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?

I was induced at 12 days over and would have been at 10 days over for my second if I hadn’t had him at 9 days over, I’d have insisted for the induction. Being pushed to have unnecessarily earlier inductions is the opposite of my experience, I was going to phone every hour the next day and ask about induction.

How long ago was this? I can only speak for my experience & where we are but as I say mine are 2 & 7 months so very recent and of everyone at our baby sensory class there is 1 spontaneous birth, 1 planned section, 6 of us induced and of those 5 ended in EMCS.

With both of my babies induction was mentioned early and pushed often, of my close friends who have had babies in these last few years they have all said the same. It has been a case of arguing against having one rather than hoping for one!

I think only one of my 5 close schoolfriends has had a c section. I am not sure re induction. That’s over 15 babies total.

Longer than that but they are all still young! 10, 7 and 4, was at uclh for dc1 and dc2. I complained after about the induction process and other things, they were supposed to tell me when to expect it and didn’t, they were supposed to give me an information brochure and didn’t, it was supposed to be at 10 days over which I found out because I was phoning up to ask, but no room, no room on 11 days over… placenta was ageing by the time baby came out with a true knot in the cord, would take any kind of cs over being left 12 days over again. Which doesn’t mean that I think csections are preferable, obviously an important option to have and medically necessary some of the time. I had them all vaginally in the end.

We need much better staffing, much better continuity of care and less fragmented care in the NHS, so women actually feel they have a relationship with their midwife / obstetrician and have confidence in them and the time to ask questions. Antenatal care in most cases feels like an overcrowded factory assembly line, it’s incredibly depressing. Same for postnatal care!

We also need to do far more outpatient inductions, which are much more tolerable for women and make it less of an ordeal. Even the majority of our ‘high risk’ inductions were outpatient in Canada, ie they went home with a balloon or prostaglandin in situ. But the NHS is so conservative and risk averse, and it makes the experience hellish.

The NHS does some things really, really well and I actually think that clinically, the care is highly evidence based. But the way it’s structured is a disaster and I think it’s having an effect on women’s experiences and choices.

Yes, it is the lesser of 2 evils.

But your question is whether we should be concerned about the increase in c sections.

The actual data in the recent news pointed a specific increase in emergency c sections. So yes, my original point is a need for concern. Many of them may be due to care issues with the NHS.

I'm sorry but that's rubbish.
Natural doesn't always mean better.

If I opted for what nature intended rather than what science could offer:

• I wouldn't have been born as my mother would have died during pregnancy (if not before)
• I wouldn't be typing this because my natural eyesight is so poor. I wouldn't be able to work, would have been unlikely to marry or have children as would have needed lifelong care.
• one of my children would have died. Tbh she would have died several times over is it wasn't for science, rather than doing what nature intended.

Diabetics all die, curable cancer is now fatal, and millions in the UK would die from entirely preventable causes. Nature doesn't care about our survival, all it cares about is that enough of us survive.

Take poor lady hyenas. About 20% of first time mums due in childbirth because it literally involves them giving birth through their clitoris, which tears open in the process. Most cubs die through suffocation in the birth canal. But nature does it best right?

As for formula, at the moment breastmilk might be better (marginally), but we shouldn't perfume that natural will always be better, as we have no idea what scientific advances are possible. Nature is a good starting point for most things, but not more than that.

i was reading that it’s getting towards HALF of all births being c-section in England. It’s interesting that you’re now just as likely to have a C-section as a vaginal birth. If statistics keep heading this way then most people will give birth via c-section.

I think the word elective is misleading. I am booked in for an elective c-section because my baby is breech. I am absolutely devastated and it isn’t what I wanted at all. I think they should call them scheduled rather than elective. Yes some women choose to have them for personal reasons, others really don’t.

This was me. Planned section for medical reasons in my first pregnancy. Fairly straightforward pregnancy and VBAC second time. Undiagnosed placenta accreta and a huge blood loss third time when everyone, including me, had taken their eye off the ball because I had had a normal pregnancy and birth after my difficult one.
In my experience, the discussions around risk/benefit only focus on the current pregnancy. Nobody talked to me at any point about potential impact on future pregnancies. To be fair, I probably wouldn't have cared anyway as at the time nothing was further from my mind and the idea that I'd ever want to be pregnant again would have seemed ridiculous.
But the non immediate effects such as the increased rate of placental problems in subsequent pregnancies and the downsides of having multiple sections really do need to be part of the bigger conversation.

My mum was born in the 50s by C-section.

I was born by C-section.

I wasn't mucking about.

I would like to have different categorisations purely to make clear distinctions and be better able to see what is happening.

So medically recommended
Mental health related
And other.

ATM we have very little data on the levels of birth phobia/previous trauma and this would be useful to separate out from other ELCS for a variety of reasons.

So? I didn’t say csections were non existent then.

Make sure they triple check before doing it. The number of women who have had sections for the same reason where the doctor was ‘surprised to see they’d turned’ when they opened them up.

Yes I’m well aware of that, I am artificially alive as a type 1 diabetic as I write this, thanks to modern medicine. I didn’t say ‘let’s get rid of all modern medicine’ but the responses on this website ALWAYS seem to jump to an extreme don’t they.

Don’t they have the category ‘maternal request’ for that?

although even the definition for that can vary between hospitals etc, so I agree it would be good for statistics to record specific reasons. I wonder how many women who have them for trauma reasons are having a second baby after a poorly managed vaginal birth

I think the mental health grounds are quite complicated though.

I enjoy have quite severe primary tokophobia. No history of trauma, no other mental health issues aside from a phobia of needles, emetophobia and medical procedures generally.

But there's a huge difference between needle phobia and tokophobia. An injection isn't going to potentially kill or leave me permanently disabled. At least it's vanishingly unlikely to. Whereas childbirth in it's natural form throughout history has been the number one killer of women. So it's a very logical fear to have.

I don't feel like it's a mental health issue to prefer a relatively painless and safe surgery to hours or days of agony followed by 90% chance of my private parts being ripped or cut open and sewn back up again without anaesthetic. To me that's a logical decision for someone to make, though I'm not suggesting it's the one that all women should make.

So I've referred to my decision to have c sections as both maternal choice and due to tokophobia at various points because they're impossible to separate.

So you think 1 in 20 is acceptable? Because I absolutely don’t and if someone told me those were my odds I’d pick c section every time. Thankfully we have modern medicine to massively reduce those odds.

Stillbirth is also not the only adverse outcome it’s reasonable to try to avoid.

If you're going to say natural is better except for infections, then it's not extreme to look at what happens if we go the natural route with medicine. It just shows that you didn't consider the consequences of promoting nature rather than science. I think we can both agree that medical advances have enabled a large percentage of us who would have died to now live, and that should be celebrated.

Pregnancy isn’t diabetes. If you can’t distinguish between illness that needs treatment, and the rough and smooth of health that the body can process or resolve itself, you’re not really up to this discussion. There are proven benefits to natural delivery and breastfeeding. Saying there isn’t doesn’t change that. Of course on an INDIVIDUAL level it’s more complex. But we are generalising.

So you think I said let’s get rid of medical care altogether? If not; why are you asking such a silly question?

Op you sound very defensive about your personal choices, to the point you’re making out is widespread caesarean OR many many babies will die.

I didn’t mean to seem defensive so apologies if it comes across that way.

I am genuinely really perplexed by your view. Putting stillbirth aside, there are still potential negative consequences of a vaginal birth (severe tearing, prolapse, birth injury to baby) as well as positive consequences (gut microbiome, reduced risk of infection). I really struggle to see why, if on the balance of factors a woman chooses alongside a medical team to have a planned c section or during an attempted vaginal delivery it is determined it is safest to move to an EMCS, that is a bad thing.

I’m so sorry this happened to you it sounds incredibly traumatic. I agree these types of long term consequences should be part of the discussion, as should potential long term consequences of vaginal birth.

There isn't anything you can do to speed up labour.