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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To ask how many people have asked for a cesarean out of preference?

457 replies

VioletteValentia · 12/03/2018 07:36

I did it. I’ve never met another person who has, or who has admitted to it. I have come across people who seem convinced that supporting maternal choice would lead to everyone asking for cesareans, which I think is bullshit. Not everyone wants one!

Did you do this? Would you? Would you be more likely to if you felt the option was equally acceptable?

I’m interested in how many women feel like I did.

I shouldn’t have to say this but...no “natural v cesarean” insulting please.

OP posts:
VioletteValentia · 13/03/2018 20:09

Unless you have a cesarean! Wink

OP posts:
ChocolateWombat · 13/03/2018 20:23

If c-section was cheaper, no I wouldn't be suggesting everyone has a c-section.

I absolutely haven't said cost should always be the determining factor and said several times that anyone requiring a c section should have access.

My question is quite simply, whether there is a right to have a c-section for any reason whatever? Clearly c-section isn't the natural way and whilst I totally accept that the natural way would result in far more fatalities that we obviously don't want to return to, and that many women need a c-section, I am simply wondering whether it should simply be a matter of choice, because 2 options exist and whether natural is to be encouraged when there are no clear medical needs for c-section and extra cost?

In the end, with other procedures, there isn't total free choice. There are drugs which are not available to all patients because of cost and we don't apply the idea that there should be total free choice of treatment regardless of cost to most other treatments......so I just wonder why this?

Is woman's right to choose c-section the same as the right to choose abortion for example....or is it different? In reality, we don't actually believe in total free choice (without personal financial implication) in many areas, so I wonder why this one, if there is no medical need? And again I'm not suggesting anyone who needs a c-section should be denied one.

VioletteValentia · 13/03/2018 20:28

My question is quite simply, whether there is a right to have a c-section for any reason whatever? Clearly c-section isn't the natural way and whilst I totally accept that the natural way would result in far more fatalities that we obviously don't want to return to, and that many women need a c-section, I am simply wondering whether it should simply be a matter of choice, because 2 options exist and whether natural is to be encouraged when there are no clear medical needs for c-section and extra cost?

Why does it being natural mean that vb should happen? Why should I, or anyone, be forced to give birth vaginally if our reasoning is we don’t want a vb or find the risks too severe?

OP posts:
Beetlejizz · 13/03/2018 20:30

Would you mind elaborating on why you wouldn't advocate that the approach you want for ELCS now be mirrored for VB if ELCS were cheaper chocolatewombat? And it may well be, so you really shouldn't be predicating your arguments on the idea that offering ELCS costs the NHS more. The evidence for that simply isn't there.

MarthasGinYard · 13/03/2018 20:34

As I said in Pp

I had my natural birth

An ELCS

Beetlejizz · 13/03/2018 20:36

If we want to make comparisons to other medical situations, the best analogy anyone's come up with so far is this from user upthread:

A man has a broken leg. He knows there are some risks associated with leaving it to heal naturally. Some of these risks would have a long term negative impact if they were to materialise and could affect him on a daily basis. He also could have an operation to repair his leg. This too has different risks associated with it and would generally involve a longer recovery time, however the risks are more known. Both options cost the NHS around the same amount of money if you factor in the costs of said risks materialising at a population level. The man assessed the risk profiles associated with both options and chose surgery as he felt more confident that this approach would work best for him.

Birth is rather closer to this than it is very expensive drugs, for example.

nowater34 · 13/03/2018 20:41

What do people think about CS & the increased risk of asthma/allergies/obesity etc?

IMBU · 13/03/2018 20:43

I did after I very nearly lost my first baby and ended having an emcs. The ELCS was a breeze and recovery didn't take very long at all. I had no regrets

ChocolateWombat · 13/03/2018 20:44

If a surgical operation can be avoided, and is not needed for medical or mental health grounds, why should a natural process (vaginal birth) be avoided?

Are you saying that there should simply be free choice, absolutely regardless of reasons? For example, would choosing c-section because it is possible to state which day baby will arrive on, unlike the uncertainty of vaginal birth, be an acceptable reason, because simply any reason is acceptable? And I think this can only be answered by also considering if this also applies to all other medical procedures too - are people entitled to absolutely free choice of procedure, regardless of cost or reason?
And following the logic, do you think that at their booking in appt. women should there and then be offered the choice of vaginal or c-section? Is the fact that this doesn't happen, denying them their fundamental rights to choice?

Again, I believe anyone who needs a c-section should be able to have one.

Makes me think of another question - similar but different. Most babies are conceived through sex. If you don't want to have sex (assuming you have a partner who you might be able to conceive with) - would it be reasonable to expect to be offered IVF on the NHS so you didn't have to have sex with your partner? Is it your right to choose this alternative route, if the standard route is available to you - again, not for medical reasons such as genuine terror of sex, but just because you'd prefer IVF?

Is there a difference between this scenario and wanting a c-section? Genuinely interested.

Beetlejizz · 13/03/2018 20:46

The evidence that pre-labour ELCS increases the risk of those things isn't there nowater. If there were robust evidence indicating that, or indeed any other risk, women should be advised about that as part of the informed consent process.

nowater34 · 13/03/2018 20:50

Beetlejizz It’s just what my surgeon friend told me, she said research suggests its linked to lack of vag bacteria.

ChocolateWombat · 13/03/2018 20:51

I don't know the full costings of vaginal birth vs c-section.

Just to clarify, medical grounds aside, are you saying that if there were no difference in cost, free choice should be given?
And are you suggesting that medical grounds aside, if there were a cost difference, there would or would not be justification for free choice?

Just not quite clear if you are saying free choice because there is no cost difference, or free choice as a matter of principle regardless of cost.

IAmADancer · 13/03/2018 20:52

I had an elcs and have absolutely no problem in telling people. I’d had a difficult pregnancy with twins, my body was not equipped to carry two babies and I fought tooth and nail to have what I felt was the safest birth for me. If I had to do it again I would choose an elcs, it was calm, well managed, efficient, not remotely stressful.

ChocolateWombat · 13/03/2018 20:52

And again, is anyone suggesting that at their booking in apt, all women should be offered a choice of vaginal or c-section birth, as a matter of course?

ChocolateWombat · 13/03/2018 20:53

Did you have to fight tooth and nail for an elcs for twins?

VioletteValentia · 13/03/2018 20:59

I think it should be free choice, yes. It being a natural process doesn’t matter. It’s not a risk free or pleasant process - it is unpleasant and risky.

Regarding IVF. I struggle to see a scenario where someone would want IVF as a choice and not have a mental health problem. Sex, with a long term partner, is not usually a health risk or unpleasant. The only situations where it would be would be previous rape, or physical illness, or something like HIV. All of which should qualify you for IVF.

I think people forget a vaginal birth is a risky procedure too.

OP posts:
VioletteValentia · 13/03/2018 21:01

And again, is anyone suggesting that at their booking in apt, all women should be offered a choice of vaginal or c-section birth, as a matter of course?

I think the risks of vb should be discussed in the same way the risks of cesareans are

OP posts:
tenbob · 13/03/2018 21:01

What do people think about CS & the increased risk of asthma/allergies/obesity etc?

I think that some people don't understand the difference between correlation and causation

What do you think about it?

laddylonglocks · 13/03/2018 21:01

Yes it should be a choice at the booking appointment, with full pros and cons of both presented.

Beetlejizz · 13/03/2018 21:04

If a surgical operation can be avoided, and is not needed for medical or mental health grounds, why should a natural process (vaginal birth) be avoided?

There are a number of problems with the way you're framing this. First of all, you're assuming that the natural process should be the default. But as you have admitted yourself, you don't think natural processes are generally better per se, so really you would need to provide an explanation as to why you're doing this with birth. Privileging the natural simply because it is natural is illogical, and given that nobody does it in relation to everything, it's inconsistent.

The reality here is that there are two possibilities with their own risks. VB has more risk of tearing, incontinence and dystocia. CS has more risk of future miscarriage, stillbirth and pregnancy complication. It is simply a question of balancing the risks for each woman: that is the only appropriate way to frame this. If you're talking about need, you're doing it wrong. I mean really, who are you to say a woman doesn't need to reduce her risk of prolapse, for example? Or to eliminate the possibility of shoulder dystocia? Why is someone's anxiety more important than someone else's continence? It's at best an absurd construct.

Are you saying that there should simply be free choice, absolutely regardless of reasons? For example, would choosing c-section because it is possible to state which day baby will arrive on, unlike the uncertainty of vaginal birth, be an acceptable reason, because simply any reason is acceptable?

Certainly. All pregnant women with capacity should be given the choice. It's interesting that you mention choosing the day here as a reason in that you seem to be presenting this as perhaps a less 'good' reason? Unless I have misunderstood. But actually, a woman might have existing children who need childcare, she might only be able to rely on family support at a particular time. So choosing the day is a fantastic reason! Could reduce her risk of PND, since we know this is more likely when there is no support.

And I think this can only be answered by also considering if this also applies to all other medical procedures too - are people entitled to absolutely free choice of procedure, regardless of cost or reason?

You're allowed to think that, but given that it's not at all analogous to this issue I consider it to be an unhelpful distraction. I posted what I thought was the appropriate comparison a couple of posts ago, and in that scenario yes the broken leg man should certainly have the right to choose.

And following the logic, do you think that at their booking in appt. women should there and then be offered the choice of vaginal or c-section? Is the fact that this doesn't happen, denying them their fundamental rights to choice?

No, later than booking in would be better. Yes.

Beetlejizz · 13/03/2018 21:10

Research doesn't do a good enough job of separating EMCS and ELCS nowater, or of controlling for confounding factors. For example, being asthmatic increases your chances of EMCS and asthma can be hereditary.

There are people swabbing CS born babies with their mother's vaginal bacteria though. I believe attempts are being made to research whether this has any positive or negative impacts.

ChocolateWombat · 13/03/2018 21:33

Thank you for answering my questions.
I haven't heard these views/arguments before. They are an interesting angle and a counter argument to the prevalent natural birth lobby.

I will think about it some more.

Regardless of the efficacy of the arguments, I think it is clear that many women think they can only have a c-section on extraordinary grounds, not by request. I also think that the majority of the population accept this. And I also think that most women, whilst seeing giving birth as something rather unpleasant in many ways, also see it as a key experience of becoming a parent and embrace it, even if rather fearfully. I don't think we are at a point where most women would choose a c-section - that's not to denigrate the choice of many or the need of many to have one, but most see a natural birth as preferable if possible, in the same way that many see breast feeding as preferable if possible.

Thanks for clarifying your views and reasons. I can see the logic (although I don't know the figures and if the 2 are absolutely comparable on cost) and clearly the argument runs counter to what society is generally saying about childbirth. Interesting.

IAmADancer · 13/03/2018 21:35

chocolatewombat* yes as the consultant was determined to make me deliver naturally. She wrote on my notes in my first meeting with her that I was hysterical. I was very upset as she flatly refused my request but I was really struggling with the pregnancy and was on crutches by five months. I then had to go back for another meeting where I went armed with research I had done and she eventually gave in. It was pretty stressful.

espressotogo · 13/03/2018 21:37

I did it -I had a phobia of natural birth - my consultant explained the risks and said I was an intelligent adult and was entitled to make my own decision based on the information he gave me. I was happy with my decision.

boboismylove · 13/03/2018 21:39

I gave birth in a developing country with 40% C section rates - I heard the reason why is that struggling hospitals actually find it easier than dealing with complicated deliveries and a lack of midwives.

The problem is that lots of people there have crazy amount of kids - at least four, so it gets quite risky. The best argument I've heard against C sections is if you are planning for a big family...