need info

Hi to all,

I'm new to this forum and I need some questions answered. My partner and I have just moved to Adelaide and I am 15 weeks pregnant. I have concerns that it is not permitted to have an elective caesarean in Adelaide. I am a Registered Nurse in another state and have worked in theatre as a scrub nurse for many elective c/s, and have also seen vaginal births live in the birth suites there. Due to my experiences and having seen first hand the multitude of things that can and do go wrong in vaginal deliveries, not to mention the more often than not damage, as compared to the controlled and calm situation of an elective caesarean, I am adamant that I will in no way deliver vaginally. However, many have told me that here in Adelaide 'they' won't allow a c/s unless it is on medical grounds. Is this true and can anyone tell me their experience with this?

If you birth in a private hospital with a private ob you should be able to have an elective on request.

In a public hospital, not so sure. Perhaps find out if there are any private obs who work in public hospitals that might be able to accommodate your request.

Either way I do recommend you get a copy of the excellent book "Delivery by Appointment" which gives a good unbiased look at the benefits & pitfalls of c/sections. Just be aware that there are plenty of post c-section issues that aren't apparent at the time of birth - I had a maternally requested c-section and ended up with a post-surgical infection that lingered on for 10 weeks after my baby was born - during that time I was largely housebound and had problems carrying my baby for any period of time. Also you need to understand a C/S can impact on subsequent pregnancies. Even if you have already made the decision (like I had) the book will give you a good idea of what to expect.

Thanks for your reply. As I said, I am well aware of the risks and complications associated with surgery as I am an Australian Registered Nurse. However, I need to know how to go about GETTING the c/s in a public hospital in Adelaide. I have been told that since this a 'conservative' city, they generally don't allow it, but I've already made up my mind and am even prepared to travel home to NSW a month before so I can have it done...if its easier over there as compared to Adelaide.

My understanding as an RN is that it is my right to autonomy, to choose my treatment, as long as my decision os well informed. Did anyone choose a c/s in Adelaide and was outrightly refused? Or is it that they agree if you insist enough pointing out your well-informed reasons? I just dont know what the system is like here in SA.

I agree with Marydean in that you probably never got to see the after effects of the CS being a scrub nurse. The healing process can be bad and many women have complications after a CS. The loose skin that hangs after the cut heals and also the numbness in the scar which does not get any better. Oh, and the risk that you take every time you have subsequent children that your uterus won't take it with the scar or that you are limited with the amount of children you can have. I have had 2 elective CS and would change it if I could go back.

Yes, I'm sure that if you go Private, you will find an OB who will give you a CS and put the reason down to whatever and the private Health insurance will pay.

Good luck whichever way you decide to go.

Perhaps the College of OBs can advise you of the general consensus in SA. Even some of the public NUMs could give a colleague some insight.

Meringue, I think the best thing for you to do is make an appointment with a Dr, get a referral to an Ob and go from there. You wont know for sure what the truth is regarding this until you ask because you will probably just encounter a lot of confusion and conflicting stories. I recommend you do a lot of reading to make sure that you are making a truly informed decision, because having a surgical birth is classed as a major operation and it isn't always as simple as it seems. Have a read of some of the articles on the main BB site here Birth Articles - Give Birth With Confidence and Knowledge and go from there. All the best :)

Thanks ladies, but I have also worked on surgical wards. My concerns arent with the recovery, even though Ive seen all sorts of post-op patients, I know EXACTLY what to expect pre, post, and peri-operatively - risks and all. My concerns are more with the damage that I am well-informed to know about that occurs with a vaginal delivery, and nothing will change my mind about what I have actually seen in both forms of delivery. I know the pros, cons, risks, etc. and absolutely will not have a vaginal delivery.

I cant go private, my private health doesnt cover it. I'd love to hear from women who had an elective non-medical c/s in a public hospital, and what obstacles they faced, and how they eventually got their c/s.

I'd be very interested to see if there are women who have received an elective CS in a public hospital. I had my first elective CS in a private hospital but did not have Health Insurance this time around. Even though it was my second preg and the first was CS they tried to push a vaginal birth on me until the end. Luckily because I had had a CS previously, they couldn't force me to VB but they really tried.

Hmmm...thats not very encouraging news. Im thinking of going the psychologically traumatised angle because of all that Ive seen in birth suites - not something Ill scare you all with details. Let me just say that Ive seen a significant number of VBs go wrong as compared with elective c/s.

Actually I suspect you might find it more difficult in NSW as there was a lot of publicity (in 2007/2008?) when the health dept there published a new policy about doing C/Sects only for medical reasons in the public hospital system there.

I've had a bit of a trawl around on the SA dept of health website and this is the only guideline I've been able to find, and it makes mention of maternal request C/S but doesn't indicate any policy of refusing such requests, so you might find it's quite possible. When I was pregnant I rang the local public hospital and spoke with the midwife in charge of the maternity ward, and discussed it with her. I'm sure you could do the same with whatever hospital you are thinking of going to, and it would save a lot of speculation and asking around. Your GP might be able to answer this too, if you're doing shared care.

ETA - Miss H I had an elective C/S in a public hospital in Canberra, which I asked for. It was considered medically appropriate because I was genuinely traumatised by my first birth which was grossly medically mishandled. (But I didn't know that at the time of my request). I was able to describe the impact that trauma had on me for a long time after the birth.

That's fine, but I really don't think it will be helpful to you to start pushing an agenda against vaginal births because BellyBelly's ethos is aligned with natural, vaginal births so you may come up with some opposition if you start pushing that wagon ;) I also don't think that it is helpful to exaggerate nearly to the point of being untruthful to get the birth you want, because we have many, many women here who have had traumatic births and this just belittles their experiences.

Didn't the OP ask about how things are done in SA, not what people though about her choice or preference?

Thanks Marydean for that info, its very helpful actually and Ill definately look into it.

And I certainly am NOT belittling anything or anyone Trillion. Just for your information, I actually clearly am traumatised from the births I have seen, otherwise I wouldnt be so adamant to avoid it, dont you think? I am certainly not just "too posh to push" as some of you may think. I actually cant bear the thought of a VD BECAUSE of what Ive experienced. I genuinely feel bad for the women who have had traumatic VBs because Ive nursed them in the wards so Ive seen what they go through. My decision is well-informed and I really do feel a c/s is the only option for ME. Please dont belittle MY choices.

Im just here asking for info of how to go about getting whats best for me, not to offend anyone. Im just as freaked out by all this as everyone else. I have no family support, or friends here, and just need info.

Yes she did ask and she's been given some wonderful information. I'm merely giving her a friendly heads up ;) What the OP chooses to do is none of my business.

thanks also Stretcher Bearer - you're right in that comment. much appreciated

In fact I've just remembered, several years before I fell pregnant (when I was dealing with the tail end of the trauma) I asked my GP here in SA about whether c/sections were even possible in the public hospital, and she said yes and that she would write letters etc to support my request. That would've been around 2002, so of course things might have changed since then, but a good conversation with a GP might be a good starting point. If you don't have a good GP already, I was able to find one by contacting the Women's Health Statewide clinic in Nth Adelaide, they used to keep a list of preferred female-friendly doctors so might be able to give you some recommendations over the phone.

I apologise but I think I have been misunderstood. You post here

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Hmmm...thats not very encouraging news. Im thinking of going the psychologically traumatised angle because of all that Ive seen in birth suites - not something Ill scare you all with details. Let me just say that Ive seen a significant number of VBs go wrong as compared with elective c/s.

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comes across as being quite flippant, like you would go to that length if it meant that you get the birth you want. I was just pointing out that by hinting you could scare women with stories of what you have seen may not be appreciated by a lot of women because it is effectively using their trauma for your own gain. Plus as I said BB is a site that does align with natural birth and tries to educate women. If you have been traumatised by it as well, I'm really sorry because the effects of birth trauma can be far reaching and long lasting and no one should have to experience it.

But it sounds like you are pretty well informed already :) I fully respect your decision - it was never in question to start with and I wish you all the best.

Yes, unfotunately all the sites push for natural births, and thats fine for those who want and feel that its right for them, but we dont all hold the same views. Those of us who have unfortunately seen the side of natural births that are not publicised are at a significant disadvantage because we cant get the information we need for what we feel is best for us. I said Im not going to go into detail because I know women dont want to hear it because they also have made up their minds about having a natural birth. And thats fine, but no one gives them a hard time for their decision, so I dont think those of us wanting a c/s should be given a hard time either. Its merely a choice that each woman should have either way.

Thanks for you well-wishes. And should anyone find any extra info, Id be HUGELY appreciative! I will def look into the info you've given me so far.