Can I INSIST on having a caesarian?? also how are caesarian op dates decided?!

[MissDelighted]

I am 5 weeks pg with DC1 and am due to see the doctor next week. I wondered if it is possible to insist on a caesarian (in a normal NHS hospital) or if it is down to the doctors/midwives/hospital/postcode. I am certain I do not want a natural birth and want to make this clear as early as possible to the medics.

I am so set on a caesarian birth I am prepared to use savings to go private as a last resort, although I don't wish to have to do this.

Also, for anyone who has had a Caesarian - do they perform them bang on your due date or is it down to the baby's development nearer the time, or even beds available on particular days? How is it decided?

I would really appreciate any info/advice prior to seeing the doctor as I want to make sure I am armed with enough information not to be swept away with what she thinks should happen. Thanks in advance

that's strange isn't it Izy, my Grans are/were just the right generation, they had 9 homebirths and one in a cottage hospital type thingy(the nan with 6 had my 2nd uncle there because she got extra coupons hated it though)I've 3 generations of midwives(I'm hoping to make it 4) in my family, starting in 1920 and they've all been community ones as well, so the homebirth ethos must be pretty ingrained in the blood or something-saying that, i'm the only one who's homebirthed in the last 2 generations, but I'm the only one ever to have a C/S as well. One thing i can say is that we are, and always have been a very matriarchal family -My nan, who is 87 is very much the one everyone goes to with their troubles and she was my best advocate -she really spurred me to keep pushing for my 1st HBAC and was so proud that i was breastfeeding as well! perhaps i should hire her out as a doula!

Well Jamila its great that you have those family ties. I am a bit envious actually because I am an only child with just my mum (who is unwell). I really wish I had lots of family support to help me bring up my kids and to have supported me through childbirth.

It is true that I would not have chosen a cs if I had relatives living locally to have taken DS at short notice while I laboured (my friends offered but did not want to inconvenience them as labour can occur day or night as we know. Most of them work and have small children).

It was a huge relief to know that I was able (as far as poss) to plan care for my fab son and also to have DH with me for the birth of our second child. I honestly think that knowing who was going to look after him meant that DS was relaxed about the whole thing.

Some may think it is a scandal that I was allowed a cs on the NHS for such a reason but I do not take it for granted and I am very grateful.

Starlight....sorry to hear of your experience

I was offered EVERYTHING despite repeatedly saying I didnt want ANYTHING, but I think thats because I had a student midwife and she needed the practice She soon lost interest when it became clear I would not deliver on her shift

In the end I told her to get stuffed and leave me alone...I was coping OK with the TENS and breathing.

I think there is a case to be made for women being offered cs when suffering from PTSD due to their birth experience - but not just becasue they are afraid of the pain! I am due in September, like you, and of course I am scared of the pain and going through it all again, but after my experience of hospital antenatal "care" my son and I received I am angling for a hmoe birth this time round!

By the way, sounds like you have got PTSD due to your birth experience starlight - perhaps thats why the counselling didnt help you?

I am having an elective c-section. I was given the option as had an emerg sec with 1st pg. Drs contiue to try and talk me into have a normal delivery, probably because makes life easier for them and less expensive.

It is possible to insist if you really don't want to have a natural delivery. It depends on what the policy is of your hospital. You'd have to really badger them right until the end. If the thought of a natural delivery causes you a lot of stress then they may consider it.

Are you nervous about having a normal delivery because of the pain? I was the same with my first. One thing you can insist on is an epidural as soon as you get to hospital

Dizzy -the Op said that she is going to take advice from her midwife and consultant (as soon as she's far enough along to be booked in) and the reason VBAC is pushed is because it is less risky than repeat C/S, not because it's cheaper with the C/S rate creeping up, so was the mortality and morbidity(things caused by a procedure) and Cemach,Nice ,and the DoH are understandably unhappy about it,so hospitals are encouraged to go with the research and cut the C/S rate down -it's been as much as 40% in some private hospitals, where the rate for medically necessary ones is estimated by the WHO as 13%
anyway there's been some lively debate on this thread, well worth a read(as long as you miss out the personal attacks between some posters)

Starlight, if you read my last post you'll see that I think elective CS should be available for people with a true need for it. If you are phobic about childbirth then that's a medical need as far as I'm concerned. I just think it's VERY brave of women who have such phobias to plan a pregnancy when they don't know if they will have to confront that phobia head on or not.

Missdelighted - congrats on your pg
TMI alert
I haven't read most of this thread, but just wanted to share my experience.
I have suffered for years with a condition called vaginismus, which meant my vagina closed up completely when I tried to have sex. Eventually with the help my Dh it got to the point where I could have penetrative xes but was uncomfortable and times down right painful.
When I was pg with ds, I was frightened that because of this condition I would struggle to give birth natually. However I did - it took me 20 mins to deliver my son and I didn't even tear!
5 weeks is very early, most PCTs won't even book you in until you are 8 weeks gone. You can request consultant lead care at that point and discuss your options.
My dsil had an elective with her second daughter on her consultant's advice, and she had a horrendous time. It is not an easy option and you do need to weigh the pros and cons of delivery method. There is lots of good advice on this thread, both for and against. But I guess you need to make the decision that feels right for you.
Good luck in whatever you decided, but I sincerely hope you do decide that if your consultant says that a VB is safe for you that you give it every consideration. For me it was an absolutely amazing experience.

I have has both elective and VBAc so no axe to grind but just wnted to point out that the reason you cannot drive for 6 weeks is not just medical it is because most insurance policies will not cover you for 6 weeks after abdomminal surgery so if you drive adn have accident you and poentially your baby are not covered.

Sorry but jus a practical note ,I once kneew someone who drove within the 6 week period,insurance co would not pay out and she was left permanently disabled

I think the situation is variable according to your insurer. My insurer was happy to accept the word of my Dr. My Dr was prepared to ok my physical capacity to drive any time after 4 weeks. In his opinion as long as I was happy that I could do an emergency stop then I would be ok to drive.

There's some very interesting points being raised here and lots of food for thought. I am really pleased that the thread has developed into a good debate where people may not agree with opinions but say so very respectfully rather than scornfully. This is what I hoped to gain from the MN experience and I am learning a lot from posters' information, both about positive VB and positive EC experiences.

It seems it's mainly a case of reading up as much as possible and then making an informed choice as to what is right, all things considered. I do feel strongly though that women shouldn't be made to feel bad for wanting one type of birth over another (whatever it may be) by either other women or the medical professionals. Surely everyone is unique and has the right to be treated as such? Just because a person is 5ft tall and tiny who has a VB no problem does not necc mean the same result for a person who is 5'10" tall and struggles with VB. Actually I knew of someone from years ago like this which has obviously played a significant part in shaping my thinking. She was left to go overdue for 14 days despite feeling something wasn't right and requesting an EC after her due date passed, it was denied, they eventually induced her, the baby was enormous, she struggled in labour for 5 hours then the baby got stuck, they performed an emergency CS but the baby had already sustained serious brain damage and died after a few hours v v v . She was also terribly ill for weeks afterwards and needed several blood transfusions.

I know that for every bad VB story there is likely an equally awful CS story but even so this is the sort of thing about VB's that sends a chill down my back. Ridiculous though it sounds I have slight claustrophobia and possibly I am projecting that in some way onto a VB (getting confined/stuck in a small space) I just feel I have a sixth sense (and have done for years) that this is what would happen to me. Yes I know it may seem illogical but it's how I feel and I would need a lot of reassurance that this would be highly unlikely to be my experience. Particularly as this lady begged for an EC when overdue but was waved away . Now please nobody jump on me to tell me how foolish/stupid/misinformed I am being. Any constructive critisism or encouragement would be gratefully received though. Perhaps this is really a breakthrough time for me to face my fears.

It is difficult to overcome a tragic experience like this. I can see where you're coming from - I watched my sister give birth when I was 16 and it was a horrible, horrible experience and I'm still traumatized by it. It is important to talk with the medical professionals about it and make sure they are on your side and want what's best for you and can help you, individually through this. Email me if you're up for it - [email protected] - I'll let you know what I have done so far (I'm 22 weeks)

I also know someone who lost their baby at 2 weeks overdue after being refused an induction or CS (labour room too busy). It does happen. But I think you have to remember that it does not happen a lot. And whilst some reasons may be unpreventable, what happened it the case of my friend and yours was that they were given very poor care. Their concerns should have been listened to. Their babies should have been checked. And if there was any doubt then placenta function should be checked. In your friends case, during labour, any concerns over the babies wellbeing should have been noticed. And if it was the case that her baby didn't show any signs of problems until becoming stuck, then that in itself is very rare. Babies getting stuck isn't that common at all I don't think. And it's usually very easily remedied.

I think you have to write off your friends story as a "one off" or "poor standard of care" rather than a "because she didn't get a CS".

You never know, you may have a fantastic VB. I did with my DD. Actually, I would LOVE to do it again. It doesn't have to be all bad. Even the pain was good. I know that people do have bad experiences, but there are people that have good ones too. Though they tend not to talk about it as much in RL. There are some brilliant childbirth books out there, perhaps someone can recommend one? IIRC, one is called "Birth without fear"? but can't remember who by.

I also think that if you do go for a VB, then you should try and read up as much as possible to feel confident and positive about it. Negative reinforcement is powerful and if you feel your baby will get stuck, then perhaps your baby will get stuck IYSWIM. If you have some confidence in your body's ability to give birth, then you may have a better outcome. And before someone says it... yes, I know that positivity won't always make for a good birth experience. And I also know that some womens bodys fail them. But I can't see either of those as reasons not to have a sunny outlook before it happens.

missdelighted That's really interesting about the claustrophobia, I'm a bit like that in that I do get incredibly uncomfortable very quickly if I'm in a small space or if someone invades my personal space - I was born breech, with the old 'forceps for the aftercoming head' mallarkey, and I've wondered if that's had an effect -perhaps rebirth therapy might help both of us

MissDelight I am so pleased that you feel ok about coming back to the thread you started. Indeed it is ok to have a 'full and frank' debate (without belittling those who hold an opPosing opinion to yourself). I too feel that we have manged to achieve this in a positive way for the latter stages of the thread. Thanks ladies I have enjoyed sharing with you.

OK, I admit I haven't read all of the posts on here, it all got a bit nasty after a few pages and I gave up, so for what it's worth here's my contribution...........

A friend of mine who was due with her first baby a few weeks before my first was ADAMANT she was going to have a section. I thought she was mad, but there you go. She was refered by her midwife to a consultant who said there was no reason for her to have a section so she asked to be refered to another consultant - aparently we all have the right to ask for a second opinion and if your first consultant doesn't agree with you you can ask to see someone else. She was successful with her second consultant and got exactly the birth she wanted on the NHS, an extremely happy and relaxed planned section. She had to really fight for it though and is a pretty stong character thankfully or she woudn't have managed it.

In retrospect (after 2 sections, one emergency and one elective), I no longer think her as mad as I once did.......

Hello NTE & izyboy, yes I was certainly caught off-balance with the uncomfortable start but it's now developed into an informative and interesting thread that I am finding very helpful and perhaps others who daren't open the CS/VB debate themselves are too. Star6 - I will email you over the next few days and we can swap notes

NTE, I do think that something someone said earlier was good, that the woman fares better if she has achieved the birthing experience she wanted, whatever that birthing experience may be - that sounds just like your friend, also the others who have written in with positive experiences of VB's too.

suzi2, you are right, it is more about the poor standard of care than her not having a CS as such. Who knows, perhaps she would have received the same poor standard of care if she was having an elective CS, and suffered anyway . I just got the impression that the medical staff had been very high-handed with her, because they were the "experts". Ultimately there was an error of judgement made that cost that family dearly but I accept this is not the norm.

I do agree that a positive mindset would be neccessary whichever birth plan you take.

Jamilia - ! I hate being sat in the window seat on the plane, or being in the middle of a row of seats in the theatre/cinema (will do it, but don't like it), I always have to sleep on the side of the bed nearest the door, I am moderately uncomfortable in crowds/large queues - little things like that! I'm fine in cars, lifts, cable cars etc etc though. Maybe that rebirthing thing would be good!

Hi MissD if I can find the letter I wrote to my consultant I will post the quote from a Pschology study that revealed exactly what you propose. Those who received a cs because they wanted one are generally happy with the outcome and have no problem bonding with their babies.

No reason why you cant make subtle enquiries with your midwife as to which consultant may be amenable to your cs. This is what I did from about the time of my dating scan.

Just bear in mind cs is no walk in the park but I didnt find vb to be easy either. I am pretty pragmatic about childbirth so I think it helped me to be quite logical about my choices.

I had to laugh when I first requested a c-section for medical reasons on the NHS (from the consultant who was dismissive of my condition). She said that perhaps counselling would help and that she could refer me for it. Thinking it might help I agreed only to be told there was a six month waiting list.

I was 4 and half month's pregnant at the time. She couldn't understand why I thought that was funny. I refused the referral and a all future appointments with her and decided then and there that I was going to go home to have my baby.

Mind you, I think that for someone with a genuine fear of childbirth (as opposed to someone who's asking for a section because of a complication or because they've had one before) counselling is probably not a bad idea if available.

I had no fear of childbirth but I had a fear of the consequences of my condition if I had a VB - something that councelling wouldn't have helped unless the councellor could have magically cured me!

I had no problem bonding with my baby and no problem with recovery (apart from one very small wound infection that cleared up within a week with a cream).

Regarding your friend - that's horrible! But hardly indicative of a VB. Unfortunately, it sounds as though she had poor care and attention and what happened was down to old-fashioned neglect on the aprt of the hospital/midwifery team. Sadly, it does happen.

suzi2, I think the book you're thinking of is Childbirth without Fear by Grantly Dick-Read. I have just finished reading it and was v impressed - although it's not an easy read as it was written 50 years ago and is quite heavy going in places! (I like to think I'm an intelligent woman, but pregnancy brain means reading any book now without pictures and big words is a bit of a struggle!).

I have found this whole thread very interesting and pertinent to me - I also have 'weird' anatomy and always have a nightmare with smears, etc, but I do know that this won't affect how the baby comes out. However, I do have a fear of something going wrong during the birth and did go through a period a couple of months ago (I am now 38 wks pg) when I was convinced I wanted a c-section and nothing else - hence, the reason for reading the book. I have now done alot more research and think I have changed my mind, but the thought of the pain does frigthen me alot. I have a very low pain threshold and am scared about how I'll cope.

All my fears are not helped by the fact that the last FIVE women I know who have given birth since January have all ended up having c-sections! Is this just a statistical anomaly or are they becoming more common again? Tbh, I really don't want a c-section now cos I already have a very nasty keloid scar from my lap and dye last year so god only knows how bad a CS scar would be.

Anyway Missdelighted, I hope you find enough information here and in RL for you to make an informed choice and are happy with that choice. Fear of the unknown is huge and scare stories don't help - either about VB or CS - but what I keep telling myself is that women were designed to give birth and have been doing it for thousands of years without surgery and pain relief so I guess I'm hoping my inner cave woman will help me out at some point.

Good luck.

Have you read The Gentle birth method by Dr. Gowthri Motha??

I was afraid of giving birth until I started reading up on natural birthing and doing hypnotherapy. I think watching TV programmes depicting childbirth started them all off. I just needed to reprogramme my brain.

Poohbah, I'm not sure that TV births (like those on discovery channel) are any good at preparing you for birth either. It's very hard to watch someone else in pain and perhaps struggling. When I had DD if anyone had been filming it what they would have seen is me mooing like a cow, near tears telling the MW I couldn't cope anymore and to take me into hospital, and then when pushing screaming that I was scared. But actually, I loved it! Those moments were just that - moments. Overall it was great.

Spongebrain, CS rates can vary widely from hospital to hospital. One near me your odds of a CS are about 1 in 3. But at another hospital they're more like 1 in 10. www.birthchoiceuk.com is a good site to see the stats.