RCOG considering informing women of the risks of vaginal births

[pinguina16]

Clare Wilson from the New Scientist broke the news last week.

www.sciencealert.com/scientists-say-it-s-time-for-doctors-to-warn-women-of-the-true-risks-of-childbirth

If they decide to properly inform women about the risks to their babies and their own bodies, I view this as a landmark. #righttoknow

[Alisvolatpropiis]

Information is power, I think it is right that women know these things ahead of time. I think it would make post birth recovery time because expectations of labour and birth would be coming from an informed place.

[Incognita82]

Quite right too. If I had known then what I now know about the damage vaginal births cause I would have opted for caesarians.

[sparechange]

It isn't just the RCOG that needs to be more transparent about the risks.
The books are ridiculous as well. I remember reading a whole chapter in one book about the risks of c-sections, including the stats of PPH and damage to the bladder which would cause incontinence.
Then for VB, 1 or 2 lines on tearing and how this was most likely to be minor and not cause any lasting damage. No stats or further info at all...

From memory, the risk of bladder damage after C-section is 0.5%, where as the risk of a 3rd or 4th degree tear is 9%
It is totally wrong that 0.5% is presented as a big risk to be discussed at length because of the risk of incontinence, while a 4th degree tear, which could cause double incontinence isn't even mentioned. I had to find the stat from the NCT website where it is also buried away and minimised.

[MadrigalElectromotive]

Let's hope they do. It is shocking that women still aren't properly informed of the risks and allowed to make a decision based on their own priorities.

[MadrigalElectromotive]

Oh yes, my NCT classes were a complete joke! No-one in my class had less than a 2nd degree tear, and one had a 3c tear. Yet the risks of tearing and incontinence were never mentioned.

[hazeyjane]

If I had known then what I now know about the damage vaginal births cause I would have opted for caesarians

which can cause long term damage and have long term consuquences also.

[sparechange]

hazeyjane
Yes, they can and do and you won't find a single person who isn't aware of that
You see the irony there, right?

[Fomalhaut]

Yes they can - that's why you sign a consent form and discuss risk. Just like you should discuss risk for vb

[hazeyjane]

I found when I had my elcs that there were a lot of threads on here, where some of the consequences were not talked about, and there was very much an attitude of it 'easier' because it could be prepared for.

I think there can be a glossing over of some of the devastating effects of both vaginal and caesarean births - and then a dismissive attitude to the aftermath from hcp. The idea that we should just get on with it and shut up when we suffer health problems post (any type of) birth, is what needs to be sorted out.

[sparechange]

But Hazey, when you had your ELCS, did you have to have a fairly in-depth conversation with a consultant, where they went through a long form which listed all the risks and then got you to sign at the bottom acknowledging those risks?

And when you see threads on here by women desperate to get an ELCS, do you see how the common advise is always to arm themselves with all the facts and make sure the consultant knows you are aware of the risks?

[UnikittyInHerBusinessSuit]

What I think is interesting, but I don't know enough about, is the relative risks to the baby. As I understand it, in terms of immediate catastrophic damage to the baby, VB is far more risky, although there may be more subtle long term effects from CS. But that side of it is rarely spoken about.

I don't know enough about the stats though - except that CS shifts the risks from the baby being born onto the mother's subsequent children, who are at increased risk of uterine rupture and the associated consequences.

[TurquoiseDress]

I think this would be a very important step from the Royal College.

The risks of VB are definitely glossed over- especially from my experiences in ante-natal classes etc.

I realise that the midwives do not wish to scare women, but equally a balance of information is required.

Women can choose not to listen to the risks and that is up to them- but those he seek information should not be shut down and be given false reassurances that all will be ok, bad tears are v v rare etc.

[Batboobs]

I agree with hazeyjane.

I do think it's important to discuss the negative effects of a vaginal birth, but not with the purpose of scaring women so badly that they believe a c-section is the 'easier' option as it is so very often painted on this forum. I felt the same reassurances prior to having mine, only to realise afterwards that a section has it's own cons that are not often discussed.

[Scuttle22]

My DH used to do surgery and he advised me to have c-sections due to the risks to baby and my health. I am glad I took his advice and has 3 sections. I must admit I was pretty horrified about some of the complications associated with natural births.

[Ummusomebody]

But wil they support the consequences of the informed decisions? Are there enough staff/plans in place? Let's say after I've heard of pro & cons of both, I now want elcs despite being classed as low risk by my team, will I get one. I very much doubt it.

[Bella123456789]

Oh thank god! It's about time! Let's just be honest that some birth injuries (no matter which way the baby comes out) are horrific and some birth injuries can cause real difficulties for women day to day and let's be honest about how frequent those injuries are. Then women may be able to talk about them and get the help support and sympathy that they need after birth. No wonder it's taboo if even Ricog are scared to mention it in a leaflet!

[DowntonDiva]

This is so important, I really hope this in put into place. I thought I was well informed but no where did I read or have a discussion regarding the realistic recovery times after an episiotomy.

[Evergreen17]

Damn
I am pregnant with my first and should NOT have opened this thread.
Now completely paralysed with panic

[SchnitzelvonKrummsverylowtum]

I think it's important that women are made aware of the risks of both options. I'm expecting DC2 at the moment. DS was born in a midwife led unit, with no tearing or subsequent problems, and I would like the same for DC2.

While I think women need to be as informed as possible, I don't think this means that women should be terrified into having surgery where it may not be necessary, or the best thing for them. The key is making sure all the information is available and women are able to talk through with doctors/midwives what is best for them and make a choice for themselves.

[Junosmum]

I'm incontinent following vb. I also have ptsd. I was certainly not made aware of the risks. I knew that mild stress incontinence was common, but that's not what I have. My consultant said it was alarmingly common.

[LaContessaDiPlump]

I think it would be a really positive step to have such dangers made clear. I had 2 VBs; 3rd degree tear requiring surgery immediately post-birth the first time, 'only' a 2nd degree tear requiring stitches the second time. Stitches then got infected and I was not very well for a while. I had barely any info on what to do if these events occured ahead of time, while the info is at least out there for c-section recovery.

There is such a tendency to minimise VBs because millions of women do it every day. Millions of people break their legs and have heart attacks every day too but at least they don't get told to just get up and get on with it!

[Jenijena]

I have had two vbs. The second in a mlu, waterbirth. No stitches. Pretty damn perfect if you take eg the nct view of things.

Apart from the fact my internal organs have rearranged theirselves and I have a prolapsed bladder and, I suspect, bowel. Apparently up to 50% of women who have vbs will at some point in their future but I had no idea.

Information doesn't have to terrorise people but why, for example, do we have pelvic floor education sessions in pregnancy?

[Heatherplant]

@ Evergreen17 Don't panic! I've had 2 children both VB. Baby 1 back to back position so it was painful and I did end up having stitches but I was at home again within a few hours and made a complete recovery. Baby 2 was a planned home birth due to the 1st birth being relatively quick. Baby 2 born in approximately 20 minutes. I had stitches again but they healed within 4 weeks. I've had no further health problems relating to the birth of either child. All birth comes with risk so weigh it up and make the right decision for you.

[Evergreen17]

Heather but people here saying they have now incontinence and tearing and surgery.
This is all very scary I dont want this

But I dont want to opt for a cesarean either