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 ☺️☺️

But early term ones are more likely to be emergency ones. Electives are generally not early and have less risk (not no risk but not as much as the NICE stats). https://pubmed.ncbi.nlm.nih.gov/32969374/

You come across as a troll who doesn’t want to read other people’s posts. I read yours and acknowledged what you said. You have responded to everything people have said to you dismissively. It’s interesting that you want to swat down caesareans on a thread where OP is having a caesarean and is happy with that choice. Your comments are not adding to the thread; they’re trying to say others are wrong and you’re right. I’m not going to feed the troll anymore.

I have read every post on this thread and I have wittnessed hundreds of births.
Your paper is comparing elective vs. emergency c- sections. Of course planned sections have a better outcome that should surprise no one.

If you had read my post and other people’s posts you’d know that that is the whole point. OP is having an elective and this has better outcomes than you are saying. You’re scaremongering but you’re probably using NICE (I work clinically too so I know where guidelines come from). Elective and emergency aren’t separated in the statistics.

C sections aren’t as bad as you’re saying if they’re elective. That was my whole point so I’m not sure why you’re trying to say it’s redundant. Read people’s posts; they’ve afforded you that courtesy.

I bet you’ll have something high handed to say.

But your issue is with elective sections, as obviously by definition emergency ones are medically necessary.

@Goldencup what are the huge societal implications of 46% C section?
Why does this concern you?

@Superunknown1 so glad it's all going smoothly. Had section with DS1 (maternal request at Kings - no problem there) and booked in for 2nd. Was a great decision.

@Goldencup just read your updates sorry... even if breastfeeding is slightly lower with c section (are you sure this isn't just correlation?) that's hardly having a huge societal implication.
I breastfed my c section DS btw and so did many others I know.

Elective sections as an alternative to vaginal birth. Elective c- section as the default. Elective c-sections which prevent emergency ones or birth trauma for either mother or infant are wonderful. The rate (according to the WHO) needed for that is about 15% ( that includes the emergency ones). So up to 30% of women are having a c- section they didn't need. We need to look at why this is, is it really what is best for the women themselves ? Their babies ? Or the women and babies who come after them ( which I know many women on this thread think is irrelevant) or the health service ?

My own bit of aneccdata my grandmother had 4 vaginal births, she was continent till the day she died at 96, my mother had 3, she is post- menopausal, no continence issues. I work in a religious nursing home as a student many of the nuns were incontinent in their old age. I am not sure there is a direct correlation between child bearing and later continence. Obviously significant birth trauma (3rd and 4th degree tears) will impact google tells me this complicates only 6% of births.

I think some of the responses here are really harsh. I think the issue with society isn't how we give birth its how we talk to each other.

In my opinion, I didnt want to give birth either way 😅 but baby had to come out. A very close relative of mine had a traumatic vaginal birth so I totally understand OPs fears and I think you are well within your right to opt for c section. I was in labour for 48 hours and had a vaginal delivery with a 2nd degree tear and a bad post partum heamorrage, my husband genuinely thought I was dying so I understand why people would want to avoid that. My view on my birth was so different to my husbands. I felt so empowered and revelled in what my body did and never feared for my life but the birth was just one part. No matter how my baby arrived I would still look at them every day and revel in the fact I grew that baby with my body. I should point out though that I was on the ward about 6 hours before begging to go home and a poor woman across from me was going through hell after being in 2 days post c section with complications after. She seemed in so much pain. Every single birth is different. Some people recover well from c sections some don't. Some recover well from vaginal births some don't. Why don't we all just accept each others decisions and not call people out and tell them their wrong?

@Superunknown1 I wish you nothing but the best of luck with your birth and baby and I'm so glad the midwife was so understanding. Hope your consultant is just as good 🙏

Lil update on this! Saw consultant last week and was given paperwork to read through, and if my mind hasn’t changed then the appointment at 33 weeks we will be getting the c-section scheduled!

For anyone in the same boat as me, do bear in mind that the consultants do seem trained to dissuade you from it (I mentioned my stepdaughter’s birth which was horrific for both her and mom, her head ended up stuck in birth canal after unsuccessful forceps and ventrouse and had to be ‘pushed back in’ for an emcs and consultant said this was not physically possible and just something exaggerated to scare me! I went with my mom and can’t imagine how it would have been if partner had come, he was the person who saw his daughter’s birth firsthand and knows it definitely happened!
She didn’t come across nice at all but I understand her job isn’t to be nice. She recommended I have a look at a midwife-led unit to see what it’s like and I declined. Was almost in tears on the way out but was proud for standing up for myself x

OP I'm not sure if this an option for you but I did private maternity and had an elective csection (in London). If you start private maternity towards mid/end of your pregnancy its less expensive than starting from 12weeks. If you like, DM me and I'll give you details.
It was expensive but worth every cent to be able to make my own decision as opposed to begging some NHS midwife / consultant- there's no dignity in that.

@Superunknown1 well done on standing up for yourself and good news that you’ll be able to have it booked at 33 weeks. Your baby, your body, your birth! I think there obviously are some people out there who are either easily put off when they try to give you the skewed risks or will actually be open to being swayed into a birthing unit (or home birth as they tried to suggest to me 😂😂)! I am definitely not one of them though but these tactics must get their numbers down sometimes.

I’m not getting to book mine (second baby) until 37 weeks this time and it’s stressing me out 😬

It's awful how much is a postcode lottery when it comes to birth choices being respected and listened to properly!

I feel really lucky as I was ready for a battle to have mine signed off but have been so pleased that the midwife and consultants have made it very clear that as far as they're concerned, as long as I've been told all the pros and cons of different choices, it's absolutely up to me to decide and they haven't pressured me.

I'm gutted to hear that it's a rare experience and that other women are being reduced to tears by it - that's awful

The rising rate of sections won’t just be for first time mums, it will most likely be for second time mums. At the moment there is likely due an increase from women who gave birth during the pandemic and were treated like animals (myself included). Another issue is that pain relief isn’t guaranteed in vaginal births. No matter how much you ask for an epidural in your birth plan, if there aren’t enough staff to give you one on the day, they are perfectly happy to let you tear your flesh without pain relief.

I also just had a chat with the consultant midwife who was going through all the c section risks with me, one of which was excessive blood loss. I said that’s interesting as my friends who have had quick second vaginal births or been forced to attempt VBACs are the ones who have had the blood loss.

Just seen your West Midlands. This wasn’t at UHCW by any chance?

Ugh can't stand the pressure, let women decide what they want with no judgement! What if you were someone not mentally as strong and were easily persuaded.
Well done you OP.

@QueefQueen80s Honestly if I’d gone in not braced for a fight I’d absolutely have crumbled because it was quite intense! Everything I said she had a comeback for, it was quite stressful 🥲

Awful. I had sections and they were so safe and unstressful, no damage causing issues for years to come.. women shouldn't be pressured to go one way just because it's cheaper.

I completely agree with Goldencup, the rate is way too high. The optimal rate for good outcomes for both mother and baby is 10-15%. Definitely not 50%!

I’m over 40 and because research is so poor they are pushing C-section before due date on me when I don’t want major surgery. I’m not ill, I’m pregnant.
I have had a very healthy pregnancy, but they admitted they push more women over 40 to have induction (likely leading to C-section), or C-section, just in case as they have no evidence based research good enough. Literally hundreds of women that don’t really need it. Staffing, avoiding liability and resources and eliminating very tiny risks, are all a factor in what they say.

Media and terrible clueless films scare everyone, women struggle more, you hear a bad story and the cycle continues. Fear is literally the worst thing for labour but we are being conditioned to fear it.
Education into how birth should be is right, and women suffer unnecessarily because we are so lacking in normal happy birth stories. Hypno-birthing for example. How many people I know now have done that and had 4 hour labour with barely any pain relief.
It makes me angry that the research is so poor and the support is so bad women can’t trust themselves or what they are being told and think C-section is the only option left. It’s not a walk in the park.
I dearly wish they would stop pushing it on me and let me just crack on with my own far far better way.

@Emmerz Glad to hear your way is ‘far far better!’ - I’ve had my baby now. He’s 5 months old now and was born 2 days before his due date by elective c-section. For me that was far far better than what was best for you, and that’s totally ok! Mine would have ended in a c-section either way as my baby was very large and the people who did my section told me this, so for me it saved trauma for both me and my baby, both physically and mentally as the idea of giving birth was a bit traumatizing. I’ve only ever heard of people I know being pushed towards sections when there’s good reason, as at least in my local NHS trust they prefer saving the money and theatre staff I think! It’s. It the convenient option for them. I was sent home from my first scheduled date as they were run off their feet with emergencies.

I do know people who were advised strongly to have c-sections and ignored this and tried to deliver vaginally and had bad outcomes, I am all for advocating for my own body and needs but also taking the advice of people who know better than I do. I think the key thing is that women should have the choice and not feel vilified for it either by medical staff or by other women. For me, my decision was best and it mightn’t be the same for others, and that’s okay. But I gave my baby the least stressful start to his life I could and learnt a lot about sticking up for myself in the process!

Well thankfully not the case ♥️♥️
Love how women can choose now! I've been saying it for years.
I chose my two and no regrets.
All that stuff @Goldencup posted pales in significance compared to women escaping the chaos, pain and lifelong issues from vaginal childbirth.
I don't know anyone who didn't have issues for life
But it's considered just a normal part of life?
No, our bodies are not ideal for that process

Folklore! 😂