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?

I agree with pretty much everything you've said. The dc needed intensive care after c sections are likely those delivered via emergency. Both my births were planned sections. It was medical need, but in a country where c sections are far more common. In the UK I'd likely have been pushed to try natural. Anecdotally I know lots of people who have had complicated or traumatic births too, some ending in emergency sections after it all that has affected them and/or dc long term. I k ow no one with long term effects for a planned section. A good friend of mine is a consultant anaesthetist in a maternity ward. Both her dc were delivered via elective section. You sound like you've made your mind up so don't be pressured by others. I mean, it probably is the easy way out but so what. As you say why not take that ....

I had an ELCS, at my request, 21 years ago. I'm so glad I did. My GP was very anti it, and grudgingly referred me to a consultant, who was absolutely all for it, and added further medical arguments to those I had put to him as my reasons. ( I was expecting a battle, and came away from the consultation thinking I must have been imagining what he had said- but DH had heard it too!) My DGM was in total agreement with my view, although she had given birth to her last child in 1950- and had issues arising from that throughout her life. Bizarrely, the only person against was MIL who had significant health issues from a breech birth in the 60s, and who had had numerous surgeries to try to fix.
I'm sure the latest figures state that over a lifetime, c sections actually cost less, so I would say OP, absolutely go for it. Feel no guilt at all. Your health is more likely to be maintained, and you will most probably end up costing the NHS less, not more!

Your ignorant post is littered with so much untruths it's laughable.

Firstly you are not sliced in half! In our unit we regularly administer analgesia and give it before we help our ladies get up out of bed.
Mobilising slowly and at their pace is encouraged to help prevent DVT as it would be with any operation.

Most women having babies are young, fit healthy women so recover quickly and well from this surgery.

We do not have specialist midwives sitting next to them helping with everything, for a start there aren't enough of us to do this!! If a women needs assistance with anything feeding, changing nappies and dressing we encourage them to use the call bell and we then go and help.

Your last comment shows your total ignorance and lack of knowledge re fear of childbirth.
Not everyone thinks like you (thank God) and you would do well to keep your untruths and ridiculous opinions to yourself.

Me too Louise. Bangers, mash and beans for dinner five days a week

Good luck OP and congratulations! You'll be fine with an elected c.section. Make sure to get up and move around as soon as you can - probably next day. And enjoy your baby.

.. and yes, no special help needed after the section. There will be a bell so you can call for help if needed but you'll manage. Recovery quick too.

TBH I tend to think it's the opposite of the easy way out due to the extended recovery time. I have had three vaginal births, all forceps, all episiotomies, one of my babies was 11lb and I also had a tear. He was in a hideous position for delivery (twisted almost back to back but not quite, brow presentation instead of crown, and of course was the size of a 3 month old 😅). When they suggested they needed to do a CS as he wasn't coming out, I was devastated as I had a not even 1 yr old at home and didn't know how I would manage with her plus newborn while recovering from a CS. They thankfully magicked him out of my vagina on the last attempt 🤣 and the point to my story is that it sounds traumatic but I honestly loved giving birth, and I have even more respect for mums that have sections, whether emergency or elective.

Took the words right out of my mouth. Is “choosing” an elective c-section for your first child any different to choosing to have 3 more children knowing you’d need an ELCS?! From a cost perspective, it’s far worse. The risks increase with each c-section and thus, so does the cost to the NHS.

Good point well made eastegg.

My c sections babies have got to aged 12 and 9 having never had a sickness bug, I'm going to assume their stomach bacteria is ok..

I read your post but haven't read the entire thread ....... I totally understand how you feel, I felt exactly the same when I had my first child 12 years ago -!there was no choice then! As things turned out I ended up with an emergency C Section and whilst the surgeon was uncomfortable telling me that this was how he perceived things ending (assuming I would be disappointed) my first thought was Elation - fantastic, I never have to do this again! My recovery was actually very easy, I vividly recall walking around the park with an NCT friend within a week of emergency C Section and being in a far better / more comfortable way than my friend who had a "natural" birth two months previous but had an episiotomy ! I had another 2 children by elective C section and with both was out of hospitals after one nights stay and walking around after a few hours. My personal experience of a c-section is very little if any pain and the only negative being the inconvenience of not driving for 6 weeks

Crikey, I'd never think a C section was the easy way out if that's your choice.
I had a vaginal birth, no rips or tears or forceps etc but I was induced because he was a tiny bubba and he practically jumped out of me .The contractions were still painful of course but I doubt as painful as the after effects of a C section.
My sister had an emergency C section and i saw how much pain she was in for weeks and she wishes she'd had a vaginal birth.
Each to their own I think, so good luck OP and enjoy your bundle!

Awww I honestly want to climb in the screen and go for a coffee with you! 😂 You are ME!! I had a baby last August, had planned my entire life, literally since I was a child, that I’d have a section. I think when you’re born they add all the ingredients and they forgot to include the one that makes you have any fibre of your being that WANTS to do that when they produced me (and you it seems). It BAFFLES me! I ended up full of anxiety my whole pregnancy for fear of going into labour but also due to people’s constant judgements. I told a woman at work and she told me I’d regret it and looked at me SO disappointedly. Cannot wait to go back to work and tell her how my bladder functions amazingly and I am completely unchanged since having a baby 😂 Meanwhile another girl at work is off for an op due to incontinence since having a vaginal birth. I ended up just not telling anyone else I was having a section. Even ended up with my nosey MIL at the end asking where I’d just go with gas and air or have an epidural for my labour (I hadn’t told her). I brushed it off saying I’d see what happened 😂

You aren’t hopefully having a section, you ARE having one and if it’s anything like mine itl be the best experience of your life. As my baby was lifted out within 90 seconds of being cut open then I was wheeled back round to recovery holding him, I just could not get my head around the fact people go through days of pain just to have that moment I was already having. I think hats off to anyone that wants to do it but it’s just not for me and never will be!

Section number 2 for the next one in a few years hopefully but this time without the shame 🙌🏼📢

I had 3 CS . The first one was emergency as complications arose after I got to 9.5cm. I wanted to try again, naturally,, second time round- but nature intervened. Third time round - the choice was taken from me

I didnt have major complications with my C section, but I did hate being in hospital for 5 days afterwards, struggled with lactation and I have never regained any feeling in the scar area.

I think a natural birth that goes well is the easiest and safest option all round. And that is why first timers with no complications are guided to them. Saving the NHS precious resources is also part of it, and not to be sniffed at

The main thing is - this is a controversial issue, and you may wish to reconsider your attitudes on this basis. You may have planned a C Section at 39 weeks, but what if baby comes at 36/ 37 and you make too much progress before they can intervene. Ultimately, you can't control it all - but you can try and make the best choices at the time.

Presuming C Sectons are better than worse case Vaginal births is not a fair comparison

@Rosesandbutterflys I have had two c-sections, the first was an emergency after labour didn’t progress. The midwife didn’t spot DS had his shoulder presenting not his head. Whipped into theatre. I was soon up and about, no issues bonding with my baby, was able to breastfeed. Sore for a while but recovered well.

DS2 was transverse so I was booked in for a c-section. He then moved but I refused to opt for a natural birth. Turns out at 39 weeks he was 10lbs 5oz, so who knows how big he’d have been if I’d waited. Had a bit of a bleed but came through and again all well with me and DS.

My sister had all four naturally, she just popped them out.

Some people love the rigours of labour but you need to make the right choice for you. A fear of childbirth is a valid reason. Nature may intervene and you may have a swift natural birth, but it’s your body, so your choice to have a c-section.

It’s such a personal choice. I’m menopausal now and I had vaginal births but I’d have sections if I could do it again. No one explained when I was at the point of deciding, that scars from where I tore would be so troublesome in menopause. I didn’t anticipate the damage to my pelvic floor, the impact a weak one has on exercise and the knock on effect on my self esteem when I couldn’t exercise to lose the baby weight without peeing my pants.

I can't get into a headspace where someone else's birth choices are anything to be 'judged' in the first place. I've had one home birth and one hospital birth (DTs so couldn't have another homebirth).

I couldn't give one shiny shit how other women choose to have their babies. Mind you, I don't care whether you BF or FF, spoon feed or baby-led wean, stay at home or go back to work... anything really (apart from car safety - that is the hill I will die on).

@Hmm1234 ”Plus the recovery time is longer and you’ll struggle to get up, move around, use the toilet and even feed the baby.”

I struggled to get up, move around and use the toilet after my vaginal birth, and continued to do so for months. In fact I couldn’t go to the bathroom at all because my bladder stopped working. I had to go back to hospital three times in the first two weeks for that, including one overnight readmission. Wonder how much that cost the NHS together with my transfusion, and 5 day hospital stay? A couple of weeks post birth trying to walk for 5 minutes felt like my pelvic floor was falling out (it was - I had a prolapse and my stitches were gaping and infected). A month after the birth I was walking the 10 minutes to a medical appointment when I started feeling urine pouring down my legs - I had no control over it whatsoever. None of that is even a slight exaggeration.

If you can come up with horror stories about c sections, I can do the same about vaginal births. Difference is, the latter is my own lived experience.

Oh, and I’m a C section baby - lucky enough to be naturally slim, no food allergies at all, no hay fever.

The second reason is that costs persist after the births. Costs of treatment required after complications of vaginal birth and indeed of EMCS are both costs of attempted vaginal birth. They have to be part of the pot as well.

I don’t disagree with any of what you say - but you show complete ignorance in the way pots work. Everything you say is true. In an ideal world it would all work like that. Funding models though are all about people doing the best they can in the immediate term.

The analogy is funding via Govnt of the day. No Govnt pumps money into something that shows benefit down the track. They are in it for the here and now. They may not be in power down the track so why do they care what happens down the track, the MO is kick the can down the road and look as good as you can for today, so that’s spend on stuff in the immediate term to make themselves look good. In Health that translates to short sightedness. They don’t care that extra funding today will result in better outcomes down the track. All your stuff about benefits down the track is 100% correct. Well done, pat on the back, you are correct. You are not the Lone Ranger and only person to have figured this out, everyone actually knows this. The people responsible for funding don’t care though. So when budgets are handed down all that stuff for down the track doesn’t factor in. This often makes a complete mismatch with Guidelines and best practice, which do factor in a long term approach.

Then that woeful budget that lives for today is split up into buckets, those buckets are distributed out into pots. Some poor person peers over into a near empty pot and thinks how the fuck am I meant to run a department on that. This is not going to give patients the care they deserve but we will have to try and do our best to ensure the majority of people are treated adequately, recognising not all will necessarily be treated ideally because that funding does not match Guidelines etc.

Another analogy. A parent has a limited amount of cash to provide their kids food. They have 2 choices. They can buy nutritious food food that will have long term health benefits for their kids. Buying this food will mean their kids eat for 4 days. Or, they can buy cheaper crap that will feed their kids for 7 days and no doubt lead to poor outcomes down the track. If they go the nutritious food they know they will have kids crying for 3 days so they take the crap option. The parent is not proud of this and does not feel good about it but believe they have done the best they can with the choices they had. Medical care, including birth, is no different.

Lastly, a sad fact is, sometimes you know that in order to feed the child for 7 days, if something adverse results from this, then Legal has a pot they will use. Hang on, but what if you had of had the money that Legal has in their pot in your pot to begin with because ultimately it all leads back to the same bucket. You could have fed the child for 6 days at least, and there would be no need for someone to use that pot. No one who distributes buckets and pots has this common sense, so your pot will never be bigger and Legals pot smaller.

Will add, that’s why people will also experience discrepancies in care across institutions and you will find policies differ as sometimes pots at some places are bigger than pots at others, or various factors mean you are luckier in spend and your pot tends to last longer than your counterparts corresponding pot at another institution so you have more of an ability for optimal treatment than your counterpart. It can be a lottery system at times.

I had an elective c section a few months ago. When I told people I was having it, I was often met with either a sad or scornful 'why?'. It seemed strange that I had to produce my list of reasons (some of them being: forceps, severe tear, haemorrhage, blood transfusion, prolapse from previous vaginal delivery). It never ceased to amaze me when they would say 'ah ok', as if to give approval, as if it was their business.

For those who talk about the impact that elective sections have on the NHS should maybe çonsider the wider implications which traumatic births have on mothers, and, consequentially, babies. PTSD, difficulty bonding with the baby, difficulty establishing breastfeeding, postpartum depression/anxiety as well as some of the life-limiting physical changes which a complicated vaginal delivery may entail. Birth trauma can impact the entire family and have so many knock on effects.

My ELCS was nothing special. It was surgery and not the day spa experience that is so often espoused on Mumsnet. The recovery was long and quite brutal at times. However, it wasn't much worse than the recovery from my vaginal birth and I didn't have to endure hours and hours of suffering and unpredicted interventions to get the baby out. I would do it again.

My answer to anyone prying about why you're having an ELCS would be 'oh, lots of reasons but basically my doctor and I have decided that a c section is the best option'. End of story.

This is quite the goalpost move, and as an explanation for your views, isn't consistent with half of what you said.

Saying that ELCS costs the NHS more is not the same thing as saying it doesn't cost more and may even cost less over the longer term, but because of the way in which NHS funding works and the reality that people and institutions are generally short termist over costs for obvious reasons, people aren't receptive to that. They're two different points. There's actually a good argument to be made about NHS short termism here, speaking as someone who's actually had a bit of professional involvement on the subject as it happens (although the legal costs are concentrating their minds a bit on that one). But you didn't make it.

Additionally, even if we look solely at the costs while the woman is in hospital, that still doesn't tell us why you thought straightforward VB only was the appropriate comparison to ELCS. You talked of theatre time, anaesthetists, extra hospital stays etc as though those aren't also a risk of attempted VB. Basically, even taking an extremely short term approach, ELCS costs v straightforward VB costs are the wrong way to look at it, because attempting a straightforward VB doesn't mean you get one.

I had an emergency Cs (went into labour with breech baby) and then vbac. The lasting thing about the Cs for me is the crappy not even symmetrical scar that will ensure I never have a flat or even nicely rounded belly. If I had the choice again I'd still try for a natural birth. Just speaking from personal experience.

I assume the scar is the result of emergency as my 2 scars from planned are neat and too low to affect my stomach at all. They are below any knicker/bikini line

For heaven sake, having any kind of postnatal or antinatal care costs the NHS money. Maybe she shouldn't get pregnant at all.
Smokers cost the NHS money. Drinkers cost the NHS money. Cyclists cost the NHS money. Car drivers cost the NHS money. Everybody costs the NHS money.
If she wants a section she should have a section without the holier than thou shite.