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 )

I think that PND is also more after sections because you spend 9 months prepping for a vaginal birth and getting in the mindset for one. No one preps you for a C-section birth. Many of my friends of had PND after their emergency sections because it wasn't what they wanted and weren't emotionally prepared for it. Those that chose to have an elective for their second birth came out feeling great because they were emotionally and mentally prepared for it.

Emergency cs's and ones associated with life threatening conditions may lead to an increased risk of PND, quite possibly for reasons that are nothing to do with the procedure, but not, I think, planned ones by choice. At least that's what Birth Crisis says.

Vaginal births don't always turn out exactly as you wanted them to either.

Interesting. What constitutes 'too posh to push'? And what constitutes 'elective'? I'm going for an 'elective' c-section next time; my first baby got stuck and after 38 hours he was finally delivered by forceps. He was bruised, traumatised and had breathing difficulties because of being in the birth canal so long and I swear the difficult delivery made him a very difficult baby for a while. We had a 3 day hospital stay, and quite frankly, the injuries caused to me by my forceps delivery were so bad that my friend who had a c-section recovered months before me. Does my 'choice' to have my next child by c-section make me 'too posh to push'? No, there's no guarantee that my next baby would get stuck but like hell am I putting myself, let alone another baby, through that again.

parp

"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. "

so that is totally different from an elective , chosen in light of a very , very traumatic birth......

I do wonder who these woman are who prefer major abdominal surgery to vaginal birth because they see it as a soft option. It plainly isn't - unfortunately there is no easy way to have a baby. It strikes me as a tad heartless to make these assumptions about other people's decisions, which are IMO always the product of very deep feelings, fears and motivating factors known best to the individual woman herself.

It surprises me that some women are calling for less choice, less control over our own bodies than we are currently afforded. Does anyone want to go back to routine shave/enema/episiotomy/lithotomy stirrups? I don't.

Vaginal birth don't always turn out the way you want them, but there are classes to help prepare to have one. Women go in expecting the baby to come out vaginally, it may not go very well and there are plenty of women who have had traumatic vaginal deliveries. You can still come out saying, "It was terrible, it's not what I expected, but I did it". You still have a sense of power over the situation because you got through it. I think many women come out of C-sections saying, "It was terrible, it's not what I wanted, and I couldn't do it." I think many women come out of (emergency) C-sections without that sense of power.

In reality, I don't think TPTP as I defined it exists really - I certainly doubt it exists in the NHS anyway. People have insisted before on MN that if that's what the mother wants though, that's what they should get and this I don't agree with.

Those of you who do think that TPTP sections as I defined them should be available on the NHS, do you agree that the NHS should have paid for my birth pool and the cost of filling it with hot water, the cost of providing the midwife with tea and the electricity needed to adequately illuminate the repair work?

MKG, have to say I came out of DSs and DDs births thinking "thank that's over". No sense of power

No, MKG, I had/have no "sense of power" over my birth experience with ds1. I very nearly lost my son, it was terrifying, it was humiliating, I felt butchered. There were no classes to prepare me for losing more than half the blood in my body, having my urethra torn in half by an incorrectly sited catheter, or having my placenta clawed out without anaesthetic, etc etc. Quoting research findings just doesn't work in individual cases, I'm afraid - and women should be treated as individuals when it comes to childbirth, not statistics.

"...deep feelings, fears and motivating factors known best to the individual woman herself."

exactly, greensleeves...which is why antenatal counselling for a woman whether she has a phobia of birth or scared of having another traumatic birth...would be beneficial.. if at the end she decided on a c.s..then fine..she has made the choice and it will sit well with her as it would be a very informed choice...

that is not advocating less choice, it's advocating more information....

no-one is saying there is only one way to give birth or have a good birth...just that options should be explored...and ultimately, it is the women who has to give birth, so she has to know she has made the right decision...and feel empowered by the experience.

what if she turned down the counselling lulumama?

Would that still count as an informed choice?

I'm with Greensleeves...I went to the classes, was as prepared as I could be. All that meant was that I was informed enough that I knew that everything was going wrong! No feelings of power for me, I'm afraid, and IMO yes, I've done it, but not again, thank you...

true...but i wonder how many women would have had the counselling and opted for a trial of labour..at the end of the day...you can choose..that is absolutely right..doesn't mean those choices shouldn't be examined.

2 of my friends who had elective c-sections expressed regret to me after i had my VBAC, that they hadn't gone for a trial of labour...

when a medical professional offers you a c-section, you are feeling scared and unsure..why not go with what you know?

so the benefits of pre birth help would be a help to many..

but not everyone would want or need it..those that didn;t could hardly be forced to give borth vaginally!

if a woman is sure of her own mind..she wouldn;t need the counselling... but i;m sure many more women would struggle and have to weigh up the pros & cons..

Soupy, your last question is slightly different though - your choice was not just in the manner in which you gave birth, but in the location:- a birth pool is available at Mayday (though admittedly it might have been in use!), and tea for midwives and lighting are already funded by the NHS.

I wouldn't expect the NHS to pay for me to have a c/s at the Portland just because that is where I want my c/s. If the NHS is funding it, then Mayday it is.

Greensleaves I'm sorry you had a terrible experience .

I have more to say but I don't think it will come out right.

I think some of the problem with rising cs is doctors' decisions. Our local hospitals managed to lower their cs rates by making every clinician responsible for explaining why the decision was made to go to cs. I could go on at length about the good and bad points of this but won't in this post!

It's just been on the Midlands news that the Leicester hospitals have said that half cs's were medically unnecesary. Funny how this has come up in a hospital which is so desperate to save money that people in meetings now have to drink tap instead of bottled water (shock, horror!!). Perhpas they've worked out how much money they could have saved if they had been better at helping women to give birth vaginally in a minimum of discomfort.

I agree with Greeny - I certainly wasn't eager to have major surgery aka cs, although due to varous medical factors I was prepared beforehand for my labour possibly having to end in one. As it happened, I had ds vaginally after a 50+-hour labour (start to finish), epidural, syntocin when fully dilated, episiotomy and ventouse. At one point ds's heartbeat was dipping and I asked for a cs because I was quite frankly terrified of losing him, but I had an oxygen mask, a fantastic mw who kept me focused on pushing and a doctor who did the ventouse really quickly and well. Afterwards I actually did have the 'sense of power' MKG spoke of - well, not power exactly, but yes, pride in myself for having got through it. I think I was very, very lucky, though. The birth sounds like a nightmare, and afterwards (i.e. 1-2 days afterwards) the shell-shock set in, but because I had such fantastic care at the birth I actually feel like I have had a positive birth experience. But I can well imagine someone who'd had a birth like mine with bad or uncaring care wanting a CS next time.

I think éven if we feel someone's motives for wanting a CS are not valid for whatever reason - what effect will denying the CS have on their birth experience and their subsequent bonding with their baby? One can never know that for sure and that's why I'd be wary of denying a CS to anyone who wants one.

Well, there are quite a lot of us about who had horrendous birth experiences. I don't want to silence debate though, far from it - do keep posting MKG, I think this is a really worthwhile thread even if we don't all agree.

I get a bit carried away on this subject sometimes, I really ought to pay a counsellor to listen to it all instead

Greensleeves,

FWIW, and to back up the point about choice/information/support being the relevent issue rather than type of birth - I was lucky and did come out of dd's birth feeling empowered and amazed. It was a section, it was an 'emergency' (not very, but necessary), it was not what I had wanted. BUT I was supported by the MWs 100% in making decisions; I stood up to the OB (who was not remotely supportive) with regard to timing, and felt like I had made an informed decision rather than being bulldozed into anything. And loved meeting my dd.

I felt less empowered about the events leading up to my induction in the first place, but thats another story.

greensleeves - your birth story is absolutely horrific...i am very sorry you and your LO had such a terrible time...

what is very impressive is that despite your obviously strong views on this subject- which is clearly very close to your heart - is how eloquently and sensitively you are expressing your views...

thanks lulu There are some hair-raising birth stories on MN, it's amazing what people go through and survive.

I think those stories are bound to come out on a thread like this, but it shouldn't stifle debate, that would be pointless.

I still don't really believe in the "too posh to push" mums, though, I think it's a myth. Surely nobody relishes the idea of a C-section any more than an awful natural birth?