Does anybody actually know anyone who had an ELCS just because they thought they were "too posh to push"?

[InAStateOfReflux]

Just watching the Wright stuff. One of the hot topics is that apparently ELCS rates being performed by the NHS are rising because people are deciding they are "too posh to push" and it's costing the NHS lots of money.

They are suggesting that these women should be offered psychiatric counselling to bring them round to the idea of having a vaginal birth.

Now correct me if I'm wrong, but I was given an ELCS because my dd was breech and was in fact strongly advised to (not given much choice in fact) and anyone else I know who's had one has been offered it because of significant trauma or complications in a previous birth.

I have never however met a woman who insisted on one on the NHS just cause she didn't fancy pushing it out of her fanny, and I doubt the NHS would go with this anyway tbh...

And if they're talking about women who have real fears and emotional distress regarding child-birth, then yes of course lets force the hysterical wench to push it out, does she not know how much money she's costing the NHS?

Oh how I love the way the media portray these issues...[sigh] Yes perhaps ELCS rates are rising and perhaps this should be addressed in some way, but to suggest it is for such fickle reasons is so juvenile. Perhaps it is the HCPs fault and not the whole female population who are apparently too cowardly to push their babies out?

My discharge midwife said I "...could go for a natural birth next time, at least then you could say you tried.." Tried?! DD was breech, I went into shock, lost loads of blood and narrowly avoided a transfusion. DH watched and said it was so deep you could practically see my spine. I was terrified as my mum had a paralytic ileus and was in ITU for 2 weeks when she had a section with me. Why does this too posh to push persist? It's a major abdominal operation and v unpleasant.

I'm sorry you had a bad time, but CS is a fairly standard operation these days, closer to a tonsillectomy than a heart transplant.

It wasn't during a CS that your DH could see your spine, I hope. It would be very worrying if your doctor cut through both your uterus and your intestines to reach your spine during a CS.

The balanced considered posts here are appreciated. I had two big babies naturally, rapidly and painlessly but now wish I had had them both by CS as I suffered from terrible stretch marks ountside and the tissues similarly stretched never to return on the inside - no one tells you that! After much heartache and depression I got an internal repair op but the doctors were very hard hearted ("That's what happens when you have babies - what did you expect"). We are not all the same remember - both psychologically and physically. It is surely better for all if our various needs and predicaments are catered for? Let's be caring, open-minded and generous to each other!

I can't say CS was unpleasant, either. It was painful the first day, OK the next day, and fine on the third day.

Try having a huge infected wound with hematoma at your fanjo, unable to sit, walk, or generally live without crying and whimpering in pain for three weeks. Try to imagine keeping this wound clean and dry down there with all that bodily plumbing right next to it. Then imagine trying to have a semblance of a sex life for months as the wound heals but is still painful to touch.

That was unpleasant.

I gave birth in Liverpool Womens hospital 2006. xstitch I totally agree. Scary thought on how that child is now, I can see one of 2 ways, either pranced about dressed like a doll, top to toe in burbury and alike or threaded like dirt living with its grandmother 90% of the time.

why would having a csection prevented you from getting stretch marks??

I think she was talking about stretch marks on the inside, but I'm not quite sure what she meant by that.

If you look at the data here:
www.hesonline.nhs.uk/
Maternity data> maternity data archive> table9 method of delivery

...the rising CS rate over the past 30 years or so in the UK is actually due slightly more to the rise in EMCSs than ELCSs. Doesn't look like the evidence really fits well with the Wright Stuff's hypothesis. What a surprise.

Stretch marks generally occur in the last few weeks of pg when the baby grows by about 1/2lb a week. An ECS would be done before 40 weeks probably thereby preventing you getting to peak fatness! That's how I understand it anyway.

Oh, didn't realise that was in response to a specific post. I just alway thought that was one of the supposed reasons some slebs have been 'too posh to push'.

Keepingupwiththejones, this woman was in the bed opposite? So she had already been admitted? There must have been some (other) reason she was there, in an allocated bed and possibly this was related to the c section. You can't just get fed up at 35 weeks, turn up to hospital, get in bed and demand a c section!
FWIW I was told very clearly by both nhs and private obstetricians that unless there was a clinical need no one would deliver before term.Ever.

I realise that, apparently she had been booked in by a doctor in clinic but when she was at the hospital the doctor who was actually doing the c-s said exactly what you say about the timing, god only knows how she had managed to get the clinic doc to agree to booking her in!

YANBU!
Thank God someone is actually saying that loud!I ve had so much pressure when had my DD in the UK because after hours of pushing,ventuse etc my consultant gave me the "option" of ELC.I fail see to why in a free society I have to apologise for not continuing labor for endless hours only to have a c section later anyhow.not to mention the painfull recovery afterwards. how you give birth is not something that makes you less mother than others .furthermore, I couldn't agree more with what you ve said "And if they're talking about women who have real fears and emotional distress regarding child-birth, then yes of course lets force the hysterical wench to push it out, does she not know how much money she's costing the NHS?" seriously someone had to say it!

Someone mentioned that the NHS can't magic up more staff just because a woman "wants" an ELCS.

Just reiterates my point that it appears to be socially acceptable to say that you insisted on a home birth and forced the NHS to provide the relvant midwife support despite the local hospital attempting to use staff shortages as an excuse not to allow it. Not acceptable however to opt for an ELCS ?

Double standards anyone ?

You can get an ELCS on the NHS, the mother just needs to be thick-skinned enough to put up with the potentially obnoxious attitude of those staff (and others) who do not agree that a woman should have this (informed) choice.

Given a guarantee of competent 1-2-1 midwife care from admission through to the period after delivery and I may not have persisted in my request for a medically unecessary ELCS.

The NHS needs to look to the degree to which its own failings are contributing to the rise in ELCS, although, from experience, NHS generated statistics can be very misleading, usually being published for a reason (to manipulate opinion and influence behaviour in line with its current agenda)

YANBU, when i get PG i will be asking for a CS. I grew up with mum's stories of the trauma of giving birth to me - she had a large tear, + forceps delivery. The drs were inexperienced + i have epilepsy as a result. Mum has a small fissure (vagina to bowel) which is embarrassing for her (PV wind + faecal leakage). She only found out within last 10 yrs as it worsened due to pressure from walking, standing at work, + a renewed sex life. Now at 61 she has to consider surgery.
Many of my friends had painful tears, one had her vagina so stretched she doesn't enjoy sex. Then there are the older ladies i look after with continence issues that they say often started after childbirth (PF exercises don't always work).
Obv a CS can be risky, and many women have problem free vaginal births. But i would prefer an ELCS.

i agree that the 'too posh to push' thing is ridiculous, probably made up by some man who know he will never have to do anything remotely as tough as giving birth!!

however, i do think that nhs and private obstetricians will scare women into thinking their bodies are not in fact designed to give birth, based on NO actual medical knowledge at all. the fact of the matter is that the vast majority of women are able to have a normal, natural birth if only they were encouraged and helped to understand how and why this is really important - but the nhs does nothing of the sort, because it is much easier for them to 'control' birth by scheduling a c-section, rather than have to deal with natural labour.

next time your obs or midwife says you need a c-section, ask them where the actual evidence for this decision comes from - eg. breech babies - absolutely not true that ALL breech babies need a CS. some certainly do, not most though.
basically there is no justification for our current CS rate, none at al!! why are women now unable to give birth naturally, more so than in the past? are our bodies more badly designed?? i think the blame goes to doctors and the medical profession to be honest, for turning birth into a medical process, which is most certainly is not.

sorry to rant - every pregnant woman should read this book - 'Ina May's Guide to Childbirth' by Ina May Gaskin, it will put into question some of the 'facts' that our obs and midwives tell us...

also i just wanted to encourage those women who don't feel they can do a natural/vaginal birth - this is a natural process, our bodies are MADE to give birth and it is a process that can really empower a woman, encourage bonding with her baby, and also we are lucky we get to go through this amazing transition! why turn it into an operation?

and yes, it is painful but then life is also hard isn't it? we go to the gym/running and that's painful, we work hard to get promoted and that's mentally and physically painful to some extent - so don't you think it's reasonable we'd have to 'work' a little to birth our own babies?

a CS is a serious op - you entire abdominal muscles are sliced through and you have to rebuild them from nothing, this can really affect posture and general health. vaginal birth should not create a massive tear/infection if you are handled professionally, helped to relax and let go, and you prepare for you birth (a bit like you would for a marathon i guess!).. i work with a lot of women helping to prepare them for birth with yoga, breathing and relaxation, i HIGHLY recommend this method, it reallly does work!

"the fact of the matter is that the vast majority of women are able to have a normal, natural birth if only they were encouraged and helped to understand how and why this is really important"

Now, I am pro natural birth (although I've had a planned section for breech frank breech for my first and will be requesting another for this baby)

'Vast majority' is a moot point. 'Most', is perhaps an descriptor I'd agree with. There significant issues that can arise from our species evolving large heads and pelvises that enable us to walk. Our species is different from other mammals in this regard and although plenty enough will go onto give birth without major issues, a large enough proportion to worry about will not.

No amount of 'getting in the zone', 'relaxing', or 'preparation' will ensure that that some women will not encounter problems. You are sadly falling into the 'natural fallacy'. It can certainly help, but it is largely down to luck. Also, the attitude of Ina Gaskin et al sadly promulgate a myth that if you didn't have an empowering, pain-free birth, you have 'been failed' or you have 'failed'.

Nonsense. You predominantly were unlucky, with other factors, such as too-early interference, not being able to move about etc, not having 1-1 midwifery care playing a role.

I have a obstetrician friend (sadly in the US otherwise I'd use her services) who is pro natural birth but in a long discussion explained that things go wrong, get stuck, don't go to plan -- however many caring doulas, birth partners, hypnobirthing cds, one-on-one midwives are in the room. And that these problems are fairly common.

"and yes, it is painful but then life is also hard isn't it? we go to the gym/running and that's painful, we work hard to get promoted and that's mentally and physically painful to some extent - so don't you think it's reasonable we'd have to 'work' a little to birth our own babies?"

I've read some bollocks in my life, but that is one of the most odious, wrong-headed, patronising sentences I have ever stumbled upon.

And totally contradicted by your next graph about CS being a major operation riven with potential complications.

I don't normally do ad hominens, but you are being an idiot.

i just wanted to encourage those women who don't feel they can do a natural/vaginal birth - this is a natural process, our bodies are MADE to give birth

Absolutely, with about a 20% attrition rate. Also, don't forget that it's utterly unnatural for women to be having their first child in their late twenties/thirties- fifteen is about the "natural age" to be having a first child, and Obstetricians agree that older women tend to have longer, more complicated and more painful labours than younger women.

OP FWIW, I do know 2 women who basically had CS because they didn't fancy a vaginal delivery.

'also i just wanted to encourage those women who don't feel they can do a natural/vaginal birth - this is a natural process, our bodies are MADE to give birth and it is a process that can really empower a woman'

Our bodies are also made to walk but some people can't walk.

I don't feel I can't give birth vaginally in my personal circumstances I know I can't.

'so don't you think it's reasonable we'd have to 'work' a little to birth our own babies?' Oh worked at trying to give birth to dd, I really worked at it. I lost count of the number of times the MW said 'you are 10cm dilated now not much longer we'l give it another couple of hours. Well we kept giving it another couple of hours again and again. Until dd's heart rate dropped below 50. How so fucking lazy of me not wanting my dd to die. I was in labour for 4 days and 2 hrs btw contractions from 10min down to about 30seconds apart. The 10min between stage only lasted the first 12-14hrs after that it was generally 2min or less with them becoming progressively stronger. Still I ended up with a section, I'm a lazy fuck up with no idea of what my body's meant to do. In all this time dd didn't just get stuck she never entered the birth canal.

Due to my pelvic deformity it will happen again so I am so lazy that I have decided I want my baby to live and that I don't want my dd to be left motherless (I nearly died too the last time). How pathetically stupid and selfish of me.

otchayaniye - i totally agree. i am not trying to blame women for not having vaginal births or wanting a CS, i totally agree that a lot of other issues come into play, like you say - some are simply luck, and others are to do with how the birth is handled by the professionals.

and i don't mean to imply that anyone has 'failed' at all, i just think women should be more informed about the reasons why a vaginal birth is a positive thing, but obviously everyone can then make their own decisions.
i just feel like a lot of women are maybe scared or fearful and that they should be helped to feel like the pain of birth isn't going to kill them - and that is might be worth it, that's what i mean when i say we need to 'work' to give birth - not meaning to be patronising at all, i just feel like noone on this thread had voiced that point of view!!
no reason to call me an idiot though :))

I know a great many women who have CS and do not any who had one because they "chose" to.

People's perception and willingness to accept the risks of childbirth may vary wildly, leading to one doctor and mother deciding on a CS where another set may adopt a more wait and see approach (eg elective at 37 weeks for breech, vs waiting to see if the baby flips, or elective at 37 weeks where there has been a previous very late stillbirth).

If you are 40 and this is pretty much your last attempt at a live birth, you may feel very differently in the same set of circumstances about the risks of natural childbirth than if you are about to have out your 3rd at 30.

'franlib' I didn't call you an idiot. I said you were being 'idiotic' about this. But yes, I ought to apologise as I don't think it furthers my case and I don't want to be offensive to you! My point that you are misguided and ill informed still stands.

I think plenty of the women on this thread have been very vociferous about the hard work they went through in labour before having to resort to a section, which in and of itself involves significant (although usually/often not disastrous and life-lasting) sacrifice from the women.

I think it is DEEPLY patronising to suggest that women are being scared into sections in a wholesale manner and are largely ill-informed. Most of the women on this thread and on the childbirth board are not ignorant first-time mothers in the thrall of a white coat and buckling at the knees at whatever they say. They do their own research, speak to others and make what is often a very difficult emotional decision in an area where it is hard to be purely rational about it.

As it happens, taking a look through the Childbirth section you will find there are plenty of women feeling bulldozed into vbac instead of repeat section, which rather weakens your argument.

Are you an obstetrician or a midwife?

Time to trip this out again. If you scroll down to the pelvis and baby's head diagrams it explains a bit better why modern humans struggle with childbirth and need more intervention than other species. Whilst this may ultimately be our undoing as a species, we are very lucky to be clever enough to be able to circumvent nature when necessary.