Does the NHS have an (unhealthy) obsession with vaginal birth?

[eastmidlandsmove]

There's a really upsetting news story about a premature baby who was in the breech position who died when a doctor insisted on vaginal delivery. The details are really quite distressing.

The case is clearly horrific and exceptional, but I was wondering if it maybe reflects NHS pushing women for vaginal birth. I used to think this was a great thing, but I keep hearing so many stories where women knew something was wrong and asked for a C section, and they were ignored.

[1234sam]

I was just talking about this story to my husband. I don't think
It's anything to do with the nhs this is just 1 stupid doctor. The details are horrific. I don't actually understand what was going on in the doctors mind at the time.

[thetriangleisarealinstrument]

This story was horrific but from what I read I think the issue was that the doctor thought the baby needed to come out there and then? Not that they thought a vaginal birth was better than a section.... I think the implication was it would be quicker... Thats how I interpreted it anyway.

I think the biggest issue was the lack of communication between the medical staff and the mother. It sounds like they made decisions without consulting her or telling her what was going on clearly... which is awful... I very much agree with the doctor being suspended and prosecuted

[Hatelove]

Yes! I’ve been saying this for years

[NorthernLurker]

No of course it doesn't reflect that. If you actually read the case it's clear that the medical staff were panicking as they tried to get a very prem baby out before the baby's heart stopped. At 25 weeks the baby was much smaller than term and doubtless the doctor thought she could deliver it despite the breech. In fact the cervix wasn't dilated enough, it sounds like there were errors of judgement and poor communication but that's got nothing* to do with a vaginal birth agenda.

[NorthernLurker]

The doctor isn't being prosecuted. It's a fitness to practice hearing.

[thetriangleisarealinstrument]

I mean she was scheduled for a c section but had gone into labour and the baby was in distress... so im assuming that the doctor just made this decision to try and deliver the baby as she was there and it would be quicker and give the baby the best chance of survival.... obviously it was very much the wrong decision.
The bad thing is how little info the mother was given at the time and how she was not actually consulted over what she wanted to happen herself.

I really dont think the NHS in general try and talk people into giving birth vaginally if the baby is breech. They should support you if you do want to give birth vaginally to a breech baby... but the advice is that a c section is safest. All NHS info they give you clearly states this. If you type in 'breech baby' on the NHS website it clearly state that you will offered a c section. So I very much doubt any doctor would actually push a mum having a breech baby into having a vaginal birth against her wishes.

[eastmidlandsmove]

@thetriangle

I agree - horrific accidents happen and doctors make mistakes, no matter how dreadful, but the way they were treating the poor mum sounded awful.

[Itscurtainsforyou]

It was a massive cock up by the sounds of things. They knew she wasn't dilating enough, protocol is for a GA crash section in these circumstances, but the doctor, for some reason, tried to get the baby out vaginally.

I've had a very premature baby and it was stressed to me how fragile they are. No HCP should be trying to put a baby like that out by the legs.

Completely tragic and very distressing for all.

[eastmidlandsmove]

@triangle @lurker

Thanks, these replies are reassuring

[Fatted]

I was really upset by the story, so frankly couldn't bring myself to read the whole thing. So I can't comment on it.

As someone who needed an emergency section with my first baby, I'd say no. The staff were quick and efficient about getting my baby out safely.

With my second and it came to the whole section/vbac debate, all but one member of medical staff I saw recommended I have another section. The only doctor who said it wasn't a good idea was generally incompetent from start to finish and even the MW said as much at my following appointment.

I do find it interesting the push towards natural labour, home births and all of that also coincides with the NHS being in financial crisis and needing to save money.

[NotUmbongoUnchained]

I found the opposite and was pushed towards having csections! I stood my ground though.

[BestZebbie]

I was booked for a section due to the baby being very breech (told that 'it won't come out from there') but when I went into labour three days before the planned date it was extremely hard to actually convince the staff that I needed a section and they made me labour to 'give it a try' for many hours, gaining permanent injuries, before the baby got distressed and I had to have a rushed emergency section.
On the one hand both the baby and I would have died in childbirth so did save our lives (eventually). On the other hand, wtf!!

[Unihorn]

Both of my sections happened very last minute despite both babies knowingly being in strange positions (shoulder presentation and face presentation). I was allowed to push for 3.5 hours with my first with the midwife actively delaying the doctor's arrival to give me more time to try. With my second I went into labour 6 hours before my planned section and, despite being told on the maternity ward that the face presentation would hinder my hope for a VBAC, the midwives on the labour ward told me I should try. I went to 9cm in the hour before being rushed in for a section again after a doctor assessed me and told me there was no way I could deliver.

In both cases I'm certain my sections could have been much more calm and positive than they were had I not been rushed in with several minutes to spare. They've since told me they think the shape of my pelvis would make VBACs almost impossible.

[Midthreademergencynamechange]

I had a crash section, took about 15 minutes from realising there was a problem to me being given the GA. Why was that not an option?

[postwoman]

That story is uniquely horrific, I'm not sure it's really fair to use it as evidence of an obsession with vagina births.

[postwoman]

I don't think nhs frontline staff have an agenda, they don't care how much stuff costs, there is no way in a situation like that the dr is thinking "oh let's get her to push cos it'll save the trust money", staff want your baby out safely and sometimes judgement calls are made to ensure that, sometimes they are right and sometimes they are wrong, this one was obviously horrendously wrong.

[Believeitornot]

No.

Anyway vaginal birth is on average the best way but there will always be the need for c sections.

[Sausagema]

This case has nothing to do with a pro vaginal birth NHS agenda and everything to do with a doctor getting every single aspect of this delivery utterly utterly wrong and against every protocol/guideline/procedure there is. I literally cannot comprehend what was going through her mind, I can only imagine she panicked, with the most horrendous consequences.

[ConfessionsOfTeenageDramaQueen]

Yes, the NHS is obsessed with vaginal births and it's purely for financial reasons: C-sections come out of the surgical budget and vaginal births come out of the maternity budget.

It's not the first time babies have died because of this and mothers have died too (I recall one in Tower Hamlets a few years ago who was denied a C-Section during delivery and died and afterwards it was clear she should have had one due to issues with her bowels).

I know someone who very prematurely went into labour with a breech baby. Her cervix was short and dilated and she was immediately whisked off to have a CS. No way in hell would any sane person think a vaginal birth is quicker than a CS, especially with a first time mother.

Every time I think about what that poor mother went through.... It would be enough to drive you mad with grief. It makes me extremely angry.

[Racecardriver]

They do it too save money. They also put undue pressure on first time mothers to have home births for the same reason. Same for encouraging women not to use pain relief. And during women away from labor wars when guidelines indicate that they should be admitted, delay medically necessary inductions etc etc.

[Racecardriver]

@postwoman many of them don't want to get your baby out at all I. E. They want it to haplen on the next shift if possible. They are also faced with the economic realities I F not have enough beds for birthing mothers. And off course many of them are brainwashed. I remember my first midwife (don't judge me, I would have gone private if there was a private service within reasonable distance of where I live) hassling on about how great home births were despite the fact that I said I didn't want one.

[Killerqueen2244]

It’s a horrendous story and I have to admit thinking the same kind of thing. It sounded like the dr would try anything before a C section and what a horrible horrible outcome just to save a bit of cash?!

[halfwitpicker]

As pp said its about financial reasons.

[doodlejump1980]

It is such a heartbreaking and horrendous story. My heart goes out to the family involved. What was that doctor thinking? Just awful.

[RiddleyW]

It’s really offensive to suggest the doctor was (in the incredible stress of a delivery going horribly wrong) thinking “oh I need to save my employer some money here”.