Elective C-section (Questions)

[Babyenroutee]

I am due in 9 weeks with my first born, and I am considering putting myself forward for an elective C-Section. I have Epilepsy (CPS) and although I have been seizure-free for a few years now, I don't want to run the risk of triggering seizures again during labour, as mine are triggered by stress and tiredness there is definitely a risk. A consultant for this is already seeing me during my pregnancy so I can discuss this with him. (Wirral NHS)

I have a few questions below I am hoping people might be able to help with / share their experiences:

• My next appointment with my consultant isn't for another 3.5 weeks. At this point, I will be almost 35 weeks pregnant. Is this too late to request one? (I haven't discussed this with anyone as of yet)
• Will I need to be referred for further conversations about this or have to 'prove' my case, or should it be quite straightforward considering the epilepsy?
• Will I likely go in for the c-section at 39 weeks? Or is there a chance it might be scheduled for before/after that point?
• When will I likely be given my CS appointment? (As in how many weeks in advance of the date will I be given it) And do you just get given a time on the day, or is that given in advance too?
• Do you have any say on the date of the CS or are you just given a date? I am 39 weeks on the 27th Dec and 40 weeks on the 3rd Jan, so conscious my 39th week is just after Christmas and in between Christmas and NY? - will this make a difference due to staffing levels etc?
• Can I do skin-to-skin straight after the baby is born via CS?

Sorry for all the questions and thanks in advance :)

I'm 2 days post section. Can't answer all your questions, but he's some info:

ELSCs usually happen around 39 weeks. When babies are born vaginally, something happens to their airways to prepare them for life outside. Obviously without passing through the birth canal, sectioned babies don't experience this. They are kept in until around 39 weeks to give their lungs time to fully mature. Alternatively, if birth has to happen sooner mums can be given steroids to aid this maturation.

Appointments are given depending on circumstance. Mine wasn't scheduled until I was 35 weeks, but I was given 10 days notice. You don't get to pick the day; it depends on the doctors' availabilities. Notice will vary depending on circumstances/availability.

You're told to be there in the morning, and they take you to theatre when they're ready for you. You may get bumped to the next day if there are emergencies.

Your specific dates you'll have to discuss with your consultant, because no one here knows your hospital's staffing levels.

Skin to skin during c section is encouraged. My baby was taken to NICU but I was able to hold him first, even with all the tubes attached.

All the best!

@UnravellingTheWorld Thanks so much, that's really helpful.

Fingers crossed it's not pushed until the following day, I'm sure I will be feeling impatient by that point haha. I will have a chat with my consultant and see what he says then.

Thanks again & hope you and the little one are recovering well.

I had an EMCS with my first and elective with my second. I can answer your questions from my experience but things do vary between regions

"I will be almost 35 weeks pregnant. Is this too late to request one?" My appointment to request a c section was about 36 weeks - I remember as I was desperate not to be pregnant anymore but they wouldn't do it before full term!

"Will I need to be referred for further conversations about this or have to 'prove' my case, or should it be quite straightforward considering the epilepsy?" I imagine it would be straightforward, I only had one appointment and mine was just because of the previous birth experience

"Will I likely go in for the c-section at 39 weeks? Or is there a chance it might be scheduled for before/after that point?" Just depends on the availability, they were originally booking me in for 40+1 as that was what was available but luckily I ended up getting a cancellation a few days earlier.

"When will I likely be given my CS appointment?"
"Do you have any say on the date of the CS or are you just given a date?" I got my appointment at the consultant appointment. I had no choice as it was busy but my friend did get a few options of day. You don't get a time, just to go in first thing for pre op stuff and that you have to fast and then you get taken when there's a space. I was lucky and went in at 10am, the other woman waiting was later in the afternoon, I know one person who was sent home and had to come back the next day!

"Can I do skin-to-skin straight after the baby is born via CS?" Absolutely ☺️ I did with both. My youngest had to be taken away for a bit but was brought back before I was out of surgery!

@mumofbun Ah brilliant thank you. Glad to hear I haven't left it too late to discuss as I know some people know right away they want one and mention it early on, but it's taken me some time to consider my options and weigh them up, I'm pretty set on a C-section now though.

I bet that wait when you go in feels like such a long wait until you get a time.

Thanks for your help :)

You are allowed a c section according to NICE guidelines even without a medical ‘need’ both of mine have been maternal requests as I didn’t/don’t want a vaginal birth.

in my area they don’t book c sections in until around 35 weeks due to staffing, so this should be fine, however if you are worried there’s no harm in letting your midwife know that you want one now, then you might be able to get questions answered/booked in sooner.

at my trust they do all c sections after 39 weeks. Last time I was 39+1 and this time I’ll be 39+3. I have to go in for 7.30am, last time I was lucky and was the first c section of the day, had him at 11.30am, but it could be later or even the next day if there’s emergencies happening.

good luck!

@Peonyyyy Thats good to know when you had both of yours too, I'm just wondering about mine because of the Christmas period but will speak to the consultant and see.

Hopefully, I will be first in too! How long did you stay in for after yours, please? Thanks

Can’t answer all your questions but: I had an elective in the week after Christmas. I was given a choice of 4/5 dates. There was no problem re staffing - I picked what you’d think would be a tricky day and had one of the most senior surgeons. The operation and postnatal period were both very calm and relaxed. Much better than my previous emergency section!!

wishing you all the best xx

@PiratePetespajamas Oh brilliant that's so good to know thanks. How many weeks were you when you had yours just after Christmas? And were the 4/5 date options you were given, all post 39 weeks? Thank you xx

My section was a week earlier than planned and baby lungs weren't ready despite the steroid jabs so some time in NICU so do 39+ if you are able, despite the Christmas period

@HappyHedgehog247 Okay good to know thanks. I would ideally like to go for 27th which is a week exactly before my due date but of course, I appreciate it'll be down to their advice and availability etc. Thanks for your help

My friend was originally booked in for her birthday. When the midwife spotted it she shifted it a day so they have separate birthdays! If schedules permit their can be wiggle room obvious baby can have other ideas! My daughter arrived the day before my mat leave started at 38+6!

They told me they usually book it when you are 39weeks and 5 days, but put it on one day with DD as it was a leap year and she would have been born on the 29th February.

I got the date at my 36 week scan, I had a scan the morning of the section to make sure she hadn’t moved position as I was having one because she was breech. It was a surreal experience but very calm.

@Babyenroutee i also have the Christmas issue this time! They have booked me in for 27th December. It’s tricky with all the bank holidays!

last time I was discharged the following evening so was in just over 24 hours. I had some feeding issues which kept me in, but if I hadn’t had those I would’ve been out first thing the next morning. I think they just like you to be able to go to the toilet and you have to fill a couple of containers with wee, and they do other checks too. If you want to go and pain is all manageable etc they are happy for you to go.

I was worried about pain as I’m a wuss, I took all the morphine offered in hospital but when I got home was only allowed ibuprofen and paracetamol, and they were honestly fine. I don’t remember having any pain really (I just had to walk around carefully for a few days and try not to use the stairs too much!

@Peonyyyy Ah thats good to know. What date is your due date if your scheduled in for the 27th, if you don't mind me asking?

Thats all great info though, thank you for your advice x

@Babyenroutee 2nd Jan 🙂

@Peonyyyy Ah soo exciting. I am the 3rd Jan. I have my MW appt on Thursday this week so I will discuss it with her then and see. Thanks again & best of luck to you 😊

Sounds a sensible choice to me. The hospital will know better than you about the staffing levels and can set the date accordingly. Although be aware you can be bumped if others need emergency sections. (It happened to me!)

I honestly found elective section to be an excellent way to have a baby. Very calm, and surprisingly easy recovery too. I had one day where I was sore after missing a dose of painkillers, but keep to schedule and you'll be fine. Take it easy of course. Best of luck with everything xx

Just to add I didn't take the cocodamol at home as DD was a very sleepy baby and I was struggling to get her to feed. Paracetamol held off the pain really well for me.

@PlantDoctor Thank you for this, the more I have thought about it the more I also think its the most sensible option for me.

I have my next MW appt on Thursday this week so I will mention it to her then, and hopefully, it can be agreed and planned at my next consultant appointment on the 27th Nov.

Were you bumped to the following day? Or just later in the day?

Thank you xx

We waited around for several hours (maybe 6 or so?) in scrubs, then eventually they sent us home. It was rescheduled for 5 days later, which was 2 days before my due date. All went perfectly that day.

You don't have a say on thw date they'll do on a weekday on or just after week 39

Ask your midwife now - call them

You might need to do a 'birth choices' appointment so they can be assured you understand the risks but they should let you go ahead - my hospital didn't

Did*

@PlantDoctor Thanks for that, it's good to know and prepare myself in case I am pushed out by a few days too - I can't imagine that wait is the easiest! Glad to hear all went perfectly well, that seems to be the general consensus with elective CS's.

I was quite sad, but I guess it was an emotional rollercoaster of a day! (Plus pregnancy hormones!)

ime they book you in around 37 weeks for the section as near to 40 weeks as possible.

as pp said they may question- they won’t deny but they need to make sure you have thought it through properly, are aware of the risks, and are making an informed decision.

have all your reasoning prepared, and request your section based on the risk of your epilepsy being triggered and the greater risk with a VB etc.

i absolutely hated my ELCS, it was awful. But still the best choice in my situation- my first child nearly died and they weren’t sure whether the same issue would occur in the second pregnancy.