Elective C Section

[LKH27]

How far in advance can you book a C Section? Assuming you don't go private.

I'm not considering it as an easier option, I want the safest thing for my baby, which is a c-section, that's all that matters to me at the end of the day. Most of my friends have ended up in very dangerous situations and ultimately having emergency caesareans and I am very fearful of what could happen. Interestingly on the costs, the latest NHS study recommended more use of caesareans even on cost grounds as while the initial procedure costs more, there are so many more complications with vaginal births that overall they end up more costly.

It was confirmed and booked at about 25 weeks when I had a consultant appointment. I'd been asking for it since my booking in, and all the way along had been told it should be fine. I was under the care of the perinatal mental health team for tokophobia which actually turned out to be due to PTSD and I'll soon be having therapy.

It definitely wasn't the easy option - 12 weeks later and I still have some pain, though I think that's SPD-related too. But without it I wouldn't have got pregnant in the first place, despite very much wanting a child.

@Cinderella812 NICE guidelines state women now have the right to an elective for non medical reasons. I was talking to a consultant about it the other week, they are not able to refuse although it IS more costly to the NHS if there are no health related indications for CS. They can't force you to have a natural birth so don't get upset and anxious about it, you just need to calmly insist.

Cinderella make it clear at your booking appointment. Quote NICE guidelines. Ask for a referral to whatever counsellor, birth choices clinic or other hoop they’ll want you to jump through right away. IME the midwives were very understanding of why I wanted a c section, it was the consultants who were shit about it. Take your partner with you and ask them to advocate for you.

If you get nowhere, immediately contact the head of midwives at your local unit and ask for an urgent meeting. They usually know which consultant to send you to to get things signed off rather than seeing just anyone.

The only thing I'd add to the good advice above @Cinderella812 is that the consultant didn't want to see me until after my 20 week scan although my midwife had said earlier that there would be no issue having a c-section. I never had a battle though, they were more than happy to accommodate my wishes although I did have the support of a psychiatrist which helped.

As others have said it varies per hospital to what degree they follow NICE guidelines. Mine has an extremely negative policy toward this. What's worse, they pretend to be open to requests, wait until after 30 weeks for a consultant appt, and then refuse at the last moment. To avoid all this I saw my GP in week 13 and asked for a referral to another Trust, which had been recommended by Birthrights. They were lovely and agreed right away after a discussion with the consultant at week 20. I'm sure it could have been arranged earlier too if I had wanted. So if you get any negativity, my advice would be to consider another hospital and bypass the whole midwives/consultant/mental health hoopla. In parallel you could continue that route of course if you prefer your local hospital, you can always cancel with the other one (they stressed that I could ALWAYS change my mind!).

Mentioned it at my booking appointment, had it signed off by both the consultant and surgeon at about 20 weeks (literally. I may be a tad paranoid!), due to go in to book the date at about 32 weeks.

Totally elective and not based on phobia.

Hospital policy varies so check out Birth Rights and your local hospital's individual policy which can usually be found online with a bit of digging. If they quote NICE guidelines in full you shouldn't face a problem. I researched, self-referred to my preferred hospital (which was unbelievably easy) and have had no problem following a rational chat with the surgeon and consultant.

Incidentally, a couple of myth-busters:

1. the 6 week no driving - the vast majority of insurers actually have very loose requirements requiring you to take the same common sense approach you would after any surgery, or occasionally ask you to confirm your doctor has okayed it. Have a check.

1. While c-sections are a greater upfront cost that difference dropped significantly when only the cost of follow up treatment for incontinence is taken into account (again, see Birth Rights or the NICE 2011 economic modelling). Electives are also considerably cheaper than 'emergency' c-sections which risk you are running when you opt for a vaginal birth.

I'm not advocating c-sections particularly - all ways have their risks and benefits and the are no great options! - but there seems to be a confused and scare-mongering approach to c-sections that I think could do with some sensible confronting.

I requested a csection and they really tried to steer me away but I was persistent, it got to 20th May (38+2) and they still hadnt given me a date, we called Pals and complained, they called me yesterday and I am booked for next Wednesday. I suffer from anxiety and a heart condition and made it very clear from the start. This just heightened my anxiety because it was getting closer and closer and I didn't know. If you are still waiting for a date so close its definately worth giving pals a call because they will help you out