Elective c section is the term used for a c section which is planned in advance of labour, rather than being advised as a medical necessity as a result of concerns during labour. Elective c section is often recorded in medical notes as ELCS. It is also referred to as maternal request c section, but I prefer to use non- gendered language.

Elective c section can be appropriate for a variety of reasons. These may be physical or psychological/emotional. I provide midwifery care which acknowledges and respects your personal situation.

People often assume that as a private midwife I only work with those who want a homebirth. That is incorrect. I support choice and individualised care. I support both home and hospital births. If an elective c section is most appropriate for you I am glad to provide a package of antenatal and postnatal care supporting this.

Private midwifery care can work well for people based in East Sussex or West Sussex who prefer to have a private c section. If your chosen obstetric surgeon is based in London, I can provide your regular antenatal checks, blood tests etc, so avoiding unnecessary journeys into London. This is a time saving and cost effective option. I visit you at home at a time that suits you, including weekend and evening appointments.

Whether you are using private or NHS services for the birth of your baby, the time rich style of antenatal care I am able to offer allows time to talk through questions or concerns at all stages of pregnancy.

Having a private midwife available to provide post natal care means that you are able to return home quickly and confidently. I will visit you to monitor your recovery from what must be remembered to be major surgery, to assist you with getting to know your baby and to ensure that they are adjusting well to independent life. Depending on your personal situation you may also want to consider booking a doula to help with adjustment to the realities of your new family life. A doula colleague who has provided wonderful support for a number of my clients is Laura Batten.

There are physical issues which may mean that the decision for c section is clear. These include placenta previa, transverse lie of baby at term, or various health conditions affecting parent of child. More complex are decisions regarding situations such as birth after one or two previous c sections or whether to choose a planned c section rather than induction of labour. I am glad to explore clients thoughts and feelings as they seek to make the decision that is right for them and their baby.

Emotional/psychological factors include previous trauma/PTSD, gender dysphoria or conditions such as vaginismus. In such situations clients sometimes decide that (with high quality, respectful and personalised midwifery care and support) a vaginal birth may be achievable and acceptable. I am always willing to talk through options in a non directive way. I am clear that elective c section is an option which can enable the individual to retain a sense of agency and to feel respected or to avoid psychological harm.

If you feel that elective c section would be right for you, you may be told by family or friends that you will have to “fight” for this choice in the NHS. Although in recent years years this was the case in some areas within the NHS, most units are now less resistant to a well reasoned request. The NICE guidance sets out how a request for elective c section should be addressed by NHS providers. The organisation Birthrights provides useful information. It is important to be clear that c section is major surgery and there are potential risks which must be clearly understood. I believe that emotional and psychological reasons can be valid reasons for making this choice. If you are making an informed decision I am happy to work as your advocate if needed.

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