Woman's Hour Childbirth special on now - with Kirstie Allsop

[VinegarDrinker]

Not sure if this is being discussed on any other threads?

[Minifingers]

"to make the suggestion of coercing women is bad, in all things but healthcare"

Sadly we are all 'coerced' into choices we'd not usually make by a lack of funding in the NHS and across public services.

My elderly disabled FIL is bedridden and is currently being 'coerced' into staying in bed by a lack of funding for physiotherapy which would help him regain some of his mobility, for example.

Not offering surgical birth on demand across the NHS isn't misogynistic, really it isn't. It IS about the fact that hospitals can't safely accommodate higher levels of surgical birth than they are currently doing without an increase in funding. And it's hard to argue that any increase in funding should go towards expanding elective surgery for healthy women when women with complex health conditions (including tokophobia) are experiencing higher levels of mortality and severe morbidity because of a lack of consultant cover and postnatal care.

Women who have significant mental health problems relating to childbirth should already have access to surgical birth if this is what they need. If they are not being diagnosed and put on the right care pathway then this issue needs addressing, but that is not what's being discussed here is it?

[RedToothBrush]

And you are saying coercision is good? And making excuses for it on the basis of cost?

Utterly appalling. Lets let old people sit in their shit because we can't manage our resources. We are a wealthy nation. We CAN afford this.

Stop justifying the unjustifable.

You are the reason why healthcare is in the state its in. Because you are accepting it instead of saying this isn't acceptable. You allow those running the services to get away with it and carry on, rather than tackle the issues.

[LaVolcan]

That's very harsh RedToothBrush - trying to lay the blame for the problems of the NHS at minifingers door.

No one was saying coercion was good and I doubt if anyone thinks it.

I think that anyone who wants to deviate from the standard package that their hospital offers runs the risk of meeting with some sort of 'coercion'.

[Minifingers]

Redtoothbrush - I would LOVE for the NHS to be given enough money so we could all have optimal care. But you know what? IT'S NOT GOING TO HAPPEN.

In fact not only is it not going to happen, but there is going to be more and more rationing - it's inevitable as we have an ageing population affected by very high levels of obesity, and a huge host of sophisticated and expensive new treatments for cancers and complex conditions which the public will expect the NHS to provide.

There will be more and more 'trimming' of services.

Please don't think by saying this I'm in favour of it. I'm frightened for the future of healthcare in the UK.

[Minifingers]

And I'm wondering what YOU are doing about the situation?

Are you part of any activist groups arguing for a massive increase in funding for the NHS?

[RedToothBrush]

Sorry, but anyone who justifies coercion should get that treatment.

You can not cut corners in care without it doing damage and harming people. The idea that you can is utterly absurd. And the truth is you end up paying for it elsewhere further down the line anyway. You don't get something cheaper because you cut corners. The greatest efficiency saving is to treat properly in the first fucking place.

If we can not afford things, then thats what should people should be told. They should not be coerced into anything. The idea that we should coercise because of cost is an appalling thing to suggest and say that we should be happy with.

At least that way it creates a situation of transparency and people can actually then be held accountable for, rather than this things of lying and saying this is the best treatment for you, you just have to wise up and agree to it and consent to something you are not at all happy with. This attitude of coercision destroys all confidence and trust in the system that you will be able to make an informed choice that is in your best interests and properly considers your needs.

If you don't actually get that, and you work in healthcare, then we really are already so fucked that the NHS is beyond all repair anyway. We might as well all sling women under the bus along with the elderly and save some precious money that way. Afterall its in their best interest to save their pain and dignity later one.

[Minifingers]

Red - you need to learn the difference between the words 'explaining' and 'justifying'.

The NHS is in a state of financial crisis, and this is set to continue.

Even a change of government won't make a difference in terms of future priorities for the NHS.

[LaVolcan]

RedToothBrush: You should be addressing your complaints to your MP for a starter, but maybe you have done?
Or join a pressure group to support the NHS.

Remember that Cameron promised 3000 more midwives
blogs.channel4.com/factcheck/painful-contractions-cameron-breaks-his-promise-on-midwives - a promise which he has quietly reneged on since becoming PM.

[Ushy]

But midwives don't do caesarean sections, la volcan

Whether elective caesareans are better for the mother depends on what she wants. Red is right - coercing people will never result in better outcomes and women are regularly coerced into vaginal births they do not want. (Read the thread about the Mner blowing her £13000 life savings on private care to avoid another vaginal birth).

However, caesareans pose fewer serious risks for babies ; Slightly more minor respiratory distress with electives but much less serious morbidity and mortality. There was a good study that actually quantified the risks here:

www.ncbi.nlm.nih.gov/pubmed/17011400

What is wrong with a woman wanting to choose the safest mode of delivery for her baby? Why should it not be her choice?

Resources don't come into it. The difference between caesarean and vaginal - taking into account the long term costs was estimated by NICE as only £84.00 BUT that excludes litigation costs. Since you almost never get brain damage or cerebral palsy caused by elective caesarean, the legal claims more than wipe out that small difference.

So basically, we should just be letting women make their own choice once they understand the risks of both modes of delivery.

[LaVolcan]

But midwives don't do caesarean sections, la volcan

Did I say they did? I was commenting on Cameron reneging on a promise to improve staffing of maternity units. As far as I am aware he didn't make any promises to improve consultant cover, but that is also a problem in some units, where it would be best to avoid an EMCS in the evening or at the weekend.