Elective C-Section

[SpongeCake23]

Hi I think I may have posted about this before but I can't find the thread.

I'm very very early days into my pregnancy and of course I know anything can happen.

But due to my extreme anxiety and other MH issues, I don't think I can go through a vaginal birth. The panic and emergency of getting the baby out. Especially if something bad happens. A lot of vaginal births seem to end in emergency c sections, especially first births.
I also have a slightly high BMI (over 30) so I know I'm at risk of vaginal birth complications,

I've read many accounts of elective c sections and they all sound very relaxed, calm and in control. One lady even said the surgeons were playing the local radio station in the background (probably because they do it so often).
I'm terrified of childbirth, I wanted to test out and see whether I still felt the same, so I just watched a video of a baby being born and I was nearly sick. Honestly I know it sounds like an exaggeration, but it's not.
Other women were commenting saying how beautiful it was and how it made them cry. It just made me feel really nauseous!

Hey SpongeCakes I'm not sure what I want to do but I was really considering C section as well. They are not keen on the elective option where I am but I am freaked out of the v birth especially after horror stories of my friends whose bits been destroyed etc... Everyone keeps repeating women are built to give birth but it only frustrates me... Why would I want to go through hours of pain etc with so many risks of damaging myself etc (I am on the other hand quite small and do have narrow hips so worrying it will actually cause a lot of damage...). I may be freaking out but the c section sounds like a better option...

@PinkyPromise77 what did they say when you asked for an elective?

Having a vaginal birth is not an option for me. I won't be able to go through with it due to my extreme anxiety about things going wrong, needing emergency intervention etc.

I'm hoping they'll let me speak to a therapist and get the go ahead from them that this is the correct thing for my mental health.

I also can't have anyone putting implements inside me. Especially inserted into my lady bits.
If it came to using forceps or something, I couldn't cope and would have a huge panic attack and it would spoil everything.

I don't want to spend the entire 9 months on edge about this.

I can't give you much help with whether you would pick a c section but I wanted to reassure you about first time vaginal births. I had my DD 4 months ago, mybwaters broke at 2am and contractions started immediately. I managed at home with a tens machine until 5pm when I went to hospital. Although I wanted the midwife led birth centre there was meconium in my water and I was taken to delivery suite. I was examined once (2cm) and within 3 hours DD was born. I felt so safe and looked after on delivery suite and the care staff were all amazing.

Don't watch any more birth videos, that must be terrifying. I didn't even look at my own birth! Do you think an epidural would relieve some panic? You wouldn't be able to feel examinations or anything else?
There is also the catheter that is required with c sections so it wouldn't be as though your bits are ignored completely.

Good luck & congrats

I said to my midwife that I was considering elective c section and that's when she told me they are not keen on it where we are...

I'm quite early on too so still loads of time to make a decision but I also like the idea of knowing when things are happening rater than wait and see if I go over the due date and then worry at every single contraction and panic etc...

I suffer with anxiety, quite extreme anxiety and I ended up having an emergency c section as my baby's heart rate kept dropping. I felt it was very traumatic at the time and I really regretted that I hadn't been able to have a "natural" birth.
Thankfully my baby and I are fine which is the main thing. If I was to have another baby I had considered a planned c section as it would be much calmer etc but you know what, a planned c section still carries more risk than a natural birth. It's not an easy recovery I will be honest and I found the recovery itself massively increased my anxiety. I couldn't get out of bed all night because my legs were numb- sounds stilly but this was a massive trigger for me. I had to stay in hospital longer- massive anxiety increase. I couldn't hardly walk for a few days- again increased my anxiety. I couldn't drive for 6 weeks- made me feel very trapped at home and increased my anxiety.
I am not saying this is the case for everyone- I just wanted to share my thoughts. I get a bit defensive when people feel that a c section is an easy option. Please please please listen to the wonderful positive stories about natural birth and remember the majority are like this! I know there are some very positive planned c section stories but it is a massive decision. It is major abdominal surgery. I hope you understand where I am coming from.

Okay, I understand where you are coming from, I do.

I have had two emergency sections. First failed to progress after a 29 hour labour and second because both baby and me developed a nasty infection so needed to get her out quick.

What I will say is that do not consider a c section as an easier alternative to a vaginal birth it is NOT. It hurts like hell, is far more dangerous and takes weeks to recover. But you don't have to suffer labour which is pretty grim! I haven't had a vaginal birth so unable to compare but from what others have said, it's much easier to recover from, a lot less invasive and you an be home with your baby in a matter of hours rather than stuck on a hospital ward for days afterwards (now THAT is grim!)

I'm about to have mine, for exactly the reasons you said.
I was lucky enough to have an excellent community midwife who supports my choices and what keeps me calm. I've been asking consistently since I had my first booking in appointment at 8 weeks and made sure it's been written all over my notes at every appointment and scan. They want to be sure it's not a last moment panic decision.They basically won't properly confirm it until much later but it is 100% possible, just do your research, be open to the possibility of needing to talk to someone about it and know your pros and cons, they need to know you understand the procedure properly.
I went in the other day as I thought my water had broken (it hadn't) and they asked if I still wanted a section and I said yes, I don't want to go through labour. Just stay calm and sure.

@HappyGirl86 I do understand it's major surgery, but for me it's planned in advance, knowing what's going to happen and when (lack of control is a massive trigger in my anxiety).
I've read that emergency c sections are more traumatic and take longer to feel recovered from than planned sections, because most women have already been through hours of pushing etc.

I'm not denying that it's a hard process and I'm sure it carries risks, but for me, the positives out weigh the negatives when it comes to an elective for me.

I have exactly these worries about my next birth in June. I'm under consultant led care and have been asked if I want an elective C-section as I had an emergency one under general anasthetic with my DD (which was fine and didn't cause me any stress really).

I'm terrified of a natural birth too, and although I was induced in my last pregnancy, had an epidural and dilated to 9cm, I was very pleased I had a c-section as the thought of pushing out a baby kind of freaks me out. I know people say women are designed to give birth etc but it was bad enough being examined (and having a doctor put his whole hand up there to see if I was fully dilated!). OTOH, I am also a bit scared of an elective c-section as I don't like the thought of being able to feel when they are making the first incision etc. I know it won't be painful but I am still worried about 'feeling' everything that happens, as when I had my epidural and c-section last time I still had senstation even though it wasn't painful!

Sorry - my reply probably doesn't help you much!

I’ve had both. I shall give you a list of pro’s and cons for each from my perspective. Remember we all differ in healing and recovery so it’s only a rough guide. My vaginal birth came first and I was fortunate enough to deliver my 6lb er without any drama or damage. However, even intact my ‘bits’ burned and stung for a few days, there are substantial after cramps which can be intense for a few days after as the womb contracts. There’s a lot of clotty blood which stops and starts for weeks. I was lucky enough to avoid it but lots of women get slightly leaky bladders for a while. I recovered very quickly in terms of ‘back in my jeans’ despite crippling pnd. Birth two , c-section which was an emergency, but not a surprise (I ‘knew’ he wasn’t coming out the vj somehow) breach 9lb er but they didn’t know until I’d laboured. Anyway, the surgeon spent a long time putting me back together and did a great job! I barely bled at all after the op to the point that day 4 I was using a mini panty liner. The pain in the scar and inside is bareable from day 2 if you take the painkillers ( I didn’t breastfeed so used cocodamol as well as ibroprofen) and was doing housework and cooking by day 3. Something still felt delicate in there for about 4 months ( had sex 3 weeks pp which was fine) and now at 9 months the scar is virtually invisible and I never feel anything so I’m sure it’s fully healed. Only disadvantage is that any belly fat (most of us have some) will sit a bit proud above your incision so you have to live with a slightly imperfect tummy or be mega fit or maybe even a mini tuck once the family is complete which is what I’m doing. Honestly , don’t waste your pregnancy being scared of a birth, if you truly can’t face it then push for a section . I would never entertain another vaginal birth and mine went really well. It’s your body and you must do what feels right to you. Good luck

Congratulations on your pregnancy, OP. If you want an ELCS then speak to your midwife at your booking in appointment (around eight weeks) and be politely firm that you are referred to speak to a consultant. Your midwife cannot refuse this.

Then I would advise reading up on the NICE guidelines and also looking at the stats for your local hospitals, as it might be one is more likely to agree to a section than another (although, of course, a high section rate at a hospital might mean they are under more pressure to persuade women to have a vaginal birth). Some hospitals treat the NICE guidelines as just that, guidelines, but others see them as rules to be folllowed. Being prepared for your consultant appointment and realising you are likely to be referred to a birth options/fear clinic to either go through or persuade you out of an ELCS will help but if you just firmly reiterate what you want and if your consultant refuses, ask to be referred to another consultant. Good luck.

I understand how you feel, I felt the same and have done ever since I can remember. I also suffer from anxiety.
I am now coming up 20 weeks and my mind has changed completely on the subject. I am now thinking that I will try a water birth instead if I can.

All I would say is don't put all of your eggs in one basket, there are risks with both and pros with both. You may be like me and change your mind as your pregnancy progresses, so don't panic about it just yet. Speak to your midwife and see how you feel then.
Good luck!

@0310Star I did consider a water birth as a possibility if I had no choice but to give birth vagibally but I think that option is out because of my high BMI.

Just a couple of points:
I have had 1 emergency and 1 planned section. The recovery was much easier from the planned. I didn't find either traumatic.
Unlike a pp, I had horrid afterpains and bleeding for 6 weeks after my planned section - it is definitely not a guarantee against either!
Be aware that even if you have a planned section, you may go into labour beforehand.
I was very very aware of the needles/impending operation/what the Drs were doing etc during my planned, much more so than when I was just going with the flow during my labour and subsequent emergency section - you may want to consider the effects of this on your anxiety.

The difficulty is that sadly most trusts won't give you a concrete answer until much later into your pregnancy, which is frustrating. I requested an ELCS for my 2nd pregnancy after and EMCS and a baby in SCBU for a few days. The midwife was happy about this right from my first 10w appointment, she didn't even send me to the VBAC clinic as she knew it would be a waste of everyone's time. An ELCS was always an option in my trust because of my previous EMCS. And I was in a trust that was quite comfortable with performing maternal request ELCS's. Even with all of that, I was well into my pregnancy before it was signed off, and then probably around 8 months when we all agreed a date. Which I'm just saying to pre-warn you that even if people agree it can still take a long time before its all confirmed.

If you have phobias of vaginal birth and instrumental deliveries than you do have a very strong argument and generally most places agree to this now, though there is a good chance they will ask you to attend some counselling and discussions etc just to be sure that you are comfortable with your choice. Talk to your midwife about this from the beginning and get the ball rolling asap with any hoops you do need to jump through.

Just as a warning over the lack of control (which I completely understand and was a huge draw for me with my ELCS), there can be last minute changes to the plans which can throw you. I was scheduled for a Monday morning surgery, arrived on Monday to find the maternity unit had been shut all weekend because it was too busy, and after waiting 10 hours (they were desperately trying to fit me in that day) got bumped to the Wednesday. Which was not pleasant in terms of feeling in control. But I think that is rare,

If everything else is normal then having a raised BMI alone wouldn't necessarily exclude you from having a water birth.
It is usually up to the individual Consultant to agree whether or not to book someone for an elective cs but they will have both national and local guidelines at the hospital to consider. They usually have to evidence that the benefits to both mother and baby outweigh any risks of surgery so it's not always easy to predict what their answer will be. They also have to take into account the additional cost of cs vs. vaginal birth, not that this is the be all and end all but one of the reasons why they have to evidence benefit over risk.

Hi OP, I had an ELCS and you have quite a few times when people are messing around “down there”, first of all you have the epidural which is in the bottom of your spine so no probs there, then they put the catheter in, the section happens and you’re stitched up and then back on the ward later there’s a few examinations to check whether the bleeding and clotting is ok. Eventually after the epidural has worn off you have the catheter out and then you have to produce (really can’t temember how much) a certain amount of urine in a set time otherwise you have to have the catheter back in - no epidural that time if it does go back in! Luckily I produced above and beyond on that one!
Just wanted you to know that there are other times where things won’t be in your control even with the section. However the section itself was fab and I’ll be having one with this pregnancy, it’s different for everyone but I was able to be discharged at 24hours post op and moving around etc was no problem for me and my terrible SPD that I’d suffered disappeared straight away too. So I’m not trying to put you off, I’m just letting you know that you will still have your fair share of people being involved still and there’s still things that aren’t fully in our control. Good luck with your choice, I think waterbirths sound fab too.

ive got an appoitment with an obstrecian next week and this will be one of my main questions, Can i have an ELCS? I suffer loads from anxiety, been in hospital in/out of it in the last month 6 times already, still have another month and a half to go and i cant see myself going through so much anxiety and being in hospital every few days just because.
Also i've got a bacteria(Group b) that needs to be treated if a vaginal birth happens but not a CSection. However, i've got anterior placenta, so the placenta covers the baby so not sure it's the best option for me :(

I dont care what the rest think whether it's the easy option, people never stand on our shoes and realise we want the best for us and the babies . I was referred to one after the second time i was admited in hospital a few weeks ago, so i'd recommend you speak with your midwife quite soon and discuss this option for you.

Good luck with it and congrats on the pregnancy

BTW i keep going to hopsital because of Reduced Movements (mainly the placenta covers many movements and my baby likes to have lazy days) mixed with my anxiety levels.

daisyland I too have anterior placenta but they haven’t said that will be a reason to not give me the section, I actually get my caesarean date on the 16th March so I’ll ask then if they think the placenta will cause issues during the surgery.

I also have GBS and did when carrying my daughter, they took her temperature every hour (unlikely to be passed on via caesarean but not impossible) after birth and she was fine thank goodness.

I think you’d be better off focusing your attentions on overcoming your fears, than indulging them by “electing” for a C Section. You’ve got 9 months.

A c section is NOT the easier option, planned or not. If you don’t like implements or things inside you - well, chances are that’ll happen a fair bit over the next few months. There will definitely be implements inside you for a section. You may get away without in a vaginal birth. As for anxiety around not knowing what is going to happen and when: you know the baby is going to be born at some point within a two week-ish margin. Even with a planned section: what if you go into labour before the planned date?
It’s growing and birthing a baby. You will never have full control over this. In the nicest possible way, you’d do well to try to get over that, than to try to corral something that can’t be corralled.

@Plumsofwrath I can't just get over it. It's not as easy as that. My anxiety is ridiculously high. I've actually considered a termination since finding out I'm pregnant as I'm so out of control of the whole thing. But I feel having an elective (although not the easy way out in principle) for me, it really is. I'm going to refuse vaginal examinations, unless absolutely necessary. And for some reason having them 'inside' my belly doesn't seem quite as bad to me as having them inside my vagina. I just have a real issue with that and I don't know why, I haven't been abused or anything like that. I can't have smear tests and I can't even insert tampons, so I've always used pads. Clearly I can have sex, but it took me a very long time to pluck up the courage, I refused many partners until I was 19 and drunk at university. So it's a very real fear and anxiety of mine.

Hi spongecake, after my first dd i was terrified about having to go through labour and vb again as soon as i found out i was expecting my ds and i discussed my options with my midwife and consultant agreed i would have elective csection (ended emergency as went into labour early) and without a doubt i was the best experience i have ever had and if i was to have a 3rd i would be requesting another csection i was up mobile moving alot quicker than what i was with my vb, but again everyone has different experiences some of my friends had csections and vb and some would take vb hands down over csection, you just have to go what you thinks better... i did a lot of research before deciding csection and alot of people did try put me off but im glad i stuck to my guns. And i also did have radio on during my caesarean

I had an ELCS for similar reasons (not anxiety as such, but fear of VB).
I was in my 40s so managed to get the consultant to grant me an ELCS on that basis, even though he said it wasn't medically necessary. I'm not sure I can be much practical help, but I would just keep raising it at appointments and make sure they're aware of your mental health concerns.