This article has me fuming....thoughts?

[PrincessZ]

I just read this article and I am so shocked at how they can categorically ban cesarean sections!
www.dailymail.co.uk/femail/article-2028443/Hospitals-ban-pregnant-women-having-c-sections-cost-cutting-move.html?ITO=google_news_rss_feed

I'm pregnant and I was going to ask for a cesarean. Reading this article has made me lose all hope.

Getting back to the article.......
I'm in one of the areas that the sunday times reports on and I've just had my 2nd ELCS. I was told that I wouldn't have got my 1st section because it was my choice to have a section. It was in a different part of the country.
so the article is somewhat true.
I felt that Bristol were penny pinching all along. poor aftercare.I was asked a few times by the Obs to change my mind for the 2nd section. If I had a 1st section elcs, why wouldn't I have a second as it was a good experience?!
I don't get why the NHS doesn't have a top up system? There was no way I could have afforded Portland money but could have paid some money towards the cost of it.
But I have to say this conversation is sounding very familar!
Try MUMS in Solihull for private maternity care.

needing to transfer to feminism thread now Princess!!
Not sure about hard evidence about some of your claims, but worries about this and other possible problems can be very serious. You really need to speak to a doctor and get a referral.

"I am personally convinced that the availability of epidurals, and in particular of early epidurals (eg at 2 cm or less) actually decreases the EMCS rate in Canada, as women are not left in pain for hours and get to delivery more rested and able to push. There is also less of a 'need' for ELCS as women know they will be adequately supported with pain relief while in labour. But I don't have data to back this up"

There is no data to back up your hunch.

tbh, I don't know many people who would have wanted to go to hospital at 2cm dilated. Personally I can't imagine anything worse than spending all those extra hours staring at the wallpaper in the delivery room while listening to a fetal monitor going bleep, when I could have been at home watching tv, sitting on my own toilet, out shopping, sleeping in my own bed, etc.

yes, i was 2cm dilated for a week before anything happened, as was my sil recently. i'm not sure the 2cm or less thing is right, tbh.

Princessz - your other option is to hire an independent midwife and have your baby at home (if you are healthy and your pregnancy is low risk). Women birthing at home with an IM have lower rates of emergency c/s, instrumental birth and perineal damage, and just as good outcomes as women being cared for in hospital. They are VASTLY more likely to breastfeed successfully and are overwhelmingly likely to give their care the big THUMBS UP!

So if the proof of the pudding is in the eating.....

Aitch, a week in maternity at my local hospital would have left me in no fit state to look after a baby. The food for a start , never mind the filth and the escapees from Jeremy Kyle who were in the beds either side of me when I had my third.

People who I know who've been through the classic four day induction followed by emergency c/s special 'package' there look like they've spent a month in the trenches by the time they get home.......

Spudulika, did you not understand a word I said?

How on earth can you suggest a HB to a woman wanting an ELCS?

I have no desire to birth at home, thanks very much.
I'm not one of those. A CS may be more risky for me, but a HB is more risky for the baby in case he/she needs a doctor immediately.
Your idea is quite useless.

tbh princess, you are only three weeks pregnant, i would try not to stress about this now. spudulika was trying to help you, and actually her idea is a good one, much as it isn't to your taste.

Please come back to this thread in a year to fill us in on what happens.

Btw, they refused to see you or have a policy of not seeing women until then? Tbh, you sound as though you might as well give up on nhs care all together. You seem far too pampered.

My last point as a tiresome poster, rather than get into debt to have a c section I suggest the money might be happier spent having a bit longer off work.

Flossish
I will gladly return and hopefully to share a positive CS story.;)

I'm curious why you referred to me as "pampered".
People who know me and the tough life I've led will have a nice hysterical laugh at that.

Is the idea of paying for healthcare so alien to us?
Are we so used to free loading that we can't even pay for a delivery?!
Will you call people in countries with widespread private healthcare "pampered"?
Anyway, just suppose I am pampered. Jealous? You want everyone to have a tough birth experience and suffer from possible neglect on the NHS?
Maybe you did hmm?

How can women trivialise another woman's concerns and fears is beyond me. How can they be so judgemental is beyond me?
I don't agree with HB. But if a well informed woman told me she wanted one, I would fully support her. It is her body, her baby and her choice.

you have glossed over the more than doubled incidence of infant mortality in non complication (ie. Prefered) cs. Yet you refer to the idea that a hb baby would not have access to a doctor...who as i understand it they are unlikely to need.

I think spud is suggesting hb as they have lower rates of tearing etc which would give you a better chance of keeping your fanjo intact.

You could do with some work on how you assess risk imo.

tbh the majority of threads where posters are trying to decide whether to have, or are trying to fight for a cs, are nothing but supportive.

Can I just say there are risks to the baby with elcs, that need to be considered. Ds had respiratory distress syndrome and was in scbu for 8 days. You may have considered all the risks and be fine with them, but having your baby whisked off to scbu and not being able to cuddle them for days is pretty hard.

I had a section just because I wanted one. It was a fantastic experience and I was up and about sooner than an acquaintance who gave birth a day earlier vaginally.

Do as much research as you possibly can. There are risks with any type of birth but ultimately it is your choice. People will judge you but decide now to just laugh at them.

Also: I was out of hospital in 48 hours, I breastfed immediately, i could hold the baby just fine and my stomach is perfectly flat.

Apols for what sounds like hideous gloating, but these are all things people assured me would not happen after a CS. They were talking out of their arses.

I am the most lily-livered person ever, so believe me when I tell you that VB is most likely not as bad as you think. :) I was terrified and it turned out to be , if not a walk in the park, a million times better than I thought it would be.

I had an epidural and still managed to push.

But if you want a CS, well, whatever. No skin off my nose I suppose.

I am from the UK, but am currently living in Singapore and have given birth here and in HK. In both places you have to have medical insurance which pays all your medical costs including giving birth. I can share with you the other side of the coin. In Singapore and HK many women are given unnecssary C-Sections. In fact, I avoided one doctor because he was nicknamed Dr. Snip and chose another for his pro-natural birth approach. On my birth plan (as advised by other expats living there) I put in bold that I was not to have a C section unless there was a threat to me and/or my baby and a 2nd opinion was sought. With my second child I had issues and had to see a fetal medical specialist. He advised me that I was perfectly OK to give birth naturally, whereas my OB advised that this was not a good idea and we needed to time the birth with having an ICU bed free and a specialist pediatricion on hand. He really scared me so of course I went with the C Section. My son was brought out at 36 weeks and he was fine and in my room an hour later. When I gave birth to my first son in HK, there were 8 deliveries that day and mine was the only C Section. 2 other women from my antenatal class where in the rooms at the side of me. Both had the same OB, where in labour at the same time and both ended up in emergency C sections. Funny that since the Doc was birthing 2 at the same time. By the way, your OB does your birthing here, not the midwife.

I can see why women would opt for one and I see why you should have a choice, but then I have also seen the downside of letting docs give C's willy nilly. As for me post C Section I had very low blood pressure, had no milk to breastfeed for 3 days and couldn't drive for 6 weeks whereas with natural birth I was showered, dressed and up and about an hour later. Doctors are using the C Section option as a way of controlling when women give birth and and it is not always in their best interests. Of course, as a result, a few bad apples have spoilt the barrel for the others.

I haven't read the entire thread, but for what it's worth I had an ELCS because I decided that overall the risks were lower this way, especially for the baby. I was prepared to accept more risk, pain and longer recovery for myself, but as it turned out it was a lovely experience with a faster recovery than some friends' VB. However, to get it I had to go to Greece (we live in France where no doctor will contamplate ELCS, neither publicly funded nor private), find the right OB and go private.

As for the costs of c-sections in general, they can't be considered in isolation because the choice is not between c-section and nothing, after all the babies will have to be born somehow and the NHS can't avoid all childbirth costs. If the c-section costs are compared to an unproblematic VB then the numbers are clearly against c-sections, but compare them to even one problematic VB that results in a child deprived of oxygen and the massive costs associated with looking after a severely disabled child for the rest of its life justify thousands of c-sections.

Another here, Cheerful Yank! I'm the biggest wimp I know but had an uncomplicated birth so managed with just gas and air for my vbac, remember thinking that labour was nowhere near as bad as I thought it would be and escaped with no tears, interventions etc whatsoever and a v speedy recovery despite labouring for almost 22 hours with an 8lber.

Not sure what it says about me but DH cannot tell the difference "down there" before and after and I haven't had any incontinence issues (although now heavily pregnant with dc2 so may have shot myself in the foot on this one ). So while it can undeniably all go wrong for some women, it's a spectrum and there are millions and millions of us who came out of childbirth completely unscathed. I was terrified and didn't trust my body to be able to do it and I'm still nervous about the birth this time, it's the human condition to imagine you will always be the unlucky one!

You still have plenty of time to arrange this so speak to your care-provider as soon as they are available to you and see if they can put your mind at rest. This is probably something they deal with often and even if they aren't able to accommodate you, they will know what direction to point you in for further help in plenty of time. Hope you get the birth you want!

Sorry Princessz - was just thinking about your fanny.

I can see how an elective would be far less stressful and difficult than a vaginal birth especially one which is complicated and involves interventions. Recovery may be quicker for some too if you're comparing an uncomplicated c/s with a difficult vb.

But for me going through labour was a life changing experience - I felt so strong afterwards - it made me feel more confident and more self-sufficient afterwards.
I surprised myself. I'm not alone in this - I've seen many women here expressing these feelings. Labour is an education and I'm glad I had the chance to experience it. I appreciate that many people don't want to be challenged in this way. Or think they don't. You can never really know what you are rejecting - even for those who've done it before as every labour is different.

booboo but surely if there was any indication that vb would lead to disability there would be no question of cs in that case. The point is we can't/don't offer a cs to every low risk woman in case of oxygen deprivation because it costs more and the risks associated with non necessary cs are greater.

Spudulika, I am not saying that in Canada you are not allowed to labour at home and that mounties will come and whisk you off to hospital for a mandatory epidural! Of course women can labour at home, but they will not get turned away from hospital if they get there dilated less than 3 cm, as they routinely are here.

However, there are plenty of women who by the time they are 2 cm dilated are in massive pain, and just hours to delivery, and yes they will get pain relief in Canada whereas they would not on the NHS. And once they express a wish for an epidural, they won't be fobbed off with gas and air (doesn't exist there) or pethidine (much less used than here).

The fact that epidural rates are more than twice as high as here, yet CSs, forceps and ventouse rates are lower, flies in the face of the argument most commonly made against epi here, ie that they lead to increased intervention. I have ventured one possible explanation, which you disagree with although you also have no data that proves me wrong. How then do you explain it?

Why is it so difficult to accept that the way things are done in another country just might be better, in some ways, than the system we have here, since they achieve less intervention and pain is more effectively managed?

spud i completely agree re labour as a life changing experience. I think it's shit that despite it being safer than ever women are still scared shitless by society and disempowered to experience labour as a right of passage.

Not saying everyone should view it like that but lots of people seen to see it as a necessary evil rather than anything positive.

I've spoken to a midwife friend at length about my birth experience and a couple of points stand out that have been mentioned in this thread.

Keilland forceps - yes they can be difficult to use but in experienced hands they will assist the birth quickly and relatively gently (as my 1cm cut will testify).

Secondly, if the mother is not tired (which I believe was your point Primafacie about the canadian system) it is perfectly possible to push a baby out with an epidural. I was in theatre for a possible section if the forceps didn't work and I pushed my DD out with a full spinal. My friend tells me it's not possible to deliver a baby by forceps without "maternal effort".

Finally a lack of ability to push is more likely to be due to a knackered uterus after a protracted labour than simply the mother being tired. The easiest way to ensure the mother isn't too knackered is to make sure labour doesn't stall, which it typically does (particularly in first time mums) if they go to hospital before labour is fully established - something to do with the cortisone/ adrenalin response to unfamiliar surroundings coupled with apprehension about the birth.

I would have done anything at all in my power to avoid a section - I was completely and totally petrified of it due to my previous experience of abdominal surgery.

I know women who have recovered very quickly from sections and others who have struggled and found the recovery hard. I agree that it's not belittling the risks of natural birth to say that the vast majority of VBs are without problem and it's wrong to compare a problematic VB with an easy section.

Princess I'd really recommend you read Spiritual Midwifery by Ina May Gaskin - yes it's about natural childbirth which you don't want, but it will give you a view of labour and childbirth as a much less scary thing.

Plus I don't think you mean you are 3 weeks pregnant - pregnancy dates are measured from the date of your LMP. So you are 3 weeks one week after ovulation. If you are 3 weeks since a positive pregnancy test then you are actually 7 weeks pg and can get seen sooner than you think.

Midwives/ doctors don't want to see you before 3 months as so many pregnancies are lost early on, and you don't actually need any primary care so early on.

northern i thought about recommending ina may's guide to child birth as there are tips for not tearing but tbh i'm not sure the op would want it. You are right though that it might help the op feel less worried about birth which can only be a good thing.