Elective C Section on Christmas Eve

[LilacPandas]

Hello 👋 first time poster here - just wanted opinions/advice on my current situation.. sorry it’s a bit of a long one!

I’m a FTM, 37+1, and baby has been frank breech for the past few weeks, including at my last growth scan yesterday, despite all efforts to turn them (except ECV, midwife basically advised against it as I have an anterior placenta and low PAPP-A so risks outweigh likelihood of it working). Baby is also on the 97th percentile but I passed the GD test at 28 weeks and nobody’s ever mentioned retesting.

Ive been low risk the whole pregnancy but was sent to maternity assessment after scan where I saw a consultant for the first time for all of 2 mins to discuss options. I say discuss, I was literally handed a leaflet by the receptionist titled ‘Your options for breech baby at 37 weeks’ then consultant came into the waiting room and asked what one I wanted to go with (she was in a rush as en route to perform someone else’s section). Luckily I’ve had lots of discussions with my midwife about my options or I’d have felt totally rushed, uninformed and uncomfortable at having to make a huge decision like this in a public waiting room.

I opted for an elective section and have been told all along by midwife this would be booked for some point in my 39th week following a breech 37 week growth scan (39 weeks is Boxing Day on wards).

I then had a call from the consultant saying there’s no space in my 39th week so she’s booked me in for Christmas Eve. She said theyd rather not do it then as it’s before 39 weeks but because of the time of year it’s currently my only option if I want an elective. This has sent me spiralling as means it’s now before 39 weeks for no medical reason and the consultant herself said this isn’t what they’d prefer. I know it’s only a matter of days but it feels like my babies health is being put at higher risk purely because of bank holidays restricting availability.

As a ftm it’s taken me a while to come to terms with having a c section over natural labour anyway but given babies size and position I felt it’s the safest option. I still think it is but feel I’ve lost any control over my birth as it seems my choice is to take the earlier date or just dice with the chance of going into labour and needing an unplanned section instead or risking an emergency which is my worst case scenario.

I’m also obviously a bit sad at the prospect of being in hospital on Christmas Day for no medical reason. Healthy arrival of baby is of course the priority but I’ve experienced hospital around then before and it wasn’t a great experience with less staff on etc.

This is essentially just a bit of a vent but what would you do in this situation and is it likely there will be cancellations or something in my 39th week? Any reassurance is appreciated 😔

You’re going to be fine, you’ll have your lovely baby, relax and look forward to it.

(2x DC, 1x ELCS, would definitely recommend an ELCS, mine was great!)

I think you'll be fine too, the consultant wouldn't suggest it if it'd harm the baby. My son was born on 39w0d by c section and he was exactly average weight (and is now a huge unit of a 2yo, biggest in the nursery class). Incidentally quite close to Christmas too!

I'd just lean into the christmas thing - there are names like Natalie or Noel or Nicholas for christmas babies - your baby will have a special birthday and no chance of people forgetting it!

My baby was born born at 37 weeks by c section and was absolutely fine -
you will be fine x

I’d take the section on that day, so many things can go wrong, a healthy baby is all that matters.

You wouldn’t have a say when the baby came if you had VB. The medical team know the schedule and the BH impact, take their advice and go with the date they give you. Remember it’s new to you but it’s not new to them, they know what they’re doing.

Thanks all, totally get it wouldn’t be offered if seriously unsafe and as I say of course my baby’s health and wellbeing comes first. Also know I wouldn’t have any say in the birth date naturally anyway and what will be will be. I suppose I’m just more sensitive as already facing the heightened risk/anxiety of a frank breech baby on top of usual FTM nerves that I might not have otherwise.

It’s just a very different situation to the birth I’ve envisioned this whole time and now to be given an earlier date because of some bank holidays rather than a medically essential reason is definitely a bit of a disappointment that I wouldn’t feel if it was medically necessary. Also the worry of less staff etc.

Baby is full term so risk wise, it’s minimal, so try not to worry about that.

But if you’re unhappy about the date, can you try and discuss with your midwife, as surely other consultants can do it? Or perhaps look at transferring to another hospital?

But a slightly earlier date is safer than running the risk of going into labour and having an emergency c section.

I've had both types of c section, an emergency one after days of labour and syntocin, and an elective one a week "early".

I haemorrhaged severely after the EMCS and took literally a year to feel well again. I would not wish that on anyone. Do the ELCS a few days early to reduce the risk of that, and your baby will be totally unaffected by being born at 38w5d as opposed to 39w0d.

Anything from 37w counts as full term. Just trust the consultant.

But you can’t control nhs Xmas staffing so don’t worry, just take the advice of the professionals and enjoy baby holly / Noel!

I think you're well within your rights to feel how you do, and I'd feel the exact same

Having said that, baby will be absolutely fine!

So much of labour / children is out of our hands

A Christmas Eve baby sounds so magical. Good luck.

Have they offered you a steroid injection to help mature the baby’s lungs because guidelines say this should be offered for all elective sections up to 38+6. Yes baby is term at 37 weeks but there’s a slight risk specific to elective sections. I’d want the injection and have the Xmas Eve section.

In terms of Christmas staffing, I was in hospital from the early hours of Christmas day, gave birth on the 26th and was discharged on the 27th. The staffing levels were really good and it only started to get busy on the 27th. I had a whole bay to myself overnight on Christmas day which was amazing and I actually got some sleep! (everyone else I know who stayed overnight after having a baby say the post natal wards are normally noisy and you get no rest). Obviously there are no guarantees but there might be advantages as well!

i was just about to say that Xmas even and Xmas day the postnatal ward be at it’s quietest but staffing will be normal. So hopefully a better nights sleep and more attention from staff?

Minor point but I had a Christmas baby and (from a Christmassy point of view) it was actually lovely and my memory of being in hospital was really special and hasn’t just blurred into all my other Christmases like so many do. Obviously the least important thing but it might make you feel a bit better.

I’ve had 4 cs, the most recent was 2 weeks ago. Aside from the first which was unplanned, the other 3 were planned for 36+6 (twins), 38 and 38 weeks. 39 weeks is definitely an ok time to have your baby.

And from a timing perspective, I would much rather an Xmas eve birthday than in between xmas and new year (thinking school parties etc). Good luck!

DD2 was breech and I was induced at 37.5 weeks. She popped out with minimal help from forceps and I think having an EC is fine for both you and your Christmas baby. How exciting!

Really isn’t a baby considered term after 37 weeks? I had my first at just under 37 weeks - 10lbs 4oz he just wanted out (I had my medically recommended section booked for ten days later but my waters broke). My second was born at 38 weeks - again a planned section fur medical reasons.
I really don’t think a few days is going to make any difference. Too bad about Christmas though!

Thanks, lots of good points! Good to hear staffing levels have actually been good for most people, that is reassuring.

It’s more that the consultant herself said it’s not their preference to do pre-39 weeks and the only reason that is happening is because it’s Christmas and there’s less ‘39 week days’ available. So that makes me feel a bit frustrated, never mind being asked about it in the middle of the waiting room. Just felt a bit ‘squeezed in’ rather than properly managed.

As I say I know it’s only a few days at 38+5 and my baby could equally be coming naturally today for all I know! But I’ve also read about them needing things like steroid injections and the NICE guidance itself says lung development is stronger from 39 weeks and this is what’s been discussed the whole time so this is all I have to go on.

Just all a bit tough having no control when you’ve never done it before. Plus all the unsolicited comments I’ve had from people about how awful a Christmas birthday is going to be!! But it’ll all work out I’m sure and whatever happens then it’s a great festive present!

I don’t understand why they haven’t offered you the steroid injection in line with nice guidelines as that would take away the worry about lung development.

I'm a midwife, and the until where I am doesn't offer the steroid injection for lung development after 36 weeks as it is of limited benefit.

The midwives on the ward will do their best to make it as special as possible for you and your baby. Where I work it is always really festive for the families that are with us for Christmas.

It is always a bit of a shock when things go out of your control, so hopefully you will have a bit of time to get used to it all. Best of luck!!

Interesting. I’m a midwife and we wouldn’t offer steroid injection for labour after 36 weeks but we would for an elective section prior to 39 weeks. Which I believe is in line with nice guidelines? If it’s in nice guidelines I assume there must be evidence behind this?

I feel you OP, although my first section was due to DD having IUGR due to my placenta not working as it should, so when she had to come out.. she had to come out. She was too small to have a natural birth and the contractions on my umbilical cord would have prevent even further oxygen to her.

I got booked in for NYE. Was all good section wise, nothing to worry about, and at the time you’re so nervous to meet the baby, and then elated that baby is here that you’re not really thinking about the day or time your there.. but now I think back and think it’s pretty crap we spent new years in hospital 🤣 and DD’s birthday is a battle, no one wants to celebrate her, parties are hard to organise because everyone’s got grown up plans, she gets ‘joint’ presents which is just absolutely shit for a kid. Boils me.

but as said, you’ll be fine!

To be honest I think it’s because it was booked following a literal 2 minute conversation in the waiting room that there’s been no mention of the injection😩 this is where my apprehension is stemming from, it all feels very rushed, clinical and box ticking rather than well informed and managed properly. I had similar issues at the beginning of pregnancy where I was lost to the ether and had to chase constantly to be assigned a midwife, almost missed the 12 week scan and testing cut off because they just ‘forgot’ to allocate me to someone. So it hasn’t been the best experience so far anyway!