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Why do medics argue for VB over CS?

281 replies

EmeraldIsle81 · 22/12/2019 00:29

Just reading so many threads where medical teams really argue with patients to do vaginal birth over Caesarean section when the patient wants a CS. Can anyone tell us why that is?

The uncertainty of vb, the risk of distress and damage to baby if vb doesn't go well, damage to mother, length of time in delivery, pain management. Midwives having to go to find a specialist if complications arise.

I just don't understand why all of that is so preferable to a patient wanting a CS where everything is prepped, planned, no surprises, quick procedure with the right people there in the room just in case, recovery is monitored and managed.

Thanks all!

OP posts:
olivertwistwantsmore · 22/12/2019 00:31

Because vb is generally much safer than a CS! Do your research.

HappyHarlot · 22/12/2019 00:31

A caesarean is not an easy option and also has high risks. It’s major abdominal surgery.

nocoolnamesleft · 22/12/2019 00:33

Pros and cons. For instance, an elective section is more likely to result in an admission to SCBU with breathing difficulties (which is pretty common). On the other hand, an elective section is less likely to result in brain damage (which is thankfully much rarer)

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SleepWarrior · 22/12/2019 00:33

Because overall, in cases where a CS isn't otherwise warranted, VBs have fewer complications than CSs and more benefits for the baby (for instance exposure to the bacterial in the mothers genital tract is a good thing).

DoIhavetobejolly · 22/12/2019 00:35

Not a medic but having given birth vaginally if I could possibly have a VB over a CS I would.

A VB certainly isn't pleasant, but it's so much easy looking after a baby when you haven't had a major surgery. I feel very sorry for women who find themselves having to have a CS and I think it's unfair that it's seen as the 'easy option' by some.

RUSU92 · 22/12/2019 00:35

The recovery time from a cS is much longer, so while it seems like the better option in the midst of all the pain and exhaustion, the knock on effects for a new mum, recovering from major surgery while looking after a newborn, mean it isn’t an easy option at all.

Also VB prepares the baby for birth, whereas the suddenness of a CS can mean the baby needs extra help outside of the womb.

PenelopeFlintstone · 22/12/2019 00:36

Money?

MyNewBearTotoro · 22/12/2019 00:40

Women are up to 3 times more likely to die following a C section, stillbirths are more likely as are breathing problems for the baby. Plus a C section is a more expensive procedure for the NHS to provide.

www.livescience.com/amp/45681-vaginal-birth-vs-c-section.html

EmeraldIsle81 · 22/12/2019 00:48

That's interesting, as a lot of the threads posted on MN relate to problems from VB eg delivery not managed well and or becoming stressful emergency CS eg problems with tearing and repairs which are long lasting/have knock on effects.

I haven't seen as many threads of CS women posting their problems/seeking advice on MN.

Hence my curiosity about it.

Thanks all for your replies!

OP posts:
ChazsBrilliantAttitude · 22/12/2019 01:12

I have had a EMCS and a VBAC. The recovery from the vaginal birth was much easier in my case. There were no problems with the CS but you have had multiple layers cut open and restitched. My abdomen was numb for about 18 months.

Gardai · 22/12/2019 01:12

CS is major surgery - have a google

PicsInRed · 22/12/2019 01:23

A planned c-section (without existing issues e.g. placenta accreta) is safer than a vaginal birth. Obviously a damage free vaginal birth is preferable, but that outcome isn't possible on request - it's a lottery.

Money and resourcing is the reason - though a lot of the saving comes of simply refusing to repair the considerable damage borne of vaginal births and gaslighting women into thinking that damage is "normal".

mrbob · 22/12/2019 01:46

It is literally NOTHING to do with money

goingtoneedabiggercar · 22/12/2019 02:04

When I requested my C-section the consultant was quick to point out how long my recovery would be compared to a vaginal delivery, this whosever was done completely on the assumption that I would have a straight forward vaginal delivery.
There's so much unknown with any delivery, will you have a bad tear? Will it become an instrumental delivery? Will it end up an EMCS? If you have an ELCS will you have a heavy bleed? Will you have a bad infection or worse?
The main concern my consultant seemed to have with my section was that this was my first child and if I wanted another there were risks related to that.

PenelopeFlintstone · 22/12/2019 02:17

MrBob 'It is literally NOTHING to do with money'
www.telegraph.co.uk/news/2016/04/15/nhs-is-rationing-caesarean-births-to-save-money-coroner-warns/

TracyBeakerSoYeah · 22/12/2019 02:25

I had an EMCS.
Beforehand the idea of having a Caesarean terrified the life out of me.
But my ECMS was a walk in the park compared to a VB & the recovery time (in my case) was minimal.
If I ever get pregnant again (unlikely as I don't want anymore children) I will definitely have an elective.

Pixxie7 · 22/12/2019 02:37

It’s also the cost not only the op but in terms of hospital stay nursing time etc.

omtotheg · 22/12/2019 02:56

It's deff down to money!
I had an elective CS and as I private patient when I asked for it no issues I got it. When the consultant asked me was I sure and I said yes he said 'yes it's better my wife had cs too'

Before my op I saw another young doctor for bloods and I asked him why do you's prefer your wife's etc to have cs he said it's because it's a controlled environment we know in a theatre the events that can happen and are prepared for that normal labour is not and can take so many twists and turns

aurynne · 22/12/2019 03:50

Apart from what people have already remarked on, there is increasing evidence of the mid- and long-term side effects of CSs on babies. A baby been born by CS does no acquire the mother's vaginal microbiome, and this has life-long consequences (regardless of how much skin flora the baby acquires through skin-to-skin). Babies born by CS show abnormal skin and gut flora, and longitudinal studies are now showing significant increases in these babies having allergies, eczema, IBS, Chron's disease, and all sorts of immunological problems when they grow up.

Being born by major surgery is not how our birth was intended, and no amount of reasoning based in pain and inconvenience will change our physiology to make CSs good for us. It is similar to the situation we'd be in if everyone opted to have an intragastric tube inserted and being fed directly into the stomach to avoid having to chew their food and hence prevent die by choking.

And yes, it is also based in money. A CS often requires 12+ highly-skilled health professionals, a very expensive theatre, huge amounts of sterile instruments, most of which are one use only, which produce huge amount of waste. Women exit the theatre on IV antibiotics and pain relief which requires frequent observations by nurse and midwifery staff. CSs result in a high proportion of uterine and scar infections a nd deep vein thrombosis. Post partum haemorrhage is a commonside effect of CSs (average blood loss of a VB is 400 ml, CS is 800 ml).

An elective CS with no labour also results in interrupted hormonal changes which affect mood, lactation and recovery from birth. Your body does not have the natural reaction which helps your body heal, so late postpartum bleeding also occurs more often. Lactation is often delayed. Bonding with baby is affected due to the inability of oxytocin to be regulated by labour.

There is a massively long list of side effects, and growing by the day, of electice CSs. Unless absolutely necessary due to risk to mother or baby, it is an intervention that most health professionals agree should never be done without a medical indication.

A straight-forward VB, on the other hand, needs 2 midwives, a birthing room, some linen and towels, some instruments which can be sterilised and reused, and little more. Women are able to get up and walk an hour after birth and do not require regular observations. They require minimal pain relief, and often no opioids. The effect of second stage helps release hormones which facilitate bonding and lactation, which often happens earlier and more effectively after normal birth.

And before the predictable "I had a CS, bonded immediately and had litres of colostrum from day 1, let me explain that these data are population-wise, not individual. Yes, there will be mums who have a terrible time with VBs and plenty of side effects, and children who develop asthma and allergies, and mums who have a CS, recover in no time and their children are perfectly healthy. But if you give me two populations, as small as 100 mothers each, I can tell you with 100% certainty which population had a VB and qhich a CS by asking 3 simple questions about the mother and babies' health.

goingtoneedabiggercar · 22/12/2019 03:55

@aurynne oh wheesht and get off your high horse.

aurynne · 22/12/2019 04:02

@goingtoneedabiggercar I am a midwife and a molecular biologist. I work every day in this area. I participate in putting together guidelines in the hospital I work for. I can provide you with evidence of every single point I have explained here. There is no "high horse", it's just how things are. It is not meant to make anyone feel bad for their choices, it is only meant to inform. And the OP asked exactly the questions I am answering. if you don't like my answers, i am always open to discussion.

goingtoneedabiggercar · 22/12/2019 04:02

If every human condition was left to "how nature intended" well we wouldn't live very long. Vaccines for example are really quite useful and prevent a large number of deaths, they are a human invention. The same way surgery is.
I've only had one child so have no comparison. My mum however had a "normal" birth (me) and an "abnormal" c-section (my sister). We're both absolutely fine. However please point me in the direction of the studies that state my now 21 year old sister is irreversibly damaged by being born by ELCS. If she's at deaths door I'll return her Christmas presents, she won't need them.

aurynne · 22/12/2019 04:11

Vaccines are a human invention created to prevent disease. Surgery was created to correct something gone wrong, not to prevent disease from happening. An elective CS is a major surgery performed on a body which is perfectly healthy.

"However please point me in the direction of the studies that state my now 21 year old sister is irreversibly damaged by being born by ELCS." --> you don't understand how population statistics work. Let me point the obvious: sorry to disappoint you, but there are no studies made specifically for your sister. However, your sister is part of a population with much higher chances of developing a long list of issues as a result of being born by CS. Many of them will not be obvious and will act concurrently with other risk factors. She may be perfectyly fine, or she may not be. even so, this information is completely useless for your sister's current health as her CS already happened, however she may want to take it into consideration when (and if) she chooses to have children herself, and she will consider it together with other thousands of social, financial, personal, psychological and medical factors which affect her and her family's life. She may still choose a CS, and that will be perfectly ok. Having as much current information is actually a good thing, it does not create any obligation or any restriction of freedom. NOT having the availabnle information, on the other hand, does affect your capacity to make decisions negatively.

goingtoneedabiggercar · 22/12/2019 04:13

I hear you but none of this information is provided prior to choosing your delivery. I'd like to know I'd fucked my son up prior to doing it rather than a month too late. If this is all true (and I hope to god it isn't) then why aren't you told this before?

fallfallfall · 22/12/2019 04:21

goingtoneedabiggercar that information is freely out there and has been for a decade at least.
and lots of people choose a c/s because they think it's easier and are not necessarily swayed by any facts.

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