Birth choices - the right/wrong answers

[Cinnamon2013]

Hi

Just booked an elcs for dc2. Emcs last time. After a lot of thought and consideration I'm happy enough with the decision.

Last time I hoped to have a hypnobirth. I keep seeing friends on FB talking about their lovely natural births and hearing the same in real life. I am (genuinely) happy for them.

But then I think why in this age of full good discussion about consent, women's control over their bodies, abortion etc. is it still (at least in my experience) pretty much taboo to talk about the potential plus points of caesarean as a birth choice.

I still feel it's the 'wrong' answer to give to people even though I'm content it's the right choice for me.

Does anyone see what I mean, or am I overthinking...

Really interested in views. But please don't flame me :)

And I meant to say 'right choice for me AND my baby'

I think so too. Even ostensibly sympathetic articles tend to take the line 'mothers who have caesarean go through so much, they lose out on the experience they hoped for' rather than 'mother chose caesarean because she preferred that option'.

The thing is, an emergency section is, well, just that isn't it? It's horrible. I had no pain relief on board and the second (yes really) time the emergency team came in to take me away for a section they tried to do some more Checks to prevent doing one and I asked them to start prepping me so I could have an epidural. They refused because they didn't want to Give me a section unless necessary two minutes later they knocked me out and ripped her out
Now, I was doing very well with the whole birth thing but I'm not sure I'm risking the emergency again. There IS an herditary element to such situations (in my case my mother and 2 sisters had the same births, generally due to poor position + something else. My midwife thinks it's a pelvis thing.
Surely anyone could understand a woman having been through an emcs choosing elcs next time?

I agree completely Cornish. It's almost unsayable.

90s forever. God that sounds tough. I'm glad you're doing ok. My emcs was pretty much a walk in the park compared to that, but obviously still a massive shock. Long story but I don't think I could deal with the drama again.

I do feel people understand. I'm lucky enough that no one I know would judge.

But I just feel that it would not be OK - and seems mean and insistently really - to mention some of the other reasons for my choice - in particular the permanent birth injuries resulting from vaginal birth that I've heard about from friends.

Unsisterly - not insistently

I don't think that's the case within my friendship group/church.

Emergency sections are hard work, and I do always feel sorry for people who have had late sections so have gone through so much of labour, including, as with a couple of my friends, failed ventouse and/or forceps, so they are battered and bruised at both ends and must just be exhausted by it all.

Everyone I know who has had an elective section (and I've helped to perform them as a medical student so can agree from that end) speaks very positively about their experience.

An elective section is normally a lovely, calm experience because the mother (theoretically at least, given how difficult it is to sleep at the end of pregnancy) has had a good night's sleep and can come in refreshed, the anaesthetist can take their time getting the spinal in, the surgeons can take their time rather than rushing to get a distressed baby out, the baby is hopefully happy rather than distressed (if that was the reason for an emergency section).

That said, lots of people have very uncomplicated vaginal births too, so "permanent birth injury" doesn't always happen.

Can completely identify with this. I've got an ELCS booked in 6 wks time and I feel judged too. I've already had people asking why I'm having a c-section.

Er you'll find the answer at the corner of "mind your own business" and "fuck off"

As it happens, I suffered from recurrent miscarriage before this pregnancy and lost 3 babies so I don't have much confidence in my body. I'm terrified of things going wrong and I don't know anyone who has had a good natural birth in my circle of friends. Lots of forceps, stitches, stitches getting infected and being in agony, and like Cinnamon, I just don't feel the potential damage is an acceptable risk

I totally feel like I'm being judged, but actually as I'll be the one at the business end if it goes wrong then I don't really care

I'm proud to say I had a caesarian section. My DD2 was breech and I refused an ECV. She was due by ELCS but as I went into labour the night before, it was classed as an EMCS (depriving me of the good nights sleep, freshly washed hair and tasteful make-up look I was aiming for ha ha ha!).

But my experience is coloured by my DD1 who was stillborn at term. She died before birth but I had a vaginal birth (physically problem free and the type of straightforward, quickish 7.5hr labour you'd likely love to have). But while I was so proud to give birth to her, the usual arguments about 'natural' birth go straight out of the window because I didn't get to bring her home.

Hearing your baby cry when born is the most amazing thing, even more so when you have experience of the opposite, and to me it did not matter one jot that she came out the 'sunroof' rather than vaginally.

I totally agree with this. I'm opting for an elective after an emcs last time. Never thought for a second anyone but dh and I would care but I've had some odd/awkward responses when I've mentioned it and now I'm getting awkward about it too. Ridiculous.

The only people I know who are really enthusiastic for me are mums who've had 1 or more bad vbs. A few of those have been a bit jealous!

Mumberjack I'm so sorry for your loss. That sounds incredibly hard. And yes, a baby to take home is the bit that really matters.

I had an ELCS. I never wanted to give birth naturally. I think it's frightening and painful and the chances of something going wrong are high.

I had several people say to me "a cesarean?! God I wouldn't want one! They're horrible" despite them having had ventouse, episiotomies, stitches which to me are far worse. I also had one person insist I'd regret it.

Well it was fine. 15 minutes, pain free, very calm. I didn't find the recovery painful, I was out the house 6 days later it would have been sooner but my baby was ill (not related to the birth).

Don't feel bad about your choice, a cesarean is a valid decision

I agree actually. I think NHS midwives really push 'natural birth' as if it is the right choice for everyone. It isn't and I speak of someone who has had 2 natural births. One was great, the other was horrendous (a very very quick back-to-back birth that meant there was no time for pain relief of any kind). That pain traumatised me, as did the attitude of the NHS afterwards - 'oh well done you! A completely natural birth!' when I was suffering flashbacks that left me shaking. It makes me furious that women's pain is minimised in this way.

When I get pregnant again, I will ask for a C Section. I cant risk that happening again.

The trouble with the vaginal v. CS debate (and indeed the bf v. ff debate) is that the arguments are always phrased in terms which belittle the other side.

'I couldn't bear the idea of tearing - gross', 'I couldn't bear forceps or a ventouse - ouch', or (most pernicious) 'but a ff just isn't as healthy for the baby' (suggesting you are jeopardising your child's health).

The popular debate just hasn't found kind enough terms for all this.

What's wrong with just saying (as we do about lots of things, whether we mean it or not), 'oh that's nice, glad it worked for you' and leaving it at that? Why the insecurity and massive navel-gazing about these things which are, ultimately, nothing to do with anyone other than the people involved?

Yes I was going to say that chosing to have a elcs seems to be viewed in the same way as choosing to ff from birth. Even selecting an epidural seems to be looked down upon. Why? Baby is born alive and well. Mother is alive and well. Baby is getting fed and thriving.
It really shouldn't matter how it all happens as long as it does and nobody should be made to feel inferior for their choices.

My obstetrician (who's a global key opinion leader on minimising further interventions after epidural and has a very high NVD rate) said "Yes, well of course vaginal deliveries are perfectly natural, but there's nothing natural about having your first child in your mid- thirties. "

i.e. yes, natural, intervention free delivery is great if you get that, but we shouldnt be pursuing that at all costs when our other reproductive behaviours arent supportive of it, and then beating ourselves up. I had 2 NVDs with epidural. Had I not had an epidural with DC1 I would have had an ELCS for DC2, absolutely no doubt in my mind.

I think we've been conditioned to believe 'natural is best' and to be proud of going through the pain and anything else is frowned upon. To go all feminist (and I don't usually do this) if men were giving birth we'd have invented a star trek type transport to zap baby and uterine contents out with no mess or fuss years ago, or at least a section would be standard!

There are some really good posts here. Sushi I think women are so hard on other women. They're are 2 sides- saying ie... On a population level more women should breastfeed (they should, hardly anyone does) is taken as a personal gripe against those individual women who FF. we need to stop taking things so personally and making things "all about us" (although, without this MN would die a death, lol)
C sections can be the Perfect choice for some women. Not all women should have a c section- the risks make that clear. We should be able to make a distinction between "some women" and "every woman" and that's sorely lacking because for some people, making other people feel bad makes them feel good

90s just to point out the risks of an ELCS are a lot lower than an EMCS. But in research they're often lumped together so the risks as such are skewed

My friend chose an ELCS for the same reasons I chose a homebirth.

The safety of our babies.
The health of our own bodies.
Control over our experience.

We had different opinions about how to achieve those things and we both did a lot of research and placed a lot of weight on our own previous birth experiences.

I respect her decision and she respects mine and we both had excellent birth outcomes and good recoveries.

I had a caesarean with my eldest after an induction failed (no contractions). So it wasn't planned but it wasn't an emergency and the experience was calm and positive. But I was exhausted already after 3 almost sleepless nights on the labour ward. Like the OP I had planned a hypnobirth but in the end only used my breathing for the epidural! With my second son I chose an ELCS. Most people were supportive of my choice (or at least didn't tell me what they thought) but my SIL did tell me I should try for a VBAC because the recovery would be easier. I actually think it's pretty rude to criticise other people's birth choices but she is quite vocal and tends to think her way is the right way so I just ignored her. Anyway my ELCS was great - I was rested, the whole experience was calm and we have some great pictures of our son being born with everyone looking happy (the medical student in the background has a massive grin). No regrets here. I've never had a natural birth but I've had two great births. I've done well.

This is so cultural.

I come from a third world country where the cities are home to private medicine I.e. Big big business. As in - like - you think you've hurt your ankle, you walk into an oriole did surgeons office of choice and pay through your nose for a battery of unrelated stuff.

So, growing up, every pregnancy I saw was a caesarean. Gynaecologists in that country are rich beyond measure. You get pregnant, choose your gynae and pay in advance for your C section at the second appointment. Not one cousin, friend, relative of mine has had a vaginal birth, gynaes simply won't entertain it. People in the cities there now view vaginal birth as dirty, abnormal, something only the impoverished starving majority of the country are forced to endure. No urban woman goes to 40 weeks, gynaes operate under general anaesthetic at 37 weeks. Not one woman I know including all family, friends, school and college mates has ever experienced a contraction. Each pregnancy in cities leads to massive incomes for the medical team.

Coming from there, my vaginal birth 9 weeks ago makes me very happy that I could give birth in the UK where patient choice is a thing. In my home country doctors choose for you. Everyone back home is stunned that something like this "was allowed to happen" and that pushing a baby out of my vagina without pain relief was at all possible. At least my family know that it's not dirty, weird and is quite okay, and that the caesarean business there is a gigantic...well...business. Just thought I'd share the story!

Orthopaedic surgeon*

What fascinating and informative responses, thank you - I learned a lot from reading each of these.

I agree re: kinder words are needed, women are being pitted against one another as with ff and bf.

Focusfocus - what a story. You are a great example of why choice is so important. And that's what this whole debate is about for me - choice.
Mumberjack - thanks for your post and I'm so sorry for your loss.