Why is there so much judgement directed at c sections?

[DanceLikeTheWind]

I honestly don't want to start another endless VB v/s CS debate. I am just eager to read any insight that people may have on this topic- Why are other women so judgemental towards women who opt for c sections, whether elective primary c sections or repeat c sections?

There are several reasons why I will opt for a c section: a prior (minor) uterine prolapse, anxiety issues, and a family history of erb's palsy and incontinence.
I have faced nothing but judgement, ridicule and even hatred from other women :(:(

I am well aware that this is a major surgery with a longer recovery. I'm well aware it shouldn't be done prior to 39 weeks (unless of course I go into spontaneous labour). I'm well aware of the increased risk of complications in future pregnancies, however I don't plan on more than two babies.
I'm also aware of the risk of staph infection.

However, by opting for a c section I'm reducing my chances of developing
incontinence and prolapse. I have a zero chance of suffering an obstetric fistula, a third or fourth degree tear and perineal trauma.
My baby will be at a reduced risk of cerebral palsy, erb's palsy, brachial plexus nerve injuries and trauma caused by a possible assisted birth.

I'm not hard-selling c sections here, just pointing out that there are some benefits to a c section as well.
Why then do people only focus on the negatives? And why are the varied risks of a VB ignored simply because it's 'natural'?

This link:
www.ncbi.nlm.nih.gov/m/pubmed/12911445/?i=6&from=/17486467/related

States

"RESULTS: Out of 903 women with planned vaginal birth, in 484 women (53.6%) minimal perineal surgery had to be performed after birth, 41 women (4.5%) had vacuum deliveries, and in 93 cases (10.3%) emergency CS had to be performed. In the 147 elective CS (103 based on medical and 44 on psychological factors), a significantly lower rate of maternal and fetal complications was observed when compared with vaginal birth (5.4% vs. 19.3%; p < 0.0001). Birth experience (Salmon test) was significantly better in elective CS compared with vaginal delivery, but worse in women with emergency CS and worst in those with vacuum delivery. We found that 83.5% of women with vaginal delivery would choose the same mode of birth again, 74.3% of women with CS on demand, and 66% of women with medically necessary CS. Only 30.1% of women with emergency CS wanted to receive CS at the next birth.

CONCLUSIONS: Elective CS is a safe and psychologically well tolerated procedure. The results are comparable with uncomplicated vaginal delivery and far superior to secondary intervention such as vacuum delivery or emergency CS."

This heartbreaking story describes how obstetric fistulas are a reality even in the developed world.

www.guardian.co.uk/lifeandstyle/2010/dec/10/torn-apart-by-childbirth

I want to thank everyone for their kind words and support of my concerns. I am also grateful to all those who shared their stories, both good and bad.

I'd like to state that I firmly support a woman's right to ask for a c section for ANY reason as long as it is a fully informed decision.

I find it appalling that women are not educated about the very real risks of forceps and people actually claim that they are safer than a c section when ample studies have proven that they are not.

The risks of c sections are announced by all and sundry, grossly exaggerated. However, even doctors don't inform women of the very real risks of a vaginal birth.

I'm not saying VBs are not the way to go, I just feel that women MUST make themselves aware of the risks. It is far more traumatic when a complication catches you you aware.

For the record, I do know women who would prefer a c section even in the absence of psychological and medical problems. They are mostly well aware, well researched women who prefer the risks of a c section as opposed to those of a VB. It's not about convenience because no method of giving birth is convenient to be honest! It's just about individual preference.

The question is how do you know your baby's birth is the one which will end up with problems if you go the VB route? I would go for a VB if I could change my mind at the first mention of forceps......

Sir Charles,
I don't know whether my VB will be complicated or not.That's the whole point of it.
There is never a guarantee for a simple, uncomplicated VB.
There can be trouble at any point. Even once the baby's head is out, the shoulders may get stuck ( shoulder dystocia ) which can cause brachial plexus nerve injuries.

I prefer to avoid those risks entirely.

Secondly, you aren't always in a position to "change your mind" in labour. You may get bullied or scared into agreeing, you may be too much in pain or too tired to argue. You may be too worried about fetal distress. It's not so simple.

I forgot to mention it- Fruitybread your first post in this thread is brilliant.
you're spot on about why some women are so judgemental.

And there is no guarantee of a simple, uncomplicated elective section either, Dance.
No matter how much preparation I had done, nothing prepared me for how I felt after ds's birth.

dancelikethewind, yes it is very true in what you have said for me forceps should be banned now im left with bowel incontience and have no support at all im due a stoma after xmas and still have had no therapy why would a dr risk my health my using forceps when I should of had a emcs im fuming with what happened to me and what im suppose to accept this wishing you all the best

And, phsychologically, the effect of his birth was far, far greater than my previous births, and the physical damage that occured during them.

Hazeyjane, was yours an ELCS? Secondly had you wanted it or been bullied into it?

There is no doubt that ELCS is a far more controlled and predictable process.
A VB is definitely more unpredictable. If you read my links above, they clearly state that a planned CS is tolerated best psychologically.

You may not have enjoyed your experience because You may not have wanted a surgical birth.

If I'm forced into a VB, I'd never recover emotionally. Its also a matter of preference.

soapy,

I'm so terribly sorry to hear that:(:(

Is there no way to fix your problem completely?

DanceLikeTheWind

You need to get rid of the bias and also read the other half of this debate. Your view is terribly open sided and I bet I could find studies that 'prove' the opposite to some of those studies.

Whilst I'm all for choice you are giving a point of view which is potentially damaging for some women.

What is right for you, isn't necessarily right for someone else. Psychologically a ELCS COULD be damaging for some women. I HAVE seen at least one study that says that being granted a request for a ELCS is no guarantee a woman will have a satisfying birth experience. Certainly one that doesn't match her expectations.

Please post the study then.

I've posted three studies that clearly state that for women who request it, a CS is a psycho.logically better tolerated procedure.

I'm curious, since I've posted only valid research papers, how is my view one sided?

I'm not discouraging VB at all, just saying that a CS is a preferable alternative for many women. Denying them that request and forcing them to birth vaginally is going to result in emotional trauma.

Dance, I think you are too bloody closed minded for anything.

Whats the point?

You should be looking for these yourself, instead of just finding pro c-section stuff. The fact you aren't says a lot.

Dance, No my problem cannot be fixed, I had to be be induced the 1st time it ended up into a emcs which I would not want ever to have again so now I end of with a bag im soooo angry about this I think sections are less risky and wished I had one now but that is too late good luck

Dance, my cs was elective. I had previously had a 3rd degree and 2nd degree tear. I researched c-sections, and posted a lot on here (there is thread about elcs for people who have suffered traumatic births), as I has suffered some double incontinence, and really the only way that i could prevent any further damage was to have a c-section, which the consultant agreed to.

The pyschological trauma caused by my c-section probably stems from the fact that I bled so much, I reacted badly to the pain meds, and worst of all that I didn't get to hold my ds after he was born as i was such a vomiting, shaking mess, he was then taken to NICU because he was struggling to breathe, and i didn't get to hold him for another 2 days. The fact that he now has all sorts of problems (global developmental delays, hypotonia and problems with swallowing, amongst other things), probably adds to the feelings that I have around the birth.

When i say that nothing could have prepared me, I suppose the main thing that took me by surprise, was how brutal the whole thing felt - don't get me wrong, the surgeon,anaesthetist and other hcp were all great, but i felt detatched and terrified throughout the whole thing, and afterwards i felt like a lady who had been sawn in two. My body felt wrecked and strange for months afterwards, and i say this as someone who had a 3 day labour, with nothing but gas and air ending in episiotomy, ventouse and a tear that was stitched in surgery.

The thing is that there are no guarantees with either method. I had heard a lot about tearing and stuff that could go wrong during vaginal birth, but with elective sections, i had only really heard positive stories, and i think this added to my feeling afterwards that I was just not coping, because i couldn't believe how shit i felt, despite being morphined up to the eyeballs!

Dance, Just wanted to add I had to be induced have my waters broken then had an emergency section which left me scarred for life even 12 years on I pondered with the idea of another child as my section was bloody awful I could do nothing for 2 months and had no help the trauma is awful if I had of known such injuries could occur with forceps I would of had to have a section but I did not not know now I wish I never had another baby do not get me wrong I love my dd so much but the trauma has been too much to deal with and my tear went unnoticed what the hell !!!!!

Hazeyjane,

I'm so sorry to hear about your awful experience:(:(

I do know that those outcomes are possible after a c section. However, whenever I pick between two options, I essentially pick between the worst case scenarios. I'm not denying I could feel like you did after a section, but I could also end up like soapy if i attempt a VB.
Even given the worst case scenario, a c section is preferable to me when compared with a vaginal birth.
People think I'm crazy, but I'd rather deal with a long and painful recovery or even a staph infection instead of fecal and urinary incontinence or uterine prolapse or a colostomy. Probably because I have women in my family who have these conditions so I know how terrible it is.
Does that make sense?

Soapy, I'm horrified and heartbroken for you. I wish I could say something positive to make you feel better, but I really don't know what that will be:(

NICEyNice, I'm actually very aware of the fact that the existing research states that an uncomplicated, spontaneous VB is the safest way to deliver a child. The research also states that there is never a guarantee for an uncomplicated VB. In light of that observation, several obstetricians do feel that a planned c section is the next best alternative.

I'm sorry you think I'm closed minded, but I'm simply somebody who wishes that c sections weren't judged quite so harshly.

Every pregnancy website has a long list of scary ( and some incorrect ) complications of a c section. However, not one of them lists the possible and equally horrifying risks of a VB. I only wish for women to be informed and therefore I feel that the risks of a VB should also be discussed more openly.

I may be closed minded in the sense that I will always prefer a CS for myself because I'm convinced it's the best way for me. I only ask that the informed choices of women like me be respected.

Something to bear in mind is that people attach different values to risk. In ANY birth scenario, there will be risks that are a source of grave concern to some women, which are simply less important to others. (for a non c-section take on this, go and have a look at the thread where women discuss the recently published research about home births for first time mums being twice as risky for babies in terms of death and injury).

I think a very good point is being made that there ARE risks attached to VBs, especially once they fall outside that description of a straightforward unassisted birth. They are not discussed in the same way that the risks of CS's are. I can't see how keeping women in the dark and leaving them poorly informed/shocked when things do go badly is anything other than infantilising and disempowering.

I think historically, the risks of VB, to mother and child, have not been articulated because they've simply been seen as things women 'should' put up with (pain, incontinence, trauma to baby). No say in the matter and certainly no choice. This is partly thanks to a patriarchal medical establishment being dismissive of women - partly something women themselves collude in (seen those threads about what to tell a first time mum about birth? 'not much' is the most common answer).

fruitybread, Very true so why are these risks not told to mothers? especially assisted delivery when they know full well of what could happen and a section would be less risky for sure I had one before and never heard of incontience when having a baby and yes it seems it is something that we have to live with I was refused therapy? why or probably because this my tear was neglected and nobody cares about me im torn into pieces sections are less risky.

Soapy, I suppose the thing is that even if you know there are risks to vaginal delivery, I think a lot of people will hope that these things won't happen to them (in the same way as when one chooses a section)

I had a friend who had suffered a 4th degree tear before I had dd1, and my mum loved to tell me in great detail how giving birth to an 11lber - er, me! - had resulted in an enormous tear and wrecked her lower back, I still went for a vaginal delivery, because I think I really believed that these things wouldn't happen to me.

As it happened I did tear badly, and with the 3rd went for the supposedly less traumatic option of elcs, which in my circumstances was far more traumatic!

I wonder, given all the stats and a fair balance of anecdotes, how many first time mothers would choose to have a cs over a vb?

Me! Chose ELCS for my first (no medical reason) and had a fabulous experience and a very quick recovery. Had a second child 15 months later also ELCS and same fab experience and recovery. Each to their own I think.