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 😔

I have 3 dc now but I remember feeling the same as you on the first. I was young, and no one had ever even mentioned a c section. It’s all new and scary but went absolutely fine.

On my third I was offered the 23rd Dec, but I would have been in hospital on Xmas day if there were any complications. I couldn’t risk not being at home for my other two so they checked the next date and I went in on the 30th and spent New Year’s Eve there instead.

My first was born at 37 weeks, he was 8lb 7 oz, and apart from a bit of jaundice was absolutely fine.

The earlier you have an ELCS the less likely you are to go into labour naturally, which would complicate matters so slightly early is in fact better.

Being in hospital on Christmas Day really doesn’t matter in the great scheme of things.

You'll be fine, and so will baby!

No thank you I’ll hang on until you can get me in post 39 weeks as per clinical guidance is also perfectly acceptable and I would have gone nuclear about the waiting room situation. All sounds shoddy.

I expect the timing would be fine but it's poor you didn't have a proper opportunity to talk through the options. I'd call up today (what with the doctors' strike coming up in a couple of days) and see if you can arrange to speak with one of the doctors, OP.

If it's any consolation, whilst we say x happens at 38 weeks and y at 39 I doubt the body works in exact 7 day periods so it's probably more of an average of when things roughly happen. We're talking a couple of days anyway and your dates may well be out by that margin or more. It's also a fact of planned c-sections that there are limited slots and so availability very often trumps what would be the ideal medical scenario. For instance, they don't happen at weekends (at least not at our trust) so if you were to hit 39 weeks on a Saturday, it wouldn't be unusual to be booked in during your 38th week instead.

I wouldn't be hugely concerned about the steroids - I've had one baby at 36 weeks and one at 37 and neither was offered them (it was discussed for the first but our consultant was involved in research indicating that the potential downsides likely outweighed the benefits by that point). Neither had breathing difficulties or needed special care but I appreciate that's anecdotal.

All the best for the remainder of the pregnancy and for a safe arrival 💐

OP, I feel for you. We all know the NHS is under a great deal of strain and that maternity services are often near breaking - but knowing that doesn't take away the worry and frustration. Some high-minded posters here might do well to imagine themselves in your shoes.

Obviously the most important thing is that your baby is safe and you are safe, and you're being well looked after. I agree that nobody would suggest anything less than safe to you - but ASK those questions! You are absolutely entitled to a proper talk with the consultant or someone on her team about this and I'd be ringing the secretary to see if you can grab ten minutes of someone's time. And you can ask about steroids for the lungs at that point.

You do still have a couple of weeks to go though. My second child was breech until 38 weeks and I was booked for an ECV - he must have been aware of how scared I was of that as he righted himself with a great deal of kicking and thumping the night before! So you never know. I don't know if certain postural positions are still suggested to help the baby turn - suspect they probably have little influence but might be worth talking to MW about.

As to the inconvenient date - I feel your pain! I was due Boxing Day but DS2, having turned head-down, then came at 39+2 and we have a 5-days-before-Christmas baby. I will be honest and say I regret not doing the maths (we were actively TTC and I apparently can't count, despite my postgraduate education...). He was always going to be born sometime around then. A lot of parents bite the bullet and opt to do the celebration bit (big presents, parties etc) 6 months away in summer, when the weather is nicer and parties have a better chance of attendance. I sort of wish we'd done this now - DS2 is profoundly autistic/LDs and honestly would not have noticed, but at his age it now seems too late. (I also came up against a lot of pushback from relations...) So we have to come up with present ideas x 2, and for everyone else too. But like with us, your baby was always going to be born at some point really close to Christmas and though there's a world of difference between a 24th Dec and say, a 12th Jan birthday, he could easily have come two weeks earlier naturally...

I was in nearly the same situation frank breech baby, 3 failed ECV’s, I’ll be exactly 39 weeks in Christmas Eve but I already have 3 daughters at home so discussed my concerns with the consultant about Christmas Eve and they moved it to Boxing Day and where so lovely and understanding! (I’ve also never actually made it past 37 weeks pregnant before and this is the most pregnant I’ve ever been) Is there more than one consultant that you could request another opinion from?
it’s a crazy busy time of year and I’m not sure if the strikes effect what’s available.
I ended up starting with contractions on Saturday so my section has been brought forward to this week (if I can make it that long) and all the staff have been wonderful but I have had to be quite firm and vocal with how I feel about things

I had a Christmas Eve c section almost 4 years ago, bang on 39 weeks. It was absolutely fine and I’m sure yours will be too.
I can see why what the consultant said worries you but agree with other posters that they wouldn’t recommend if unsafe and a couple of days shouldn’t make much difference.
When I was in this situation we had an early Christmas a few days before as we knew it would be a strange Christmas with me in hospital. The section itself was fine - far preferable to my previous traumatic “natural” birth (nothing natural about it - forceps, ventouse, episiotomy). Now my son has a super special birthday and tells everyone about it! Much nicer than a birthday in the no man’s land between Christmas and new year. Wishing you all the best - all will be well.

Honestly the whole business of raising a child is learning that nothing goes to plan. Might as well adapt early. Good luck with your Christmas Eve birth. Planned c sections are great (I had one). No dr would suggest something unsafe for you and baby.

Bless You
You , and baby will be fine .
I had 4 ECS , due to medical reasons .
Youngest two were born at 37 weeks and then, my youngest, at 38.

That was the conclusion to the arguments in my family. Christmas Eve isn't actually that bad, you can still get out for dinner without it costing an arm & leg.
As you get older your pals will be happy to party on with you.

It doesn't really matter when the birthday is December to Mid January you as Mum are always going to be asked for 2x ideas for everyone.

The last few years we've done late lunch for Birthday, and home for a Christmas film. Which being honest was a MN suggestion after a couple of boring, non-event covid birthdays.
This year I'm thinking lunch then cinema 🎥. I liked the panto idea someone up thread suggested but too late to book that.

@LilacPandas sounds like you are decided on an ELCS, but just to flag that if you did want a conversation about options with a well informed team you could contact optibreech.

https://optibreech.uk/participating-sites/

Like you I had a breech presenting baby, and was told in a very rushed way that an ELCS was basically my only option unless the baby turned. Fortunately I had a successful ECV. Sounds like that isn’t an option for you, which might not be a bad thing, ECVs are not for the faint hearted, my actual turning only took ten minutes or so but the pain was so intense I fainted, labour was easier!

However, I did some reading up on breech births and I was annoyed that nobody at my hospital had the time to talk to me about options. Vaginal births for breech babies used to be much more common and consequently there were lots of midwives and doctors who had the skills and experience to manage a breech birth safely. In the year 2000, there was a big trial on outcomes for breech babies that showed there were more risks with vaginal births (true, but the difference in outcomes between vaginal and ELCS was not huge). As a result NHS guidelines swung towards a position where ELCS for breech births was very strongly recommended as a care pathway and very few women with breech babies were given the option to have a vaginal birth. As a result of this the skills needed to manage a breech birth successfully started to diminish, as midwives and doctors were doing it much less, people with experience retired etc, and the gap between the risks of an ELCS and a vaginal birth got wider.

NHS policy is now trying to swing back to a slightly more balanced position, where maternal choice is enabled. The optibreech project is a group of hospitals where there are clusters of consultants and senior midwives that have the skills to manage breech births vaginally and are teaching these skills.

I am NOT advocating for you to have a vaginal birth, but just letting you know that as you feel nobody talked to you about options, there are people out there who will take the time to discuss things with you. I think if my ECV hadn’t worked I would have reached out to the optibreech team for a conversation and would probably in the end have opted for an ELCS as while the risks of vaginal birth with an experienced team are much lesser a section is still safer, but it would have been really nice to have had the conversation and to have felt listened to and like I was making a really informed decision.

I also ended up giving birth over a bank holiday weekend, and did not have a great experience. The hospital was probably adequately staffed, but it was horribly busy - I was in labour for six hours in a waiting room on a plastic chair before they found me a private space, and it was another four hours until I got an actual spot on labour ward. There were also a lot of locums working, and communication between different teams and wards was awful and I had a really long labour so kept being passed onto new people who knew nothing about the hospital or the other medical staff they were working with. I expect with an ELCS you might not get this issue though, as it’d probably be quicker.

Good luck, hope that whatever happens, you and baby have as good an experience as possible, no future Christmas presents will compare x

I would take that date , get baby safely here , easier than spending several days wondering and waiting , or any false starts which is common with first baby.
Especially with staff being off / etc over Christmas.
This way you can plan and they will give you a lovely Christmas and then when you get home you can have another Christmas 🎄 🎄
It's going to be magical and you can plan.
Congratulations

Just wanted to add don't worry. They really wouldn't suggest it if it was determinantal. It's just not ideal which is fine. I think they would rather you went in 2 days early then risk an emergency section.

Also baby does still have time to turn - my youngest was breech at my 37 (or 36 cant remember which) growth scan (I had GD) and predicted to be 90 odd percentile. She turned on the table for the ECV between the arrival scan and the doctor coming in (that was confusing to them) and turn again a week later only to be back head down when I went into labour. She also popped out at 25th centile.

I have a few friends that have Christmas period baby (one on Christmas day). Some chose another day to celebrate a birthday (with obviously recognition on the day as well) others just go full on switch between birthday and Christmas on the day. No one says it is a bad thing from what I have experienced.

I wouldn’t wait if you’ve been offered Christmas Eve. No guarantee you’d be offered cancellation and you risk going into labour naturally and it becoming an emergency.

My planned section was NYE and it was absolutely fine but NYD was a skeleton staff only due to bank holidays so it did take us a lot longer than it ought to have done to be discharged. It was still fine, but just telling you this so you’re prepared, as it hadn’t occurred to me at all for some reason!

Trouble is a frank breech is folded in half, with legs straight up and his feet by his ears, not at all easy for a vag delivery.

This. Honestly. It will be totally fine and u might have a surprisingly lovely day in hospital and u will hopefully discharged that day ? Evening ? And there is no pressure to do anything for Xmas day etc. It will be a story to tell your child. Don't over think it. There is no one putting pressure on yourself except you. It would be different if you had another child at home.

Tbh I wouldn't be very impressed with the way it's been handled. Is there another hospital local to you?

I was in this exact position 10 years ago with DD. No issues or complications whatsoever- and bring in on Christmas Eve was strangely lovely- it’s a very special time of year for me when I think back to that Christmas!

Personally I would take the date given.
It could be you get sent home on Christmas Day anyway.
I had emergency c section and was sent home next day as all ok.
At least it will put impending visitors off for a bit so you can chill as a family.

No it’s far from awful, having a healthy baby on any day of the year is amazing. If you are looking from the perspective of wanting the perfect birth, it may not be the ideal. If you would be happy to take home a healthy baby from hospital, as is the dream for some (including me), the day it’s born on is probably the least important factor

I had an elective c section, good thing I did cos she turned out to be 9lbs 10oz!! But I had her at 11:45 on the 6th and I was at home with her by 11am on the 7th! You could be home in time for dinner on Xmas day, what an amazing Xmas present! Have the Moses basket next to the tree for the first photo at home! Congratulations, hope it all goes well for you. Good luck x

Hi, my son was due on Christmas Eve but because I needed a c-section they did it earlier. If it wasn’t safe you would have been told. But it will go all ok.
its only this year where you get to spend Christmas Day in hospital but your child now get to have all his Christmas and birthday presents as one😁
PS my son turned 10 yesterday!

one of mine was breech until 39 weeks, they turned themselves and delivered naturally at 42 weeks

Is baby still waiting for Christmas Eve @LilacPandasor are they thinking of arriving sooner?