'If I go to hospital I will have to have a c-section' Can we dispell this myth?!

[Flymetothemoon123]

I've heard from several new mums recently this statement 'if I had been hospital [during labour] I would have had to have a c section'. It was said in reference to slow labours and It's said like the c section would have been forced upon them when they wouldn't have wanted it. I even met a lady who ignored the advice of her midwives and at stayed at home for hours after they told her she needed to go to hospital so that she could avoid 'going to hospital and having to have a c section.' So I think this could actually be dangerous if women who need to be in hospital are too scared to go because they think they will be forced into something. I don't understand why people are so suspicious of doctors? Where does it come from? Firstly, they need your consent (often written consent) to do anything and secondly, my experience was that they only intervene if there is a danger to mother or baby and they worked really well with me and discussed and we agreed. I had an extremely slow labour so would be a prime candidate for clock watching and intervention due to slow progress but it was made very clear to me that they only intervene if there is a clinical reason. I thought the hospital were great from start to finish. So what do other mumsnetters think? Is this a myth we can dispell? Or should women genuinely be wary of hospitals?

[ShowOfHands]

I think we need to examine the whole language set around childbirth. A caesarean is often billed as a negative thing only. They're a lifesaving, fascinating, brilliant tool in a birthing arsenal.

You can stick failure to progress and poor maternal effort and geriatric mother and pain threshold in room 101 too if you've time.

[kiki22]

I had problems with my baby's heart rate dropping we monitored for hours then decided to head to theatre they done one last check in theatre and decide not to go ahead with the section he was born with forceps instead so in my experience it's a last resort if it's in the best interest of the mother and baby if they can avoid it they will, however if I hadn't wanted to wait they would have took me right away I was deffinetly not forced into anything.

I have to say where I live we don't have midwife led units and home births are practically unheard of no one bothers about where to give birth we all just go to hospital I've only every heard of people going other ways on MN I don't know if it's a regional thing

[MyBreadIsEggy]

Personally, if the odds are in my (and my baby's) favour, I would never choose to give birth in a hospital ever again in a million years - vaginal birth or csection. Not because the care I received during my labour and delivery was shoddy, but because I'm terrified of ever needing to stay on a post-natal ward again. The care I received there wasn't shoddy, it was downright neglectful. I totally understand that maternity services are over stretched and under staffed, and I really do appreciate the job midwives do, but when being understaffed means patients are not being fed, giving drinking water or told where toilet facilities are when they are bed-bound, some serious overhaul is needed somewhere!

[Absy]

There is a culture in the uk (ime, vs say the US or South Africa where I'm from) to have as natural a birth as possible, which is nice. When my sil fell pregnant in SA the first thing her gynaecologist asked was when did she want to schedule the c section for, without any medical reason. However, the whole natural / unmedicalised birth thing does seem to be pushed a lot. The hospital I went to was lovely but they were really pushing (subtly though) to go into the midwife led birthing centre rather than the labour ward (which I insisted on from the beginning). Even up to my overdue appointment (and when I was in labour) I was asked if I was sure I wanted to go to the labour ward rather than birthing centre. Thank goodness I insisted on labour ward, because I ended up having an emcs as first they found that the labour wasn't progressing, and then during the c section they found that he was in a really awkward position, so either way it would have happened. I'm so glad I insisted. There is this (somewhat justified) view that the birth experience can be too medicalised, but on the other hand it seems like people in the first world forget that actually it is incredibly dangerous, and thank goodness to medical advances and interventions far fewer women and babies die in childbirth.

[NotCitrus]

It does seem to be a thing in the American system - you get x hours from being admitted or have to agree to a CS, as your consultant wants to go home. On the NHS I've never heard anyone complain they'd be 'made' to have a CS, only the other way round.

I had a very long first labour but CS was only suggested and highly recommended when meconium appeared - they tried a ventouse just to help me feel we'd tried everything to avoid the CS, and as it happened he popped out, to everyone's surprise.

Given the extra care postnatal women need if they have CSs, I doubt the UK would ever do one unnecessarily (which is different from it possibly being OK not to).

[dulcefarniente]

YY to Mybread although my experience before and during wasn't any better. Staff were totally overstretched so during induction/early labour you were only checked at most every four hours. Communication with and between hospital staff was sparse so nobody had a clear idea what was going on. I didn't feel safe at any point and ended up on day with an emcs. Never again.

[MyBreadIsEggy]

dulce I was told my midwife would come back and check on me in a few hours because "induction usually takes ages". 3 hours in, my husband was ringing the emergency bell and literally screaming for her after asking politely for someone to come and check me for the last hour.....when the midwife came in, my DD's head was crowning!....and then she told me I "shouldn't have pushed" until she got there

[DeffoJeffo]

I'm not sure about this one. I agree with PP that c sections are amazing things and save many lives but I do feel that my own experience would have ended up a much more intervention heavy one had I gone to hospital or headed into the MLU sooner. I had a very long labour and pushed for 3 hours. Despite my baby's heart rate being ok my midwife assured me that in hospital I would have had forceps after 2 hours. To be honest I would have been begging for an intervention if I had known I could have accessed one. I would have probably had an epidural too and that coupled with my crap ability to push effectively anyway would have definitely resulted in forceps, if not a section.

[dulcefarniente]

Mybready that sounds so typical. Two of us in the same boat were told on the first evening to get some sleep as we would be taken for a 3rd attempt at induction the following day at 7.30am. Saw no-one until we were handed breakfast at 8.30. Didn't see anyone clinical til noon and they clearly knew nothing about us but said we'd have to wait until there was a gap in patients in the induction suite as there was no way they could do the procedure on the ward. Didn't see anyone until 4.30 when they announced the induction suite was closed for the day and they were going to do it on the ward. Left alone again until midnight when they decided a section would be done at 8am the following day. In the end I got the emcs 27 hours after the scheduled section. All down to far too many women in the hospital so sections were only being done once it became critical for either you or the baby.

Hopefully you and dd were ok eventually.

[Flymetothemoon123]

NotCitrus - maybe it comes from the USA then. There certainly does seem to be an idea that it's the amount of time you take that's important rather than what is healthy for mother and baby. When I was actually in hospital it was very much the latter - intervention was based on the health of mother and baby and not the amount of time in labour.

[mrsjskelton]

If the alternative is you both haemorrhaging because mum refused a c-section then they are literally a lifesaver. I had an EMCS and it was fantastic. So much so that I'll be electing next time.

[Flymetothemoon123]

DeffoJeffo - this is the kind of comments that I don't understand based on my experience you wouldn't have had interventions just because you had been pushing for x hours or even begging for it. The attitude at the hospital where I was was that they don't intervene unless there is concern for health of mother or baby and they were looking at multiple indicators of feotal distress before stepping in.You definitely wouldn't have had a c section in hospital as there was no risk to you or baby. why would they do major surgery without any clinical need?

[Micah]

I've not heard this before?

I thought generally people managed at home as long as possible, going to hospital at the stage pain relief is needed.

in the uk hospitals have a target for c-sections they have to keep under. They are only give when medically necessary, you dont pull a surgeon/theatre staff/anaesthetists/paeds/midwife off their normal wards unless its essential.

[Tomboyinatutu]

I have never heard of this being said either. I had both of my children in hospital. My first was quite difficult, I wouldn't dilate past 7cm and his heart rate was worrying the consultants when they came to check on me. C-section was not mentioned once, they just told me they needed him out right now and cut me the rest of the way to make the opening bigger for him. Second baby I had was a really slow labour and again I was not given the option (which I am glad about as the thought of a c-section terrifies me). My next baby is going to be delivered at hospital aswel. I though c-sections were a last resort only?

[Xmasbaby11]

I've never heard this either. I know you're not encouraged to go to hospital too early on or you get sent home. But from my experience a c section is offered as an absolute last resort.

With dd1 I was in labour for hours and hours and not progressing. 24 hours after the waters broke I was finally given an epidural and induced and had a forceps delivery. It was a horrible experience for me and the prolonged pushing left me with a severe prolapse.

I had dd2 by elcs and I have just had keyhole surgery to repair my prolapse.

I have a friend who went private and asked for an elcs for no reason. She had heard too many horror stories of her friends' labours. She still had to argue for it but as she was paying they couldn't say no.

[Flymetothemoon123]

Maybe it's a local thing then. I've heard it a few times. We have 2 MLUs locally so maybe they are trying to encourage women to go to them rather than the hospital? If that's the case I really wish they wouldn't use scare tactics. Some women need to go to hospital and scaring them is not helpful.

[ValancyJane]

I had an EMCS, and it was presented to me as a "you can continue to keep going if you want, but we very strongly recommend a Caesarean section at this point" (meconium in waters and heartbeat dropping with contractions). It was 100% the right choice for us, and I can't imagine anyone in that situation with potential health risks to the baby wouldn't take it, but it was made very clear that it was a choice, so definitely no forcing.

[Murphyslaw21]

I think it depends on how labour is going. If there is difficulties to baby or mother. I don't think it common practice.

[Junosmum]

The issue of consent is a tricky one. By the time you need intervention (section or assisted delivery) you are usually exhausted, in pain, having been in pain for a long time, your are weak and in some cases delirious.

You are also very worried about your baby and the drs present you with an option. You aren't in the best situation due to the above and don't have the brain power to make an informed decision, you can't discuss the pros and cons, as the next contraction is only minutes away. I certainly didn't feel able to give informed consent - saying 'yes' isn't the same as giving consent.

20hours in to my labour I would have done anything for section. It wasn't an option though and I ended up with a forceps delivery. I did not want to give consent but I did as I just wanted it to be over. I now know that there was a very real threat of me going in to heart failure due to my exhaustion. I still wish I hadn't had forceps - I'm still suffering, and wish I' been more persistent in my needing help earlier on (when a section would have been possible).

I think decisions are case specific, and maybe some of these women would end up with sections, maybe some would end up with forceps. Maybe some are lucky they and their child survived due to their obstinance.

[TheDisillusionedAnarchist]

I think people are suspicious of doctors with good reasons. Doctors simply do not have the same investment in your health and your child's health that you do. Of course they don't. They are willing to accept some collateral damage along the way and if that collateral damage is your or your child's mental or physical health then that is is unlikely to be acceptable to you. I think it is good to have some healthy suspicion of medical staff.

And as for "if I went into hospital earlier I'd have had a c-section" A fair body of research supports that theory. Early admission to hospital is associated with higher intevention rates. Personally I have brilliant obstetricians and the junior doctors on when I was in labour were fantastic, followed the plan perfectly and were very responsive to my requests (perhaps even too responsive) but not all are like that and I sadly can't say the same for the neonatologists.

Infact if informed consent is an issue in maternity, it is much more of an issue in neonatology and paediatrics.

[Hufflepuffin]

I'd heard that my hospital had a reputation for being too slow to suggest a c section (some say it's because so many women want a vaginal birth at any cost). My dh was under strict instructions to tell the staff I would be happy with a c section if they started talking about forceps (and I wasn't with it enough to advocate for myself). I was much more scared of the implications for me and baby of a bodged vaginal than an appropriate c section.

[Whereismycastle]

Junosmum- heartfailure?! Is that a risk of long labour? Or is that a pre-existing medical condition that put you at higher risk? I'm sending you flowers either way!

[Whereismycastle]

I've heard of the idea that going to hospital earlier can increase the likelihood of interventions but isn't that just if you go in before 4cm? And has anyone proven that the early admission causes intervention or have they just found a correlation. These are 2 very different things. I've always thought that the women who go in earlier are likely to be higher risk or have a specific concern (maybe even just intuition that things aren't as they should be) so they would always be more likely to have interventions because there is likely to be something wrong. If this is the case, then going into hospital early is the first sign of an issue/concern rather than the cause of an intervention (the intervention would have happened anyway as the cause is something else). Maybe someone will tell me they've proved causation on this?