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'?

"Who cares how you make it into this world. What is important is that both mother and child are healthy"

But the arguments about this issue are all about health, in relation to clinical outcomes associated with different modes of birth, and also in relation to public health within a healthcare system where funds are rationed.

I agree that healthcare funding in the UK shouldn't be rationed. But it is. It always will be. I would love to see a really significant increase in funding for maternity care. Also for cancer care, elderly care, neonatal care, for pain clinics, for psychiatric care.

We all would. But in the absence of that happening we need to have a really thoughtful discussion about how best we can use the money that we've got NOW, in order to improve the safety of mums and babies delivering within the NHS.

And it would really help if people didn't disrupt the discussion by turning it into a bunfight by moralising about individual attitudes! (and it's boring too!)

I'm all for informed choice. In an ideal world I would recommend waterbirth for pain relief, home birth and delayed cord clamping as a gentle way of birth. However we do not live in an ideal world. There is a place for cs, when things go wrong, when there is adverse medical history or for extreme anxiety. Different women make different decisions and we should not be judged for these. Sometimes a birth plan goes out the window but as long as you are treated with dignity and respect and understand the reasons for intervention, then you are less likely to be traumatised by the experience. Every woman should have a good midwife to help her through the experience and out the other side.

"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."

I believe that the woman's right to her own body and personal freedom should take preference over the marginal benefits of breastfeeding vs formula feeding in the industrialised world.

A woman is more than an incubator and nutritional support system.

(I'm saying that as someone who breastfed her first child for 18 months and all going well will do the same for the second)

"I believe that the woman's right to her own body and personal freedom should take preference over the marginal benefits of breastfeeding vs formula feeding in the industrialised world.

A woman is more than an incubator and nutritional support system."

While not supporting your view that the benefits of breastfeeding ARE marginal, I agree with you that all women have the right to make the choice as to how they feed their babies without interference and without being judged.

"but as long as you are treated with dignity and respect and understand the reasons for intervention, then you are less likely to be traumatised by the experience"

I couldn't agree more. Which is why my concerns about maternity care in the UK are more focused on the issue of short staffing on maternity wards, as this is leading to women being traumatised, and women and babies dying unnecessarily.

Strangely I had and don't have a fear of childbirth (not exactly looking forward to my 2nd CS but just excited about meeting DD) however I am dreading BFing...I had lots (far too much) of milk first time round and DS latched perfectly and put on weight etc..but I hated it. I found it extremely painful even though he latched well and hated the fact that no one else could feed him (felt terribly isolated and overwhelmed), was embarrassed about feeding in public and therefore hardly ever went out..boobs squirted milk the whole time and had to wear breastpads all the time...makes me sweat just thinking about it as due DD in May. Ironically I didn't feel external pressure to BF and everyone told me I should stop as it clearly was affecting me mentally...I am trying to be positive about it next time round though and know I will give it my best shot and hope I feel better about it this time. I do, however envy those who FF from day 1 and don't feel bad about it..

I think sometimes we put pressure on ourselves whether it's to BF/FF or CS/VB and it's not always other people who put pressure/judge us..

Anyway wrong thread for this comment - apologies!

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

No, it's not an argument against c/s.

It's an argument for better care for labouring women.

Which eventually would have to lead to a reassessment of the risks and benefits of vaginal birth and planned c/s.

I think lots of people can get over a bad start with breastfeeding, but the cell changes which are happening in the breast in those first few hours are so important. If a baby isn't suckling and the mother isn't helped to express, so much damage can be done to the breastfeeding mechanism in the first three days, that full (sometimes even partial) breastfeeding becomes impossible, even with really good help.

shagmund - my total support for choice also goes for how to give birth - whether at home, in a midwife led centre, in hospital, vaginally or surgically - a woman should be presented with the risks and benefits of her choices, and not just by given the best case scenario for one and comparing it with the worst case scenario for the other.

For example, I chose ELCS over VBAC, after looking at how a VBAC would be managed in that particular hospital, the success rate, and also the severity of possible adverse outcomes (not only the likelihood). It was about what I was willing to risk in my situation.

I'm grateful that I had the chance to choose, and I firmly believe that whilst of course obstetric history should be taken into account when analysing your personal risk, the choice to make an informed decision should be open to every woman, no matter what her personal history is

i myself had an elective section 2 years ago folowing a car crash at 6 months pregnant, it was a wonderful experience made all the more better by the fact i went into labour the night before it was booked! so my DS was completely ready to come out and it was a beautiful and calm experience (except the part where the anaesthatist tried to get the epidural in 4 times and i almost had to have a general)

I think women should have the choice and not be judged and that c/s can be beautiful and special.

However

following mine i got a kidney infection from the cathetar and was re hospitalised for a weekwhen my d/s was 3 weeks old with him. i struggled with breastfeeding becasue of this and after he suffered with jaundice i eventually gave up.

since then the lasserations from the scar on my womb have started to open and i was told previous to my current pregnancy i would only be able to have one more pregnancy. and my current pregnancy is higher risk because of the pressure on my womb from the scar opening.

even though i only wanted one more child this still saddened me, and i feel extremely anxious that the baby will develop fully before the scar ruptures and i have to deliver.

i would never judge anyone for choosing to have a c-section,but i just wanted to share my story about the complications post c-section....
p.s my c section was planned.i was 24 and in good shape, fitness, my scar is tiny and very neat and there was no complcations with my d/s. on the face of it you would not thjink my section would have caused post problems!

I do believe in personal choice. I do however find it strange that some women are genuinely very afraid of VB when this is giving your body the opportunity to do something very natural and perform the function we were all put on this earth for. I felt very excited about performing this role when I was pregnant and the idea of surrendering my autonomy to a surgeon, being deprived of my mobility, catheterised, and cut open and being out of control of my being was the scenario that I feared.

I gave birth the first time at the Garden Hospital, which was the predecessor to Lizzie and John. I had a very long labour and was told that anywhere else I would have had at least an assisted deivery. Instead I got a good talking to about trying harder, and I felt such a sense of achievement when DS1 was born. The combination of being as excited as a child at Christmas and coping with all the pain was unique and amazing, I would not have had it any other way unless it was an emergency situation. (DS2 quick and easy at home)

higgle I don't think we were put on this earth to perform a process, but that humans, just as any other life form want to pass on their DNA and have their offspring grow up to pass on their DNA again.

How the baby comes out is pretty irrelevant to that, and I personally believe that the "it has to come out vaginally with as little pain relief as possible, because that's how nature/God intended it" rather misogynist.

If someone chooses for themselves to want to do it that's fine. But saying that that choice is better or worthier because "nature intended it that way" is bobbins.

Nature doesn't give a fuck about process, all it cares about is outcome.

I haven't read the whole thread, so apologies if someone has raised this point before....

Something that really surprises me (having read a lot of medical studies while preg with DS4 last year and deciding whether to request a CS due to medical issues), is the assumption the induced birth should be the method of delivery when things go wrong (and it's not an emergency). Inductions are far more dangerous to both the mother and the baby than a CS. Around 25% of inductions end in Emergency CS, and a significant % need an instrumented delivery (which results in a lot of birth injuries and damaged babies. Why is induction still seen as better than CS when it clearly is not (in terms of risk of death or serious injury to mother or child)? Why are women really pushed into Induction as a birth option, and CS is dismissed/not mentioned when they go over-term or have complications? Is it just because that's what the Consultants were taught 30 years ago, or is it because Vaginal Delivery is seen as "natural" even if it is achieved in a very unnatural way? I mean are we all being subject to a bit of medical paternalism here (vaginal is best even when it's not, because women need "real" birth)?

For example, 2 of my DS were induced when around 41 weeks, when the amniotic fluid dwindled. There were complications with both inductions, including serious birth injury to myself. The events of the first Induction were dismissed when I was pushed into having the second. There were short term problems with my DS1 and long term (lifelong) problems for me. Both times I was knocked back when I asked that surely, if the baby was at risk of death (dwindling amniotic fluid can mean the placenta is failing), surely I should have a CS rather then an induction which he had just told me could take "a couple of days"? It was apparently "much better" to "do it the natural way" - as if there was anything natural about induction!

Widow you say "Nature doesn't give a fuck about process, all it cares about is outcome" - but what if the process does have a long term impact on the outcome?

Iggly - if the process has a long term impact on the outcome than this will show obviously in the survival rates. That's how natural selection works.

Also, you could argue, that CS is no more unnatural than a dam built by beavers. Humans have evolved to use tools.

higgle until now, I'd intended just to nose on this thread, but you've drawn me in!!

Good for you with your sense of achievement after accomplishing such a "natural" function, and I agree, it's so very silly to be scared of VB - after all, it's just doing what your body is supposed to, after all?

Although, if my body had been allowed to "do what it wanted" whilst having DS, I would be dead and so would he.

Nonetheless, well done on being ever so brave and being able to try just that little bit harder after "a good talking to". How lovely to have that combination of excitement and pain.

In return, I would hope and pray for your forgiveness for not being able to do it the way you did.

"my total support for choice also goes for how to give birth - whether at home, in a midwife led centre, in hospital, vaginally or surgically - a woman should be presented with the risks and benefits of her choices, and not just by given the best case scenario for one and comparing it with the worst case scenario for the other."

I suppose in theory I agree with completely free choice as to mode of birth and models of care.

Did you clock the point I made earlier about the meaninglessnessness of comparing outcomes for a standardised surgical procedure, with those associated with vaginal birth, where the outcomes vary wildly according to the model of care and birth environment?

The only justification for offering c/s on demand to women without tokophobia or pre-existing medical conditions is on the basis that it's not associated with worse health outcomes than planned vaginal birth. And going on national statistics it's not - because nationally we have an emergency c/s rate of 15%, which is where where most of the serious morbidity associated with planned vb comes from.

However, individual hospitals will have emergency c/s rates which are much lower than this, so for these hospitals the financial and health rationale for making planned c/s available will look very different.

And as far as I'm aware, there have been no announcements made by the government about increasing women's access to caseloading care, or one to one midwifery care in labour, or to homebirth - all things associated with the lower rates of emergency c/s that we'd all like to see and that are essential if our primary aim is to reduce the incidence of birth trauma and serious maternal and neonatal injury.

And that worries me - that access to planned surgical birth is being made easier within a context where emergency c/s is on the rise, and where a lack of resources is leading to unsafe care.

If more resources - in the form of obstetric, surgical and midwifery care, are diverted from labouring women there will be more deaths of mothers and babies.

But maybe that's a price some people think is worth paying for maternal choice c/s. Particularly as those women who are currently most likely to die tend to be the poor, those newly arrived in the country, and ethnic minority women generally. Actually those women who don't generally fall into the category of 'worried well', and who are the least likely to be requesting a planned c/s themselves.

I have had both a vb and a c ..(which was not at the time through choice,)but I have to tell you I recovered far more quickly than with the vb.
If I was pregnant again I would opt if I could for a section
My vb was trouble free and only 6 hours but for months I could feel everything pulling inside and it was sore for months too.
A couple of years later I developed stress incontinence and had to have some muscles around my bladder repaired..so for heavens sake why feel bad if you opt to avoid all that ?
Honestly we do make things hard for ourselves ..whydo women beat up on other women so ?

Don't feel guilty, don't beat yourself up about it just get on with it. Why is everyone so precious about this ?
Life is too short

"Did you clock the point I made earlier about the meaninglessnessness of comparing outcomes for a standardised surgical procedure, with those associated with vaginal birth, where the outcomes vary wildly according to the model of care and birth environment? "

I did - that's why I think it's important to have a look at the outcomes/stats which apply to where you would be giving birth.

And, I repeat, likelihood of occurance is not the only thing to be taken into account.

I know it's anecdote, but for example, I know someone who in her homebirth attempt had to beg the midwives to let her go to hospital, and she found the whole experience very disempowering and traumatic - so having a homebirth even though the transfer rates are low (and I'd be surprised if they are the same across the whole of the UK) doesn't neccessarily mean that you will be getting a problem free birth.

That shouldn't stop anyone from choosing one (within reason, a heavily obese first timer with a footling breech probably should be councelled against it), as above experience probably isn't the norm.

I've had 1 CS and 2 VBs. I find it hard to understand why anyone would choose a CS as I found that birth so much more traumatic and harder to recover from than my VBs. However, I am also aware that this was just my experience and everyone is different and would never judge someone whatever their choice.

HIGGLE, birth may be natural but nature has designed us very badly! The move from 4 legs to 2 legs has resulted in a pelvic girdle not fit for purpose.... our increasing brain size meant our babies are essentially partly formed fetal beings, born helpless because we can't get a larger head through our pelvis and birth is dangerous to human females and babies in a way that it is not for other mammals. The mortality rate for women and babies in unattended "natural" births is massive compared with other animals.

Nature/natural is not always fantastic, and we are lucky to have options our ancestors would have killed for. I don't think people should be criticized for being scared of VB just because they are aware of the risks and have decided that, actually, they don't need to take those risks, they have that choice now. So each to their own.

It should all be about education of the various risks, giving women choices and supporting women in their choices. It shouldn't be about the Medical/Midwifery profession trying to push us down one road or the other.

Well said old mum! Couldn't agree more :)

LOL ilikekerfuffle, someone will be along to disagree in just a moment I'm sure :)

Very good point oldmum. I had to shout and scream (literally) to get a cs instead of the induction at 36 weeks the hospital wanted to do. I'm normally very calm and hated resorting to a tantrum on the labour ward, but having read up on early inductions there was no way I'd let them try that on me and probably end up with an emcs anyway. The way the medics wanted to make decisisions without speaking to me was far scarier than going under the knife or the (as it turned out, very easy) recovery.

decisions. tsk.

Good for you FloraPost, My inductions were sometime ago (the DS's are teenage now), I was younger, less confident, there was no internet sites with ready access to medical studies.....

I wasn't such a walkover this time!