When to discuss birth plan/requesting c-section

[Superunknown1]

Hi, I’ve found this forum so helpful throughout my pregnancy and am back with a couple of questions about requesting a cesarean as a first time mother.

When do you generally start discussing a birth plan? I am 25 weeks tomorrow and have a midwife appointment and currently fretting writing down things to mention in case this will be my chance to express the fact that I would like to opt for a c-section.

If you opted for a c-section, did you have issues getting consultant to agree to it? When do you have to raise this as an issue, am I overthinking it? I have a list of pros and cons of section vs. vaginal birth to show I’ve researched both extensively and in a non-biased way.

Finally, my partner is coming to my midwife appointment tomorrow and we are worried that his presence if birthing plan comes up may affect things negatively, as in we are concerned it’ll look like he is influencing me in some way. I am mouthy and it is entirely my choice, but I’m aware for some women they may not have partners as understanding and lovely as mine and I’m sure midwives come across women whose husbands have wanted their partners to have a c-section for vanity reasons (to put it politely). Is this something anyone has experience with, am I overthinking it or am I better off discussing this alone just so midwife doesn’t make any assumptions? OH has already said he will keep quiet through any discussions of birth plan but I just want to give myself the best chance of not having to battle to be heard.

Any general experiences massively appreciated. I am West Midlands if that helps! Thanks in advance ☺️☺️

TTN
https://kidshealth.org/en/parents/ttn.htm
Much more common in babies born by c-section

https://kidshealth.org/en/parents/ttn.html

Stuff on breast feeding
https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0876-1

From that paper:
C-sections are associated with poor maternal and infant health outcomes 4–6], such as higher incidences of maternal infection and uterine haemorrhage, and infant respiratory distress and hypoglycaemia 6, 7]; all of which may adversely impact breastfeeding success.
Researchers have shown that women who deliver by c-section delivery are less likely to breastfeed, or delay breastfeeding initiation 8–14]. Breastfeeding within the first hour post-delivery has been cited as an important predictor of continued breastfeeding 15–17]. An early study by Rowe-Murray and Fisher (2002), found that babies born via c-section were less likely to be have skin-to-skin contact immediately after birth and were more likely not to have attempted breastfeeding within the first 24 h post delivery 8

I'm amazed the NHS allow a C section that isn't medically necessary. Your body/your baby/your choice, fair enough...as long as you go private and cover the cost.

I initially raised the statistics re c sections. I meant it to be helpful, in a 'this might not be the fight you anticipate' way, rather than to start a debate. So my apologies for derailing your thread.

For what it's worth, I have recently had an elective c section following a both physically and psychologically traumatic first labour. ALL consultants and midwives I spoke to agreed it was the best way forward but they were also happy for me to labour if it happened naturally. It was therefore technically classified as maternal request. I'm only 10 days pp but healing has been much faster and simpler than my vaginal birth and neither I nor the baby have experienced any of the negative side effects detailed by previous posters.

You do you op. Hope you get the positive elective c section you wish.

Glad you had a good experience Whentwobecomesthree enjoy your LO

To spout off at someone who’s made an eminently sensible choice to give birth in a way that doesn’t involve intense pain, trauma, the risk of haemorrhage, ripping, etc - and then state that they’re putting their baby at risk by making this choice is the lowest of the low. Losing the folklore of giving birth? You must be joking. Many women feel pressure at giving birth “naturally” and put themselves through absolute shit precisely because of small-minded comments like this.

Quite a lot of people are extremely ignorant.

Not least the poster who is unaware the majority of elective sections are medically indicated, but is sure it’s every woman’s responsibility to contribute to…….folklore.

How is linking to scientific papers either "spouting off" or small minded ? I am responding to questions ask of me about why it is a societal problem. Not about OP I know nothing about her or her reasons for requesting ELCS

I would say that responding to someone who’s made their (understandable) decision by flat-out stating that people who opt for c-sections are putting their babies at risk is… problematic.

It’s interesting that you view the rise of c-sections as symptomatic of some kind of societal breakdown. I -and many others - view it as a sign that women are finally realising they don’t have to put themselves or their babies through intense pain and trauma because society expects it of them (for the development of folklore apparently).

Respectfully bowing out of this thread, it’s only making my blood pressure rise and I’m currently pregnant. Can’t wait for my elective c section! I suggest the people sniping at OP also find themselves something else to do. Maybe go and tell some bottle-feeding mothers that they’re terrible people or something.

Again, OP, congratulations and I wish you the very best.

I stayed exactly 24 hours after DD was born by elective section. We had skin to skin within 2 minutes and she breastfed in theatre recovery. She did not breastfeed long-term due to three members of NHS staff telling me she was not tongue tied, when in fact she had an 80% TT, was not gaining weight, and my nipples were shredded.

Perhaps the NHS should focus on improving maternal access to adequate pain relief during labour, providing timely inductions instead of leaving people sitting on wards for days on end and actually providing adequate care for those who suffer birth injuries instead of fobbing them off by telling them their birth injuries are normal.

Or maybe we could just accept that c sections do not cause societal problems and stop being so judgemental towards women who choose to try to avoid being left doubly incontinent and disabled by an NHS who won't pick up the pieces after a vaginal birth?

I'm glad you've got your section OP. Mine was fabulous and I'd do it again every day until I died. It was the perfect way to meet my DD 💗

Thank you so much for the supportive messages, I’m so glad to hear other positive experiences regarding ELCS and makes me feel a lot better about the whole thing.

For me, retaining ‘folklore’ around birth is a lot less important than ensuring my baby gets out of me safely. I have friends who all ended up having emergency sections because babies got stuck and were starved of oxygen and have long-lasting health concerns as a result, and someone close to me whose baby and herself almost lost their lives during vaginal birth (turned into an emergency section to save them) and resulted in prolonged hospital stays for them both. I do have other reasons that I don’t really want to air out on here, I just don’t like being told that I am putting my baby at risk by making this choice for myself.

I’ve had enough surgeries in my life that blood clots anaesthetic risks and recovery pain from such don’t scare me really. I am informed on the risks and confident I’m doing what’s right for my baby (who is measuring big and I imagine a VB would not be uncomplicated, as my midwife did tell me yesterday).

Feels wonderful to not be the only one who has made this choice, and seeing people not regret it is fab. It’s a wonderful thing to have a choice X

@Goldencup Concerned? This is fantastic news! 46%! All women should have the choice. My two sections were my best decisions ever.

Didn't want to breastfeed anyway, my kids never get ill, bonded straight away. Ignore the doom mongers OP. Sections are amazing.

No, women can choose now on NHS. And long may it continue ♥️

Interesting information here
https://www.birthrights.org.uk/factsheets/right-to-a-c-section/

@Goldencup The Birthrights site is where I got a lot of the guidance I took with me regarding my rights with it and the NICE guidelines, I found it reassuring and good knowing that if I didn’t receive support that PALS could help. Hopefully consultant is on board! Luckily the trust I’m under is one of the best for allowing maternal request CS without too much battling which is good

'Folklore' around natural birth. I've heard it all now.

Glad you're getting it sorted super.

amy the costs of c-sections are virtually the same as natural births apparently. Post birth gynea, bladder and bowel problems aren't cheap to repair.

This seems very unlikely do you have a source ?
I thought the latest understanding was that it was the pregnancies that causes weakness of the pelvic floor not child birth per se. But would be very interested in your evidence.

The vast majority of prolapses are from vaginal birth, stop pretending to not know that.

Pregnancies do cause pelvic floor weakness so even elective c-sections don’t totally prevent that. Prolonged pushing during labour exacerbates the pelvic floor issues massively though.

Also, the NICE evidence for outcomes from c-sections lumps electives in with emergency c-sections. So though those statistics make c-sections seem like they have poor outcomes (emergency ones often do); elective c-sections have fantastic outcomes for the baby. I can’t link the evidence because the evidence is intrinsically flawed by definition.

It’s true that an uncomplicated natural birth arguably has the best outcome for the mother but electives have the best outcome for the child. I’m going for an elective for that reason. I have disabilities and so does my brother because we got stuck whilst being born naturally. My youngest siblings were born by elective c-section and are fine. The cost of looking after disabled people is high over a lifetime. Caesareans aren’t necessarily more expensive than natural births.

Glad the midwife responded well to you OP. I am not far along and just had my booking appointment a week ago. I mentioned then that I wanted a c-section and the midwife responded well and just explained what would happen and put note on file. So for anyone reading this I’d advise to bring it up asap. I too came with my reasons but didn’t need them as she was very supportive. Although pregnancy forums are useful I think you do tend to get more negative experiences reported on so you don’t realise that for a lot of women they don’t have to fight for a section.

Also I know just anecdotal but on c-sections and breastfeeding. I had an emergency section and found it hard to breastfeed at first as my milk hadn’t come in straightaway but once it came I switched to only breastfeeding and found it easy. So totally possible to breastfeed after sections even if there’s a delay.

My clinical experience is probrably 10 years out of date. But early term sections do cause respiratory difficulties and reduced breast feeding rates.
Ready to be corrected though, could you link some evidence please ?