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 know countless NHS doctors and I can’t think of any who had a scheduled c-section.

So actually, the only study so far I've seen that compares maternal request sections (excluding sections for health reasons of mum and baby, which would be expected to have poorer outcomes generally) to vaginal births had shown that maternal request sections have fewer adverse outcomes than vaginal births. Which is very interesting.

Here's the study if anyone wants to get their geek on:

www.cmaj.ca/content/193/18/E634

No, I've heard similar.

'We know the reality of childbirth' | Society | The Guardian

@EC22 You put it very well here. I think that a lot of women are put through very traumatic birth experiences, but that isn’t natural as you say and is rather an issue of the approach to birth in modern society

@Gwenhwyfar FACTS🙌🏻

I had an EMCS after 3 days of labour where my DS was back to back and I never got over 4cm. I was never going to give birth vaginally and it was only when DS1 showed signs of distress that I gave birth via EMCS. The midwife prepared me for that and said 'I see you have given up'. I ended up in ICU as I had a major haemorrhage in theatre. For DS2 I had very very little midwife contact and an elective CS which was a really good experience.
I think there is such a range from normally progressing, uncomplicated labour to difficult and life threatening situations. My experience with two births has been that the medics and midwives see themselves on different teams and kind of guard their territory. It would save many EMCS and the awful experiences that many mothers go through if antenatal wards were better resourced and interventions were earlier.
There are many fantastic midwives so this is not a criticism but just my experience.

"Most women want a vaginal birth surely as it's considered safer, that's why it's pushed by health professionals. "

I think the whole point is that the NHS has a huge funding problem so in some cases things might be encouraged mainly because they're cheaper and not always safer.

If its to save the cost, then its obviously very wrong.

On the other hand I do believe women need support and information to be able to have a vaginal birth, if possible. We have to remember that a good birth has the potential to be very empowering to the new mother.

How many other mammals have such a large head to body ratio of newborns? How many mammals have such a high maternal mortality rate (before modern medicine)?

”Natural” doesn’t mean better. A lot of diabetics and asthmatics would be dead without medical intervention.

I agree OP. I was medium-high risk due to several early pregnancy losses and an endocrine condition. My consultants were fine with me having a planned C section, one of them even nudged me towards its, then my midwife tried to cancel it behind their backs!

I ended up going into Labour naturally two days before my section and was given a last minute choice to “try naturally” at 2am and alone due to Covid and after nearly having the baby in an Uber. (This was also after they’d fobbed me off twice cos they didn’t believe I was in Labour cos I wasn’t making enough noise to suggest I was in sufficient pain. Seriously, they’d actually sent me home mere hours earlier.) I said no to natural, thank goodness, because minutes later I was rushed to theatre bleeding with alarms going off because my baby’s heart rate was dropping. The hospital later apologised and said I should never have been given the option at that point.

I am lucky because my aunt is a midwife and she told me to stick to my guns. She told me natural is slightly safer for Mum and C section is slightly safer for Baby.

A lot of the pressure comes from the outdated Natural Childbirth Movement, which was mainly promoted by Grantly Dick Read. He was a eugenicist who said white woman were imagining the pain of childbirth and African women didn’t mind dying in childbirth because they understood it was a consequence of their own failure. I kid you not.

Most of the hippy dippy home birth fanatics and their unqualified doulas have no idea how their movement started!

I had 2 vag births. I really don't like the idea of a CS but if I'd have had to have one then of course I would have done. There was no "pressure" for me from anyone. And the people who I know who had sections for whatever reason weren't pressured either.
And one had 2 electives on no medical grounds whatsoever just because she had a fear of vag birth. AFAIAA she didn't have any pushback either.

@Cantsleeper I agree, pre and postnatal care are huge issues nowadays, I’d argue perhaps more of an issue than whether women chose a vaginal birth or a c-section.

In the past, we accepted that women needed to recover properly, whether at home or in hospital. Staying in hospital for a week was the norm, now everyone’s turfed out as quickly as possible and not everyone has good support systems at home.

Agree so much with all of this!

I also struggle to see why you wouldn’t breastfeed if you are able to, the benefits to both mother and baby are incredible when you look into it and it’s really sad that it’s not ‘the norm’ when it absolutely should be.

Just the fact it’s normal to choose to give your baby milk from a cow meant for her baby cow rather than from their actual human mother shows how far removed we are from reality. The environmental and health impacts of just how many people in the UK formula feed is huge. There needs to be much more support in hospital with breastfeeding to get our awful rates back up imo but that’s a whole other post 😅

Frankly I think the whole system is broken.

I had all of my babies at home and had easy births. I am very grateful that I live in an area with a dedicated Homebirth team and a partner who is happy to support my wishes.

I don’t know anyone in real life who had a straightforward hospital birth.

How do you safely free birth?

My point was that to suggest vaginal births aren't normal or natural is patently false in mammals that have evolved to give birth vaginally. You will see in my follow up post I clearly said anyone who would make anyone feel bad for having a c-section is an idiot - but facts are facts, and vaginal births are both normal and natural. I don't know why everyone needs to obsess about other people's opinions of things. If you have properly researched things and are dead set on an ECS, and your trust supports it, good for you. But the idea that the NHS should just ignore facts and not tell people them because they might make someone feel bad is madness.

I always wanted a natural birth (didn't want the section recovery) and it all went fine. Currently pregnant again and hoping for more of the same.

My friend is a midwife and pregnant with her first, she's having an elective section. I was surprised, as the advice I've always had from midwives is vaginal birth, but she said she's seen so much happen with vaginal births that she isn't willing to risk it.

The risks of sections are better known and there is a lot more control over the variables!

C-sections are major surgery and if its unnecessary it should be avoided, same way you can't just opt into any major surgery unnecessarily.

That obviously doesn't mean its not a proper birth.

Any birth is a proper birth but scared inexperienced people should NOT be sold the fallacy that C-sections are some magic, easy, safe, pain free option because they are not. They are sometimes a necessary option for the mother and/or babies health but they are still very serious surgery with serious risk/complication and complex recoveries.

@doodleschnoodle thanks for sharing this. I’d just like to point out that the cohort who opted for Elective sections in this study were much more privileged than the vaginal group in a number of ways (I’ve screenshot for reference) which could easily account for the disparity. I’d also like to see a study like this take into account the benefits/downsides to the child as well as the mother in this equation.

Took me 1 second to Google about animal C-sections.

Caesarean Sections in Pets: What You Need to Know - The Animal Medical Center (amcny.org)

This toxic narrative that birth is only birth if you give birth vaginally is another abuse of women

Do people really still say/thank this? Loads of my
friends have had C-sections, both emergency and elective. I don’t think one way is seen as easier than the other. They are hard in different ways.

I don’t see myself as having given birth more authentically (or whatever word you would choose) because of a complicated vaginal birth and long labour. I just think that was the least bad option for me in my particular circumstances.

I personally would rather avoid a c-section because I want to drive again earlier than six weeks post partum and want to get back to exercise, including ab exercise, as soon as it’s safe to do so, as I did with my first. And I don’t want to be recovering from abdominal surgery with a newborn. Not for any noble or ideological reason! Others make different choices or find themselves in different circumstances and I respect that.

Outcomes for vaginal birth will depend very significantly on how a vaginal birth is managed.

Continuous monitoring, routine induction of labour, supine birth, routine augmentation, all likely to result in worse maternal outcomes than births managed with more support for (and respect for) physiology.

Go have a look at information on planning place of birth in NICE - resources for midwives. For low risk multiparous women planning a homebirth the rate of blood transfusion was half that for similar women who'd chosen an obstetric setting for birth. Less than 1 in 4 women having a homebirth had an episiotomy. The figure for similar women who chose an obstetric setting for birth was 4 times that. 1/4 the rate of forceps for mums choosing a homebirth. No difference in outcomes for babies. Also lower rates of anal sphincter injuries associated with home birth and birth centre birth.

Looking at outcomes for women attempting vaginal birth in obstetric settings and assuming that these risks are similar across all settings isn't supported by the evidence.

Not that it's relevant what animals do anyway. There are lots of things humans do that (other) animals don't.

Your post seems to focus much more on your rhetoric of the "abuse of women" and your reference to the anticipation of a natural mammalian process as a "toxic narrative" than any other point.

We're one of more than 6000 species of mammals on Earth, and you're we're no more special than any of the others, so yeah, a vaginal birth is the norm, and not an act of abuse, nor is the encouragement to breastfeed.

We're fortunate enough to have a national health service which under certain conditions will grant an elected alternative, and one can always choose this route unconditionally through private routes.

Whilst there are undoubtedly a small minority of pregnancies whereby a Caesarean section provides significantly less risk, your mention of a consultant referring to the encouragement of vaginal births from a cost perspective is anything but appalling, especially considering the levels of entitlement and self-importance of many in today's society.

There's no abuse of women here whatsoever, and the only possibly toxic narrative I'm able to find might well be your original post.

I’d also like to see a study like this take into account the benefits/downsides to the child as well as the mother in this equation.

This covers one of the benefits of a vaginal birth to the child.

How method of birth alters babies' bacteria https://www.bbc.com/news/health-49740735