I don't think "too posh to push" cs should be allowed on the NHS

[SoupDragon]

And by "too posh to push" I mean can't be ar$ed to do it "naturally, want to fit the birth into a busy schedule or want it early to avoid stretch marks. That kind of thing.

Obviously where there is a medical need (and by this I include maternal fear/distress where it can not be allayed beforehand} then yes, they should be provided by the NHS.

In the same way, I did not expect the NHS to provide me with a birthing pool, pay for the electricity and increased heating costs or provide me with food for my home waterbirth.

(yes, I know this will descend into popcorn and hard hats but I don't want to clutter up the other posters thread )

Becky, people with no insurance and VERY low income get better care in the US (in my opinion). But, my experience is VERY limited. I only know two people poor enough to qualify. So I'm probably not really qualified to speak for the masses.

It's also dependent on your state of residence, becky, so it's not something that can be answered uniformly.

SOME states of indigent/working poor healthcare and/or programmes for children of parents who cannot afford or whose employer doesn't offer health insurance.

Others don't or the care coverage varies.

ALL states offer free vaccinations to all children, funded by the federal government.

Now they may not pay the fee for hte healthcare provider giving out the vaccines, or they may be offered at a free clinic.

It's highly state dependent, just as state income tax varies, w/a limited number of states having no state income tax at all.

Would it be the same GP?

I'm just thinking that GPs are cutting down on their out of hours work (and not earning the extra that would bring in) to avoid the antisocial hours. Would the lure of private patients on a Saturday change things?

I was resident in three different states at one point or another: Texas, New Mexico and Colorado.

And coverage for hte working poor varied widely, just as it does here among the different NHS Trusts.

I certainly found that almost all private practises in my area in Aus would have a GP on duty on the weekends if not a number of GPs.

So, let the GP keep the money. £15 per ten minute slot. If the Gp goes to work for 4 hours she/he makes £360. Not bad for half a day's work. Okay, probably have to pay a receptionist (aka prison guard) too.

When I was in chicago a couple of weeks ago my mum said hmm my jaw hurts a bit when I open my mouth like this, I thinkI'll call the dentist. She picked up the phone and had an appointment within the hour, and off she went to the dentist. I was stunned. I thought wow, in the UK you'd have to wait weeks, at the very least.

But that's my point. Private practices yes. But NHS practices who do private work as well? Presumably the NHS income would be less, which would be an incentive for taking private patients, and then market forces would shape when the surgeries were open.
I'm not sure our village could sustain a private AND an NHS practice.

I suppose I don't really have a solution (apart from wanting to bin the whole NHS altogether), but I do think the middle range of affordable quality care is missing in the UK market.

Oh, and I have BUPA and it is pracitcally useless. Doesn't cover anything I want. And the prices charged by the hospital are much higher than what they charge the NHS patients for the same treatment. So, obviously, the NHS is so underfunded (or mismanaged) that they have to take private patients for a ride in order to make up for NHS deficiencies. This is crazy.

So - should you be given a c/s on request as an alterntive to a forceps delivery?

For all the reasons I'd been offered a section, if I'd gone for a "natural" birth it probably would have ended up with forceps (she was breech).
Okay, I've never had a forceps delivery, but I think I prefer the idea of my section to that (based on what other people have told me!)

Must say to Expats post about the american system....I am not american and never been there, but used to be a member of a mainly american Cleft club (People with cleft lip and/or palates) and I heard a lot of the system and what it meant to people, i.e. if good care was affordable then voila, brilliant and brilliant results, and if not, well, you basically had drawn the short straw, cleft lip/palate would be classed as a minor and mainly cosmetic surgery and the parents would have to pay for it if they could, and so on.....which is just ridiculous of course...so, other the Healthsystem definately , to me, seems not exactly the perfect one (the old german HI system was great, but I mentioned in one of these posts or another thread, that the system is going down and bascially is a system of a bit of both of america and britain, I suppose...the worst bits mainly, lol)!

NHS is, per se not free though,, people that work pay for it by taxes, so, why shouldn't they also, as well of those that for whatever reason can't work, reap the fruits of the taxes they paid...without the people that pay taxes there would be zero funding in the NHS....and well, those that are seriously well off they will be privately insured anyway, but you do have to be rather well off for a good deal!

Boowila, in Gremany you will always have a walk in clinik at the dentist or immediate available emergency slots, and if your own dentist is closed then you will be able to go any of them that are on for their night/weekend slot, which is brilliant, but now you also have to pay a fair bit towards special treatments, i.e. a root canal, or if you need a crowsn, and I suppose if you weren't reliant on social you may also had too always, but when you were on low income or social you didn't have to when I was a Kid!

So - should you be given a c/s on request as an alterntive to a forceps delivery?
what do you mean by this Bethbe?
Usually, in an emergency the Doc should have to be able to argue the point that the C-section is the only safe way to deliver this Baby!
Pn advance you will not be able to know if any Baby will truely be a Forceps Baby or need any intervention, as you will never know how labour goes, although, of course there are some exeptions, i.e. pelvis defiantely to small or whatever...but then a forceps would not be suggested!
Truth is, that most interventions and traumatic Birth are experienced when Birth was intervened with in the first place, Induction, E[idural, wrong Birthing position, etc...!

It comes down to a basic ethic, surely - either you think people should shoulder a collective responsibility as part of society, in which those who can contribute pay taxes and support those who can't - or you believe that it's every man for himself, and "if you don't work, you don't eat" - you should only pay for yourself and your family, and sod the poor/dispossessed, it serves them right for not making more of themselves.

I know which society I would rather be part of.

Elf I know a fair few people that have given Birth completely naturally, without even gas and air to Breech Baby, some bums down some legs first...all safe deliverys and good experiences for those people, but then that is the "secret" with breeches, that they have to be born and not delivered, i.e. interfered with, i.e. pulled, etc..!

lets hope it's the first lot, greensleeves ;)

I think women should have a choice.

why Glitterfairy, ubless there are medical reason, why would anyone put their child in that position to be born by elctive C-section?

absolutely agree with greeny's comment about collective responsibilty

adn 3andnomore

your comments about breech birth rather than a breech delivery/ extraction is very true...

apparently, the skill of allowing breech babies to be born vaginally is being lost as so many breeches are now c.section...or if vaginal..undiagnosed breech at which point your room would be filled with staff observing this rare event.....

if you read ina may gaskins work.and see the statistics from 'the farm'..it puts modern obstetric practice to shame in terms of vaginal birth for all sorts of births..

i have heard of women being told they will need a c.s because the baby is posterior

Greensleeves,

I have to say that although the idea of the collective is a good one here not everyone has private insurance. When I was working I had great insurance through my job, however I lost my job and have insurance through the hospital charity care (the hospital eats most/all of the costs) and medicaid (government sponsered healthcare for low income families). Although there are many people that are in the middle and have nothing, people that are very low income have a way to be covered. My hospital and doctors have stayed the same and the quality of care is the same.
Correct me if I'm wrong, but from what I'm reading UK has public and private hospitals. Here all our hospitals are run like businesses. They have to compete with each other. Maternity is always the best ward (private rooms in most hospitals, good food because they know we don't go for medical reasons) We have LDRP (Labor Delivery Recovery and Postpartum) rooms. This isn't true for all, but most are changing to this format. Here maternity is the best ward because hospitals know that it is like an advertisement for families. From what I hear about UK women sharing rooms with paper thin walls in and out in a few hours (here mandatory stay for two days for vaginal and 4 days for C-section) I'm lead to believe that the collective system doesn't try to cater to the needs of any one person just give typical care to everyone.

So what about the people who aren't covered under your system?

It sounds like "I'm all right, Jack" to me.

That's the problem, because we have a system that allows people to take care of themselves, and the government takes care of lower income it's the people in the middle that are getting screwed. We definitely need healthcare reform, and luckily most individual states have a program that will at least cover children that aren't insured. We need overwhelming reform.

I'm not saying that are system is great, but I don't want people who are looking in from outside to get the impression that if you're poor and have no insurance you have no way to get coverage. We do have a government that will step in and help.

It sounds like "I'm all right, Jack" to me.

In my experience, that's the general mentality there, GS, of many folks.

Of course, you can't generalise for a population that large.

But read LadyDooM's comments on the other thread, 'What's wrong w/the NHS?'

She's another American.

The old 'If you're poor, it's probably your own fault' Victorian ideology is alive and well in many parts.

Yes, I'll get jumped on by other Yanks on this board for stating that opinion.

But you know, I did NOT like 'the system' there.

So I left for good and won't be going back there to live chiefly thanks to that AND to the live to work mentality, among other things.

Obviously I've gone more native than I thought, a fact that's brought home - no pun intended - often enough.