Maternal Request C-section through public system is it possible?

[Mod-Wise Enough]

I was private and had a CS, my baby was a bit big (4.2kg at just on 39 weeks) but i requested it.

I didn’t regret it, I probably would have ended up in a CS anyway. However with bubba 2 it did make it much harder. The physical limitations are hard with a toddler. I found it much harder.

Since you’re not pregnant yet you have time to take out PHI.

[Pcos30]

I had an elective through the public system.

I went in with my reasons, namely that I was likely to end up needing an emergency one anyway as I would be induced and had a lot of risk factors for failed induction. I also listed my anxiety about getting Bub here safely after TTC for so long and IVF.

They didn’t even hesitate - booked on the spot. This was with the OB though - midwives who do mostly antenatal care I’ve found are very anti c-section.

I think going in having done my research on my risk factors (BMI, GDM, previous issues with artificial hormones) and already being on medication for my mental health helped.

Turned out I didn’t need to go that far anyway as Bub ended up being breech [emoji23]

[MLadyEm]

They didn’t even hesitate - booked on the spot. This was with the OB though - midwives who do mostly antenatal care I’ve found are very anti c-section. [emoji23]

This would be because as midwives we can’t give any kind of guarantee that a maternal request caesarean will even be considered by the doctors as it’s not within our scope of practice. We have to promote a vaginal birth as that’s what midwives specialise in.. normal vaginal birth.

[MissTwiggley]

I think going in having done my research on my risk factors (BMI, GDM, previous issues with artificial hormones) and already being on medication for my mental health helped.

If you have risk factors it's no longer a case of 'It's my right' but rather one of safety, and falls under medical reasons.
In your case, the person that booked you in on the spot had enough foresight and common sense to realise that those risk factors would still be present at 38 weeks. A different scenario from the OP.

[Moonlight n Magic]

I had an elective c section, the history of issues with my cervix weren’t a huge concern to the OB but he did say he wouldn’t support a lengthy active labour due to my age. He supported an elective c section and in the end we went early due to PE. Baby didn’t need SCN and my incision is neat and healed well.

All that being said, I travelled 1.5 hours from my local hospital to a private facility with private OB.

I agree that the choice of delivery should be yours, however it isn’t something the system supports. Get PHI make sure it’s top level and pick the OB you want. Or pay out of pocket for the service of a private facility and OB.

[Simyt]

I would just discuss it with your team. Only they can say if they will or won't, however It's very likely being public unless you NEED one for medical reasons you'll get one.

If you're 100% dead set that's the only way you wish to birth, you should probably take out PHI to ensure you get the birth experience you want. To give you the choice you want/guarentee you your right to choose.

I have had 3 csections - because I HAD to, no complications from them, fast recovery, minimal pain....I've been incredibly lucky. However. I would give anything to have had a vaginal birth instead.

It IS major surgery. It DOES still take a toll on you. There ARE extra risks - not just for you - also your baby. It could have breathing issues after birth because it wasn't delivered naturally among others, and need to go to Special care.

Keep in mind you've just had major surgery so you can't just walk over and check on them. You can't see or touch them. You can't hold them, and if you intend to breastfed, you miss out on that first feed (very important) and instead will be hand expressing (or the midwife can).

Be prepared that when there's no one around and if your baby is in its bed and cries, there's nothing you can do but buzz the nurse and sit and listen to them screaming unto they get there to you - because you can't just get up and pick them up due to the major surgery you've just had, the catheter that may still be in, wound drainage, iv, and whatever else you're hooked up to...

Anyway... there are just a few things many people don't consider until they're there. It's not pretty, nor something I'd do by choice

Sorry EnchantedGrace but some of this is inaccurate.

I went self funded in a private hospital because I wanted to see my own OB and my hospital were very much all for skin on skin asap and breastfeeding within an hour of birth.
It depends on your hospital and there are absolutely some that support all those things.
I agree with all the others though that if it's not for medical reasons why should the tax payer fund the surgery? Sounds blunt but that's how I look at it. I chose to see my OB and have an elective C section so I paid to be in a private hospital.

I would also suggest self funding in private or having phi so your partner can stay with you, it's extra support, help after your surgery and even more important is that they can bond too

All the very best

[MLadyEm]

Maternal Request C-section through public system is it possible?

Sorry EnchantedGrace but some of this is inaccurate.

I went self funded in a private hospital because I wanted to see my own OB and my hospital were very much all for skin on skin asap and breastfeeding within an hour of birth.
It depends on your hospital and there are absolutely some that support all those things.
I agree with all the others though that if it's not for medical reasons why should the tax payer fund the surgery? Sounds blunt but that's how I look at it. I chose to see my OB and have an elective C section so I paid to be in a private hospital.

I would also suggest self funding in private or having phi so your partner can stay with you, it's extra support, help after your surgery and even more important is that they can bond too

All the very best

I think what [MENTION=66469]EnchantedGrace[/MENTION] is saying is that the risk of breathing problems is slightly higher in elective Caesarean births and IF bub has to go to special care because of this that is when you miss out on the first feed, skin to skin etc.

This doesn’t happen all that frequently though and tbh if bub is placed prone (on their tummies) on mums chest, they actually tend to resolve their breathing a lot of the time. Obviously if they come out flat needing any kind of resus or CPAP, then that’s a different story (but also not that common).

[EnchantedGrace]

I think what [MENTION=66469]EnchantedGrace[/MENTION] is saying is that the risk of breathing problems is slightly higher in elective Caesarean births and IF bub has to go to special care because of this that is when you miss out on the first feed, skin to skin etc.

Yes, thank you. That's what I was trying to say.
Because baby doesn't get squished coming out, the gunk left behind can make it hard for baby to breathe. (In simple terms [emoji28])

That being said, my first was put in my arms while I was being stitched up and apart from when I wanted to hurl (thank you medication), he stayed in my arms all the way back to our room.

My 2nd and 3rd were taken to recovery with df while I was being stitched up. My 2nd was fine, my 3rd had cpap at delivery, and by the time I got to recovery they had a paed there because the midwife was still concerned with his breathing. We were lucky, he improved, the paed was happy with him and he stayed with me. But there's always that chance.

[Simyt]

Yes, thank you. That's what I was trying to say.
Because baby doesn't get squished coming out, the gunk left behind can make it hard for baby to breathe. (In simple terms [emoji28])

That being said, my first was put in my arms while I was being stitched up and apart from when I wanted to hurl (thank you medication), he stayed in my arms all the way back to our room.

My 2nd and 3rd were taken to recovery with df while I was being stitched up. My 2nd was fine, my 3rd had cpap at delivery, and by the time I got to recovery they had a paed there because the midwife was still concerned with his breathing. We were lucky, he improved, the paed was happy with him and he stayed with me. But there's always that chance.

Sorry for any confusion, I was not addressing the breathing cuz I don't know much about that other than, more so about breastfeeding and skin contact and that you don't always lose those things with a C section.

[EnchantedGrace]

Sorry for any confusion, I was not addressing the breathing cuz I don't know much about that other than, more so about breastfeeding and skin contact and that you don't always lose those things with a C section.

I probably didn't word my original post clearly. You're right. You don't always miss out on those things with a csection. But as there's a slightly increased risk of complications it's possible. That being said, a vaginal birth doesn't always allow it either you roll the dice either way!

[Stretched]

This would be because as midwives we can’t give any kind of guarantee that a maternal request caesarean will even be considered by the doctors as it’s not within our scope of practice. We have to promote a vaginal birth as that’s what midwives specialise in.. normal vaginal birth.

This is such useful information for the OP. She needs to learn about 'the system' and how to work within it to achieve the best outcome for her. This is going to vary state to state and hospital to hospital.

East of Melb, I know a few people who have birthed at the Angliss and they seem to have two streams of intake depending on if you have complications or not (birthing centre versus hospital ward). So if you're going there, you need to make sure you're talking to the right people from the start. Again, this may have even changed in the past few years.

It's really not anyone's place to tell you what you should be aiming for. I have had 2 emergency CS births and am always happy to share the good the bad and the ugly. But IMO it's not relevant right now.

What is relevant is what you need to do to achieve your goal. It sounds like you may get there on anxiety grounds, but not as a certainty. So can you afford PHI and ensure you get your preferred birth that way?

When it comes to the body autonomy issue, I guess I would liken it to a breast reduction. Some women can get a Medicare funded breast reduction due to back pain etc. However some women may feel they need the reduction, but may not meet the criteria set for Medicare funding. Their pain may be bad, but not bad enough, maybe not enough evidence of ongoing issues, blah blah. You get the idea. So to ensure their desired outcome, they would need to go private. It is their choice, their body, they have autonomy there. No one is forcing them to do anything unnatural.

Vaginal birth is a natural process that we are designed for (maybe not me as I failed at it, twice! Lol) and a CS is surgery essentially used for when our body's fail to do what they were designed to do - or try to kill us or our baby in the process. The Medicare system is set up based on medical needs, lots of specific criteria and often hoops to go through. Hell, I went in for an early pregnancy ultrasound and walked out being charged $100 more because medicare classed it as an abdominal ultrasound since I'd miscarried and their was no pregnancy to scan! Medicare is a bunch of paperwork and policies and different people know the right boxes to tick to help the system work better for their patients.

Learn as much as you can about the system. Work out your best plan of attack. Find out the right people to talk to at your local hospital. And have a plan B.

[Gloss100]

Thankyou all for your insight.
I'm going to speak to my PHI provider (currently only have extras/no hospital etc..) and upgrade my policy to include hospital pregnancy/birth. Looks like it has a 12 month exclusion wait though but at least I'm not pregnant atm which would have put me in a bit of a pickle!

I wasn't sure if both systems would be super difficult to navigate with my request and I'd be pretty pained to spend thousands to whind up in the same state of anxiety - voice not being heard.

I'm 99.9% certain it's the birth method of choice for me and just want to be heard and understood rather than fought and dismissed at every turn. I know that professionals are going to say their peace and try to see if i can be persuaded otherwise and they wouldn't be doing their jobs if they didn't. I just need the option of my preferred method on the table for me to feel safe and anxiety free during pregnancy.

Thanks again! Fingers crossed 2021 brings some happy news :-)

[Rocky27]

Thankyou all for your insight.
I'm going to speak to my PHI provider (currently only have extras/no hospital etc..) and upgrade my policy to include hospital pregnancy/birth. Looks like it has a 12 month exclusion wait though but at least I'm not pregnant atm which would have put me in a bit of a pickle!

I wasn't sure if both systems would be super difficult to navigate with my request and I'd be pretty pained to spend thousands to whind up in the same state of anxiety - voice not being heard.

I'm 99.9% certain it's the birth method of choice for me and just want to be heard and understood rather than fought and dismissed at every turn. I know that professionals are going to say their peace and try to see if i can be persuaded otherwise and they wouldn't be doing their jobs if they didn't. I just need the option of my preferred method on the table for me to feel safe and anxiety free during pregnancy.

Thanks again! Fingers crossed 2021 brings some happy news :-)

Gloss100, great idea adding it to your private health! At least you’ll have the option either way now [emoji4] I was exactly the same as you. Before I got pregnant I 200% wanted an elective c-section. I have now had two babies, both in QLD but both in different towns/cities. Both elective c-sections. I ended up going private & each time my OB has been amazing & supportive. I’ve gone in expecting to have to plead my case but after making sure I understood the risks involved they were on board for it to happen. I did go into every appointment being confident that this was the way I wanted to birth. I stopped telling people around me as I can’t believe in this day & age how many people are against women having elective c-sections!! I think do whatever fits you best, do your research & find a doctor who is supportive. I’ve now had two c-sections & I’ve had such positive experiences. We’re not having anymore babies but if we ever did I can hands down say I’d be opting for another elective c-section again. It was the right choice for me [emoji4]

Good luck with everything & I hope the New Year brings a positive test 🥰 And if you’re Brisbane based I can message you the name of an amazing doctor!

[EnchantedGrace]

Good luck!

Having it on your PHI should help you with choice. It would still be worth calling your preferred public hospital/ health carers, just incase.

Given your anxiety you MAY be granted your request, but I believe it'll be easier under PHI To get the birth options you're wanting.

Beast of luck for a fast conception, cruisy pregnancy and stress free delivery