Elective Caesarean at 40 + 3, acceptable?
Discussion
Elective caesarean has been booked for 40 + 3 , they have known that it was needed for several weeks but only just booked it for 3-4 weeks time.
Is this normal? The consultant went to great pains to point out the increased risks of emergency CS over elective and then passed us on to the midwife who stated that it was the first date they could do.
To me this seems like a very good way of heading for an emergency CS, with the associated increased risk.
Any doctors on here know whether this would be considered acceptable practice?
Many thanks,
James
Is this normal? The consultant went to great pains to point out the increased risks of emergency CS over elective and then passed us on to the midwife who stated that it was the first date they could do.
To me this seems like a very good way of heading for an emergency CS, with the associated increased risk.
Any doctors on here know whether this would be considered acceptable practice?
Many thanks,
James
I would definitely be questioning that! SWMBO was told they would first start prodding to get junior PG out at 40 + 1day.
Are you getting any drugs to try make sure Labour does not start?
Randomly, PG junior popped out 2 days early, I highly recommend the midwives and doctors in Aberdeen, they were amazing, really helpful.
Edit cause I am now a sleep deprived dad who thought 40 + 3 meant 43 weeks...
Are you getting any drugs to try make sure Labour does not start?
Randomly, PG junior popped out 2 days early, I highly recommend the midwives and doctors in Aberdeen, they were amazing, really helpful.
Edit cause I am now a sleep deprived dad who thought 40 + 3 meant 43 weeks...
Edited by Peanut Gallery on Saturday 22 July 00:11
Is it the mum's first baby?
Without knowing the medical reasons for the recommendation, for most people when labour starts there can be many hours before the delivery; plenty of time to prepare for a CS.
An EMCS sounds dramatic but there are different grades; if the baby doesn't need delivery immediately then it's done camly and safely and the mum stays awake throughout.
Not a doctor, but been there twice! Good luck
Without knowing the medical reasons for the recommendation, for most people when labour starts there can be many hours before the delivery; plenty of time to prepare for a CS.
An EMCS sounds dramatic but there are different grades; if the baby doesn't need delivery immediately then it's done camly and safely and the mum stays awake throughout.
Not a doctor, but been there twice! Good luck
It was the fact that the consultant had just spent a great deal of time explaining the various increased risks associated with an emergency CS versus elective (and that CS once in labour is by definition an emergency CS), and then we were booked in for 8pm 3 days after the due date and 10 days after we were originally told it would be.
If they are already running 10 days behind, I would imagine that (if she makes it that long) there would be a very good chance of being bumped anyway.
I am a vet, I would find it hard to defend increased risks to my patients in a similar situation and just wondered what any doctors thought.
If they are already running 10 days behind, I would imagine that (if she makes it that long) there would be a very good chance of being bumped anyway.
I am a vet, I would find it hard to defend increased risks to my patients in a similar situation and just wondered what any doctors thought.
If it is 'needed' then surely it isn't 'elective' or am I missing something.
But yes - planning for a section that far on would seem to be increasing the odds of nature taking its course beforehand.
My mrs had to, for safety reasons, have a section and to avoid that risk it was scheduled for week 37.
But yes - planning for a section that far on would seem to be increasing the odds of nature taking its course beforehand.
My mrs had to, for safety reasons, have a section and to avoid that risk it was scheduled for week 37.
jmsgld said:
Elective simply means planned ie before labour has started, so your wife's was an elective CS.
Emergency is once labour has started...
Eh? Emergency is once labour has started...
Ours would probably have been elective CS anyway, as my wife is a type 1 diabetic, but our first was very much an emergency as my wife was admitted to hospital with preeclampsia, and a scan showed that our daughter was showing signs of distress.
Forty minutes later, they'd yanked her out at six weeks premature (although at almost 6 pounds, thanks to the diabetes!) with labour absolutely nowhere in sight.
OK, so it was elective in that the doctors chose to take her out that way, but when the alternative is a rapidly diminishing likelihood of survival, so just a touch of the old emergency in there too...
jmsgld said:
That's my understanding of it, but that certainly sounds like an emergency situation !
I hope all went well.
Yes, thanks. Said eldest offspring will be 15 in January, and still happy and healthy, at least as much as a teenage girl can be! I hope all went well.
I do sometimes even now ponder on the fate of the poor child of the woman in the bed next to my wife in the ante-natal ward. She was being induced because her baby was at weeks on the +3 and starting to show signs of distress, despite still being under average full term birth weight.
The after the midwife did whatever unmentionable female thing it is they do to induce a baby, she asked the mother if she had any questions. "Yes", she said. "Have I got time to pop outside for a fag before anything starts to happen?"
Glad to hear all went well, not a situation I would wish on anybody.
Nice, although to be fair I have heard that the "sweep" was more painful than child birth from one of our friends.
Have decided to go privately, some things are more important than money...
Nice, although to be fair I have heard that the "sweep" was more painful than child birth from one of our friends.
Have decided to go privately, some things are more important than money...
Edited by jmsgld on Monday 24th July 19:40
With our first we had an emergency C section at 42 weeks (40 + 15 days) which wasn't ideal. I guess it depends on a number of factors, such as the health of the baby, the health of the mother, medical history, risk factors, accuracy of the due date etc etc. I'd be asking some questions of the healthcare professionals responsible.
From the discussions I had at the time (nearly 9 years ago now admittedly) going much beyond a week after the due date increases the potential for complications, it's not intrinsically dangerous but does increase the risk of complications.
For our second we had an elective c section at 39 weeks because it was either a week early or 2 weeks late as there were no appointments nearer the due date. The consultant seemed much happier with a week early rather than 2 weeks late.
ETA, glad it all worked out ok in the end.
Congratulations, that's the easy bit out of the way. Welcome to new baby hell
From the discussions I had at the time (nearly 9 years ago now admittedly) going much beyond a week after the due date increases the potential for complications, it's not intrinsically dangerous but does increase the risk of complications.
For our second we had an elective c section at 39 weeks because it was either a week early or 2 weeks late as there were no appointments nearer the due date. The consultant seemed much happier with a week early rather than 2 weeks late.
ETA, glad it all worked out ok in the end.
Congratulations, that's the easy bit out of the way. Welcome to new baby hell
Edited by RTB on Tuesday 25th July 08:32
Kermit power said:
Indeed. Before I had babies, I had never imagined for a moment that I would willingly ask a stranger to approach my testicles with a very sharp blade! 
There aren't many experiences that makes having someone set about you're family jewels with a soldering iron seem like a good idea RTB said:
Kermit power said:
Indeed. Before I had babies, I had never imagined for a moment that I would willingly ask a stranger to approach my testicles with a very sharp blade!
There aren't many experiences that makes having someone set about you're family jewels with a soldering iron seem like a good idea 
Hope all goes well. Can understand why you have gone private though I have found if insistent enough you will get what you need via NHS with re: pregnancy!
I was 40 second time pregnant. I told the midwife that I absolutely did not want to go more than a couple days over due date (unnecessary risk I think) midwife told me they would not act until 10 days over. I got a bit stressy about this!! so she referred me to a consultant (I had a couple of queries that I hadn't been happy with re: midwife inc strep B testiing - I was +ve for first two pregnancies 2nd pregnancy I miscarried but they still wouldn't agree to test me on the third one) Anyway the first thing the consutlant said was because I was 40 they would not let me go over date and would induce me, apparently the placenta in an older woman will begin to deteriorate a lot more quickly after week 40 so not a risk they like to take. She also reassured me re strep b as well though I was still not 100% happy on that one.
Anyway my feeling is, if you kick off a bit they normally try and accommodate you (that was my experience anyway!)
Exciting (and lets face it, some nerve wracking!) times both ahead for both of you!
I was 40 second time pregnant. I told the midwife that I absolutely did not want to go more than a couple days over due date (unnecessary risk I think) midwife told me they would not act until 10 days over. I got a bit stressy about this!! so she referred me to a consultant (I had a couple of queries that I hadn't been happy with re: midwife inc strep B testiing - I was +ve for first two pregnancies 2nd pregnancy I miscarried but they still wouldn't agree to test me on the third one) Anyway the first thing the consutlant said was because I was 40 they would not let me go over date and would induce me, apparently the placenta in an older woman will begin to deteriorate a lot more quickly after week 40 so not a risk they like to take. She also reassured me re strep b as well though I was still not 100% happy on that one.
Anyway my feeling is, if you kick off a bit they normally try and accommodate you (that was my experience anyway!)
Exciting (and lets face it, some nerve wracking!) times both ahead for both of you!
Thanks for the support, the community midwife was a little shocked and voiced her concerns with the NHS Obs / Gynae consultant who then arranged the CS for the correct day, however by this stage we have completely lost faith / trust with the NHS and are still planning on going privately as long as they can find a suitable anaesthetist.
I think you are right, if you are insistent enough/ kick up enough of a fuss you will probably get the appropriate treatment on the NHS, however I don't want a surgeon under duress to perform a CS on my partner nor the stress of them cancelling at the last minute...
There is a a lot more to this story that I won't go into, but suffice to say that if I were to behave clinically as the NHS consultant has done I would fully expect to be hauled in front of the RCVS and face disciplinary action.
I think you are right, if you are insistent enough/ kick up enough of a fuss you will probably get the appropriate treatment on the NHS, however I don't want a surgeon under duress to perform a CS on my partner nor the stress of them cancelling at the last minute...
There is a a lot more to this story that I won't go into, but suffice to say that if I were to behave clinically as the NHS consultant has done I would fully expect to be hauled in front of the RCVS and face disciplinary action.
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