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!

At the end of a c/section, they insert a swab on a stick vaginally to remove as many clots as they can, so this is something to be aware of if you are concerned about vaginal examinations.

It sounds like you need some counselling, having a baby and more so a toddler is unpredictable and even with a good routine you can't be in control all of the time.

My midwife is trying really hard to get me an ELCS after my first birth. (I won't go into details because I don't want to scare anyone!!)
I was supposed to see a consultant last week to discuss as I'm 28 weeks and getting very anxious about the birth. I was fobbed off by a male doctor who wasn't my consultant with numbers and percentages 😡 apparently I'll be fine giving birth naturally again....that's nice but how does he know that? He doesn't! So when I told my midwife about it on Tuesday, she was so angry that she's got me another appointment next week so I can discuss my options.
I don't mind giving birth naturally but I don't want to a repeat as it could lead to problems in the future and I actually want to remember this birth and enjoy it (if that's possible!!!)
Definitely speak to your midwife, hopefully she's as supportive as mine! X

plums there shouldn’t be any internal exams in a normal pregnancy surely? I had a few complications and I had no internals, I thought they dont do that any more?

Anyway OP, if this is what you want then you may find you have to be quite firm. Most trusts prefer to put women down the VBAC route as a default. You may need to attend a few counselling sessions. I’d suggest you look up the RCOG green top guidelines on maternal request ELCS as well as the NICE recommendations. Be polite, be firm.
Don’t close your mind totally to the possibility of VB - have a see if the sessions work, but if they don’t, then you do have a right to request.

For what it’s worth I had an elcs and I wouldn’t describe it as calm. The spinal wore off part way through, leaving me able to feel what was happening, my blood pressure went through the floor and I had to have a bucketful of drugs to sort it. They had to extend the incision due to the position of the placenta and they ended up using instruments to hoover him out anyway. So while the final outcome was ok, there was a definite loss of control and one or two moments I found very unpleasant indeed. I also lost 2 l of blood and I felt like I’d been run over the next day.

I personally feel that maternal request is an important right. Birth is a big deal and I dislike the thought of women being railroaded into something they’re terrified of, or frankly just don’t want to do. If men were giving birth there would be none of this rubbish - you’d get options, better pain relief and more importantly, your opinion would be listened to.

Polite, firm and informed is the way to go with health matters.

@SpongeCake, it seems to me that it is unavoidable that you have some mental/emotional work ahead of you during this pregnancy. The point I’m making is that it makes sense to focus that work on overcoming your anxieties; it would be truly miraculous if you went through your entire pregnancy and childbirth without examination vaginally. What if you have to do it for the baby’s sake?
I’m not unappreciative of your worries, but it’s an unfashionable and rarely expressed truth (imo) that with pregnancy and childbirth and at least the early years of childhood, there’s much much less room for the mother to put her wants and needs first. Ideally - and luckily most of the time - the sacrifices are small or minimal, and are counterbalanced by the joys (or else why would any woman have babies?!). But you can’t tell what the future holds. So you just have to knuckle down and wrap your head around the fact that there will be things happening, in all probability, that make you uncomfortable or uneasy. If you try to engineer a highly controlled situation which you’re comfortable with, you’d be totally unprepared for any unforeseen eventualities. Does that make sense?

By the way I would have another ELCS quite happily - just wanted to point out that it’s not always super calm.

It’s your body, and you have a right to have a say in what’s done to it. Good luck

Hi @SpongeCake23

I had an NHS ELCS 7 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

I found that in the early days and weeks of pregnancy I worried about the birth a lot every option sounded bad. But by the time I was about 38 weeks I was pretty much prepared to go through anything to meet my baby. I think it's a combination of hormones and exhaustion of pregnancy that stops the worry about the birth ( there's plenty of other things to worry about). As it happens my birth didn't go to plan and a long labour ended in a emergency c section, but both the labour and c section were ok.

And my c section was maternal request during labour. If I have any more children I would have an elcs.

You mentioned op that you'd be terrified of implements being used inside your lady bits. Would it be ok then when they're using implements during a c section? X

@spongecake23 I'm the same, I did my research before I even got pregnant and made my GP aware before we started trying that I'd want an elective c section. I'm now around 6 weeks pregnant. I've already seen my GP, she's supportive and has booked me in early with the practice midwife so I can talk it through with her, so she can consider being my advocate. Not even got my booking appointment yet, but elective CS is the way I want to give birth. It's best for me, my mental health, my baby and my family. I'm an intelligent woman who's made an informed decision I just hope they can give me the reassurance that I need (ie that they will agree to my request if I follow their pathway, and jump through the hoops and it's still what I want). I already have a list of things I won't consent to (vaginal examination, forceps, ventouse, induction etc).

Oh And on vaginal examinations my GP said that they are not usually required if the pregnancy goes well and you have a c section (although you obv have the catheter etc during surgery) -I was concerned about post birth examinations. Yes you gave to be prepared to consider them if things don't go as planned, but I suspect like me you have coping mechanisms for that. If you ever want to chat message me. You are not alone in feeling this way. X

Hi currently ttc dc2. Because of my first birth I only want to give birth by elcs.
No one I know and no one I have heard of who has given birth by elective c section and has only had one or two sections, has any long term problems or trauma from this. Totally different case to my Vb.
I’m following this closely as I’m scared of falling pregnant and being bullied to have a vaginal delivery.
I just keep thinking that they want to keep costs down and what could we do if they refuse? Not a lot really baby has to come out and if they say no caserean section baby will exit vaginally if we like it or not. It’s so disempowering to think of and we wouldn’t have much chance if the consultant is anti c section and with the backing of the hospital bosses all wanting to keep costs down behind them. It’s quite terrifying really I keep changing my mind because of this about whether or not I really want to conceive.
I agree with the above poster who suggested if men gave birth there would be choice/better pain relief options and any issues after birth would be taken seriously.

Also I have read despite the nice guidelines that of requests made for caserean sections with no medical reason (what we are asking for) only 50% are granted. So what happens to the other 50% of women? They obviously still wanted the section if it was refused. It wasn’t a case of them changing their mind. So therefore they must have gone into labour terrified and bullied by doctors it’s awful.

@Incywincyteenyweeny totally agree, I feel like I'm being bullied by these 'doctors' to give birth 'naturally' again.
I don't call a baby being dragged out of you by forceps very natural personally. And there is no way on this earth I want it to happen again. Especially with the complications it can cause later on in life!
I'm sick of hearing percentages and numbers and being told that I'll be absolutely fine 2nd time round!

Hi Emily sorry to hear about how you are feeling. You don’t need it when pregnant.
The way I view it women wouldn’t ask for major surgery, if they weren’t sure it was best for their health. You have nothing on your agenda other than your health and the health of your baby.
They have one very big agenda. Money. Yes they are concerned with your health as in getting you both out alive. But they don’t care about your mental state or the state of your pelvic floor in later life. That will be a gynaes surgeons problem to sort out later on if a woman needs surgery for prolapse. It’s terrible that you could have a ‘successful vaginal delivery’ yet no account for a prolapse and incontinence that follows possibly needing surgery later on. and women are just left to get on with the mental trauma from childbirth ‘you have a lovely baby it’s worth it’ is a personal favourite of mine.
I really believe they don’t want what is best for women. Not to sound hysterical and I don’t believe they want to cause harm to women, but I don’t think they think about the bigger picture and risks and benefits in that way.
I think there is also a lot of manipulation of the statistics.
I haven’t got there yet but all I could think to advise you would be to inform yourself about the actual statistical risks (nice guidelines provide a good summary at the end in tables). And tell them they can’t predict a vaginal birth would be fine and that you won’t be bullied. If they do tell you it will be fine, ask them the statistical chance ‘it will be fine’ whatever that even means. Ask them to put that in writing if they are so sure ‘it will be fine’ I’m sure they’d agree to that....

@Incywincyteenyweeny @emily199027 I totally second the point around stats. I even did an FOI to my local trust to get data on first time moms over 35. It showed that over a three year period the percentage of women who laboured and gave birth with no intervention and suffered no injury was just 7%.

Emily, be firm with your midwives and consultants. If you've had a traumatic natural delivery you are well within your rights to request a section. Don't take no for an answer, and if they refuse (which technically, they can't) ask for another consultant.

I had a very traumatic and long labour with DD1, which ended with her in distress, her heart stopping and having to be rushed into theatre to get her out. I requested an elective with DD2 and was coerced into a natural delivery. Didn't go to plan and ended up with an emergency section again and just wish I'd been firmer with them.

If it's a first pregnancy then I'm all for trying for a natural delivery as it's much easier to recover from but if you've already had a traumatic first delivery then you are well within your rights to request an elective.

I'm pregnant with #3 now and will definitely be having an elective (though that is recommended after 2 sections anyway)

Hi Op, I could have written your post when I was pregnant with DC1. I had always been afraid of childbirth too and suffer from anxiety/panic attacks. From the very first midwife appointment I was very open about this and how I felt that an elective c section was the right choice for me. I had to be assertive, jump through quite a few hoops (see a consultant midwife and a psychologist) and show the consultant that I was aware of all the risks etc, but they did agree to it. It was absolutely the right decision for me. It was a calm, special experience - I took my ipod and they played my playlist I'd prepared specially, I got skin to skin straight away and it was all very stress free. Yes, it was a painful afterwards, but was fine with painkillers and I wasn't knackered because I hadn't been in labour for days on end. A very positive experience. Good luck.

I had to have 2 elective c sections (for medical reasons I was not given any choice in the decisions) and it isn’t as easy as people might imagine. Recovery is very slow and with my 2nd I had to have a general anaesthetic as the spinal didn’t work...so missed my daughter’s birth altogether. :-(

@Incywincyteenyweeny @Laney79 @LauraO1905
Thank you ladies. My midwife is very supportive, she's actually got me an appointment on Thursday to discuss my options as my 28 week meeting with a consultant turned out to be a less than 5 minute check up with a man who wasn't even a consultant. He even called me Vicky in my notes!!!
They keep putting me off until 36 weeks, which to me is very late (and my midwife agrees) to be making big decisions like that. I am going to really push for an ELCS, after my meeting with the man at 28 weeks I decided I was just going to try to go natural again because no ones listening to me or taking me seriously, but after seeing my midwife, I've decided that an ELCS would be best for me this time. I really struggled to bond with my son for the first few weeks, and I think it was mainly because I don't remember him being born, and I didn't like him for the pain and trauma he caused, and that's horrible and I feel terrible! No one should feel like that about their baby!