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 certainly don’t feel guilty about having a c section. I am a tiny size 6, all of the other women in my family (who all have much wider hips than me!), have had the most horrific vaginal births - tearing, episiotomies, ventouse, forceps. There is no way I consent to those practices, and I know what would inevitably happen if I attempted to birth vaginally. Not a chance. The NHS have finally been called out on their barbaric practices towards women and babies, denying c sections when they have been needed. Unfortunately, they conflated their elcs and emcs data for safety and costs, so they could continue to spin the yarn that vaginal is best. Absolutely sickening, intentional lies.

I think it boils down to spite and resentment that someone has had something they didn't even if they didn't want it the very fact that someone else chose it is enough. As I said misogyny through and through.

@BattenbergdowntheHatches wtf 😂😂🙈🙈 I think this is the most ridiculous. mumsnet competey batshit post I’ve ever read.

No MY vagina is the tightest 😂😂😂😂😂😂😂😂

I don't think @BattenbergdowntheHatches was saying anything of the sort, she was merely agreeing that some women have smaller vaginas than others. It's hardly competitive or a boast, it's a statement of fact and it's relevant to the topic.

I have exactly the same issues @BattenbergdowntheHatches describes with smears. Was my post ridiculous and batshit too, then?

Op just do whatever you want. Can't imagine who is even asking you what kind of birth. Just be vague. If anyone is rude enough to pass judgement tell them to mind their own business. Then make arrangements for a section.

I was lucky to get the exact birth I wanted (nothing like yours!) I hope you do.

You think women shouldn't have an epidural either? Because it could take an anaesthetist from an emergency.

I’m not knocking vaginal births for those who choose one. But to clarify, for those who are trying to suggest that c sections pose some unknown danger - In Greece, over 50% of births are c sections, and guess what… they have the second lowest maternal mortality rate in the world. ELCS are, overall, very safe.

Remember, only about 50% of vaginal births go to plan in the UK, the rest result in EMCS.

The Ockenden review shows that the hospital with the lowest rate of c sections also had the highest rate of infant deaths.

Have a look at the stats for poor countries in Africa where there are no c sections available - if birthing women are ‘doing what their bodies are designed to do,’ how come the lowest c section rates = highest death?! In South Sudan 1 in 7 women will die during pregnancy or birth due to a lack of medical intervention. Their ‘bodies are designed’ for it?!

Also, with humans having evolved to walk on two legs, and to be so intelligent, the birth process really is on the cusp of possibility. The ratio of babies head size to mother’s pelvis size is touch and go - no other mammal comes close.

The NHS continues to spout this BS that it is ‘incredibly rare’ that a woman is ‘too small.’ Utter rubbish - it’s only after the Ockenden review had been published that my friend’s Dr finally admitted the truth - her hips are physically too small (he didn’t bother to mention this for her first birth, and she almost died). Another friend was rushed to EMCS, and afterwards the Dr admitted, ‘it’s a good job we could do a c section, baby was completely stuck, you would have died if this was the fifties!’

I have not heard a single negative ELCS story, but of the women I know who have had one, and the women I know who have had both a vaginal and and an ELCS, they have ALL said an ELCS was a good, calm experience and they were not traumatised, and all made quick physical and mental recoveries.

Of the women I know who have given birth vaginally, I know at least five who have been utterly traumatised, and unable to consider another pregnancy. Two who have had to sue the hospital for mismanagement of the birth. Several permanent birth injuries. And not a single women I know has spoken positively about her birth experience. Not one.

Sorry correction, that was supposed the say:

the rest result in EMCS, ventouse, forceps, episiotomies, and still births.

I told people I was having an ELCS (whenever the subject came up, like in NCT classes or if people asked) and after a while learned to have a look in my eye which indicated the topic was just not up for debate.

This was at a time a few years ago when NICE guidelines saying there should be maternal choice existed, but lots of hospitals had been totally captured by natural birth or bust ideology and were choosing to ignore the NICE guidelines. The hospital to me (a very big London teaching hospital) even had a little box on the obstetrics section of its website saying words to the effect of “Please don’t ask for a CS because refusal may offend”. When I complained, they took the box down, but would not confirm that the actual refusal policy had been altered, so I went to another hospital which seemed to be a bit less dogmatic, although I still had to fight for it quite hard.

It later turned out the kid had in utero restricted growth (spotted by the hospital, assumption was he’d need to go to NICU), AND I had pre-eclampsia (not spotted by the hospital until too late), so probably would have ended up EMCS if I had not already negotiated an ELCS. (EMCS would have been worse. But hey, doctors always know best right?)

The procedure itself was fine, up and walking around within 24 hours, no post-op complications, “systems below” were completely intact, all good. Best of all, despite being born at very low birth weight 3.5 weeks early, no NICU needed for the kid - which I put down to the super short, minimally traumatic birth. He was out of there within ten minutes of going into the OR. No chance to get stuck or distressed or starved of oxygen, no need for forceps or vacuums or any of the other hideous tools they use to assist in so called “natural” births.

I had two ELCS for the same reasons you’re considering it. No regrets whatsoever and anyone with a problem can go swivel. Two happy healthy boys and a happy healthy mum.

Don’t listen to anybody else, how you plan to deliver your child is your choice. My two are 8 and 5 and how they were born never comes into conversation now, so ultimately it doesn’t matter. As long as you and baby are safe and we’ll that’s all that matters. I had a long labour with my firstborn which resulted in an emergency section and massive blood loss for me. I was ill for months after. With my second I was advised to have an elective section which I did and the difference was night and day! If that is what you want to do go for it. In a few years how your baby was born will never come up in conversation. Good luck!

Interestingly a lot of these attitudes towards c sections (and pain relief in childbirth, and pain relief in other situations- e.g. coils being fitted) come from other women. I’m yet to meet a man who would presume to pass comment on how I choose to give birth (other than express respect for women doing so), but plenty of women who have. As I said on another thread, I wonder if some women think they know all about “womaning” and don’t grasp that we all have different ways of experiencing things, and different circumstances.

As an aside, I also know two women who were physically unable to give birth vaginally because of narrow pelvises. One of them had been in labour for 30 hours before the team admitted it. Both had EMCSs.

It's very naive to think you have any kind of agency once you're on the operating table - many things can and do go wrong.

when I was on the operating table, I was given plenty of choices

• delayed clamping or not


• immediate skin to skin or not


• lights lowered at birth or left as normal

hell, I was even able to choose the music the nurse played through the speakers!

and let’s not forget that I had signed pages of consent pages beforehand, which gave me plenty of options in the event of things not going to plan…

@BronwenFrideswide and @GirlSYML Obviously there are complications and interventions required in vaginal delivery's, I myself needed an episiotomy and ventouse delivery with my first birth. But the OP is talking about opting for a an elective
C-section by choice before even attempting a vaginal delivery. Obviously sections are often needed and the best option in many births as was the case with my friend in my post. but I think it is silly for a woman just to decide she wants a section due to fear of the unknown (unless it is extreme fear that has become an actual phobia) like I said I was also very scared but all turned out well in the end and I did it again with dc2. I just think it is silly for opting to have a section without even trying, like my friend said recovery from her section was far far worse than her 3 previous natural births. Do you think c-section is the way to go and all woman should opt for it? people die in the world every day doing all kinds of things that are natural eating is natural but people choke to death doing it sometimes? I myself definitely wouldn't want that major surgery if it could be avoided.

I couldn’t give a shiny ‘shit’ if you think I’m ‘silly’ for opting to do something without trying something else that is absolutely of no benefit to me and not mandatory.

I have a medical reason as to why I will probably need a c section but I would be opting for one anyway because why endure hours and hours of pain, possible forceps and other interventions when you don’t have to? All the women I know who have had c sections have had a good recovery. Yes there’s a chance I won’t but that’s a risk I’m prepared to take. I’d rather take that risk than risk a vaginal birth. I’ve only got one friend who had a half decent vaginal birth, the rest were awful, traumatic experiences and a few are now left with permanent injuries. Why, just why would I want to risk that when I don’t have to?! Would it just be for the pat on the backs Id get from women like you because I wasn’t ‘silly’ and ‘gave it a go’ yeh, no thanks.

www.theguardian.com/lifeandstyle/2022/feb/13/caesareans-or-vaginal-births-should-mothers-or-medics-have-the-final-say

apologies if this has been posted upthread - interesting article which references a study in which ELCS are shown to have fewer negative outcomes than planned vaginal births.

im like you OP. I’d rather have the given risks of an ELCS than the unpredictable risks of a natural birth. Similarly, I’ve yet to hear a positive vaginal birth story other than that of a friend who had home births- which are also frowned upon!

Bigyellow, I personally think it's very 'silly' not to do your utmost to minimise risk to your future health, and to knowingly increase the chance of incontinence and prolapses etc.. But each to their own.

My thinking on this has shifted since I had DS. Shifted for me to be clear, I always believed people should be able to chose.

I did a very low intervention home birth which was an extremely positive experience. No tearing, not really very painful, it was an amazing day and I look back on it really joyfully. No pain relief needed, I had some techniques from the birth skills book that worked fantastically. If we’re reporting on our vaginas I’d like to report mine as still tight, thanks. I can also trampoline without pissing myself.

However the more studies that come out, the more I think I’d chose an ELCS if I had my time again. Although with hindsight I was right to go vaginal birth because it was great I do think the risks are much greater of injury. I think if I’d really understood the data at the time I’d have decided losing the chance of the optimum outcome of an easy vaginal birth was a reasonable payoff for reducing the chance of some awful outcomes.

Anyway sorry for the ramble!

Individual risk factors are a big part of it too. My last birth all odds were in my favour (age, weight, previous v birth, spontaneous onset of labour, no pregnancy complications and so on) and statistically chances were low enough for me to feel attempting vaginal birth was the best option and indeed I had a very good straightforward birth.
For other women that’s not the case eg first-time mums who undergo induction often have very high odds of ending up with an instrumental delivery or emergency Caesarean (as in that’s more likely to happen than a ‘normal’ birth!) ditto induced mums of a certain age etc. Often these women aren’t even told what the odds are and feel unlucky to end up with an emergency section despite there being a 50% chance that would be the outcome.

i find this view ridiculous-how far do you take it? Is deciding to have more than 1 child selfish? Or deciding to have children at all for that matter as it is guaranteed to cost the NHS money? How about deciding to engage in high risk activities that might result in an accident that will cost the NHS money (such as skiing)-is that selfish? The NHS is there to be used and people are free to make choices that may result in costing the nhs more money. The consultants job is to provide both elective surgeries and emergency cover-this is factored in to the NHS staffing rota/budget. On an individual level, the cost of 1 operation to the nhs is negligible so surely shouldn’t need to be considered when making a big decision such as how to give birth. There’s nothing to feel guilty for-the nhs wouldn’t offer elective c sections if it wasn’t viable and in the best interests of patients.

Often these women aren’t even told what the odds are

Excellent and important point. At the antenatal classes we went to (NHS ones in the maternity centre) we were told about the possibilities of interventions, but not about the likelihoods. 1 in 3 women having their first baby will need an instrumental delivery! A third!

Source: https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/assisted-vaginal-birth-ventouse-or-forceps//*

I mean, are women even able to give informed consent without these statistics? They are so careful to hammer home the risks of c sections and quietly never mention the odds with vaginal deliveries - the more I looked into it when making my decision for this birth, the more appalled I was, frankly.

Yes that’s a very good point. The odds of various scenarios should be clearly communicated to women who want this information. Birth injuries stopped me from doing proper aerobic exercise such as running for a long time because I was incontinent until they were fully sorted out and every bounce would make me leak a little. Not exactly good for my physical or mental health to be effectively prevented from doing the exercise I love. I used to compete in a sport pre children and it all stopped. And I’m having problems with the area where I tore now I’m at menopause. If I’d had proper information I’d have elected to have a CS.

I did read an article in which a doctor was arguing for this. I think (although my statistics are probably way off- please could someone correct me) that he said a greater than one in one thousand risk in relation to surgery had to be discussed, but the odds of tearing with vaginal birth, especially over the age of 40, were something like one in three ( although may have been much higher or lower). Regardless, it was a far higher risk than the one in one thousand risk, or whatever the actual threshold is for discussion, in relation to surgery. And yet this certainly wasn't mentioned to me until I brought the subject up.

Anecdata of course, but I had the same concerns as you, and to my surprise and delight I had a far, far easier time breastfeeding after my ELCS than after my traumatic vaginal birth - my son latched on in recovery after my ELCS and it was more or less plain sailing apart from a tongue tie which was snipped at a week old (and of course was nothing to do with the ELCS).

Prior to having my ELCS I discussed my concerns with my midwife and she said that in her experience BFing difficulties after caesareans are more common with emergency sections where the mother has been in labour for age and is exhausted and traumatised.

Best of luck with your section. Mine was lovely and I have such happy memories. My one bit of advice is to take a camera into theatre and ask the midwife to take lots of pictures. I have beautiful pictures of the moment the surgeons lifted my son out of me and when they put him on me for skin to skin.