Meet the Other Phone. Only the apps you allow.

Meet the Other Phone.
Only the apps you allow.

Buy now

Please or to access all these features

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

to think elective repeat caesarian is a valid choice?

522 replies

schmee · 01/03/2011 17:58

I'm currently pregnant with DC3 and would like to have a repeat c-section. I had a planned c-section last time as had twins, one of whom was breach. I haven't seen the consultant yet, so I don't know if I'll be allowed one on the NHS but I hope so.

I remember last time round people saying "oooh I don't blame you if you're having twins" when I said I was booked into for a section. I really don't understand what "blame" has to do with it, particularly as the decision was made to safeguard the health of my twins. This time round if I say my preference is for a repeat c-section the response is even worse, with people from frenemies to strangers feeling able to question my choice and try to get me to reconsider. WHY?

I wondered if people here think repeat c-section is a valid choice. And whether anyone's mind about planned sections had been changed by watching One Born last night which showed what a calm and baby-focussed scenario a scheduled section can be.

OP posts:
QuickLookBusy · 02/03/2011 21:45

Yes when I went in for ELCS, the same midwife "booked me in", prepared me for op then went into theatre with me and came back up to ward with me. She was lovely.

Violethill · 02/03/2011 21:46

schmee - I have re-read my last post, and there is absolutely nothing whatsover in it that could remotely cause offence. My point about some women regretting having highly medicalised births is absolutely true - just scan the MN threads and look at the number of women who have had huge interventions first time, and actively seek a different, non medicalised experience next time. If you extrapolate from what I said that a woman who regrets her birth experience is feeling 'to blame' for it, then that's your spin on it - not mine. I don't think 'regret' implies guilt or blame whatsover. It's simply about wishing things had been different.

As for your point: "I think most people who have a large degree of intervention first time round do so out of medical need" - well, that's highly debatable, which is the whole point. What do you define as 'medical need'? Most epidurals aren't for 'medical need' (though in some cases the doctor will recommend it as safest if the mother has particularly blood pressure problems). Many instrumental deliveries, and csections, occur as a result of the cascade of intervention - so one could argue that it wasn't a medical necessity which instigated the process.

Actually, if anything is offensive, it's your comment about the culture which glorifies natural childbirth as 'ignoring the history of maternal and infant death rates'. It's actually pretty underhand and nasty to imply that women who choose natural childbirth are somehow risking their own and their children's safety. Women who choose natural childbirth (where it's possible to have one, which is for most births) do so precisely because in a normal pregnancy, minimal intervention, unless complications occur by chance, is safest for the baby.

If a woman chooses to have a different kind of birth, then as long as she has weighed up the risks, then whats the problem? I have a colleague who recently gave birth who told me from about 12 weeks pregnant that she would have "every drug going" in labour. She did - and was happy with her choice. Horses for courses. But that doesn't mean those drugs were medically necessary - they were what she wanted.

Schmee - my first post to you on this thread was: find out from your consultant which is less risky for this particular pregnancy. Surely that's the only thing that matters to most women?

I am not anti intervention at all. As I've said, I was told I needed a CS at 32 weeks to save the life of my dc2. So I had one. When I was pregnant the 3rd time, I asked my consultant which carried the lower risk for me, with this pregnancy. If he's said Csection, I'd have happily had another, for my baby's sake. Because he said that for this baby, a VBAC would pose less risk, and that it would be safest to try to do it naturally, but in hospital (nor MLU because I was now considered a higher risk generally) that's what I did.

I still fervently believe that better resources should be in place to enable women to be supported through labour by midwives - they are the experts in 'normal' births, and the evidence shows time and time again, that it isn't always having powerful painkilling drugs, or medical interventions which makes for a better birth experience, it's being supported in non medical ways.

loueytb3 · 02/03/2011 21:48

I'm pretty sure there was no midwife in theatre with me - there was one before and in recovery but not in theatre. It may be that I was having twins though because there were an awful lot of (male) Drs. One of my twins was taken off to scbu pretty quickly. I wish I had my notes from last time to double check but I'm not sure that the hospital would take kindly to me asking to see my notes because of a thread on MN Grin

I will check next time round whether there are any midwives there.

EmptyCrispPackets · 02/03/2011 21:50

Louey you have every right to see you're own notes.

Alimat1 · 02/03/2011 21:58

Generally if its a twin delivery there will be 2 midwives - one for each baby

AintMissBeehiving · 02/03/2011 21:58

Had 2 midwives at my ELCS (great birth experience btw after a previous awful VB)- one for me and one for DS2.

schmee · 02/03/2011 22:02

Violethill - it's just a question of semantics then as you feel that "I don't think 'regret' implies guilt or blame whatsover. It's simply about wishing things had been different." I interpreted differently but was sure you weren't intending offence as I made clear. Apologies to jump on your words though.

Similarly however, I think I implied that women are risking their babies lives by choosing natural childbirth in normal circumstances. Of course I don't think this. Although incidentally I would have seriously risked my babies if I had pushed for a VB in my first pregnancy as many people in real life think I should have.

Going back to points earlier posters have made, I think it is bizarre that we reject medical progress in the area of childbirth. Perhaps it wasn't medically necessary for me to have local anaesthetic for a tooth extraction, but I don't think anyone would question my judgement for having it. Nor would there be any sense that I might regret it.

OP posts:
schmee · 02/03/2011 22:06

Sorry, too late at night "I don't think I implied"

OP posts:
schmee · 02/03/2011 22:10

Alimat1 - I think it's a bit of red herring discussing whether midwives were there or not, but I really don't think there was one there or at least not one that made themselves known, which you think they would have done if they had "a duty to care for mum".

OP posts:
pippitysqueakity · 02/03/2011 22:12

Just to add my bit, had EMCS with DD1 after 3 day labour and 12 days late. When was pg again, was told VBAC perfectly poss, was happy with that. When 7 days late, consultant said was no way DD2 coming out on own, so was booked in next day for 'ELCS'. My point being, calling it an elective, does not always mean you actually elect to have it. Medical advice might suggest it, but is not exactly a choice. I did not weep bitter tears of disappointment, but neither did I choose to deprive others of vital operations simply because I could not be arsed with labour pains.
So OP, if you still there... I think YANBU. And good luck with it all.

Alimat1 · 02/03/2011 22:29

Yes schmee - which is why im interested in who looked after you.

I dont think its a 'red herring'.
As I said ealier - it was implied by someone that we didnt attend all sections, therefore how could we possibly have a view on electives as all we see are nasty emergencies, when the shit is hitting the fan.

That is simnply not true

Violethill · 02/03/2011 22:29

"I think it is bizarre that we reject medical progress in the area of childbirth."

It would be bizarre if we did. But we don't.

I am hugely indebted to the medical advances which saved my dc 2s life. It was modern doppler techniques which identified problems, a safe, sterile caesarian section which delivered her, and state of the art NICU technology which saved her. It would indeed be totally bizarre for anyone to not want progress.

However, there is a problem in your simple comparison of medical advances with local analgesia for tooth extraction. Of course there have been incredible advances in pain relief for childbirth, notably epidural, which works by blocking pain. However, the difference between having a baby and having a tooth out, is that some methods of pain relief will have an affect on the baby, and some may make further interventions likely. If I am having a tooth extracted, I only need to balance whether I want an injection or not for myself. I don't need to consider the effects on my baby, or the fact that the injection might then have knock on effects. It is far more complex. And added to that, there is the simple fact that for many women, experiencing birth naturally is important, in the way that experiencing having a tooth pulled out naturally isn't. And you can analyse that til the cows come home - it isn't necessarily a logically explained thing, but a very deep feeling which many women have, and which should be respected just as much as another woman's decision to be drugged up to the hilt. Many women find natural childbirth an amazing experience, and they should be allowed to feel that without being told they are 'not embracing medical progress', or 'inducing guilt in other women who don't have natural births.' That really is nonsense.

schmee · 02/03/2011 22:34

Who said that enjoying natural births is "inducing guilt in other women who don't have natural births"? I certainly didn't.

OP posts:
Clytaemnestra · 02/03/2011 22:38

There were, if memory serves me correctly (at least) one midwife who came down from the ward with me, three anaesthetists, a paediatrician and two surgeons present when I had my elective c-section. And possibly other nurses who may or may not have been midwives.

At least one of the more junior anaesthetists seemed to not have much to do once the spinal block was in so kindly spent most of her time taking lovely pics of DD with my camera while I was being stiched up.

Actually there might have been two midwives.

schmee · 02/03/2011 22:40

And very fine photos she took too clytaemnestra!

OP posts:
Clytaemnestra · 02/03/2011 22:42

Grin There are benefits to having procedures done in a big teaching hospital, lots of students hanging around who can be put to good use :)

Violethill · 02/03/2011 22:50

You implied that celebrating natural childbirth is somehow responsible for women who don't give birth naturally feeling bad. Its nonsense. Giving birth naturally first time is the most incredible, empowering thing Ive felt. Having my csection was also awesome btw.

schmee · 02/03/2011 22:57

No I didn't. Please reread my posts if you are unclear. Really I don't think anyone would argue that if someone wants to try to have an amazing birth experience, has no medical reasons not to try and ends up with one then that is a fantastic outcome all round.

OP posts:
Violethill · 02/03/2011 23:05

And thats MOST women who could have one if they wanted (as most labours are medically 'normal') - so yes, it is fantastic, and to be celebrated.

schmee · 02/03/2011 23:06

So in your view it is just a case of them not wanting it enough?

OP posts:
Violethill · 02/03/2011 23:16

Eh?
I am agreeing with you. If a woman wants a natural birth, and is one of the majority of woman who are 'medically straightforward', then yes, its fantastic.

schmee · 02/03/2011 23:25

Clearly we're talking at cross purposes. You sounded like you were making a point when you said "most women could have one if they wanted" but obviously you weren't - so hurrah let's agree.

Fantastic for those who have the great birth they want. Fantastic for those who have a great elcs when there is a very clear medical need.

I'm more interested in the areas in between - if you look at my OP.

OP posts:
Violethill · 03/03/2011 06:44

My point is - once again - that thankfully, overall, MOST births are straightforward. So yes- hurrah! Whether a woman wants a natural birth is another issue anyway- some women are very happy not having one. And Some women aren't happy with their birth experiences- which is not good.

Violethill · 03/03/2011 07:09

Schmee- I think what really confused me is your assertion that: "I think it is bizarre that we reject medical progress in the area of childbirth". I don't know where you get this notion from. What medical progress is rejected it? And who rejects it?
What IS bizarre, is thinking that there are scores of women out there who are actively rejecting medical procedures which improve outcomes! I have never come across a woman who says , no thanks, don't bother with those scans to check on my baby, or no thanks, don't bother with that Caesarian section to save my babys life!!!

If you are referring to medical advances which are not medically necessary and which carry an element of risk- eg amniocentesis to detect abnormality, or epidural anaesthetic to block pain, then absolutely- SOME women will weigh it up and make an informed choice to reject it- but that is entirely their right, and certainly doesn't mean they are making some blanket rejection of medical advances

larrygrylls · 03/03/2011 09:04

This debate is becoming increasingly bizarre.

I think very few people have said an ELCS is NOT a valid choice after a first C section. It is also, at least in the UK, always offered on the NHS. In fact, if you have already have a section, you have a right to convert to a C section at any time of your choosing.

On the other hand, Schmee, you have asserted above that infant mortality is 10x higher for a VBAC than a section. I really doubt that and would love to see the stats to back it up. I have googled and could not find any. There is also a protocol for a VBAC and people who choose not to follow the protocol (labour at home, stay in labour for too long)etc are clearly putting themselves and their baby at risk. In addition, to the best of my knowledge, the stats for scar rupture are not separated into minor rupture with no sequelae and major rupture with potentially very dangerous consequences. I believe the majority are the former.

Women should make whatever choice they feel is right for them, ideally in an informed manner and in consultation with the medical profession. On the other hand, VBAC is an equally valid choice and not a rejection of medical progress.