To ask why having an elective C-Section is so frowned upon?

[Rosesandbutterflys]

I am (hopefully) having an elective C-Section soon. First baby, don't want anymore children after.

I've always had a fear of child birth, which over the past 5 years has been compounded by a lot of people around me having children and the vast majority of these (though I appreciate I'm probably unlucky here) have been pretty traumatic births that have ended in severe tears, forceps and a lot of the time, an emergency section anyway. Granted their experiences have mostly been better on their second birth/ child.

Nothing and I truly mean nothing about natural childbirth/ labour appeals to me. Not the hours of pain, pushing, potential rips/ tears, forcep intervention, epidural (yes I appreciate I'd have one of these for a section), damage of my pelvic floor and the panic and stress of potentially having to be rushed to theatre because it just wasn't going to happen naturally and the baby is in distress or whatever.

Now don't get me wrong, nothing about a c-section appeals to me either, it's absolutely no walk in the park and I'm dreading it, but it has to come out some way and I am a person that likes to plan things and to somewhat be in control/ aware of the plan. I have also had abdominal surgery before (though not as severe as a C-section) and I know recovery is likely to be painful and slower than if I were to have a natural birth. But for me, this is the preferred/ lesser of the 2 evils option.

I have also spent hours pouring over research as to the benefits of a vaginal birth over a c-section and last night came across a NICE/ NHS study/ research that found that actually, for a planned/ elective c-section, the risk to the mother of a c-section compared to a vaginal birth is pretty much the same. It states that the risk of the baby ending up in NICU with a C-section is 13.9% compared to a vaginal birth which is 6.3%, so double the risk, BUT it says the research does not take into account the fact that most c-sections undertaken are for medical reasons and therefore the likelihood of the baby needing NICU attention after it's born is increased anyway.

It then went on to say that the risks of an unplanned, emergency C-Section are a lot higher than a natural birth/ elective/ planned C-Section. So I guess if each woman was guaranteed to have a straightforward, natural birth, then great, but a lot of women do end up needing an emergency c-section so, technically they are more at risk than someone who has chosen an elective.

This now seems like I am bashing natural delivery and I'm not at all I totally admire and respect women that chose that route, I only wish I were that brave.

However, the responses I have had from people my whole pregnancy when I have admitted I am opting for an elective C-section have been ridiculous. Not one person has responded positively, all I've had is 'Oh, really? Are you sure??' and 'Oh, why on earth would you elect to have that?' etc etc. Or just a stony faced, tight smile and 'oh right' making it clear they disapprove but not actually coming out and saying it.

I got told last night that the reason I'm getting these reactions is because a C-section is 'taking the easy way out '😕

If that's the case, why on earth wouldn't you? Why is it that it seems the prerequisite to being a good mother is seemingly having to martyr yourself all the time?

So many of my friends that have had children and also the women in my NCT class who are preparing for their births have all expressed dismay/ distress at having to have any pain relief, they all want it to be as natural as possible and I know my friends that haven't had 'textbook' births still harbour 'guilt' and sadness to this day. Why? If you need gas and air or an epidural, so what? What exactly am I missing? If they ended/end up with forceps or an emergency section, it's not their fault, it's just one of those things. Surely modern medicine has provided these things to make childbirth safer?

Anyway, gone off on a tangent now but if you disapprove of someone having an elective c-section, could you tell me why?

"Trial of labour" is such a misleading term. It gives the impression that the "trial" can stop at any point if it's not working. It can't. What I mean is: women are often told that they have the option to decline forceps and move on the ELCS if the labour isn't going to plan. In reality, that's not true. When labour gets to the point where forceps is needed, it's often too late to have an EMCS without significant risks to both mother and baby, because the baby is often low in the birth canal and would need to be pushed back up for the EMCS. I know, because I was in exactly that situation myself. I said on my birth plan that I would want an EMCS over forceps. The team were ready to offer me one, but explained very clearly why this would be risky for both the baby and me. Obviously I went for forceps; I would always avoid putting my baby in danger, whatever the cost to me. So would most women.

Also- the ventouse. Everyone knows the risks of forceps, but the ventouse is less talked about, and is brutal. Two people were holding me back on the operating table whilst they were pulling with it. The damage to me (3b tear) was done by the ventouse.

From the RCOG "Caesarean in the late stage of labour is a more complex operation than a planned caesarean and in some circumstances may increase the risk of harm to both you and your baby.
Decision making in labour can be difficult which is why it is important to explore any concerns you may have with your healthcare professional before you go into labour.
If you are certain you would not want an assisted vaginal birth, one option is to choose a planned caesarean birth before you go into labour."

Yep exactly! People like @HoppingPavlova can be a martyr all they like and kid themselves that they are such a good person for saving the NHS all that moneyyyy (even though they actually aren’t). You do you girl. But I and plenty of other women will do what is best for them when it comes to how they give birth and rightly so. Times have moved on.

‘In reality, that's not true. When labour gets to the point where forceps is needed, it's often too late to have an EMCS without significant risks to both mother and baby, because the baby is often low in the birth canal and would need to be pushed back up for the EMCS. I know, because I was in exactly that situation myself. I said on my birth plan that I would want an EMCS over forceps. ‘

I could have written that! Wish that was common knowledge.

@MassiveSalad22 yep, I wish that too. Especially as I asked that question in my NCT class and was assured that it was never too late in labour for an EMCS...

Why are you so wrapped up in incorrect assumptions on cost, @HoppingPavlova?

Did you not read the very first line of the article @EarlGreywithLemon posted?

According to a 2011 Nice analysis, the expense of MRCs [Maternal Request C Sections] is only marginally higher than that of planned vaginal births, if treatment for related issues such as incontinence is taken into account.

Marginally higher. Clearly not much of an issue. Cost is much more complicated than the upfront cost of an ELCS vs VB. Clearly the cost of a VB can vary massively from being a lot cheaper than ELCS to much more expensive if lots of follow up treatment etc is required.

And never mind the human cost- of a woman being able to live comfortably, without incontinence and awful injuries, probably exacerbating PND, that's just a few things off the top of my head.

Yep exactly! People like @HoppingPavlova can be a martyr all they like and kid themselves that they are such a good person for saving the NHS all that moneyyyy (even though they actually aren’t). You do you girl. But I and plenty of other women will do what is best for them when it comes to how they give birth and rightly so. Times have moved on.

Agree 100% @LuckySantangelo35

I confess to not having RTFT - because back in the real world no one I know has ever made comments to me or each other about people’s choice of labour or feeding. It’s such an non-issue it’s not discussed.

That’s probably because I don’t hang around with bellends who are judgy, nor do I judge other people. In fact judge isn’t even the right in this scenario.

When your child is older you’ll realise this is all just nonsense and blown way out of proportion, both in your head and what sounds like others around you. If you want an ELCS go for it.

@HardyBuckette you said what I wanted to, much more articulately 😂

*right word

And if anything the relative costs probably look more favourable to ELCS now than they did in 2011, for two reasons.

One, because the birthing population has only got older, heavier and with a higher percentage of first timers since then, so the chances of the sort of vaginal birth that's cheaper than an ELCS is probably lower now than it was in the 00s. If I were being totally cynical, I'd speculate that this is part of the reason why we've seen the move from NICE and in clinical practice.

And two, because the case law in clinical negligence has developed since then. At the time NICE made that calculation, the Montgomery v Lanarkshire Supreme Court decision was still a few years away.

Yes - I wonder if those figures take into account the whopping amount the NHS pays out every year in negligence claims relating to botched vaginal births? If it doesn’t, I suspect the true financial balance would be vastly in favour of ELCSs.

Thanks!

Who are these people asking about how you plan to give birth? It's no one's business.
Even with an ELCS planned there is a chance you could have a vaginal birth of things were to happen very quickly so if you don't want to tell them just say you aren't sure.

No one apart from my husbandand medical staff knows that I had an ELCS booked. I suppose I could foresee a lot of the negative responses here and just decided to avoid listening to a load of crap.

And as someone who has had a VB followed by an ELCS, I am absolutely certain that my VB cost the taxpayer far more than my ELCS.

My VB required three surgical repairs, with all that entails - anaesthetists, consultant gynaecologists, lengthy hospital stays, etc. My initial repair in theatre took nearly four hours. I had countless gynae and GP appointments and a year of physiotherapy.

My ELCS required one visit to theatre, lasting one hour, one night in hospital, and then I was just reviewed at the standard midwife checks thereafter. Job done.

The assumption that VBs are automatically or even usually cheaper is complete nonsense.

I presume the push for "natural" births is that hospitals are set up to have mostly natural births, in terms of staff etc. But if the default was ELCS it could easily be the other way around. In fact, I wonder what the cost difference would be?

Def not an easy option! Not least because you cant drive for around 6 weeks afterwards. I had an elective section for safety due to chronic illness and I had an eventful recovery. !

I had an elective c section and I’d defo have One again!! Ignore what other people think and do it for yourself babe! Good luck!! Xoxo

I insisted on CS with my second, after a pretty traumatic emergency CS with my first. The health care team all tried to talk me out of it but I Insisted and it was the best choice I have ever made!! People are very judgey about it for some weird reason, especially our NCT lot! Go for it. Mine was a great experience, and without the months of anxiety leading up to the birth.

The thing is people judge absolutely everything, especially women and what women do in motherhood and their birth stories.
What you have to do it not let anyones opinions matter to you, who gives a shit how anyone gives birth? It doesn’t make anyone less a mum, same as breast feeding, which will be another judgement. There’s so many things that people have opinions on, let them cos those people are never gonna be happy what ever you do cos they aren’t happy if they’re busy judging how you got your baby out of your own body.

Don’t even let it worry you.

Actually, the cost of a CS, especially an elective, is pretty close to a VB once all the hidden extras for a VB are added in.

The cost of a VB doesn't include stuff like surgical repairs for incontinence, etc, work on pelvic floor damage, any counselling for trauma, and so on. The overall average cost should include this, as these extra NHS costs are a direct result of having a VB.

It's also hard to find accurate statistics for outcomes on VB. I went digging and found there's around a 40% risk of needing forceps during the birth, that inductions can result in a higher chance of interventions, and quite a bit more (can't recall it all, was about 3-4 years ago I went digging).

It's almost like the NHS minimises the risks from a VB while trying to discourage women from opting for a CS. I had an ELCS followed by VBAC, and still wish I'd pushed for a CS as I healed a lot quicker afterwards.

It's also the case that people forget that only around 100 years ago, pretty much every birth was a vaginal birth, a natural birth. And the mortality rates were higher than today. I, for one, am glad we now have safer options, and feel no shame in opting for them if needs be.

Once your baby is born, no one is going to give a flying fuck how the baby came out. No one gets a medal for opting to forgo pain relief, and not having pain relief doesn't make you morally superior (I had one wazzock try to make me feel guilty, didn't work).

There is nothing wrong with wanting a c-section imo. I wanted one (due to minor pregnancy issues) but was talked out of it (scared sh**tless) by pushy doctors/midwives and ended up with an emergency c section which is always more dangerous than a planned one anyways. But now I'm left on the other side where, due to complications during surgery, I cannot give birth naturally so now I feel like I'm missing out on this huge, amazing moment that other women get to experience! Guess it comes down to choice, you feel more comfortable with a planned c-section then push for that, but it will be a push as they won't want to just give it to you. Good luck!

Because you must suffer and be in a huge amount of pain to show you are worthy of motherhood / and atone for Eves sins

Firstly, it is super unusual for an elective cesarean to be offered on the NHS for first time mothers unless there is a specific medicial reason, are you going private? I'd hate for you to make all these plans in your head only to be told no!

Secondly, a cesarean is NOT an EASY WAY OUT. It comes with a whole host of complications and is one of the most serious surgeries a woman can have. It is very involved and the recovery is very serious. It is downplayed by the world because all expectations on new (and even existing!), mothers is fucking disgusting.

I ended up with an emergency cesarean for my first and am having an elective for my second (8 weeks to go!!!), but I certainly wouldn't recommend it just out of fear of the unknown for a natural birth.

Fear of childbirth is so normal, it is bloody terrifying! The human body is a fantastic thing, but let's be honest, the hole that babies come out of is not big enough!

Whatever you choose, it is your right to decide. Screw anyone being judgmental and mean. It is your body and your child, you do you and GOOD LUCK! ❤️

Thank you!

They’re not allowed to refuse you anymore for an elective. Well, they can, but then they have to refer you on to another consultant who will do it. Pretty sure this has been the case since 2011.

I had 2 electives but due to trauma and damage from my first vaginal birth. I wouldn’t have opted for one for my first birth though although that’s entirely your decision of course. I’ve never had any negative comments about it being easier, quite the opposite.

However it was easier, 1000 times easier, I recovered much quicker and it was altogether a better experience. The recovery is quite painful though. Many many vaginal births are fantastic , if I were you i wouldn’t rule it out.

My only advice is don’t discuss it with others.