Medically necessary elective at C&W

[nichito]

Hi everyone.

First pregnancy, couple months in and already hit a stumbling block.

I have a complicated orthopaedic problem subsequent to an injury about 5 years ago that will (according to my surgeon, not to mention sheer common sense) absolutely 100% necessitate a c section.

Aviva have just informed me that although they accept that the section is a prerequisite, they won't cover a penny towards any private care (or the section itself) since it is a pre existing problem that necessitates it.

So am in the process of self-referring to the C&W via the NHS, in the hope that I can be overseen be a consultant(s) nevertheless.

This is all completely new territory so apologies if this is a daft question, but I've read that an elective c section at C&W will have to be private. Have I got the wrong end of the stick? Would a medically necessary section count as an elective, or are electives classified as any non-emergency section?

Completely at a loss! And still in a bit of a huff with Aviva. Paying out of pocket for private care is a complete no go, the full cost would probably be more than I earn in a year.

C&W have quite a high CS rate, as they tend to have a lot of older mothers and complex cases. They tend to be pretty unapologetic when taken to task on their stats, always pointing out that they also have one of the best safety records in the country. I would be surprised if they ultimately refused you, especially if your surgeon can back you up. It would be quite difficult for them to say no if your surgeon is clear it risks damage to you. If that damage was then caused by a VB you had asked to avoid, they would then be wide open for you to sue. So I wouldn't worry too much, but you may have to jump through hoops first.

It may make a difference which consultant at C&W you see, as to how many hoops you have to jump through. Can you choose who you see?

Re Aviva, you may have grounds to complain, first with them, and then with the FOS. But it will depend on the wording of your policy. If it lists c section as discretionary you may be out of luck, I'm afraid.

Do you need to be seen privately?.... I would have thought that you would be able to request an elective CS if your orthopaedic consultant has written this in your notes that it is essential and mentioned this when referred you to consultant obstetrician ?