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?

This article is so wrong. Pushing is the posh thing. Lucky for me, I'm not posh. So I have had 3 sections.

I always thought that the reason for the major rise in cs rates overall was due to emcs rather than elcs. Does anyone have any figures which show this? It's quite easy to see why that would be. More inductions regularly booked at early stages leading to unsuccessful labour and "failure to progress", women left completely unattended, unsupported because there are not sufficient mws (1 for 4 ladies in my experience) so they are left hooked up to a monitor and again "failure to progress". Also a loss of knowledge on how to deal with breach births or anything slightly not normal. And finally (and not a bad thing) more concern in high risk cases and fear of litigation meaning that a conservative approach is taken which leads to early inductions/elcs.

I had an emcs after a failed induction at just before 39 weeks for type 1 diabetes. I would very much like to vbac this time (my recovery the last time wasn't great although not in the league of some of the bad vbs on here) but since I'm expecting twins, am a vbac with failure to progress and because of type 1 diabetes eviction date is set at 37 weeks plus would be heavily monitored ie strapped to the bed it does seem unlikely to occur. However, the most important thing to have at the end of the day are healthy babies and healthy mothers and whatever is going to achieve that is the best way to go. Obviously that will be different for everyone else.

Men just looking for some new way to make cuts on the nhs without affecting them. Epidurals are expensive let's axe those - maybe it's time for some men to watch those great episodes of Coupling.....

Also, I don't buy the whole "the pain doesn't actually harm you. You won't die- embrace the pain" bollocks.

Getting waterboarded doesn't actually harm/kill you but it doesn't mean it's empowering.

Oh I'm not scared of the pain, I just would prefer not to die and I do know it wouldn't be the pain that killed me. I also understand how the body works and what it is meant to do. I understand it so well that I realise that it sometimes doesn't do what it is supposed to.

I had 3 vaginal births and a crash CS, in that order, so I can definitely attest that when a CS goes well, as mine did, it is a lot less painful! If you get problems (infection, suture rupture etc) they are often a lot more shit than problems after a vaginal birth.

The only thing I would add is that the hormonal rush, so strong after the VBs was non-existent for me after the CS - the whole gazing at your baby in wonder and amazement just did not happen. That could be very upsetting and damaging in other circumstances. I just felt numb for weeks. Luckily for me and for DD3, she was so very loved and wanted and waited for before she even got here that I bonded with her anyway. You cannot underestimate the power of those hormones it the whole process.

Oh I'm not scared of the pain,

I am or rather I wasn't, until I got in there and felt like my right leg was being ripped off my body. I think I might have been racked in a former life.

no i'm neither - i work as a doula and teach yoga for pregnancy - but what i said on this thread is my personal view, i don't expect anyone (let alone my clients) to believe or follow it, and i don't like to preach.

and yes i think maybe i was a bit too forceful about the whole issue simply because it worried me noone had brought it up!! but i realise that most women are informed and make decisions based on what they think is best, so apologies for sounding patronising or judgemental, that was not my intention at all!! i guess it just came out that way because i feel quite strongly about the issue..
anyway, i am training to be a midwife starting September, so I'm sure my views will change based on what I learn..

and duchesse - i think you are right to bring up the age issue, and the fact that many women have their first child after 35, which does change things a lot.

YANBU. But why are you wathcing Kyle when HUTH is on??!

'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. '

What a load of twaddle. You don't have to 'rebuild them from nothing'. They don't vanish! They do heal.

My abdominal muscles split during pregnancy with my 2nd and 3rd and it very much affected my posture and health. I had to go to physio.

And what TheBride said. We traded bipedal locomotion and larger brains for being able to give birth like chimps.

So franlib would you have advised me to keep trying when I had been fully dilated for hours and my dd's heartbeat had dropped to under 50 and her head hadn't even entered the birth canal yet. Just in case you were wondering they had not long hooked me up to the monitor and I had to lie down as after 3.5days bouncing on a birthing ball and pacing the floor the lazy bitch in me had no energy left.

'The only thing I would add is that the hormonal rush, so strong after the VBs was non-existent for me after the CS - the whole gazing at your baby in wonder and amazement just did not happen.'

It didn't happen for me, either, with any of them three vaginal births. I had PND every time.

Your abdominal muscles are not "sliced through" during a CS. They are torn by hand, which makes it a lot easier for them to heal.

Your skin is sliced through (nice neat scar, assuming no infection).

"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. "

This is worrying, you profess to being a doula and yet are woefully misinformed. I thought Doulas had some sort of governing body?

3 sections in, my posture has not been affected. My abdominal muscles all of which incidentally were not "sliced through" are all in tact, and so are the nether regions. They do cut through some layers, and of course through the uterous. But the major (verticl) muscles are separated by hand. It is more like tearing them apart, and it heals much better than a slice through vertically. Years on, my only section side effect are the scar and its a bit itchy sometimes. There is so much scare mongering about section. If you go to a good cleanhospital and get a good consultant it seems realtively straightforward. That's my experience, anyway.

Whilst I don't ever fancy experiencing vaginal childbirth, I do so love a good run. Somehow I don't think the two are really comparable.

You still haven't answered my question franlib what should I have done.

franlib- I sure hope your views do change while you qualify or you're going to be one of those heart-sink unsympathetic midwives. And I for one am jolly thankful for c sections and antibiotics without which neither my daughter nor I would be here now. Mother nature would have left my three older children motherless.

"'The only thing I would add is that the hormonal rush, so strong after the VBs was non-existent for me after the CS - the whole gazing at your baby in wonder and amazement just did not happen.'"

I'm sorry it didn't happen for you. But just to add a different anecdote, I DID feel that rush (but then they'd given me a massive injection of oxycontin) and had no problem breastfeeding and am still doing it 2-1/2 years on while heavily pregnant.

Preparedness, the right mental attitude, relaxation can probably help the soft tissues but it can't help bones move.

I actually think it's empowering rather than disempowering for women that there are safe (albeit, maybe not 'nice) ways to get a stuck or distressed baby out in an emergency.

And then to realise afterwards that often (I won't be so presumptuous as to say always as I've read enough badly handled birth stories) it was just plain bad luck and an awkward situation that was the major cause and that so many women have problems because of pure body shape/baby shape and that they didn't do anything wrong, they didn't fail womanhood, motherhood or their babies.

That's empowering. Not to be told by a doula that you 'weren't informed', that 'poor you, you were pushed by the nasty men doctors' or that if you'd breathed properly or done some stretching in advance would have meant things would have been completely different.

franlib I appreciate that your heart is in the right place and I expect you've helped some women have the birth they were after. I don't disagree with doulas and feel that on balance the NHS should promote natural birth even if 20-30 pct end up requiring surgery. Simply because it's a matter of public health rather than an individual basis (which private can do, and contrary to your outdated presumption, they are not all scalpel happy either, they might just put maternal preference higher up the list of factors to consider).

But your view on this seems naive and well, it comes across to experienced mothers (do you have your own children?) who haven't had a smooth natural birth as judgmental and patronising. Even if you don't mean to be. And an important part of midwifery is to see beyond your own views and empathise with the patient.

If you are seeking a career in midwifery and I wish you all the best I think it would be a good idea to read what NICE says about natural birth and caesarians, what the Royal College has to say and also take a long read of childbirth forums to realise just how high the proportion of women who encounter difficult situations is. It's not small. It's not ignorable and breathing isn't going to make a jot of different.

Many, won't want to come across views like yours in a birthing situation. Luckily my childbearing years will be behind me.

franlib I am still interested to hear what you think I should have done and in what way I wasn't prepared to work to have my baby. I have had to listen to 6 years of people telling me I was wrong and a failure yet not one person has adequately explained what I should have done and how I could have changed things. You seem so sure of how it can be done, please tell me.

I think the phrase, too posh to push, is aimed at those too scared to go through the pain of childborth. Only its a stupid phrase. These individuals aren't 'too posh', they are actually uneducated, lacking knowledge of what the human body is capable of. They should all be given a copy of Ina May's book on childbirth.

And I do know someone who argued with the NHS for an ELCS. Their primary reason was that big babies 'ran in the family'. The NHS put up a fight but caved eventually, probably fearing a law suit should their coincidentally be any complications with VB

Sayasitis, you're assuming (wrongly) that elective c sections at the mother's request are from badly informed, cowardly women who should be told better. How utterly patronising, ignorant and offensive.
There are many reasons why women request ELCS not least of which is a poor, painful, frightening experience first time round, attempting a vaginal birth. Or being scared witless by the terrible experiences of her friends/mother/sisters. Or having gone through such a tough time to even stay pregnant that the thought of any more unknowns/variables is too much to bear.
ELCS can be a lovely, calm, positive experience, and absolutely the right choice for some women without a physical requirement.
It is YOU that is ill-educated, and by spouting such foolish notions you erode womens' rights and choices.
And if you knew ANYTHING about Ina May Gaskin you would know that her teaching focusses firstly on the woman's emotion and choice, NOT on forcing her into situations which may be utterly unsuitable for her as an individual.

xstitch - perhaps some 'faith in your body', saying some namastes and taking a few deep breaths would have helped you ...

And maybe this 'education' (some fool up above mentioned 'uneducated') could have saved the 100s of women my friend (US obstetrician) had to deal with who suffered fistulas during births handled solely by village midwives.

Could save the NHS millions. All this breathing air and stretching.

There is about a 20-30 percent attrition rate (as someone mentioned above) given our evolutionary path. The NHS rightly sees 70 pct having a natural (though this includes assisted) birth as good odds for them.

For the individual woman, some will feel that a 1-in-3 or 1-in-4 chance of an emergency operation isn't good odds for them, because, as BagofHolly says, they may have known family members suffer trauma, they may be at increased risk (such as me, for example), or they may have gone through umpteen rounds of (perhaps they didn't have 'faith in their bodies to conceive'?) rounds of IVF.

And maybe this 'education' (some fool up above mentioned 'uneducated') could have saved the 100s of women my friend (US obstetrician) had to deal with who suffered fistulas during births handled solely by village midwives (I meant to add in Sudan, when she was over there)