Elective C Section

[Lauraaax]

Hi all!
I’m only in first trimester however due to ongoing mental health issues I had already planned my explanation for wanting an ELCS months ago 🤦🏼‍♀️ I’m fully aware this is not an easy route and have done a lot of research. Below I have included briefly why I want one. I am keen to hear stories from others about how they got theirs and if they had it refused initially by consultants etc! Many thanks x

Mental health issues - want to enjoy pregnancy
Need to know what is happening and when
Aware of risks but not willing to take risk on - epi not working, tearing, ecs, assisted
Aware of right to have one - NICE guidelines

Lower risk of trauma to baby
Lower risk of baby being oxygen deprived

Not wanting an assisted delivery (RCOG - 1 in 3 FTM need assisted delivery) - risk of haemorrhage, bruising (cephalohematoma), nerve damage, cuts, jaundice, bleeding in the brain

Anxiety around intimate examinations - history of abuse

They can't refuse you and from the reasons you've given, I can't imagine anyone telling you no anyway. But they literally can't refuse to do a c section, and if they do for whatever reason then they should refer you to someone who will do the c section. They will probably encourage you (and I have found that encouragement to be quite forceful in the past but they do need to make sure you are fully informed) to have a vaginal birth and give you all the pros and cons of a c section but stick to your guns and you'll be fine.

@BelieveInRainbows

They can't refuse you and from the reasons you've given, I can't imagine anyone telling you no anyway. But they literally can't refuse to do a c section, and if they do for whatever reason then they should refer you to someone who will do the c section. They will probably encourage you (and I have found that encouragement to be quite forceful in the past but they do need to make sure you are fully informed) to have a vaginal birth and give you all the pros and cons of a c section but stick to your guns and you'll be fine.

Thank you this is really reassuring. I’m anxious about not getting a final answer until the 3rd trimester and then someone saying no so this is really good to know x

I’ve got my first consultant appointment tomorrow but I’ve had conversations with my MW and then was referred to the consultant MW to discuss birth options. She was supportive of my choice but obviously the consultant has final say. I’ll let you know.

You might find it helpful (if you haven’t already) to look at the Birthrights website - you probably have already though.

I think you sound well-informed and all your reasons seem sound. I have a consultant appointment next week to discuss the same thing, although my reasons are different because they relate to my first birth (third degree tear).

One thing I’ve heard from friends who’ve requested sections is that it really helps to emphasise that you are fully aware of the risks of a caesarean - eg blood clots, heavy bleeding, hysterectomy, complications in future pregnancies, infection etc - but that you still feel caesarean birth is the right choice for you.

My hospital trust website basically says they don't do maternal request C-sections and you can pay for it if you want one.

The Birthrights website has a rating of green, amber, red for maternal request C-sections, mine is rated amber.

I mentioned it at my booking appointment and the midwife said it was my choice how I gave birth (which was a surprise as I know some midwives push the vaginal birth as the only choice).
The consultant agreed to ELCS and I received a date for it before the 20 week scan, I was amazed.

It is NICE guidelines (most recent publication date 31 March this year) to discuss the pros and cons and it should be offered.
It's not a right enshrined in law (you'll see some posters saying you have a legal right to ELCS) but it is something you should be able to arrange, you may need to be firm depending on your hospital and who you speak to there, if it is what you are set on.

Many say an uncomplicated vaginal birth is what they would want (if I could be guaranteed it I would) but the consultant agreed my chances of that were less than half so for me ELCS is the way forward.

Get the ball rolling now. The things that really got me was that none of the midwives were willing to discuss the risks of vaginal birth. I did my research (as it sounds you have) and found whilst I was happy to accept the risks of a CS, there were some VB risks that were unacceptable for me to run, regardless of the statistical improbability. My argument to the consultant midwife that I had to see was yes, it may only happen to 1% of women (or whatever it was for a given risk), but if I was unlucky enough to be that 1%, I was be affected for the rest of my life and that was not something I would risk if I had a 0% risk of it happening in an ELCS. I also stated the risks related to a CS and that I had considered them and can accept them.

Definitely stick to your guns OP, I so wish I had an ELCS!

Good luck

You can always request it. With any surgery the consultant / surgeon has to go through the risks with you. Even if you've done your research they need to be able to tick a box that says they've told you the risks and youre making informed consent.

Request it at your booking in, but be prepared that they might not confirm it or give a date until your third trimester. Everyone I know who has had a planned section knew it would be around 39 weeks, but not the actual date until around 35 weeks.

Grateful for all of your comments, all of your advice is so helpful so thank you!! I have my booking appointment in 2 weeks so I am planning on mentioning it then so that it’s on paper from the beginning. Really hope I get it approved early if I push for it - the uncertainty for months seems horrible!x

Granted this is my second baby, with my first ended up with emergency c section. I had my booking in appt and 12 week appt and both times the midwives were more than supportive of my decision to have an elective c section this time round. With the first midwife being amazing and said that she’ll fight for my right to have an elective if anyone else wants to push me to have a VBAC. Hopefully you’ll receive the same level of support

@Lauraaax

Grateful for all of your comments, all of your advice is so helpful so thank you!! I have my booking appointment in 2 weeks so I am planning on mentioning it then so that it’s on paper from the beginning. Really hope I get it approved early if I push for it - the uncertainty for months seems horrible!x

Please don't be worried if the midwife if non committal at the booking in or just says you have to see a consultant.

That's the process. It's not her decision or her that books it in. She will need to refer you and the consultant will book it.

As a maternal request, you'll be low on the priority list for the consultant appointments so you might have to wait.

That doesn't mean they won't let you have one, it's just where you'll be in the queue to sort the paperwork.

Just had one last month for similar reasons. I worried all my life about giving birth, it literally consumed my life for so many years. I’d go on holiday and lie at the pool watching videos about it, just ruining my holiday when I wasn’t even pregnant 🤦🏼‍♀️ I think it was because I knew I wanted to have children at some point but was just so certain I’d die giving birth and the entire thing would be so traumatic. I started requesting a c-section from my first appointment at 6 weeks. It was a telephone appointment and at the time I thought they midwife listened and took me seriously but after it I realised she didn’t put anything in my notes and seemed to just fob it off as if I was the typical scared, newly-pregnant person. I didn’t have another appointment with her until 16 weeks and knew from my hospitals policy that it should be her I request it with. So I waited til 16 weeks and by this point I was already getting worked up about not knowing what was happening. I, again, told her my reasons and asked when I’d get to speak to a consultant. She said we’d deal with it at the 22 week appointment and did note it down this time. At the 22 week appointment I was so anxious waiting to speak to her. This time it was in person and I think she could physically see how much it was affecting me and said she’d refer me for a consultant appointment. A few weeks past and I’d heard nothing about this appointment. I was now waking up during the night worrying and spent every hour of the day googling things about sections, how to get one etc. I eventually called my midwife and explained the state I was getting myself into over this and asked if she had any update on when the appointment would be. She chased it up with the consultants receptionist and I had a telephone appointment with the consultant at 29 weeks. This was the one I was most worked up for. I was so scared she’d just say no or dismiss my reasons and I’m not the best at confrontation anyway so I was so worried I’d just back down. I prepared 5 pages of notes for the appointment. Most of it was my reasons (so I didn’t forget any). I also included the nice guidelines and a lot of stats from the birth rights website (where you can find your hospital on the maternal request c-section page - look yours up if you haven’t already)!

My voice must have been actually shaking on the phone to her and she could obviously hear how anxious I was and said it wasn’t her job to tell me no. She even quoted the nice guidelines without me mentioning them. She was really nice in that respect. The only thing she did do was try to scare me with the risks of a section and I absolutely get that they have to inform you of the risks but it was very extreme worst-case scenarios I was being given like the chance of death and was I willing to have a blood transfusion. I, of course, said yes yes yes to it all as I’d spent years looking into the risks myself and knew exactly how likely each one was. I think she expected me to suddenly back down at that and I’m sure some people probably do but I wasn’t one of them 😂 I was given my date at our follow up appointment (again over the phone) at 34 weeks. I was booked in for half way through the 39th week. A huge weight was lifted from me at that point but it didn’t take long until my fear was now going into labour early and what would happen. I never went more than 5 miles from the hospital the whole third trimester just in case I went into labour as they’d made a comment about me being able to still have my section only if I was in early labour at the time, so I wasn’t taking any chances! In the end up I made it to the date and it was the best day of my life 😊 So calm, virtually painless and none of the awful things she’d warned me about happened! The consultant on the day who did the operation actually read me the risks he expected were relevant to me prior to going to theatre and he said because I was healthy and it was my first baby he didn’t expect any complications and he’d have the baby out in under 5 minutes. He did too! The recovery was nowhere near what I imagined either, its been completely fine!

Good luck, hope you get it all sorted and are able to relax a bit for the rest of your pregnancy. It’s such an amazing day, I would do it all again tomorrow ☺️

I had EMCS with my son, I think for this reason they scheduled me an appointment with consultant to discuss birth preferences this time at about 12 weeks but at that point I hadn't given it much thought!

I looked into it and decided on ELCS but then haven't had much opportunity to actually discuss it! Only just put 'on waiting list' this week (34 weeks) for ELCS in 39th week!

I went armed with pages and pages of notes but consultant basically said 'you don't need to justify yourself, you are perfectly entitled to a section' so I am feeling better about it now.

'Maternal request' is lower down the priority list but it is still perfectly normal/acceptable and your reasons are totally valid so stick to your guns :)

@sarah13xx I too was surprised by the consultant agreeing without me having to go through the reams of notes I'd written!

They also said if I go into labour to come to the hospital any time of day or night (though I'm quite sure they're not going to do the surgery immediately but it was a reassuring thing to hear).
They did also point out that if I somehow changed my mind and wanted to try for a vaginal birth to let them know, they said it doesn't happen often but it has done a few times.
Honestly having the date booked has been a huge relief (I'd had nightmares about it after reading the website information) but I know it's unusual to have it agreed so early, I was expecting at best an agreement in principle and a date nearer the time.

My friend went into labour before her scheduled section. I think how it's handled depends a bit on why you're having the section, but for her they checked her over. Established it was early labour and got her into surgery ASAP.

She wasn't a candidate for a VBAC so they needed to make sure labour didn't progress too much.

I think if you've no medical need for a c section, they might let you decide if you want to go to theatre ASAP or try labouring for a bit.

Firstly you don’t have to justify yourself, you have every right to want a section and no ones business why. I knew I wanted section since I was 20! I’m 37 now! No other option was ever possible for me. Secondly- unfortunately no one will give you a section unless you go private. You need to fully private with a consultant and then there is zero problem. You pay, you ask, you get. No questions asked and no problems. Both of my consultants said absolutely, they will do whatever I want. Good luck !

I suffer with mental health too OP, but mostly health anxiety so I’m the opposite to you; I wanted a vagina birth but had a planned (but not elective) c section due to baby having IUGR.

I found recovery quite tough.. but only because of my mental health, I was constantly worried about sepsis, stitches opening up, blood clots ect. But I’m reality I lost less than the average amount of blood, healed brilliantly, quickly and with no infections or complications at all. - if I hadn’t been so panicky my experience of the c section would actually have been lovely, very relaxed atmosphere, overly quickly and baby held within 10 minutes of lying on the table.

The thing I found to be the most helpful was using the thick maternity pads stuck to the inside of my knickers over my incision while recovering for the first 2 weeks, it kept it dry and gave me a ‘cushion’ to press on when getting up, sitting down, coughing, sneezing, laughing and pooing! It was honestly a priceless too I read and would recommend it to anyone.

They can’t refuse a c section; they’ll give you the risks and benefits and let you make an informed decision.

Best of luck!

@Elisemum

Firstly you don’t have to justify yourself, you have every right to want a section and no ones business why. I knew I wanted section since I was 20! I’m 37 now! No other option was ever possible for me. Secondly- unfortunately no one will give you a section unless you go private. You need to fully private with a consultant and then there is zero problem. You pay, you ask, you get. No questions asked and no problems. Both of my consultants said absolutely, they will do whatever I want. Good luck !

This isn't true. The NHS will grant a maternal request c section (as show by other posters on here)

Oh ok I didn’t know that sorry OP. Im in Ireland and no one will give you a section unless you are private (then no problem)

@Elisemum

Oh ok I didn’t know that sorry OP. Im in Ireland and no one will give you a section unless you are private (then no problem)

I’m actually booked in for a c section on maternal request in Dublin in two weeks as a public patient. Consultant agreed to it very easily once she knew I was clear on the risks of each.

@Rossea great, almost the same time as me, good luck to us! May I just ask, how did you even see a consultant if you are public? In rotunda and other holes st you don’t ever see a consultant if you are public unless you are bight risk. I’ve been private both times so no other experience.

I’m with the Coombe. When registering initially you’re given a choice of going with the Domino midwives or consultant obstetrician regardless of your risk. I see either the consultant or a registrar at each appointment and have found it great so far.

I see, well good luck, hope everything goes well for you, not long now

I’m 35 weeks with first baby and having an elective, it’s booked for 39 weeks. I asked at my booking appointment citing worries about complications of a vaginal birth and explained that I knew the risks of a c section.

A lot of sources actually say that an elective c section when you have no high risk elements to your pregnancy is actually the safest way to deliver for both mum and baby. But all the stats for c section risks have emergency c sections lumped in with them, which skews the results as obviously women having an emergency one are having a difficult birth anyway and are more likely to have complications.

I’m still in the minority - at my NCT class of 9 couples it’s just me and a woman having twins who is having a c section.

I’m with West Sussex Hospitals and they describe themselves as very pro choice. I had to speak to a midwife first who was fully supportive and lovely, and then a consultant who tried to scare me but then still signed it off. It seems they must be able to scare some women into a vaginal on these calls but I was so well researched she couldn’t change my mind.

Good luck with it all! X

Great to hear that elective sections is becoming more and more popular and easier to get. Everyone should have a choice- it is that simple. I cannot imagine anyone wanting to have viganal birth, I mean why would you go through all of this? For what sake? It’s so horrific. Section is so much nicer, safer, overall better for woman