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.

Yep. That's another thing that would be worth considering before comparing the CS, infant mortality and maternal mortality rates and trying to draw any conclusions at all from them.

"Too much enthusiasm for natural birth" means that the relevant midwives ignored labouring women, dismissed the concerns of them and their partners and, crucially, didn't know how to recognise when things were going seriously wrong"

What you're describing is poor care by people whose midwifery skills and knowledge are inadequate.

The midwives within the NHS who are the most enthusiastic about and supportive of physiological birth tend to be those working on NHS homebirth teams. And yet the outcomes for home birth in the UK are excellent. The reason why the outcomes are excellent is because the midwives working on these teams tend to be the most confident, knowledgeable and skilled when it comes to managing non-medicalised births.

BTW - suggesting that midwives working at the clinical rock face are deliberately and knowingly risking women's lives to save the NHS money is deeply insulting and a bit deranged.

100% this.

"but there is this bizarre push to tell women that a vaginal birth will go smoothly and no mention of the risks."

Genuine question - WHO is telling women that vaginal birth WILL go smoothly?

Who?

You'd have to be living under a rock to get to adulthood and not be aware that you live in a country where the majority of women having vaginal births are having shed loads of interventions.

Midwives NEVER tell women that vaginal birth is always straightforward.

But the bottom line is that surgery is surgery and like any other invasive medical procedure requires informed consent.

Labour and birth is a normal physiological process, like breathing, walking or going to the toilet, all of which can also go horribly wrong but which don't require a formal consent process.

@izimbra

It's not deranged. It is what was concluded in multiple maternity scandals in several areas. I'm not saying that all midwives are like this, obviously. What I am saying is that where this criticism has been levelled at the system, this is part of what has happened.

I agree that there are lots of experienced and caring midwives in the system. Sadly, I did not experience any in my birth, but I imagine that is because I was induced at 42 weeks, so I couldn't have the option of the birth centre. In hospital, where the births are most difficult, you seem to get the most junior people who know the least, with inadequate obstetrician support. These birth centres might be truly magical places, but they are not allowed in my trust if you get past 41 weeks, are over 40 with a first birth, are induced etc - surely these women also need good care? That is a lot of women!

I get the impression that experienced midwives, indeed all midwives, like women who are easy and give them the warm glow of delivering babies. I feel as if this sometimes results in the rest of us being treated unfairly.

Maybe I am wrong, but my examples are:

1. The midwifes that tried to dismiss what I said when I felt like things were going wrong in my induced birth and told me I was just in transition (I wasn't, there was no downward pressure, baby was stuck far too high). The same midwives told my husband that they were concerned things were not going that well but that I was doing really well and they would just give it another half an hour or so, then came back to my bedside and said "you are doing fine you just need to push MORE" with their weird rictus grins. And then shifted awkwardly at the back of the operating theatre when they had told me I would probably have forceps and the consultant told them there was no chance and it was straight to section

1. Waking up after having fallen asleep (after 72 hours) to one of the same midwives berating me for not having tried to feed my baby yet

1. Not being given tea and toast like the ladies who gave birth vaginally in the same ward. There was no food available once I was allowed to eat, as we had missed the trolley, so we had to order a takeaway.

1. When my dressing for my section had to come off but was stuck really tight my community midwife remarked that I had coped really well with having my scar waxed and she didn't think I'd have such a high pain threshold because I'd had a section.

(And I am not saying that the individual midwives knew they were risking women's lives in those areas, they were just following protocols that expected them to push women as far as possible, probably for cost reasons, without realising how far they had gone)

If you don't agree, what do you think went wrong? It wasn't just about staffing, though it might be about expertise.

Ah, you're overlooking the many cases where the mother actually cannot produce enough milk to safely sustain her baby. Failure to thrive is a thing we'd be a lot more intimately familiar with if not for formula. Exclusive breastfeeding is the number one risk factor for re-hospitalisation of newborns.

We really do owe it to mothers and babies to be honest about infant feeding, clear about the risks and benefits and pros and cons of all methods (exclusive formula, exclusive breast, combo, pumping) and to support new mothers in feeding in whichever way is safe and desired for her and her baby.

Instead of attempting to pressure new mothers into breastfeeding no matter what the cost, even when it's not safe to do so. And no, the figures of babies who suffer from insufficient supply aren't vanishingly small. It's surprisingly common.

(I spent two weeks with my newborn being hospitalised for starvation, even though I knew I wasn't making enough and wasn't listened to, he almost ended up with brain damage as a result of complications from starving at the breast. I am extremely lucky he turned out okay, no thanks to medical staff who were insistent that bf is possible if you just try your best and don't give up, apparently will alone is enough to force milk production, who'd have thought it!)

(yes, I know the responses will be well you didn't try hard enough, despite 9m of triple feeding on domperidone. Some bodies just can't do it, and more to the point some mothers don't want to. And that is their choice, end of story)

NHS infant feeding education is dismal. They push 'breast is best' until they're blue at the face and pretend if they don't acknowledge insufficient supply it doesn't exist. Causes great harm across the board.

I agree with the OP. It’s a shame because vaginal births actually cost the NHS similar or more in the long term because of all the postmenopausal issues with prolapses, urinary issues etc. But the NHS isn’t good at thinking long term.
I work in the NHS and fell for the crap with my first. Wound up with a third degree tear and loads of issues that I had to get physio for. I dread being post menopausal. My two subsequent sections were blissful and much easier to recover from. Regret not having an elective section for my first. I remember talking to someone that worked in theatre's (ODP) that thought women that had elective sections were selfish taking spaces in theatre, a man of course.
I know a consultant obstetrician that had an elective section for her first normal pregnancy. Says it all really.

@izimbra
Antenatally midwives talk non-stop
about vaginal births with no mention of what could go wrong or the risks. There was no mention whatsoever of interventions, the % getting bad tears or ending up with an instrumental birth.

The walls of the midwife led unit were covered in cheesy affirmations about "You can do it" or that cobblers about your body can birth your baby. They were even pushing the fact you could choose the colour of the lighting in your room to suit your mood!

Personally I wanted the labour ward and access to pain relief rather than a light switch...

This! So many are completely unaware of the dangers of EBFing which people were well aware of in the past. My newborn was also hospitalised and only narrowly avoided brain damage from dehydration. And that was with copious BFing support in hospital and a lactation consultant on the postnatal ward. The anti-formula narrative and obsession with EBF targets meant no one could suggest supplementing until your baby is seriously ill.

Sometimes the milk just isn't there no matter how much effort you put in. Mine didn't come in until eight weeks!

BTW - suggesting that midwives working at the clinical rock face are deliberately and knowingly risking women's lives to save the NHS money is deeply insulting and a bit deranged

But that's what they are doing. Or would it be less insulting to say they are doing it because they are incompetent?

But that's what they are doing. Or would it be less insulting to say they are doing it because they are incompetent?

Or would it be fairer to say that deliberately running down the NHS and staff shortages mean that many less experienced ones are shouldering more work and of a more complex nature than they are ready for? Hence their leaving in droves a few years after qualifying?

That's a a long winded way of saying incompetent

That's a a long winded way of saying incompetent

But it takes away the blame from individual people who have only a limited power to change the system, and sets it into a wider context where change might be effected.

It seems that you don't like midwives full stop. Not all of us agree with you.

I don't know whether you think all obstetricians are wonderful but I am quite sure that they possess their share of incompetents but it's usually that they have a chain of people below them so that the bad ones can pass the buck.

It seems that you don't like midwives full stop

Yup.

Smurf1993 I think overwhelmed is the word you are looking for.

Correct, I don't like midwives. My maternity care was dreadful.

Whatever way you want to dress it up, all the stories women are sharing if Midwives literally not knowing what they are looking at or what the problem is are examples of incompetece. They're not too busy or overstretched and could have known what they were looking at if they had longer to look, they literally just didn't know what they were doing.

You seem to be keen to defend midwives who are doing untold damage to mothers and babies and delivering poor care, not everybody agrees with you. And that's fine, we don't all have to agree.

You seem to be keen to defend midwives who are doing untold damage to mothers and babies and delivering poor care, not everybody agrees with you.

Yes, I am happy too because I have seen good midwifery care. That is a standard that all women should have an entitlement to.

I have also seen poor Consultant care, so I don't share the enthusiasm for obstetricians. I don't however come on to post about why people shouldn't put themselves in their hands and have a CS.

Or because it’s the way women have given birth forever??? I don’t think it’s anything to do with cost.

As previously discussed, in the UK planned c sections are safer and have fewer adverse outcomes for mothers and babies than vaginal births due to poor midwifery care being widespread. There are statistics and reports showing this is a fact.

Whatever ideal we would all like to see doesn't actually exist so if a woman doesn't want to chance it, she shouldn't have to. As long as women understand the risks of vaginal birth in a maternity unit in the UK and do it anyway out of choice and not because they are forced to then it's all hunky dory.

But that should be an informed decision they are making and not something the NHS dictates they must do. As long as these are informed decisions I don't care what they do, what I have a problem with is the narrative that vaginal birth is safe, maternity care is good, and women who want a c section to protect themselves and their babies are selfish princesses.

I'm not interested in debating this anymore have a good day.

I don't think a single person has claimed that maternity care in this country is good at the present time.

For many women vaginal birth is safe.

"BTW - suggesting that midwives working at the clinical rock face are deliberately and knowingly risking women's lives to save the NHS money is deeply insulting and a bit deranged
But that's what they are doing. Or would it be less insulting to say they are doing it because they are incompetent?"

I'm saying they're providing poor care and that's because of poor clinical skills and poor judgement.

What you're describing is reckless homicide, which is a criminal offence. And you're suggesting they're doing it to 'save money' - not for themselves but for the organisation they work for, which would be sociopathic.

Are you really accusing large numbers of midwives of engaging in criminal behaviour towards women and infants?

That's a bit dramatic isn't it.

Obviously they're not killing women and babies deliberately to save money. They give them their emergency the in the end. They just push them too far because they've bought the hype a c section can be avoided if you just push the woman hard enough and long enough.

The trusts literally admitted to having a policy of keeping the c section rates low at any cost and causing harm in the process. There was a whole report on the maternity scandal in many hospitals, this was the finding, it's been on the news repeatedly for years. Just give up trying to deny it's not about money.

Again, done with debating this it's getting silly.

"As previously discussed, in the UK planned c sections are safer and have fewer adverse outcomes for mothers and babies than vaginal births due to poor midwifery care being widespread. There are statistics and reports showing this is a fact."

FWIW I think discussions around mode of birth safety aren't meaningful without looking at individual situations.

Planned caesarean will likely have better outcomes than planned vaginal birth in a population where 1 in 4 planned vaginal birth ends in an emergency surgery.

But a low risk women who's already had a vaginal birth, who's not giving birth in an obstetric setting has a very low likelihood of having an unplanned caesarean.

The figures given in NICE for a woman having a second baby at home are less than 1%. So the risk/benefit analysis of vaginal birth vs caesarean would be completely different for a 26 year old woman having her second baby at home than they would be for a 35 year having their in an obstetric setting . Ditto for women who are planning future pregnancies vs women who aren't.