to think that so many women have traumatic damage during childbirth, and why can you not have a CS on demand?

[GetOrfMoiLand]

No I know this is probably a contentious point, and financially there would be a hell of a burden, but it seems that a woman's body is not brilliantly well designed for childbirth, and so many women have had terrible vaginal damage caused by birth, you only have to look at the threads on here.

I was only thinking this because SIL went to A&E on christmas day due to severe rectal damage, she was in utter agony and couldn't go to the loo. And one of her friends who gae birth at the same time had terriblt third degree tears also.

Disclaimer - I know bugger all about anything, but childbirth can cause such trauma, there is a perfectly good alternative which would reduce these incidents of damage (yes, I do know that a CS is major abdominal surgery, I have had abdominal surgery myself and although painful, I wouldn't say it was as painful as my poor SIL's injuries, not by a long shot)

animula, exactly (re: this thread being just a bit too pro-CS).

Another point to remember is that CS is not a pain-free option. Without regular pain-killers, there will definitely be pain, but you are given pain-killers to manage that. Coughing, laughing, bending over are also difficult, lifting an older dc is out of the question for several weeks, getting up and downstairs can be painful, there is a higher risk of suffering from PTSD. I lost a litre of blood with my second section and ended up severely anaemic after both, needing a transfusion. This is not all that unusual.

That is not to say that a CS is not necessary and life-saving in many cases (my own included), but it is not the "easy"/more civilised option.

I think it's ridiculous to generalise at all. Any birth (vaginal or CS) is potentially traumatic to the body and has the potential for complications, for so many reasons.

I find this discussion quite upsetting actually. My (emergency) CS left me infertile (tubal damage). Who would choose that option?

I have never had a VB (thankfully). I have had 2 wonderful ELCS (by choice no medical reason)on NHS.

I had no pain, lifted the older child and was back driving within days. For me they were both great experiances and the birth I wanted.
Whats wrong with being pro CS?? Plenty of threads are pro VB and no one complains. Each to their own.

This is the trouble, it is all so personal, and the choices are not as black and white as your post suggests, ihearthuckabees, it is horrendous that your cs left you infertile, but that is not the choice you are presented with. The choice that one is presented with is such an amorphous one ie the risk of all the complications of cs v the risk of double incontinence. The burden of choice is a huge one.

I agree with posters that are concerned over the pro-cs/ anti vb vibe of the thread. Despite the damage that I had as a result of my first 2 vaginal births, there were amazing positive things about them as well.

sorry, crossposted with you Chynah. I think the difference is that for someone like me who was trying to come to a very dificult decison about whether to have a csection or a vb, then it is important to have some balance, and to realise that not all sections are a walk in the park. I remember the (very good) thread you started asking for people experiences of sections - good or bad. It made a huge difference to the way I feel about ds's birth to realise that there were a lot of posters who had had similar feelings to me. I wish I had read that thread before choosing an elcs, but I'm not sure my choice would have been any different (gawd, it's complicated!) I remember being surprised that -ve/+ve experiences seemed pretty well balanced in the thread.

I would support any woman in their choice - that is really important - but actually I think it makes a nice change to have a pro-cs thread.

I actually find the tyranny of "you must try for a natural birth" as it is the way it is "supposed" to be really oppressive to women. I have read so many posts from women who have ended up having an emergency c-section and say they felt like a failure that I find it depressing. Why does putting up with hours of pain make you a success?

Every woman who decides to conceive/carry a baby is awesome and however that baby comes into the world teh Mum should feel like the cleverest person ever on that day.

hazey - I agree, and that was my point. If you are making a choice, even an informed choice, there is still an element of risk involved, whether a VB or a CS, so the OPs point - "Why not have a CS to avoid all the horrendous problems of VB" - is silly (not attacking OP, as she admits she doesn't know much about it). The choice isn't about avoiding risk, is it? It might be about avoiding pain, but then these things seem to vary so much between people that even that is a non-starter (not to mention the fact that some people withstand some types of pain better than others).

'I just don't understand why women put themselves through vaginal delivery.' stangirl with the greatest respect, as it appears from your post that you've not had a VB and you had a positive cs experience, of course you can't understand this. However, there are those of us who have had very negative cs experiences and can't imagine anyone opting to put themselves through that when there is an alternative.

maybetomorrow I had an emcs and it took at least 16 weeks before I could move around without pain (I was still in a lot of discomfort but not pain by that stage). After my vbac I was up and walking around pain free pretty much straight away (despite sustaining a 2nd degree tear). So IME, the vb was far better than the cs. I'm sorry you're still suffering now btw.

The difficulty with this whole issue is that no-one can predict how a delivery (by any method) will go. But it would be very helpful for the DoH to collect stats on the occurrence of tears/incontinence etc to help women make an informed choice.

Statistically it is better for baby to be born via elcs, this is because the worst outcome is emcs and it is negated by the emcs. The highest indicator for failed labour is fear of labour, which sounds like a woman should be in control and have power over her own body by trusting her instincts.

I have had 18 labour followed by emcs,
failed VBAC and GA emcs
2 x elcs.

You should not drive for 6 weeks after a c-sec. because your muscles are not strong enough to do an emergency stop, your body would react to your own pain which overrides the foot being to the floor and therefore braking.

negated by the elcs.

maxpower - I am sorry you had a bad experience. I didn't mean to offend with my comment. I hope my second post made it clear that I support any choice and appreciate that experiences vary widely.

I see that your cs was emcs where as mine was elcs - I think that is a very crucial difference. I often include emcs when I am talking about vb because I count going though contractions, interventions etc that lead up to emcs as part of the horrifying childbirth experience that I was so keen to avoid by having an elcs. I put off having a child for 20 years because I was so scared of the pain and when my first baby miscarried the pain was so intense and blood loss so great I was hospitalised twice - once due to blood loss and once to give me morphine - after that I knew there was no way I would be willing to go through the pain of contractions etc so elcs was the only way. If the NHS hadn't provided it I was going to take a second mortgage out on my house to have it done privately.

I've had two CS. The first elective and the second emergency. It was traumatic and I was unprepared for the operation first time round. But then when I went in to labour second time (I was aiming for a VBAC), that was traumatic and I was unprepared for the pain. Childbirth in any way shape or form CAN be scarey and overwhelming.

I was incredibly lucky to have no complications following either operations. My recovery second time round was much quicker than the first, which was pretty good. I was up and walking, albeit slowly, about 6 hours after each birth and yes it was painful but painkillers helped and I BF'd both babies straightaway.

Having said that, we toyed with the idea of having a third child and to be honest I couldn't have put myself through another CS and recovery thereafter (I don't think they would have allowed me a VBAC with number 3 after two sections). I'm grateful that I have two healthy children with a healthy mother.

I feel for anyone who comes away from childbirth with scars of any description. There is no right answer.

Stangirl, the trouble is that elcs can also be traumatic (it is still an operation with all that entails, and recovery can be just as hard). It can also have consequences for the baby. Ds's consultant said that she sees many babies with breathing difficulties in scbu, that are due to the fact that with elcs the liquid is not squooshed (medical term!) out of the babies lungs, and also because some babies are just not ready by 39 weeks (in ds's case she thinks my dates must have been wrong because he seems to be 5 or 6 weeks premature).

Less risk of breathing difficulties if left to 39 weeks, these risks are minimal.

It's sad to hear stories of women with on-going terrible damage from vaginal births. I had a (very open and candid) colleague who did suffer serious damage after the birth of her third child but went off to somewhere she laughingly referred to as the "Ladies Bum Hospital" (on the NHS) for corrective treatment and was fine afterwards. Is that uncommon? Surely if this is happening a lot then there should be a post-natal care system for dealing with it, or am I being very naive about women's health provision?

hazeyjane - if there's one thing reading this thread has taught me it is that there are no guarantees than any childbirth will be straight-forward. In fact It has quite unnerved me for my next one. My first elcs was so easy - baby bf'd in recovery room, after the operation painkillers wore off I only took 2 paracetomol for pain(and I'm not even sure I needed them), practically skipped out of the hospital and was pushing the pram up Primrose Hill within 4 days - I presumed elcs were always like that. My DD (and my current bun-in-oven) are IVF conceived so I know exactly how old they are - to the hour - so at least I don't have the issue of the dates being wrong. 39 weeks is definitely 39 weeks with me.

Stangirl, I am really sorry if my experience has in any way worried or upset you. I am sure the fact that you have previously recovered from section so well, means that the outlook is good for you. This was my first section, and it was unfortunate that I was allergic to the painkillers, had low blood pressure and that my dates were obviously wrong (more common than you would think, MargaretGraceBondfield). From the experience of getting pregnant, my previous 2 births and breastfeeding I have come to the conclusion that conceiving, birth and breastfeeding are not my forte!

Congratulations on your pregnancy, and good luck with the birth.

stangirl no offence taken I was just trying to say that because you had a good cs experience, it makes perfect sense that you should wonder why a women would want to go through the pain of labour and vb. If you'd had a difficult cs experience, you may have felt differently. I know that anecdotally women say recovery from elcs is quicker/better than from emcs but I was so traumatised from my emcs I was adamant I'd try for a vbac second time round as I just couldn't contemplate another cs (even though I was well aware that my decision to try for a vbac meant I was at risk of having to have another emcs - iyswim). I'm sure your next birth experience will be just as good as your first - good luck

If I'm honest, I don't think anyone should be able to opt for a CS with their first baby - labour shuold be allowed to take it's course, and treatment offered as and when.

What DOES hack me off is this country's obsession with CS statistics to the point that they're NOT offering them to women who clearly could benefit from them

My poor DS was ventouse delivery after 44 hours labour, born with cuts and bleeding all over his head, needed cranial osteopathy. I had sever 3rd degree tear followed by infection for 13wks PP.

If I ever had another (which I won't, incidentally, as it's still too upsetting to think about 3 years later), I now have no choice but to have a CS as I risk incontinence in my 30's if i deliver vaginally. Charming. Hospital admitted that "in hindsight, yes, we probably should've given you a CS at 27hours when you were contracting every 60secs and only 1cm dilated"!. Well done NHS!

I think if someone goes through a tear in labour that is severe enough to warrant concern on the part of the patient, they should ABSOLUTELY be offered the option of a CS next time round.

Other than that, though, I don't think it should be the first option...

Both my DSs were maternal choice eCSs.

A CS is clearly not everyone's cup of tea, but as women we should support each other in our birth choices NOT start up the whole 'brownie points for VB' competitiveness.

IMO, midwives spend waaaaaaaaaaaaaaaay too much time at ante-natal appts planning whalesong births - the focus should be on the post-natal period; educating women about breastfeeding and solid parenting.

Given that midwives are not involved in post-partum care beyond 10 days, I think they might modulate their views slightly on VBs if they were more involved with women who had suffered ghastly birth injuries

agree noway I can't understand why first time mums are given elcs (unless there are medical grounds of course)

highlander you make a good point about the limited pp involvement from mws. Extending mws period of care or allowing women who do suffer injuries which require long term treatment to remain in contact with mws may refocus them.

"to the point that they're NOT offering them to women who clearly could benefit from them"

Nearly one third of babies in the uk are born by c/s. The WHO, most midwives and a very large proportion of obstetricians think that's way too high - that more women could safely give birth vaginally than are currently doing so.

The best way of reducing the number of women who are not receiving appropriate care in labour (both the women who are having avoidable c/s and those who are damaged from a lack of timely intervention) is to increase the number of consultants and midwives working in hospitals day and night. The result would be better targeted intervention and less suffering and ill-health all around.

"midwives spend waaaaaaaaaaaaaaaay too much time at ante-natal appts planning whalesong births"

Sorry - but that's just utter rubbish. Most antenatal appointments are taken up with routine medical care. A very small number of women have a chance to discuss their birth plan with a midwife, and even then it usually just consists of a quick run through of their plans re: pain relief.

Would like to add that if any pregnant or planning to be pregnant woman is reading this and is bricking it at the thought of giving birth - there are things (other than opting for a c/s) that will reduce the likelihood of you having a serious injury in labour: have a water birth, give birth at home or choose your hospital carefully, and think very hard about whether you want to be induced.

Highlander, I'm all for women not being signed off by the midwife at 10 days. But midwives are in no way naive about the problems associated with vaginal births. For goodness sake - they're the ones who have their hands up women suturing them day in day out, or have to prep them for surgery if they need colorectal repair.

I agree that MW don't have sufficient contact with women with birth injuries long term to really understand the consequences of them. Yes, they sew up women or prepare them for surgery immediately following childbirth. But they don't see the number who need surgery to revise scars or the consequence of infections or those who never regain full continence. They also only see the women again who decide to have further babies, not the ones who were too injured or traumatised to have any more.

I found that MW were blase about my prospect of further VB when I had a large, open infected episotomy/tear which required surgery (although one also told me it wasn't infected because it didn't smell which is a scary diagnostic technique). My gynecologist has said that it would be my choice whether to have CS or VB and in contrast my GP who has worked in obstetrics said that there was no way that she would risk another VB if she was me.

I did not want to be induced, but my baby showed no signed of coming on her own and given the lack of fluid around her, the cord around her neck twice and her low birth weight given her gestational age (I think her weight had started to drop), leaving her in to arrive of her own accord would have been risky. It is lovely for the natural birth brigade to tell people to avoid induction, but when you are 42 weeks and MW and doctors will only tell you the hospital line that you are risking your baby's health if you don't go for induction you have very little choice. I really do think that CS should be offered as an alternative to induction for first timers with full information on both.

The reason that I only have one DS has a lot to do with this. I had DS at age 40, he was induced at 38 weeks due to pre eclampsia. I was induced 3 times before consultant "broke" my waters (in a very painful manner). 24 hrs later ended up in theatre (DS back to back) for ventouse & 2nd degree tear, horrible experience, made worse by subsequent harsh advice on breast feeding by MW who had never given birth!