Should elective C sections for no reason be allowed?

[Dori92]

Just curious on people’s opinions on this.

Would like to point out I’m not opting for an elective section.

Thanks 💞

Yes women should be able to choose one if they want one. Or not to have one, if they don't want one.

And before someone says they cost too much it costs the NHS a lot if a baby is disabled, or to sort out a woman's bits if they get badly torn. Or to sort out the woman's mental health if she's traumatised by a difficult birth. Elective c-sections are very safe and are not dangerous "major surgery". They are totally different to emergency c-sections when you are getting a baby out in a hurry.

It's time to stop treating women as if they are too feather-brained to know what is good for them and let them choose. It doesn't affect anyone else but them. It is completely immaterial to me how other women give birth and that should be everyone's opinion. Same applies to abortion etc. If it doesn't affect you, why would you care?

What has one to do with the other? A maternal request c section doesn’t mean that a woman with a breech baby won’t get their section. And a section without medical need already is lowest priority and will be bumped back if emergency sections come in. I think you need to be a bit clearer about what you actually mean if you want a meaningful discussion.

No it isn’t. Emergency sections always take priority. I don’t know a hospital where your scenario would actually play out.

i had an elective for my second after I was unconscious and blood transfusion with energy c for my first. I never wanted that experience again though I cannot fault the care I received - both times.

our body. Should be our choice.

When I was scheduled to go down for my maternal request section (due to tokophobia), we had a delay of about 30m because a woman needed to give birth first as it was looking like she might need the theatre. Her baby was born then I had the section.

They always deal with emergencies first.

I would imagine that a situation where the mother or baby is unwell and delivery needs to be rapid…this would ‘take priority’ over anything else ‘waiting in the queue’

If it’s breech (footling or otherwise) I don’t think that alone trumps an elective CS…do you mean the order of the surgical list?

Any emergency need to for a CS is going to trump any elective need for CS (including due to being breech)

With the inhumane way too many women in labour are treated, thank goodness maternal choice is allowed as a reason. It's totally unsupportable to make someone go through something as prolonged and traumatic as birth (especially given the way they'll likely be treated).

Why?

Yah my son is 19 months old and I added up all the appointments I’ve had since I had him. (Enormous baby, vaginal birth, very bad.) 36! + 10 with a private physio. My bum got ripped, I nearly died and I got a blood clot from being in hospital for so long. THEN my bladder fell out when I lifted the car seat at my 8 week midwife appt. Then, rather inevitably, I got PTSD and needed therapy. So 46 appointments total + my husband is on the waiting list to get his PTSD sorted out and I might still need surgery to hitch my bladder back up again when I hit the menopause. A c section would have been way cheaper.

I had the msot traumatic vaginal birth imaginable. Was failed at every single part of it. In training midwife left to deal with 5 of us all in labour on her own at once. Left it too late for pain relief so I gave birth with the emergency team, naked, in pain in agony and with chaos around me.

I dont blame the people. The NHS is where it is and they are doing their best.

Would I chose to have a c section next time? No. But I can fully see why people would.

Through prior experience or just plain choice.

Thats the thing about the modern world. We have choice.

I think every elective c-section without medical reason I’ve known of personally, has been because the mother previously had such an appalling, physically and and mentally damaging multi-day (usually medically unnecessary) induction courtesy of the NHS ending in emergency c-section or instrumental birth - that they never want to put themselves through that ever again.

Which seems like a good reason to do it.

This is a slippery slope though…I had an elective c section mainly due to my age which makes complications more likely (but I still was encouraged to try vaginally by NHS midwives). You could say now I should pay because I chose to have children later in life which led to having a c section, but then we need to think about whether obese people should pay for additional tests (eg gestational diabetes which you do if BMI over 30) and potentially a section, whether smokers should pay if they need treatment for lung cancer etc.

Yes

In my opinion no, not if the reason is purely preference rather than anything medical. Birth is a natural process and shouldn’t be interfered with for no reason. Major surgery, risk of infection, need for antibiotics, poor start for baby’s microbiome and immune system, need for blood thinning injections for days after birth, increased need for pain relief. A c section is a medical intervention so should occur when it is medically needed. The whole reason anyone is even opting for a c section purely out of preference is because birth has become so medicalised that women are fearing giving birth, so they address this fear by going down a different medicalised route.

Yes this has happened to at least 3 friends of mine

Years ago I would have agreed with you OP.

Since then I have witnessed two of my friends be forced into inductions they didn’t feel comfortable with that led to emergency C sections and associated trauma. Categorically if they had their time again both would say they would have preferred the control of an elective.

My cousin is a women’s health physio and she often expresses concerns about the induction to emergency c section correlation and the impact that this has on women’s long term outcomes in terms of pelvic floor, core and general recovery. Not to mention the risk of the stress on the baby.

Another friend of mine is considering an elective c section. Not because there is a true medical reason to have one, but because she is asthmatic and stress is a big trigger for her. She wants to exercise control and limit complicating factors.

So I’m really pleased to say I have changed my mind. A c section wouldn’t be my preference over natural birth but I firmly believe it should remain as an option to women who feel it is the best choice for them.

The elective sections don’t take place in the same theatre as emergencies; the team dealing with elective sections are different to the on call team who attend emergencies

There are so many reasons women opt to have a CS and it is absolutely their right to do so.
Women should not be made to feel guilty in the choices they make over their body.
In my unit women are counselled thoroughly on the risks and benefits of elective CS.
There is always a reason for an elective CS. It's so sad to see women stand in judgement of other women at such a vulnerable time in their life.

“Birth is a natural process and shouldn’t be interfered with for no reason.”

Some hospitals now have rates of >50% of inductions. In some hospitals 50% of those inductions end up in emergency c-sections.

Which is rather important in understand the current birth landscape and choices women are making IMO.

Absolutely yes. I had one with my DTs, got told by one consultant that the only reason he was ‘considering allowing’ me to have a section was because of the multiple pregnancy which is ridiculous and I pointed out against guidelines. It’s my body and should be my choice and was as the next consultant booked me in without asking any questions at all.

Priority should be medical emergencies first, then work the way down the line with riskiest first irrespective of whether it’s maternal choice or not.

I ended up with a surprise elcs due to severe pe. I would’ve been earlier in the day but they had to scrabble to get enough people in for it as we each had our own team.

I had an elective for medical reasons, and I waited 4 days from my booked in date because there were so many emergencies. I would never have been placed before them on the list.

Elective sections never take priority over emergencies. What are you talking about? Medical need always takes priority. My hospital did electives and emergencies as separate surgeries anyway.

I think the induction rates are shocking, and they lead to increased amount of c sections as you said. As I said it’s all become a very medicalised process where women who aren’t having a c section and are having a ‘natural birth’ aren’t even left alone to be allowed to have that. They’re hounded into having inductions - interfering with the natural process and leading to poorer outcomes. So my view is in general that the birth process shouldn’t be medicalised, there should be a significant reduction in inductions and planned c sections should be reserved for medical reasons. That is my opinion.

I honestly feel like every other person I speak to having a second is having an elective c-section because their first birth was so horrendous.

And basically if you’re looking like you’re going beyond 40 weeks they’re going to be putting pressure on you to get induced now - and elective c-section may feel like the only way to avoid that.

I had obstetric cholestasis with my second and was due for induction at 37 weeks. My waters broke the day before that. I went into hospital, was in agony and ignored most of the day, to be shoved two paracetamols, baby was back to back not much was happening and she suddenly turned, was fully dilated and told I ‘couldn’t be’ and to calm down etc her head was crowning, then a trainee delivered her, pulled her head so hard she stretched her brachial plexus nerve and fractured her arm in the process. Had she of torn her BP nerve she’d have been disabled down that side of her upper body.
She was far too aggressive when my birth was straight forward, no emergency, and they admitted this. They also missed the fracture after her X-rays for 2 weeks and left a physio doing exercises on her arm during this time, until a radiographer called and was mortified it wasn’t picked up initially.
I got a letter of apology from the head of midwifery and I pushed for a proper investigation with outcomes and have been ignored.
Its traumatised me and if I got pregnant again I’d have an elective c section. I do not trust midwives.
I was also recently a birth partner for my sister and they just did not listen to her (FTM) whatsoever. I was advocating for her and baby, but both ended up so exhausted (as was she on hormone drip) ended up in her being cut from arsehole to breakfast time, forceps to yank baby out and both contracted sepsis.

Not a single person has the right to make any woman feel shit about how they choose to deliver their baby.
Especially being so incredibly vulnerable during childbirth, and the state of our healthcare system.

If you're pregnant and full term, there's a reason. I'm against people who aren't pregnant having elective sections however. Or emergency ones tbf.