To ask for an maternal choice elective C-section?

[Miphy]

I am 20 weeks with first baby- name changed for this thread.

Prior to pregnancy I was already leaning towards requesting a section. I am a doctor, not working in anything related to it now but obviously spent time in obs & gynae placements.
In my obstetric placement we had to spend a week with the midwifery team so that we had a chance to see ‘normal’ birth. Without exception every single birth I attended went ‘wrong’ and either ended with assisted delivery- forceps, episiotomy, in one case horrendous tearing, or emergency section and massive postpartum haemorrhage.
In contrast elective section list was lovely- but wham bam baby out, happy well rested mums.
Then later in gynaecology saw clinic lists full of women with birth injuries and PTSD.
This massively influenced my perception of birth.

I had thought more more about water births, hypo birthing etc and thought I may as well give it a go vaginally.

However the more reading I do now about birth the more I read about horrendous birth injuries, and of my friends the ones who had sections all fully recommend it whereas some of my friends who have had a vaginal birth have told me some pretty horrendous stories. One still can’t have sex two years later. I know there’s a recovery after section but somehow surgical recovery seems more straightforward and I’m not short of hands on help and support- both our mums are retired, husband works from home, all very keen to provide hands on help.

It feels to me like an elective section involves known small risks, I know what I’m getting. Whereas with a vaginal birth I can have some lovely water birth, minimal tearing, quick recovery, or I can end up exhausted from a prolonged labour maybe with a wrecked undercarriage, maybe a distressed baby and then even potentially a high chance of needing an emergency section with even higher risks. And it seems I won’t know which way it will go until it literally happens. It really feels like the injuries by women after vaginal birth are minimised and you’re just supposed to deal- so they aren’t treated as ‘risks’ in the same way.

I find myself hoping the baby is breech so my decision is made for me. I’m thinking Of asking about maternal choice section at my antenatal clinic appointment. I wondered if anyone had any experiences or any advice?

[quote Monday26July]@Thehighlandcoo

I had a straightforward water birth with gas and air and no stitches. Recovery was a breeze and genuinely felt back to normal after a week. I did soooooo much research on how to avoid interventions and did all the spinning babies activities to increase the chances of my daughter being in the best position for labour.

I'm really pleased that you got the birth you wanted! But I do want to highlight that no amount of preparation of educating yourself on 'how to avoid interventions' is going to remove the need for those interventions if that's how it goes on the day. So much of birth is about luck: your body shape, your baby's positioning and size, your skin elasticity, none of which are things you have any control over.

It was such a positive experience. I know that things do go wrong (in both vaginal and c section births) but ultimately, a straightforward vaginal birth is undeniably the best option for your body than major abdominal surgery - and there's nothing at this stage to suggest you won't have a straightforward vaginal birth.

Unfortunately short of a fortune teller there's no way for any of us to know which type of birth is the best option for OP, it's an informed gamble either way. It's really time we stopped telling women one form of birth is 'undeniably better' than another, and instead gave information about the risks and benefits of both and let people decide for themselves.

I'm not trying to be critical of you personally so I'm sorry if it comes across that way, I just see birth stories shared very frequently where a mother has 'done all the preparation' and 'had a straightforward birth with good recovery' as if the latter is a direct consequence of the former.[/quote]
Just giving my experience, like everyone else here.

It's your body and your choice but I'd always go with naturally if I could as I think the recovery from a c section looks so difficult. I had to have an episiotomy and ventouse delivery and I have quite a lot of scar tissue from being cut that still bothers me three years later but I'm still so glad that I didn't need a c section. I was so grateful to be up and about straight after the birth even though it was sore.

@Monday26July

But I do want to highlight that no amount of preparation of educating yourself on 'how to avoid interventions' is going to remove the need for those interventions if that's how it goes on the day. So much of birth is about luck: your body shape, your baby's positioning and size, your skin elasticity, none of which are things you have any control over.

This!!! Unless a positive birthing course or other preparation is going to change my risk profile, then I don’t see what good it will do for me.

[quote KiwiDramaQueen]@Monday26July

But I do want to highlight that no amount of preparation of educating yourself on 'how to avoid interventions' is going to remove the need for those interventions if that's how it goes on the day. So much of birth is about luck: your body shape, your baby's positioning and size, your skin elasticity, none of which are things you have any control over.

This!!! Unless a positive birthing course or other preparation is going to change my risk profile, then I don’t see what good it will do for me.[/quote]
There's a real push I've noticed to promote 'natural birth' aka vaginal without pain medication or intervention, and a whole industry dedicated to telling women that if they just do these exercises, buy this course, buy this book, watch these breathing videos, they'll be able to have the birth they want (which invariably seems to be a vaginal unmedicated no intervention birth).

It's so exploitative. It might give someone a slight reduction in anxiety if they perceive that they have some control over whether they will end up needing intervention or not. But it's a facade. It's scary to realise that how you birth is largely out of your hands and stuff like hypnobirthing, spinning babies etc. give people the illusion that it'll all be okay as long as they do the right things.

And it of course has the effect of ensuring that women who required intervention or had a c section feel inferior and like they just didn't try hard enough or prepare enough. So much of it is down to luck and that's a scary thing to realise!

@EarringsandLipstick

🤷‍♀️ Of course everything’s contingent on the situation. You asked why there would be an increase in morbidity associated with emergency sections. There is (it’s well-documented - you can just Google it). I’ve given some of the broad factors that explain why - I’m not saying they apply to every situation.

@EarringsandLipstick

And I’ve no idea about Ireland but in England that fact that the standard of care - both in maternity and elsewhere in the health service - dips out of hours, and particularly at weekends, has been extremely well-publicised.

[quote MissChanandlerBong22]@EarringsandLipstick

And I’ve no idea about Ireland but in England that fact that the standard of care - both in maternity and elsewhere in the health service - dips out of hours, and particularly at weekends, has been extremely well-publicised.[/quote]
Happily that's not the case in Ireland. Sorry to hear that in the UK.

No need for the 🤷🏻‍♀️either. You provided some reasons, I countered with a post saying that an EMCS per se didn't mean there was an emergency. Just a response, that's all.

@Monday26July

The course I did actually wasn't like that though it wasn't pressure to have a "natural" birth, it just armed me with information about my options which enabled me to communicate better with my care providers and feel more positive about the process of giving birth whatever route this ended up being. I think feeling more informed and less anxious about the process is never a bad thing.

@Terrazzo

YANBU! But I had an ELCS and lost half my blood so it’s not necessarily flawless. But definitely more controlled.

Same here! Massive pph with an elective section. Elective sections very commonly have the perception of very little can go wrong but this is far from the truth.