cause.

If not, then maybe put a formal complaint in about your GP. Its not like you are asking for a ELCS because you can't be bothered to push normally.

Could you see another GP at the practice?
Your MW should have a cover person for when she's off (they usually work as part of a team) could you ask the hospital for the team number or the head of community midwifery. I saw a different MW last week because mine was on leave and she was fab, the appointment just took a little longer as I had to explain things.
If not I'd be on the phone the moment she's back from leave to get her to sort it out as a priority.
What area are you in perhaps somebody has contact details for somebody that could help?

It really annoys me that GPs / doctors / midwifes think that they have the right to tell you how to deal with your own body. If you give birth naturally you potentially could cause yourself damage and your dignity will suffer because of this. Where the hell does your GP get off telling you no, it's your body therefore not his decision. I really hope you manage to push this further xx

That should say some GPS / doctors / midwifes because obviously the majority will be wonderful you've just been unfortunate

Get the contact details of a supervisor of midwives and discuss it with them and ask them for a referral. And yes, a transverse baby should be born via section x

GRRRR! So annoying and totally agree with kaytee. Why is it in this country that the only scenario where you'd be under medical care and be fobbed off like this - not to mention all but refused pain relief for the most painful frigging experience known to woman - is pregnancy and childbirth. It's driven us to going private which is prohibitively expensive for the vast majority of the population - including us, but luckily we have a very kind family benefactor. The difference is vast though in btoh the pregnancy and the birth itself - in the very same hospital and with the very same consultants that the NHS ladies are using. And when you're private I can tell you that you have aneasthetists hovering round you to give you an epidural at pretty much ANY point you want it, so this crap about it not being the right time for one (too early/ too late / too y-in-the-day-y) is total codswallop. So many of my friend suffered unnecessarily due to that. You woudlnt have a tooth out with no pain releief. Well for me and for many it's more painful by a running mile! So GRRRR again! Feel for you. STAND YOUR GROUND. Go to your MP if you need to. Or the frigging paper!!!

Thank you everyone.

I spoke to the head of midwifery at the hail oral and she has told me to leave it with her and she will see what she can do if I haven't heard in a week I will request to change hospital as I've had nothing but problems.

I'm just worried what do I do about pain relief after 36 weeks if they are stopping my prescription? They've already taken my omeprazole away and I'm just feeling pretty shitty.

What the fuck do I do if I go in to labour before this is all sorted?

Look at the hospitals rate of c sections. I was refused during an induction due to their numbers being too high.

Read up on the NICE guidelines, so you know exactly what you have to do.

I had no progress after 6 pessaries and I know 2 other hospitals would have sectioned after 2/3.

I was in the hospital at the end of the month too and knew they had gone over their 'allowance'.

Your birth plan isn't decided until hot 35 week appt so i wouldn't have expected them to sort it earlier anyway.

Why aren't you under a consultant anyway?

I believe elective sections are booked at 39 weeks.

(I was the same re sections but I'm actually glad I was talked out of it - I basically gave birth before they would have taken me to theatre)

The hospital I'm currently at has a high percentage of ELCS (about 60%) which is why they have a special committee to try and reduce this number significantly by Febuary and I'm due in Jan. My other choice has a fairly consistent ELCS rate of 40% and everyone I've spoken to who has requested a CS on medical grounds has been granted one no fuss. This makes me think I should swap but worried about the what ifs and timescales as I'm due next month!!

You say next month but it's still 8 weeks away!

I would just relax a little, like I said most birth plans are decided at 35/36 week appt. ANYTHING could happen or change in the mean time.

I know it's hard but just talk it easy until that time.

The other people who have been granted a section on medical grounds may have fallen within the guidelines ie previous section etc

You unfortunately in the eyes of the NHS are not being given one for your symptoms, you are requesting one. Which will be more challenging.

You could change hospital but you aren't even at that stage for it to be discussed properly.

Personally I would go to the next appt, armed with your facts, then if your not happy decide then.

Don't take this the wrong way but they are trying to cut down on all those unnecessary sections, so they have to put up at bit of a wall in the hope you will give in.

You cannot be refused. Speak to your midwife Asaph and ask to be referred to consultant to discuss it.

The NICE guidelines www.nice.org.uk/guidance/cg132/chapter/1-recommendations see section 1.2.9 say that your request has to be considered and discussed with a team but they can refuse your request and then pass you on to another consultant who maybe happy to offer you an ELCS.

Would it be worth considering a birth plan that states you would trial labour (if you are happy with that) but of intervention (I.e stirrups) is required then you will have a CS.

I had a birth plan like this with my 3rd (1st was an emergency section, VBAC for no 2- was rather messy). It worked out well although I did have another section, but there was no fuss or drama over it with the team.

The nice guidelines make it sound like to should be an easy thing to arrange!!

Nick I have considered that option, however there is no guarenas that would help as the worry is that my pelvis might not be able to safely accommodate the babies head without fracturing. It makes me wonder if there is a reason the baby is transverse, IE my pelvic injury is preventing the baby from turning head down?

Note

*After discussion and support.
*
This means you will there will be steps to encourage you to have a vaginal birth. (36 weeks appt)

*Meeting with obs.
*
You haven't had this bit yet so you never know you might get an agreement first time!