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 do not agree with giving anybody a CS by request, how stupid is that! it is a major operation with all the risks involved, a number of friends of mine have had serious complications due to having had a CS - including oone friend who had her ureter cut in the op and had to go back for surgery to repair this. S how someone can say it reduces risk is beyond me. Having a CS section also diminishes the chances of being able to breastfeed- read the info and you will see that his is true. Another fact is that after a CS you are not insured to drive a car until you have had your postnatal examination - not good in the run up to xmas

Also, the question I referred to was whether it matters to babies, not about the impact on maternal health.

N=2, but I don;t think either of my children cared much about their mode of delivery

Breastfeeding - actually not true, it's not the mode of delivery that makes the difference, but what support the mother gets afterwards.

Driving - complete codswallop - CS is not a condition which is reportable to DVLA, so there is no driving ban. I've talked to my insurers after both CS and both times I've been told that I'm allowed to drive as soon as I feel fit to drive, and there is no medical sign-off required. These were two different insurers.

"but in absolutely no way do I think the choices I made are better than someone who had a section, bottle fed and gave jars of food. There are other elements of mothering that they may be far better than me at so why on earth would I list research to try and prove superiority when all it does is point to your own inferiority"

How old are you?

This is not a discussion about the rights and wrongs of individual choices when it comes to birth of feeding. These are not moral choices. There is no need for you to start being personal about it!

Infant formula is a commercial product. Surgical birth is a medical procedure. There is no harm in discussing the evidence underpinning the public debate about these things.

PML at 'you're exactly the sort of mother I was referring to'. Where have I expressed an opinion about rights and wrongs when it comes to individual women choosing a c/s?

On whether it "matters" to babies - I'm not sure that's the right question. If it has long term implications, it's worth considering what's the right option.

shagmund

"Where have I expressed an opinion about rights and wrongs when it comes to individual women choosing a c/s?"

You come very much across as saying that vaginal birth and breastmilk are superior simply on the basis that they're "natural".

I'm having an ELCS, is safest thing for me in my circumstances, I have had nobody judge me at all. I do think the way you are weighing up your evidence OP, doesn't really mention individual circumstances so you are comparing yourself like-to-like with people having a VB and I can see why they would get defensive if you approached it like that - it is like you are spoiling for a fight. Is it possible that your anxiety issues are making you more defensive than you would otherwise be, because you feel they make you appear weak in some way (they shouldn't, perfectly valid). I just can't see why this would get to you otherwise or you would make such a fuss.

People judge each other day in day out, from what shoes someone wears to the car they drive or what they name their pets - who cares, really, if your opinions sometimes fall on the different side of a fence than someone else's.

Regarding the science, we don't really have enough data on the reasons behind childbirth choices to make firm conclusions on any associations. We can't even follow up a group of women who chose ELCS for no medical reason as it is extremely unlikely they would be representative of the general population (richer, older, perhaps undiagnosed anxiety). Current ELCS stats probably involve fatter mothers, having planned (at short notice) sections following high BP/GD or other complication.

A Csection does not cost £1000 more than a VD if you take into account the cost of repair op on serious tears, fistula and prolapse (short to medium term). I've seen costings that say the difference (at a population level) is about £200 extra, and this does not include the much longer term costs of birth injury such as double incontinence. CS heal well on the whole, and if they require surgical repair, this tends to be very successful. Birth injuries on the other hand heal less well, and may require several surgical repairs, still with an imperfect result.

I has a planned CS for DS4 due to previous birth injury (I had to ASK for it, despite NICE stating that all woman with my problem should be OFFERED a CS), and I have to say, the op and the recovery were very easy and pain free compared with recovery from the birth injury.

Women should have the risks and benefits of both explained to them, long term risks and benefits too. They should not be denied choice for the sake of a couple of hundred pounds.

As I said before I am not in the UK so maybe different rules here but we are strongly advised not to drive for 6 weeks after a CS with no complications...our insurance company would not have paid out for medical costs if an accident occurred whilst I was driving before that 6 weeks was up...

You have to account for the medium-long term costs of all those urological-gynae problems resulting from VB that cost the NHS money- prolapses, incontinence, backpain from prolapse etc

I don't know. I never understand why anyone cares about anyone else's choices.

Re Driving

"Two studies performed after inguinal hernia repair suggest that the patients can drive one week after open hernia repair5,6. Wright et al carried out a randomised controlled study comparing driving reaction time after open and endoscopic tension free inguinal hernia repair. They found that patients can return to driving one week after the operation compared to earlier advice of ten days or more5. Colin et al6 advised that patients should not drive for 10 days after hernia repair.
Considering that most gynaecological abdominal surgeries and caesarean section are done by transverse suprapubic incision, which is similar to the incision used for open inguinal hernia, it may be best practice to use that advice after gynaecological surgeries. If such advice were followed and confirmed by research it would lead to earlier driving after gynaecological surgeries with potential social and economic benefits to patients."

Oldmum42 - there are also potential costs post-CS and not sure these have been factored in...I understand you had a positive experience but not everyone does..on average it would be more than £200 as per NICE's report and yes I agree £200 in itself is not a lot of money but times the number of women who subsequently choose to have an ELCS then this figure suddenly becomes very significant to the NHS. In my opinion it is also not just a cost issue it is also a resources issue which is clearly already a problem within the NHS.

As far as judging people for having a CS that I don't get...

I love kumquat's post:

Lady at playgroup, 'Too posh to push are we?'
Me, 'Yes.'
Pinteresque silence.
Lady - exeunt.

I think it's a real shame that women get judged for having elcs. I can certainly see why you would have one if you've had a very difficult first birth, esp if it ended in an emergency c-section. With a first baby, it's a trickier decision, because I think some people do underestimate the things that can go wrong even with an elective caesarean - it's not an easy option and recovery can take a long time. But I wouldn't judge anyone for making that choice. I think this "too posh to push" business is vile.

"but I don;t think either of my children cared much about their mode of delivery"

I think you'll find that there are many things children don't care about, including things which we know are important, like them getting a good quality balanced weaning diet, or spending too much time in front of the tv.

"Breastfeeding - actually not true, it's not the mode of delivery that makes the difference, but what support the mother gets afterwards."

You're right that support afterwards does make all the difference. The fact that post elcs women are generally giving birth during 'office hours' when staffing tends to be better probably makes a huge difference to the levels of support they receive in the first crucial 6 hours. I suspect it's probably this which makes up for some of the physiological barriers which surgical birth puts in the way of establishing breastfeeding so that when we're comparing breastfeeding outcomes, they do as well as women who've delivered vaginally.

"I think you'll find that there are many things children don't care about, including things which we know are important, like them getting a good quality balanced weaning diet, or spending too much time in front of the tv. smile"

And you're really surprised why people think you come across rather sanctimonious?

(But it's nice that you acknowledge that there is no difference in outcome when it comes to breastfeeding.)

I had an emergency c section first time round. I was gutted about it but the baby was in distress so it had to be done. It wasn't fun and was painful afterwards, but I had no problem feeding baby or looking after him. Second time round I had a Vbac which was a much nicer experience all round, though my stitches stung like merry hell for weeks! I'm sure most people would prefer a vaginal delivery if possible, but if it's not possible ( and there are lots of reasons why it may not be) a c section is not the end of the world.

For what it's worth, I didn't find people judgmental about my c section, but I was very disappointed about it, and I may have projected my own feelings onto other people at times.

shagmund

"Where have I expressed an opinion about rights and wrongs when it comes to individual women choosing a c/s?"

Your tone, the way you express your argument. Judgement is there front and centre.

I am old enough to realise that not respecting peoples choices is judgemental and uneccesary

To be fair to the OP, I think she drew attention to the benefits of CS and risks of VB because this is never discussed by professionals. If you want a CS then there is a discussion of all the HUGE risks you will be taking. However, there is no similar discussion of the risks of VB.

I had an ELCS as I decided I was not happy with the risks of brain injury etc with VB. The risk may be exceptionally small, but the outcome is catastrophic. For me, that outweighed the risks of CS - especially as the risks were to me not the baby.

I had an emcs after 24hrs of labour. I have a back problem and after the initial exam at 8wks my obn told me that there was a good chance I would need a cs due to my pelvis. At 41wks it was determined that I had preclampsia and they induced me. I got to 5cm and didn't progress. My obn was finishing at 10pm so had me wheeled in at 9pm. The same dr who saw me throughout my pregnancy delivered DD at 9.11pm.

I am in the US and the only people who pass judgement on those who give birth are the women who have too much time on their hands (La Leche League!). Who cares how you make it into this world. What is important is that both mother and child are healthy. When I lived in the UK I paid a lot in taxes and it grinds my gears when I hear people say it costs the NHS too much. Quite frankly, if they can fly an Iraqi in and give them expensive treatments then clearly the money is there for pay for women to have a CS.

haven't read the whole thing but have 3 DCs, all by C-Section. First one emergency, second two elective. Quite happy not to have had a vb at any time. DS has five DCS, all VBs. she is equally happy never to have had a C-Section.
Whatever is right for you is right. A healthy baby and a (reasonably) positive experience is the thing, however you do it.

"But it's nice that you acknowledge that there is no difference in outcome when it comes to breastfeeding"

No - but only because so many women having vaginal births out of office hours in UK hospitals receive substandard care when it comes to breastfeeding support.

"And you're really surprised why people think you come across rather sanctimonious?"

Why the need to bring personal criticism into this discussion? I've not said anything unkind or judgemental on this thread.

"Your tone, the way you express your argument. Judgement is there front and centre."

Well - I know how I think and feel and I can assure you, that whatever my feelings are about public policy and public debate on this issue, I have no negative feelings towards individual mums who choose a surgical birth. And I feel the purpose of personal criticism of this sort is to discredit the arguments I've put forward elsewhere on the thread.

"I am old enough to realise that not respecting peoples choices is judgemental and uneccesary"

Where have I not shown respect for someone's choice in relation to infant feeding or mode of birth? Discussing the risks or benefits of different choices isn't disrespectful, if the discussion remains general and isn't focused on the particular choices of an individual.

Actually it's you who's being disrespectful by coming onto a fairly peaceable and sensible thread and making personal criticisims.

But surely this is an argument for better breastfeeding support out of office hours, not an argument against CS?

FWIW, my EMCS was in the middle of the night, but I had a midwife sitting down with me for ages in the afternoon sorting out my latch.

Also found (but that's just my anecdote), it;s not the first few hours which make the huge difference in BF, but having the right support over the following days until after the milk comes in, day 5 was the hardest for me both times, and I was long out of hospital then. My peer supporter told me that that's normal (and nowt to do with the CS)

Both BF/FF and VB/CS are weird topics to debate because there are two peoples interests at stake, the mothers and the babies (sorry three if you include the partners state of mind).

If there is a clear cut safety case to be made that for the sake of the baby one of the options was preferable then I think I would judge someone determined to do the other for purely non-medical reasons. Ie. I would find it hard to watch someone determined to have a VB (because its Natural) if they'd been told their DC would have a better survival chance with CS, or determined to avoid an episiotomy when their DC would have a better survival chance with a VB.

I'm afraid the same cant be said for FF/BF. In the absence of all possible medical complications there is still a strong enough bias in favour of BF for the babies safety that I can't agree with people who choose not to BF purely as a lifestyle choice.

Of course I dont ever actually get judgy about either issue because you can never know if someones decision was purely lifestyle or if they had medical grounds. Anyone walking around assuming everyone with a CS scar was too posh to push or anyone FF didn't give BF a go is a total wankspanner.

In fact the only thing that actually annoys me about both debates is people saying it not right to discuss the statistics because people will be scared or feel judged by them. Oh and people denying the validity of the statistics because "that didnt happen to me when I did it."