When I got pregnant with baby number 2 I knew straight away that I wanted a c-section (you can read more about my decision in my post Don’t call me too posh to push). But I also knew that it wasn’t going to be easy to get one. I’m a resourceful woman though. I armed myself with the right information and had the right conversations with the right people. I had to wait for nearly all of my pregnancy to get a firm decision but I kept pushing and eventually, was booked in for a c-section at 39 weeks.

I’ve read enough forum posts to know that I was one of the lucky ones. That I was able to get what I needed when so many other women were denied it. If you are reading this and thinking that you too would like an elective c-section because of your birth anxiety then there are a few things you should know.


Be prepared for a fight

As I’ve said, it wasn’t easy to get an elective c-section. Each NHS trust will have a different policy. But usually it falls along the lines of ‘we won’t do any medically unnecessary c-section’. I found that most of the midwives I saw were judgemental about wanting one. I had to justify myself every step of the way to every new person I met. Plus I had to put up with snide remarks about being too posh to push. It was exhausting.

But I kept going and maintained that it was what I needed. It was only at my last consultant appointment (in both pregnancies) that I actually met someone who was supportive of my decision (other than the mental health midwife). There were a lot of tears and anxieties along the way. Living with the uncertainty that I was going to get what I knew was right for me was really hard. I developed antenatal depression as a result and just generally, felt like the whole world was against me at times.

So if you want an elective c-section you need to know that it isn’t going to be an easy road. You will have to convince people. You will have to put up with negative comments or questions. It can be hard to wait for the final decision and live with the uncertainty. But if it’s what you want then it’s a fight worth having.


You need to know your stuff

Information is power. It’s that simple. You’ll most likely face people who don’t want to grant your request therefore it’s essential that you know what you are entitled to. Make sure you read the NICE guidelines (which currently state that women who request a c-section should get one). Print them off and take them with you to any appointments. Also make sure you are aware of the guidelines that your trust has as they may be different. I know my trust has a nice little box on the front of the antenatal notes saying that they don’t grant c-sections on maternal request.

Don’t get disheartened by the guidelines though. There is always wriggle room and scope for discussion. Generally there needs to be a medical reason for an elective c-section but don’t for a moment think that mental health isn’t medical. If you have severe anxiety about the birth then that is a medical reason. If you have antenatal depression because you are worried about the birth then that is a medical reason. Worries about suffering physical trauma again or fears over bonding with the baby because of another difficult birth can all be argued as having a medical impact. Read the small print carefully and think about how you can work within the guidelines of your trust.


You may change your mind

You should be offered counselling as a minimum and, if it’s your first baby, antenatal classes may also be suggested to help you learn about how you can cope with birth. If you had a traumatic first birth then most hospitals should offer a ‘reflections’ service. This is where you have the opportunity to talk through what happened and why. This understanding can help you to feel more empowered to avoid the same thing happening again. It can also help you to feel differently about the decisions that were taken.

Hypnobirthing is also massively popular now and it could be that classes are suggested to help you feel calmer and more relaxed about the birth. Your midwife might be able to suggest certain elements are put into your birth plan to help remove some of the areas that are making you the most anxious.

In short, there are lots of options available that might make you feel more comfortable having a natural birth. Make sure you don’t dismiss them out of hand. You might well find that they do, in fact, help you feel confident doing it naturally. And if they don’t, you will be able to show that you have taken steps to address your concerns before deciding that a c-section is right for you.


Get help and get it early

I can’t say this enough – you will need support and help if you want to have a happy pregnancy and feel confident about the birth. I saw a mental health midwife, had over 12 hours of counselling and saw a birth trauma specialist for hypnotherapy. And even though I still felt that a c-section was right for me, I know that I probably would have been able to cope with a natural birth if it had been denied as a result of all the help I got.

The biggest problem with birth anxiety is that there is a clock ticking. If I’d waited until the final decision (which was at 36 weeks) then it would have been far too late to get the right help if I’d been told no. It pays to prepare for the worst so find the right help for you and then get it early. Ideally, what this will do is help you to have a more relaxed and anxiety free pregnancy. But if you are denied a c-section then you will be in a better position to go through a natural labour.

Make no mistake…

Having an elective c-section is not the easy option that people think it is. It’s emotionally hard as well as having a longer physical recovery afterwards. If you think you want an elective c-section because you are anxious of the birth then start the conversation early. Do your research and make sure that you get the right support as soon as you can. It is possible though so don’t be afraid of asking for what you need. And trust your instincts. You know what is right for you and your baby.


If you are anxious about giving birth and want to have a coaching session with me to help you feel calmer, happier and more positive about your upcoming birth then get in contact here or email kate@howtosurvivemotherhood.co.uk. I’ve got your back on this one!