To think good on her ?

[bluelollipop99]

I have a lovely friend who is 36 weeks pregnant, ( her first baby ) , and she mentioned she was having an ELCS.

I asked if the baby was breech, and she said "no medical reason, but I didn't want hours of absolute agony, being told too short staffed for an epidural, tearing , never being the same down there again , feeling tearing with a 25% risk of an EMCS anyway. The NHS will never tell you this , but the NICE guidelines say if you request an ELCS they have to give you one, even if the midwives fuss about it."

I had a great fear of giving birth, but went ahead with vaginal birth as there was the clear pressure at the hospital that having an ELCS for non medical reasons made you "less of a women."

But thinking about it , my cousin had an ELCS at the same time and her recovery was not significantly longer than mine; to make up for the agony I went through.

I also think it's a bit bad that you only get this of you are literate enough to check the NICE guidelines.

AIBU unreasonable to think ELCS is often the best option for some people, and good on her for not being shamed / guilted out of this ?

I had an emergency section and an elective section.

Utter bollocks over how the baby is born. So long as they are healthy who actually gives a fuck.
I’m glad over not having vaginal births. My fanjo is still in great condition and I have two beautiful babies.

This really minimises women's emotions around birth.

A healthy mother and baby is the baseline of expectation.

It matters to women how they give birth and their feelings around it are valid.

This thread feels like it is promoting CS and demonising vaginal births.

There are pros and cons to both births and women should definately be able to make an informed choice.

The biggest benefit for elective Cs is it reduces the risk of an emergency cesarean section or instrumental births to 0%. It can also reduce anxieties around labour and pain especially if women have has previous negative experiences.

However, it should be considered that the reality is the risk of complications is much higher with surgical births. Postpartum haemorrhage rates are higher, injury due to surgery, infection and longer recovery are higher risks. Also, you increase your risk of placenta previa/accretia in subsequent pregnancies - neither of which are a walk in the park.

All this evidence is out there in abundance including neonatal outcomes.

Obviously - having a straightforward vaginal birth is the best option and I struggled with making a decision. In the end I aimed for a vaginal birth with a low threshold to progress to a more relaxed emergency CS at the hint of things not progressing well - rather than leaving it until last min.

This worked well for me - I felt relaxed and in control, found the pain manageable and ultimately had a really lovely, quick, natural birth that was all done in a couple of hours, no stitches and home within a couple of hours. I can't believe I'm saying this but I actually enjoyed the day.

I've had two; best decisions I made

The choice should be there and good on people who choose it. I had 3 vaginal births and if I could have avoided the many many stitches I had to have I would considered a section!

Age & health makes a difference too, a young woman who is healthy will likely find a VB the best option whereas the CS is likely better for older mums.

"I knew all about the NICE guidelines and I imagine if you had a real phobia you would have googled about this and found out - its not a huge secret."

Lucky you having google

I think women experience huge disappointment when their planned birth doesn't, well, go to plan. So having a huge forceps or tear/theatre drama or emergency caesarian etc. To actively PLAN for a C-section is to be owning it, I think it's a really good idea. Too late for me but, yes, I say good on her!

@safeplanet are you sure most O&G docs go for cs? All the ones I have spoken to think the opposite.

I am scared of cs despite it being my day job

I find your post illogical because women are not comparing a CS with a no interventions vaginal birth. That comparison is ridiculous because they don't know if they would manage to have a straightforward vaginal birth. They're comparing a CS with the possibility of a birth with interventions and a straightforward vaginal birth, without knowing which camp they'd fall into. The risks are then completely different and what you've said does not hold true.

You would be very naive to assume you could have an unplanned c section the moment you wanted to regardless of what is in your birth plan.

This is the crap the midwives feed you to guilt you but is just not true.

😬Hope it's only the shit talking lying midwives reading this not the other ones.

Pulling a tooth and shitting bricks are also naturally painful but we still have analgesics and laxatives. What a bizarre post.

But they aren’t naturally things our body does are they so completely a random comparison

Yep, and anyway it’s bullshit that c-sections cost a lot more. Once you take the long term impacts of vaginal births into account at a population level, they’re as expensive or more expensive than caesareans. Not to mention the millions paid out every year settling claims in respect of botched vaginal births.

My tear after my vaginal birth required no fewer than three trips to theatre over the course of 12 months, one requiring a general anaesthetic. I can say with absolute confidence that my planned c-section with my second child cost the NHS less.

But I wouldn’t argue for one second that all women should have to have planned caesareans to save the NHS money. Because that would be barbaric. So I don’t really understand why it’s acceptable to say the reverse.

It is also quite natural for many mothers and babies not to survive childbirth, as we know from maternal and foetal mortality rates before the early to mid 20th century, and even today in poor parts of the world without access to the kinds of medical interventions we take for granted.

What a terrible comment -- you don't know anything at all about the circumstances of women who choose a CS over vaginal birth.
I chose one for my second pregnancy after my first baby died in childbirth, and yes, I was scared when I was about to give birth again, but not because the pain. I was scared the baby could die.

I wouldn't say there's always weeks of recovery. After my DDs I had maybe a week of mild/moderate pain from stitches but after that it was just bleeding which was more inconvenient than anything else.

I appreciate that was luck, and some women do have longer recoveries. And I wouldn't use my experience to be blasé about the potential negatives of vaginal births. But I definitely think you're wrong to say all women have weeks of recovery time.

Our bodies often die giving birth without medical advances. For a multitude of reasons, we are not evolved terribly effectively for child birth. It's complex but suffice to say that our bodies are unfortunately not adapted to perform this function 'naturally' without frequent loss of life and injury. So talking about it in terms of medical pathology is not inappropriate.

Our bodies often die giving birth without medical advances. For a multitude of reasons, we are not evolved terribly effectively for child birth. It's complex but suffice to say that our bodies are unfortunately not adapted to perform this function 'naturally' without frequent loss of life and injury. So talking about it in terms of medical pathology is not inappropriate.

Seriously 'we are not adapted to perform this 'function' 'naturally' without frequent loss of life and injury' ?

Is that a quote? Are you a HCP or in academia? Have you studied this? Genuinely interested.

That sounds really, really sweeping to me.

I thought that previously a huge amount of loss of life in childbirth was due to infection.

Tbh @Everyonesinvited I wouldn't want anyone who hadn't already given birth reading that statement.

This OP was mean to be about maternal choice in childbirth, which I'm all for, not how shit it is to have a VB. Which still remains how 75% of the child bearing population manage to produce babies on a daily basis in the UK.

Agreed. I also feel that some midwives prefer not to issue pain relief.

I gave birth to my second dc on two paracetamol because the midwife was in no rush to call the anaesthetist. By the time he was called (3 hours after I’d first asked) it was too late.

Dsis had a similar experience when she requested an epidural. The midwife said that she was coping fine and it wasn’t necessary. She wasn’t offered any alternative, she was just expected to deal with the pain.

It makes me so angry to think of how women’s wishes are ignored, particularly during childbirth which we are all aware can be excruciating. There is no right or wrong and women should be able to choose how they give birth and what pain relief they receive. You can bet this wouldn’t be an issue if men had to give birth.

I’ve had both, one vaginal and one section, the section was far better, less recovery as I tore really bad with my first, no pain labouring and I could plan everything as I knew what day my section was planned well in advance. I’d say each to their own.

I jumped through a thousand hoops to get an ELCS and then changed my mind at 6 months 🤣. The hormones were so strong I just knew I wouldn’t feel ‘done’ without the finale at the end. I felt exactly the same with DC2 also. I would have felt robbed if i hadn’t laboured.

to my thinking if you get to 36 weeks and are still adamant you want a section then you blimming well should get yourself one.

Just look at the figures for mortality in childbirth for pre medical advances in developed countries or currently in undeveloped countries. The harsh reality is that pregnancy and childbirth are two of the most dangerous things that can happen to women over the normal course of their lives and we are extremely lucky to have technological and medical advances to make this process much safer. I wouldn't want to suggest childbirth in a good hospital with proper staffing is likely to harm you. But that is precisely because of the staffing and the medical facilities available. Doctors acknowledge that c sections are individually safer and any increased risk relative to the unknown nature of a vaginal birth is so small as to be medically unclear. The idea that labour doesn't need to be medicalized could and has killed women because it isn't true for many of us. It's lovely when it's true. It's lethal when it isn't.

The idea that the process is naturally 'safe' and a bit like a fancy bottle of cordial with "100 percent natural" on the side of it, is better without medicalization is now discredited and it's been recently acknowledged that this view has been responsible for British women and their babies suffering harm and trauma. Britain has figures to be ashamed of in this regard, for a developed nation.

In my opinion British women have the worst of both worlds. We don't have midwives who are present throughout the birth and experienced in managing by themselves due to staffing levels and changing practices around difficult presentations. So in that respect we are losing out on what we would have had in the past. But we also aren't benefiting as much as we should be, given we're a developed nation, from medical advances because of a multiple of factors including staffing shortages and the phony idea that helping a labouring mother will lead to a cascade of unnecessary and harmful medical interventions.

Many women never get to complete a birth plan (I didn't) and opt for a c section if there is a remotely challenging scenario because they know they could in all likelihood be labouring without a professional in the room until everything goes tits up. By which time it will be too late to avoid traumatic interventions. We've ended up with a system where we hope for the best, it's not a very good best, and do a EMCS if it all goes wrong. We're lucky have the option of EMCS but it's not ideal and I suspect it's the only thing that spares us from mortality rates on a par with countries Britain sends medical aid to.

Re the evolutionary aspect, I'll try and see if I can track down where I read this. It's quite obvious though if you think about it - we've taken a step forward in the shape of our skull/cognition and the pelvis currently isn't as well adapted relative to other species.