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?

debating today whether or not to ring the hospital and speak to them? I will be going there anyway on the 25th for my 20 week scan. Whats everyone suggesting I do? ring them now or wait until the 25th?

You'll probably just be in Radiology/us dept for your scan. They'd have nothing g to do with anything else, so best call them

I'd get a consultant appointment booked next time you see your midwife. Or you might be able to arrange it at reception when you go for your scan. Depends on the hospital but at mine the midwife had to refer me to the consultant. The sonographer can too but usually only based on scan results e.g. low placenta, not based on maternal request.

Hi OP - I can't offer practical advice on how to proceed with your situation as I'm not in the UK. However, I recieved similar backlash for wanting an elective csec. Lots of people have had a horrid csec experience and they will tell you all about it. In the same way that women who had horrific vaginal births will scare the shit out of you with their stories - people love sharing their bad experiences with others. To balance this out, I had a great experience. In response to the upsetting things that other posters experienced:

• Spinal - wasn't painful at all for me? They gave me a little local anaesthetic first which most people have felt at some point - hurts as much as a vaccination or a tetanus shot. After that I couldn't feel the spinal happening and chatted through it.
• Pain afterwards - was easily managed by taking my painkillers regularly and not attempting too much (I was in a private hospital for 4 nights, so it was easy to not do much!)
• Picking up baby - I was up and walking the next morning and able to pick my baby up just fine. I imagine it would be very difficult going home to a toddler in the first week and attempting to bend to the ground to pick them up, but no issues for me with newborn.
• Breastfeeding - my milk came in just fine and I had no issues establishing feeding and have been EBF ever since.
• The scar - people complain about this, but mine is so low noone except my husband and gyno will ever see it. It's below my pubic hair line, so VERY easy to hide! It has already started to fade and I was lucky to not have much hard scar tissue it seems.
  I hope you get the support you need and have a positive birth experience no matter what

I think it's rubbish that so many women are mad at OTHER women for what we decide to do with our bodies.

I had an elective CS with DC3 (was expecting to be induced but opted for a CS on the day when offered). The birth was a very calm, positive experience. Bonding went better and more quickly than after my natural births, when I was too exhausted to bond immediately. BF was fine, spinal was fine. No problems with the scar.

But, in comparison to my textbook natural births the CS recovery period was far more difficult. I strongly recommend making sure you have help available for several weeks afterwards in case you need it. Not everyone does, but you can't know in advance how it will go.

Good luck!

Couldn't agree more ginger

Hi kelslakeishax , I'm in the same boat - 16 weeks today and extremely anxious about natural birth (due to age related reasons). I'm going to ask for an ELCS on mental health grounds. I have my 16-week midwife appt this Wednesday but really worried I'll be fobbed off again .. I was booked in for an appointment with a consultant midwife a few weeks ago (having mentioned my fear of childbirth at my booking appt. I was told I should discuss it with consultant midwife before being referred to a consultant) but the midwife in question called and cancelled the day before the meeting and abruptly informed me they didn't do maternal requests ELCSs. So I'm wondering if I get anywhere further this time, and if not, what my next steps should be... This is extremely stressful and I feel like it's sucking all the joy out of me as I constantly worry about being railroaded into a mode of delivery I don't accept.. Please keep us posted, I'm following your thread with great interest!

MrsLeBear I have written a letter to give to a consultant/midwife when I see one. I have done this as an easier option than trying to speak to them because I find it difficult trying to get my words across sometimes. You should give the NICE guidelines they have helped me out loads!!!

As a related article of interest, the RCOG are considering warning women about the risks of VB in the same way they currently warn about the risks of CS: www.google.co.uk/amp/s/www.newscientist.com/article/mg23130813-000-uk-doctors-may-starting-warning-women-of-childbirth-risks/amp/?client=ms-android-samsung

The hold up is the pro-VB lobby thinking it will put women off VB. Personally I feel being fully informed of risk when making this decision is the most important thing for women. It'll be interesting to see if/when this happens.

I attempted to get elcs with dc2. My first birth was so horrific and I had to have counselling afterwards. I even spoke to a midwife before I got pregnant asking if she could guarantee I'd be allowed a cs as I would rather abort than go through childbirth again. She wouldn't guarantee anything and said similar to yours - just that she'd arrange a meeting with consultant for 36 weeks.

I'm the end we remortgaged the house and went private. The cs was tough but there was just no way I could've gone through pregnancy knowing I'd have to give birth naturally.

Good luck. Keep insisting it's what you want and that you understand the risks etc.

Dugee couldn't agree with you more! It's such a damaging analogy for women that a natural birth is best.

I think the whole area of consent, risk & informed choice is changing, thanks to the Montgomery ruling.

More it'll be a huge step towards taking the patronising and paternalistic attitudes out of childbirth. My anxiety levels would be much lower if I felt I was being taken seriously having properly researched the risks. I was told by my consultant she thought I should consider VBAC because 'at least you'll have tried'. That sort of attitude has no place in risk management or medicine.

been trying hospital all morning for 2 days still no answer. just gunna wait till my 20 week scan now x

To whom it may concern,
I am writing this letter to you to explain my reasons for wanting an elective c section and why I think this is best option for me.
Even though this is my first pregnancy and have no previous bad experiences during child labour, I have a genuine fear and anxiety of a vaginal childbirth. My first fear and issue is that being in labour is not a controlled experience so therefor a possibility of multiple complications may occur during labour I do not feel as if I can take that chance of having a bad traumatic experience. My biggest complication fear would be a hemorrhage,severe loss of blood which could result in me having a blood transfusion or in the worst case scenario where the bleeding might not stop and could result in death. I know this only happens to a small minority of women but to know that in this day and age it still can happen and does sometimes happen has given me terrible anxiety. The thought of not being able to see my baby ever makes me very scared. Knowing this going into labour that this could be a possibilty I know would cause me to stress and panic to a degree of not being able to have a calm and relaxed birth. Being under this amount of stress would make me panic the whole time which would be bad for my baby's health aswell as mine. I do not want to put myself through this stress and would prefer everything to be planned and controlled as I feel this would put me at more ease which would ultimately make me calm and relaxed.
Another reason for my fear and anxiety of childbirth is my maternal mothers experience during her labour with my younger sibling. She informed me about her experience which was bad and very traumatic for both her and her unborn child. During her labour she had a complication involving the umbilical cord wrapping around my siblings neck which caused my sibling to completely stop breathing which could've resulted in her dying in the womb. Due to this happening my mother was rushed into theatre to have a emergency c-section. This resulted in her having a traumatic experience because everything was very rushed,unplanned and very uncertain for the outcome of her child and herself. After this experience she was very ill for a number of weeks suffering from depression because at the time of birth she thought her child could've died and that it was her fault even though there was no possible way of this being true. Hearing this and seeing my mother so ill and sad at the time has made me fear that this could be a possibilty for me or another complication like this one could occur which could result in a emergency c-section,a bad labour experience or even worse my childs health being put at extreme risk.
I am aware that a c-section comes with just as many risks as childbirth and doesn't always go to plan. I am aware that it is a major abdominal surgery and all surgery has risk and complications. I am aware of the following risks which I have done a great deal of research into:
⦁ blood loss
⦁ infection of the wound
⦁ damage to my pelvic organs e.g bladder
⦁ a cut into my baby's skin
⦁ breathing difficulties for my baby
But after long thought out consideratiom of weighing up the risks that come with c-sections and the risks that come with childbirh I still know that a planned c-section based on maternal request is the best and safest option for my baby and myself. If you want me to see a professional about this anxiety and my fears I am more than happy to do that.
I hope you take great care reading this letter and take my feelings and reasons into consideration when making your decision.
Yours sincerely,
Miss Kelsey Hargreaves

my letter

OP, not sure if that's your real name at the bottom, but if so you may wish to report your post as it contains identifiable information.

I don't think your letter is useful. You need to get a referral to discuss your issues in person with a consultant at the hospital. Don't focus on haemorrhage, just as risky with a c section.

I've got a few thoughts on it.

Firstly, I think you need to make it snappier, and less based on a few anecdotes. Use the anecdotes, fine, but back them up with research about the interventions rate, statistics of tearing etc, to show that you aren't just taking a few isolated incidents out of context.

Remember that the more detail you go into, in some ways, the more they have to come back on.

Secondly, some of your concerns like pph are actually a higher risk with a section, so I'm concerned that your are shooting yourself in the foot.

The things you need to mention that scare you are those that are typical/risks with a vaginal birth, but not so much with a section.

Thirdly, you mention your anxiety towards vaginal birth, but maybe more about the effect this is having on you. It's it causing sleepless nights, tearyness etc? Also mention that the unwillingness to discuss a section yet is adding to this stress, and the effect of this on you.

Fourthly, don't be afraid to quote the guidelines. You can do it gently. You could say something like you are aware the Nice guidance allows me the option for a section on request, but am concerned at the unwillingness to confirm so far, that I will be able to opt for a section, and that for your own well being and mental health, you need confirmation of this as soon as possible, so that you can start to enjoy the pregnancy without the fear of birth clouding everything.

Lastly (and this comes back to the guidance again), it is, (or should be at least) your decision how you give birth, not theirs, so don't delegate this decision to them in the last line. You aren't asking a favour, you are asking for something the guidance says they should give you. Don't go in all guns blazing at this rate, but if they are not following the guidance, then they should refer you to a hospital that does.

So I'd replace the last line with something like -

Thank you for taking the time to read this letter, and hope we can discuss the way forward together, as soon as possible, as the uncertainty over the birth is really affecting me.

Or somethibg. But don't give them the power to decide. It's your body.

Personally I would write your concerns in bullet points and take it into appointment with you so you can discuss each concern/ element with the doctor. I also wouldn't focus on blood loss. I lost 1.8 litres during my first planned section which meant I needed transfusion, time on HDU etc. (to balance things I lost less than 500mls during my second with no complications at all.

I agree with all the above about your letter. I think blood loss and transfusion is more likely with a section so I'd not put that bit.
Focus on your reasons such as your anxiety and not what's happened to others. Sorry I don't mean that to sound harsh. Having been through all the hoops to get an elective after an emergency I think they will rebut a lot of those points.
Also have a think about family size. If you want one (or maybe two) children then they are a bit more happy with a c section as they get riskier the more you have.

Also it gets a bit easier once you actually see a consultant. Keep asking to see one. The midwives can't decide or sign off a section.

NEW LETTER
*To whom it may concern,
I am writing this letter to you to explain my reasons for wanting an elective c section and why I think this is best option for me.
Even though this is my first pregnancy and have no previous bad experiences during child labour, I have a genuine fear and anxiety of a vaginal childbirth. It is causing me to have sleepless nights and causing me alot of stress and upset. Also when I mentioned to my midwife that I wanted to discuss having a c-section the unwillingness to discuss the conversation further added to my stress.
My main fears are:
⦁ Prolonged labour (which can end up with an infection)
⦁ Umbillical cord compression (this happened to my maternal mother)
⦁ Perinial Tears
⦁ Pelvic floor damage
⦁ Excessive bleeding
⦁ Having a bad experience which can lead to depression or trauma
But after long thought out consideratiom of weighing up the risks that come with c-sections and the risks that come with childbirh I still know that a planned c-section based on maternal request is the best and safest option for my baby and myself. If you want me to see a professional about this anxiety and my fears I am more than happy to do that.
I have read the NICE guidelines thoroughly and I understand that if this is what I want after everything it is my right to have a planned c-section and you must refer me to someone who is willing to persorm it.
Thank you for taking the time to read this letter, and hope we can discuss the way forward together, as soon as possible, as the uncertainty over the birth is really affecting me.

Yours sincerely,*

STATS I HAVE FOUND! ARE THEY USEFUL?

.

I had an emergency c section under general anaesthetic. Others have already answered your initial questions but in terms of what to expect from the experience, I would tell you it's very cold in the operating theatre, there will be several medical staff in there with you, be aware you can ask for general anaesthetic, and the recovery is longer than you may have been lead to believe. Not meant to put you off at all but cos you're generally in hospital for only a couple of days the recovery is longer than what you might think, it was longer than I realised. I felt much better after two weeks, and had some soreness on and off for a few months but nothing too bad. If possible enlist support at home for housework etc. I hope this helps you.

Thanks UrbanYokel x