How to go about elective c section in low risk pregnancy

[BeckyG86]

Hello everyone.

This has probably been covered before and I apologise for any repetition, but I can't find a thread from before. I have just commented on another thread briefly mentioning this but as I want to ask advice and questions about this I felt a new thread was best.

A little background about me. I am 33 years old, married and am 32+3 weeks pregnant with our first baby. We are having a baby girl. I am not on maternity leave yet, due to finish work on 13th December (baby is due 2nd January). I work full time as an ICT tutor so my job allows me to sit and stand to my heart's content, so no manual handling or heavy lifting, so I am happy to work as long as possible before our baby girl is born to allow me to spend more time with her when she is born.

I have Emetophobia (fear of vomiting) that I am undergoing CBT for, and have been since I was about 5 weeks pregnant. This is due to finish in about 4 weeks time. I suffered with anxiety as soon as I found out I was pregnant (it was a planned pregnancy and I knew it wouldn't be easy for me with the Emetophobia). I was having some kind of anxiety attack at least daily. I felt sick but feel this was more due to the anxiety. I didn't want to go out, go to work, go in a mini break we had planned, couldn't plan things in advance or bring myself to feel excited in those early days even though I was as I felt I was asking for morning sickness (silly I know). I still did everything as normal though and this eased closer to the second trimester.

In the back of my mind I have had worries and concerns about labour, which I know is common and normal. Now that I am due in just under 8 weeks time it is getting to me even more. For months I have talked about the idea of opting for an elective c section as the anxiety and fear of nausea and vomiting in labour are so high. I know you can't guarantee anything but this option along with a load of anti-emetics feels like the best option for me and the one that would seriously reduce the anxiety and fear for me. I have been trying to think of things to help me with a natural birth but I hear too much about people getting nausea and vomiting during labour and when using certain methods of pain relief, and it just gets me more worried and the anxiety will start soon.

I am considered low risk. Our baby girl is healthy, all tests including the glucose tolerance test have come back clear, baby is growing well (I am on the smaller end but not under the lower centile line, and last time I was under the average centile line so there are no worries or concerns). The only things I have had as a sort of worry are a bit of slight discharge when I was about 6 weeks pregnant, but so slight it would have been easy to miss (I paid for an early reassurance scan and all was fine), one visit due to reduced movements (but she became more active on the journey to hospital and all was fine) and they took me for one additional scan as I have a small fibroid that was spotted on my 20 week anatomy scan (at 29 weeks they said there was no change and they weren't concerned so they are not doing anything about it). This is all good news and I know people would give anything for this and the chance to have a natural birth, so in that sense I feel bad for asking about elective c sections.

I asked my midwife at around 14 weeks when I would need to discuss birth options and she she about 34-36 weeks. It is on my notes that I am Emetophobic and have anxiety with it, but I feel that they wont consider this and just persuade me to have a natural birth. So far my notes for child birth just say give me anti-emetics due to the Emetophobia because I am scared to write anything and they say no.

I know we can choose an elective c section but i know they will discourage it unless medically necessary. I understand why, and I understand it is not an easy decision to make, but I feel it will help me with the anxiety.

Has anyone here gone for an elective c section for similar reasons? I don't mean because medically it is advised but for personal choice, and if so how did you go about getting doctors/midwives to agree with it? I suggested it to my midwife and she pulled a face!

Any advice would be greatly appreciated. I am going for an ante natal class on Thursday so I hope they can advise me but I feel lost, scared, worried about not getting listened to or what I want, and time is getting closer and closer!

Thank you in advance.

You need treatment for your phobia. You need to think about what happens with your baby. The little blighters vomit all the time.

Just to give another view - I went through labour but ended up with an EMCS with a spinal. In contrast to others, I vomited a couple of times through labour, but was fine in the C section and afterwards. I found the shaking as the anaesthetic kicked in to be the worst side effect. Id planned on using gas and air in labour, but found it made me queasy (similar to an unpleasantly drunk sensation) so didn't continue with it. I was in a hospital that took a very conservative approach to post-C section recovery and pushed for you to lie down for up to 24 hours (abroad at the time) so don't know if that reduced nausea as I had limited movement.

Hope all goes well.

I've had a vaginal birth and ELCS. I didn't feel sick or vomit in either. Personally I found the whole experience, from delivery to recovery, much much easier with a c section but then I had a difficult first birth with lots of complications. Good luck with whichever you choose.

I'm emetaphobic too, it was agreed no pethadine for me and I stopped the gas and air as it made me feel sick. The pushing stage did make me feel sick and I was sick. I will say though usually when I'm sick I have a panic attack during labour I didn't care, my my and husband High fived they were that proud of me throwing up 🙈

Thank you.

I'm sorry, I am not very good with using this so not tagging or quoting.
Someone said I need to go for treatment for my phobia. I am currently undergoing treatment. I have been having CBT since I was about 5 weeks pregnant (I am now 32 weeks) and I have done the Thrive Programme book (not a meeting with them as I don't know anywhere around here that does it, and not sure on the costs if there is anywhere)

It was a big step for me to make the decision to have a baby due to Emetophobia. I knew there was chances of morning sickness and I would have a lot to deal with mentally because of it, but having children was something both me and my Husband wanted, we are both 33 years old and said if we are going to try for a baby we needed to do so sooner rather than later. My Husband is brilliant, but it wasn't fair on him either to be kept waiting! We are genuinely over the moon and can't wait to meet our baby girl, I just need to get over the labour and recovery hurdle now that the first trimester worry is over (now that I am in the third trimester!)

Strangely baby sick does not bother me, its milk, it is bug sick that gets me. I know I need to face it, and it has been brought up in CBT. Also my Husband would help in that department. I can't leave it all to him I know that, and I know there could be times he is not around when our daughter is sick, but he understands what I am like and how it affects me so would help. When I have been sick in the past (twice since being together) he has been brilliant with me because he knows what I am like, so I know he will be the same with our baby girl.

I think I need to sit with medical staff and have a real heart to heart.

I had a c section and could not stop vomiting and shaking. So much so the surgeon severed an artery. Not trying to scare you here but I’ve heard it’s much more likely with a c section.

I had really bad nausea in theatre after having my elective c- section.

I had 3 natural births without vomiting, my DD who, like you is emetephobic, has also had 3 natural deliveries. In the long run natural delivery is far less painful than a c section

Labour sickness isn't bug sickness. You don't catch it, it's not something living in you. It's just your bodies reaction to hormones (or painkillers if you have them).

Try to think of labour sickness like milk sickness. It's nothing you've caught, just your body coping with labour.

I have had three natural birth and no nausea or vomiting.
My fourth and final baby was difficult (stuck and dislocated shoulder) and ended up emergency C-section. Unfortunately, I reacted to the painkillers and vomited for several hours in recovery. I even had to have a few stitches and the glue stuff redone because I was retching very hard.

I just do not think a C-section helps you avoid vomiting. You have had good advice on which pain killers and drugs to avoid.

I had been in labour for 48 hours before my emcs, they didn't allow me any food, so I hadn't anything to be sick with, if you get my meaning. As you go down to theatre, they usually give you some antacid tablets like omeprazole to swallow & the anaesthetist is next to you while the section is done, you only have to tell them & they put drugs in to stop whatever is happening. I would try & see someone for hypnosis before your due date to help you mentally to relax whilst the section is going on if you manage to get one.

@BeckyG86 - after my forceps & my one throw up, I was 100% fine. It was horrible throwing up when laid flat and it took me a little while to stop shaking & get over it! But 20 minutes later, I was in recovery & holding my baby feeling great! I felt sick my entire pregnancy & 20 minutes after birth, I didn’t feel sick anymore at all. It was incredible! When I got down onto the ward, I was presented with dinner & I wolfed it down like it was the best meal I’d ever eaten! I wasn’t sick again.

I forgot about painkillers, I cannot stomach even low level coedine. They make me sick. But in hospital they prescribed one called dihyrocoedine and it was a revelation. It was really strong but no nausea or sickness. Worth a shout!

Def be open & honest with your medical professions, they’ll support you! And you will get through it!

I had an elective for my first born, on maternal request. I have fibromyalgia and was suffering bad SPD so was concerned about the physicality of birth. I only had 2 meetings, the first dr tried to put me off, but not aggressively, and in the end said think about it for 2 weeks and come back. The 2nd dr asked if I what I decided and I said elcs and they said fine and booked it as maternal request without hassle.

My operation went smoothly and my recovery was quick and easy, so generally I would say if that's what you feel is best for you then go for it. But I'm another one who felt incredibly nauseous about half an hour post surgery as the spinal block wore off. It passed relatively quickly, but it is a common side affect from the anaesthetic.

I think there is a risk of sickness and nausea whichever option you choose, but you may mitigate the risk somewhat if you aren't anxious, so go with what you feel most confident with.

Another one here who threw up during a C Section, and given I was flat on my back and couldn't move it was particularly stressful.
Def speak to your midwife but I'm not sure Sec is the answer you want it to be

Just echoing what many others have said but a section is likely to have you heaving your guts up.ive had two - an emergency and a planned - and before the planned one I actually sought out guidance from an anaesthetist weeks beforehand, because the nausea and vomiting was so horrendous the first time. The answer seemed to be that both a spinal block and an epidural are likely to make you throw up. I vomited for hours after the planned one - right up until it was just dry painful heaving. Sorry.

OP you sound just like me, up until pregnancy I actively avoided taking medication in case it made me feel sick.

If you've been doing CBT to overcome your phobia I'm assuming that you have been in contact with the perinatal mental health team in your area? At the hospital I gave birth in there was a fantastic mental health midwife who created a birth plan with me, meaning that I had anti-emetics through labour and a private room to recover in overnight as I would not have coped on a bay with the fear of others feeling/being sick around me. If you haven't already, please get in touch with your local team and ask for their help. I found it really reassuring.

As for labour I managed the whole thing on a TENS machine, paracetamol, gas and air and an couple of different types of anti-emetic. One anti-emetic at the beginning, just in case and another later because I thought I might be starting to feel nauseous. At no point did I get to the stage where I was panicking about feeling sick though. I was a little dubious about using gas and air because of the whole nausea thing but the nice thing about gas and air is it is incredibly short lived so if it makes you nauseous you just stop and you get almost immediate relief from the feeling.

I have Emetophbia so i can fully sympathise
it is awful.
I habe 3 children. I emergency c section after a horrendous 3 day labour where i vomited with every contraction.
I also vomited with the spinal with my c section.
second child planned c section due to her having a malformation in her brain.
I vomited badly with the spinal.
third child planned c section.. i asked for anti emetics and still vomited badly throughout the procedure.

I’m so glad I didn’t see this thread before my section! OP I was in your exact position and chose ELCS because I read many more stories of women being sick in natural labour. My experience was brilliant, didn’t feel remotely sick during the op. As many have said, it’s almost always the painkillers. In recovery, they gave me a morphine drip and that made me dizzy almost immediately so I had them turn it off before it got worse. As it turned out, the pain was totally manageable so I only took my own Solpadeine or ibuprofen afterwards.

I vomited for hours after my emergency C-section. I couldn't even hold my baby because I was so sick. However, with my elective C-section I made sure to tell the anaesthetist that I didn't want to feel like that again and that I wanted anti-emetics. Although they don't give them as a matter of course, they did on request. It worked like a dream and I didn't feel the slightest bit sick. So if that is the route you go down I hope it works as well for you.

I think I need to sit with medical staff and have a real heart to heart.

^ yes do this, good luck to you.

A friend had an elective c section last year just because she was nervous about something going wrong in a natural birth and no one turned her nose up at her, if it's what you want just say!

I have a similar phobia to you and I must admit the idea of being sick during a csection terrifies me more than a natural birth as at least you can be upright and move around in a natural birth whereas i think id almost feel claustrophobic on an operating table and if I felt dizzy/sick and lying on my back would make me feel worse

The idea of a c section terrified me. To be cut open and not able to be close to my baby immediately. I remember crying on the way to theatre because I so badly wanted a natural birth. I was looking up at dp holding her and he told me it just felt wrong and I should of held her first. I wasn’t sick at all but it was emotionally so draining as I had done most of the work on gas and air.
I think you should really consider a vaginal birth if you can. I think I will have no choice In having a c section again because my baby was in difficulty and the other reasons I had to have a section.
You get a horrible scar and I can see why professionals want it as a last resort option.

i had a vaginal delivery for my first pregnancy and had pethidine and gas and air, and no inclination to vomit at all.
Just a thought - if you would consider a vaginal birth, could you ask to try out gas & air in a delivery room when/if one is free?

Vaginal birth here with just gas and air and not even a hint of nausea before or after (despite feeling it most my pregnancy!). I told the MW firmly that I didn't want pethidine due to risk of being sick and was actually scared to try has and air for a while but Mw gave me tips on how to use it to avoid the drunk/sick feeling.

Basically keep eyes closed during puffs and for a few secs afterwards (in the bit in between contractions) and you won't feel drunk. It's when eyes are open and you get room spin that apparently the nausea can set in.

Hi OP, I know you have asked for advice re how to get agreement for a c -section, and I don't have any...but just wanted to add to the people saying you have a reason to request it! I do hope that you are supported in thinking about the pros and cons from a kind and knowledgeable health professional given your phobia so you feel reassured you are going down the best path for you.

Best of luck.