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'?

Very reasoned and thought-out post, Shagmund

"I find one of the most frustrating things about this discussion is that there's very little acknowledgement of the fact that ALL women who have a planned c/s will face increased likelihood of complications (some very serious, like placenta accreta and percreta) in subsequent pregnancies, whereas only a minority of those opting for a vaginal birth will have a c/s resulting in the same worries for future pregnancies. Really - we should be looking at the risks and benefits over a woman's whole reproductive life, not just with the present pregnancy."

Indeed. And ALL women who opt for a vaginal delivery will face the risk of an EMCS (which always carries more risks than an ELCS) Something the anti-choice advocats like to downplay. It's rather patronising to assume that women who choose ELCS over VB have not taken the wider risks into account. (And at least in my case this was also discussed when the ELCS was scheduled)

I had a CS with my first - breech, and a forceps assisted VBAC with my second - stuck half way down - and would go with VB every time even with the forceps delivery and episiotomy - recovery time was soooooooo much quicker for me and my second was much "healthier" / less prone to chest infections and the like from birth.

CS is NOT the easy option, it bloody hurts too - but for AGES afterwards, and you get isolated due to being unable to drive and lift. I also lost all feeling in the scar zone for 3 YEARS...

competitive birthing,if you haven't had analgesia free birth,chanting an incantation bouncing on a free trade birth ball made by artisans whist sucking a Trebor mint then....according to the right on competitive burghers you've failed

and their ire about slash and dash birth doesn't stop there, he'll no they can throw ff in the mix too.another thing to judge new mums about

"it's a myth that it affects it"

Everything which happens around the time of the birth which impacts on women's postnatal hormonal and physical state will have SOME impact on breastfeeding, however subtle. It's not a 'myth' that mothers who have c/s may find it affects on how their milk comes in and how easy they find it to get their babies to latch on. However, most mums who have good care, whether c/s or v/b, will go on to breastfeed successfully because most minor difficulties can be overcome.

"both were joyous, delivered my babies safely and were easy to recover from in my case."

I should imagine that most births which result in a well mum and a well baby, and where the mum has been treated with kindness (and has had access to the pain relief she needs), would be described as 'joyous'. You're meeting your baby after all - it's the most thrilling event any of us will ever experience, whatever the mode of birth.

But I can't imagine that a surgical birth takes place with you lying flat on your back and naked from the waist down, surrounded by strangers. I imagine the 'thrilling' bit is the anticipation and then the appearance of the baby, rather than the surgery itself. (just saying - I've had surgery under regional anaesthetic and I don't recall it being enjoyable in any way).

But I've only witnesses c/s, rather than had one myself, so there's probably a failure of imagination here.

I think people who've never had a 'good' vaginal birth (and by 'good' I don't mean 'easy' or 'uncomplicated') find it impossible to imagine the emotional journey you go on in labour, which can leave you feeling not just joyous at meeting your baby, but feeling like super woman. That feeling 'If I can do that, I can do anything'. Bloody marvellous and sometimes life changing.

there are risks either way. both vb and cs can be problem-free with no further problems developing throughout the rest of a woman's life. They can also both be hugely traumatic, even resulting in death (of mother and/or child).

So, whatever the statistics are, they are only indicators of what may happen, based on what happened previously to other women.

You just have to make the best choices you can at the time, and that may well mean ignoring the statistics & getting the baby out by any means necessary.

It's ridiculous for people to pass judgement on this issue. Even if they were there, with full medical training & understanding of the situation, how the mother feels at the time (unless she's completely lost the plot & thinks that swinging from a chandelier above a pit of alligators is how she will best enjoy the birthing experience) is probably the deciding factor.

I normally only peruse the boards but this topic prompted me to join! I agree with HeadsRollingInTheAisles as I too struggled with having a ECS. I had to have a ECS, not elected by myself but by my specialist as my baby was in breech the full pregnancy & measured large so unlikely to move even with manipulation as it was effectively wedged so it was felt this was my only option. I was extremely nervous about the procedure and found the spinal anesthetic very painful. The anesthetic wore off half way through, even though I told the Anesthetist I thought this was happening, I was ignored and the procedure continued. By the time I got to recovery I could lift my legs which alarmed the nurses and because I had already had anesthetic I could not have anymore painkillers for a further 5 hours :-( I was put in a ward with 3 other mothers who had VBs. They were up and about within a few hours after returning to the ward cooing over their babies and picking them out of their cots whilst I could barely lift my shoulders off the pillow and feel I missed out on valuable bonding time with my baby as a result. I found I got no extra help from the MWs on the ward after having a ECS and was made to feel like I was being a burden when I would buzz them to be helped out of bed to go to the toliet or to pass my baby to BF. I left the hospital after 3 days and it was a further 5 weeks before I was deemed fit to drive & it was only after being assessed by the community MW that it came to light that I had extensive fundal bruising that went down the tops of my legs. I therefore feel that having the CS was a major contributory factor to me getting PND which then affected my ability to continue to BF. My little boy was 1 last month and I feel it is only now that I am starting to feel back to normal but the thought of having another baby leaves me in a cold sweat because I don't think I could face the trauma of having to have a further CS. I know that this may sound like a worst case scenario too but wanted to put my experience over. Hope I haven't put anyone off but don't think that CS is the easy option which is portrayed.

all my births cs,no vb.no complications from cs and up on feet few hours later.wound healed text book,and no cs doesn't necessarily=pain & trauma

and all my cs were crash sections

Good posts fromshagmundfreud.
Thats how I feel about it, but expressed far better.

"I think people who've never had a 'good' vaginal birth (and by 'good' I don't mean 'easy' or 'uncomplicated') find it impossible to imagine the emotional journey you go on in labour, which can leave you feeling not just joyous at meeting your baby, but feeling like super woman. That feeling 'If I can do that, I can do anything'"

Well some people say that about their experiences of doing coke, but nobody would go as far as saying that everybody should try that.
Not having had a CS you can't imagine that you would feel the same exhilaration - but you know nothing of the emotions a woman has during CS, you just apply your own prejudices.

I seek not to belittle your birth experience, and the exhilaration you felt at the birth of your baby. I'd appreciate if you tried not to belittle mine. I've managed to grow two humans. With fingers and toes and everything. That's mindblowing enough for me.

My first CS was after several hours of trying it vaginally. The trying it vaginally part was terrifying, I felt helpless, scared, sick and absolutely not in control. As soon as the decision was made to stop and go for a CS, I felt calmer, more in control and actually could enjoy what was happening, as I wasn't out of my head from pain anymore, and scared about what was happening to my baby.

My second CS was kind of surreal, but I found it was a very interesting experience, and I enjoyed it, there was no stress, nothing was rushed, no fear and I basically could really take in what was happening around me (plus I had a really nice chat with the anaesthesist and the midwife during the procedure). I'm glad I had this experience, but wouldn't evangelically say that every woman should try it, just because I enjoyed it.

Risk assessment and phobias aren't best friends...

Are you a half full or half empty type of person? Do you go for a 75% chance of a VB birth or do you have a 100% chance not having a EMCS?

I don't think its about an 'easy' choice for a lot of women - its a lot more complicated and involves a lot of other factors - such as how they view risk.

I've been reading one of the studies that the NICE report references. Theres an interesting bit about personality traits and patterns in women requesting a CS seem to differ from women who have a VB. There does seem to be a difference.

For example:
Women requesting a c-section perceive their health to be worse than those planning a vb, even when both groups have been assessed as healthy.

Women requesting a c-section were on average 33.9years old compared to 30.8years.

Only 33.7% of women requesting a c-section were planning a second child, compared to 73.9% of women planning a VB during pregnancy.
After birth this was 52% compared to 81%.

Women who had IVF were three times more likely to request a c-section.

"I think people who've never had a 'good' vaginal birth (and by 'good' I don't mean 'easy' or 'uncomplicated') find it impossible to imagine the emotional journey you go on in labour, which can leave you feeling not just joyous at meeting your baby, but feeling like super woman. That feeling 'If I can do that, I can do anything'. Bloody marvellous and sometimes life changing." ........

I think some people find it impossible to imagine how you can have a 'good', easy, vaginal birth with no intervention or stitches and everyone says 'lucky you'..... and yet be totally traumatised and shocked afterwards by the speed and the pain and the loss of control.

And "naked from the waist down" is kind of a given, isn't it....?

I will take technology any time. My last two babies were induced with an epidural sited before it kicked off. If I couldn't guarantee an epidural I would have a C section, no brainer.

I totally support anyone who wants a C-section - your decision - the only thing I would say to anyone wavering is, you don't know how many children you might want. I never thought I would end up pregnant with DC5, 15 years after I had DC1.

Oh, and I have had four vaginal deliveries and not a spot of incontinence. Not even now, 34 weeks into 5th pregnancy. It DOESN'T have to be like that and I agree with a previous poster who couldn't believe women were putting up with this. Awful :(

I had an elective c section (elective sounds like I had a choice in it but it was for medical reasons). And now I'm pregnant again and in the process of deciding what to do this time. I'm really leaning towards another ELCS as the last one went well for me - I recovered quickly, don't feel I missed out in any way, no trouble bonding, breastfed.
I do think it must be a rude awakening for the baby though.

I have to query that about the baby having a reduced risk of cerebral palsy with a c-section though.

"I do think it must be a rude awakening for the baby though."

I think being shoved through an opening so narrow that the skull needs to be mouldable, and so tight that all fluid is squished out of your lungs is probably no gentler than being pulled out through a slit in the abdomen.

Having seen some bruises on vaginally born (without instruments) children, I find the idea that it would be gentle hilarious.

ikwym Widow, but don't they say that all that is good preparation for the baby and that's why c-section baby's are perhaps more likely to have breathing problems?

many women feel scared of child birth as they have such poor support whilst in labour and as they approach the latter stages of pregnancy there is such little NHS 'birth classes' that you almost inevitably appraoch your labour fearful, hearing all the horror stories and anxt amongst the women who have been through traumatic labours without support from midwives that the option of a c section seems appealing, safe, and a situation that is in control rather than being afraid, alone, and in unmanageable pain in labour delivering your baby - that is not a criticism of all midwives but a critism of some and a service that does not allow midwives to care for women as they are trained

I was listening to the today programme on Radio 4 this morning and the "expert" pointed out that women are having more caesarians because of obs saying that they should have a CS.... eg// if the baby is breech.

She said few women actually want CS' and the guidence and evidence supports CS in instances where the women have a psychological fear which after counselling is still present.

Surely all women fear birth. I did. I've have had two VB's, the first without any pain even with a second degree tear. I fear a caesarian more though

widow you make an excellent point. My DS's "natural" VB was so traumatic that he had deep cuts in his head after being yanked on by ventouse for almost 2 hours. He had to have cranial osteopathy just to stop the constant pain which caused him to scream uncontrollably for the first 8 weeks of his life

He's 4 now and still has the scars

Ohanotherone - maybe you should be offered counselling to help you cope with your fear of c-sections.

I am unsure that you fear what you are prepared for (as much as youn can be for something you dont understand until it happens) , but thats where a great midwife steps in .. supports you through something you dont think you can or cant get through without help or guidance,

sandalwood - yeah the squishing is good for the lungs, however risk of respiratory problems can be vastly reduced if CS is scheduled no earlier than 39+0.

Have a look through the RCOG guidelines, they're a great help, and I know that people have used them to support either decision, so they're not really pushing you into one direction.

FWIW, my ELCS baby born at 39+0 had an apgar of 9/10 and had no issues whatsoever.

Where I am we seem to be losing that 'great midwife' support. I'm under the care of a team of midwives and don't expect to see the same one more than once.

apple I also agree with you. An ELCS is something I would go for (if I ever got over the first birth, which is unlikely) simply because I would know what was happening at all times, it would be planned, structured, and I''d know what kind of care I'd be getting

It's because of shoddy midwifery that I went through the hell I did with DS, so I do'nt trust them as far as I can throw them (sorry for generalisation)