C section - do you agree?

[ndpp]

I always wanted a vaginal birth. Due to some significant trauma in my pregnancy, mentally I did not feel able to do this and I asked for an elective c section. I was sad at this choice but felt it was best overall in the circumstances I was in. Although it was a tick box exercise to have the elective, I was surprised at the emotional pressure from nurses, doctors, HV, friends, etc to avoid a c section.

However, having had it, and a close friend desperate to have a vaginal but ended up with forceps delivery and massive tearing that two years later she’s not recovered from, I can absolutely say that the c section was easier all round. I know that’s not the case for everyone. But since then, 9/10 women I know from work and friends have all ended up with emergency c section which is of course worse than an elective.

AIBU to think that the main driver for woman to have a vaginal delivery is actually cost and not safety? I wonder if men were giving birth whether they would have comments made to pressure them into going through such trauma when actually, an ELECTIVE c section, although major surgery, is less painful for a woman and less dangerous to her.

Absolutely, and again i think every woman has the right to decide the birth they want.

Interventions are just that, either chosen by the medical professionals or the mums, sometimes they are needed, other times they are wanted but either way the will increase the risk of a c section.

I think there should be more unbias teaching for mums and mums should actively research their options so they make the right choices for them, their baby and their body.

Denying the CHOICE of a woman in labour, by not offering all the options on site is outrageous. Having to be blue-lighted to the nearest hospital when you finally decide to have epidural is not a reasonable solution.

Just clearing this up, woman are made very aware of this before they chose to birth in a birth centre, i know i certainly was.

And yes, VB might have happened for me if someone had tried to help me turn my baby, or if they hadn't made me stay close to or on the bed at all times whilst being induced. I couldn't even kneel on the floor once I had the drip. Fucking awful.

(I had an epidural and let it wear off so I could push, so I am probably at fault, but I was in terrible pain continuously in my back from back to back baby and throwing up blood and shaking and my teeth were chattering and I wasn't allowed to walk around, kneel, have a bath).

YABU. It depends on everyone's circumstances. I think choice is important, but this "the main driver for woman to have a vaginal delivery is actually cost and not safety? I wonder if men were giving birth whether they would have comments made to pressure them into going through such trauma when actually, an ELECTIVE c section, although major surgery, is less painful for a woman and less dangerous to her." is too much. For many complication-free pregnancies in healthy women, a vaginal birth is safer and easier to heal from than a C section.

I had an emergency section with my first and I was so uninformed about birth and labour compared to second time round, I made so many decisions about pain relief etc when I didn't actually realise the potential impact it could have. I was adamant I was trying my hardest for a vbac 2nd time round. It was bliss! I was home the next day instead of being in hospital for almost a week and recovery was much easier which was important to me with a 5 year old as well as a newborn at home. If it had got to the point where they wanted to induce I would have asked for an elective section, I would have avoided that at all costs.

I don't think it's just cost, but a vaginal delivery is often the safest for both mum and baby. It's major abdominal surgery which in itself has risks and extends your hospital stay, hence why they want to explore all birth options

clarebear111
There are plenty if potential long term side effects of C-, sections as well

C sections don’t always go to plan and I think the fact it is major surgery is overlooked.

I had multiple wound infections then ended up with sepsis and back in hospital for 2 weeks (separated from baby as they weren’t allowed on the general medical ward), then ended up with a pulmonary embolism.

So although the actual delivery of baby was easier the recovery was so much harder.

Its because an uncomplicated vaginally birth has the best recovery and is thought to reduce babies risk of asthma. And yes cost, why pay got unnecessary surgery. Equally either vaginal or c section can have negative consequences.My emergency c section had a quick recovery, another person's had complications.

However, it's your choice and I think in your situation you made the right one.

The emotional pressure you mention was real. In my case, from the female consultants. Specifically female - no issues at all when I saw men! There was a lot of emotional manipulation about risks etc, mentioning my weight but what every single one of them failed to consider was that I have severe osteoarthritis and I knew physically it would be awful for me. I can’t move around to ease pain, I didn’t know the long term implications on my hips (turns out just a pregnancy has resulted in a fast track to a hip replacement waiting list when they usually try other options first!), I get exhausted very easily from another heart condition etc etc etc. I knew in my heart that a c-section was safest but they didn’t care. I just knew if I tried vaginal that I would end up with an emergency section anyway.

I get very concerned when people start throwing about the opinion of c-sections being reserved for cases decided by the consultants because I would have had a lot of difficulty getting the right consultant in order to get the OK. In the end, my husband snapped “well you’re not the one who’s going to live with the long term effects if you force her to give birth vaginally, are you?” and it got dropped.

Anyway, my point is you are so correct and I think a lot of women try for vaginal when they don’t really want to because of this type of attitude from the medical team. I think there is also a lot of societal pressure to do it the “right” way when in reality the “right” way is for mum and baby to be safe and healthy whether a section or vaginal!

There are risks with both but it's so circumstance-specific that I don't think it's possible to make generalisations. The focus should be on what is best for the particular pregnant woman/baby, along with what type of birth she would prefer, and it may be necessary to balance the two. Cost shouldn't be a factor as (at least in my understanding) the cost savings of VBs are marginal once EMCSs and costs of birth injuries etc are taken into account (as opposed to ELCSs). You're not really comparing like with like if you outright compare a VB to a CS... lots of planned VBs will end in an EMCS and they will inevitably cost more. And tbh while it's good to have a plan for giving birth, you just have to be flexible to a degree as things can change quickly.

That said, one huge advantage of a straightforward VB is recovery usually being quicker. A CS is complex abdominal surgery and it amazes and angers me that as a society we expect so much of women afterwards and don't give them sufficient time and space to recover (though I suppose that also applies to VBs as well, only less so usually!).

Yabu to suggest it's essentially about cost although I'm sure that's factor - as it should be for a potentially unnecessary expensive medical procedure that is paid for by the state.

It's major surgery. An uncomplicated vaginal birth is always the ideal.

I had a waterbirth - a great natural experience with no complications. I was home the next day (could have gone home the same day) and had no tearing or stitches. This was in the UK. However I spent many years in Australia previously where ECs seem to be fairly routine. From what I have seen with others and my own experience I think overall I’d rather have had an EC. I do think the NHS pushes natural delivery to save money and they don’t always have the woman’s health and well-being uppermost in their minds.

The UK birthing centre my DC was born in was attached to the hospital. If you needed surgery they put you in a wheelchair or stretcher, put you in the lift and wheeled you along 1 corridor to theatre.

Anyway, they are not denying a choice to the woman. The woman has chosen to give birth there instead of in a hospital. It suits many uncomplciated pregnancies much better to have that more relaxed environment.

I can't believe you were put under pressure to give birth vaginally when you had such a clear reason why you didn't want that. Well done to you and your husband for saying no.

@Picturesofowls Thank you! In the end it was an emergency anyway due to a failing placenta so a bit of a moot point but it was all just ridiculous! I’ve heard the hospital have had a change of leadership in maternity since then and the new guy is much more forward thinking and just generally supportive of women’s decisions.

@Goldbar

Yes, totally agree! That's why I wish they triaged people better - if there were more focus on this, there might be fewer VB injuries and more money to spend on midwives and the general service.

And yes to the demands on mothers. I split my CS scar post birth. Because all the HCAs refused to help with my food tray and made me waddle to the door :(

@stormteacupandcake I do have a problem with UK birthing centres however, run and managed by midwives but which generally do not offer any epidural let alone a theatre for c-sections. If they were part of a general hospital, with access to anaesthetists or surgeons "on demand", it would be great.

Why do you have a problem with them? There are actually very few stand alone birth centres in the UK that aren't part of a bigger hospital with immediate access to epidurals or theatres if needed. Fully midwife led units absolutely have their place and offer a middle ground between home and a labour ward.
Removing the choice based on your personal preference seems ridiculous. Would you also ban home births?

I had a planned c-section as my baby was breech and it was an amazing experience. Really peaceful, beautiful and fast and easy recovery. If my baby weren’t breech, social pressure would have made me try a vaginal delivery (even though I would have been terrified as pretty much everyone I know who has had a vaginal delivery suffered insane amounts). However, knowing what I know now, I will definitely have planned c-sections for my future babies.

I think mums should be able to do informed choices without feeling the pressure to please anyone. We should all learn as much as we can about both processes and do what’s right for ourselves.

I had a VB .. not a “shitshow” not “horrendous”. I was drug free, no long term (or even short term) issues. The only tear was a small internal one, due to retained placenta.

I know women who have had VB like mine, ones who have had interventions, ones that have been tricky. I know women who have had uncomplicated CS, and ones who have had pain & infection afterwards

It’s whatever is right for baby, and whatever is right for mum.

@FoxtrotSkarloey and @PinotPony the statistics are skewed though and @PinotPony you're confusing risk of of those outcomes with them actually happening in real terms and also their are massive risks with vaginal delivery but frustratingly we are still unable to talk about them let alone know that when they do happen know that they are recorded properly for them to form an actual statistic, I’m taking about vaginal prolapses and urine or fecal incontinence.

The problems with the statistics are also that the older figures/studies lump medically required sections, true elective and emergency in together and even newer studies lump medically required (either because of the mother or the baby) together, they also don’t treat emergency sections as a complication of a failed vaginal delivery. It can only really be properly judged by comparing outcomes of a ‘normal vaginal’ delivery and a truly elective c section.

And yup I’m with @ChatBFP spot on.

I’ve had both and both without complications Personally I wouldn’t choose a cs over a vb. My cs was lifesaving for both of us but it is major surgery and does have long lasting effects
With birth whatever option you choose or end up with it can go very well or very badly.

I had two elective sections. Absolute dreams and such a quick recovery. Driving and exercising and generally back to normal in a fortnight. I have no shelf, no diastasis, no adhesions, no pain and most importantly, no birth trauma. They were what I wanted, so I had them. And I love my scar.

I am extremely positive about choice in maternity care.

Same here. ELCS for medical reasons then VBAC. VBAC recovery much better, plus breastfeeding easier too.

Anecdotally the people i know who've have a bad time of it have almost without exception been induced - that's the aspect I really have a problem with. My view is that, if it's medically necessary to induce, 9 times out of 10 they'd be better off saving everyone the trauma and going straight to c-section.

When I had dd1 it was all over news that highest cost to NHS was payouts to people injured understand birth who should have had c section and paralysed brain damaged babies who had problems in birth.

I did loads of research. It's easy to skew figures and massage each way but at that time elective c section wash definitely safest. I think emergency c sections had been included in figs.

I had a chosen selective second time around and it aas definitely the correct choice for me.

It makes me angry when I hear the language around birth it's a process like evacuating your bowels.

Do you feel proud to have passed a really massive poop? Do you congratulate yourself that you didn't need a pessary??