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 agree. I had three vaginal deliveries and two of them resulted in either me or DC nearly dying (shoulder dystocia with one and retained placenta with subsequent severe PPH and blood transfusions with another). Then had two ELCS and they were fucking great. Not saying the recovery was a walk in the park, particularly with the second when my wound opened and became infected resulting in re-admittance to hospital for a few days but the actual process of the birth was 1000x less stressful.

The NHS tried to deter me from an ELCS at every step both times but I stayed strong. The only reason I could see for this was cost reduction but it went so wrong during two of my births, I really can’t see the cost being any less overall.

Nope, it’s because it is underpaid. Like all female dominated roles are.

Meanwhile every outlet that's looked into this reports pay fairly low down the list of reasons they leave. It's perfectly possible as a midwife to get band 6 within 6 months and be on a higher salary than some doctors- of course more would be good but there's a myriad of things that need addressing to make a real difference to retention before pay, which is a shame as its not such an easy fix.

I’m talking about the reduction in applications to do the training. Not those who leave the profession. I don’t know a single nhs employee who would encourage their son/ daughter down that path. They can earn more money for less stress doing something else.

I mean, in theory there are plenty of pain management options, sure. But actually getting them can be a very different story!!!!

And yet the degree is highly competitive still. Sure people drop out during the degree, but it's still one of the most desired healthcare degrees and applications still outstrip places. I'm always keen to know where these decent pay with low stress jobs are though, they're mentioned a lot on here.

I was desperately terrified, in what I now recognise was a fully fledged phobia, of vaginal birth. I would have done anything to avoid it. I can’t imagine anything worse than a vaginal delivery and have always been very clear I didn’t want one, however “natural” it was.

But this was 2011 and at the time the narrative was still very much that a VB was the default unless it was a serious risk. So despite seeing a therapist and presenting the notes to the obstetrician I had a VB. By the standards of some births it wasn’t especially traumatic: 24 hour labour with a ventouse and minor tearing. But I still found it horrific.

I am still angry to this day that the NHS issued a collective shrug and I had a VB because there’s wasn’t sufficient momentum to support women who wanted planned caesareans.

So I agree with OP. Yes all things being equal a straightforward vaginal birth is the safest option but only about half of births are straightforward. I think the NHS and the midwife driven “cult of natural birth” which drives it has had a profoundly toxic impact on maternity choices.

Less stress, not necessarily low stress 😂. I’m amazed that it is one of the most desired healthcare degrees, truly. Band 6 is not high pay, especially when many people are stuck on that grade for years. How long have you worked in the nhs? Perhaps I’m just disillusioned by now.

I really dislike the "our bodies were built for this" "there's nothing more natural than vaginal birth". Our bodies are badly built for birth as bipedal mammals with huge heads. There is nothing more natural than death in childbirth. Its only in modern day that the death rate has significantly fallen. Who cares how babies get out? Mothers and babies are no longer dying in massive numbers.

I've had a section not because I was scared of pain in natural birth but because I'm terrified of tearing, incontinence, prolapse and a wrecked pelvic floor. A section lowered my chances of those things. My preference was for that to be all intact as I knew it would effect my mental health if it wasn't. I prefer to be a happy active mum than not but having given them some birth canal juice, my choice. Get out of other women's choices!!!

I don't understand why breastfeeding is such a debate. Do it. Don't do it. At a population level it makes a difference but other factors can't be separated out and statistically mothers who breastfeed are more likely to have a higher socio-economic status and be better educated so go figure.

Nearly 20 years. We are a low wage economy in this country, band 6 is above the average wage and with enhancements not too bad. Sure we deserve more and higher pay wouldn't be sniffed at, but it's just one of many issues as you'll know. And yes, even though applications for healthcare degrees overall has dropped midwifery still has more applicants than places by a fair bit every year (obviously less spaces than for nursing but still, plenty of people keen).

This year though newly qualified are finding it hard to find jobs due to hiring freezes despite a shortage of midwives which is wild.

I had three straightforward, not particularly painful (gas and air for one, no pain relief needed for the other two) vaginal births one of which was at home. I;m not sure why I should have been insisting on an unnecessary (in my case) operation.

I also didn;t see a doctor at any point for any of my pregnancies or births - all of it was handled by midwives so they were, presumably, pretty cost effective too,

Another typical 'me, me, me and my needs' post.

Surgery requires an anaesthetic, surgical room and surgical staff in addition to the doctor. It requires close supervision during recovery.

It's not just about the money, it's about resources required that ultimately means that an essential operation can't take place because space and staff are elsewhere.

All this because some women think a cesarian is easier, less painful and that alone takes over someone who needs their gallbladder taken away due urgently due to horrendous pain not for hours but days.

Sounds like you were lucky. The research shows you have a much lower risk of stillbirth, complications or needing a CS if induced at 39 weeks vs expectant management (ie waiting for labour to start naturally).

Indeed, one of the trials was ended early after deaths in the expectant management group - if wouldn't have been ethical to continue.

Are you a man? Genuine question.

I get annoyed that all the risks of Cs are trotted out regularly, but there was no mention of the risks of VB when I was pregnant, just constant pressure to do it. I would far rather have a balanced discussion antenatally with clear pros and cons for my circumstances (older mother, bigger baby, health problems).

VB with shoulder dystocia is a nightmare and I was lucky to get away with the few injuries I did. One of my friends suffered such severe injuries giving birth she was unable to work again.

I know several women who've had stillbirths. Nobody should have to go through that. Most of those babies would be here now if they'd had timely CS.

Vaginal secretions benefitting the baby?! Mine picked up an infection from the birth canal as she came put. Again, no mention that this was even a possibility in advance.

This year though newly qualified are finding it hard to find jobs due to hiring freezes despite a shortage of midwives which is wild.
@Happii it’s crazy!

I am not sure if it's related to this but my cousin went to 42 weeks and the baby died shortly after birth. The baby had injested meconium (sticky waste usually excreted by a baby shortly after birth) and couldn't be saved. However I also went to 42 weeks and delivered safely.

It also shows complete ignorance of normal human reproductive careers throughout history. The average woman in the UK is fertile for 15-20 years before going on to have one or two children in her 30s, often quite close together. We were not evolved/built/created for that. It's something quite new.

Perhaps it is best to go the natural route if you're actually getting pregnant and giving birth in the way that human females have for most of our history. Pretty much nobody is, so that's irrelevant for the vast majority of women in the UK today.

@XChrome yes informed choice should always happen but it has to work both ways. The NHS never highlights the risks around vaginal births, the current state of NHS maternity services and what that could mean in reality for things like accessing pain relief, treatment for birth injuries or the reality of an emergency c section or induction.

A Mum's personal preference is important too even if that goes against any evidence/perceived benefits. I read a lot when deciding on a c section for my first (due to have a second c section in a couple of months). I also did lots of courses and classes in case something else clicked but nothing changed my mind from my gut instinct that a c section was right for me because I'd seen some horrible realities that no amount of hypnobirthing, breathing or pregnancy yoga shifted.

The only person who even swayed me for a moment was a lovely home birth midwife who I met by chance. After we talked about what a home birth could look like she realised I'm too far from a hospital to get to one quickly enough for them to feel comfortable and in between areas which mean there wasn't proper home birth provision for me. Nobody was going to persuade me to give birth vaginally in an NHS hospital.

This is another typical short sighted anti CS post. If you're going to go for the silly selfish mares angle, you need to actually have some idea about the practicalities.

Attempted vaginal births are often more expensive than straightforward planned sections. Some attempted VBs result in EMCS, which is dearer than planned section, or instrumental birth which can be. This is very important when our birthing population gets older and heavier with time, and when the percentage of first timers is so high.

And this is just in the short term. Litigation costs to the NHS from obstetrics are of course disproportionately skewed towards attempted VB as against planned section, and then there's the long term effects of sorting out the problems after VBs.

Nope. Woman. Who gave birth to two children. Vaginally. Very painful. Large babies.

But also well cognisant of NHS and hospital pressures.

Attempted vaginal births are often more expensive than straightforward planned sections. Some attempted VBs result in EMCS, which is dearer than planned section, or instrumental birth which can be. This is very important when our birthing population gets older and heavier with time, and when the percentage of first timers is so high
SOME is the key word. Of course sections are highly recommended for medical reasons. When there no documented medical reasons, yes, it is absolutely right that vaginal birth should be encouraged.

It has nothing to do with sex. I feel exactly the same with teeth removals and people opting for general anaesthetics when it can be done perfectly under local.

Obviously it's not all. Nobody thinks that. But since we have an EMCS rate of about 1 in 5, which is more expensive than ELCS, and instrumental delivery rate of about 10% which can be, this needs to be factored into our analysis. They certainly aren't all medical reasons that arose in advance of the birth either.

So you need to consider these. The fact that attempting a straightforward VB doesn't mean you get one is hugely more important than your feelings about teeth. The most expensive births are almost always attempted VBs that have gone wrong, and the only failsafe way to reduce the numbers of those is to offer ELCS more widely.

Basically, if you want to make a resource based argument, do it properly. You haven't so far.

Bit it's not just about costs. Costs are only one consideration.

The most important issue is that surgical rooms and teams are limited. One surgery is another that can't take place. Priority should always be based on medical need, not people's preference.

This can only possibly be posted to be in inflammatory. Nobody can really be this stupid and lacking in empathy.

I see further down you had two painful vaginal births with minimal pain relief out of some form of strange martyrdom to the NHS. I am not risking my baby or my health in martyrdom to the NHS who just leaves you to suffer for years regardless of what's wrong with you because it's such a shit show. And if you think for one minute someones gallbladder is more important than a babies life you really are stupid.

This comes from someone who sat on a waiting list for 4 years in excruciating pain waiting for endometriosis surgery. I certainly didn't expect mums and babies to suffer for my benefit.

Take the resources from somewhere less life and death and save on the diabetes patients who won't help themselves or something. Or can you look someone with a ever birth injury, or a stillborn child in the eye and say well someone needed their gallbladder out and shrug at them?

Maternity care is unsafe and we have the highest fetal mortality rate in the developed world. Its appalling and attitudes like this are what make the services so dangerous.