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?

I had to jump through many hoops to get my first CS 7 years ago. Had to finally get signed off by a top psychiatrist despite never feeling more sane and rational about my choice. He totally agreed with me and said he thought women should have the right to choose how they birth as it often had a direct impact on recovery - both mental and physical. Both my elective sections were great. I have no tummy muscles to speak of and breast feeding was a struggle but I wouldn’t have chosen differently. I wonder if those who are saying the costs are too great for the NHS would also like to ban NHS monitored home births, where at least two midwives are sent out. The ongoing costs of vaginal deliveries that go wrong are greater - particularly in psychological terms. The only thing I would warn is if you plan on having four or more children, a c-section might not be your ideal choice for the first birth.

Coming back to the bonding issue. The ideas put forward by odent aren't necessarily about initial mother-baby bonding, but also geared towards how as a society we form relationships later in life. Considering how if we aren't exposed to natural oxytocin at the point of birth, how does that impact later relationship bonds. As I said earlier, it's a theory and an interesting one at that.

The risks of c section are many and varied, and most women who sign that consent form won't even give them a second thought, because they expect 'pain and bleeding'.

What they don't expect is major haemorrhage, scar dehiscence, infection possibly leading to sepsis - (and I've seen some really grim wound infections, requiring packing daily and several corrective surgeries.)

They also don't expect potential bladder damage and having to self catheterise for months on end while trying to restrain themselves to be able to pee.

They don't expect continuing scar pain, ongoing for years and years.

They don't expect in a next pregnancy to have placenta praevia, placenta accreta (or percreta or increta for that matter), they don't expect massive adhesions to bladder and bowel (most likely cause of ongoing pain), they don't expect their subsequent elective c section to take hours of a consultant's time to separate those adhesions safely.

They certainly don't expect a DVT or Pulmonary embolism and despite being told to use their prophylactic ante-embolic devices, such as stockings and heparin injections.

For years and years now, the two key causes of maternal morbidity and mortality in childbearing are DVT/PE and Sepsis - both of which are far more likely if you have a C section.

Women don't expect to have any of these complications after a c section, yet they are very real risks; risks which those who work in maternity see every single day. Women don't expect to die during or shortly after a c section, but it is one of the risks. You sign that consent form stating that you're aware of those risks and I bet that many, if not all of you don't even consider that it could happen to you. It can. It does.

That is why medical professionals will discourage anyone against an elective c section for no clear medical indication.

That is why the 'I want one so I should have one' argument doesn't and shouldn't stand without detailed enquiry into why someone would opt for it with no medical need.

When it comes down to those working in maternity, we couldn't care less about the cost of what happens to you. That's not the point and really doesn't factor in the delivery of your care. What we do care about it the short and long term health implications that this choice can have on you, your baby and your family.

I couldn't give a shiny shit if your birth cost £10 or £10,000, what I do give a crap about is that you and your baby come out of it in the best possible condition and I can guarantee that the rest of the nhs staff do too.

Just because what the extensive research says isn't what you want to hear does not give anyone reason to be dismissive or rude. If you made a choice to have a c section without medical necessity, then own that decision but don't downplay the very real risks of that intervention.

Gunty What about the risks of vaginal birth?

I don’t think that anyone downplays the risks of intervention.

I do think many people downplay the risks of giving birth without interventions.

It is not all candles and whale music. If women had to see a full list of the potential consequences of a natural birth and sign a consent form as they do for a c-section, the birth rate would be a fraction of what it is today. But they don’t have to sign such a consent form and most people don’t even know what some of those risks are.

I had an unplanned c-section. I was fine, up and about next day. I was in hospital for 4 days, breastfeeding was fine. I stopped when my son was 2. He's normal . I recovered quickly and without issue. I took my son to see a friend who is a cranial sacrat to perform some laying on of hands. Apparently it's helpful? I believe the issue is about cost. Childbirth is risky however you do it!

Ohyesiam what? More sections happening on Fridays than on the weekends is to be expected, isn't it, as elective surgery only generally happens Monday to Friday. Emergency sections still happen as required on the weekend. So it'd be elective plus emergency in the week and emergency only on the weekend. Medics cover 7 days a week, it's not a choice.

C sections have great risks. Iv had 2 for medical reasons. My last and 3rd almost killed me. The placenta grew through my old scar amd i jad to have a hysterectomy. This needs to be told to women before they make a decision about having a section

How do you define medical necessity? Just had my second section. Mostly as had already had one and knew my chances of successful VBAC were lower but my antenatal depression and previous experience of first baby being whisked to NICU for 3 weeks definitely played a part in my decision. This probably wouldn't meet some people's thresholds. Anyway I bonded, breastfed and was out next day on paracetamol. Unlike my Friend who had to stay in 5 days with complications following her VBAC... So that probably evened up the bill eh?
It was an amazing experience which has totally healed all the trauma from first time round.

Of course they do, that's the preferred method of birth!
Why wouldn't they encourage this, CS has a place in situations ofnrisk.

Sadly OP the stats are deliberately misrepresented so that ELCS and EMCS are classed as the same risk, which they very clearly are not.

I had an elective section and it was a dream. In and out in 40 mins and in the shower same day. All pain manageable by nurofen and no infection.

I'm fed up of the 'natural is best' brigade telling other women not to have a c section because they think they have a right to an opinion on someone else's body.

In other areas of medicine when we have advancement how often do we say, oh no don't bother with that, the patient will clearly prefer the more painful.and unpredictable option because... It's NATURAL.

How many doctors and their partners have sections.. I think you'll find it's most and that's very telling isn't it?

How do you define medical necessity?

This.

I'm hypermobile, for which I'm obviously under different medical care than an obstetrician. For my first birth I had two doctors disagreeing - the one who knows my body and my hypermobility made it clear to the obstetrician that my pelvis was not capable of remaining intact during a natural birth (regular subluxations during pregnancy backed this up). The obstetrician felt that natural birth is better so it would be OK for my pelvis to break .

As it happened it was out of all of our hands and became an emergency C-section for entirely different reasons, but the insistence on natural is better would have been disastrous for me.

I'm pregnant now and for various reasons it is definitely going to be a planned C-section, for medical reasons and whether I like it or not - as it happens I do because at 43 I am capable of judging the risks and know what's best for my body and yet some doctors seem incapable of understanding this. I'm 23 weeks and already on crutches regularly due to hip subluxations, and yet while there is no question of me attempting a VBAC this time, there are some obstetricians who still suggest it's worth giving a try. As I'm on crutches for my falling apart pelvis in front of them. I can't even lay down properly and yet they're busy insisting natural is best. It's hideous and thank God more sensible minds are in charge this time. So who gets to decide the medical necessity?

I have had two c-sections. They are not a a walk in the park and I have been left requiring further surgery. I hate when people Say they are the easy option. They are anything but.

From my own experience I would never choose a section. I pushed to have a vbac with my second and third babies. I really wanted a natural birth, after seeing my blood trail across the theatre floor from a post partum haemorrhage.

My first vbac was amazing, the recovery time was minimal. The second wasn't as great but still way better than the section.

In other areas of medicine there is no normal or natural. Obstetrics is the only clinical area in which the patient isn't ill. So that's a pointless comparison.

The issue here is whether c sections should be offered when there's no clinical need for them. I don't think they should. A surgical intervention wouldn't be available on the NHS under any other circumstances just because the patient fancied it.

Bluelady what about plastic surgery? Sex changes? Dentistry?

You really are out of date, aren't you? The only way anyone gets plastic surgery on the NHS is if they're severely disfigured, you can't get a nose job because you don't like the one you were born with.

And do you actually know how many hoops people have to jump through for gender reassignment surgery? That's why so many trans gender women either pay for their surgery or don't bother. It's also why a large number of trans men pay for their mastectomy.

Same with cosmetic dentistry, private patients only. Even NHS patients pay for their dental treatment.

Ok, does that mean that you think clinical need can be overlooked if people can pay privately for a c section? But clinical need should be a factor for NHS services?

www.google.co.uk/amp/s/www.newscientist.com/article/mg23130812-000-a-womans-right-to-choose/amp/

If you're paying you can have what the hell you like. On the NHS the kind of birth you get should be based on clinical need, just like any other surgery. I really don't care what NICE - that wonderful organisation that denies people cancer drugs - says.

I don't think this is the case and it's certainly not been my experience. I have a spinal cord injury and many other problems and a normal birth was always going to be a very risky thing for me, not for baby.

I was induced with dc1 and it went to section.
I was encouraged to have another section for safety with dc2
They have advised me again with dc3 I should have another section as it's too risky.
Not one professional I met has questioned or discouraged that decision once. In fact it was encouraged

Surely that's because there are sound clinical reasons for you to have a c section, justwant?

Er. Yes. Of course is discouraged 'on purpose'. What do you think? Its for fun? To spite you and all women? A caesarian intervention, generally, is far more dangerous to mother and baby than a natural birth unless there are specific medical reasons making it essential.

Is vaginal birth safer for the baby? There was a thread - I'm a consultant gynaecologist AMA, which said the opposite.

There is no getting away from the simple fact that vaginal delivery is significantly more risky for the baby than a planned C/S (but safer for the mother).

www.mumsnet.com/Talk/AMA/3303150-I-m-a-consultant-gynaecologist-AMA?messages=100&pg=1

Excellent. No more live births for us then. Ladies, line-up please and surrender yet another thing that only a woman can do.