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 :)

The 'convenience' angle is also easy to dismiss but the reality is that, with the closure of maternity units, many families have a distance to travel to get to their nearest, risk being turned away because it's full or they're not considered far enough into labour. If you don't have a car, having to work out how you'll get there in labour, knowing that no taxis are available at some times of day, that you could be sent home again and have to return with the same transport problems makes it all very stressful. I was absolutely terrified of being forced into a home birth I didn't want or ending up giving birth in a taxi on the motorway hard shoulder because of this.

Having an induction (medical reasons!) and being booked for a particular day and time so we could organise a lift from a friend in advance removed all this stress and fear. It meant I could do all of labour at the hospital without having to travel whilst in pain. And the same would apply to a CS.

I hope this has changed but I've seen people say on MN for years that 'they can't refuse you because of the NICE guidelines' and that wasn't always true. People said that in 2018 but my local hospital then had a 'refuse and refer to another hospital' policy, and so did the next nearest one (in the same trust). So the only option if they didn't deem an elective 'justified' was to request referral to a hospital about a 90 minute drive away and try your chances there. As I said, hopefully that's changed now but hospitals definitely haven't always followed the guidelines in place.

I’m having an ELCS in a few weeks and have met absolutely zero resistance, it has been very refreshing and reassuring to have had the support from the midwives. In my case it’s because my first birth was an EMCS but I’ve had no one persuading me to try a VBAC.

You are absolutely allowed to have en elective for any reason you want, you might need to jump through some hoops but you should get it.

Personally, I’d go with trying for a vaginal birth if your body seems up for it (ie going in to labour naturally, few cm dilated upon presentation etc etc), then a c-section, then induction as absolute last ditch scenario.

I'm based in Scotland, but I'm pleased to say I had no issues requesting an elective c-section. The midwife I first spoke to about it, which I think was an appointment at around 28 weeks, referred my straight away to the Obstetrician, I explained my reasons and she was happy to refer me. I hope this gives some comfort to other women who want to make that choice. I was so worried I was going to have to fight for an elective c-section and it lead to a very anxious few weeks, where I ended up focusing on this imaginary battle rather than all the other things I could be doing in pregnancy to prepare. Good luck!

I had an appointment with a senior midwife where we went through a long list to work out my individual risk factors. Based on that I decided to go for ELCS and no one tried to persuade me otherwise. Obviously that might have based on the risk factors, they may have been less receptive otherwise. My risk factors were previous EMCS, previous failure to progress during labour, previous very large baby, gestational diabetes, age, previous gynaecological surgery.

Good luck, OP! I had an elective last Friday after a previous EMCS and it was a genuinely lovely experience and I have recovered brilliantly. I had the option for a VBAC but didn't fancy rolling the dice on tears, birth injuries to baby, damage to pelvic floor and a long, drawn-out labour where I would be too exhausted to look after my baby. Just stick to your guns and keep repeating yourself if need be.

Im not sure they refuse as such but seriously think about your reasons for wanting a C-section and the pros and cons of both vaginal and csection births as well as how many children you want to have and discuss all these with the consultant before making your decision so you have all the correct facts. I’ve had 3 csections (both emergency and electives) and pregnant now and due a 4th csection (I have very little choice it has to be a csection) and each csection has been more difficult than the last both for the surgeon and myself recovery wise (complications in surgery, bladder, bowel and womb problems) as well as problems in pregnancy and I have various long lasting health issues due to having had csections that I have to live with everyday. It certainly is not the easy option as some people assume.

No idea if this is the case in Sheffield but not every hospital does electives. A trust in Birmingham for example runs 3 hospitals, they only do elective at one of those sites so those wanting electives at the other 2 hospitals have to travel. Just something to keep in mind in case you gave your heart set on a certain hospital.

@Louise0701 it will be at Jessops, so I'm pleased to read you've had an elective there.

Thanks again for everyone who continues to share their experience! I hope this thread is as helpful for others as it has been for me. I definitely do not think a c section is by any means an "easy way out" of childbirth, but after understanding the pros and cons, I continue to believe it is the best option for me, and am greatful to be pregnant in a time when I have the choice.

I'm glad you created this post as I am going to ask for an ELCS. Personally I think my complications will be a lot worse than having a CS. I don't have any underlying medical conditions but i most certainly know i will tear and i don't think it will be a small one at all. I will mention this at a midwife appt

Hi @Corgisandcoffee you've already been given some good advice, but I'd also recommend reading a copy of 'Why Caesarean matters' as it's a really good non-judgemental book (so suitable for the full range of women's c-section experiences) that explains everything in case you do have to fight your case a bit! Good luck - I had a planned section for breech in 2019 but had been on the cusp of requesting one anyway & due to have another one in October.

Mine was refused at Wakefield despite me having birth trauma and PTSD from the first birth. They had to in the end as the baby was breech but they tried to get me to cancel my CS and wait.
I also got several remarks while they were stitching me up about there being no reason for me to consider another CS as I could have given birth 'properly'.

I might be having an elective c section and my Consultant is fully onboard. For those wondering why a woman would choose, I've had 2 miscarriages and am pregnant through IVF. I'm extremely anxious and we all want baby to come before 40 weeks, but if he doesn't come of his own accord by approx 39 + 5 I will go straight to c section rather than induction.

My body has struggled to get pregnant and stay pregnant, so it's not unreasonable to consider the possibility that it won't "know" how to go into labour.

I'm very lucky that I'm under the care of a very experienced and understanding Consultant.

It's worth thinking about anaesthetic choice as well.

I was chatting to a friend this morning who's had an emergency c section with a general (proper life saving serious emergency type thing) and a standard planned section where she was awake.

She's no regrets about the second section as the reasons for the first one made it necessary BUT she does regret being awake for it. She said she found it quite traumatic being aware of what was happening and the feelings of the birth.

She did say that she struggles with medical procedures in general and found the over medical environment hard.

If you want a planned section it's worth thinking about how you feel in medical situations and how you'll feel being awake but not able to move etc. obviously there are issues with having a general, but it was another view of having a planned section id not considered before.

It's also worth remembering that with a 'maternal request' section you might not get your date until much later in pregnancy. Typically they happen around 39 weeks, but as (currently) there's no medical pressure for a particular date you might get slotted in.

For me, I couldn't stand the hours and hours of labor, tearing, bladder issues and so on. I knew people who had horrific experiences. I preferred the certainty and planned procedure. It was an absolutely calm and beautiful experience. The recovery is nowhere the horror that people make it out to be. I had placenta previa so had to have one in any case.

Hey! I'm having my first baby and having an elective C section in 2 weeks. No medical reasons this was entirely maternal request (happy to explain why). Had an appointment with consultant today and they were lovely and advised that as I am healthy the "risks" of the section are very very low and that the elective sections are very calm. They did go through the risks but they didn't try to argue at all and took my reasons on board. As long as they're happy with your reasons they shouldn't argue- you have a right to the birth that you want. My advice would be not to "ask" but rather say "I've decided I'd like a section can you please make the appropriate referrals". It's your choice entirely whichever you choose. Good luck x

@Corgisandcoffee I will be pushing an ELCS this time at jessops. I have been a consultant at 12 weeks who said its was your to me what delivery method I go for.

@Regenbogen22 I will be choosing ELCS this time after a 4th degree tear last time, tough recovery, blood transfusion, long term health issues and two prolapses. No thanks to that again.

@Regenbogen22 too many risks with a vaginal birth for me and I’ve witnessed horrendous “recoveries” and lifelong damage.
I have had 3 elective, calm, thoroughly planned c sections which I have recovered from amazingly each time. Driving after around 8-10 days each time, my body functions normally, my pelvic floor and bladder function normal, breastfed with no issues which I’ve seen on here as a case against c-sections before. No scar trouble, no wound trouble, no numbness, no overhang.
3 perfect births. Wouldn’t risk the many complications that come with a vaginal birth for anything.

@Whatelsecouldibecalled Hi! In your last post, did you mean to say that you were told that you are able to choose your delivery method at Jessops without pushback? I hope you get your elective c section and that this birth experience is smoother than your last one 💐

@Corgisandcoffee yep I was told I can choose what I do this time. Probably more to do with previous birth trauma. My friend had both her girls via ELCS first and second at jessops through purely maternal choice.

My advice would be not to "ask" but rather say "I've decided I'd like a section can you please make the appropriate referrals"

this is excellent advice ^^

I’m still being made to jump through a hoop of going to a special presentation on VBACs

is it an actual presentation? Sitting, slides etc?

i went to VBAC clinic which was actually bloody useful. Specialist m/w went through my previous birth, what had happened, my risk factors, and how statistically likely a vbac was.

I was given some clear, well written and researched papers on risk:benefit, and told to read and consider.

there was no bias, no push either way, just the information.

it actually helped confirm my decision was the correct one. I went back a week later and booked the section there and then.

o/p i find if you can present your case to show you have considered the pros and cons of both vb and cs they will agree.

My advice would be not to "ask" but rather say "I've decided I'd like a section can you please make the appropriate referrals

they will still ask why, because you need to show you know the risks. They can’t just agree, they have a duty of care to make sure you are making an informed decision.

I have had 3 elective, calm, thoroughly planned c sections which I have recovered from amazingly each time. Driving after around 8-10 days each time, my body functions normally, my pelvic floor and bladder function normal, breastfed with no issues which I’ve seen on here as a case against c-sections before. No scar trouble, no wound trouble, no numbness, no overhang

while that’s great for you, that’s not always the case and it’s misleading to suggest it is. There are risks to cs, same as there are for vB, and all need to be considered so individuals can make the best choice for them.

Sounds like a great experience! My ELCS is next Tues 🤞

Good luck OP!!

I had a previous EMCS and will be having a section with this baby. I don't mean to preach and I'm not trying to judge either but before my first section and even after it I couldn't understand why so many people were against c sections as my experience wasn't a bad one and my recovery wasn't particularly difficult either. 10'years later I'm pregnant with my second child and have developed some serious complications with my placenta I.e Vasa Previa, a succenturiate lobed placenta which is low lying and also placenta accreta as one of the placentas has attached to my previous section scar. I didn't choose to have a section the first time but had made that choice this time prior to finding out about my complications. Worst case scenario, my complications could result in a hysterectomy removing my choice about whether to have another child if both baby and I make it through this pregnancy. I'm so thankful for my first section as it saved my sons life and if I had a choice, it's absolutely what I would have chosen but I do wish I had been told about the potential risks that come following a c section so that if I did have a choice to make, I could make a fully informed one. I don't feel like that is done as well as it should be xx