TTC & already thinking ELCS

[PixieN]

Hi,

My partner & I have recently been trying for a baby & I’m already very anxious about childbirth. I’ve always wanted a baby, but think I’ve subconsciously been worried about the thought of giving birth for a long time. My partner didn’t want any more children for a good while (he has a son at uni) & I felt elated when he changed his mind, but can’t stop worryingly about the birth I’m 35 & he is quite a bit older than me. If we do manage to conceive, this will be the only one.

Anyway we started ttc just before Christmas & it’s suddenly seeming very scary & real. I can’t face the thought of VB & know that I would prefer an ELCS for a number of reasons.

I’ve read so much on the subject, including the NICE guidelines, RCOG, ‘The Caesarean’ by Michel Odent as well as ‘How to Grow a Baby & Push it Out’ by Clemmie Hooper (to have a rounded view) so I know about the pros & cons of both methods of delivery. I’ve read so much it’s becoming obsessive!

A huge factor is that my mum suffered from terrible PND after her 3rd child (ironically c-section due to pelvis size) which was never treated (her midwife told her to pull herself together which led to her becoming an alcoholic. She suffers psychotic episodes & had to be hospitalised at one point. It’s had a huge affect on my whole family. I’ve always hated the idea of being out of control. I’m the same with alcohol & would never drink until I didn’t know what I was doing. I know anything can happen in childbirth, but feel an elcs would be more controlled.

Anyway, I made an appointment to see my doctor last week where I outlined my concerns & he made it clear that I wouldn’t be entitled to an elcs on the NHS & would struggle to find anyone to do it privately either (he mentioned risks of suing the hospital if anything went wrong) because i’m fit & healthy. My Doctor is usually brilliant, but I didn’t feel listened to & nearly started crying. He said if I was his wife he’d be advising Vb & if I was rich I could go to the Portland. I have actually looked into private, but we can’t really afford - it would mean loans & credit cards. My Dr also advised me to just get pregnant & speak to the
consultant

Anyway, I know this is all hypothetical as I may not get pregnant, but I just wanted to ask if anyone has had a maternal request elcs on the NHS in a staffordshire hospital? I would just like to have a choice.

Sorry this is such a long post & thank you if you have read it. I don’t feel I can’t talk to friends & family about this - though my dh has been lovely & supportive

Sorry - that should read ‘I don’t feel I **can talk to friends and family about this’

I think your GP was right to let you know that it is very unusual for an NHS doctor to grant an elective cs for maternal request only; one of the reasons being that the NHS has to consider the cost implications.
I am not saying that it never happens but it could be difficult and possibly stressful to find a doctor/hospital that will do it and maybe your GP was just trying to be straight and realistic with you rather than giving you false hope.
I think it's quite common to be fearful of a vb and maybe more women feel like this than we think. Maybe think about some counselling to explore the issues further before becoming pregnant?
Hypnobirthing is also something you could look into as it helps with staying relaxed and in control. Good luck

I just have to say that the description of a c section recovery here is not necessarily reflective of everyone’s experiences. I have had two ELCS and both times the recovery has been nowhere near that bad. Second time round in particular I had an excellent experience. I was in hospital for one night walked up the road to the shops pushing a pram on day 3 was driving again by four weeks. The first week was painful but bearable with regular pain relief (just paracetamol and ibuprofen nothing stronger). I certainly didn’t feel like my guts were falling out or that I was unable to carry a plate.
A VB is more of a roll of the dice than a c section if you have a “good” birth without much intervention chances are your recovery will be quicker and easier than a c section. But a complicated VB resulting in interventions may be a more difficult recovery. Unfortunately there is no way of knowing in advance how difficult your recovery from either would be.

I'm really sorry for your anxieties and for what sounds like some really awful experiences with your mum, but I think the doctor was right to give you no false hope, and I don't think it's going to be very helpful to you if you do manage to find someone on here who had a maternal elective C-section, as their circumstances will be different to yours and so it won't make it any more likely that you will too.

The thing that really struck me about your post is this: I’ve always hated the idea of being out of control. I’m the same with alcohol & would never drink until I didn’t know what I was doing. I know anything can happen in childbirth, but feel an elcs would be more controlled.

I think this is the issue that you should explore in counselling, preferably before getting pregnant. I found that, for very different reasons, the TTC process brought up and set off a lot of my own issues around control. It was the first time I'd really been brought up against the fact that I couldn't even control my own body (I was, of course, lucky that I'd never had any serious illnesses to teach me this lesson previously). I found counselling very helpful. As you acknowledge, having a C-section isn't going to solve this problem (even if you somehow managed to get one): there's still so much of pregnancy and childbirth that you can't control at all. So that's the issue to address, I think.

Why don't you see how you feel when you're pregnant? My understanding is that they will give you a c- section if you insist on it (have a look at the NICE guidelines and the NHS page on them). But you really don't know how you'll feel yet.

My maternity notes contain a standard letter from the Trust saying that they won't do a C-section except on grounds of physical health or major mental health problems. I guess OP could try and persuade them she falls into the latter, but I suspect they'd try very hard to block her, and that that would in itself be very stressful for her.

If she were already pregnant then I'd agree with you, but I think if she could get to the root of the issues and try and walk through them before getting pregnant that would be the ideal course of action - she could of course also have counselling in pregnancy if she needed it, but from what she says the sense of panic from an impending deadline (ie the birth) could be pretty harmful to her.

I thought it was your body, your choice. And that mental health issues such as past trauma and intense fear of VB were adequate for an ELCS to be granted. I’m booked in for an ELCS.

My trust say this, which seems rather less encouraging on the matter... They also don't offer care in accordance with NICE guidelines on other things, including fertility.

I had an NHS ELCS 5.5 weeks ago based on maternal request due to fear of childbirth (tokophobia). My GP said it might not be possible but I spoke to the midwife at my booking appointment and she was very sympathetic. I saw the consultant at about 6 months and they were happy to agree to proceed on that basis. The hospital I gave birth at (SE London) is apparently very supportive of maternal choice but my understanding of the guidance is that if a consultant refuses to agree to a c section they must refer you to a different consultant.

My experience of the c section was very calm and my recovery was much easier than I expected. I was out of bed the same day and discharged the next afternoon so only one night in hospital. The scar has healed really well and I was up and about walking etc pretty quickly.

For me, the ELCS was definitely the right option and I wouldn't hesitate to do it again.

@Bluebirdsky - my GP is realistic & I do appreciate that about him, but I have heard of women having maternal request elcs - I read one experience of a woman travelling to a different hospital which was miles from where she lived, but she felt comfortable there as her choice was respected.

@RosieCotton - that sounds hideous. I’m amazed you had another baby after that! I certainly don’t think elcs is an easy option - far from it. I think I must have read hundreds (maybe thousands) of anecdotal stories with positive/negative stories of both deliveries since my late 20s as that’s when I first really wanted a baby. I actually sought out positive vb stories as the alternative is too hideous to imagine. One of my friends has been left incontinent from vb birth, another has a disabled child & another was born stillborn. My GP says it might be better for us to be ignorant of what can go wrong. Maybe he’s right, but I would rather know everything that could go wrong, make an informed decision & have that respected.

I think that @Lindorballs is right - it’s like the roll of a dice & there’s no way of knowing what you’ll get. I think it’s fear of the unknown that freaks me out the most. I just think I could more mentally prepare for a c-section & the potential horrors that could bring than the potential horrors of vb if that makes sense.

I’m going to be saving like crazy as I think I would go for private if the NHS turn me down. I have considered counselling - I actually asked my GP, but not sure it would change my mind. I’ve had years to think about it. Also had a period of counselling when my marriage hit a rough patch so know it can be helpful. I just wish i’d saved more, but recently bought a house so all my savings went into that.

As I said in my original post @PixieN I am not saying that it never happens but it's better to be prepared that it might not be plain sailing and may involve travelling around to different doctors and hospitals to find someone who will do it. Some pregnant women would find this quite stressful. You could be fine and the first dr you see is happy to support you but it's better to be aware that this may not be the case.

@OutThereToo - why are you booked in for an elcs if you don’t mind me asking?

@JW13 - I’m glad you were given the choice & had a good experience. Were you referred for a period of counselling first?

@LisaS - I would be open to counselling, but I don’t think I would change my mind. I can’t unread everything I have already read about risks/statistics etc for vb & elcs. I think it’s amazing what women put their bodies through for a baby tbh, but the drive to have a baby is so strong & it has to come out somehow. I’m also worried about my age as i will be 36 very soon & my dh is early fifties. We might struggle to get pregnant anyway.

I think the main thing for me is wanting to feel listened to. I can imagine how vulnerable you must feel when pregnant which is likely to heighten anxiety. Not good for mother or baby. My job is quite stressful & i’m prone to UTI (and thrush) infections which hasn’t helped with ttc. I’m also extremely worried about how pregnancy & birth will affect my pelvic floor. A friend confided how nothing feels the same again after 2 vb births & another friend is incontinent after having her baby recently.

Has anyone got any experience of going private with MUMS in the Midlands? Apparently they will do the delivery you want at an NHS hospital. It’s pricey though at £9000

After a difficult delivery with my DS (I won’t go into details as I don’t want to upset anyone) I will be requesting CS if I have another baby. I was under the impression you can have a CS if you want to, and if you can’t get your dr to grant one you can request a dr who will. My main fear if I ever have another baby is that I will be leaving my son, so I see a CS as the best way to ensure he is well cared for (ie delivery is planned).

@LisaS - which trust are you in if you don’t mind me asking?

@1sttimeunicorn - from what I’ve read, you’re far more likely to have it granted for a second baby after a difficult 1st delivery. I’ve read about women being put off trying for a 2nd for years because of a terrible 1st experience. Maybe I should just stop reading!

I don’t like the idea that it’s such a gamble in the first place & would hate to go through a traumatic vb when I’d wanted an elcs from the outset. It wouldn’t matter if that meant I could have a cs later as my dh & I only want one baby.

You GP is totally wrong regarding the comment that you’d be hard pressed to get an ELCS going private. In my experience most private deliveries are ELCS- when I met my consultant for the first time when pregnant with DD, he (correctly) assumed that I’d want one but said he’d be happy with whatever I wanted.

I’m London so don’t have experience with MUMS but £9000 does sound on the low side cost wise for private. It’s usual to pay consultant fees, hospital fees, the anaesthetist plus every blood test/ultrasound so I would definitely double check!

Good luck.

I wouldn't shun it off yet op I have had three c sections two were planned one emergency, medical reasons so slightly different, I wish I could of given birth normally, I went thru the labor and was pushing but baby wouldn't come out so had to have a emergency one for one of them what was worse then natural birth, pregnancy is a beautiful thing, try it or you might regret it, the recovery is a lot longer with c section you are limited to doing much for a while I would pick a natural over c any day sometimes I don't feel like a mum because they didn't come out that way .

You’d have to fight for it, but under the circumstances in my trust at least you could absolutely have an elective c section.

I had terrible tokophobia but didn’t realise how severe it was until I was already pregnant. I was having panic attacks daily (previous history of abuse and traumatic gynae treatment). They sent me for specialist counselling and after a great deal of resistance agreed to book me in for an ELCS. My husband had to push quite hard as I fell apart in consultations and could barely speak. In the end I had to have an emergency cs anyway.

I understand how extreme and uncontrollable this fear can be.

In my trust, it is possible to discuss this in advance with an obstetrician under the general gynae clinic - might be worth asking your GP if this is a possibility.

I currently work for the maternity service and I can tell you that there is absolutely a difference between a maternal request c section and a c section request due to tokophobia.

I don't want to give my trust (and therefore location) but if you're in Staffordshire it's a long way from you. Note that it does say 'proven psychological grounds', so this could well be possible even in a trust like mine - but you'd have to be prepared for encountering a lot more attitudes like your GPs along the way, which I think would be horribly stressful for you.

@lemonsquisher - the cost is for private delivery & up to 3 days hospital stay, though I’ve heard of people going home the day after providing the op goes well. How did yours go if you don’t mind me asking? Was it the right choice for you? All the other stuff is on the NHS - it’s just private delivery you pay for. I think i’d prefer the NHS for everything to be honest (and not just because of the cost) but know it’s unlikely.

@roseannalee - I think women have it drummed into their heads that vb is best. I’m amazed at women feeling inadequate after a cs birth - all types of birth sound bloody hard to me & it doesn’t make you any less of a Mum, whichever way the baby comes out My friend was offered a cs as her labour was so long & difficult, but she was determined & kept going & has had so many complications as a result. Yes, she might have had other complications with a cs, but her vb caused real damage & has put her off having any more children.

@FancyNewBeesly - I’m sorry to hear your experience

I’m very anxious, but not sure it’s to the extent i’d be classed as tokophobic, but maybe I am. How do they diagnose that? I feel panicky about vb before being pregnant, but would that get worse if I was actually pregnant? I feel quite sensitive about mental health as it is, due to my mum’s experiences & not wanting to go down that route. One of my worst fears is becoming like my mother! My mum is very childlike & i’ve always felt responsible for her - I often help her emotionally & financially & at the worst point had to attend all the meetings with doctors when she was hospitalised & having psychotic episodes - all while trying to hold down my first proper job. It’s had a huge impact on me. I’ve discussed all this in counselling before, but this is bringing up a whole load of new fears.