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Elective C Section
Private? Public? Insurance?


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#1 MissingInAction

Posted 22 January 2013 - 08:06 AM

Due to anxiety issues, I would strongly prefer to have a C section birth.

Can you elect to have a c-section?
How do you go about this?

Can you have an elective C section in a public hospital? What about private?  I have private health but am not sure whether elective c sections come into this?  Has anyone been down this road before?  Please help!!



#2 copham

Posted 22 January 2013 - 08:17 AM

Yes with private health care you can elect to have a c section for no other reason then you want one. I had a c/s with my DS after my DD passed away during labour and although I had a reason I didn't have to. Your paying for the service you want just be aware not all OB's are Into "intervention deliveries" when finding one I always asked the receptionist takinng the call if I could have a c section onthe phone as one OB's receptionist told me right out that he wouldn't perform one without a reason.

In the public system there are electives but you have to go through a whole heap of procedures talking to a social worker etc to assess if you are eligible for an elective as it is a lot rarer for them to give a elective on the first pregnancy and mostly just let you have elective if you have previously had one.

My advice if you have PHI go as a private patient you will get what you want. I am going to be having my second elective in 9 weeks and my decision has never been questioned.

Edited by PinkNBlue85, 22 January 2013 - 08:19 AM.


#3 littlesticky

Posted 22 January 2013 - 08:21 AM

I had one through the private route, I think it's a lot harder if you go public. More expensive, but absolutely no regrets.

#4 pandamum

Posted 22 January 2013 - 08:25 AM

QUOTE (MiaMoo86 @ 22/01/2013, 09:06 AM) <{POST_SNAPBACK}>
Due to anxiety issues, I would strongly prefer to have a C section birth.

Can you elect to have a c-section?
How do you go about this?

Can you have an elective C section in a public hospital? What about private?  I have private health but am not sure whether elective c sections come into this?  Has anyone been down this road before?  Please help!!



Hi there! I had an elective c section 9 months ago now. I had my baby at the Mater North Sydney (Private Hospital). I'm not sure if you can have an elective c section in a public hospital - I have a feeling you can't unless there is a medical reason. You'll have to check with your own health fund what exactly is covered. My hospital charges were fully covered, you'll be charged seperately for the anaethetist which should be partially covered. I think from memory our total out of pocket expenses for the surgery, anaesthtist and obstetrician fees was around $5000-5500. You'll need to get a referral to an obstetrician and discuss your options. I have heard that some obstetricians do more elective caesars than others. I discussed my options with my obstetrician and although he encouraged me to have a vaginal birth, as I am healthy and low risk he allowed me to make my decision based on all the information he provided me. I was anxious about a vaginal birth and felt that having a elective caesar was the right choice for me, and I have absolutely no regrets.

#5 Cat Burglar

Posted 22 January 2013 - 08:28 AM

Subscribing to this!

I have had a friend in SA with anxiety issues (documented history, on meds) who was refused a c section for that reason in the public system.
I would only have another baby if I could guarantee an elective c-section at about 38 weeks due to severe antenatal depression/anxiety issues but I dont have private health. So I would love to hear anybodys experience if they have had an elective c-section for this reason in the public system.

#6 joy6328

Posted 22 January 2013 - 09:02 AM

I was always under the impression that to have an elective C-section Privately, you needed to find an OB that supports that. Some are amazingly pro-vaginal birth. Others love the convenience of booked Caesars. You are paying for a service, you just need to find the right provider.

With Public I had been "told" that you need to have a reason. Be it anxiety, health concerns etc. You can't just ask for one. You may need to have a mental health referral or some other way to back it up other than just "wanting" one. If you can't do that - I would imagine you'd need to use your Private insurance...?


#7 lucky 2

Posted 22 January 2013 - 01:02 PM

If you don't ask you wont find out, I'm talking about the public system here.
If you have reasons for the c/s and this is seen to be the best option for you and your baby then you may just get it.
There are risk factors with vaginal and c/s births, more with c/s, for both mother and baby.
It's also more expensive to have a c/s and it is appropriate that unnecessary and costly surgical procedures are avoided.
It's a risk:benefit situation.
Be prepared to explain yourself well so you are can make your carers clear about your concerns.
You sound like you could do with some counselling during the pregnancy and post birth as having a c/s is not an anxiety free experience, it just depends how your body and baby respond.
If you have a therapist who knows you and your particular issues then a supporting letter to the OB/Hosp will be an excellent place to start the ball rolling.
All the best.

#8 kay11

Posted 22 January 2013 - 01:21 PM

QUOTE (lucky 2 @ 22/01/2013, 01:02 PM) <{POST_SNAPBACK}>
There are risk factors with vaginal and c/s births, more with c/s, for both mother and baby.


Risk factors are best discussed with your obgyn and doctors that know your medical history rather then getting from the internet. It is certainly not the case in every situation and my understanding is that c-section actually has less risk factors for the baby than vaginal birth. At any rate - don't take anything about this as gospel from the internet but discuss with your doctor.



#9 Louise2203

Posted 22 January 2013 - 01:28 PM

I had an elective c section in a public hospital in WA.
I was referred to the obstetricians attached to the public hospital, they went through the risks with me and let me choose. Nothing further was required.
I was advised that you have a choice in WA and a couple of other states, which I can't remember now sorry.
I sent an email to the department of that hospital explaining why I wanted the cs and it was from this that I was referred to the obstetricians.

#10 MrsLexiK

Posted 22 January 2013 - 01:42 PM

I am similar to you, I have very bad anxiety surrounding the idea of giving birth.  I will be talking to my OB's midwife about c-sections for this because I have not gotten better as the pregnancy has progressed.  I am terrified of having more damage down there (with all my issues it already is a mess) but to go back to the public or private

Private - as long as your OB is happy to do a c-section for anything other then health (and in some cases anxiety would be considered a health reasons, in other cases not) You will have the cost of an attendent at the birth, and perhaps all or just the gap fee or nothing for the anthesit. On top of any charge from the OB (delievery fee, management fee, appts etc).

Public - again whilst anxiety might be a health reason they may not see it that way so you would not be assured in some states/hospitals.  You wouldn't pay extra for it though.

#11 waawa17

Posted 22 January 2013 - 02:01 PM

The internet can be a great way to fill yourself in on background information - it gives you direct access to Pubmed, the Cochrane Database, Medscape, etc.

Risk to the baby can be lesser with C section with some complicated pregnancies, but a normal pregnancy is a very different situation, especially but not exclusively when the elective C section is done at an arbitrary early date before commencement of spontaneous labour. Maternal risks of complications and/or deaths are higher with C section, as are risks to any future pregnancies. When doing a C section for anxiety, the risks need to be very clearly weighed up, and alternatives to surgery at least considered. As a poster says above, in addition, abdominal surgery is a stressful experience in itself, not the magical stress and pain free wonderland that it's often treated as in popular culture and the news media. Even without major complications, neonatal respiratory complications and mother-baby separation are more likely, breastfeeding establishment can be more difficult, and post-op pain/minor infections/consequences of greater blood loss can be a bear to have to manage while you're just trying to bond with your baby.

A severe and unmanageable anxiety disorder may certainly be an indication, if it's truly more unsafe for the mother to even attempt labour and if all other avenues have been exhausted. It's just not anywhere close to an automatic indication or an equally safe option, and it would be unreasonable to treat it as such in a public health system that's supposed to be providing evidence-based care.

#12 lucky 2

Posted 22 January 2013 - 03:34 PM

QUOTE
Risk factors are best discussed with your obgyn and doctors that know your medical history rather then getting from the internet.

Yes I do realise that kay11, hence my suggestion to start talking to care providers, getting a letter in regards to anxiety issues to support the case for c/s.
A risk:benefit assessment is needed, as per my post.
Apologies if my post wasn't clear enough.

#13 bebe12

Posted 22 January 2013 - 03:50 PM

Hi,

I had and elective C/s at Public hospital but it took weeks before they would say yes. I got the green light at week 37 and had him two weeks later. Process was started at 30 weeks after bub had heart scan.
  
I had a difficult first vaginal labour that had complications, leading to mental health issue, and our bub had a heart issue and was breached and i still had to jump through hoops to get a yes.

#14 Soontobegran

Posted 22 January 2013 - 07:34 PM

QUOTE (Soccer Mum @ 22/01/2013, 09:28 AM) <{POST_SNAPBACK}>
Subscribing to this!

I have had a friend in SA with anxiety issues (documented history, on meds) who was refused a c section for that reason in the public system.
I would only have another baby if I could guarantee an elective c-section at about 38 weeks due to severe antenatal depression/anxiety issues but I dont have private health. So I would love to hear anybodys experience if they have had an elective c-section for this reason in the public system.


It is definitely possible for elective C/S to be performed in a public hospital but I am certain there will be some less likely to be compliant than others.
Psychiatric illness is as valid a reason for an elective C/S as any other illness however in the public system you will almost certainly be required to have an assessment from which the final decision will be made.
Because the public purse is paying for the surgery the hospital is made accountable for the number of C/S performed and funding could be impacted if it is noticed that there is an unusually large number of C/S happening that do not appear to be medically indicated.

Good luck OP, it is really important that you speak to your caregivers at length and know that the delivery you are choosing is right for you.





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