NICE recommend all women should be able to have a cs

[LoveBeingAWitch]

Just seen tomorrow's front page of the Sunday times saying that NICE are saying cd has become such a safe op that every woman should be able to have one if that's what they want. Im quite surprised by this.

I am biased because I did have a CS. I think I've read that the majority of female Obstetricians would opt for a CS over natural birth which is quite telling.

Having only been able to read the front page of The Time I'm surprised that it's (apparently) only £800 difference between a natural birth and a CS. Although I would guess that's a planned CS?

I've happily had 2 of them (emergency and planned) and part of me feels I got off lightly compared to what some women go through with a natural birth, but they are a major op and there is a longer recovery time.

I can't imagine thousands of women will be marching off to their midwives requesting them though. I watched one on You Tube the other day and it made my stomach squirm.

A planned section is worth every penny of that extra £800 IMHO and is the civilised way to have a baby. Having had a VB the first time I would never have had my second child if I'd been told that I must go through that again.

Thank god NICE have come round to a compassionate way of thinking and that they seem to be prepared to treat women as thinking beings by supporting their right to choose.

Well after having had 4 dc's vaginally I wouldn't have another if it had to be a cs.
The vast majority of women are capable of a VB, we are designed that way after all. I would hate to have to be cut open that way when there ios a much easier (imo) and natural way to give birth

Female obstetricians often have quite a distorted view of childbirth as do male obstetricians and anethestists. Many of them have never witnessed a nice natural birth. They only see women who are screaming and experiencing things going hideously wrong. The majority of women in the world can and do give birth naturally with complications.

I would like doctors to learn more about natural birth and learn how to optimise a good outcome for the mother and baby. Often fear upsets the birthing process, as does continous monitoring. Many women experience more pain than they need to.

I think its a good idea to allow a C-section on demand, but doctors and women need to be informed. C-section is not a pain free option.

Ah yes, Debs, but that's you. We don't all feel that way - I wanted to die when I gave birth to DD1 and had I not been permitted that ELCS with DD2 I'd have had a termination rather than go through vaginal birth again. Surely we should have the right to choose how we give birth and we should support other women in those choices?

IMHO NICE's stance has been far too long coming.

Brilliant, whole heartedly agree. If a woman wants a CS she should have one, as long as she's fully informed about the pro longed recovery.

I also think this is brilliant.

When I was pregnant, for various reasons it looked likely I would end up with a CS. Even the consultant thought so but I was told I had to 'give it a go' with VB first. Of course I went through a prolonged and awful labour before getting the CS that had been expected anyway. I would have much rather had the option for a planned section.

And I agree this is treating women more like responsible adults rather than delicate things that can't possibly know what's best for them.

reallytired, I have to say that for me, my ELCS, carried out under spinal block whilst I was awake, whilst not of course being pain free was pain controlled.

I felt the first ache of pain when in the recovery room. Called the nurse, was given a jab of morphine, the pain went like turning out a light and so it continued. I had DD on the Monday morning and by the Thursday lunchtime was at home and took just 2 paracetamol that day and nothing thereafter as pain relief.

I have to point out here too that I'm a complete wuss, have the lowest pain threshold imaginable and I'm needle-phobic!

Now, I know that not every woman has as great an experience with ELCS as I did but to say that it is not a pain free option when for some (many of us??) the pain is managed in such a way as it is as good as a pain free option is scare-mongering and doing ELCS a disservice IYSWIM.

reallytired But I believe OBs in the US also prefer CS, even though they see the whole range of childbirth all the time (no midwives)

I have had VB, emCS and VBACs - all were good birthing experiences. And I am a GP having looked after lots of women with good and bad births whether they had VBs or CSs.

Given the choice, I Personally would opt for VB again, but am very glad of a proposed policy change to make access to CS easier.
It is not usually the 'easy' option, has it's risks (as VB delivery does), but has it's place.

I really think every woman should be free to choose how to give birth for herself - at home, in hospital, in a birth pool or in an operating theatre. No woman should have to beg for an epidural, a c-section or a homebirth.

Having said that, I wouldn't choose a c-section myself. Giving birth to ds was pretty unpleasant (30 hour labour and a forceps delivery) but I did feel physically back to normal within a few days, so that was the right choice for me.

screamingbohemian,

OBs in the US hardly ever see a pain relief natural birth. It hardly ever happens in such a medicalised enviromnent. It would be lovely for trainee OB to go out with midwives in the community and see a natural birth. I also think they should have the experience of being with the woman for the entire first stage as well as the exciting second stage. Prehaps it would give more insignt to pregnant women as people.

I don't think that a c section is a better option for the coward. There is no easy way to give birth. Recovery from a c section can take weeks. Prehaps what is needed is more research to predict who will give birth easily and who will have problems. I know someone who was left with secondary infertility as a result of a c section. There can be major complications with a c section as much as with natural childbirth.

Giving birth by C section is as much an achievement as a natural birth. It is not a soft option for those who can't be arsed to push.

"No woman should have to beg for an epidural, a c-section or a homebirth."

I agree with you most of the time, although I am not sure about a complete right to a homebirth. The problem is that birth involves the health and welbeing of at least two people. Prehaps better ante natal education is needed before women have that right.

I'm American and I think the idea that all women in the US have a medicalised birth is a massive stereotype. My cousins gave birth in hospital but intervention free, as did a few other women I know. Actually none of the American women I know ended up with sections. To say American OBs 'hardly ever' see natural birth seems off to me.

Also I think it's rude to refer to women fearing childbirth as 'cowards'

I've been thinking about this with dc2's arrival getting closer. I genuinely don't know what I would do, given the free choice between a CS and a VB. I had a quick but painful induced VB with dd. Do I want to go through that again? Not especially. Do I want abdominal surgery? Easier at the time but far harder afterwards I imagine. Not especially.

This is all assuming everything is straightforward btw. But as a free choice, it's a bloody hard one.

Are they saying that it will be free on the NHS? As it's not necessary I can't see that it would be. Just wondering if there was a 90%+ take up whether there would be enough surgeons!

I think it's a good thing, women should have the choice over how they give birth.
I think the NICE guidlines also state that a woman should be able to request an epidural even if she is in the early stages of labour and only one or two cm dilated. Going on the experiences of women I've spoken to epiduras are often refused in the early stages of labour. I think that's appalling.
I also think it's appalling that women are not given the option of a CS when they are giving birth to a baby who they know has already died. I think that's so cruel.

It's lovely in principle.
Now I wonder which area of the NHS will suffer as a result - elderly care? or cancer? or will it be paediatrics? who knows.
Or which money tree will they be getting the extra costs from?

Really tired you're making bold and incorrect assertions how on earth did you work out that most Obstetricians's and Anaesthesits have a skewed view of normal labour?given that at med school and post qualifying have participated in and assisted normal birth it's not correct to say it's a slash and dash ethos,or they have predilection for cs

whiteoleander I doubt it would be of much cost to the NHS. I don't think most women are going to start requesting them. I certainly wouldn't.

Some of the planned caesareans though would otherwise have been births that might have resulted in emergency caesarean or a complicated assisted delivery, which presumably is expensive as well. So the extra costs are not as straightforward to work out as you might think.

I agree that this will affect only relatively small numbers of births. Most women don't want a section (or indeed any type of surgery) for no reason, or for frivolous reasons, and for those who have valid psychological reasons, it is absolutely right that they should have this choice.

And I'm sure most of us would gladly pay £800 to the NHS for this option if we could. I would certainly be more than happy to do so. After all a fully private caesarean would cost well over 10 times that (I think it was in the region of £15,000 at least last time I checked).

I agree that all women should have the choice on how to give birth but it is an informed choice which is the key here.

Im not a hippy all natural mother either, I had 3 epidurals, 2 of which were after inducing. A CS to me is an emergency birth, which is how it was first performed. Major abdominal surgery shouldn't ever be seen as the norm for birthing. It should be an alternative if it is needed. We have much better ante-natal care which can pick up reasons not to give birth naturally. If there is no medical or mental health reasons to have a CS then a VB should be attempted. IMO.

I think it is brilliant that women are going to have a choice and not to have to 'beg' for a CS if they want one. I am not convinced that this is going to cost the NHS a lot of money. My thought, when I saw the headline, was that just knowing that they had the choice might make some think about having a vb, human nature being what it is.

Some people have wonderful painfree births and pop out to Sainsbury's afterwards. Some have an agonising time and use what breathe they have to demand that their head is chopped off. (anecotal evidence) It seems to me to be largely luck, or size of pelvis, not evidence of superior moral backbone.

I have a cousin who is an obstretician, and she told me, after the birth of my first, that she was not going to give birth until it was normal to give birth on the NHS under a general anaethetic. She also told me that, in her London teaching hospital (St Thomas's? can't remember, she has moved on now), pain was more or less not allowed, and as soon as the whelpers screamed too much they were given a CS. (She now has 3 children herself, by CS)

It is true that most doctors and medical students only see the births that go wrong. My brother is a consultant (nothing to do with obs), and when he heard that I was pregnant he rang to tell me that it was either the biggest or the second biggest cause of death in women of childrearing age. I don't know how he got to his position with a bedside manner like that. Both cousin and brother had only seen the worst case scenarios.

I don't mean births that 'go wrong', I mean breech births or births with complications, which require the presence of an ob.

I think this is great news.