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?

The OP of that thread also notes that a planned csection was the cheapest delivery option.

Would have saved the NHS and state at large a hell of a lot of money if they'd not left me with lifelong injuries from a mishandled birth where I should have been offered a c-section first time around because of my issues, and definitely should have been offered one second time round because of the amount of damage the first birth did and the previous birth trauma.

Instead I had the farce of being sent to see the "specialist birth trauma midwife" who opened the appointment with a snarled "if you've come here to demand a c-section just go away now cos you ain't getting one". According to guidelines here it should have definitely been a serious consideration purely on the grounds of the amount of undercarriage destruction the first birth had done... let alone all the other factors.

Is it possible that the OP of that thread might be the tiniest bit biased?

I'd bet my best knickers that women who have had a really bad experience during vaginal birth would tend to say 'well C-sections are easier and would have less risk than MY birth experience' and women who have had trouble free vaginal births that have left no long term scars, either emotional or physical, would say 'well C-sections are very high risk'...

Our opinions on this are obviously coloured by our own experiences, and not only based on data and statistics.

I have had three vaginal delivies. Big babies nearly 10 lb and I’m only 5ft 3”. Quick labour less than four hours, no stitches and was out at a wedding dancing the day after one birth. Just saying to all those saying sections are best not always. A friend ended up with a hysterectomy with her Section due to complications .

I had a c-section and although it was needed due to the situation, it wasn't entirely pleasant.

I found the recovery really hard to be honest. I'm hoping to avoid one this time.

I was offered a section for my second child, due to a third degree tear with my first. I was told there were risks either way, and it was up to me. I didn't feel any pressure either way when making that decision.

However, when it emerged that I needed to be induced at 36 weeks (they were threatening it from 32), that did change slightly, and they were keen to let me know the benefits of a vaginal birth for the baby's lungs. The consultant wanted me to go through labour, even if it ended in a section, as it could be the difference between a spell in neonatal or not. Which seemed fair enough, to be honest.

I've never thought of it that way. Surely a C-section is given if it is dangerous to have a vaginal birth. No doctor or midwife is going to discourage that. A good friend of mine had two emergency C-sections over the last few years, she hadn't wanted that but when they became necessary there was no hesitation. Some, for various medical reasons, have planned C-sections.

Of course everyone else has a vaginal delivery but it's not a question of discouraging C-sections, just that they generally aren't necessary.

Personally, I don’t think I would like a c-section. I don’t necessarily think it’s more dangerous, but I wouldn’t like to be catheterised and epidurals carry a higher risk for me due to a back deformity. Of course if one was needed I would either take the risk or get knocked out instead.

However, I don’t think it’s really fair that (where I am) ELCs are not discussed at all, and I think it’s symptomatic of women’s issues surrounding birth not being taken seriously. That’s not to say there aren’t MWs that are fab (because there are loads), but I feel like psychological and physical trauma from labour gets shrugged off.

I am a doctor and will be having a section.
I'd much rather try for a vaginal delivery and I've seen plenty of both though I no longer work in obstetrics.
The two patients I've seen closest to death of my own age were both complications of sections. That sticks with you.
Of course cost is a factor - as it should be. I don't think a section should be an option where there is no indication medically but equally it shouldn't be a battle either. And the pros and cons need to be discussed in a more balanced, factual way than they often are.

Bluelady, if you read the whole thread, I think the doctor comes across as pretty balanced. She said she had vaginal births herself and that vaginal birth is better for the baby's lungs (and she explains why).

I don't know if the NHS is giving full and unbiased advice to women regarding the risks and benefits of each way of giving birth, but I fear they might not be.

CS is safer for the baby and that's what they try to hide.

Crossposted, FlamingFlamingo. I suspected as much.

I had a thread about my experience requesting an ELCS a few weeks back. The price between an ELCS and vaginal birth is negligible, honestly nothing in it. I think they have targets to meet and are told to keep c-section rates low so discourage it as much as possible. An EMERGENCY c-section carries far more risks than an elective yet the statistics get merged.

I requested one due to previous traumatic deliveries so it’s not my first delivery, I had very good reason to want one. I’ve had to go through five different medical professionals and had to listen to endless scaremongering tactics before finally getting it accepted. It’s been horrendous. The last consultant basically assured me I would wind up having a hysterectomy should I go through with a c-section .

"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. "

Could that be because the vaginal birth was unusual? Traumatic? Left them physically damaged? They didn't receive effective pain relief either by choice or not? Because I can understand why they would feel that way under circumstances like that.

However for women who have had straightforward vaginal deliveries, without tearing, or with tearing that healed nicely, who weren't traumatised or left physically broken...it's hard to imagine a c section would have been the better option for them.

I would like to see some research on exactly why there are so many emergency CS, as well as traumatic VD's. Is it late motherhood, obesity, larger babies, unnatural hospital environments, lack of training in midwives, lack of time to labour naturally, anxiety of mothers due to lack of knowledge or fear of labour etc etc etc.

I had two VD's, one induced, and one back to back, but neither traumatic nor with cuts, tears, or injuries. I was very lucky in that I had a senior midwife, who was also a friend. She would say that a good midwife can prevent most birth injuries, we do have too few midwifes, so is this the main issue with difficult VD's.

I have also read that doctors that deliver their own children by CS now "seed" their babies with vaginal fluids for the benefit of their gut bacteria and to kick-start their immune systems. Another interesting thing to consider.

@Goingonandonandon I think you have hit the nail on the head. It is all relative and if it is your second birth then dependent on your previous birth experience. I have had one child and my birth experience of a vaginal birth was horrible and traumatic. I have since been looking into birthing options for second child, thus my thoughts on c sections

Also, I am in no way suggesting that a c section is a 'walk in the park' or an easy option. I think that, as another pp has said, giving birth any way hurts like hell. I just wonder about the differences in pain levels and the comparison in damage to your body.

Personally I worry that all my scar tissue will tear really badly and make things awful down there if I went with a vaginal birth. However, I'm now a bit worried about all these suggestions of possible harm to the baby, it's lungs, gut bacteria, and breastfeeding

I had a planned Cd for health reasons. Recovery was a buggar & lengthy but you get there.

My milk took longer to come in however, due to the health reasons, it didn't improve & I had to stop BF at 2wks. That was hard!

Neither me or my DD are physically or psychologically challenged in anyway, we simply enjoy the very close & great relationship we have.

They put women off because it is a long sore recovery.
My first 3 all natural and up walking same day, no problems at all and able to pick baby up no problem.
My 4th was breech and I got booked in to have baby turned, but didn't work so I opted for c section the week after.
Not as easy as some made it to be, I couldn't walk properly for the first week and was in absolute agony couldn't even pick my baby up myself for the first week.
It was torture imo.
Very difficult when I was breastfeeding so baby wanted me all the time, on top of being in agony due to the surgery I had cracked and bleeding nips.
I wish I could have had a natural birth, but glad he got here safely

In the interests of balance, I should probably post a bit more from the AMA thread. I found it a really informative thread, BTW.

I am extremely pro-vaginal birth, as a straightforward, term, spontaneous vaginal delivery is the safest option overall. The problem is that this is a retrospective diagnosis - not all vaginal births are straightforward, and you cannot predict which ones will or won’t (risk factors are meaningless in an individual basis). Some complications are life-threatening or catastrophic, but thankfully rare. Things we do to try and avoid these can cause more harm than good on an individual basis, but improve the outcome of a population.

eg: we induce by 14 days after due date, because rate of stillbirth goes up sharply at that stage if undelivered. Induction is more likely to end in intervention, so more women will end up with assisted deliveries or emergency sections than if not induced. But their babies have a higher chance of being alive!

Vaginal birth definitely not cheapest option due to need for emergency 24h care and intervention. Cheapest probably planned C/S for all, but no one would recommend that.

Yes, any vaginal birth has a more possible complications for baby than a C/S - distress, failure to progress, delivery problems (shoulder dystocia, assisted delivery). Better for their lungs though!

....

Heartease - see my posts of this evening - vaginal delivery riskier for baby at a population level, but not on an individual level - as you don’t know what your outcome will be with vaginal delivery.

C/S has different and some serious risks, especially for the mother, and risk goes up some with each subsequent procedure.

When I did obstetrics, I DID tell women this! But also pointed out that it was meaningless for them unless they had access to a crystal ball.