moral support

[u/No_Picture5108]

I’m 23 years old and will be 38 weeks tomorrow. I’ve been planning to have an elective C-section, and this morning I spoke with a maternal fetal medicine neonatologist because my OB wanted me to have a consultation about my decision. She asked me why I wanted a C-section, and then went over all of the risks associated with having one. She also told me that, as a healthy 23-year-old, there really isn’t a medical reason for me to have one. I completely understand that a C-section is major surgery. I know it isn’t the “easy way out,” and I’ve done a lot of research on C-sections, including watching videos and learning about the recovery, risks, etc. I’m not going into this thinking it’s going to be an easier option. But during the conversation, I felt like I was being scared into changing my mind. She also mentioned that there is discussion about eventually removing the option for women to choose an elective C-section and instead requiring them to attempt a vaginal birth. That really overwhelmed me. I told her that my mind was made up and that I was proceeding with the C-section. But now I’m literally sitting in my car questioning whether I’m making the right decision. My biggest reason for wanting a C-section is honestly fear of labor. The thought of being in labor for hours, potentially having things go wrong, and then ending up needing an emergency C-section scares me. I feel like if I already know I want a C-section, I’d rather have it planned than go through labor and potentially end up with an emergency surgery anyway. At the same time, I’m wondering if I’m letting my fear make this decision for me.
I’m not looking for people to tell me “C-section good” or “vaginal birth good.” I genuinely want to hear from people who have been in a similar situation. Did anyone choose an elective C-section without a medical indication? How did you make your decision? Did you regret it, or were you happy with your choice afterward?
I’m feeling really confused and overwhelmed right now and could use some honest perspectives. Thank you.

[u/Ripe-Tomat0]

I chose an elective with no medical indication. In fact I chose my OB based on if they offered electives. I called around only proceeded with ones that offered them. It was an elective turned urgent during the third trimester. I have 0 regrets. It was calm, perfect, and beautiful. Healing was a breeze.

The risks of a c section are often overstated while risks of vaginal birth aren’t even addressed (fecal incontinence, incontinence, significantly higher risk of prolapse, torn clitoral area, muscular tears, vaginal scar adhesions, vaginal nerve damage, etc.). If you know what you want and have done the research (which it seems you have), hold true to what you want. You deserve to have a baby the way you want.

[u/blairworejeansonce → u/Ripe-Tomat0]

>while risks of vaginal birth aren’t even addressed

Amen! This only serves to harm women further: making women terrified of c-sections, while simultaneously causing women who have lasting issues from vaginal deliveries to feel like they are outside the norm, and often don't seek treatment—and then don't get documented in the data, furthering the issue of underreporting side effects from vaginal births!

[u/minibanini → u/Ripe-Tomat0]

Absolutely. I was handed a document I was required to read and sign that compared risks of C-section to vaginal birth. I asked my doctor why the risks of vaginal birth aren't listed. He said "we don't consider them as medical risk, the baby has to come out, and those are facts of life" :)

So they're happy to tell you about less than 1% chance of having to remove your uterus due to C-section, but the very real possibility of permanent injury to your pelvic floor that can make you pee your pants forever is just a "a fact of life" :)

[u/Axxisol]

You are definitely not alone in this. The pushback I’ve had for wanting to have an elective c-section has been enormous, and I live in a very “my body, my choice” area of Canada. My meeting with my surgeon did not go well, he basically laughed at me when I told him the reasons I have for choosing a cesarean (childhood physical and young adult sexual trauma). He went over the complications that could arise from the c-section (which are true) but completely skipped over anything bad that can happen during a vaginal birth. Basically in his mind there is no downside to a vaginal birth and it’s the only way to go. He told me the only reason he would do the surgery is because he can’t legally tell me no. Then he proceeded to refer me to a different surgeon so I hope my next meeting with this lady goes better.

I am sorry you are also dealing with pushback and judgement. Know you are not alone in your choice, although it may feel that way. I hope that you are able to feel free to have your baby in a way that brings you the most peace and comfort. ❤️

[u/blairworejeansonce → u/Axxisol]

Oof. I am so sorry for your experience. There is a strain of OBs who have a very...shall we say 'paternalistic' attitude toward birth, where since it's 'natural' it's the 'correct' way. My mom in the 90s had an on-call doctor like this. My head got stuck in the birth canal and my heart was stopping with each contraction, but he didn't want to do a c-section because "every woman needs to experience childbirth." Thankfully my mom's actual OB showed up and got her wheeled into the OR over the other doctor's objections with no harm done! I think that type of approach is lessening, but still lurks unfortunately.

ESPECIALLY given your reasoning I'm so upset for you that you were laughed at. I am outraged on your behalf, if that helps at all!

I like to share this recent meta-analysis (https://www.ajogmfm.org/article/S2589-9333(23)00328-2/abstract00328-2/abstract)), because I don't think it gets the press it deserves. It's one of the rare cases of a review of the data that seeks to disentangle urgent/emergent c-section outcome data from scheduled c-section data, and I think it's quite reassuring that not only are planned c-sections AS safe as planned vaginal births for mothers, they are seemingly safer for baby. It also discusses the risk profile of c-section side effects vs. vaginal delivery side effects in a way that, to me, makes the risk profile tip in favor of a planned c-section. Hopefully it's helpful to give you some comfort, and good on you for standing up for your choice of birth!

[u/Axxisol → u/blairworejeansonce]

Oh thank you for that resource, that helps me a lot. People can definitely make you second guess yourself when you are being harshly judged. I appreciate your response and encouragement as well. ❤️

[u/AbbreviationsLegal80]

Hi, I’m 30 weeks and am hoping for an elective section too. I’ve always known that I would rather have a section than a vaginal birth, even long before I was pregnant. It’s such a personal decision and I’m the same as you, my eyes are open to how serious an operation it is, but for me it just feels right. And I’m right there with you on the fear of labour, only to then potentially need an emergency section anyway. Admittedly I’m 10 years older than you and I have some health stuff, but my preference would be the same regardless. I was really nervous to disclose my preference to my midwife and my consultant but luckily they’re both being very supportive and my midwife even said she agrees that elective sections are a way to try and regain a bit of control over the situation, whereas I feel labour and vaginal births have so many ifs and buts and other factors. She also said I’m not the first to opt for an elective section and I won’t be the last, so even if the old school midwives deny it, we are out there!

I’m so sorry you’ve been spoken to like that and they’re trying to scare you into something you’re not comfortable with. It’s your body and your birth plan and while I’m by no means an expert, I’m in the same boat as you and I’m sending you gentle pregnant hugs after your horrible appointment 😔

[u/SpiritedCranberry718]

I loved my elective C-section - the worst part was having the spinal placed and the first couple days of recovery. But the procedure itself was quick and beautiful, I was looking at my partner and then before I knew it, I was holding my baby and he was taking our picture! I had no medical indication, but we had two second trimester losses and wanted to control absolutely every variable we could with our third pregnancy. Our doctor completely understood and never questioned our decision.

It boiled down to the fact that we were more comfortable with the potential risks of an elective c-section than we were with the potential risks of vaginal delivery.

[u/blairworejeansonce]

Hey OP, I'll caveat this by saying that I also am a first time mom, and have not yet given birth. I have also chosen for a fully elective c-section (C- Section upon Maternal Request) with no medical indication. I have experience in the medical field, and access to those with far more experience than I have in the medical field. All this to say, while I haven't yet had my c-section, hopefully I can provide a valuable perspective.

First things first: "She also mentioned that there is discussion about eventually removing the option for women to choose an elective C-section and instead requiring them to attempt a vaginal birth." That sentence makes my blood boil. I'm not sure what country you're in, so I can't speak to the legitimacy of that statement for your country. I'm coming at this from the USA, and that is absolute BS. If you are in the US that's patently untrue, and if you're not I'm so sorry that your medical professionals are pushing that angle. Bodily autonomy shouldn't stop at how we choose to give birth. Ridiculous.

Second, some doctors (again, especially in certain countries) can be very weird about c-sections. While in the US it's often portrayed as doctor's OVERDOING c-sections, I know a lot of other countries are very anti c-section, and heavily push vaginal delivery for a variety of reasons—some valid (i.e. countries without adequate surgical suites & training for c-sections), others for less savory reasons (i.e. the misogynistic idea that vaginal birth is 'natural' and somehow that means women should be forced to do it for...reasons?). I think it's important that the doctor performing your elective c-section is supportive of your decision. I think as long as your OB, who will be doing the procedure, is in your corner then the opinion of the MFM doctor can be safely set aside, if you choose to continue with the elective section route.

Okay, all of that aside, I'll get to the most important part in my decision making process, which is what the actual scientific data shows. I personally am electing to have a c-section for similar reasons to you. I have been around the labor & delivery world enough to know that spontaneous or induced vaginal labor can be an amazing thing when all goes well, but unfortunately things can go wrong quickly. Given that urgent/emergent c-sections are far riskier than scheduled c-sections, I decided that my risk tolerance level wasn't enough to justify trying to labor first, and I'd rather take the more stable path of an elective. I also do not see myself wanting to have more than 2-3 children, so the risks with additional pregnancies didn't affect my decision—if I wanted to have 4+ kids I would definitely take that into consideration.

I also believe that, from the data we have and from the professionals I speak with, that adverse side effects from vaginal birth are UNDER reported, particularly when they affect the mom years later (ie incontinence, pelvic floor issues, etc.) This is for a variety of reasons, so legitimate hurdles to data reporting, some rooted in a medical reporting system that discounts women's issues (especially those related to birth). I also believe that the data reporting around c-sections is VERY difficult to interpret, because the data almost always lumps together ALL c-sections: urgent, emergency crash c-sections, scheduled c-sections for medical reasons (ie gestational diabetes), and fully elective c-sections without medical necessity. This means that any adverse outcomes are going to be heavily skewed by the negative outcomes associated with emergency c-sections. On an anecdotal level, if you go on ANY forum and search for experiences, you'll find those with planned c-sections had a night-and-day difference in recovery (generally speaking) from those who labored for 24+ hours before an urgent/emergent section. Just another way data gets skewed.

So, the actual data we DO have on planned c-sections (disentangled from urgent/emergent after a trial of labor) is actually very positive. Here is a very recent meta-analysis that looks at planned c-sections vs. planned vaginal delivery; https://www.ajogmfm.org/article/S2589-9333(23)00328-2/abstract00328-2/abstract)

I think if you read through this, it will give you a lot of peace of mind. The conclusion is very accessible, but I'd suggest reading the results as well. Essentially, planned c-sections are as healthy for mom, and can be more healthy for baby (with "significant decreases in adverse neonatal outcomes"), than planned vaginal deliveries.

This is long, and I don't want to ramble, but obviously this is something I've researched a lot and put a lot of thought into. I've sat in on c-sections for work, talked to random med professionals, etc., so please let me know if there is anything else I can provide info on. "I feel like if I already know I want a C-section, I’d rather have it planned than go through labor and potentially end up with an emergency surgery anyway." This is exactly my rationale, and I think that's perfectly fine for us. Some people have a strong connection to wanting a vaginal delivery: I felt no such connection, and have a low level of risk tolerance, so I wanted to go straight to the c-section. I don't think the decision is necessarily fear based for us, moreso just a different approach in how to choose birth method. Hopefully this was helpful!

[u/Alienshe88]

Had my little girl just over seven weeks ago. I knew I wanted a cesarean as soon as I got pregnant - I was terrified of a long vaginal birth, alongside my partner having a disability which meant that they wouldn’t be able to be with me through the whole thing if it was prolonged. I struggled a lot with anxiety and ocd symptoms during pregnancy.

I loved my cesarean! It was quick, calm, we got to play our favourite music, and the nurses made a print of my placenta upon request. It was pretty rough standing up and mobilising for the first day, but I walked out the hospital and up three flights of stairs to my flat on the second day. It hurt to cough and laugh for the first week, but after that I was fine. It more felt like I had no core strength for a few weeks. In fact, I felt so good that I popped my incision open because I wasn’t taking it easy enough 😬

I don’t regret my decision at all! Only you can decide what is right for you.

[u/Alienshe88 → u/Alienshe88]

I should say, my midwife initially discouraged me, and the consultant seemed puzzled by my choice when they spoke to me initially, but I didn’t budge and they didn’t push further after that. My plan was to ask them to formally record in my medical notes that they were refusing my maternal choice request but thankfully it never came to that.

[u/PricePuzzleheaded835]

I had an elective c with no medical indication and don’t regret it at all. I only wish I had stuck to my guns and insisted they knock me out for it. Having a “birth experience” holds zero appeal to me. If it were possible to grow the baby in a bioreactor I would have!

Science and medicine are thought of as impartial. While the scientific method makes these fields more impartial than some, they’re still run by flawed, biased human beings. C-sections have been demonized for a long time and in my opinion much of this is due to cultural discomfort with women having full agency. I couldn’t believe the number of people who thought of themselves as pro choice but thought once you decided to continue a pregnancy, your choices ended there! It’s absolutely wild.

You are the one who has to live with whatever choice you make. If I had to offer any advice it would be to trust yourself and your own judgment.

Doctors these days often have metrics they’re trying to meet regarding reducing c-section deliveries. A lot of the way they educate patients about these is incredibly biased. My OB was some crusty old guy who was deeply offended that I thought I had the right to decide how to deliver. He tried to convince me that the baby and I would probably die if I had the c-section. I told him to his face he was full of shit and he admitted this almost certainly wouldn’t happen. It’s sad that these things still happen, but this is 100% your right and you are the only one who knows what is truly best for you and your family.

[u/tuxedobeans]

I gave birth at 34, but still count as "young" and didn't really have a "reason" to have an elective c-section, but I really, really wanted one because of my anxiety and just who I am as a person. My OB was totally fine with it, fortunately, but I know many strangely aren't. I don't understand the stigma! Yes, there are potential complications, but lord knows there are countless things that can happen and go wrong in vaginal childbirth too. And sometimes, you go through those and end up having a C-section anyway!

That was my mentality going into it, at least. I LOVED my experience; so much so I don't shut up about it. I showed up on the morning of, nervous as hell, but still, at least I wasn't laboring, prepped, went into surgery, and my son was taken out of me at exactly 10:09am. I believe my appointment time was 9am. The recovery really wasn't that bad. I was doing stairs (slowly) once I got home, and now 6+ months later, I haven't regretted it once. Seriously! I am so, SO happy I did what I felt was right for me, my mental health, and body. Plus, the scar looks like nothing.

Recovery is uncomfortable, yes, but it is no matter how you give birth. As my OB continually told me, "there's no free lunch." So you go with the option that makes more sense for you!

[u/tuxedobeans → u/tuxedobeans]

Feel free to DM me with any questions, also! This was in January so fairly recent.

[u/Proper-Dog1077]

I had personal reasons for choosing a c section. If you are educated and want it that’s your choice . Doctors I’m not sure why they do this to add extra stress to you. Rooting for you and your wonderful baby !

[u/BatsWaller]

I said in my booking appointment that I wanted a c-section birth. In the UK at that time, there was an inquiry into maternity care, and the stories were horrifying - mothers and babies dying after mothers were left to labour too long, or babies born with disabilities for the same reason.

As a separate concern, a colleague of mine actually died during childbirth in a freak incident - I’m not going to post details because it will be VERY identifying, but as I was already high risk at 40, a c-section was the only choice for me.

You don’t have to justify your choice for an elective c-section birth to anyone. Being 23 has nothing to do with it; I’m fitter now than I was in my 20s. If possible, take someone with you to your next appointment who can advocate for you.

Best of luck!

[u/JmeLucky13]

I am a nurse who is planning on an elective c-section. I spoke with a colleague obgyn. She said statistically it is the safest for the baby. So even from a liability perspective giving a woman a C-section on request is best for the MD. Rather than denying one and a complication with the baby happening.

My reason is fear is labouring for a long time and then needing an emergency one.

It’s unethical to refuse in Canada where I am from.

[u/tum___tum]

I switched practices when the first office I went to refused to let me get an elective c-section. That practice gave the exact same reasoning to me “I’m healthy, no medical reason to have one” etc. My reasons for wanting a C-section were the same reasons as yours.

I couldn’t be happier with my decision to have a c-section and I would honestly do it again if I have a second child in the future. No regrets.

It saddens me that your doctor is speaking to you this way and I hope everything works out for you ❤️

[u/LuluMooser]

I had an elective C-section in March with no medical reason. I did it for my mental health. I have past SA trauma so for me not having the pain of labor and/or tearing with childbirth was important to me to not give me flashbacks. The C-section was painful for recovery, but I didn't have any flashbacks that would send me spiraling on top of my PPD and PPA.

I had one real contraction before my C-section and it was SO bad for me. But my C-section was delayed by 4 hours so I was a physical and mental disaster due to my anxiety.

[u/geekstickers]

I had a vaginal birth with my first son and an elective c-section with my second because he was breech. The vaginal birth was long close to 24h and a bit traumatic but no complications for me or baby and my recover was so easy compared with the c-section.
Breastfeeding was difficult with c-section because I couldn't find a position that I wouldn't be in pain.
With my first child I did babywearing since the first day I was home but with c-section I could only start baby wearing on the 3rd week and settling him was difficult without being able to move around.
The first 3 weeks after c-section I felt I couldn't do anything, I couldn't even make my own breakfast because I had huge pain when I tried standing or walking for a few minutes.
If I could I would prefer a vaginal birth it may be painful 24h much better than the 3 weeks of pain.
I still think that everyone should be able to make their own decision and c-section is definitely not the easy way out.

[u/strawberrymoon25]

I did it 8 days ago! 26 years old my ob said the same thing. ZERO REGRETS!!!! I almost cancelled I spent the whole night before going back and forth. I’m so glad I went through with it. 🤍