Do women feel as if they're being told 'you shouldn't have a section'???

[tiktok]

Various organisations, including NCT, campaign for choice of place of birth and type of birth, and point to the rising caesarean section rate with concern. This is because the high numbers contrast with the likely figure of women and babies who need a section for medical reasons. It also reflects concern that on the whole, recovery after a section can be longer and more difficult. I don't think this is the equivalent of telling individual women they shouldn't have sections (clearly, the op is life saving for some, anyway), but this is how it seems to be interpreted. Comments?

well thats fair enough

apparently, some of the signs i was showing can point to rupture of the uterus, which i didnt know at the time and ok, it probably wasnt the case but no-one even thought to show any concern...i dont feel that i was well informed at all and wish i had read up on it beforehand...i dont trust my local hospital anyway. there has been some controversy in the past with regard to them and i was extremely scared of what might happen. Both of my births were a traumatic experience and it puts me off having another child somewhat.

Nightowl, you said you've felt a failure about demanding your second c section. It sound to me like you did absolutely the right thing. You mentioned the hospital wanted to put you on a drip to speed things along with the labour. This is a really big no no if a woman has had a previous c section. It has now been proven that drugs used to stimulate labour in women with previous c sections can lead to uterine rupture - almost certain death for the baby and a very ill mother. You were spot on in your instincts in my view.

I believe it is simply no longer allowed to induce or stimulate labour where c section has previously taken place because of the dangers involved. I do hope I'm right and its not another "depends on the hospital's policy".

I have read since that there are dangers regarding that twogb but unfortunatly i didnt know anything about it at the time. Something just didnt feel right to me IYKWIM, call it instinct i dont know but i did know that induction by that method does apparently cause stronger? contractions. It just seemed at the time that i was in intense pain but because i didnt make a fuss, no-one could be bothered. I would really like to get my hands on my notes because if i have any more children i want to know exactly where i stand. I WOULD like a normal birth but im not sure its possible after two sections and if it would be safe for me personally.

I haven't had time to read all the posts as I'm at work but I wanted to add my two penn'orth. What has annoyed me this morning is the media coverage of the NICE report. The coverage has focused on the small percentage of sections that are elective which - for me anyway - kind of misses the important points. Surely part of the reason that the section rate is so high is because of all those things that I've harped on about before (sorry!) - about midwife shortages; lack of support for women in labour; low support for home-births etc etc. I felt this morning that the media were giving the message that it's our (by which I mean women's) fault! I find that outrageous. I also agree with someone else's point that "medical need" shouldn't be defined too narrowly, and that real anxiety, fear (ie your mental health and well-being) should be taken into account and can often be a legitimate reason. There probably are some people who are "too posh to push" and I don't have much sympathy with them but the vast majority of women (including those who choose to have sections) don't fall into such a category and I think it's an unhelpful label and an unhelpful focus for the debate.

There. I feel better now!

I completely agree with you Hatter. Its all on Sky News this morning and its an extremely ill informed "debate". The rise in caesarean rates is about much more than elective c sections requested by women accused of being "too posh to push".

I too see the risk in elective sections being complex and driven by many factors, including (especially?) midwife shortages. In turn midwives are leaving in droves partly because the job is unsatisfying(not enough midwifery) and the pay is low.

However, aloha (further down) is quite sure the drive is coming from women....is she right?

One of way of cutting down c sections is to control the sodding induction process, monitor women more closely and their unborn babies, rather than slap them in 4-10 days overdue and fill then full of synthetic hormones and expect it all to go nicely!
The trigger happy induction process is what needs controlling as much as the truly c section for convenience option.
I had to fight tooth and nail to avoid induction with my second baby, for a mythical preg condition they thought I had! I have several friends who were induced on a Wednesday 3 days overdue as the hospital didn't want to induce them on a weekend.
Now who is being convenient?

tiktok, it is rather chicken and egg isn't it, i mean as to where the drive comes from... if the "medical profession" including mws presents a view of sections as safe and straightforward, coupled with an increasing fear of litigation, then that in turn will create a climate where women are more willing to ask for them, surely?

I'd be fascinated to know how many c-sections are really and truly "elective" in the too posh to push sense. I'd say a very very tiny minority are. I don't think you can class a c-section as elective if it is because of the mother's fears of childbirth for example. I'm sure that a large number of "elective" c-sections arise as a result of advice from consultants etc and I think it's unfair to say that they are elective or that the mums are doing it out of genuine choice. If a consultant told me (as a first time mum) that a c-section would be the most suitable option for me then I'm afraid to say that I don't think I'd feel confident enough to disagree (unless some wise MNs could persuade me otherwise...)

7% piglit, as of the stats this morning in the news, these are from NICE.

but why is a section seen as the cure for a mother's fear of childbirth rather than say therapy/counselling? there are a number of women here including myself who have had quite appalling first births and didn't go on to seek sections as a result.

I was wondering that too Piglet. With the exception of Aloha on this site I do not know anyone at all who has had a truely elective CS.

In fact most of the women I know who have had a CS have done so under quite a lot of pressure from the consultants and were very reluctant to do so.

That's higher than I thought it would be. Are NICE saying that these 7% of women really choose of their own free will?

Hi ladies, haven't had time to read all the posts but wanted to add something. I was going to start a thread on this very discussion after watching The Wright Stuff this morning. I had an emergency section with DS and am now considering an elective for my second baby. The debate on TV this morning actually had me in tears with all the talk of what a 'good mother' would do (vaginal birth).

I do think that a woman should have a birth choice that includes C sections. In this day and age it isn't necessary to go through the pain of labour if you don't want to. Though DS was an emergency section due to failure to progress I am quite pleased that I still have full control of my bladder (many friends who had vaginal births seem to constantly have little accidents). I also had dreadful piles throughout my pregnancy and will need an op as soon as my second baby is born. I can't imagine how much worse that might've been had I got to the pushing stage of labour!

On the other hand, I do agree that there are perhaps too many sections given and classified as 'emergency' due to the lack of experienced midwives and, in the States, due to the fear of lawsuits, but I don't know if that applies in the UK. I was happy with my emergency section but a part of me does think that perhaps I could've delivered vaginally in different circumstances. I did feel disappointed at the time but now I'm seriously considering an elective section (for various reasons) and I think that that decision should be supported without the judgement of being a good or bad mother.

Actually even with Aloha if I recall rightly she would have gone for an elective CS but in any case was advised to have one anyway. So not elective in the 'too posh to push sense' as you put it!

Exactly Soapbox! So in the NICE figures a situation like that would be classed as an elective c-section even though it was hardly a case of the mum saying "sod it, I fancy a c-section because I want to go the Ivy for dinner the following week" (which is what this whole too posh to push thing seems to be implying).

IMHO our lives are hard enough without being made to feel gulity about every (difficult) decision we take in pg or childbirth.

that fact and stat is as far as I can tell, women that choose c section for non medical reasons

Yes, I would have died (probably) and so would ds (almost certainly) if I hadn't had a cs - I had complete placenta praevia, which even the most ardent anti-cs campaigners agree is an "OK" reason. However, having had one could not imagine a better way to give birth.
I have a friend who chose cs for her two girls because of a horror of labour and birth and fought for and got them. I also know a woman who is having a cs to fit in with work - I think it's vanishingly rare. Hers is 100% private and she says she deserves it after having twins vaginally ten years ago!
I don't see any reason at all to condemn their choice. As LadyMuck has eloquently argued, cost is not the main consideration normally - we all want more midwives, for example. So there has to be more to it with the caesarian thing and I do think there is a belief that it is somehow immoral for women to want to 'get away with it' ie not suffer.
I don't agree though that therapy or counselling is necessary in the case of women who find the idea of birth deeply repulsive. MY friend is the sanest most practical and unsentimental person in the world. She didn't need therapy. And I think we can all agree (surely?) that someone who goes into the process full of horror, fear and dislike of pain (justified IMO) is hardly likely to have a good experience by anyone's definition. I don't think it is abnormal to fear and dread labour and childbirth. It is pretty much the historical norm, only there was no choice.

Also, why pick on the 7%? Why not look at the 93% - I think they'll find they cost a bit more.
As I said earlier, it seems odd that the focus is on women who want cs not those who very much don't. I think it is due to a mixture of misogyny and the fact that getting more midwives and updating practise and cutting down on inductions etc etc cost money.

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I'm sure we've all seen the studies about the difference your anxiety levels/state of mind can make to the birth you have. For example, people say doulas can make a real difference to some women because you have the comfort and confidence that someone is there for you who's been through the experience many times before. It's inevitable surely that if you are more relaxed (if that's possible!!) then the whole experience might be less traumatic. I do feel that to make women feel guilty about their birth choices only serves to make the whole birth experience more difficult than it already is.

But surely the cost has to be a factor. The NHS is short of funds and elective caesarians cost £1000 more than a vaginal delivery. I have no problem at all with c-sections being used when medically necessary but I think it is a waste of public funds to give them on demand when there is no medical reason not to have a vaginal delivery.