Elective caesarean?

[kara000]

So I’m considering asking for an elective caesarean. This will be my first baby. I realise that an unassisted natural birth is the ideal option, however in the UK 15% of births are assisted (ventouse or forceps) and in most cases with assisted births the doctors do an episiotomy. I’m more concerned about the baby though as I have read some awful things about forceps being used and in most countries they stopped using them a long time ago. The UK has the highest rate of infant mortality in Western Europe, partly because of the use of forceps. This is why I want an electivecaesarean as it is the only way to guarantee that forceps won’t be used. I know people who’ve had very long labours and ended up having an emergency caesarean anywaywhich is more dangerous than an elective.

I spoke to my midwife and she said I can’t have one as it’s too expensive for the NHS however on the NHS website it says it is a women’s choice and if one consultant refuses you should be referred to another one who will. I have a telephone appointment with a consultant soon to discuss this as I had to tell my midwife it isn’t her decision it is the consultant’s. Any advice on this would be appreciated, thanks!

You do have the right to request one but you have to see a psychiatrist first who makes the recommendation. I did due to a family history of still birth and also forceps delivery leading to brain damage. In the end baby was breach so I would have got one anyway

BUT given the current pandemic I can see why they aren't allowing pure elective ones with zero medical needs.

I would however do what I was advised - on ALL paperwork state you would refuse permission for a forceps delivery that way the midwives are aware that if things aren't progressing you would need an EMCS.

I did not have to see a psychiatrist.

@Uptheduffy

Really? Although mine was 4 years ago - in fact I had to see 2 blokes and never thought they'd sign it off! To be honest It was the best 1 hour of therapy - unburdened my soul and they wrote on the report I was a control freak (took my husband years to realise that!) 🤣

Hi op, I had a horrible first birth with instrumental delivery, leading to a severe pph. I would never have an instrumental delivery again, although I know this isn't always the case for everyone.
In two weeks I'm having an elective for my second birth, I had no issues getting it. So id certainly ask for one and see how you go. The NHS seem to be very maternal choice at the moment.
The other alternative is you add to your notes that you don't want an instrumental delivery, and make it clear to them when you arrive at hospital, when I had been pushing for too long with ds they asked me if I wanted forceps or c section, as it was time for them to intervene. So you could always try naturally if you felt able too, as you may have no issues pushing the baby out without any help. My ds was back to back which didn't help. Then take the section route if it's needed.
Good luck what ever you decide.

I didn't have to see a psychiatrist and nor was I referred to the perinatal mental health team for counselling. It's to do with your reasons for requesting an ELCS. If it's anxiety or trauma related then those services may be beneficial but if, like me, it's down to the associated risks, there's nothing anyone can tell you that will change those. There are no guarantees with childbirth, regardless of delivery method.

@Caneloalvarez I was very lucky! My consultant actually said to me that it's luck of the draw with regards to who you see. It's very much down to their views and discretion unfortunately. I agree with you, it's a real shame that some women have to jump through hoops and suffer real stress due to the uncertainty.

ivfgotto I'm glad you got it in the end!
Do I didn't I explained how I felt to the consultant and she was quite happy - another one may not have been I suppose. This was about 13 years ago.

I've had 2 elective c sections. Good recovery from both. Stick to your guns. Say that you've read the nice guidelines and royal college guideline and are fully informed of the risks of section but want one anyway. They will do finally ask u at each appointment, actually right up till they wheel you into theatre, however just keep saying he above and you will get one

Midwife told me no even though every time I went they told me how big I was measuring. Got to a week after my due date with my last scan estimated at 9 lb 5. They were going to induce me the next day but I had a wobbler just as I was leaving - trying to pretend I was fine but the reality was I was terrified of the baby getting stuck.

They got me the consultant and had a chat with her. She said she couldn’t guarantee he wouldn’t get stuck and if anything steered me towards a c section rather than away from one as ultimately it was my choice. She pointed out that he could be bigger than the estimate.

She did my c section the next day. He was 10lb 5.

Currently pregnant with DD. Due a c section in June. It was completely up to me this time - no pushing either way - but all I had to go on was how big DS was and I was 10lb myself. I’m glad I opted for the c section route now as I’m 7 months and she feels so big already. I’ve got a foot under my boobs and a hand wiggling down by my hip - feels like a box of frogs!

Hope you get the birth you want OP. I wish I could be in and out in a few hours - one of my friends was only in labour for 10 minutes! In both pregnancies though, the babies felt/feel massive.

Hi everyone thank you for your replies, so I spoke to the consultant this morning with all of my reasons for wanting an elective caesarean, he said to wait till I'm 32-36 weeks and see how things are then. I said mainly about my fear of assisted birth/forceps and he said that that won't be done without my permission and that we can go for a caesarean if the baby is struggling. He said there are many reasons why we may need to end up doing a caesarean anyway (size, position of the baby, etc). I said so basically I can't have a caesarean through maternal choice and he said he would write on my notes I am in favour of one if any complications arise. I said about being referred to another consultant or health board and he said it's too early for that and it may be the case I need one anyway. I still feel I may not have a choice in this and may need to look into the private route as obvious the nhs is under enormous strain right now, or like a previous poster said wait a couple of months till things may have improved a bit and ask again. The area I'm in has had the highest rates of covid outside of London. Not really happy but not surprised, I will speak to the Midwifes again when I go for my next scan at 20 weeks :(

I had a c-section 10 days ago, following stall in natural labour at 9cm dilated (2 hours). Baby was breech so it was felt best (by myself and medical team) to go for EMCS.
I was up and about the next day, I did have a horrible headache for a couple of days which I struggled with, baby also in NNU and no partner allowed. However I am now feeling heaps better physically and nicely mobile. Scar is numb. The tiredness is another issue but you’ll get that whatever mode of delivery!
Anyway I never wanted a c-section, but have been pleasantly surprised by recovery.

Hi OP, I chose an elective one and my hospital were fine with it I just had to go through a process but I believe if they won't they they do need to find you a hospital that will. I did have to go through the counselling of two separate people to check I understood. I found one very pushy for a natural birth and couldn't give me stats I want on emergency v elective. I had no problem it being agreed too though. My DS did need to go in to Neonatal overnight due to mucus on his lungs but he was fine after that. I am debating if I would try a VBAC next time just because of recovery and I did find it very clinical and it is a major op, plus sometimes I do wonder if I missed out on something - I think this is more how other people have made me feel. But I suspect I will probably choose an elective again for the same reasons I did the first time. It was the right decision for me for my first pregnancy. Best of luck OP x

I spoke to the birthrights charity who said that most trusts won't allow you to change after 28 weeks so surely if I leave it till I'm 36 weeks to arrange the elective cesarean it could be too late if all the available consultants I speak to at my trust don't want to do a cesarean. Just seems like in theory and on the nhs site it's meant to be a woman's choice but the reality is far from this

I didn't have a problem with that I said at my first appointment that's what I wanted and they set the wheels in motion. I am unsure if different trust have different policy but I would perhaps double check that with another person in antenatal department. X