Why do medics argue for VB over CS?

[EmeraldIsle81]

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!

@OntheRoses insinuations are also in your head, I never said anything of the sort. You are the one who needs to reflect about how that event has conditioned the rest of your life and how you respond to normal conversation as a result of it.

In the nicest way, people say VB is natural as though natural=good. It's not that simple.

Mother Nature isn't interested in individual women or babies, what matters from an evolutionary perspective is that enough women and babies survive the process to keep the species going. It only needs to be enough, not all or even most. Individuals are disposable.

Throughout the world more than 800 women a day die as a result of childbirth. That figure used to be much higher but advances in medical science in some parts of the world (unfortunately by no means all) have reduced the death rate somewhat.

There are no "better" choices when it comes to birth there are only choices (or there should be). Women should be given information about all birth options, discuss their personal risk factors with their healthcare team and make an informed choice. It's not happening but it should be.

It's OhTheRoses actually not OnTheRoses.

That's why the "@" thing woudn't come up, dammit!

Its supposed to be for complications only

Who decided this?

I agree, sunshine.

Auryne your posts are aggressive and patronising and this is out of order

'You are the one who needs to reflect about how that event has conditioned the rest of your life and how you respond to normal conversation as a result of it.'

@Fraggling, perhaps you didn't have time to read what she wrote on the deleted posts

Dismissing women's description of birth trauma and telling them essentially to shut up is a dick move, it really is.

I can read what you wrote perfectly well.

vb is natural. cs is an operation with serious consequences. Infection being one. Its supposed to be for complications only.

Electives cover a wide range of "complications". I wanted an elective with my 2nd because dc1 got stuck at full dilation in an optimal position, couldn't be pushed out or pulled out with forceps. He had a giant head (97 percentile) despite only weighing six pounds nine ounces and just didn't descend. I was told afterwards by the midwife who had spent hours trying to deliver him that I had a flat pelvis. My uterus also tore during the surgery because of how low down and wedged ds was and the fact that it had been contracting for 75 hours.
Given that no one could tell me why dc1 got stuck and that it wouldn't happen again, I really didn't fancy the gamble I'd be taking attempting a vbac. An elective seemed like the lesser of two evils.

Dc2 also had a giant head and was also an emcs.

The main issue with the approach to childbirth is that women's actual experience is considered secondary. Pain, injury including severe and long term injury is minimised, women are expected to keep quiet and get on with it.

The risks of VB to the woman are not explained in the same way as risks of CS.

The costs associated do not take full account of the treatment (or lack of treatment) for MH issues and physical issues as a result of childbirth. This is a large missing piece.

@fraggling thank you. I am speechless to be honest. But it does underline why maternity care is so disgraceful.

'. I was told afterwards by the midwife who had spent hours trying to deliver him that I had a flat pelvis.'

Also seems to be a tendency to blame the woman when things don't go smoothly, loads of women on her over the years with these types of stories.

With DC1 I was on a pregnancy website and one particular member was a complete over zealous advocate for ELCS.

She would pop up on every bloody thread about labour (and I swear she stalked the tri 3 threads and posted on them as people got close to their EDD) to tell people what a fabulous ELCS she had, and how they had the right to demand an this this. She posted pics of herself pre and post section [looking fab or course], lamented her fantastic experience and as I say she popped up everywhere to sing the praises of ELCS but she couldn't and wouldn't be told that she was very lucky with her experience but it was irresponsible to push her views onto other women (most of whom were terrified of labour!!). I challenged her a lot during my 3rd trimester as did several other posters, whom I'm still in a group chat with 8 years later and called her out on her bullshit [in a netmums kind of way..... pregnancy forums 8 years ago were full of huns and X]

I remember when I posted my birth announcement that she replied with congratulations, bet you wish you'd gone ELCS (I had a long labour - 50+ h - but natural delivery without tearing or grazing). Told her to fuck off.... unheard of in the flowery world of 2011 pregnancy forums

I cant believe someone could be so prescriptive because they'd had a good experience? Often felt this woman posted so much to validate her own choice (she pushed for ELCS with no medical reason) but she has always stuck in my mind due to her pig headedness about ELCS and how she thought everyone should have one!! It was like she was part of an MLM

Interesting how the norms vary country to country. A French colleague was shocked I wouldn't automatically have an epidural whereas a friend who lived in Thailand for 15 years said it's the norm to have a section and many hospitals aren't equipped for a VB

@aurynne who exactly is she? The cat's mother? And you have the audacity to call me rude

@aurynne out of interest, if a woman you were caring for said "I have looked at the stats and for me the risks of VB are scarier than those of an ELCS, so if like an ELCS please" would you accept that or would you try to talk her round?

@catinthefireplace absolutely, and I would refer her to an obstetrician, as where I work midwives cannot just request an elective CS without a medical indication. I have no personal interest in any woman having one or other type of birth, it doesn't affect me in the slightest. It is not my job to "convince" anyone to do anything. In fact quite the opposite, the job of a midwife is to advocate for the woman, offer her evidence-based information and listen to her choices.

I do understand that a miwife who works in a hospital where every service is stretched thin, with understaffed wards, overworked health professionals... will find it hard to offer the best service. As will obstetricians and a nyone else working under these conditions. Mistakes will be made. Tragedies will happen. But this has nothing to do with the discussion about "advantages/disadvantages of VB vs CS".

Something I tell every woman in my care is that, regardles of how birth ends up happening, the happiest mothers are the ones who felt listened, respected and felt they had options. A woman who has the most "perfect" normal birth may still end up traumatised if she felt she was not respected or listened to. A woman who ended up with an emergency CS may be very happy with how her birth was managed and how she felt supported.

Listing statistical advantages/disadvantages of one or other mode of birth is just part of the process of offering information. It does not validate or invalidate anyone's personal experience. As many women have said, personal experience, perceptions, family background, circumstances... will all play a part on the final decision. Of course a public hospital will advocate for a physiological process to happen without intervention unless there are complications, not only in labour and birth, but in any other area. But pregnancy and birth is a very specific area in which women bear the brunt of the consequences when things go wrong, and is also an area in which a lot of abuse has been dished out on women.

Of course a public hospital will advocate for a physiological process to happen without intervention unless there are complications, not only in labour and birth, but in any other area.

This really isn't an attitude that we should be willing to accept. It does a massive shit all over the case law, for a start.

'Of course a public hospital will advocate for a physiological process to happen without intervention unless there are complications,'

I don't think this is what the guidelines say here and seems very broad brush. Just 'of course'.

In the UK an elcs means planned, no more no less. As opposed to emcs. You described elcs as choice and have not corrected that.

I don't know what country you work in but to speak authoritatively the the approach on a country you don't work in feels off to me. Your tone tells me you don't like to be disagreed with and the way you talk to women with their individual birth trauma accounts is not how I would like a midwife to feel about things.

@BoxedWine I disagree with you there, however I do no have any influence in hospital policy either so my opinion bears no weight. A publich health organisation must advocate for "first do no harm", and protect patients from unneccesary intervention.

'protect patients from unneccesary intervention.'

Interesting turn of phrase.

For the vast vast majority of women who have elcs in the UK it is not unneccesary at all.

How much pain and damage women are expected to bear before it's deemed reasonable to 'allow' them CS is an interesting line.

@fraggling, this is an online chatting forum, perhaps the way I express myself sounds "authoritative", but I swear to you I am just spending some entertaining time in MumsNet, with a coffee, enjoying my first day of holidays, completely relaxed and without intention to sound like a Nobel Prize :). At the same time, i am also posting about my puppy.

I have ASD, and I suspect the way I express myself tends to sound more pedantic than intended.

How does that tie in with inductions? I had a VB but was induced, so not just a physiological process. Only risk I was warned about was the risk of it being unsuccessful and needing a caesarean!