Elective c section

[Corgisandcoffee]

Hello! Are woman in the UK now truly allowed the choice to have an elective c section? I'm pregnant with my first and have thought for many reasons that an elective would be the best choice for my situation. However, my friend gave birth in Sheffield (I'm there too, we are both expats) in late 2019 and begged to have an elective and was told no. My friend also told me that she was made to feel like a horrible person for asking for the elective, which is just awful. That said, I was wondering what to expect. I have my first appointment next week, and I wasn't sure if this is something I should mention early on. Thanks in advance :)

From my understanding it was allowed to be requested if there was a medical reason for doing so. Why would you rather ECS if you don't mind me asking?

I believe it really depends on your NHS Trust but it shouldn't. Technically we are allowed an elective though. That's what my consultant said when I chose mine.

The nice guidelines say that you can and they should be followed nationally. I've had 2 electives, both in different trusts. The first one I had to fight for, quite nice guidelines, prove that I understood the risks, meet consultant etc.
i went armed with printouts of the guidelines and the published statistics on risks of c section Vs natural birth.
I did get it but it was a bit of a battle!

Second pregnancy got it no problem. Didn't have to jump through any hoops and got a date for my section about a week after my 20 week scan.

Arm yourself with the knowledge you need and if they don't follow the guidelines, refer to PALS for support in making sure that they do.

I would also genuinely be interested in why people decide themselves to have an elective C-section (I'm talking about no medical reason, no risks factors for a natural birth).

Personally I wouldn't want to be cut open and have what is invasive surgery without a good reason!

Maybe someone can explain their reasons? No judgement, each to their own.

You might have to jump through hoops and go armed with lots of provable knowledge, but yes you should be allowed one. You can ask to see a different consultant if yours refuses.

If you claim maternal anxiety (which is a legitimate reason) they might ask you to speak to someone about your anxiety first.

@Regenbogen22 I don't think you need this explaining to you at all. Whether you realise it or not, you're just inviting other women who make this choice to defend it to you because you clearly feel differently to them. If you thought about it for a few minutes objectively, you'd probably be able to fathom the pros and cons for both vaginal birth and elective c-section quite easily. If you're genuinely interested, you can search posts where women share their experiences, positive and negative, of either birth choice.

FYI most women in the west don't have a "natural" birth . Natural is no intervention whatsoever- no gas & air, no forceps/suction, , no induction with synthetic oxytocin, no epidural, no perhadine, no operation (c section).

What you are calling a "natural" birth is actually a vaginal birth.

It's none of your business how/why people make their birthing choices.

In theory you do, but women often seem to have to fight for it and it never seems to get mentioned as a possibility - eg I was recommended to have an induction but no one mentioned that MRCS even existed. Even though that would have been far preferable.

Birthrights has some information:

www.birthrights.org.uk/factsheets/

You should be able to request a c section but I do understand why an obstetrician would want to persuade someone who didn't need surgery not to have it.

I had two planned c sections and neither massively went to plan (both early, some complications etc) so I would just do your research and explore why you want a c section over a vaginal birth).

Wow 😳, okay, first apology - I meant "vaginal" as opposed to "natural". Wrong term used!

Second apology, like I said, zero judgement, I am just curious! I was thinking anxiety about pain or wanting to select a particular date, I just wondered if there were other reasons and wrote the post.

I shan't go off and intensively research this because it's not hugely important to me, like I said each to their own. It was just a question provoked by the OP asking if women can choose ECS everywhere. Carry on and ignore!

You should be allowed one -if you encounter resistance quote the nice guidelines as well as the interim and full Ockenden reports. One of the immediate and essential actions for all trusts from the first report spoke about informed consent and maternal request c sections.

I do think it varies by trust. I’m pregnant with my second and because my first was an EMCS, I’ve been told I can have an ELCS, “no questions asked” – but I’m still being made to jump through a hoop of going to a special presentation on VBACs, only after which can I request the ELCS. So not really on demand or no questions asked, and if I hadn’t had the EMCS, I was told I couldn’t request a section.

I can see the NHS’s reasoning – vaginal births are much cheaper for them, and an uncomplicated vaginal birth has fewer side effects and shorter recovery time than an uncomplicated section. But how many women have uncomplicated vaginal births, especially the first time? It’s certainly what I tried for – I started out with a home birth, hypnobirth, unmedicated, birthing pool approach – but DD was never ever going to come out via my cervix, so that was that. So many first time births have interventions that lead to maternal injuries that are far worse than recovery from a planned section.

@Regenbogen22 I was all geared up for a natural birth after completing a hypnobirthing course to be told I had to have a c section due to my baby being breech. I was so upset at the time. I did some research and read other peoples stories and I started to feel ok with a c section. It ended up being a wonderful experience. DD was out quickly, I experienced hardly any pain (other than getting out of bed for a week afterwards and I’d say that was more uncomfortable than painful) I was home the next day and having a pub lunch and a glass of champagne two days later.

I still haven’t decided if I’ll go for a VBAC this time due to the unknowns and after having such a lovely experience last time.

I know in my trust you can request one. I had one 3 weeks ago due to breech baby and it is not the easy way out the recovery is hard work. Really think about what the pros and cons of are of vaginally vs section.

Thanks for the insight, everyone! I feel a bit more knowledgeable on what to be prepared for :) I won't elaborate on why I believe an elective c section is the best choice for me, but I do have my reasons and ultimately have my and my little one's best interests in mind in my personal circumstance. Glad to hear that mums in the UK really do have the choice these days, even though we might have to jump through some hoops to fight for it.

@TiredInPerpetuity if you could share the info you had on the print out, that would be great. I have a note with lots of stats, but adding to it is always useful! Glad you got the births you wanted.

Good luck OP and don't let them fob you off!

I had what is on paper a 'standard vaginal birth' and the recovery was far far worse than friends who had ELCS.

The rules around electives changed recently after the tragedies in Shropshire and Telford. The Donna Ockden report stated that all women have the right to choose their method of delivery and this should be respected by hospitals. I had an elective with my first (2020), I asked the midwife, she asked why, I told her and she referred me to a consultant. They talked me through the risks, asked I was happy to proceed and booked me in. It was fairly straight forward. This was in Birmingham.

I choose an ELCS due to previous sexual trauma. No regrets here and I healed better than my friend who had a vaginal birth so I guess it really does just depend on the person.

There are lots of reasons.. avoiding vaginal birth injuries and the risk of incontinence etc, avoiding needing a forceps delivery which can be riskier/more painful recovery than an ELCS, avoiding needing an emergency c-section which is more dangerous, avoiding long drawn-out induction, previous birth trauma from labour, previous sexual abuse/trauma, wanting to feel in control, deciding that an elective c-section is actually the safest option when compared to the risks of attempting vaginal birth to name a few

ELCS are safer than vaginal birth in low risk pregnancies according to one study. Previous to this I hadn’t seen any studies that separated out electives from medically necessary c-sections. They were always lumped together which would have an obvious impact on outcomes recorded.

www.verywellfamily.com/planned-c-section-deemed-safe-for-low-risk-pregnancies-5185540

@outshinethemorningsun @EvelynParker thanks for your replies, several things I hadn't considered, particularly sexual trauma...

My path to pregnancy has been medicalised (multiple rounds of IVF) so I take a very dim view of the concept that your body “knows what to do”. Mine clearly doesn’t.

Plus, if that was truly the case then women wouldn’t die or suffer life changing injuries in childbirth.

There's also a myth that vaginal births are cheaper than CS for the NHS. That's only true if you look at the upfront cost of just the birth. Once you take into account the costs of treating the long term consequences over decades - pelvic floor damage, prolapse, babies/children who need treatment and support because of birth injuries, mental health support for birth trauma - the costs even up.

I have had 3 elective c sections at Jessops; I’m assuming there’s where you’re going?
Ask to speak to a different consultant; they can’t actually refuse you.
You can also consider Calow & Bassetlaw as they have good maternity care but just as part of the main hospital.