To think the NHS discourages c sections on purpose?

[tablebrush]

I often hear a lot of negatives about c sections (and not usually from women who have had them). You hear how it's not natural and how it's major surgery and how the recovery is awful and how it's all so much worse etc etc
But the women I speak to who have had them often speak of how positive their experiences were and how it was much more pleasant than a vaginal birth.
I understand it is major surgery but giving birth isn't exactly a walk in the park, and can (and often does) leave you with ongoing injuries.
AIBU to think the NHS/midwives put women off c sections due to cost and that they may actually be a better or at least equal, option for birth?

@tablebrush @Pollypanda

Not once did I suggest that there are links to c section and long term adverse outcomes. I actually said there is questioning over the long term effects of a lack of oxytocin at birth. Theory. Questions. Not insignificant ones, that should be looked at and considered when women are thinking about opting for an elective surgical procedure which may not be a medical necessity.

Neither did I state that those who have c sections have any issues bonding with their babies. So please stop reading things into what I've written that weren't actually stated as fact.

Read the work of Michel Odent on oxytocin. It's actually very interesting. Read through the vast amount of research which does show that there are not insignificant risks to unnecessary c sections. It's out there if you can be arsed to look. And then perhaps we can discuss how ignorant and offensive I am.

The neonatal death rate has indeed fallen, the research shows this is due to progress in neonatal care, the increase in c sections isn't even mentioned.

Hard to believe it's only a coincidence. Spain, for example, has traditionally had a higher rate of interventions than the UK, and has a correspondingly lower number of neonatal deaths. Another coincidence?

I had a requested c section after a failed induction. I wasn't dilating and faced days in labor having already been awake for 2 days with contractions coming 4 in 10 with just paracetamol. It was the best decision I ever made. He was a 9lb baby and I'm quite small so I don't think he would have come out without doing serious damage to me.
I was discharged 24 hours after having him. In the long run I would have cost the NHS more when you factor in the bed, medication, epidural I would have needed and after care should I have torn or done serious damage to my pelvic floor. I had zero complications and they never heard from me again.
Women are blanket forced into natural births which isn't right. Every situation is different and every woman has the right to decide how they give birth.

The issue with the cost argument is this is a global trend and health researchers are concerned, not based on cost but concerns for women's health.

They believe about a 10-15% c section rate is what should happen, but the UK and Ireland is more like 30%. The Dominican Republic is at 60%. I don't know about the bonding argument but there is research suggesting being born by c section can affect the baby's gut flora and that is being linked with obesity, mental health etc.

The point is, it's all a concern at population level much more so than individual. Lots of friends have had c sections, epidurals some have had home births. I'm expecting my first any day now and while I won't be having a planned section I'm aware I don't know what will happen and it could be an outcome.

The issue I have is that my likelihood of having a c section seems like it will be different based on which hospital I give birth in, rather than my personal wishes or mine and the baby's health. My two nearest maternity hospitals have quite significant percentage differences in the rate of c sections.

That's the issue I think, and it's definitely not down to cost, but to practices which I don't believe are mother-centred but more to do with hospital policy and clinical practice/experience. There should be much more centering of women's health and emotional well-being during the whole maternity process, and I think if there was there would be a reduction in the current numbers.

To those who are stating that in 30 years women’s bodies habanero changed, that is certainly true but babies have got significantly bigger. Because mostly of better ante natal eating habits, better health in pregnant mothers. I think it might have an impact on the rate of c sections?

I think it's too cheap (for CS or vaginal births) to be covering those things. NICE report is probably immediate costs at point of delivery of baby.

It probably does even out ish. To counter your fab CS experience a friend who had an ELCS had her wound packed daily for over 2 months after and has incontinence -she's told due to carrying 10lb of baby. I have had one stitch, am

Eyup, are you very small? Babies seem to be so big these days! I'm seeing it from the baby end of things, lots of planned sections result in babies not being stressed enough to prepare for life outside the womb, not getting all the fluid re absorbed from their lungs, so they come out needing respiratory support, that costs thousands! Not every woman gets continence problems after a normal delivery.

I think the issue lies in statistics assuming a straightforward vaginal birth experience, when the reality is that this can't be guaranteed. If mothers and medical staff can be certain a vaginal birth will go perfectly then of course it's best, but there are no such guarantees.

My friend was an evangelical vaginal birther but ended up having a terrible time which included long term physical effects and a complete failure to bond with her son. Her next was an emergency section and she had no such trouble afterwards except even more guilt that she can't get over the problems birthing her son vaginally gave her. How do statistics figure into such situations?

It is absolutely, undoubtedly down to cost. I had a natural delivery with my ds- well natural if you class forceps, episiotomy, horrendous recovery etc as natural.
Pregnant with dd five years later and petrified of giving birth, had to literally beg for a planned c-section. I am so glad I did- it was calm, relaxing and simply everything I hoped it would be. The midwives and surgeons were incredible and I was out of hospital the following day.
I don’t blame the NHS as they have to save money where they can but the reason they don’t point out the positives of elcs is cost and cost alone.

Habanero? My best auto correct ever. That should have been ‘haven’t’. Stupid wine.

The NHS should discourage people as it’s a waste of money if a vaginal birth is an option, a vaginal birth is better for baby. I had a vaginal birth followed by a section for my second son. I preferred my c section by miles but if I could of given birth ‘normally’ I would of and would expect my midwife to encourage me to try for a normal delivery.

@Goingonandonandon thank you for your reply, I really appreciate honest answers and advice x

I wish I hadn't had to have a c-section - I was in pain for months afterwards.
And don't believe the hype - the pelvic floor damage starts before you give birth so a c-section doesn't necessarily mean you'll have a bouncy pv !!

My experience was totally different. I had EMCS with my first and elective with my second. Only one consultant ever questioned me on why I wanted a second section. Every other midwife and consultant advised me that a c-section was probably the best option given my experience with my first.

The risks were always explained to me. In a matter of fact way. There are more risks associated with a c-section and for anyone to say otherwise is wrong. That doesn't mean to say they will happen.

But at a time when funds are tight and people are having expensive operations without being medically necessary, I do believe it is right to question the decision.

a friend who had an ELCS had her wound packed daily for over 2 months after and has incontinence -she's told due to carrying 10lb of baby

In which case the ELCS doesn't seem to be the problem, so this doesn't really counter the good CS experience mentioned in your example!

I agree with the OP. When it was clear my DS was breech I was bullied into agreeing to them trying the turning manoeuvre.... the midwife at the time apologised when the Dr left the room and said it was always attempted first because they'd prefer to avoid CSections due to cost. The turning was a nightmare in terms of pain, I ended up being monitored almost constantly for 2 days and ended up with a csection. 🙄

Gah!

...am fully continent etc after 3 8lbers.

Luck of the draw and yes probably does roughly even out in the end financially, though it'd be very hard to do such a long term study. Eg breastfeeding saves money in ear infections, statistically CS babies less likely to breastfeed, do we assess that or just things proven to be related to birth eg pelvic floor repairs.

Lily CS wound needing daily packing was defo CS related! I posted too soon, was trying to illustrate how complex it is and no simple answer. Plenty of horror stories re vaginal birth too!

Everyone always says "its major surgery"...well, yes it is, but pushing a baby out of your vagina is actually pretty "major" in and of itself. The risk and potential for trauma, both psychological and physical, that vaginal birth entails shouldn't be overlooked just because it's the "natural" option.

C sections are more expensive without better outcomes. It's absolutely sensible for the NHS to discourage them unless necessary for the physical or mental health of the mother and/or child.

I've had 3 natural births and a section, and recovery from the natural ones was more straightforward and much easier to cope with other children. I'm still very grateful that a c section was an option, it was medically necessary and was done well, but sometimes it's trotted out as an 'easy option' here on MN, and it really isn't.

Never had a c-section but would imagine it's horrendous. I would always choose vaginal. Much easier.

I think the issue is that they often seem to compare the worst outcomes of the c-section, to the best outcomes of a vaginal birth. And there is a lot of damage in between there, that can happen vaginally, and not a lot of damage from a best outcome c section...

Yes, for one birth a planned CS has comparable risks to vaginal birth. However they are discouraged not because of cost, but primarily because of the risks of repeat CS - with each uterine scar you significantly increase the chance of life-threatening pregnancy complications such as placenta praevia and uterine rupture. Each repeat CS becomes more technically difficult for the surgeon (increasing the risk of bladder and bowel injury) due to scar tissue, so you will be strongly discouraged from having more than 3 children.

If you’re only planning on having one child, then yes the risks are the same.

Risks and pain with both surely.

I had an easy caesarean, and a quick recovery. It was a wonderful birth experience. I didn’t have the choice of natural birth because of placenta previa.

I had an emergency section and it was the worst thing for me. Had to be put to sleep. And I'm still sore 17 months later. I would never have chosen it personally.