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?

FFS. The phrase "yummy mummy" comes out in the first sentence.

I have yet to meet a yummy mummy either. Most of my friends, and myself, were far yummier before they had a dc!

PollFlanders - the term ELCS refers to any CS that is planned and not done as an emergency. It is commonly misconceived as one that is "chosen" by the mother. This is not necessarily the case, and is the reason for a lot of this controversy and confusion IMO.

TBH if a woman doesn't want to risk damaging her body through childbirth she should be allowed to choose anyway

but c sections can damage your body too. i was left with horrendous scarring after my 2nd one... in fact it was one of the reasons why i had an elective with dc3, because i wanted the damage repaired.

If I had been guaranteed 1 to 1 experienced and competent midwife care throughout the time from being admitted to several hours after the birth (when monitoring of post partum mother is stopped) it would have saved the hospital the cost of an "unnecessary ELCS" .

My friend's husband had to go out in the corridor looking for their midwife, any midwife in fact, and literally beg them to come when his wife got into difficulties during her labour. She ended up with an emergency CS after a difficult labour and baby was kept in hospital for a week after the birth, sent home and then re-admitted as an emergency. I was pretty much the last one of our friendship group locally to give birth and I had not been impressed with the care my friends received. Two couples received apologies and one case for medical negligence is still ongoing.

If the hospital reserve the right to dictate and provide the quality of labour and delivery care they deem "adequate" I reserve the right to go straight for a surgical birth instead.

I wasn't too posh to push, but was clued up enough not to gamble with the service available and had no suitable local access to private hospital offering labour and delivery facilities plus I would have resented having to pay again for something that should be free at the point of delivery.

Women can kick up a fuss and insist on a home delivery which gives them a better midwife care ratio than a hospital delivery but wheras ELCS is seen as too posh to push homebirths are not seen as too posh to go to hospital with the rest of the public. Lots of women cite fear of hospitals and/or home circumstances regarding childcare of older children in their case for homebirths. Mine was fear of the quality of care I'd get and a bonus was being able to plan maternity leave/paternity leave/childcare round the scheduled ELCS date.

I don't think the nhs will do cs without good medical reason ie - it's in the best interest of mother/baby's physical/mental health.
I've got 2 friends who had cs and it's not the easy option at all.

Having just had an 'elective' cs (baby was breech - I was not given any choice) I can quite clearly state that it is not the 'easy' option. I found it to be a terrifying, uncomfortable and painful experience despite having absolutely no complaints about the care I received. Walking into theatre knowing that someone is about to stick a giant needle in your spine so that someone else can cut you open is the hardest thing I had ever done (and I had a horrible labour and forceps delivery first time round).

The recovery time is also horrible - I could do nothing for 24 hours and very little for the few days after that. We struggled with establishing breastfeeding as we couldn't try different positions - although we did get there eventually. And I won't be able to lift DD1 for another few weeks. Oh, and I feel trapped because I can't drive.

Anyone who does think a CS is an easy option should have the counselling to disillusion them. (although I also think this 'phenomenon' is a myth')

I tried when I was in labour with DC1. I specifically told them I was too posh to push and that I was now electing to have a cs. Didn't work.

" they want to offer women who request an ELCS for non-medical reasons councelling to see if they can help"

The time for counseling is immediately after the traumatic birth, not during the subsequent pregnancy when your anxiety mounts with every passing week, you can't sleep at night because you don't know if you will be forced to live through another vaginal birth, and just entering the maternity reduces you to a whimpering wreck.

The only human thing to do at this point is to offer the CS.

I think the term "too psoh to push" is crap to be honest. As a midwife I never met a woman who elected for a caesarean just because she felt she was above normal (so called) labour.
Poor Victoria Beckham was tarred with that brush and we've had the term ever since. In actual fact nobody except the Beckhams and the medical staff involved understand or know why this was done.
Caesareans are not an easy option, women that end up having them often say the same. They can be a relief after a previous difficult birth, they can be due to a woman petrified of giving birth vaginally and they can be as a result of other issues. Most women recover well but they are not an easy option (I had one and it was okay but took me a few weeks to recover).

Very well put Cote

InAStateofReflux, yes I agree that ELCS is not a term that lots of people understand. I was surprised at the time as I had always assumed 'elective' indicated choice on the part of the mother (bit dense of me I suppose). I felt rather put out about it actually as the last thing I had at the time was 'control' or 'choice' about what was happening to me or her. I do know better now and always treat these stats with extreme scepticism.

I know one person who had an elective cs without medical reason. She was just terrified of a vaginal delivery and managed to persuade a consultant to let her have one. I reckon though with her level of fear she wouldn't have managed a normal delivery without a lot of trauma, and most probably would have ended up with an emergengy cs, guess the consultant thought the same.
I do know of lots of people who've had cs though, but on the advice of medics ie it wasn't their choice!

Until Matthew Wright or any other misogynistic journo has been faced with the prospect of pushing a melon out of their rectum I refuse to acknowledge their right to speculate on the matter.

Wow! Am I the only person who knows women who have paid for a C/Section? I realise that this is mostly about the NHS and section rates,but I know plenty of women who have paid privately for sections. Because they didn't fancy labour. No other reason.
i don't have a problem with that. I think it is a little sad that they think labour/vag delivery is so awful. We need better and more midwives.

PollFlanders - Don't worry I thought exactly the same thing and I am a medical student - I always thought "elective" meant "choice" when in fact it just means "planned" and not emergency.

Just the one woman I've met. But she was having twins and didn't fancy going through a natural birth with twins as her mother had complicated single births. She didn't get it on the NHS though, she went private.

I don't believe anyone can just rock up to an NHS hospital and say "c-section please" with no medical reason just because they don't want to give birth naturally. As I've heard, it's hard enough to get an epidural let alone a c-section.

I am uneasy about giving birth naturally but it's becasue I do PI & clinical negligence law and irrational I know, I've seen some horrific complications. That said I wouldnt' expect the NHS to pay if I wanted an ELCS.

Matthew Wright wasn't on the show, it was done by Nihal today. Though I don't think he's gone through childbirth either.

I was offered an elc this time due to severe pre-eclampsia and hemoraging after previouse 2DC's. They said it was upto me and I have opted for pre-planned induction to help prevent complications and I continue to hope for a vaginal birth.

I see a CS as a complete last resort and as much as it hurts and the stitches in the lady parts are not a pleasure I would not swap it for the world. My own mother had 4CS due to medical reasons.

At the end of the day you have to look at what is best for the individual and if the thought of a vaginal birth truly frightens a woman then perhaps it's best to have a CS and less stress.... but if it's to fit around a schedule then why bother having a baby to begin with, the one thing they don't do is comply with schedules!

"The NHS COULD push down their ELCS rates by putting more resources into women's first birth experience so that SOME women don't end up traumatised, damaged and terrified of giving birth naturally for a second time"

excellent point Jordan. I consider myself traumatised, damaged and terrified by my first "natural" birth. I have just come off ADs and come to terms with the PTSD caused by my DD's birth. I am now considering having another child and wouldn't like to be the consultant who tries to tell me I don't have a good reason to request a CS ......

The backstory is that the NICE guidelines on c-sections are being updated and a consultation on this has been launched. You can give feedback via a stakeholder organisation but not directly. A list of stakeholder organisations and a copy of the proposals is available on their website: guidance.nice.org.uk/CG/WaveR/97/Consultation/Latest

If you feel strongly about this it is worth contacting the policy team at a charity like NCT (or any other stakeholder org which represents your views) to let them know why.

But to be fair to NICE there is no suggestion in the proposed guidance that women are opting to have c-sections for 'bad' reasons. Only that where a woman requests a c-section because she is frightened of vaginal birth the reasons for this should be explored.

So OP YAdefinitelyNBU. 'Too posh to push' is the most loathsome mysogynistic pile of suppurating arse garbage out there. It is bullshit that women opt for a c-section because it is easier. They may opt for it because taking into account their anxiety about the birth, or previous traumatic experiences it is likely to result in an easier recovery for them individually. But the numbers of cases like this are minute compared to the numbers of emergency c-sections so if your goal is to push down c-section rates it is hardly sensible to devote too much energy to forcing frightened women to undergo a process they find distressing.

I asked to have a C-section to protect my perineum and pelvic floor muscles from the damage that so often occurs with vaginal childbirth. Eighty per cent of women either tear or are cut during vaginal birth. The data are less clear on pelvic floor damage but you only need to read the threads on here about "laughing so hard a bit of wee comes out" to realise how common urinary incontinence is among middle-aged women. I shudder every time I see the shelves of Lady Tena pads in Boots.

That for me IS a medical reason to have a C-section.

The decision had to be referred up to the NHS consultant and, once we discussed my reasons, he was totally fine with it - and acknowledged that plenty of female obstetricians (one third according to one survey) make the same choice as me.

Nuillis just looking at what you typed " Didn't want to push baby out and "didnt want my bits being ruined for me and my man".

Wailed and stamped her feet loud enough, got an elsc."

It really comes across as very judgypantsy. Your friend should NEVER had to stamp her feet or wail to get the medical treatment she wanted. So what if she didn't want her v jay jay turned into a wizards sleeve? Its her vjay jay-Shouldn't she have the right to decide what happens to it?

why do the medical profession want to add to the drama and stress of childbirth by making women beg and plead for what they want. (I'm so damn appreciative of my consultant now).

I've had two and just been given the green light to VBA2C. My first was so footling and premature they couldn't reach her so had to cut upwards, they said I wasn't suitable for a VBAC so the next time I had another section. Both crashes as I was in premature labour and they need to squeeze every last minute out of pregnancy.

I educated myself on the risks and benefits and decided that the risk is low and benefits high enough to ask for a VBAC, I would rather have tried so that if I have to have a crash section with GA (I'm not suitable for an epidural) it's for a reason. Surprisingly I have had quite a bit of support from the doctors who had automatically put me down for a section.

If they want to lower the rates this is one place to start! Stop with the "once a section, always a section" line and start trusting the bodies of women who want to try, stop scaring them totally out of it. 5% is low risk and that's the highest risk of rupture which is connected to my rare scar. Most women have less than 2% risk.

I'm not suggesting they push women into it who don't want it but that they should stop the inevitability of sections, stop telling women they don't have a choice.

You do know that most of the damage caused to the pelvic floor is by pregnancy itself, Parakeet, right? The only sure way to avoid it is to never get heavily pregnant at all.

I knew someone (a nurse by trade) who was delighted that her 1st baby was breech and would be getting a C-section. She gave a rather nebulous reason (it didn't sound like a medical reason except previous CS) for 2nd baby getting to be born by ELCS; I got the impression that she had slight control issues and that having a baby by ELCS made her feel more confident about childbirth.

I don't understand why she preferred ELCS, having a truly "elective" C-section would be my idea of nightmare, but to each their own.

Chunkythighs - I didn't say it should be reduced, I said "I think the biggest reduction could be made on those who had an emergency section the first time who are opting for an elective section 2nd time round with no medical reason as such (but simply fears of rupture, wanting to stick with what they know, not wanting the worst of both worlds - i.e c-sec scar AND 3rd degree tear, etc, a well as the fear of another emergency section - if I have to have a section, lets make it an elective, kind of thing)"

Don't put words in my mouth. Read my post, it says I was erring towards an elective section even if I didn't have a medical reason to need one.

I don't think women's birth options should be dictated to them. Never have, never will.

The point I was making was that if they want to reduce the c-section rate, they are not going to significantly do so by targeting the too posh to push brigade, who are generally few and far between and are unlikely to make a significant impact on the stats.

There is possibly "room" for reduction if the made it very very difficult for previous sectioners to have an elective, and some hospitals are heading this way. This does not mean I think they should!