Did you know that as long as you know the risks, you can request a planned c-section for any reason? This can be for anything from a medical issue to fear, anxiety, or just personal preference.
However, as cesareans carry greater risks for both you and your baby, it’s not a decision to take lightly. Here’s everything you need to know about requesting a cesarean so you can make an informed choice.
Reasons to Request a C-Section
You may wish to ask for a c-section for one of the following reasons:
- You have a high-risk pregnancy.
- You’ve had a previous cesarean and don’t want to attempt a vaginal birth after c-section (VBAC).
- There is an issue with your placenta e.g. placenta previa.
- Your labor isn’t progressing (20 hours or more).
- You are overdue and don’t consent to induction.
- You are expecting twins or triplets.
- Your baby is in a breech or transverse position.
- Your baby has a medical condition that means a cesarean is safer for them.
- You have an infection like HIV or herpes.
- Anxiety – the thought of giving birth vaginally causes you stress or anxiety.
- Critical life experience – you’ve experienced a stillbirth, trauma, or violence that would make childbirth distressing.
- Tocophobia – You have an intense fear of childbirth.
- Preference – You feel it would be easier, less painful, or more convenient to deliver via c-section.
Non-medical requests for a c-section are called “Cesarean delivery on maternal request,” and they account for 2.5% of all births in the US.
If you think this might be what you want, keep in mind that many insurers do not cover elective cesareans for non-medical reasons. This is due to the increased risks compared to vaginal births. So check with your insurance provider before making any plans.
Can Your Doctor Refuse to Perform a C-Section?
Your doctor cannot refuse to perform a cesarean without a good reason, provided:
- You will be more than 39 weeks pregnant at the time of delivery.
- You are making an informed choice.
However, the guidelines recommend that medical professionals strongly encourage a vaginal birth. So your doctor will likely spend a lot of time highlighting the risks, and they may need some serious convincing.
Is a C-Section Riskier than a Vaginal Birth?
Risks to you include:
- Blood clots.
- Longer recovery.
- Greater chance of placenta previa, placenta accreta spectrum, or hysterectomy during your next delivery.
- Reaction to anesthesia.
- Chronic pain or itchiness.
Risks to your baby include:
- Transient tachypnea, where they struggle to clear the fluid from their lungs and breathe too fast, for a few days after delivery.
- Increased chance of being admitted to the NICU.
- Greater chance of developing asthma.
- Greater incidence of child-onset diabetes.
Can You Request a C-Section Instead of Induction?
As inductions are less risky than c-sections, many healthcare professionals recommend them.
However, they also cause stronger, more painful contractions and are more likely to result in instrumental (assisted) deliveries. For this reason, you are perfectly within your rights to request a planned cesarean instead.
Can You Request a C-Section After a Failed Induction?
Yes, if your labor fails to progress, the safest option is to deliver via cesarean.
Can You Request a C-Section During Labor?
If you go into labor naturally, it’s safest to continue until you give birth. But, if you find it overwhelming, you can ask for a cesarean during labor.
However, it may not be possible if:
- You are too close to giving birth.
- All theaters are in use.
- There are emergency deliveries ahead of you.
Can You Request a C-Section at 37 Weeks or 38 Weeks?
Most hospitals won’t perform an elective cesarean until you are 39 weeks pregnant. This is because your due date is only an estimate and could be two weeks out. So planning a cesarean for 37 weeks could result in your baby being born late-preterm.
The earlier your baby is born, the more likely they are to need help breathing. 10% of cesarean babies born at 37 weeks will have breathing difficulties, compared with just 2.1% at 39 weeks. Babies with respiratory problems may need ventilation in the NICU, which can be distressing.