Declined c section even though high risk??!

[2020lockdown]

hoping to get some advice. Essentially, my pregnancy is high risk because of baby (not because of my own health). He has a cleft lip and palate, and to cut a long story short we’ve had a very very rough pregnancy (we were told by a doctor he had Edwards Syndrome at 20 weeks, and then told he doesn’t! Results came back clear etc.). So a very tough ride but everything looking ok now and he’s growing well. I’m now 33+3 and today my request for a c section was pretty much ruled out by my consultant. I was so surprised by this given the journey we’ve been on and the baby is still technically high risk, and needs a full assessment by a surgeon when he comes out. Can anyone shed some light as to how I make this c section happen? I’ve considered all the risks, and am fully confident that this is my birthing preference. I now feel so uneasy that we have only weeks to go and I have no birth plan in place or date etc. and deflated that given what’s happened I even have to fight to get this c section.

I don't think they can decline tbh.
I'd push it again. Say you've researched all of the risks and still feel that it's in your baby's best interests and you want a c-section.

Sorry you are going through this OP. I would refer them to the NICE guidelines on maternal request for c-section. I’ve taken a screenshot for you. The last point is particularly relevant. Definitely ask for a second opinion.

www.nice.org.uk/guidance/cg132/chapter/1-Guidance#planned-cs
Link for you too.

Thank you this gives me reassurance, and I'm definitely going to keep pushing. I'm going to phone the midwife first thing to talk about it again, as I just feel so anxious and not in control of my own baby's birth.

Just to add that even with a pretty much guaranteed section for my last baby it wasn’t officially agreed until 36 weeks. It’s very stressful without the additional worries that you have. Good luck!

Sections can be and are refused- the NICE guidelines are guidelines not rules. I had to fight tooth and nail for mine. Definitely show them the guidelines but be prepared for them to still refuse. Get a second opinion and also ask your midwife for advice on which consultants might be sympathetic. I wasn’t prepared for them to keep refusing mine and they didn’t give in until 39 weeks. Good luck.

Does a high risk pregnancy necessarily affect the birth? If a vaginal delivery is considered safer I think you have to be very clear why you want to go against the doctors recommendation. I have no idea about your rights as to whether you can insist.

Hi OP just to let you know some trusts can refuse maternal requests for C sections! Follow this link and see if your trust is one of them!

www.birthrights.org.uk/campaigns-research/maternal-request-caesarean/

Also I literally had a phone conversation with my consultant today as I’m high risk as well and I was unequivocally told that a vaginal birth is better than a ELCS.

It’s obviously very situation specific and I’m not familiar with cleft pallet babies. May I ask what makes a vaginal birth high risk in your case?

Mines high risk because my waters went at 25 weeks, I have no amnio and my baby will be delivered “premature” at 34 weeks. Still I was told vaginal birth/induction is absolutely the best option. I (thought I) wanted an ELCS But I have to say even before our convo today my research even confirmed an ELCS wasn’t the best option for a variety of factors!

Again very situation specific so I’m not trying to presume anything here, just wanted to share the relevant info I was given today x

I wish I read this thread prior to my CS.

My consultant asked me I front door a room full of other expectant mums "you can go home if you want, you could do it naturally..."

My baby was 10lb 1oz, I had too much water and he was stuck and needed forceps - this was during C-Section. My consultant said "you definetly made the right decision, this was the safest option"

Despite making me cry and feel like I was being vain and demanding for wanting a C-section.

I was part of a "big baby trial" where they wanted to see what would happen to big babies if their shoulder would dislocate during birth. This petrified me, they had no problem filling my head with anxieties but wouldn't listen to my worries.

Not to mention that my scars keloid severely, so tears would become a big problem for me.

I wish I put my foot down more

My 4th baby had cleft lip/palate. I understand how worried you must be. I think you should ask for a c-section based on maternal request rather than the baby's cleft lip and palate.

OP why have you decided you want a CS? Pregnancy being labeled as high risk doesn’t necessarily mean delivery should always be by CS, sometimes the opposite. Cleft lip/palate is not a reason to have a CS - however maternal request is a valid reason for it. You just need to think carefully through your own reasons, and talk them through withDr/midwife. I understand that you just want to feel in control and that is valid- sometimes there are ways to make yourself feel more in control with vaginal birth as well. Talk to your team, ask for second opinion, try to take into account all the info and then push for what you think is right for you. Good luck.

My friend’s son was born with a cleft palette and they encouraged her to have a c-section because of this (she accepted)!

Are you aware that partners are not allowed in to surgery during the CV19 crisis? I just mention it in case you didn't know. I had two emergency CS and I would have been a wreck if DH couldn't have been with me. Plus he would have been devastated to miss the birth

Go into your meeting looking seriously business, with a laptop or notebook and say brightly ‘i hope you don’t mind, I’m taking copious notes, just in case this does not pan out as we’d like. Now, are you saying that it is your actually clinical opinion that a natural birth rather than our strongly desired c section, will have the best possible outcome for my baby and me, given baby’s health issues? Are you happy for me to note that here with the date?’

You’ll have your section in no time. Sadly.

Also I would have taken my delightful wonderful speedy section with no DH present over my gruesome car crash natural birth with him there and traumatised and helpless any day.

@legalseagull while that may be true in some hospitals, it is NOT true in the majority. There are restrictions on how long partners can stay etc but they generally can be there during the actual birth (vaginal or CS).

They can be there for the birth but guidance is for them not to be allowed in theatre. So for a CS

@legalseagull this is from the rcog website.

Like I said, it may be true in some hospitals, but not across the board. Obvs in some emergency situations/general anaesthetic etc partners can't be there, but I understand that's the case anyway.

www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/#choices

Most caesareans and instrumental births in theatre are carried out under spinal or epidural anaesthetic, which means you’ll be awake, but the lower part of your body is numb and you cannot feel any pain. In this situation, everything will be done by the clinical staff – midwives, obstetricians and anaesthetists – to keep your birth partner with you

Just to say,you can have a C section,you don't have to justify your reasons on here. Ask for a second referral to another consultant. And you can't have your birth partner in the surgery with you. Birthrights is a much bettersource of info than Mumsnet x

This happened to me. I allowed myself to be talked out of it. I ended up with one anyway, and nearly a very bad outcome for both of us. I would just keep pushing and pushing.

I had also had a previous failed labour that ended in c-section with complications. was told if I got pg again I would have to have a c section no choice, to risky. I assured them after this I would not be having further children. I might have had they had respected my choices.

I wrote a letter to my consultant. Take out the emotions. Laid out my reasons. Called out the risks to show that I'd considered them. He didn't like it, but I had my CS. Was definitely the right choice for me. Goof luck

@legalseagull my trust specifically has note on this. Dad's will be contacted when transfer to surgery is happening. They aren't allowed to attend before, or after, but are to be there for the surgery and are allowed in recovery just not when transfer to the ward happens.

Thanks all. Feel like I should keep pushing then. And thanks to those that gave advice on what I should actually do to push getting this, as that was my only question.

And To be clear, my hospital IS allowed partners in theatre, and because of the horrible journey we've been on, we've even been told it's likely my husband will be able to stay with me on postnatal. Our baby will have very specific feeding requirements and we have been told we can't even feed him until he's been assessed, so my husband has to be there to be able to learn to feed our baby too. We haven't been on the average pregnancy journey - it has been horrific. On 31 January, we were told our baby boy was going to die and we would never be able to bring him home. So When I say I've done my research and considered the risks of a c section, I mean it.

@legalseagull please don't give out advice that isn't factually correct, it could be really damaging to someone. You'll see my response above clarifies that partners ARE allowed to present for c section in my hospital.