Elective c - covered by Public system?

[rubyrags]

Hi all,
please excuse me if this is a dumb question but can you have an elective caeserean in the public system? If so how do you do that?

Sorry this is my first child and I am 39 so I am pretty out of the loop with knowing what to do...

I have private insurance for everything but pregnancy, cateracts and knee replacments :) so I am going public probably at Frankston Hospital.

[Faeml]

In the strictest sense, yes public hospitals do elective c/s all the time - an elective means any c/s that's not done as an emergency.

Elective c/s are done for lots of reasons - medical & psychological. I would suggest having an honest chat with the Dr/Ob that you will meet at the hospital and discuss your reasons/research for your decision :)

[Mikenzees mum]

im not 100 percent sure as i have private cover and went to a private hopsital, but i would say that its something to discuss with your Ob, no one has the right to tell you you must a have a vaginal delivery NO ONE, let the ob know your concerns and that yo want a C section and they will ake it happen

Good luck

[Alekay]

Hi:wave: congratualtions on your pregnancy

I had my 1st bub 3yrs ago public and had a elective ceaser for non medical reasons it was hard to get but i ended up having one it got finalised when i was about 36 weeks. First i asked a couple of midwives and they said no there is no way you can have a elective c/s in the public sysrem so i stressed and made myself sick over it then at my 35wk check up at midwives clinic i spoke to a really nice midwife her name was Gail nad she said she would get me into a consultant next time so i asked them and said my reasons why and she booked me in for 1. I think you have to be really clear on your reasons and quiet firm about what you want and in the end i burst into tears. This time 7 and a half weeks ago i went private and had a c/s as well and my OB asked me how i got a c/s and he asked if i cried and i said yes and hos comment was thats the way to get anything in the public system especially with a elective c/s

Hope this helps good luck if you want to know anything else about what happened thats cool:)

[Mikenzees mum]

there you go take mels advice im sure any dr wont be able to say no to a hormonal crying pregnant lady lol

[bigglet]

I read an article about a new policy cutting down on elective c-sections on public patients - this was in NSW though.

http://www.smh.com.au/news/national/tough-new-rules-for-caesareans/2007/04/06/1175366473929.html



Tough new rules for caesareans

Julie Robotham Medical Editor
April 7, 2007

WOMEN will not be allowed to insist on caesarean deliveries in NSW public hospitals without a medical reason under a new health department policy.

The policy was devised to tackle increasing safety concerns about the high surgical birthrate.

"Maternal request on its own is not an indication for elective caesarean section," says a circular distributed to maternity units, doctors and nurse groups this week. "Specific reasons for the request must be explored, discussed and recorded."

Under the new rules, women must be told in detail about "the benefits and risks of caesarean section compared with vaginal birth specific to the woman and her pregnancy".

The policy cites a US study of more than 5 million births, which found last year that babies born by medically unnecessary caesarean were three times as likely to die in the newborn period as those born vaginally. The death rate for the caesarean babies was 1.77 for every 1000 live births, compared with 0.62 from normal delivery.

The new policy also obliges health professionals to advise women about the implications for subsequent pregnancies, amid emerging evidence that caesareans increase risks both for mothers and future babies.

A 2005 study of 136,000 second pregnancies across NSW found those women who had had a caesarean first delivery were at much greater danger of having a ruptured uterus, hysterectomy or infection, while their babies were more likely to be born prematurely, have serious breathing problems or need intensive care.

Elective caesarean rates have increased by 25 per cent since 2001, and now account for one in six births. Many of these are planned in advance for medical reasons, such as a baby that is too large for a natural delivery. But doctors say more women are opting for caesareans from personal preference - the so-called "too posh to push" phenomenon.

An additional one in eight infants is delivered by unplanned emergency caesarean.

Andrew Child, a member of the NSW Health Maternal and Perinatal Committee, which drafted the directive, said while first caesareans were generally safe, dangers escalated steeply with subsequent births. But it was "very hard to put that into perspective with mothers and fathers who are [focused] on their first baby".

The policy had been initiated because of concern at the rising number of babies admitted to intensive care after caesarean births, especially those performed too early. It also stipulates that to reduce the risk of breathing problems, elective caesareans should not generally be carried out before 39 weeks of pregnancy.

Dr Child, who heads obstetrics at Royal Prince Alfred Hospital, said obstetricians in private practice feared legal action if they refused a caesarean and the woman then had a problem birth. "They say, 'If someone asks, we just go along with it,' " he said.

Although the new policy - the state's first on non-medical caesareans - was only binding in public hospitals, Dr Child said its impact would spread to private deliveries because most doctors worked in both systems. "It's aimed to be educational," he said, "to encourage people to have a good, hard think about it."

The secretary of the NSW Midwives Association, Hannah Dahlen, said, "People are becoming blase about [caesareans] and thinking of it as just another option for birth, rather than major abdominal surgery."

When someone insisted on surgical birth, she said, "The answer is to recognise this woman has some major issues to be explored." Such women, if properly supported, would often accept vaginal delivery.

[jaxcoop]

i had an elective c/s in a public hospital. But i had a medical reason why. we don't have a private hospital where i am anyway. If you talk to your ob and discuss why you want one then it could happen.

I think its stupid that we have the health system decide if we can or can't have a c/s.

As far as im concerned our bodies our choice!

[rubyrags]

Thank you very much :hugs: I really appreciate your help. I feel much clearer now about talking to the ob about it and asking for what I want...

Thank you all.....