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.

Thing is, that's a highly selective view of costs. Narrowly you'd also want to include the medical costs of reconstructive surgery, or treatment for incontinence, or treatment for birth trauma/PTSD or Group B Strep. But if we were to look at overall social costs we'd need to include the social costs of incontinence and sexual dysfunction?

Some dogs need C-sections! My dog is a small breed that sometimes needs them, especially if the pups are a mix. 🤷

My consultant was still encouraging me to 'try for' a vaginal delivery, when I had a complete placenta previa! Madness. 🤷‍♂️

I think lots needs to change on how we see birth in this country.

Not speaking from experience here, but inductions seem to be a massive issue, leading to lots of birth trauma. Many taking days and days (I know someone who was in hospital for 5 days getting their induction) and many ending up EMCS anyway. The reasons for induction can’t be that strong if a woman is left in room for 5 days waiting for things to kick off.

The language used when women are giving birth is absolutely ridiculous and doesn’t give them the information they need, often it’s said in a way that doesn’t give them a choice. I am just going to put in a cannula (even tho there is no need for one, seriously you are telling me that if this is an emergency situation you wouldn’t be able to put one in quickly?!) I am just going to put this clip on baby’s head to monitor them (it’s actually a screw). I am just going to give you a sweep (with no explanation of what this is) the list goes on. I am in no way against any of these things, but they have to be explained to people properly and their consent given.

Don’t even get me started on post natal wards, they are the depths of hell and would only add on to a traumatic birth.

We do indeed. If people are going to make an argument based on costs, it needs to be done properly. That was not it.

Thing is, that's a highly selective view of costs. Narrowly you'd also want to include the medical costs of reconstructive surgery, or treatment for incontinence, or treatment for birth trauma/PTSD or Group B Strep. But if we were to look at overall social costs we'd need to include the social costs of incontinence and sexual dysfunction?
You can't discuss costs and argue on the basis of exceptions!

Comparatively to the number of births in the country, the costs associated with essential reconstructive surgery due to giving vaginal birth, incontinence, and birth trauma, again, jut associated with vaginal birth are absolutely minimal.

You also of course would need to balance these costs against the cost of excess bed days due to infections post surgery. You can be assured that the latter is higher than the former.

The fact remains that surgery is more expensive than natural birth and impacts much more on other patients waiting for appointments and surgery for other reasons.

I just love how so many mners are more medically and clinically competent than doctors and nurses with all their years of training and experiences. I guess one learns so much from reading about others bad experiences and Google advice!

Yet you appear to think you're more competent than NICE to do the costs analysis...

@vivainsomnia

Here you go.... costs of c sections upfront are higher, but when you include the costs of medical negligence in vaginal birth, then you end up much more even

www.itv.com/news/2019-04-18/caesareans-cheaper-than-natural-deliveries-once-negligence-claims-taken-into-account

We do indeed. If people are going to make an argument based on costs, it needs to be done properly. That was not it
Haha, funny how those who claimed it was the same costs were not challenged!

How about YOU evidence that the cost of incontinence and other supposedly costly extra and we can then see how it justifies doing mainly C-sections!

I think those are two factors, yes. Healthy vaginal births don't cost as much, and women's pain is not acknowledged and addressed in the same way as men's (but I also think that women may have a higher pain threshold due to their biology, so will tend to endure more before asking for pain relief). I remember being told to "walk around the hospital a few times" before they'd agree to examine me and administer pain relief when I was in labour. By the time they agreed to examine me, birth was imminent. They wouldn't have asked me to just 'walk off' a broken ankle.

All of this said, a 6 week recovery from major surgery (and while adjusting to motherhood) and a higher risk of PPD must be the main consideration I would think.

NICE got there before me. And they did a better job than you have. You should have a look at their website, they have a looooot on risks and benefits of planned section compared to attempted VB. They absolutely consider longer term impacts and costs, despite your no doubt highly learned disagreement with them on that point. I wonder who's better qualified to give an opinion?

Not sure where you're getting the idea from that anyone is advocating doing majority CS as a goal in itself either. The UK doesn't do mainly ELCS or anything close to that, so none of the arguments anyone has made about costs and resources in the UK could possibly be constructed on that basis.

A lot of this may be to do with the fact that these post birth long term issues are not properly diagnosed or treated, it is of course cheaper when no one is is even dealing with problems saying things like "well you've had a baby, thats just what happens".

I'd be interested to see what costs would be involved if everyone who needed it was offered proper post natal physical and psychological care. I had a traumatic birth which still gives me physical and mental problems 20 years later. My paperwork says birth was "natural" as if it was some lovely positive experience, so many people like me will skew the stats as our experiences are not recorded anywhere or treated properly (or at all).

Yet you appear to think you're more competent than NICE to do the costs analysis...

No, I just don't select reading, including this '
Further work is needed, as data used for this adjustment were based on an American study, with the limitations of using a different population in a more intervention-heavy health economy'.

The fact that the research about pelvic floor cost effectiveness dates back to 2010, only consider women who only had one child over their lifetime and that it takes place in the states where pelvic floor therapy is likely much more expensive than in the UK renders it, as NICe stipulates, not so reliable.

If you are genuinely interested in all literature, especially abroad, how about cost effectiveness in Columbia?
Birth delivery cost effectiveness

As for the NHS costs I provided, they are 100% correct. Feel free to find otherwise!

There's no need, the NHS trusts have already done this, and the proof was linked in a previous comment to you. You just don't want to read it.

NICE disagree with you about both the costs issue and what's relevant to include. If you don't accept their conclusions, and also their recommendations from 2021 about the risks v benefits of attempted VB and ELCS, that's literally you setting yourself up as more competent than they are. This seems a long shot, given your contributions thus far.

It's telling that you've not even engaged with the people pointing out the really catastrophic levels of costs, which come disproportionately from attempted VB. You're not even using those NHS figures you cited from before correctly, because you can't possibly think the most expensive VB is £3806 and the dearest EMCS only costs the NHS £6945? You didn't give a link, but I wonder if that was an average range. If you can't tell the difference, that might be why you're so insistent on the idea that denying maternal request CS is such a money saver. If the maximum a birth ever cost the NHS was seven grand, things would look very different indeed!

The point is it is never perfectly safe to have a vaginal birth. That's why a lot of them end in emergency c section.

The choice to have an elective c section is not about having whatever you want because me me me as stated in the post I was replying to, it's about avoiding the risk of complications during a vaginal birth that can and do happen all the time because the maternity care provided is not good enough to trust that they will save you or your baby if you run into trouble.

Elective c section is safer than vaginal birth. That is why people choose them.

I think you are doing a great job of exposing the pomposity of some clinicians who do not even get as far as checking on NICE data before telling women they are talking nonsense.

The point is it is never perfectly safe to have a vaginal birth.

Of course it is. It’s how the vast majority of us entered the world. I appreciate that you’re fanatical in your zeal for C sections and that was the correct decision for you but hyperbolic and untrue statements like that really don’t help your case.

Here you go.... costs of c sections upfront are higher, but when you include the costs of medical negligence in vaginal birth, then you end up much more even
Have you actually bothered to read the actual research?

It's one consultant, hasn't been officially published and it's totally twisted!

The main cost of litigation is due to cerebral palsy. These cases are truthfully traumatic. this is why the financial compensation values are very high for each case.

Actually, in terms of number, more claims have been made over 10 years about C-sections than cerebral palsy cases.

The bottom line though is that this in no way is a justification to promote C-sections. What it should alert to is better training, lesser reliance on locums, appropriate staffing levels etc.... the less cesareans, the more consultants availability in delivery wards!

We should aim at reducing claims by improving clinical care, but by introducing more expensive interventions that also result in many claims, just not as expensive individually.

There's no need, the NHS trusts have already done this, and the proof was linked in a previous comment to you. You just don't want to read it
You mean YOU haven't read it! Because if you had done so properly, you would indeed noted, as I did, that it concluded that the research quoted was based in the USA and that further research was needed in the UK.

Unlike you, I don't just read what I want to read and stop at what suits my narrative.

@OrdsallChord, hahaha, I quoted NICE! I just bothered to read the whole thing, not just what suited my narrative. What I copied and posted IS a statement from NICE!

Elective c section is safer than vaginal birth. That is why people choose them
No it isn't. Both have different benefits and risks. The only information we currently have about costs in the UK is comparing c sections interventions and vaginal deliveries, and the costs are black and white, c- sections are more expensive.

My back to back was the WORST pain I have ever experienced - I had to BEG for an epidural and then ended up having a forceps delivery; I’m very assertive but I was dismissed as someone exaggerating the pain - I woudn’t wish that experience on my worst enemy

I think you are doing a great job of exposing the pomposity of some clinicians who do not even get as far as checking on NICE data before telling women they are talking nonsense
I'm not a clinicians. I just can research and read and not stop at what I just want to read.

So ironical that I'm accused of not reading NICE guidance when it's actually because I bothered to read it in details that I was able to point at the inaccuracy stated by those who only bothered to read the first couple of paragraphs!