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)

Getorf does make a valid point in her OP- human females are not brilliantly designed for childbirth due to the size and shape of the pelvis. Without medical advances, our maternal/foetal death rate would be way higher than most other species (but we compensate for that by our intelligence which makes us good parents so infant mortailty is way lower than most other species).

However, I think we know enough now that we do know how to avoid serious injury during birth, although this is not always the case due to poor maternity provision. It would be better to direct funds towards improving support for vaginal deliveries than towards c-sections on demand IMO.

Still reckon less indignity with a section

Definitely! All that has been mentioned plus IO had to wear a theatre hat, that resembled a shower cap & they put those tight stocking things (the name escapes me) on me. 2 nurses per leg...in front of MIL!

The horror!

"!"it seems that a woman's body is not brilliantly well designed for childbirth" It's amazing the human race has survived at all then! [hmmm]"

I think this is a misunderstanding of how Nature works. For the human race to survive, Nature does not require every individual to survive; it may well be that a few women dying in childbirth is a price well worth paying in terms of the human race for the evolutionary advantages of walking upright and having an abnormally large brain. (Though of course the individuals tend not not to see it that way...)

In some species, the vast majority of individuals die before they reach adulthood- and the species still survives. Evolution is not about the survival of the maximum number of individuals.

Teds. The stockings are called Teds!

You dont have to wear them, of course, but it is advisable. I refused mine, I had such bad swelling from pre-eclampsia (which doesn't dissapear the minute the placenta is out, annoyingly!) that I just couldn't bear it, I think they were doing more damage than they prevented. I asked for Klexane instead and hauled ass about the ward as much as possible and I managed to avoid DVT.

Thanks Tatty! I had no idea that I didn't have to wear them , just went a long with it. Tbh, when you can't feel anything tits down, you don't really care!

I had PE in my first preg, and had to wear them for a few days, during the hottest week, on a ward with 1 fan to 4 bays...didn't do much!

So yeah, just went along with it this time.

After a 49 hr labour I was given an episiotomy and DD was pulled out using forceps.

She was over 9lbs and they broke my coccyx pulling her out and on top I had blood transfusion and then all stitches came undone and got infected.

I could barley walk or lift my baby out of the cot for 3 months. It was agony plus the pain of the infection.

A C section would have been better.

I didnt get a say in what happened..my "consent" when asked about forceps was "please get her out" and DP said I dont want her to have a C section as she wont be able to get about for 6 weeks....

Casseopia

True, you don't know what you are going to get. I had a simelar situation to you in that I am tiny and my then DP was big, but I didn't need consultant led care for any reason. Obviously you did for some reason which would be the biggest difference. I was young when I had my dc's, early twenties, and the idea of a section never came up. There was no need for it to. I just imagine myself as that young first time Mum, being offered a c section when there was no medical indidcation that it was neccesary, and then ending up freaking out that I might be putting my baby at risk by trying for a natural birth. After all, if natural birth wasn't such a big risk, why would they be offering it to me?

I would have more confidence now in my own judgement, but I wouldn't have had at the time if they had just offered it because that's what they do. I would probably have had a section under the mistaken belief that it was safer for my baby, when it was completely uncalled for, and I would have missed out on that wonderful feeling of having just delivered a baby for no reason.

If the c section rate went up so drastically, there would almost be no need for midwives. GP's can deal with all the ante natal care, consultants and surgeons would do the majority of the births, and women (or men!) trained to deliver babies and assist labouring women would almost become completely redundant.

Again, better management of births is what is needed. It is horrendous that so many women have to go through hours of pain and stress for their births to end up as emcs anyway, but that could be avoided if women and their medical team were prepared from the outset to think that any birth could end up in a c-section. Women have this ideal of giving birth naturally, and when it doesn't work out they are left upset by the trauma of their labour, and the dissapointment of not being able to give birth naturally. If natural birth wasn't 'bigged up' so much by women and midwives, and hospitals didn't feel the need to keep their c-section rates down, I think the very common traumatic birth experience could be reduced dramatically.

I think all women should be prepared for the possibility that they may need a section, and I don't know if things have changed, but c-sections were barely mentioned in my ante natal classes. And of course, maternity care needs to be better funded so you don't have one midwife tring to deal with more than one birth at a time.

Women can already get a section on the NHS if they desparately want it and they have a good enough reason, and that's the way it should be. But offering all women sections just because some women have bad labour experiences is completely wrong imho.

I think women should be scanned about 35 weeks to get an indication of how big their babies are. In my case it would have been useful.

I would like to know what are all those risks from CS that people talk so much about. I know dozens of women who had CS and had no problem whatsoever. The recovery may be difficult but the 'risks' sound more like an urban myth to me.

I had a normal, natural birth and damaged my bits and now I have to wait until I have all the babies I plan to have surgery. And the care I received from the NHS when I went to hospital panicking one week after the birth thinking my bladder was falling down was horrible! I was nearly ignored and the doctor didn't want to touch me - she looked at my bits, there was no bladder hanging out so she said I was fine.

The situation only improved when I did some private physioterapy (£100 per hour!).

But the bottomline is: it doesn't matter to the NHS if you are going to pee yourself for years, or if you can't ever carry weight for the rest of your life. These are not life threatening conditions and you should just grin and bear.

Yup, that would be why the hospital get you to sign a consent form for the c-section that lists all the risks, because there are no risks at all and it's just an urban myth.

In general, a c-section is a safe procedure and the rate of serious complications is very low.

However, there are risks that during the surgery there may be infection of the bladder or uterus, injury to the urinary tract or injury to the baby.

Plus there are the general risks of any surgery -- reactions to medications and anaesthesia, problems breathing, blood loss, blood clots, infection setting in from wound site.

And there are the risks to future pregnancies, including automatically higher risk for placenta praevia, placenta accreta and uterine rupture.

In the US (I don't have figures to hand for the UK) surgical injuries to the urinary tract or bowel occur in approximately 0.1% (1 in 1000) c-sections. Risks of infection to the incision ranges from 2.5% (1 in 40) to 15% (slightly over 1 in 7) depending on where you get your figures, with a similar proportion developing UTIs (which granted are generally not serious). The risk for developing a deep-vein thrombosis is generally agreed to be three to five times higher in patients having a c-section than vaginal delivery (although there's a lot of debate about what those figures actually are). The maternal death rate for c-section is around 0.02% (1 in 5000) versus around 0.005% (1 in 20000) for vaginal birth (those figures haven't been adjusted to take account of any health conditions that led to the section in the first place, so don't give the full picture of relative risk of death if there are no existing risk factors other than the c-section).

The risks to the baby are somewhat lower in c-sections than with vaginal birth.

And, most importantly the risks associated with an elective c-section are much lower than the risks of an emergency one.

I had all three of mine vaginally, and really did not want a CS (scared of bein gcut open :)) BUT I do think that the disadvantages of a vaginal birth are not really talked about and often glossed over - the impression I get is that the "risk" of things like major tears etc don't appear in the figures as women are just supposed to put up with that sort of thing. If we are designed for childbirth then why was the maternal death rate so high in the past (and still is in many countries) and are you suggesting that we are supposed to tear?

if you really think that women are designed to give birth then maybe read this - it is about giving birth unaided in the undeveloped world so not too scary if you live here.

www.unicef.org/mdg/maternal.html

cory is right - think about most animals - th eidea is that the unfit die and that only the fittest survive, not that no one dies in child birth.

Can i ask - I realise that emergency cs are pretty traumatic, but is an elective cs more pleasant experience/ easier to recover from? I have had 2 vaginal deliveries, both went ok. But after the first I had anal fissure (tmi sorry!) leading to abscess and fistula. This coupled with tearing in second delivery has left me a bit incontinent with regards to..ahem... wind and the thought of the problem getting any worse frankly scares me. So I'm considering elective cs (if I ever decide to have a third) and want to know what to expect...

I had quite a lot of damage from a vaginal birth and took the decision not to have another dc due to risk of further damage. I think the weight of the pregnancy was a factor as well as the actual birth.

But I can't see how I'd have known that was going to happen in advance in order to opt for a c section. My baby wasn't huge (8 lb 4), I'm not small framed. Just one of those things.

It is pretty horrible and treatment can take a lot of time (2 years for me) and probably more problems in the future.

But I guess if they warned us, it would just cause more worrying than you already have with an impending birth.

Hope your sil feels better soon.

I read book a couple of years ago called The Midwives Tale which was a collection of accounts by midwives ranging from the late 1800s to the 1970s.
In that book there were several midwives from pre WW2 era that stressed they saw their job as preventing tears of the vagina and perineum. Most births were at home and a doctor may not have been available for stitches and in any case antibiotics weren't available - so tear free births were the aim.
They describe how they encouraged women to stay upright throughout their labour and would massage the perineum in order to manage the speed of second stage.
I think a lot of the problems of modern hospital births stem from the poor resources and training available to modern midwives and the fear and ignorance surrounding natural childbirth.

thanks casseopia

Hmm I have several friends who have had dreadful injuries due to vaginal cb. I think a lot of women don't talk about it due to the embarrassment of what said injuries can cause.

Rather at the c/s horror stories. Many of my friends have had c/s(many are twin mums) and not one has experienced all the c/s horror you read about-seriously over exaggerated imvho as risks are rare. I had 2 nightmare pgs and managed to give birth by c/s to bouncing twins at 38 weeks and a singleton at 39,all bang on and very good weights. It's not that difficult to monitor before hand thanks to the fantastic scanning facilities available.

Sorry but I don't think enough thought is given to the years of pain,embarrassment and yes surgery many women have to go through after a traumatic vb. I find it sad that nobody really cares as said mums have had that holy grail "natural vaginal childbirth".

Only read two posts, but I have had urinary problems for 42 years (age of firstborn son). Repair attempt had some success but now bad again. Second son was C section anyway. I wish they both had been.

But I have heard this: most women ob-gyn doctors have C sections.

Also people are bigger now than in times past.

I will put this that way....VB may be traumatic and may be painful and it probably is..mine was at least, but I think it is worth it.
but its XXI century now, there is pain relief, water births and many other options.
CS is a life-saving procedure and should be seen as such, it's not like blood sampling, they cut you in half...

Washngo my c/ss were fab,I was up about 4 hours after and in the shower. I found it scary having the spinal(I'm guessing your previous experiences will make a spinal seem trivial) but that was pretty much it and I'm the biggest chicken out.

To be honest I had several lap n dyes when ttc and there wasn't a lot in it. Just felt like I'd done some extreme tummy crunches in the stomach area. The next day I was only on paracetamol and was out on day 3,thought nothing of it.

To be honest you're so caught up in your baby(and toddlers)you don't have time to notice. I had 15 month old twins and a newborn and it was totally fine no problems at all.

All of my friends who had c/ss were the same. None of us had any gory birth or pain stories to share,bit boring really .

OK - I, technically, died twice on the table during my (second) caesarian. So the risks do exist. Kind of weird to think I'd have been the "silent" statistic, of things that can go (very) wrong with a CS, but you never hear about because, ummm, they have gone to the place from which none return .... .

On the plus side -- I'm still here! And only have a teeny, tiny scar.

Just saying this because it's an interesting thread, but should shove that in for balance.

not quite in half :) . I'm not pro CS - not anti either - and there is a cost implicaton - but I do think that the problems caused by vb are much down played and often classed as something that women should just put up with. If the whole thing were more open - ie if we actually had figures for incontinance rates rather than loads a ads for Tenalady :) then women would make more of an informed choice. As it is it seems like we get loads of info on CS risks before hand followed by "what did you expect" when we complain of tears, prolapses etc etc afterwards.

Don't be so ridiculous Ivette they don't cut you in half,the cut is tiny.

Thing is Animula there are risks for both(thankfully rare) my mum and I both nearly died during her vb.