C-section or natural birth? Which to go for?

[Pinkandwhite]

If you could choose an elective c-section, would you do it and why? I'm currently 20 weeks pregnant with my first baby and I'm starting to consider my options. I am living in America at the moment and hospitals don't offer water births which is a shame. I could go to a birthing centre run by midwives and have a water birth there. In that scenario, if there were any complications, i would be rushed to hospital. Also, there are no epidural or other drug options available there should I find it really tough. At the other end pf the scale, my medical insurance will cover an elective c-section. It would be really good to hear from people who've given birth so that I can hear what you would choose given the benefit of hindsight. My instinct is to try and have as natural a birth as possible in a hospital but I want to consider everything.

"And as the first one can not be guaranteed, it stands to reason that the most reliable and safest delivery method is an ELCS."

I'm not sure I totally agree with this. By that rationale all deliveries would be by ELCS. Many women are happy with the odds of getting the uncomplicated vaginal delivery and go for that option, understanding that if that doesn't happen they drop to no. 3 or 4. What I do totally agree with is that it is a perfectly rational decision to make that for you personally it is the best choice.

Where in the US are you? I am in NJ and hospitals here are offering water bath births. There are a few hospitals with midwife led units too.

IMO the reason for the high CS rate in the US is down to the medical community pushing boundaries with obstetrical care. The hospital my obn group is affiliated with do not allow elective CS unless you have a good reason. I had preclampisa with my first and it was taken very seriously, however, they didn't just sign me up for a CS. I had to go through an induction first. 22 hours later I was wheeled down the hallway and had a CS. 2nd time around I was only allowed a scheduled CS because DS was measured at 9lb+ at my 36wk scan. My obn did a scan of my pelvis at my very first appointment and did an assessment which showed my chance of a vaginal delivery without complications was less than 30%.

That's a lovely birth story Dachs and I'm hoping to have something similar for myself

A lot of data is flawed because it classes VBs and CS in a way which isn't comparable

How many women suffer in silence after dreadful briths? and when they do need to go through notes or counselling are is this recorded somewhere as dreadful labour feedback? Most women I have spoken too would not where to complain too, or where to even register their awful birth story with.

How many women suffer in silence after dreadful briths?

In the UK we record HOW we give birth, but complications are poorly recorded - in part because many do not occur within hospital, but only become apparent after women have been discharged.

We also do not record any information about birth satisfaction as this is generally regarded as unimportant. You don't record satisfaction for other health issues. HOWEVER the link between psychological outcomes and birth is somewhat unique to childbirth and deserves to be considered as it has implications for mental health care (and indeed any future care in maternity).

The obsession is purely about the method of birth, but I actually think women are more concerned ultimately with complications. How you could display this information in a meaningful and easy to understand method is another question altogether though.

Bear in mind the long term effects too. Both of my close friends who have had sections regularly complain about pain from the scar, generally and particularly during subsequent pregnancy, and the appearance of the op site, i.e. Overhang. Of course there can be long term effects with a vb too, including continence issues and scar pain but the people I personally know who gave had vbs don't seem to have suffered too badly.

I had a water birth with gas and air and left four hours later try watching the business of being born, very good documentary about American hospitals.

Penguins yes by that rationale all deliveries should be ECLS, but as I pointed out the assessment of risks and benefits is a subjective matter. For another women the benefits of an unproblematic VB (safety for mum and baby, sense of achievement, etc) may override the risk that a VB may have complications that result in options 3 or 4.

That is at the heart of all risk decisions though. By definition risk involves uncertainty and a subjective assessment of how much one values or disvalues possible outcomes. The decision won't be the same one for everyone.

Booboo - Yes, I agree. I was responding directly to the conclusion I quoted from Takingchances, not to your longer post about the basis of decision making

Ooops sorry! I got lost somewhere!