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Pregnancy

Speaking to midwife about elective section

25 replies

duckling3 · 14/07/2020 19:20

I have my midwife appointment tomorrow and I've decided to ask her about a maternal request c section. (I know it can be a controversial decision, but I've done my research)

Its probably silly, but I feel really nervous about it. Like I need to prepare myself to be judged, or have to justify that my reasons are valid. My friend had the same midwife as me but two year ago, and whilst I dont know the midwife very well yet, she is apparently a tough cookie.

Not really sure if there a point to my post, other than to try and get some of the nerves off my chest by writing them down.

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Hercwasonaroll · 14/07/2020 19:23

I think it will depend on your reasons. Some maternal requests are seen as more justified than others. Off the top of my head previous trauma, prior sexual abuse and refusing induction and straight to a section for a second child, all seem to be looked upon more favourably.

"Because I want one" is definitely less favoured from midwives so be prepared to stand your ground. Ultimately they can't refuse.

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Sussexmidwife · 14/07/2020 19:36

Midwife means “with woman” It isn’t our job to tell you what to do. It is our job to support you and provide information.
If you have a clear reason for feeling that this is right for you I Would hope that you would not feel “judged” by your midwife. I support lots of homebirths but also elective c/sections
Happy to support if you need it x

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passthemustard · 14/07/2020 20:00

Not sure if it's the same as where I am but my midwife just referred me to the consultant to discuss a c-section.

He just said no.

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icedaisy · 14/07/2020 20:07

What are the reasons people are refused them? Is it cost?

I ask because that was never an issue for me, to the contrary it was positively encouraged and seems to be the same advice this time.

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Hercwasonaroll · 14/07/2020 20:11

Trusts are under pressure to keep the rates low, probably due to cost.
I also had to see a consultant. I argued my case for refused induction and after a bit of a battle they agreed.

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icedaisy · 14/07/2020 20:15

Thank you @Hercwasonaroll.

I was a bit unusual, had been discharged with no hope after many losses and failed IVF. Fell and carried Dd and consultant of all those years said section was safest and calmest way to get Dd here.

Was slightly relieved when they phoned this week and said section last time, do you want same again?
Very supportive.

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Evelefteden · 14/07/2020 20:18

I don’t think midwifes have that much clout to be able to say you can have a C-section. It’s major surgery so it’s consultant led.

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Quackersandcheese3 · 14/07/2020 20:35

I was offered a c section with ds as he was measuring big and it was the day before his due date and was moving less. This was at the hospital with a consultant as I’d gone in for scan .

2 years later preg with dd went to routine midwife appointment and she said I I should try vbac. Which I didn’t want but was only 9 weeks preg so didn’t question or put my wishes across. Had my consultant appointment few weeks down the line and she asked what I wanted , requested c section. She was totally fine with it. Didn’t question my choice or anything, I’d gone with a list of reasons!

Interestingly all the clinic midwifes were like vbac vbac vbac but one day a hospital midwife was there and said the consultant will go with your choice.

I found this quite annoying and stressful because if the consultant was going to go with my choice why where the clinic midwifes pushing vbac.

However I think it depends on what nhs trust you are in and also what your reasons are. Think some places offer counselling if you are afraid of giving birth.

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MumMrs85 · 14/07/2020 21:22

@passthemustard if you don't mind sharing may I please ask if the consultant gave you their reasons before they said no? I have a meeting with a consultant in September to discuss my request and would be interested to know what to expect. Thanks

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duckling3 · 15/07/2020 06:00

Thanks all. People on here can be so lovely.

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gonewiththerain · 15/07/2020 06:55

I’ve requested a section after an emcs. Midwife has been lovely about it,consultant did agree but tried to persuade me to vbac and didn’t give me a date. Hopefully the midwife will sort that this week as she said she would.

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squashie34 · 15/07/2020 09:08

@duckling3 May I ask the reasons that you are asking for a section? As PPs have mentioned, the reasoning behind why you want one may influence how the midwife/obstetrician reacts.

I've just been booked in for an Elective section, not for any 'medical' reason, other than I am absolutely petrified and have such anxiety about vaginal birth. I thought I would get a simple 'no', but as a lovely mumsnetter on here recommended, I wrote a letter to hand to the consultant, outlining my reasons behind wanting the section and showing that I had done my research into the risks/benefits of both types of birth. She read it and agreed straight away and I was booked in.

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duckling3 · 15/07/2020 10:48

I spoke with the midwife this morning. Ended up with a different one to normal but she was lovely. She has referred me to see the consultant midwife, and whilst she cant promise they will say yes to my request, if the mothers feels strongly that she really wants one, for whatever the reasons, that is something which will be listened to.
Only downside was she said that they may not offer me an appointment until 36 weeks because there are no medical risk factors., but I'll ask again at the next midwife appointment if I haven't heard anything.
My request is on the grounds of anxiety and fear around the birth and the potential things that could go wrong. Perhaps I will prepare a letter in case it will be helpful.. great advise thanks ☺

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Needmoremummyjuice · 15/07/2020 10:55

Iv got an ELCS planned for 39 weeks at my request and I found both the midwife and consultant really helpful and sympathetic. I saw the consultant very early (around 12 weeks) as I had a traumatic first birth and she booked me into her diary at that appointment. I think a lot of people think MW/Cons are being negative but they legally have to give you the risks of a CS (even Electives are not without complications) so you are consenting to surgery in an informed fashion.

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mintich · 15/07/2020 10:58

In my experience they just need to hear a reason and that you have read up on and understood the risks.

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squashie34 · 15/07/2020 11:07

@duckling3 so glad you had an understanding midwife! Did she write it in your green notes/on the system? It will be useful for the consultant to see that you have mentioned it earlier on so they know it isn't a snap decision.

I didn't see the consultant until 36 weeks either as although I was under consultant led care I only ended up ever seeing one of her juniors. This is when I gave her the letter and then she read it before the appointment (I handed it in with my green notes to the receptionist) and then we discussed it and she booked me in there and then. She even told me she had opted for elective sections and had performed sections on a number of surgeons who had elected and was very much in agreement that maternal choice is important.

I had however saw the gp in between that time for my anxiety and been put on sertraline and had started cbt therapy in an attempt to get over my fear (it didn't work). Because of this the consultant could see that I had tried to consider all options. Have a look at the nice guidelines which explains the procedure for granting an ELCS based on maternity anxiety- I think it says that they should refer you to perinatal mental health (essentially for a chat about your options and to see why you feel that way) and if after that you still wish to proceed then the consultant should agree to the section or refer you to a consultant who will. It's worth mentioning these NICE guidelines (just google them) if you do write a letter as it shows your are well informed. If you aren't seeing the consultant until 36 weeks maybe you could ask your midwife to refer you to perinatal so you can tick that box off in the meantime? As leaving all that to 36 weeks may be a bit too late.

Best of luck xx

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ivfdreaming · 15/07/2020 13:57

My request is on the grounds of anxiety and fear around the birth and the potential things that could go wrong.

The problem is that most mothers to be have this fear and they can't grant them to everyone so you could be denied as you don't have any specific experience/background which would make this worse?

I requested one as my hospital closed and I was moved to one over 1hr away, my DH didn't drive at that time (well he could but it's a long story) and i also had several family members, colleagues and acquaintances who had either had still borns or whose babies were permanently disabled by forceps delivery and I specifically stated I would refuse a forceps delivery or to be cut. Id also had a rather late miscarriage before and was already high risk and under consultant care. I had to see 2 psychologists and it was approved

As it was DD was breach so I had no choice

BUT and this is a huge one......I have since lost both tubes and am permanently infertile to 2 ruptured near fatal ectopic pregnancies due to scar tissue from my c section. Looking back now if DD hasn't been breach my insistence to have an elective c section was too high a price to pay

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duckling3 · 21/07/2020 12:16

I had a letter through today with a phone appointment in August to talk through my elcs request with the consultant midwife. I'm pleased that's come through so soon. I was worried they would make me wait until 35 weeks. Fingers crossed she is a nice as the community midwife. Does anyone know.. can a consultant midwife sign of requests, or is that done by a different type of consultant ? Not sure how many steps to this process there are.. I guess it migh be different for different circumstances or hoslitals.

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Somethingorotherorother · 21/07/2020 12:30

@duckling3 it won't be a consultant midwife (not sure there is such a thing) it will be the ObGyn consultant or similar. I also think it's pretty unlikely they'll grant you a c-section just because you're nervous about labour. Everyone is nervous about labour.

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squashie34 · 21/07/2020 14:45

@duckling3 I can't say I've ever heard of a consultant midwife.. i doubt they will be able to sign off on a section , but it might be the 'doorman to get through to the King' if that makes sense- you may speak with her as a way of getting to see the consultant?

@Somethingorotherorother I think it's wrong to simply assume that someone is just 'nervous' about labour so wants a section- there's a big spectrum between simply being nervous and a complete fear of vaginal birth, aka tokophobia. I also believe in women's maternal choice- if the OP has read up on all the risks between both types of delivery and still decides a section is best for them, whatever reason that may be for, physical or mental health, then I honestly can't see why this shouldn't be granted.

Good luck @duckling3 I hope it's successful, do let us know!

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Brieminewine · 21/07/2020 15:13

I had an elective section for the same reason you want one OP. I saw the consultant at 36weeks and he gave me my date there and then! It was fine, he didn’t quiz me or try get me to change my mind, the NICE guidelines are it’s a women’s choice and he respected that.

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duckling3 · 21/07/2020 18:16

I googled consultant midwife after reading the replies. It seems a consultant midwife is an experienced/senior midwife. Doesn't seem like they are the person to agree or not to a section request, but someone who will talk to me about my concerns and help me make a plan and then refer me on to a consuktant as needed

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rlnx · 22/07/2020 07:36

@Somethingorotherorother
There are such things as consultant midwives. We have one at our trust. They are senior midwives & are incredibly experienced :)

@duckling3 I think at our trust they can book /request caesareans after a discussion with the consultant obstetrician
I hope you get the outcome you want, I'm almost 32 weeks and terrified about the birth more so than the labour, so completely understand your request x

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duckling3 · 13/08/2020 15:31

Thought I'd update in case anyone is like me and has been scouring the Internet for others experiences.

I had a call today with the consultant midwife and she was really lovely. We had an open talk about the risks of both options and she said, that whilst I need to speak to a consultant to book me in, if i want a c section I can have one. If for any reason the consultant doesn't agree to perform my section then the consultant will find someone else who will.

Feeling very relieved now. From what I'd been reading online I had thought there would be lots of trying to change my mind, and having to fight for what I want and that really couldn't be further from the case. Everyone I've spoken to has been very pro choice.

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AnneLovesGilbert · 13/08/2020 15:38

Well done OP, that’s great news. Good luck with the rest of your pregnancy.

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