How easy is it to insist on an elective c-section

[HairyToe]

I'm asking this question for a friend. I said I'd try and find out some info for her.

She has two children already - both born vaginally - and would love to have a third. The problem is she has developed a serious back problem. I don't know all the medical details but it is rooted in damage to the coccyx caused by both previous births. The problem was quite bad after birth number one but she recovered ok. It was dreadful after birth number 2 (she couldn't sit or stand and had to lie down all the time - not easy with a toddler and a baby to look after). Subsequent complications have now led to a related back problem for which she is having treatment (Bowen) and is on permananent painkillers.

Obviously she is not in a fit state to get pregnant yet anyway - she will need her back to recover and be able to come off the drugs. However if and when she does get pregnant again she wants to be sure that she could opt for a caesarian to hopefuly prevent any further damage. Unfortunately she has been told she won't be able to discuss it with the consultant until she actually is pregnant.

Any advice/experience that I could pass on to her?

I am insisting on en elective this time for various reasons, I think if you put your case forcefully enough they will comply

However, I have had back problems ever since my emergency c-section. I put this down to the fact that having sliced my abs in two I lifted badly for a long time, and avoided using that area of the body, overcompensating and damaging my back. This has given me a lot of pain during this pregnancy, and I am struggling with my heavy 2 year old.

I agree about a Csection making back pain worse, I found that without the support of my abdominal muscles my back got very sore.

Has your friend discussed her problem, and how she should deliver in future with the consultant who is looking after her back problem? It might be that a C Section is not the best thing for her, but if it is the best option then I expect that the consultant who looks after her back would be letting the obstetricians know that.

There are NICE guidelines on elective sections - I understand that as long as you are aware of risks yada yada women have the right to insist on a section.

Bizarrely, giving birth vaginally to DS1 sorted out my coccyx problems (caused by when I say down on a bed, missed the mattress and caught the frame instead).

I can't comment on an elective c-section although where you can show medical need it doesn't seem to be a problem - one thing that occurs to me is whether her back problems would allow her to have an epidural/spinal. She could end up with a c-section under a general). Alternatives would be a waterbirth where you are supported by the water. This means you can easily be on all fours which allows the coccyx to flex properly during the birth

FWIW I had severe coccyx problems during birth of DS1. I found that osteopathy was like a miracle - I'd suggest she tries that.

Here is a website that you can get the NICE guidelines

www.nice.org.uk/CG013

Hope this helps your friends

Can your friend ask her GP for a referal to a consultant for pre-conception advice (I think thats what they will call it)? I had problems with my first pregnancy, and didn't want to get pregnant for a second time unless I was sure how similar problems might be prevented/handled if they occurred again. I didn't have any problems getting the appointment and the consultant was happy to give me all the information I needed when I saw him.

I have found when you don't want one, you get offered one (or it is presumed you want one) and when you are advised by one professional to have one, another disagrees!

I have had grief with my knees in a similar vein to what others have mentioned about their backs after c section, overcompensating for lost muscles (isn't it surprising what you need your stomach muscles for!) Might get a zimmer frame for getting up and off my crap settee this time!

Thank you for all your replies. I wasn;t very well yesterday so have only just logged back on. Some really helpful advice here and I'll pass it all on to her. Blameitonthebogey I'll check whether she has tried osteopathy, think she's nrevous of anything too 'aggressive' ifkwim. CookieMonster2 interesting re GP referral for pre-conception advice, I'll certainly mention it to her.

Thanks everyone again. Knew I'd get some useful leads here!

I had DC1 15 years ago when I already had back problems that were undiagnosed (it took forever to get referals and by the time I was referred for CT/MRI scans I was pregnant and couldn't have them). I endured a 19 hour labour which completely buggered up my back and afterwards I was told that the worst thing I could have done was have a 'normal' delivery.
3 years later I had DC2 and it was agreed immediately I would have an elective CS. By this time my back problems had been diagnosed but not effectively treated.
8 years ago I finally underwent major spinal surgery and am now held together with titanium pins. I had DC3 2 years ago and was told as soon as I was pregnant I would have to have a CS. DC4 will be arriving by CS in 12 days.

Your friend will just need to be forceful when explaining about her back problems and not be fobbed off.