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)

I had a traumatic birth with dd1 and went to see a consultant to discuss whether CS was an option before even conceiving dc2. I was told cs was certainly an option. Don't think you should choose it for 1st but 2nd time round you know how your body coped. (or didn't)

Interesting thread. I guess the question is essentially, how much should we be allowed a say in what treatment we receive from the NHS, and to what extent should we defer to the medical system? If CSes were available automatically on-demand, how would this affect the doctor-patient relationship and power dynamic?

On the one hand, women would be empowered by a greater variety of birth options. On the other, however, women who would otherwise have no problem giving birth naturally would disempower themselves by surrendering power to medical intervention...

My birth experiences have been very long and painful indeed. Having said that I am still glad it is something it is something I was able to do. Considerable tearing and definite after effects still felt several years later! Problem is vaginal births are so very variable and I think it should be the aim for first births ideally but perhaps with more choice given for subsequent births to women who have had a traumatic time or are likely to have lengthy or difficult labours.

I think YABU, but then I suppose I am likely to, as my first DS was 9lb and had his hand next to his head when he was delivered, so it took a bit of time for them to get his arm out, DS2 was 10lb and I have had 3 DC subsequently, all with no problems at all then or now, no tears, no stitches, no incontinence, no piles, nothing. I also do not know anyone who has had serious tears or complications during natural childbirth.

During a previous pregnancy I was told that natural births are better for babies for all the reasons Peering has given, hence they prefer to deliver premature babies vaginally where possible.

C-sections are risky, as people have said, in subsequent pregnancies as well as as the time and in most cases there is no way of indentifying which women would benefit from one prior to birth, so it could lead to a lot of unecessary surgeries.

No. I can understand women who feel they have suffered badly feeling this way, but CS is more risky to child and mother, as well as significantly more expensive.

I'm sure millions of women have safe deliveries but we only tend to hear from people who have had difficulties as they need support, etc.

I know it's totally unreasonable and irrational but if I ever manage to conceive I want C-sections even if I have to pay for them. I know that CS's are mare difficult to recover from and riskier but it's the potential damage to the nether regions that puts me off of VB so badly. I'm also a PI/ clin neg lawyer so my views are a little tainted. I've seen thru my work the most appaling damage to women's bodies caused by negligent deliveries, but none of them have been c-sections!!! For example, years ago, I had a claim where the medical staff slipped with a scalpel during an episiotomy etc. You don't want to know how bad the damage was.

I just can't do it and I'd rather have a c-section. Awaits flaming!

I've had a forceps birth, then an ELCS (by choice, to avoid another instrumental delivery).

I don't have to think twice about what I'd choose next time - hands down the ELCS.

Poor DD1 was black and blue after her forceps delivery, couldn't feed properly, couldn't sleep.

The mortality rate for women giving birth today in the developing world is 450 women per 100,000.
However, in Chad the number of women dying in pregnancy or birth stands at 1,500 per 100,000 live births ? around three times the rate for British women in 1910.
(New Scotsman 08 March 2010)

Analysis of the most recent and best quality data from government statistics for different countries or from international surveys showed that complications from pregnancy and childbirth were the leading cause of death for girls aged 15 to 19 years in poorer countries (BMJ )13 May 2004

So no we are NOT - from the evidence :) not designed to give birth without risk. Thats why Obstetric intervention is so common in the developed world. Put simply it saves lives.
However, there is no available research showing that the ECS, (rather than the emergency -Oh bugger we've left you in labour to long and if we dont want sued we best get baby out NOW variety)is much safer than than the'natural' method. I think all the stats are thrown in together. Im guessing that an ELC will be a lot safer than the emergency.
Anyone got the research ?

From the evolutionary point of view, perhaps there's enough other possible ways of dying other than in childbirth that selection for successful childbirth doesn't operate particularly? i.e. if ten people are going to starve to death and eight are going to be eaten by saber-tooth tigers, the fact that some women or some babies died in childbirth doesn't make much difference.

I have to say, what really pisses me off is when people say 'Well, all that matters is that the baby's safe'.

A1980 that's the point though, if a Dr makes a mess of a natural birth the consequences are pretty visible.

If a surgeon makes a hash of your c-section not only can it kill you, you may not know for years and years until say you nead surgery on your bowel, bladder, uterus, ovaries etc. Then you find out your insides are all stuck together and full of adhesions, then what might be a routine operation, becomes very, very serious.

I think we'll see a lot of people in the future having long term complications from the repeat c-section as common as it is now. I think Dr's are right to not do it on demand until long term trends are established.

VW, there is lots of research around but the main reason an elective is safer than an emegency, is because of the reasons behind it. Generally for an emergency and the clue is in the name, there is some underlying emergency which is goig to cause a complication so by default the risk goes up. It's not the actual procedure itself.

The procedure is the same, they just speed it up a bit, no walking around chatting, playing music whatever.

*need

You can have a CS "on demand" if you pay though?

But why would you offer major surgery to the majority to save the bad experiences of a few?

I had an elective CS and it was brilliant - went in to hospital on the day, DD was out in 15 minutes, then DH cuddled her and hed her up to me for kisses while I was being stiched up again. She latched straight on in recovery and fed beautifully.

So, I think it's perfectly valid to think that c-sections are great, but I'm aware that a) I'm biased because my experience was so good and b) there is a massive difference in experience and recovery between elective and crash CS. I was up and about within a few days (hospital chucked me out a day earlier than they'd predicted because I was so perky), and had to be repeatedly told to slow down and not over-exert myself.

I think there are risks and advantages to all ways of giving birth, from home to water to maximum intervention, and the best thing is for people to keep an open mind, get ALL the information they need and make their own decisions about what works for them. I was told there was a small chance I could give birth naturally if I wanted to try, but it might not happen, so to me it was a no-brainer to go for the elective c-section rather than put myself through agony and end up having a crash section anyway. Doctor was very obliging and agreed with me entirely.

To each her own. I agree with you OP. And you know what - if men had babies, there would be no question as to the availability of government subsidised c-sections. In 50 years time I believe it will all be different.

I had a private elective section for what it's worth.

I'm glad I have a healthy baby & didn't have a traumatic birth or any damage to my body... yes there's a scar, but I knew that going in.

Serious injuries are rare. Hell, I had a third degree tear and I'd still take that over a CSec any day. ECS on demand is a crazy idea

I have had an EMCS with a GA with my eldest and a VBAC with my youngest. Although I did have a second degree tear that time, I would definitely prefer a vaginal birth to a caesarian. With the vaginal birth I was up and about the same day and healed within 10 days (from the tear). With the caesarian, it took me two days to be able to get out of bed and 6 weeks to heal.

What nonsense, if the female body is not briliantly designed how on earth did we manage to survive for so many thousand of years???
Yes , i know c section is required when NECESSARY, but should be the exception

Congratulations to the women who stoically endured physical injuries to get their babies out and who still prefer that to a C section, but surely it should be a choice. There's a lot of things governments waste money on - I think the right to choose a C-section should be a priority.

OP, work out the costings and we can get our local members involved.

If only women were given the choice.

It is only my opinion but an ECS is, as the nurse tending to me when I had DD2 said, the civilised way to give birth.

I was one of those who had an awful, agonising ventouse delivery without pain relief the first time and an ECS the second. Had I been denied that (after a birth that even 15.5 years later I can't describe in more detail because it makesd me feel faint, sick and distressed) I would have had a termination.

The ESC was a walk in the park - I was out of hospital and off painkillers within 3 days, with none of the utter horror that was normal childbirth.

as someone said lower down the thread, and it's something i wholeheartedly agree with, it's not that women are not built for birht, but the current maternity care provision is not built for it

the knock on effect of more c.s would not be absorbed by the NHS.. you need an anaesthatist, an obstetrician, scrub nurse , midwife, paed etc etc.. the drugs & instruments themselves, operating theatre and equipment, more post natal beds and midwives and auxilliaries.... the financial cost is enormous

i'd be interested to know what proportion of c.s are avoidable.. i/e following IOL for a woman whose body was simply not ready or for misdiagnosed small/large for dates or for other issues that never came to fruition or for women who had a previous c.s, or for women having c.s for breech and so on..

I had an elective section (actually necessary in the end) but I paid

I get a bit annoyed with the 'female body is perfectly designed and it is all wonderfully natural' argument

Yes evolution has done the best it can but it is not a 'pefect' design

Has anyone read 'The Hospital by The River' by Catherine Hamlin? There is a graphic account of an Ethiopian woman giving birth to her dead baby because it has got stuck in the birth canal. She then suffers a fistulae and is rejected by her community because she is passing faeces through her vagina and is incontinent.

Okay this is a particularly harrowing account, but it happens in the third world frequently to women who have not partook in western posture problems or carry big babies due to diet.

We are so damn lucky in the west to have access to medical care when it is needed in childbirth.

I had a forceps delivery with my first but was told by my obstetrician that I would be fine to deliver naturally with my second. I did everything I was supposed to. I stayed upright and used G&A only. I did hypnotherapy to relax and I gave birth to my dd in water. However I sustained a third degree tear and I will never forget the pain of her crowning. I have awful piles, a slight bladder prolapse and I pass wind through my vagina frequently. I just feel 'different' down below and can find sex painful.

I don't complain about this to others(to embarassed), I am not competing in some kind of traumatic birth competition. But if I do ever have another baby, it will be an EC and I don't care how much I have to complain to get one.

'What nonsense, if the female body is not briliantly designed how on earth did we manage to survive for so many thousand of years???'

Plenty of us didn't and still don't in places where care is not available.

Compared to the number of chimps, our nearest relative, who die in childbirth, our rate was and again, in developing nations, is staggering.

We made a trade off to walk on two legs - the pelvis shortened, we give birth to relatively immature offspring with a much larger maternal death rate than other apes.

Its true that it is a "civillised" way to give birth, as Valhalla said.

I have now produced 2 children without a single vaginal exam. Not once have I parted my legs for the gloved fingers of anybody!

I haven't farted or pooed or weed on anybody, including myself.

I didn't so much as break a sweat and no hair was out of place. Though I wasn't allowed to wear makeup!

I was off painkillers and driving within days (with my GP's and insurance company's approval)

None of this should matter, and none of it factored in me having c-sections either. Nor am I saying anyone should care about these things.

Ideal, it may be not, but civilised, it is.