Women are encouraged to have vaginal births due to…

[Undkonm]

1. cost
2. because women are not treated like men in terms of pain management

I have read (and also strongly believe) that the nhs encourages vaginal births to save money. A consultant has recently come forward to say exactly this. It is appalling and women are still falling for the narrative that vaginal birth is the only real way to give birth.

Don’t get me wrong, I know there are huge risks with all medical intervention such a c section. But I know so many people who have ended up with an emergency c section and it’s been awful for them. In contrast, those I know (including myself) who elected a c section by choice had a peaceful and largely predictable birth.

This toxic narrative that birth is only birth if you give birth vaginally is another abuse of women. I am glad I had the insight and confidence to push for what was best for me. I know other women who desperately wanted a c section but were pushed around and didn’t get to have it elected.

When will this end? I should add that I also strongly believe women who want vaginal births should be absolutely supported but it should be an active choice to do that, not the expected ‘norm.’

Do others agree? Do you have other thoughts on this? To go one step further I think the abuse of women continues when the baby arrives with huge pressure to breast feed. Just leave women alone to make decisions that are right for THEM.

I think there can often be a heavy handedness in the approach to encouraging vaginal birth, when mothers have an alternative preference. And those preferences should always be the primary reason for birth choice.
It should be considered the norm still though. It is cheaper and often (not always!) less traumatic on women’s bodies.

If they were truly encouraging vaginal births they would be supporting fully funded home birth teams across the country.

Reports say maternity services are not safe, but women wanting to birth at home (where statistically you're more likely to have a physiological birth without intervention) are being told they have to come in because services are closed or midwives are not available.

Then women are being shamed for safely free birthing their own babies due to lack of home birth support and fear of being mistreated in hospital.

It's a shambles

I have had both c section and natural. The c section recovery after was awful , just awful. Whereas the pain I experienced in natural labour was horrendous but at least it was all over after and I was able to move about rather than peeing into a bag.
having a c section is often needed and should be given for medical emergencies but I wouldn’t elect to have one, having experienced the after effects .

Look, the default should be a vaginal birth. The mechanism is there for a reason. Your entire premise is therefore incorrect; you really should be arguing for:

• better pain management during delivery
• listening to women during delivery, which is linked to having the right levels of staffing
• not dismissing women's fear of what birth is going to be like and yes, offering planned CS where the mental health impact of trying vaginal birth is likely to be serious, but also
• making it very clear that a CS is NOT the easy option - it's major abdominal surgery with considerable risks

IMO the focus should be on avoiding emergency sections by doing all of the above. It isn't about cost, it's about what's best for mother and baby. Vag beinal birth absolutely should be the norm - but we should remove any judgement at all from not following the norm.

Breastfeeding should be encouraged and it should be much, much better supported. I don't agree with pressuring women into it, but at the same time if breastfeeding works it is so, so much less of a faff than bottles. Many women could breastfeed if the right support systems were in place - which again is a matter of investing in staff. The benefits of both things should be clearly set out.

My back to back vaginal birth was so horrifically painful that my second baby was nearly born in the car. The contractions were nothing like as strong as during my first birth so I didn't think I was in labour. Also with the back to back birth I was made to feel like I was wasting their time and sent home because they didn't believe me that I was in labour. Eventually they let me back in after id got all the way home and rang up again pleading for pain relief. No trust in women's instincts and aftercare was atrocious. Men would never be treated like this.

Do I think we should be advocating for women to have surgery they don't need necessitating recovery time (and yes make breastfeeding more difficult)? No.

Do I think women should be bullied into particular birth choices/feeding choices also no.

Feel like there should be a middle ground here...

It is due to cost tho - my ( first time) experience was that I turned up in labour at 10cm dilated had baby within 1.5 hrs. One night in hospital and was home by teatime - cheap
second time was c - section Drugs hospital bed etc etc several nights in hospital was much more costly
third time. I had elective c section and I was in labour ( went into labour on the c section day) and they were still trying to push me into a vaginal delivery - I refused.

it’s been many years since I had my kids but vaginal delivery was pushed especially for first time mums as being ‘safer’

I read somewhere that the second safest way to give birth (after a textbook vaginal birth with no complications and no interventions necessary) is a planned c section. If I recall correctly it’s also considerably less resource intensive than keeping someone in hospital over 3 days trying to coax a stuck baby out with forceps, ventouse etc.

agree with pp regarding home births. We were made to feel awful for having a HBAC after an awful first time experience, and told to just have a section.

I got my healing home birth and know it would have ended up in a section if it w

I had three natural births and an elective C section for my fourth. I had a terrible time delivering vaginally and sadly lasting damage to both myself and one of my children. My C section experience was amazing. I wish I'd been allowed to have one previously. I healed so much quicker than from my vaginal tears and for the first time left hospital without experiencing trauma.

I’ve had the opposite experience, in that I would’ve loved someone to tell me the best option in my specific circumstances but I very much felt that no midwife or consultant wanted to persuade me either way. A vaginal birth certainly wasn’t encouraged and I felt zero pressure to breastfeed, although I chose to. (I know that’s a sensitive subject on here but breastfeeding at population level is better for mothers and babies.)

But yes, cost and staffing are major factors in how women give birth. As well as trying to manage the number of births. See booking women for inductions as standard practice – when I refused a midwife told me it was necessary so that they knew who was coming in when. Which felt like madness – women shouldn’t have to have babies to someone’s else’s schedule. That’s partly why intervention stats are so high.

I mostly agree with you. I was induced because of gestational diabetes which was a horrible experience. Having a c section wasn’t even presented as an option, and I just went with the induction because I felt that listening to the medical professionals was the “right” thing to do. It would have saved me a lot of trauma if I’d had a planned c section. Now I do think I may have chosen the induction anyway, but it should have been a choice. It wasn’t my experience that there was pressure to breastfeed though. Everyone else on my ward was bottle feeding, and I was treated like I was a bit odd for wanting to breastfeed. One of the nurses asked what made me make that decision, like it was a really strange thing to be doing.

There's a weird duality in NHS maternity whereby some feel medical intervention is forced upon them, and others feel they can't access the medical intervention they want; neither are wrong it's just fascinating really.

The reality is that there aren't enough qualified surgical staff or theatres to perform vast numbers of C sections, nor is there enough staff in many areas to have a properly functioning home birth service. It's sad really, most midwives are passionate about women having choices but are forced to providing crappy care due to the state of the NHS- no wonder so many leave, it's a big burden.

My experience exactly! Nearly didn't get to the hospital with dc2.

I agree with OP: the longterm consequences of natural birth can be horrendous, and not obvious for a decade or more (prolapse, trauma, etc).

And infanitilising mantra of 'a c-section isn't an easy option'... 🙄 No shit, really? Hadn't entered my female brain that major surgery might not be a walk in the park.

Let women make their own choices.

I would think women are encouraged to have vaginally births because it does t involve surgery. I can't see why anybody would opt for elective cesarian without a sound m3dical reason. Just have an epidural if you are scared of the pain.

Cost and ideology. And when you read up on the history of natural birth it's not pretty. Yes, women were infantilised and abused (twilight sleep etc) but a lot of the figures in the movement were originally men with sexist and racist attitudes. Grantly Dick-Read and his "primitive women don't feel pain" for example.

Groups like the RCM and NCT don't have a very admirable history. They turned childbirth into moral virtue.

My first birth was an emergency CS due to severe pre-eclampsia. It did make it much easier on me that there was simply no question about it, I was showing neurological symptoms and baby went into distress. Wound up with planned repeats for 2 & 3. I know women who felt like they failed in situations like that, but nothing really could have been done to prevent it. At best if I had been diagnosed a bit earlier they could have tried an induction but from what I have read and what I know of my condition at the time, it would not have had a very good chance of being effective. I was nowhere near ready to go.

I know c section recovery is awful for many- this is largely due to poor after care and pain management- i actually think it suits a lot of hospital’s agenda to let women think you’ll be totally indisposed and in horrible pain because it’s surgery and encourage them to opt for the more ‘natural’ birth - it doesn’t HAVE to be, though. I was up and about and showered within 12 hours, home within 20, however the fact that there was little to no support available on the ward spurred this on and I thought I’d be better off at home. The fact that I was expected to come back in for my five day check on the bus (don’t drive) with a newborn baby, when they only give you 3 days worth of dihydrocodiene is ludicrous though. I did it but it was madness. The c section at source i cannot fault, but everything after was shit, I’m just thankful I was lucky enough to have a ‘good’ recovery.

I was actually quite swayed by the idea of the birthing centre initially- it really was very much sold as the best option at the time- however my baby was a complicated breech and I was able to request a section. I’m mightily relieved about that to this day after hearing what some of my NCT friends went through.

It honestly wasn't my experience. With both my DC interventions were pushed, eldest i was willing to stick at it but was told baby had to come out so i had forceps & episiotomy

With youngest i was told c section was safest option for medical reasons. The only person i know who asked for a c section (after previous birth trauma) was given one without question.

“If you are scared of the pain” - I suspect you are being intentionally goofy but I’ll bite. The reasons that women may want to opt for planned c sections are diverse but I would suspect that very few are afraid of the pain. I suspect for many it is the desire to have an experience over which they have some control. If birth trauma were taken more seriously and if maternity care was better resourced, women might be more trusting of the experience. To my mind the desire to have a home birth or a planned c section are often quite similar- wanting to have some autonomy in a system which is frightening, chaotic and does not prioritise the wellbeing of women. The myth that women who request planned sections are “scared of the pain” (or indeed that you can just have an epidural at will) is born out this misogyny.

I had two sections due to existing medical condition, but there seem to be plenty of reasons vaginal is preferable if possible - high on the list being that a c-section is surgery, as people have said. My c-section experience was great and recovery was pretty easy but the surgeon will have to go through a lot of layers and complications due to scarring are not uncommon.

How are you going to pay for this?

Thats not been my experience second hand with my own daughters, compared to 33 years ago.

I would say the NHS is encouraging much more medical intervention, both inductions and c sections, rather than let woman give birth naturally. Inductions seems to increase the rates of emergency sections. Inductions give a much more painful contraction and aggressive labour once it gets going and rather different from going into labour naturally.

Ive spoken to some medics who believe the medical intervention is due to lack of midwives to control busy labour wards and avoid litigation

I’ve had two c sections. Never even wanted to entertain the idea of a vaginal birth. I don’t care enough about what other people think about it not being a “real birth” or whatever, to feel any guilt over my decisions. I don’t think vaginal should be the default just because we have the parts, when the after effects can be horrific. I wouldn’t want to risk permanently injuring myself for sake of natural. Medical advancements has given us another way to do it where it can be planned and controlled better. And yes, I know recovery isn’t always great for everyone like it was for me.

That said, I would never dream of trying to tell another woman how she should be giving birth, it should be a personal choice that is 100% up to her.

For me a planned c section is a preferable choice not to avoid pain, but to avoid the absolute lucky dip of horrifying situations and injuries you might come up against vaginally.

Yes a textbook vaginal birth is the ideal, but most women do not get one of those. You just have to go into it hoping you will.

Whereas with an elective section - especially for a first-time section - complications are less common. Yes they do happen, but most of the really bad section issues come from emergency sections.

This ^.

I find it so depressing that we are still have the same arguments about this.. Goes to show how things really have not got better.