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?

Not quite, but I do know someone who got to 1 cm dilated, could n't take the pain and demand a CS. She got it. Monte Carlo, private medical care.

sorry tatty I didn't mean to put words in your mouth my apologies

inastateofreflux I agree that the word elective tends to sound a bit like there's not a proper reason for it, and that creates a damaging impression that the media like to seize on and construct a stereotype around.

I also think there's a problem with people bandying round the phrase 'medical reasons'. natto it sounds very much like your friend did have medical reasons. Surely that can include psychological factors. And if you get a consultant to agree to it, then there must be medical reasons, even if some are less obvious and more borderline than others. What else are these women doing, bunging consultants brown envelopes?

People shouldn't get so worked up about ELCS. I think it was inevitable that the rates would start to rise again (if indeed they are doing) when the rates of EMCS inevitably go up as more women are persuaded into trying VB when in the past they wouldn't have been. Remember that case on OBEM of that poor young woman who laboured for days with a baby they knew was huge before they finally went for a CS? Shouldn't have happened that way.

yes i know 2 women who have had ELCS because they couldn´t understand why you wouldn´t take that option vs vb. Both private though.

No worries Chunky.

I've been quite outspoken on other threads about a woman's right to choose and make an informed decision, from evidence based research, knowing the risk to herself and her baby of c-section but also the risk of vaginal birth, and indeed of VBAC specifically.

Nobody ever seems to mention the risk of vaginal birth and that gives me the irates.

I know one woman personally who BEGGED her (male) OB for a section for her second twin boy, since the same twunt of an OB had insisted that she carry largish twins to term. She had delivered the first one naturally and was exhausted. He refused. The baby was deprived of oxygen and is quite badly damaged, she cares for him, his brother, an older child and a DH who has recently been taken ill. They have been told that they will probably win their case against the hospital but would swap the money any day for a healthy child.

C-section on demand? Tell me where? This poor woman couldn't even get one for clinical need!

My first dc was born 2 weeks early by ELCS. Pre-eclampsia plus breech position, and blood pressure too high for inducing birth to be safe. I managed VBAC for dc2 and would opt for VBAC for any future dcs but still get people throwing the "too posh to push" line at me.

"inastateofreflux I agree that the word elective tends to sound a bit like there's not a proper reason for it, and that creates a damaging impression that the media like to seize on and construct a stereotype around"

This is SO true. I mentioned earlier in the thread that for my 2nd child I had placenta praevia. This is actually a VERY dangerous condition (or can be) that can see you hospitalised from 32 weeks, or earlier if you have a bleed, you can bleed to death, for a grade one the operation has to be performed by the most senior consultant, and if often done under general anaesthetic apparently due to the complexity of the surgery and, according to an anaethetist's web resource that printed various NICE guidelines etc it was often preferable not to have the father in the room at the time of the surgery or have the mother awake due to the fact that if things go wrong they tend to go very wrong!

Its particularly bad if your placenta is stuck to your old scar, as there are less safe places to cut you. At one point they were talking of me having a classical incision but after a dildo cam internal scan at 36 weeks this was deemed not to be necessary.

Anyway, despite all that malarky that had me getting my affairs in order just in case (!) it was still recorded on my notes as an "elective section" which was, to be fair, exactly what it was. I elected not to die!

It should be noted that you are much more likely to suffer from this condition in subsequent pregnancies if you've previously had a section, which I had - though the first one was an emergency. C-section risks also include risks to future babies - whereas vaginal birth tends not to, even though technically for that birth the risk of the baby dying is more (slightly) for a vaginal birth...

What Jordan said.

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

How about instead offering a guarantee of 1-1 midwife care, of adequate pain relief as the labouring mother sees fit in a timely fashion, of decent postpartum care.

That would go a long way towards pushing down the rates of women terrified to give birth in conditions approaching the developing nations.

Bididbidi - it is not true that most of damage to pelvic floor is caused by pregnancy itself. What is your source of evidence please?

When I was pregnant (several years ago) I found a research paper that showed much lower rates of urinary incontinence among women who had never had a vaginal birth.

Exactly Tatty. And yet there will be some idiots who think you took some sort of easy option!

Also agree with what you say about the risks of vaginal birth. I'm thinking about an elective for my second after a third degree tear with my first. I'm tired of hearing about recovery times after CS. When you've had a torn sphincter that takes 40 mins to stitch up and you're bottom still doesn't contain things like it used to 2 years later, you know a little bit about 'recovery time'. Sorry about the TMI but 'too posh to push' just drives me crazy and I think we need a few more facts and a few less silly phrases.

Your bottom.

I know one person who had 2 ELCS privately for no medical reason, and another who was terrified of childbirth as her own mum had nearly died in childbirth.

Everyone I know who had one on the NHS was for a 2nd baby,after having an EMCS 1st time round.

I struggle to see why women who simply want to keep their perfect bis in place should be able to elect to have a c/section and further stretch an already streched NHS. If someone is scared/traumatised then that is one thing but saying it's becuase they may wee a little when they laug' or that it is inconvencient is in my opinion unacceptable - uif these things are so important to you then you should pay prviately or otherwise don't have children.

Again, I do not include here those with geniuine medical reasons.

parakeet: this article which cites a number of studies, suggests that pregnancy is the main cause of pelvic floor dysfunction; but that pelvic floor damage (and any associated dysfunction) is, of course, associated with vaginal birth.

HTH.

Taking two years + to recover from a vaginal birth is not normal though and probably says more about your care than the mode of birth. Almost five years after my first section I haven't physically recovered from it and I'm not likely to. That's not normal either so hardly proof of how bad sections are.

In my case everything was unavoidable, I was 31 weeks, in labour and only delivering membranes, I'd previously delivered a baby footling without the water breaking until it was done outside so they knew I could do it again the difference was the first one was not old enough to be saved whereas this one was old enough to be killed by that birth. Ideally for the problems I had a vaginal birth would have protected them from getting this bad but it wasn't possible.

I do know one person who had a CS because she did not want to "damage her vagina"

She was an aquaintance i knew from being a teenager who was still friends with my best friend. I saw her a few times duing the pg as we were pg at the same time and under the same consultant, infact we bumped into each other in the waiting room sometimes.

She happily told me that she had been hysterical with him, saying that she could not possibly give birth naturally and that she was terrified etc etc. He seemed to take her at her word and she had a ELCS on NHS.

Don't think it is that common, but it does happen.

Just like to point out that most women do not do pelvic floor exercises properly and in fact end up damaging it by not doing it properly, so that possibly has far more to do with pelvic floor weakness/ incontinence than childbirth.

Hmm I carried twins of very nearly 7lbs each full term then 15 months later had my 8 lber dd(both by ec/s), my pelvic floor is in tip top condition. If anybody should be weeing without control if heavy pg causes it it should be me.

I know someone who had quite a traumatic birth first time and wanted a cs next time. Nhs told het absolutely no way as she did not have medical grounds to have cs. I have heard other similar stories, but dont know them personally, so doubt very much nhs would gve cs as someone is to posh to push.
I hate this view, I had an emcs as ds1 nearly died after I had been left pushing for 3 hrs. I have been asked a few times jokingly 'were you too posh too push?' I can't describe the intense feeling to wallop the person

The friend I mentioned was NHS too and having her first child, I think the consultant took some convincing but she got her ELCS in the end. It does happen.

Tut tut, MilaMae - you should know that the plural of anecdote is not data!

I think - like all things - it is not an "all or nothing" scenario; just because some women have heavy pregnancies does not disprove the association of pregnancy with pelvic floor dysfunction; it simply means, I suppose, that they were fortunate not to have "congenitally weak connective tissue and fascia" (as that link so eloquently puts it! ).

I asked for a CS - I don't think was being 'too posh about it' but was absolutely terrified of a vaginal birth & being in my 40s thought they might offer me a CS - I was refused one without any discussion but ended up having an EMCS (which I was very pleased about and had no complications at all) - had I been allowed an elective CS it would have no doubt saved the NHS a lot of expense !

Sorry, that should read "some women have heavy pregnancies an no pelvic floor dysfunction"...

Skimmed the thread because I am on my way out but I read about this in the Independent this morning and my understanding of it was that it was suggested that women who are frightened of birth and request a CS because of that should be offered counselling to help address their fears rather than just agreeing to a CS straight off.

It was saying that CS rates have increased and was looking into the reasons and possible solutions, including counselling for women who have a fear or misunderstanding of what birth will involve.

That seems quite sensible to me.