Refused C Section- can anyone offer advice/share their experience?

[Quinners]

I am currently 36 weeks pregnant and have always leaned towards an ELCS despite being low risk (the unknown, uncontrolled element and higher risk of incontinence later in life for V birth were the main elements for my preference).
I told my Midwife at my last appointment and she was very patronising. She booked me in to see a consultant and i was hoping we could have an informative discussion about the risks, pros and cons etc. Wow was I wrong!

Firstly, the consultant took me to a room in the hospital and asked me to sit while she stood over me for the entire meeting (weird power dynamic move). When I said I'd like an elective she simply said 'no' and didnt even ask for my reasons. She then asked how tall I was and said 'oh you're tall and nice you'll push a baby out easily'. How is that a professional comment? She also dismissed my concerns around vaginal birth complications and said that she'd had three kids and was fine. I was hoping for data and statistics rather than a personal anecdote. She then became very keen on writing in my notes that l didn't want an induction (I hadn't even mentioned this) and said that if I got to 40 weeks without going into labour they'd book me in for another c sec discussion.
I left the meeting feeling extremely upset and disheartened. I don't mind the refusal so much but the way I was spoken to and the lack of actual facts/clarity is really disappointing. Would love to hear some advice or to see if anyone else has experienced a similar thing? My health board is in Wales so unsure if that makes a difference.
Thanks for listening

What makes you say that?

Ask your midwife to arrange an appointment with another consultant however from your post your perception of a c section sounds very skewed

Most consultants only allow ELCS if the woman has a severe phobia of childbirth that it's really impacting her mental health (this would be evident from the very first midwife appointment) or due to a physical health condition. There's risks with c sections too - long term numbness, shelf, infection, risk for any subsequent pregnancies, haemorrhage, death.

You can’t be refused. Just insist on a different midwife/consultant.

As a midwife I wouldn’t be so sure.

OP you are allowed a second opinion. Sadly it sounds like your midwife won’t be advocating for you. You could go through PALS or ask to speak to the community midwives manager for support. Don’t wait till 40 weeks. Do it today.

Height has a strong correlation to pevis size. That's factual. Some consultants recommend c secs for ladies with small feet/ very short.

Natural deliveries have better outcomes for mums and babies that's statistically true. I know no one with long term issues from natural birth only from c secs and epis!

Incontinence issues are often caused by weak pelivic floor and carrying the baby for 9 months- not always anything to do with delivery. The only lady I know who had bum problems long term had a c sec. Even friends who've had 3rd degree tears healed well. I think its much better than the horror stories of old, we know much more about how to protect pelvic floor in pregnancy nowadays.

But you are supposed to be able to choose so I would push for one if you're sure.

You've received some very odd responses here OP. Ask your midwife to refer you to another consultant. One that will approve the section. They aren't allowed to refuse you. Maternal request with the reason "I just want one" is a good enough reason.

I'm sorry you had such a bad experience.

By contrast, my consultant did exactly what you expected. Rattled through the stats/risk, had a very matter of fact discussion with me, and then booked me in then and there when I said I'd like to have a c section. I hope your next consultant meeting goes a lot better!

I thought hospitals/doctors were supposed to allow anyone to request a section now? Is there another hospital near to you you could ask to transfer to? I’m not sure if raising it with PALS would work.

I do understand the doctors/hospitals view though- you cannot fit that many sections into a day. The theatre turn around, staff required is so much more than a vaginal birth with one midwife present. And they always must have a theatre available for emergencies which would boot people off the planned list. To allow everyone to request a section would require so many more staff and surgeons the hospitals cannot facilitate.

Get Birthrights involved OP, you can directly contact them for help and advice. They were bloody brilliant with my situation and they can advocate for you. https://birthrights.org.uk/

Everyone IS allowed to request a section. A consultant may have the right to say no, but the patient still has the right to have one and must be referred to someone who will grant it.

That’s true- I was thinking out loud about the logistics.

The way I was treated by a consultant when I had a C-section discussion I'm not surprised or disbelieve this. I actually needed it for medical reasons and the way I was treated was actually disgusting.

Yep happened to me. I'm a high risk pregnancy and consultant led. Baby is 98th centile..they wanted to induce at 38 weeks as he'll be around 11lb at 40 weeks apparently and the risk of him getting stuck is high lala. Anyway before this saga id always wanted a section for other reasons and 2 consultants denied me. I was told I would NOT be allowed to have a water birth or give birth on midwife led unit due to my high risk pregnancy but I also wasn't allowed a section for my high risk pregnancy🫠

My plan was to accept induction and just try the pessary, if that didn't do it alone and hormone drip was needed I would decline and ask for a section again. I'd be somewhat dilated by then and they probably would've broken my waters so would've been tough. If I don't consent to a hormone drip and I'm not dilating myself they can't just leave me..

Luckily my midwife advocated for me and I have my section booked after seeing a 3rd consultant!

Unfortunately it does go down like this, more often than you obviously think

I wonder if you can get an appointment with a different consultant and have a better discussion. I understand why they don't want to give you a c section because it is major surgery and more risk for you and your baby, but it sounds like you felt dismissed rather than reassured when you are clearly feeling very anxious, hopefully they have someone else who can better support you, it is ultimately your decision.

I wanted an elective c after my first was planned due to being breach. Wow it felt like the Spanish Inquisition; me against five members of the medical team. I held firm and had to be quite demanding but they eventually relented but they were very patronising, cold and obviously using tactics to intimidate and get the outcome they wanted. I feel this is more common than we think. Another example of women being treated with contempt despite the guidance being clear on what our rights should be.

Tbh I can see the hospitals POV. there were 17 people in the room for my c section (failed VBAC). It’s such a waste of resources when you have the option of a vaginal birth

I’m so sorry that happened to you. Like other comments say you have a right to have a c section but the consultant also has a right to say no. I have a fabulous consultant who believes in every woman’s right to choose her birth no questions asked. Can I also add that I’m over 6ft tall and my relatively average sized first baby got stuck in my pelvis which ended up in a shoulder dystocia with all the manoeuvres and was deeply traumatic (hence my elective section this time round for my second). Please do get another referral and don’t worry about what the midwives think. This is your body and your baby and you can do with it whatever you want. Sending you hugs and strength.

I was first refused by a female consultant that sounded very like yours but I spoke with another consultant and he agreed to do it. It was over twenty year’s ago so I don’t remember the details but I got my c-section, and when I requested another for my second child it was agreed straight away.

But not every woman does want one. There are plenty of women who are totally set on not having one so that scenario is never going to happen.

I had both of mine by elective c-section.

Not true at all. A woman can elect for a c section for any or no reason. It cannot be refused.

OP, it sounds like you know not to go off anecdote, so please pay no mind to personal stories shared on here. I could share many an anecdote of LSCS (even elective) ‘gone wrong’. It’s scaremongering and it’s not how decision-making should work.

Maternal request LSCS is problematic. It kind of goes against the Hippocratic oath of ‘do no harm’, when we know that LSCS is fantastic as a life-saving intervention, but carries greater risks when looking at population data. There’s growing research over the microbiome and seeding and the impact that has. Again, totally irrelevant in a life v. death situation, but is it something you’d actively choose?

NICE have really screwed medical knowledge and research over here. We’re performing major abdominal surgery for a mental health or social issue. It’s actually a bit bonkers when you look at rates.

I would take this as a sign to research. Certainly book in to see another consultant, as the conversation should never be so railroaded. But I think your reasoning sounds vague and flawed, and it stands to reason they’re dubious about cutting through all your abdominal layers being in your best interests for that rationale.