AIBU to think we shouldn’t worry about an increase in c-sections?

[PancakeCloud]

I came across an instagram post earlier where someone had shared data indicating the UK’s c-section rates have increased significantly in the last five or so years. The commenters almost universally consider this to be ‘tragic’ and think it is ‘so so sad’ that some women are electing to deliver via section. There are also a whole bunch of commenters who think if only women were properly informed they would push for a natural birth even if drs are recommending inductions etc.

I accept the UK’s maternity system is under strain and needs improvement, but really isn’t the point that we have healthy mothers and babies not that women give birth via one method or another.

There are downsides of attempted vaginal births, because of course not all of them go to plan! There is an increased risk of severe birth trauma or hypoxic brain injury to baby vs choosing a c section. For women, tears and pelvic floor injury are very common. While C-sections come with their own risks, these are well known and often presented without acknowledgement that vaginal births have downsides too.

For the NHS I understand planned c sections are cheaper than other births, given so many of them end in emergency sections anyway and because of payouts when things go horribly wrong.

Are we not looking at this all wrong? The goal should be healthy mothers and babies irrespective of how those babies get out. Why are people so fixated on reducing the c section rate?

No one said labour lasting 2 hours is the " norm" as you put it but what's the need to be running up to hospital hours before that?

There are sometimes good reasons why hospitals keep people in, even if they're not in established labour, did you not know? If your water has been broken for a long time, or if they need to monitor you for other reasons, they may not send you home. I don't know if you mean to, but you're giving a bit of an 'ooh you should tough it out' vibe, and it's tedious. Very few people want to be spending hours in hospital waiting around for labour to start.

I have a rubbish womb, it doesn’t contract post birth so the placenta gets stuck and I end up haemorrhaging- I lost 4 pints of blood twice. Subsequently chose c-sections for my last two DC and much preferred it. It gives women control back. You know precisely the date you’ll give birth so can organise childcare and you’re in a controlled environment so if anything does go wrong the correct staff are there and only dealing with you. The recovery is a bit naff after but shorter than when I had PPH’s and felt like a literal ghost for months.

Yeah I know about the waters breaking but that's at least 24 hours sometimes 48

But in the majority of cases there isn't need for people to be kept 12 hours plus

And of course people don't WANT Ato be hanging around hospital before established labour so that's why I can't understand why they trot up there then

I agree. It would also risk a lot of women free birthing unintentionally, as not many women (especially first time round), can accurately predict the speed of their labour, and babies would be born in the car, car park, or still at home far more. That would lead to increased risk of injury and death to mother and baby. Women don't have a crystal ball and an alarm that goes off two hours before birth!

Arriving so soon before birth means women wouldn't be able to get an epidural if desired either.

I know I was lucky with c section recoveries. Not everyone has a pain-free recovery and not everyone is back to normal in a week. I mentioned my recovery to counter assertions that c section recovery is always harder, not because mine is the universal experience.

But this poster seems to think that a very quick labour, hospital 2 hours before, complicated vaginal birth with no injuries and then back home within a few hours is typical, rather than also being incredibly lucky.

Sorry, I just love your description of having a "rubbish womb" 😂even if it has very serious consequences. I have one too, I had placenta previa and PPROM and DD essentially got stuck and my waters burst 6 weeks early. Luckily she was very big (7 pounds!) but I obviously couldn't have given birth naturally given the placenta previa situation. I'm very glad I had a C Section and personally think it's any woman's right to choose how they give birth.

Agree. And I was in active labour, not waiting for labour. Just because it’s not progressing further doesn’t mean you’re not in very active labour for hours, and vomiting with the contractions. Sending me home would have been everything people complain about re the nhs and poor care. I have done racing to the hospital 9cm dilated also, which is something I never ever wanted to do again, and very different from the other 12-14 hour labours I had. There can be huge differences in briths and generalising like that is ridiculous - no one knows a woman in active labour will still be in 12 hours and proper care says that’s a risk factor more than a send them home factor.

Totally agree with you! People push so called “natural births” thinking we all have perfect bodies capable of having wonderful, peaceful and safe vaginal deliveries. It just isn’t the case for so many women and why should they risk their lives and MH just to follow some weird narrative about c-sections being evil? Also, my womb is useless but then my babies were all massive… My biggest was 10lbs3. It’s just genetic, all the babies in my family are minimum 8lbs.

Nobody 'trots up'. Or 'goes running'.

You sound like the sort of person who also talks about women 'running in' for too many scans or 'fussing' about baby's movements.

Hospitals are quite capable of telling people when to come in and when not to come in, just as they're quite capable of telling people whether or not to worry about other things.

On the whole, stillbirth rates have gone down because we do pay more attention to these things now. It's a very small risk, but it is so monumentally twatty to take this 'ooh silly women, going in too early' attitude.

FWIW, a woman in my NCT group when my DD was born had a stillborn daughter, and it stopped all of that 'oh, don't bother to go in too soon' nonsense immediately.

People go in because they think they might need to be there, not for fun and games.

Are they ? My DD was told to stay at home until contractions were 5 mins apart lasting more than a minute. She went from 7 mins apart to constant immediately and the baby was born in the front room.

I've had both. Much preferred my vaginal births, which were a lot easier to recover from. My last c-section was done without consent and could have been avoided if my induction hadn't been delayed by several hours (got to hospital at 10am, infection diagnosed and dr consulted at 12:15pm, induction started at 9pm.)

I'm all in favour of c-section if a woman wants one but we should be trying to prevent c-sections for women who don't want them.

Absolutely. My biggest take away from baby groups was still births are shockingly frequent. I know a few, and those mums never ever forget their baby.

Stillbirths do happen for all kinds of reasons though my own grandchild was stillborn but absolutely nothing to do with going to hospital hours before or last minute

YANBU. Plenty of people opt for a c section, maternal choice. And vaginal births of course come with real risks too.

I had a vaginal birth and deeply wish I'd stuck to my instinct to opt for a section instead.

Never had a section, but physical recovery (we'll ignore mental and emotional) from an induction with episiotomy and third degree tear was a lot easier than recovery from keyhole surgery to remove an ovary, which I assume would be a less major surgery than a Caesarian with a generally shorter recovery period.

I was very lucky that the midwife realised she wasn't going to be able to stitch me back together adequately (she did try), and so got me into theatre with a surgeon who did a fantastic job. I know others have had worse experiences with this, but I didn't even really have much pain from the stitches, and there were a lot of them! I was certainly better off than the poor woman next to me who'd had a planned Caesarian and was in a lot of pain.

No one can predict what is going to happen so you have to go with your best and most informed choice.

If elcs are harder to recover from then maybe we should put more effort into making that easier. It’s all major abdominal surgery until you’ve had one and then suddenly it can be managed with one night in hospital and 2 paracetamol.

it is to do with telling people they’re whiners for going in early or wanting to get checked. Thank goodness for all the education campaigns. But there are still people like some on here. That’s why you should get monitored more often the later you go because anything can happen.

@SomethingFun I'd never say this IRL, but I secretly think that detailed birth plans are pointless. I know several people who've made them, it but it all goes out of the window, because we don't know what's going to happen!

Why on earth would anyone risk a vaginal birth now? With Donna Okenden preparing to report on the dire state of maternity services in Nottingham next week and then going straight on to head a similar inquiry into neo natal care in Leeds, I don't blame any woman for demanding a C-section. At least you know that you will be giving birth on a pre-ordained date with a full complement of staff in the right place at the right time, as opposed to going into labour on a busy night or weekend and being one of 16 labouring women in the unit with only two midwives on duty - this actually happened in Nottingham. Or being left to the mercy of a natural birth zealot, who fails to call a doctor when everything starts going pear shaped.

Maternity services cost the NHS around £3.8 million annually and they spend three times that much on compensation every year. If that isn't a clear sign of failure, I don't know what is!

When I think back to my own birth experiences, I realize how lucky women of my generation were. After a text book pregnancy, my first birth was a back to back, brow presentation, but fortunately this was 50 years ago and I did receive excellent and timely care with a consultant led forceps delivery. I also had the luxury of a five night hospital stay post birth - which was common in those days - providing the time for me to recover before I went home. No one could be confident that either of those things would happen nowadays.

If I was pregnant now, I'd insist on an elective C-section - to do otherwise would be to invite the possibility of having a dead or damaged baby and/or the sort of birth injuries that could severely impact the rest of your life.

OP is right when she says that the most important thing is a healthy mum and a healthy baby, not a load of clap trap about the mysticism of the perfect vaginal delivery!

Episiotomy? It took them an hour and a half to stitch me up afterwards!

Episiotomies aren’t done using scalpels.

I disagree OP and completely acknowledge decisions made related to current maternity care however the consequences of prophylactic antibiotic administration during caesarean sections and impact on bacteria transfer being born by LSCS is a long term health issue. For informed consent, these aspects should form part of this conversation.

Many elective section dates are cancelled now and then they tell you not to worry because they will do it an emergency if you labour.

Hospitals are quite capable of telling people when to come in and when not to come in, just as they're quite capable of telling people whether or not to worry about other things.

Several reports into maternity scandals would suggest otherwise.

I did a birth plan and did everything that you were meant to do and unfortunately my dc and my body hadn’t read about water births and hypnotherapy so surgery and antibiotics and blood transfusions it was.

I’m a bit pissed off with all the handwringing about microbiomes and breastmilk - you do what you’ve got to do. I think me and my dc would’ve died if I’d chosen to try for a vb instead of cs but I guess that wouldn’t be as bad as a risk of my dc having more allergies! Again perhaps medicine can put more effort into making cs a better option than into shaming women for taking that option. God forbid the country that moans that there won’t be enough tax payers of the future put some money and effort into making having children less painful and risky.