Childbirth rights- are you pro-choice?

your language is loaded,emotive,you're globally critical of professionals
you're trying to make me answer I question that I didn't pose
don't try to digress into a topic I wasn't addressing

Bunny - I honestly don't know if the ever NHS 'forces' a woman to VBAC. But a VBAC is very different to all the other things you have mentioned in your post because it's the default. If the hospital does nothing, a VBAC is what will happen. That isn't the case with a sweep or an induction. I certainly do know of women who have been 'forced' to do without epidural - because if the anaesthetist simply doesn't show up, you give birth without. If all that happens is that, every time you ask, and your birth partner asks, they say she's in theatre and she'll be there soon, that's what happens.

Also, I agreed to things in labour I would never have agreed to in normal life. I hadn't slept in more than 48 hours before we even arrived at the hospital, and basically neither had my husband. We were in no position to resist 'pressure'. Pressure was almost entirely equivalent to forcing, and I suspect that's an issue for many labouring women.

you're language is v loaded and frankly anti-professional.
pragmatically clinicians manage risk and work with mums to collaborate on outcome
resources aren't limitless, nor are choices.there is no absolute wish list

Clinical risk must always be paramount and then the wants of the woman. Clinicians have to be the final arbiter on this for obvious reasons so there have to be limits to individual choice.

feminist5 thank you.

I honestly don't think the NHS ever "forces" a VBAC or anything else on a woman. A doctor may well say that they very strongly recommend it but if the woman still says no then that is actually tantamount to assault if anyone goes against her wishes.

Pressuring is different to forcing.

Pressure obviously isn't nice but as long as the woman is informed, empowered and has a good midwife and birth partner with her then the hospital has to respect her wishes.

I do agree that procedures and protocol are followed and often consent is speedily asked and presumed throughout a labour, but a woman can clearly say no to any of them. I read a lot of women over on the pregnancy section saying they've been booked in for an induction/sweep etc and don't want it, but they don't seem to realise that they can just say no thank you and instead have the hospital monitor the baby and and wait if they have gone past due date.

The problem - as I see it - is the empowerment of women during their pregnancy and labour to actually question and speak against any standard protocol.

I would support all of them bar induction on demand.

Starting with the most black and white, it is barbaric that any woman be denied pain relief they request (whilst recognising that they might have to wait for anaesthetist).

Home birth/elective section/VBAC, these matters should be totally the choice of the woman. I do think that there are caveats - like ensuring that decisions on elective section are fully informed, and ensuring that the availability of that choice doesn't lead towards women being pushed that route rather than issues like counselling for birth phobia if that is what the woman would prefer.

Induction. That one is more difficult for me. On balance I think not. Just like the decision to prescribe a particular drug (for an illness) ultimately lies with the clinician, I think induction should be ultimately a clinical decision, even though I think that the views of the woman should be taken into account and added to the equation. This includes those views being given due weight.

What I struggle to articulate is why, at an intellectual level, I think induction is different from, say elective section, where the clinician's view might differ from the woman's. I think that ultimately it's about degree. Section, etc are about the fundamental mechanisms of giving birth, and in those I think a woman's views should be paramount. I'll keep thinking on that last bit.

@feminist- why are you so suspicious of doctors- people who have chosen to work in their demanding & competitive field and devoted years of study to that end? Quite ridiculous to presume they want the worst for their patients or just to " get out of trouble". Such reductive nonsense is the type of thing the NCT has been known to advocate in its classes (certainly in mine!) which does it a great disservice....

Far better to partner WiTH rather than against clinicians to bring about safe, sustainable change with women's interests paramount

And when the Drs are counselling women about vbac they are definitly saying that vbac is the safer option. But like you say, it's different risks and the woman may not be as bothered about some of the section risks such as infection, etc.

But the dr may well be thinking about the higher incidence of haemorrhage at a section compared to a vbac. Also they may consider possible future pregnancies more. If you have two sections and then want a third then the section can be more difficult, more risk of things like placenta accreta.

Saying vbac has a 4 times higher perinatal morality rate is slightly misleading. That figure is 4x a very small number, so the actual risk still isn't very high.

Afaik, newer research is increasingly finding vbac to be safer than first thought. Women used to have to fight for vbac and now its gone full circle. They now think risk of uterine rupture is more like 0.5%, mad that risk is the same even for two previous sections! However where I work if you've had two sections you're not "allowed" a vbac even though its as safe as a vbac after one section.

bears, I agree. I see some women having inductions for reasons such as severe spd and I can totally see the need for such inductions. Glad yours worked out well.

As a midwife I always try and remember that I'm there as an advocate for women. So I will support them and fight their corner even if personally I disagree with what they want. Unless its wanting a section at 33 weeks because they want to go on holiday to Ibiza.

Feminist, I've sent a pm.

Even inductions aren't black and white. I was fed up of being pregnant. I'm disabled and pregnancy exacerbated my condition. Also no-one knew whether I'd be able to manage labour, and one suggestion was an induction alongside epidural was the best chance of a vaginal delivery. So we discussed the options, and that was what I decided. Worked out perfectly :)

Sorry, last message was in rely to teitura.

To some extent, yes. Which is why I said that been able to demand an induction or section at 33 weeks would be very silly and should never happen.

But if its something fairly straightforward such as vbac vs section at 40 weeks.....then the Dr could argue that the section is slightly riskier. But the mum would be right in saying there's a small risk of uterine rupture which perhaps she isn't prepared to take.