C SECTION ADVICE AS THIS IS MY FIRST PREGANANCY

[kelslakeishax]

So i had my 16 week midwife appointment today and i brought up the subject of having an elective c section and when i was able to book an appointment to see a consultant she said this wouldn't be further discussed until 36weeks. I think this is wrong however.

So here are some questions i have for mums who have had this done before or an opting for one now!

-What week did you have an appointment to discuss a c section?

-How easy was it to get one?

-Did it all go to plan?

-Can you get one on non medical grounds?

Have a read through this link; it's been a game-changer for consent & reaching decisions jointly with patients, rather than imposing a patriarchal-type decision.

www.gmc-uk.org/guidance/27164.asp

I would write down how anxious you are feeling and your worries so that you can show this to the consultant/supervisor of midwives when you get your meeting. It can be hard to get your point of view across in these meetings when you're feeling nervous. Your size is not a good indicator of how difficult a normal birth will be so to be honest I wouldn't go down this route as they will refute it as grounds for cs. Unless that is your main worry in which case they will probably be able to reassure you.
You don't need to wait until 20 week scan or after as some posters have said. Yes a cs can be booked in at very short notice but it is getting it agreed which will take time.
Read the NICE guidelines which pp has linked to, and if your consultant refuses you can ask to be referred to another.
It isn't right that you should have to go through this stressful process at what is already a very anxious time for you, but it may pay to be prepared for a fight just in case.

I'm booked in for an elective because of a massive fear of childbirth. Whilst no one has encouraged me to do so, the hospital has been supportive and respectful of my decision.

It should be your decision, and that decision should be respected, that's what the guidelines say. If you need to stamp your feet a bit to make sure, then do it.

And yes, a textbook natural birth might be 'better', but it's not a choice between a planned section and that.

It's a choice between a planned section and the roulette that is natural childbirth. As a woman in my mid 30s having her first baby, my chance of having a birth that isn't section or instruments is about a third. Add to that the number of non assisted births first time, which have significant tearing etc, and you're looking at the likelihood of a significant recovery either way.

Also, whilst sections cost more initially, in time they cost about the same as a vaginal birth once you factor in repair work, physio etc, so don't feel guilty about taking up extra resources.

I've had friends who have had an elective that were home the next day, and found the recovery easy, staying in less and recovering quicker than those I know who had vaginal births. Some the other way round. There are no guarantees, but your choice is perfectly valid.

It is major surgery so needs careful consideration but I'll let you know that i've had 2 c sections (one EMCS and one elective).

The elective one was a wonderful calm experience. Healing took a while but i was out and about within a week although I did have support for a few weeks after that (mainly because i had a toddler to contend with as well!) I only stayed in hospital one night.

Good luck with whatever you decide OP.

Wow, op you have had some very judgemental comments regarding your request for a c section. Noone undertakes a c section lightly and I would recommend your speak to your Midwife in more detail about your reasons for wanting a c section. Mental health issues are just as valid as any other medical reasons and fear of childbirth is valid.

C sections are not always more expensive than vaginal births and both carry risks. Perhaps if you only compare straightforward, complication free births - where mother and baby also are discharged promptly or born at home to c sections you have a point but not all vaginal births go to plan and perhaps also cost more money.

And harleysmammy you always have a choice. No one can force you into having a c section either. Growth scans are always inaccurate - I was told my baby was over the 100th percentile and "absolutely massive"...he was 8lb 11oz

Having had a c-section 8 weeks ago, I'd have a genuine fear of that. It is absolutely not the easy option - I am genuinely jealous of friends who have just had a straightforward natural birth. Yes it's painful, but they've all come through fine.

I had a emcs and will have a elcs if I have another child. Even with it being and emergency and having a baby born at 30 weeks I still loved my section. my recovery was good I just found it frustrating that I couldn't drive when I got out of hospital (difficult getting there and back every day with baby in nicu.)
Everyone's different, do what's best for you. Good luck 😊

Thanks for the support everyone. I have an appointment for my 20week scan end of this month but think I might give them a ring tomorrow morning to have a more in depth conversation x

I wouldnt mind a section as I have GD, a big baby and anxiety over the stillbirth risk. However the consultant cheerfully announced at 28 weeks that there's no reason why I can't have a natural birth. They won't even discuss induction dates until 36 weeks let alone listen to my opinion on birth choices

haveacupoftea I would be casually dropping in the words "Montgomery Case" in to your conversations - that'll get your consultants attention.

Although, in fairness, I work in a diabetes obstetric service & we don't make birth decisions till then, generally (we do an extra growth scan at that point which helps the decision-making). However, our section rate is about 50%, almost double the average.

The Montgomery case is about informed consent and foreseeable risk not demanding a right to c-section.

I had an elective section agreed at 20 weeks, within 5 minutes of starting the discussion with my obstetrician. You need to be very well informed but if you are, it will be difficult for them to refuse. It made it easier that his daughter was pregnant and he'd told her to have a section! If I could have been guaranteed a normal vaginal delivery I would absolutely have taken it, but no one can guarantee you that. As it was I ended up having my section at 35 weeks due to reduced growth and wouldn't have been allowed to deliver vaginally. Recovery was very easy, up and about that day, walked a mile to the pub for lunch day 5 and driving within a couple of weeks. I'm not having any more babies but I'd definitely make the same choice again.

I am 34 weeks and have decided on an elective c-section. My DS was big and breech, I failed to labour, induction failed, my pelvic arch/tilt was not 'right' and I had an emergency c-section. I ended up back in hospital before 6 weeks pp with an infection. It was not a pleasant experience.

I needed consultant care from the off as a result of this pregnancy and he pretty much said the c-section was my best option. Having had a growth scan at 30 weeks, this baby is also big and transverse breech.

I have another appointment on Tuesday and they will finalise my decision and then I'll be in at 36 weeks to get a date but it won't be before 39 weeks (unless there is a medical need). I really don't think your hospital are fobbing you off about waiting to arrange it. Most labour wards do not put dates in the diary until closer to the time. It's the exact same with scan and mw appointments. I wouldn't kick up a fuss about it now, it seems very pointless.

Choosing ELCS over VBAC is an entirely different situation. If OP wants a section for a first time delivery she absolutely needs to get the ball rolling now. Most trusts will have various counselling sessions etc that you have to attend before they will acquiesce.

Teabag I am aware of that. The Montgomery case was where it was decided by the woman's Consultant that a vaginal birth was "best". The woman had diabetes in pregnancy & was not adequately informed of the risks of vaginal birth, despite questioning whether a c-section was appropriate.

Sadly, shoulder dystocia (a recognised risk of diabetes in pregnancy) occurred during delivery & her son suffered brain damage.

So there are wider issues regarding "informed consent" & incving patients in decision-making, as opposed to the old-style paternalistic medicine approach.

I had an EMCS followed by ELCS. The ELCS was awful - terrible recovery, but I went for the option which was presented as lowest risk to baby given my medical hustory. Agree you need to get the ball rolling after 20 wks- so you can discuss the risks of each option for you and your baby.

Hi I asked to have a elective c-section at my first consultation after my 12 wk scan because of PTSD
do not let a midwife dismiss you

But do the research for yourself and work out if it what you really want
Birthday plan was helpful for myself and staff

I had my elective booked on my 20 wk scan And had a emergency section at 36 wks baby was distress and small
But honestly I am not promoting C-sections but it was the best possible birth experience I could have hoped for under the circumstances
One thing I would say if you do go down this road Is for me epidural was great do don't feel the pain straight away like you do with a GA and you see your baby
If you want to know more about my experience pm me a few lovely ladies did the same for me step by step what happens when etc

www.nct.org.uk/sites/default/files/BirthPlan-PlannedCaesarean.pdf

I have written a letter regarding my reasons for wanting a C-section. Was wondering if anyone will take a look? ringing my hospital tomorrow for an appointment. Midwife told me at my 16week appointment NOTHING will be discussed until 36weeks,this is clearly wrong and incorrect information

I will just PM me

done! greylove

Personally I would recommend trying a natural birth, but it is your choice at the end of the day.

-What week did you have an appointment to discuss a c section?
It was mentioned at 24 weeks by my consultant because of a previous EMCS but not discussed properly or booked until 36 weeks
-How easy was it to get one?.
They gave me no choice in the end so I can't comment.
-Did it all go to plan?
Yes, calm lovely experience, baby safe and well, breast feeding started in recovery room. Walking within 24 hours, home after 48. Sore and stiff for a couple of weeks, needed more help at home than I would have for a normal birth.
-Can you get one on non medical grounds?
Not easily but mental health (which anxiety is) is a medical condition.

Just to make a few points;
I have a friend who is tiny (size 4-6) with a tiny baby, birthed naturally a healthy 8lb baby recently.
You will need a lot of support post birth, you may want your dp to take extra time off work as you won't necessarily be able to cope alone within two weeks.
If anything goes wrong they may have to put you under a general anesthetic which means you will miss your childs birth and their first few hours in the world.
It limits the number of children you can have. I gave had 2 C-sections and despite having had no real issues during them I have been advised because of lots of internal adhesions I shouldn't get pregnant again.
If you decided you wanted a natural birth in any future pregnancies it is harder/more likely to end in another section.

Whatever you decide best of luck for you and your baby for pregnancy and birth

I had an elective c-section. It was booked because I had a lot of mental health problems and severe anxiety. I had a difficult pregnancy anyway and she was breech up 36 weeks so it would have been a section anyway.

I was already under the care of a psychiatrist and a consultant for high risk pregnancy.

I CHOSE to have a c-section. I was pretty unwell mentally, so it was decided that it was probably the best course of action for me. At least emotionally.

At whilst yes, you're body is made to give birth, and yes it will most likely be fine. You still have a right to a c-section if it's what you feel is best for you emotionally.

It is most definitely not the easy option. Recovery was 10+ weeks for me.

But it was the right decision for me hands down for me the first time.

The second time, I was so adamant I wanted a Vbac. I got my vbac 4 months ago, thank god.

After having a c-section and a vbac, in a lot of ways, the vbac is easier. But for my first child, and for my mental state at the time, the c-section was what I needed.

And they need to refer you to speak to someone about your anxieties and fears. And you do have the right to choose.

I think it's a bit of a postcode lottery tbh and whether it's referred by midwife or if you've elected yourself.

My SIL is in a different area and was advised at her 20 week scan that her pelvis was not wide enough to birth the baby so she was referred and consultant led from there.

I ended up with an emergency section first time and decided to go for a section again second time around because i was terrified that it would happen again and was told there was no medical reason that it would and i had to wait until 36 weeks to confirm with the consultant.

In the end i was referred at 32 weeks because DD was complete breech position with her bum engaged and i don't agree with ECV.

If they think you need it they will refer you, if not you need to fight for it unfortunately.

Hey OP,

You sound to me as if you could be suffering from Tokophobia. It's a known fear of pregnancy and/or childbirth and will be taken seriously by your midwife. A very high percentage of sufferers need the reassurance of an elective c section to help them feel calmer about being in control of the birth. I would also recommend seeing a psychotherapist if you can for support. If you want to talk more just pm me, I'm a petite girl who also had Tokophobia really bad so you're not alone! In saying that, I was more terrified of the prospect of a c section but ended up having to have an emergency one!