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'?

"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?"

Actually the stats become a bit meaningless when push comes to shove. I'm saying that even though I believe in informed choice and believe that it's good not to go into birth or parenthood with your eyes shut.

The vast majority of people come through birth or through a c/s in good health and with a well baby. That's real life and that's why most people generally don't agonise over the issue. The finer issues are impossible to judge when our perception is so distorted by our own personal idiosyncrasies, our experiences and those of our friends and families.

And - particularly with vaginal birth - the outcomes vary so hugely according to standards of care, and setting of care that it simply doesn't make sense to try to do an across the board comparison with c/s.

I think sometimes it comes down to your feelings about your own body, your sense of optimism and confidence. I had confidence that I could give birth and that I'd be a lovable and sexual human being afterwards, even with a body which was marked and changed by childbirth. I wanted to do it. I saw it as a normal part of the drama of being a human being. Like going to the toilet, making love, being born or dying. I didn't want birth to be something that someone else did to me. I wanted to do it myself.

I can see though that the primal nature of labour, and how unpredictable it is make it something to be feared, and I understand why people don't want to risk putting themselves through something they suspect they might find unbearable. It's not unreasonable to want to avoid doing something that's so hard. There will always be mums who feel that way. Just like there will always be mums who're up for the challenge of labour, and who feel they've got something to gain from the experience of being pushed to the limits of their endurance.

There are other ways of being pushed to the limits of endurance other than experiencing labour.

i think i worded that badly, and it is too early for me to formulate a better sentence!

my decision to have an elcs was eff all to do with the 'experience of being pushed to the limits of (my) endurance' during vb, more about the best way to avoid crapping myself on the school run!

as it turned out my elcs has been more of an endurance test than my vb were. If only we were given a crystal ball at the booking in appointment.

Shagmundfreud,
I have a small quibble. I don't really think that vast majority come out of birth (vaginal or CS) completely ok. I've actually heard of a lot of people experiencing varying levels of morbidity either way.

Secondly, you're right that the VB experience depends on the standard of care. I don't think however, that the outcome always does. Given that it's a natural process, it will always be completely unpredictable. Problems can even arise once everything appears to be over, for eg; shoulder dystocia. Even the best of consultants and midwives cannot completely prevent tearing, should dystocia or brachial plexus palsy.
It's mostly the unpredictability of a VB that puts ome women off. To me a VB can go any which way- it includes the risks of an assisted birth and an EMCS, which are the riskiest of all.

I think shagmundfreud writes eloquently on exactly why women judge others who choose a c-section, especially the last sentence. It's honest and it's what many women, possibly most women think.

I'm looking forward to my planned CS though and the 'challenge' is not appropriate for all women.

Lots of natural and dangerous processes are avoided nowadays - I don't feel like less of a woman for taking painkillers during heavy periods for example, and that's a natural process too. It doesn't make me a strong woman for suffering - it's quite a biblical pov IMO.

"....there will always be mums who're up for the challenge of labour, and who feel they've got something to gain from the experience of being pushed to the limits of their endurance."

Sure, if that's your thing. And quite right, Chynah - there are so, SO many other areas of life where woman can experience and embrace challenge. Some us too will be unfortunate enough to have extreme challenges forced upon us, and to have been pushed to their limits of our endurance without any choice. We don't all arrive at birth and motherhood via the same route, and we don't all have the same attitude towards birth.

That's hardly surprising, I know - what IS surprising is that a lot of us seem to find that so hard to understand. Or interpret other people's choices in very negative and hostile ways. It's fine not to be able to understand why on earth someone would want a CS over a VB, if you can't make that leap of empathy and imagination. It's not fine to belittle them, or dismiss their concerns as flippant or trivial. You don't have to understand - you just have to have some respect for the person who isn't you, and accept they have their reasons.

I think my problem with the whole concept of feeling proud of achieving natural labour is that by accepting the right of mothers to feel pride, it gives them ownership, that they did it themselves. The flipside of course is that women who did exactly the same thing, endured the pain, did everything they could, still end up with awful interventions including forceps and emcs - the logical conclusion is that these women blame themselves. And they do, which makes me

There was a thread going earlier about Cancer Research's current window displays which say something like 'I stayed strong and I beat cancer' - same thing. It infers that if you don't 'beat' cancer, then you're not strong. I have this niggly problem with women who do the whole 'I laboured naturally and feel like superwoman' - I appreciate they feel amazing, but the natural flipside is for some women to feel like utter failures. You can't ever control a vaginal delivery so it's misguided although understandable to be proud - mostly it's luck.

HugosGoatee - I had a forceps birth, and have needed help with all my births one way or another. If I'd had an emergency c/s I would have felt proud of myself for the work I'd put in to getting my baby born.

"I have this niggly problem with women who do the whole 'I laboured naturally and feel like superwoman' - I appreciate they feel amazing, but the natural flipside is for some women to feel like utter failures"

I'm sorry that some women feel like failures for not achieving a straightforward birth. It does help you feel more accepting and positive about your birth outcome if you go into labour with an open mind and a sense of adventure, and not a sense of entitlement to a straightforward delivery.

"You can't ever control a vaginal delivery so it's misguided although understandable to be proud - mostly it's luck."

I don't agree that it's mostly luck. I think the massively reduced rate of emergency c/s, forceps and ventouse deliveries that healthy mums delivering at home have in comparison to similar women delivering in CLU's suggests that this can't be the case: that feelings/attitude/the way a woman uses her body in labour and her ability to manage her pain MUST have some input. In any case - I don't feel proud for having managed a normal birth, because I never have really. I feel proud of myself for the way I managed to stay optimistic and pro-active in the face of pregnancy complications and long, difficult labours.

"It's misguided although understandable to be proud"

Are you only allowed to feel proud about things you have 100% control over then? Why? We feel incredibly proud of our babies, and how we've grown them and carried them in our bodies - all things which are done involuntarily. Is this wrong and misguided? To feel proud to have made a beautiful baby?

"I don't really think that vast majority come out of birth (vaginal or CS) completely ok."

The majority of women come out 'ok' in the sense that they through birth without injuries which cause continued difficulties beyond the end of the postnatal period, and without feeling emotionally traumatised.

"It's fine not to be able to understand why on earth someone would want a CS over a VB"

I should imagine the minority want a c/s because they are too frightened to contemplate a vaginal birth, and the majority because they would rather not experience the loss of control, the pain and the exhaustion of a vaginal birth. Also those who feel the possible risk of a very poor outcome from emergency c/s (though the greater likelihood of coming through the birth without needing major surgery) outweighs the risks of serious complications from planned major surgery.

There's nothing wrong with saying you don't want to go through labour because it's bloody painful and you don't know how it's going to turn out. I don't think that's trivialising women's feelings. I'm aware that this is a complex issue.

I simply feel bored with the inability of some people on this thread to accept that women can and often do find the experience of going through labour incredibly positive, confidence inspiring and life-changing.

"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?"

Oh I think probably more and more. Because we're not allowed to talk about labour as a rite of passage any more, or an opportunity for spiritual or personal growth. That's supremely unfashionable. Suffering when you don't have to is simply not a modern thing. And talking about it in these terms is seen as embarrassing.

A sense of adventure seems an odd approach to take to the delivery of a baby. It's not a bungee jump! Having my baby was the adventure for me, not how he got there. I want him out as safely as possible without unnecessary risk. Can I count the serious amount of pain I had post-ecs as a rite of passage too by the way, or somehow will that not apply?

"I simply feel bored with the inability of some people on this thread to accept that women can and often do find the experience of going through labour incredibly positive, confidence inspiring and life-changing."

I'm sure they do find it so. They say they do, so why wouldn't they be believed?

My C section was a profoundly emotional and spiritual moment. It was the birth of my much wanted son, and a birth I spent most of my adult life thinking couldn't happen. I expect people to believe me when I talk about my experience. I do think, with all due respect, that the reasons you imagine people want C sections over VBs, are rather reductive. I've seen avoiding 'loss of control' and 'pain' as reasons for people desperately wanting VBs rather than C sections...

I think it's perfectly reasonable for you to talk about your VBs as a 'rite of passage' - for you. I only have problems with this language when people try and universalise it, and start dictating to women what their birth experiences 'should' mean to them, as women. I remember on another thread, posting as cleofartra, you said - "For me it was a bit of an experiment. I wanted to see how it was to be pushed to the limits of my endurance - to see what emotional and spiritual resources I could call on to help me. Only time in my life I've ever had to tolerate something intolerable - it was very interesting."

Well, whatever floats your boat! Like I said, other women find other arenas to experience challenges. That's fine.

Actually, shagmund - I just re-read this - "Suffering when you don't have to is simply not a modern thing. And talking about it in these terms is seen as embarrassing."

Could you expand on that at all? Is it only suffering in childbirth that you are referring to, for example? (just wondering if you have religious background)

Tearing to a degree of needing a bag is mind blowing I will tell my kids to choose a section anyday and inform of why!!!!!! never mind the pain etc......

"A sense of adventure seems an odd approach to take to the delivery of a baby. It's not a bungee jump!"

Just wanted to say that my feelings about giving birth were akin to waiting for a roller-coaster ride. I would look forward to it with trepidation and excitement which increased once I knew I was in labour. Absolutely amazing experience for me. When the possibility of cs was mentioned I had feelings of anti-climax and disappointment (as if I'd got to the front of the queue and been told the ride had closed).

It wasn't anything to do with a sense of adventure ( I don't think I have that particular sense) but the bungee jump reference reminded me of the build-up of anticipation and excitement I would feel as the birth approached.

Juuule, weren't you more excited about meeting your baby then the "birth experience"? Having a cs wouldn't take that away!

Of course, I was excited about meeting my baby (that was the high-point) but I just wanted to mention that it's possible to find the labour and delivery exciting too. Of course, none of it would have mattered if there was no baby, having a baby at the end of it is the point of the whole thing.

It's been interesting to read these replies:) Every woman has such different expectations from the birthing process and approaches labour and delivery with such varied attitudes!

I know some women who think that the anticipation is fun and that planned deliveries are an anti climax, while others hate the waiting. I also know women who hate surgery and would rather birth naturally. I know others like myself who find nothing attractive about doing it naturally and much prefer surgery.

Some women want to be as involved and alert as possible during the process while others (like me) find a c section under GA to be the ideal ( although I wouldnt ask for GA due to the added risks). For the former the process is as important as the outcome. For the latter, like myself, the process is of zero importance- I'd rather wake up when it's all over! The only thing important to me is the outcome.

Sime women feel more in control during a VB, while others like myself view it as a complete loss of control and as a vulnerable situation.

Some women prefer to deliver in the comfort of their homes while others like myself would never even consider it an option.

The good thing about all this is that all of us actually have the facility and right to follow our own path to motherhood. We each can lot for what we feel safest with- be it a home birth, hospital VB, or c section.

The sad bit is that instead of celebrating these differences and being grateful for these choices we judge each other. We actually raise our voices against another woman's choice and justify it with statistics.

That should be "opt" for not "lot for"..... Stupid iPhone! I may have also made spelling errors and missed out on punctuation so please just overlook it!!

Just to add that the WHO have withdrawn their recommendation that countries try to minimise their caesarian rates as there is no longer any evidence to support the premise that a vaginal delivery is preferable or offers better outcomes than elective caesarian delivery. Personally my main concern is the lack of information you are given within the NHS regarding the skills and experience of the staff treating you. While there are (I'm sure) many brilliant and skilled midwives, it is a fact that upwards of 500 perfectly healthy babies a year die in the UK (and countless more are brain damaged but live) because the baby heart-rate monitor trace is misread, usually by midwives who don't call for an obstetrician, but sometimes also by the on call doctor. 500 midwives a year are not struck off, and I doubt that their next patient is informed. They are the NHS's own statistics, and the level of compensation payouts for mismanaged deliveries (that is only one particular cause, there are countless others) is frightening. Having a friend with a very severely mentally and physically disabled son due to a botched vaginal delivery, I am probably hyper-aware of this particular risk but there needs to be far more detailed and honest information offered about what the outcomes are. That isn't scaremongering, it is about being given ALL the information needed to make informed choices. My experience where I was encouraged to attempt a vaginal delivery of a breech baby WITHOUT being informed that it was considerably more risky for both of us than an ELCS, and then having had an ELCS I was encouraged to attempt VBAC for my second delivery, again without being informed that the statistical risks to us both were lower with an ELCS. (My consultant estimated a 1:200 risk of uterine rupture - something the VBAC counsellor had dismissed as "not really a consideration"). It certainly made me very mistrustful of the quality and honesty of the advice I was receiving from my NHS midwives.
Finally I also agree with DanceLikeTheWind that there is a huge hostility to the view that some women might make an informed choice that the risks of an ELCS are preferable to the risks of a vaginal delivery, and that this might be perfectly reasonable. I notice DanceLikeTheWind is being accused of being closed minded for stating her view, as if to imply that were she open minded she would of course think differently. DanceLikeTheWind does not criticise the decision making process of someone who would prefer to (for example) accept the higher risks of a vaginal home delivery because they value the non medicalised process and surroundings, she just says her priorities are different and that she would prefer a different option. To me "closed minded" is refusing to accept that someone might have very valid, reasonable reasons for making a different choice, and accusing them of scaremongering when they put factual information into the discussion that supports their viewpoint. For me, if I was younger and planning 3 or more pregnancies I would absolutely opt for vaginal delivery (but I would probably be saving up to be accompanied by an experienced, well qualified midwife). As an older mother, about to deliver a second and final baby there is no doubt in my mind (or my consultant's) that an ELCS is the right choice for me, and I do find questions along the lines of "are you very disappointed" or "is it so the baby isn't born on Christmas Day" extremely judgemental and insulting.

Also, the concerns about the cost to the NHS of increasing numbers of caesarians do not seem to take into account the costs of compensation awards following botched deliveries. While the compensation for a dead baby/mother is reasonably moderate, the compensation for a brain damaged baby needing round the clock lifelong care can be upwards of £7 million. Obstetricians pay by far the highest insurance premiums and (I'm pretty sure) the payouts in obstetrics outweigh other compensation payouts in all other fields of medicine added together. I reckon when you put the payouts into the equation it makes elective caesarians look like quite goos value for money, and the cynic in me wonders if rapidly increasing claims and awards is one of the reasons why the NHS is suddenly starting to be more open to elective caesarians on demand.

Emmaroos, Thanks for understanding that I'm not being closed minded :)

I'm sorry to hear that you're facing judgement about your c section, but I'm glad you've made a choice you're comfortable with and I think it's best to ignore the silly people who ask those kind of insulting questions.

Your post has put the idea of a spin off thread in my mind...

Hey I know this is a really old post but OP if you ever read this - it is clear to me that you are a very intelligent, reasonable woman who choose the c-section as the best option for your baby and yourself.

I am the same as you - 33w4d now, wanting a c section for my first precisely due to the risks of vaginal labour that you have outlined plus additional factors. I am mainly concerned here about the little child who can potentially die if there are VB complications and no competent staff around. My due date is on the Christmas Day and I have already found out there's only emergency medical cover in terms of consultants and obstetricians that day, where they have six out of the usual 12 docs... Or actually it is ONE as the remaining five are home on-call. Also easy to imagine some of them might have a drink or two since it's a bloody Christmas Day. On top of that I read the NICE report from 2014 which clearly states the risks of both VD and CS are very comparable (when you actually look at the data, VD comes with slightly higher risk percentage for some complications.)

Also my mother, a GP herself and after two C-sections has told me she recovered much quicker than VD ladies being able to walk and clean up around herself the next day, she also said C-section is one of the simplest medical procedures and obstetricians do it every day.

Btw I put this argument forward to my midwife who was trying to shame me into VD and even she had to agree! She said "well yes, but it is still a surgery." Well, you know what else is a surgery? A breast biopsy or having your appendix taken out - and at comparable level of difficulty - yet we never hear any scaremongering over these, do we?

As to the mommies hating you - I had gone through the same lens of judgement and being strongly discouraged by some (though some good friends agreed that it makes sense to go for elective CS) - what I found is they usually judge you for one or all of the reasons below:

1. They feel they had to go through all the pain so you have to as well. They reckon you fancy yourself as "too posh to push" and want to avoid pain. That, of course, should not be acceptable. As a woman you are meant to be this martyr character - even if the pain is not only unnecessary but makes no sense when you analyse all pros and cons for both options.

2. They themselves are ignorant of any research or stats and go just by what they have heard from everyone around - the official line being the scaremongering and making people feel like a "failure" for not going "au naturel." Basically they don't tend to analyse information critically and believe whatever they told. They are bewildered to hear someone could think otherwise.

3. They judge you for taking up NHS resources imagining CS costs thousands of ££. Yes CS is more expensive than VB but only by about £800 and only if VB doesn't end with an intervention. I don't know about your region but in mine 65% of VB end with interventions. Also the cost argument should make you think re: why we keep on hearing how bad it is from the local health providers. Cost savings!!

Okay my final point now - as to the "failure" argument, I almost burst out laughing when I heard that first time.

I'm sorry but my baby will be born with no stress, no risk for it to get stuck in the birth canal, death due to falling heart rate, risk of injury from forceps or vaccum (remember 65% VB end in interventions), cord around neck won't be a big problem, I will have a much more controlled and peaceful birth experience, zero chance for tearing or incontinence later, and hey yes, less pain also. Seriously, you calling me a loser here? Because I feel very much like a winner.

Awwwwww.I know this is an old thread , but for anyone who comes here seeking some sort of kindness for their choices. Please have a hug!.Although, I am slated to have a natural birth , the thought of having to be cut open scares me.I can only imagine the strength it must have taken to have the CS done and I just want to say Well done..
Please don't let anyone shame you on your choice .

I had an EMCS with DS. He nearly died. The whole experience was horrific. I am scheduled for an elective for DD next week. I haven't felt judged and to be honest, I don't really care what other people think. My consultant advised that my chances of a successful VBAC this time are v good - but I am not prepared to risk it.

If I want to push myself to the limits of physical endurance then i'll run a marathon or sign up to an Olympic length triathlon.

HoneyBee I guess you're not as judged because you have that horrific first time experience that people can agree "justifies" your choice (because of course a logical decision that works best for you and your child is not good enough.)

Sorry to hear about your experience, to be honest though I've heard many horrific stories of EMCS and birth complications from friends and family and hence don't see why would anyone put themselves and their child at risk if there is a very good alternative that also happens to be less stressful and painful.

My NCT classes basically described CS as a worst case scenario. The implicit message was that everyone should birth vaginally and breastfeed. A lot of people attend NCT so could this be fuelling and anti-CS fire? Otherwise there's the rare article in the newspapers but it is rare and then there is a small but loud group of 'natural birth at all costs' campaigners which muddy the waters a bit too. Generally though I think most women couldn't give a crap how someone else gives birth. I think some of us who have had a CS are sensitive to the anti-CS brigade but just remember there's a lot of people who really don't care either way so long as you and baby are safe. I try to focus on the latter rather than the former.